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Andorra

General
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This small country is situated between France and Spain. Because of its elevation and proximity to the Pyrenees the climate is generally pleasant throughout the year.
Climate
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During the summer months the temperatures can rise to 30c but there is usually a cooling breeze. Lightening storms can occur during the summer months associated with torrential rain.
Sun Exposure and Dehydration
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Those from Northern Europe can develop significant sun exposure and so remember to use a wide brimmed hat when necessary. The altitude can also lead to significant tiredness and dehydration so take sufficient initial rest and drink plenty of fluids.
Safety & Security
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The level of crime throughout the country directed at tourists is very low. Nevertheless take care of your personal belongings at all times and use hotel safety boxes where possible.
Local Customs
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There are strict laws regarding the use of illegal drugs. Make sure you have sufficient supplies of any medication you required for your trip and that it is clearly marked. The European E111 form is not accepted in Andorra and so it is essential that you have sufficient travel insurance for your trip.
Winter Sports
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Andorra is one of the regions where many travel to partake of their winter sport facilities. Generally this is well controlled and one of the safer regions. Nevertheless, make certain your travel insurance is adequate for the activities you are planning to undertake.
Vaccination
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The only standard vaccine to consider for Andorra would be tetanus in line with many other developed countries of the world.

Travel News Headlines WORLD NEWS

Date: Thu, 12 Jul 2018 15:24:06 +0200

Andorra la Vella, Andorra, July 12, 2018 (AFP) - The tax haven of Andorra has long been a favourite destination for smokers looking to stock up on cheap cigarettes, but the enclave said Thursday that it would soon stop advertising the fact.   The government said it had signed up to the World Health Organization's (WHO) anti-tobacco convention, which aims to encourage people to quit smoking and combat contraband sales.   "The goal is to contribute to public health and pursue the fight against trafficking," government spokesman Jordi Cinca said at a press conference.

The tiny principality of Andorra, perched in the Pyrenees on the border between France and Spain, attracts millions of shoppers each year to duty-free stores, where prices of alcohol, cigarettes, electronics and clothes can be up to 20 percent cheaper than elsewhere in the EU.   High taxes on tobacco imposed by many countries to help people kick smoking make Andorra's cigarettes a particularly good deal.   The average pack costs just three euros ($3.50) compared with eight euros in France, which has said it will gradually raise the price to 10 euros a pack by November 2020.

Tobacco sales bring in some 110 million euros a year for Andorra, whose economy is otherwise based almost entirely on tourism.   It is also an enticing destination for smugglers, with French and Spanish border agents regularly seizing cartons from people trying to sneak them out, either by car or by hiking down the mountain trails which criss-cross the Pyrenees.   No date has been set for the advertising ban, which will come into effect three months after the ratification of the WHO accord is voted by parliament.
Date: Fri, 16 Mar 2018 02:41:51 +0100

Andorra la Vella, Andorra, March 16, 2018 (AFP) - The tiny principality of Andorra is witnessing a once in a generation phenomenon -- a widespread strike.   Around a third of civil servants across the mountainous micro-state have walked out to protest proposed reforms to their sector in what has been described as Andorra's first large-scale strike since 1933.

With no negotiation breakthrough in sight, picket lines are expected to be manned again on Friday with customs officers, police, teachers and prison staff among those taking part.   The first major strike in 85 years was sparked by plans from the government of Antoni Marti to reform civil servant contracts.   He has assured officials "will not do an hour more" work under the reforms and that 49 million euros would be allocated for the next 25 years to supplement civil servant salaries.   But government workers are unconvinced with unions warning the reforms could risk their 35 hour working week and pay.

Customs officers involved in the strike interrupted traffic on the Andorran-Spanish border this week, according to unions, while some 80 percent of teachers have walked out of classes.   Strikers have occupied the government's main administrative building and held noisy protests outside parliament calling for Marti's resignation.    "We have started collecting signatures to demand the resignation of the head of government and now nobody will stop us," Gabriel Ubach, spokesman for the public service union, told reporters.
Date: Mon 27 Sep 2017
Source: Contagion Live [edited]

A recent Dispatch article published in the Centers for Disease Control and Prevention (CDC)'s Emerging Infectious Diseases journal, offers insight into a large norovirus outbreak that sprung up in Spain in 2016 that had been linked with bottled spring water. The Public Health Agency of Catalonia (ASPCAT) reported a staggering 4136 cases of gastroenteritis from 11-25 Apr 2016. Of the 4136 cases, 6 individuals required hospitalization. The CDC defines a "case-patient" as an "exposed person who had vomiting or diarrhoea (3 or more loose stools within 24 hours)," as well as 2 or more of the following symptoms: nausea, stomach pain, or fever.

ASPCAT investigators traced back the outbreak to contaminated bottled spring water in office water coolers. The water came from a source in Andorra, a small independent principality located between Spain and France. Norovirus is a "very contagious virus," according to the CDC, and it is common for individuals to become infected by eating contaminated food. Although it is possible to be infected by consuming contaminated drinking water, this mode of transmission is "rare in developed countries," according to the article.

The investigators collected water samples from a total of 4 19-L water coolers in 2 different offices located in Barcelona, "from which affected persons had drunk; samples 1 and 2 came from 2 water coolers in one office, while samples 3 and 4 came from 2 water coolers in another office. Using "positively charged glass wool and polyethylene glycol precipitation for virus concentration," the investigators tested the samples.

"We detected high RNA levels for norovirus genotype I and II, around 103 and 104 genome copies/L, in 2 of the 4 water cooler samples concentrated by glass wool filtration and polyethylene glycol precipitation," according to the article. The investigators noted that a drawback of using molecular methods is that they are not able to differentiate between particles that are infectious and those that are not. Therefore, they "predicted the infectivity of norovirus in the concentrated samples by treating the samples with the nucleic acid intercalating dye PMA propidium monoazide and Triton X surfactant before RT-qPCR," which allowed them to "distinguish between virions with intact and altered capsids."

In those 2 water samples, they found high genome copy values -- 49 and 327 genome copies/L for norovirus genotype I and 33 and 660 genomes copies/L for norovirus genotype II. This was not an unexpected finding, due to the large number of infected individuals associated with the outbreak. Through "PMA/Triton treatment before RT-qPCR assays," the investigators found that the proportion of infected virions accounted for 0.3% to 5.6% of the total number of physical particles in the water samples, "which was enough to cause gastrointestinal illness."

The investigators also analyzed faecal samples collected from infected individuals who worked at the office in which the 1st 2 water samples were collected. They detected the following genotypes in those faecal samples: GI.2 and GII.17. In the faecal samples collected from the other office, they isolated the following genotypes: GII.4/Sydney/2012, GI.2, GII.17, and GII.2.

"We hypothesize that the spring water was contaminated by all 4 strains (GI.2, GII.2, GII.4, and GII.17) but levels of viral contamination for each genotype were not homogeneous in all bottled coolers," the investigators wrote. "We may have detected only the GII.4 genotype in water samples 1 and 2 because of a higher concentration of this specific genotype or because of bias caused by the sampling, concentration, and molecular detection procedures."

The investigators admit one limitation to their study: the small number of water samples collected and analyzed. They attribute this to the fact that on 15 Apr 2016, 4 days after the onset of the outbreak, the company that produced the drinking water recalled over 6150 containers of water "of suspected quality" as a precautionary measure. The recall prevented the investigators from collecting more samples to assess, according to the article.

Although the exact cause of the contamination has not yet been identified, the investigators posit that "the high number of affected persons from 381 offices that received water coolers, and the many different genotypes found in some patients' faecal specimens" suggest that the spring aquifer had been contaminated by "sewage pollution," and the Andorra Ministry of Health and Welfare banned further use of the spring.

The investigators suggest that assessing commercially-produced mineral waters for different harmful pathogens, such as norovirus would be beneficial. They note, however, that creating, enhancing, and managing such "virus surveillance systems" would be costly. Thus, the investigators suggest taking a "balanced approach to keep both the cost and the time required for the analyses within feasibility limits."  [Byline: Kristi Rosa]
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[The interesting article published in the September 2017 issue of Emerging Infectious Diseases is:
Blanco A, Guix S, Fuster N, et al: Norovirus in bottled water associated with gastroenteritis outbreak, Spain, 2016. Emerg Infect Dis. 2017; 23(9): 1531-34; https://wwwnc.cdc.gov/eid/article/23/9/16-1489_article. - ProMED Mod.LL]

[Catalonia and Andorra can be located on the HealthMap/ProMED-mail map at http://healthmap.org/promed/p/1341. - ProMED Sr.Tech.Ed.MJ]
Date: Thu, 26 Dec 2013 22:25:05 +0100 (MET)

ANDORRA LA VELLA, Andorra, Dec 26, 2013 (AFP) - A Spanish skier and a French snowboarder have died in avalanches in different mountain ranges in Europe, officials said Thursday.

The 27-year-old skier, a woman from Barcelona, died Wednesday while going off-piste alone in the Soldeu resort in Andorra, in the Pyrenees mountains between France and Spain, a resort manager told AFP.   Although she was rescued within 10 minutes, after her glove was spotted on the surface, she was unable to be revived despite a helicopter dash to hospital.

In the Italian Alps, close to the border with France, a 24-year-old Frenchman who was snowboarding with three friends on a closed run died Thursday when an avalanche swept over him in the resort town of Les Arnauds.   Local officials said he succumbed to multiple injuries, asphyxia and hypothermia.

Avalanches are common in Europe's ski resorts at this time of year, when early snows are heavy with moisture, and several deaths occur each winter.   Last Sunday, a 35-year-old Frenchman died in an avalanche in the Alps near the Italian border while on a three-day trek with a friend.
Date: Fri 7 Feb 2003 From: Jaime R. Torres Source: EFE Salud, Thu 6 Feb 2003 (translated by Maria Jacobs) [edited] -------------------------------------------------- Close to 300 students in one school and 173 tourists staying in 7 hotels in the Principality of Andorra have been affected by outbreaks of gastroenteritis that, according to local authorities, are not related to each other. Monica Codina, Minister of Health, stated that the outbreak that has affected almost 300 children and 8 adults in the San Ermengol school was detected last Monday [3 Feb 2003] but that it may have started Wednesday or Thursday of the previous week. The epidemiological surveys of a group of pre-school and grammar school students that may also be affected have not been performed yet. Also pending are the results of the microbiological tests of the food and water served in the school dining room, but the minister has indicated that the probable cause of the outbreak is the fact that water pitchers were filled with hoses directly from the faucet. The Minister stated that this outbreak of gastroenteritis is not related to the one that affected 173 tourists, most of them young people on holiday, who where staying in 7 hotels of the Principality. The government is also investigating the cause of this outbreak and has indicated that an anomaly in the system that supplies water to the hotels was detected, requiring a process of chlorination, which has not been carried out due to the heavy snowfall of the past few days. * * * * * * * * * * [The suspicion that defective water supplies may be responsible for all of these independent outbreaks suggests that the etiologic agent may be an enterovirus, hepatitis A virus, or non-viral, rather than one of the noroviruses associated with sudden-onset viral gastroenteritis. Information on the outcome of diagnostic tests in progress would be welcomed. - ProMed Mod.CP]
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Puerto Rico

No Profile is available at present

Travel News Headlines WORLD NEWS

Date: Tue, 24 Sep 2019 07:27:34 +0200 (METDST)

Miami, Sept 24, 2019 (AFP) - A strong 6.0 magnitude struck off the northwest coast of Puerto Rico late Monday, the United States Geological Survey said, although no casualties or damage were reported.   The quake struck 62km northwest of San Antonio at 11:23 pm local time (03:20 GMT) at a depth of 10km, the agency said.  San Antonio is home to Rafael Hernandez Airport, a key air link to the mainland US.    In 2010 nearby Haiti was struck by a devastating 7.0 magnitude earthquake that killed more than 250,000 people and crippled the nation's infrastructure.
Date: Mon, 12 Feb 2018 05:54:19 +0100

San Juan, Feb 12, 2018 (AFP) - Most of San Juan and a strip of northern Puerto Rico municipalities were plunged into darkness Sunday night after an explosion at a power station, five months after two hurricanes destroyed the island's electricity network.

The state electric power authority (AEE) said the blast was caused by a broken-down switch in Rio Piedras, resulting in a blackout in central San Juan and Palo Seco in the north.   "We have personnel working to restore the system as soon as possible," the AEE said.   San Juan's mayor, Carmen Yulin Cruz, said on Twitter that emergency services and local officials attended the scene in the neighbourhood of Monacillos, but no injuries were reported.

Meanwhile, the Puerto Rican capital's airport said it was maintaining its schedule using emergency generators.   The blackout comes as nearly 500,000 of AEE's 1.6 million customers remain without power since Hurricanes Irma and Maria struck the US territory in September 2017.   AEE engineer Jorge Bracero warned on Twitter that the outage was "serious," and advised those affected that power would not be restored until Monday.
Date: Wed, 13 Dec 2017 03:08:12 +0100
By Leila MACOR

Fajardo, Puerto Rico, Dec 13, 2017 (AFP) - Until Hurricane Maria hit Puerto Rico, Jose Figueroa did brisk business renting kayaks to tourists itching to see a lagoon that lights up by night thanks to millions of microorganisms.   Today, things are so dire he's considering selling water to motorists stopped at red lights.   "Now we are trying to survive," the 46-year-old tour guide said.

It used to be that visitors had to reserve a month in advance to get one of his kayaks and paddle around in the dark on the enchanting, bioluminescent body of water called Laguna Grande.   But tourists are scarce these days as the Caribbean island tries to recover from the ravages of the storm back in September.   "We do not know if we will have any work tonight," Figueroa said. "Last week, we worked only one day."    He and another employee of a company called Glass Bottom PR are cleaning kayaks on the seaside promenade of Fajardo, a tourist town in eastern Puerto Rico whose main attraction is the so-called Bio Bay.

The year started off well for Puerto Rico, with the global success of the song "Despacito" by local musicians Luis Fonsi and Daddy Yankee.   The catchy tune helped promote the US commonwealth island of 3.4 million people, which is saddled with huge debts and declared bankruptcy in May.    But the hurricane turned what should be an island bustling with tourists into one with deserted beaches, shuttered restaurants and hotels full of mainland US officials working on the rebuilding of the island.   "What few tourists we have are the federal officials themselves," said Figueroa.

- Locals only -
The grim outlook spreads up and down the seaside promenade of Fajardo, where many restaurants are closed because there is no electricity.   On this particular day around noon, the only restaurant open is one called Racar Seafood. It has its own emergency generator.   "We get by on local tourists," said its 61-year-old owner, Justino Cruz.   "Our clients are local -- those who have no electricity, no generator, cold food or no food."

Puerto Rico's once-devastated power grid is now back up to 70 percent capacity, but this is mainly concentrated in the capital San Juan.   So while inland towns that depend on tourism are struggling mightily, things are getting better in San Juan as cruise ships are once again docking.   On November 30, the first cruise ship since the storm arrived with thousands of vacationers on board. They were received with great fanfare -- quite literally, with trumpet blaring and cymbals crashing.

- Pitching in to help -
The World Travel & Tourism Council, based in London, says tourism accounted for about eight percent of Puerto Rico's GDP in 2016, or $8.1 billion.   Hurricane Maria's damage has been uneven. Although some tour guides now have no work and many eateries are shut down, hotels that have their own generators are doing just fine.   Thanks to the thousands of US government officials and reconstruction crew members that came in after the storm, the hotels that are open -- about 80 percent of the total -- are pretty much full.

These people are starting to leave the island this month but hotels may receive tourists around Christmas, at least in San Juan, where power has for the most part been restored.   The hurricane "undoubtedly cost billions in lost revenue," said Jose Izquierdo, executive director of the Puerto Rico Tourism Company.    But Izquierdo nevertheless says he is "optimistic" and suggests an alternative: put tourists to work as volunteers in the gargantuan reconstruction effort that the island needs.   "We want to look for travellers who want to travel with a purpose, who might have the commitment to help rebuild," said Izquierdo.

The program, called "Meaningful Travel" and launched in mid-November, organizes trips on which residents, Puerto Ricans living abroad and tourists are invited to help the island get back on its feet.   "The plan aims to create empathy with this tourist destination," said Izquierdo.    "We want to be like New Orleans after Katrina, where 10 years after the hurricane, tourism is the driving force of its economy. We want to build that narrative of recovery," he added.   "There are different ways in which the world wants to help Puerto Rico. The best way is to visit us."
Date: Thu, 9 Nov 2017 12:39:04 +0100
By Marcos PÉREZ RAMÍREZ

San Juan, Nov 9, 2017 (AFP) - Andrea Olivero, 11, consults her classmate Ada about an exercise during their daily English class at San Juan's Sotero Figueroa Elementary School. The task: list the positive and negative aspects of Hurricane Maria's passing almost two months ago.

The girls only have to look around. There is no electricity and they "roast" in the heat, Andrea says. At the back of the room, computers and televisions collect dust.   "We would like to move past the topic of the hurricane a bit. It is already getting repetitive," Andrea told AFP.   She is one of more than 300,000 pupils in the public education system, although only half of schools are functioning. Barely 42 per cent of Puerto Ricans have electricity seven weeks after Maria struck, killing at least 51 in the American territory.

The lack of power has prompted disorienting timetable changes on the tropical island, to avoid both the hottest hours of the day and the use of dining facilities.   "The children are very anxious. We manage to make progress in lessons and they change the hours again. Everything is messed up and we fall behind," English teacher Joan Rodriguez explained.   "We can't use the computers to illustrate classes," she said. "They are reading the novel "Charlotte's Web," and we wanted to do exercises comparing it to the film version. But we cannot use the television.

- Suspicions -
From October 23, some directors reopened their schools in the western region of Mayaguez and San Juan.   But last Thursday, the Department of Education ordered their closure, insisting they must be evaluated by engineering and architectural firms, then certified by the US Army Corps of Engineers.   One of those schools was Vila Mayo, also in San Juan. The community presumed it would open, as it had been used as a shelter, its electrical infrastructure had been inspected and it had not suffered structural damage.

But Luis Orengo, the education department's director in San Juan, told protesters outside the school it was closed as inspectors' findings had not reached the central government.   "This is unacceptable! The school is ready to give classes but they don't want to open it. Our children cannot lose a year," fumed Enid Guzman, who protested with her 11-year-old son, Reanny De la Cruz.   There are suspicions the stalled reopening of schools is, in part, related to the prior closure of 240 schools over the past year during Puerto Rico's long-running financial crisis.   The fiscal difficulties have seen the island's population drop over the past decade by 14 percent, leading in turn to a fall in school enrolment.

Before the storms, 300 schools were at risk of closure -- and for the president of Puerto Rico's federation of teachers, Mercedes Martinez, the government's aim is clear.   "Secretary (Julia) Keleher seems to have an orchestrated plan to close schools," she said, referring to the education secretary. "Why do you have to wait 30 days to get a certification so a school can open?"   Keleher has announced she expects most schools to be open by the middle of November.
Date: Tue 24 Oct 2017
Source: KFOR Oklahoma News4 [edited]

Puerto Rico has reported at least 76 cases of suspected and confirmed leptospirosis, including a handful of deaths, in the month after Hurricane Maria, said Dr. Carmen Deseda, the state epidemiologist for Puerto Rico.

Two deaths involved leptospirosis confirmed through laboratory testing, and "several other" deaths are pending test results, Deseda said. The 76 cases, up from 74 last week, also include one patient with confirmed leptospirosis who is currently hospitalized.

The island typically sees between 63 and 95 cases per year, she said. Health officials had expected that there would be a jump after the hurricane. "It's neither an epidemic nor a confirmed outbreak," Public Affairs Secretary Ramon Rosario Cortes said at a news conference Sunday [22 Oct 2017]. "But obviously, we are making all the announcements as though it were a health emergency."

Leptospirosis may be treated with antibiotics, but many people recover on their own. "The majority of leptospirosis cases is a mild, subclinical disease with no complications," Deseda said. "But one out of 10 people who have leptospirosis develop severe illness." In the 1st stage of leptospirosis, symptoms vary widely from fever and headache to red eyes and rashes. Some people may have no symptoms at all. But a small number will develop dire complications: meningitis, kidney and liver damage, bleeding in the lungs and even death.

Doctors are required to report any potential leptospirosis cases to health authorities, Deseda said. Those cases must then be tested to confirm the bacteria, since the symptoms can be difficult to tell apart from other illnesses. After that, health officials may look for patterns or clusters and determine whether there is an outbreak.

The lab tests on the suspected cases have been sent to the US Centers for Disease Control and Prevention, Deseda said. The turnaround time is about 5-6 days.

Doctors on the island have expressed concerns about burgeoning health crises amid hospitals that are overwhelmed, undersupplied and sometimes burning hot. Influenza is another concern on the horizon, Deseda said. Drinking water is also hard to come by on many parts of the island.

Dr. Raul Hernandez, an internist in San Juan, told CNN that people were drinking water from whatever sources they could find, such as rivers and creeks. If that water contains urine from a [leptospirosis-infected rat], those people will be at risk, he said.

Deseda said people should be discouraged from walking barefoot, drinking or swimming in potentially leptospirosis-contaminated waters.

"These diseases are everywhere, and there's a way to prevent them," she said.
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[Leptospirosis is a zoonotic, spirochetal infection that occurs worldwide and is transmitted to humans by exposure to soil or fresh water contaminated with the urine of wild and domestic animals (including dogs, cattle, swine, and especially rodents) that are chronically infected with pathogenic _Leptospira_. _Leptospira_ may survive in contaminated fresh water or moist soil for weeks to months. Outbreaks of leptospirosis frequently follow heavy rainfall, flooding with fresh water, and increasing rodent numbers.

Parts of Puerto Rico saw more than 30 inches of rain and consequent flooding with recent Hurricane Maria. A map showing the estimated rainfall across Puerto Rico with this hurricane is available at <https://twitter.com/NWSSanJuan/status/910983698597777409/photo/1?ref_src=twsrc%5Etfw&ref_url>.

With continued absence of potable water, inadequate sanitation, and flooding in the streets for a large proportion of the population in Puerto Rico, food- and water-borne diseases, like leptospirosis, will be a major problem. - ProMED Mod.ML]

[A HealthMap/ProMED-mail map can be accessed at:
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Gibraltar

United Kingdom and Gibraltar (England, Wales, Scotland, Northern Ireland) US Consular Information Sheet
June 03, 2008
COUNTRY DESCRIPTION:
The United Kingdom of Great Britain and Northern Ireland is a highly developed constitutional monarc
y comprised of Great Britain (England, Scotland and Wales) and Northern Ireland.
Read the Department of State Background Notes on the United Kingdom for additional information.
Gibraltar is a United Kingdom Overseas Territory bordering Spain and located at the southernmost tip of Europe at the entrance to the Mediterranean Sea.
It is one of thirteen former British colonies that have elected to continue their political links with London.
Tourist facilities are widely available.

ENTRY/EXIT REQUIREMENTS:
A visa is not required for tourist or business visits to the UK of less than six months in duration.
Visitors wishing to remain longer than one month in Gibraltar should regularize their stay with Gibraltar immigration authorities.
Those planning to visit the UK for any purpose other than tourism or business, or who intend to stay longer than six months, should consult the website of the British Embassy in the United States at http://britainusa.com for information about current visa requirements.
Those who are required to obtain a visa and fail to do so may be denied entry and returned to their port of origin.
The British government is currently considering reducing the visa-free period from six months to 90 days.
Travelers should be alert to any changes in legislation.
The U.S. Embassy cannot intervene in UK visa matters.
In addition to the British Embassy web site at http://britainusa.com, those seeking current UK visa information may also contact UK consular offices via their premium rate telephone service at 1-900-656-5000 (cost $3/minute) or 1-212-796-5773 ($12 flat fee).
Information about dual nationality or the prevention of international child abduction can be found on our web site.
For further information about customs regulations, please read our Customs Information sheet.
SAFETY AND SECURITY:
The United Kingdom is politically stable, with a modern infrastructure, but shares with the rest of the world an increased threat of terrorist incidents of international origin, as well as the potential, though significantly diminished in recent years, for isolated violence related to the political situation in Northern Ireland (a part of the United Kingdom).
On July 7, 2005, a major terrorist attack occurred in London, as Islamic extremists detonated explosives on three underground trains and a bus in Central London, resulting in over 50 deaths and hundreds of injuries.
Following the attacks, the public transportation system was temporarily disrupted, but quickly returned to normal.
A similar but unsuccessful attack against London’s public transport system took place on July 21, 2005.
UK authorities have identified and arrested people involved in these attacks.
Similarly, those involved in terrorist incidents in London and Glasgow during the summer of 2007 were identified and arrested.
Like the US, the UK shares its national threat levels with the general public to keep everyone informed and explain the context for the various increased security measures that may be encountered. UK threat levels are determined by the UK Home Office and are posted on its web site at http://www.homeoffice.gov.uk/security/current-threat-level/.
Information from the UK Security Service, commonly known as MI5, about the reasons for the increased threat level and actions the public can take is available on the MI5 web site at http://www.mi5.gov.uk/.
On August 10, 2006, the Government of the United Kingdom heightened security at all UK airports following a major counterterrorism operation in which individuals were arrested for plotting attacks against US-bound airlines.
As a result of this, increased restrictions concerning carry-on luggage were put in place and are strictly enforced.
American citizens are advised to check with the UK Department for Transport at http://www.dft.gov.uk/transportforyou/airtravel/airportsecurity/ regarding the latest security updates and carry-on luggage restrictions.
The British Home Secretary has urged UK citizens to be alert and vigilant by, for example, keeping an eye out for suspect packages or people acting suspiciously at subway (called the “Tube” or Underground) and train stations and airports and reporting anything suspicious to the appropriate authorities.
Americans are reminded to remain vigilant with regard to their personal security and to exercise caution.
For more information about UK public safety initiatives, consult the UK Civil Contingencies Secretariat web site at http://www.ukresilience.gov.uk.
The political situation in Northern Ireland has dramatically improved since the signing of the Good Friday Agreement in 1998, the announcement by the Irish Republican Army (IRA) on July 28, 2005, that it would end its armed campaign, and the agreement to set up a power-sharing government on May 8, 2007.
The potential remains, however, for sporadic incidents of street violence and/or sectarian confrontation. American citizens traveling to Northern Ireland should therefore remain alert to their surroundings and should be aware that if they choose to visit potential flashpoints or attend parades sporadic violence remains a possibility. Tensions may be heightened during the summer marching season (April to August), particularly during the month of July around the July 12th public holiday.

The phone number for police/fire/ambulance emergency services - the equivalent of "911" in the U.S. - is “999” in the United Kingdom and “112” in Gibraltar.
This number should also be used for warnings about possible bombs or other immediate threats.
The UK Anti-Terrorist Hotline, at 0800 789 321, is for tip-offs and confidential information about possible terrorist activity.
For the latest security information, Americans traveling abroad should regularly monitor the Department of State, Bureau of Consular Affairs’ web site at http://travel.state.gov, where the current Travel Warnings, Travel Alerts, as well as the Worldwide Caution can be found.
Recent communications from U.S. Embassy London to the local American citizen community, called Warden Messages, can be found on the U.S. Embassy's American Citizens' Services web site at http://london.usembassy.gov/cons_new/acs/index.html.
Up-to-date information on safety and security can also be obtained by calling 1-888-407-4747 toll free in the U.S., or for callers outside the U.S. and Canada, a regular toll-line at 1-202-501-4444.
These numbers are available from 8:00 a.m. to 8:00 p.m. Eastern Time, Monday through Friday (except U.S. federal holidays).
The Department of State urges American citizens to take responsibility for their own personal security while traveling overseas.
For general information about appropriate measures travelers can take to protect themselves in an overseas environment, see the Department of State’s pamphlet, A Safe Trip Abroad.
CRIME:
The United Kingdom and Gibraltar benefit from generally low crime rates and rates decreased slightly in 2007 in significant categories, including violent crime.
The crime situation in the UK is similar to the United States, with typical incidents including pick-pocketing; mugging; “snatch and grab” thefts of mobile phones, watches and jewelry; and theft of unattended bags, especially at airports and from cars parked at restaurants, hotels and resorts.
Pickpockets target tourists, especially at historic sites, restaurants, on buses, trains and the London Underground (the “Tube,” or subway).
Thieves often target unattended cars parked at tourist sites and roadside restaurants, looking for laptop computers and hand-held electronic equipment, especially global positioning satellite equipment.
Walking in isolated areas, including public parks, especially after dark, should also be avoided, as these provide advantageous venues for muggers and thieves.
At night or when there is little foot traffic, travelers should be especially careful using the underground pedestrian tunnels.
As a general rule, either walk the extra distance to use a surface crossing or wait until there are other adult pedestrians entering the tunnel.

In London, travelers should use only licensed “black taxi cabs,” or car services recommended by their hotel or tour operator.
Unlicensed taxis or private cars posing as taxis may offer low fares, but are often uninsured and may have unlicensed drivers.
In some instances, travelers have been robbed and raped while using these cars.
You can access 7,000 licensed “Black Cabs” using just one telephone number – 0871 871 8710. This taxi booking service combines all six of London’s radio taxi circuits, allowing you to telephone 24 hours a day if you need to “hail a cab.” Alternatively, to find a licensed minicab, text “HOME” to 60835 on your mobile phone to get the telephone number to two licensed minicab companies in the area. If you know in advance what time you will be leaving for home, you can pre-book your return journey.
The “Safe Travel at Night” partnership among the Metropolitan Police, Transport for London, and the Mayor of London maintains a website with additional information at http://www.cabwise.com/.
Travelers should not leave drinks unattended in bars and nightclubs.
There have been some instances of drinks being spiked with illegal substances, leading to incidents of robbery and rape.
Due to the circumstances described above, visitors should take steps to ensure the safety of their U.S. passports.
Visitors in England, Scotland, Wales, Northern Ireland, and Gibraltar are not expected to produce identity documents for police authorities and thus may secure their passports in hotel safes or residences.
Abundant ATMs that link to U.S. banking networks offer an optimal rate of exchange and they preclude the need to carry a passport to cash travelers’ checks.
Travelers should be aware that U.S. banks might charge a higher processing fee for withdrawals made overseas.
Common sense personal security measures utilized in the U.S. when using ATMs should also be followed in the UK.
ATM fraud in the UK is becoming more sophisticated, incorporating technologies to surreptitiously record customer ATM card and PIN information.
Travelers should avoid using ATMs that look in any way “temporary” in structure or location, or that are located in isolated areas.
Travelers should be aware that in busy public areas, thieves use distraction techniques, such as waiting until the PIN number has been entered and then pointing to money on the ground, or attempting to hand out a free newspaper.
When the ATM user is distracted, a colleague will quickly withdraw cash and leave.
If distracted in any way, travelers should press the cancel transaction button immediately and collect their card before speaking to the person who has distracted them.
If the person’s motives appear suspicious, travelers should not challenge them but remember the details and report the matter to Police as soon as possible.
In addition, travelers should not use the ATM if there is anything stuck to the machine or if it looks unusual in any way.
If the machine does not return the card, report the incident to the issuing bank immediately.

INFORMATION FOR VICTIMS OF CRIME:
The loss or theft abroad of a U.S. passport should be reported immediately to the local police and the nearest U.S. Embassy or Consulate at the opening of the next business day.
The U.S. Embassy or Consulate only issues replacement passports during regular business hours.
If you are the victim of a crime while overseas, report it to local police.
The nearest U.S. Embassy or Consulate will also be able to assist by helping you to find appropriate medical care, contacting family members or friends, and explaining how funds could be transferred.
Although the investigation and prosecution of the crime is solely the responsibility of local authorities, consular officers can help you to understand the local criminal justice process and to find an attorney if needed.

Visit the “Victim Support” web site, maintained by an independent UK charity to helps people cope with the effects of crime: http://www.victimsupport.org.uk/
See our information for Victims of Crime.
MEDICAL FACILITIES AND HEALTH INFORMATION:
While medical services are widely available, free care under the National Health System is allowed only to UK residents and certain EU nationals.
Tourists and short-term visitors will be charged for medical treatment in the UK.
Charges may be significantly higher than those assessed in the United States.
Hiking in higher elevations can be treacherous.
Several people die each year while hiking, particularly in Scotland, often due to sudden changes in weather.
Visitors, including experienced hikers, are encouraged to discuss intended routes with local residents familiar with the area, and to adhere closely to recommendations.
Information on vaccinations and other health precautions, such as safe food and water precautions and insect bite protection, may be obtained from the Centers for Disease Control and Prevention’s hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747) or via the CDC’s web site at http://wwwn.cdc.gov/travel/default.aspx.
For information about outbreaks of infectious diseases abroad consult the World Health Organization’s (WHO) web site at http://www.who.int/en.

MEDICAL INSURANCE:
The Department of State strongly urges Americans to consult with their medical insurance company prior to traveling abroad to confirm whether their policy applies overseas and whether it will cover emergency expenses such as a medical evacuation.
If your medical insurance policy does not provide overseas coverage, you may want to purchase a short-term policy for your trip.
The Department of State provides a list of travel insurance companies that can provide the additional insurance needed for the duration of one’s trip abroad in its online at medical insurance overseas.
Remember also that most medical care facilities and medical care providers in the UK do not accept insurance subscription as a primary source of payment.
Rather, the beneficiary is expected to pay for the service and then seek reimbursement from the insurance company.
This may require an upfront payment in the $10,000 to $20,000 range

Please see our information on medical insurance overseas.

TRAFFIC SAFETY AND ROAD CONDITIONS:
While in a foreign country, U.S. citizens may encounter road conditions that differ significantly from those in the United States.
The information below concerning the United Kingdom is provided for general reference only, and may not be totally accurate in a particular location or circumstance.

UK penalties for driving under the influence of even minimal amounts of alcohol or drugs are stiff and often result in prison sentences.
In contrast to the United States and continental Europe, where traffic drives on the right side of the road, in the UK, it moves on the left.
The maximum speed limit on highways/motorways in the UK is 70MPH.
Motorways generally have a hard shoulder (breakdown lane) on the far left, defined by a solid white line.
It is illegal to stop or park on a hard shoulder unless it is an emergency.
In such cases, you should activate your hazard lights, get out of your vehicle and go onto an embankment for safety.
Emergency call boxes (orange telephone booths with “SOS” printed on them) may be found at half-mile intervals along the motorway.
White and blue poles placed every 100 yards along the motorway point in the direction of the nearest call box.
Emergency call boxes dial directly to a motorway center.
It is best to use these phones rather than a personal cell phone, because motorway center personnel will immediately know the location of a call received from an emergency call box.
Roadside towing services may cost approximately £125.
However, membership fees of automotive associations such as the RAC or AA (Automobile Association) often include free roadside towing service.
Visitors uncomfortable with, or intimidated by, the prospect of driving on the left-hand side of the road may wish to avail themselves of extensive bus, rail and air transport networks that are comparatively inexpensive.
Roads in the UK are generally excellent, but are narrow and often congested in urban areas.
If you plan to drive while in the UK, you may wish to obtain a copy of the Highway Code, available at http://www.highwaycode.gov.uk.
Travelers intending to rent cars in the UK should make sure that they are adequately insured.
U.S. auto insurance is not always valid outside the U.S., and travelers may wish to purchase supplemental insurance, which is generally available from most major rental agents.
The city of London imposes a congestion charge of £8 (eight pounds sterling, or approximately U.S. $16.00) on all cars entering much of central London Monday through Friday from 7:00 a.m. to 6:30 p.m.
Information on the congestion charge can be found at http://www.cclondon.com.
Public transport in the United Kingdom is excellent and extensive.
However, poor track conditions may have contributed to train derailments resulting in some fatalities.
Repairs are underway and the overall safety record is excellent.
Information on disruptions to London transportation services can be found at http://www.tfl.gov.uk and information about the status of National Rail Services can be found at http://www.nationalrail.co.uk.
Many U.S. pedestrians are injured, some fatally, every year in the United Kingdom, because they forget that oncoming traffic approaches from the opposite direction than in the United States.
Extra care and alertness should be taken when crossing streets; remember to look both ways before stepping into the street.
Driving in Gibraltar is on the right-hand side of the road, as in the U.S. and Continental Europe.
Persons traveling overland between Gibraltar and Spain may experience long delays in clearing Spanish border controls.
Please refer to our Road Safety Overseas page for more information.
For specific information concerning United Kingdom driving permits, vehicle inspection, road tax and mandatory insurance, refer to the United Kingdom’s Department of Environment and Transport web site at http://www.dft.gov.uk, the Driving Standards Agency web site at http://www.dsa.gov.uk or consult the U.S. Embassy in London’s web site at http://london.usembassy.gov/.

AVIATION SAFETY OVERSIGHT:
The U.S. Federal Aviation Administration (FAA) has assessed the Government of the United Kingdom’s Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for oversight of the UK’s air carrier operations.
For further information, travelers may visit the FAA's web site at http://www.faa.gov/safety/programs_initiatives/oversight/iasa.

SPECIAL CIRCUMSTANCES:
The legal drinking age in the UK is generally lower than in the U.S. and social drinking in pubs is often seen as a routine aspect of life in Britain. Parents, organizers of school trips, and young travelers should be aware of the impact that this environment may have when combined with the sense of adventure that comes with being abroad.
Please see our Students Abroad web site as well Studying Abroad to help students plan a safe and enjoyable adventure.
The UK has strict gun-control laws, and importing firearms is extremely complicated. Travelers should consider leaving all firearms in the United States.
Restrictions exist on the type and number of weapons that may be possessed by an individual.
All handguns, i.e. pistols and revolvers, are prohibited with very few exceptions.
Licensing of firearms in the UK is controlled by the Police.
Applicants for a license must be prepared to show 'good reason' why they require each weapon.
Applicants must also provide a copy of their U.S. gun license, a letter of good conduct from their local U.S. police station and a letter detailing any previous training, hunting or shooting experience. Background checks will also be carried out.
Additional information on applying for a firearm certificate and/or shotgun certificate can be found on the Metropolitan Police Firearms Enquiry Teams web site at http://www.met.police.uk/firearms-enquiries/index.htm.
A number of Americans are lured to the UK each year in the belief that they have won a lottery or have inherited from the estate from a long-lost relative.
Americans may also be contacted by persons they have “met” over the Internet who now need funds urgently to pay for hospital treatment, hotel bills, taxes or airline security fees.
Invariably, the person contacted is the victim of fraud.
Any unsolicited invitations to travel to the UK to collect winnings or an inheritance should be viewed with skepticism.
Also, there are no licenses or fees required when transiting a UK airport, nor is emergency medical treatment withheld pending payment of fees.
Please see our information on International Financial Scams. Please read our Customs Information.

CRIMINAL PENALTIES:
While in a foreign country, a U.S. citizen is subject to that country's laws and regulations, which sometimes differ significantly from those in the United States and may not afford the protections available to the individual under U.S. law.
Penalties for breaking the law can be more severe than in the United States for similar offenses.
Persons violating British law, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in the UK are severe, and convicted offenders can expect long jail sentences and heavy fines.
Engaging in sexual conduct with children or using or disseminating child pornography in a foreign country is a crime, prosecutable in the United States.
Please see our information on Criminal Penalties.
Many pocketknives and other blades, and mace or pepper spray canisters, although legal in the U.S., are illegal in the UK and will result in arrest and confiscation if detected.
A UK Metropolitan Police guide to items that are prohibited as offensive weapons is available at http://www.met.police.uk/youngpeople/guns.htm.
A UK Customs Guide, detailing what items visitors are prohibited from bringing into the UK, is available at http://customs.hmrc.gov.uk/channelsPortalWebApp/downloadFile?contentID=HMCE_CL_001734.
Air travelers to and from the United Kingdom should be aware that penalties against alcohol-related and other in-flight crimes (“air rage”) are stiff and are being enforced with prison sentences.
Please also see our information on customs regulations that pertain when returning to the US.

CHILDREN'S ISSUES:
For information on intercountry adoption and international parental child abduction, see the Office of Children’s Issues.

REGISTRATION / EMBASSY LOCATION:
Americans living or traveling in the United Kingdom are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department’s travel registration web site, and to obtain updated information on travel and security within the United Kingdom.
By registering, Americans make it easier for the Embassy or Consulate to contact them in case of emergency, and to relay updated information on travel and security within the United Kingdom.
The Embassy and Consulates regularly send security and other information via email to Americans who have registered.
As noted above, recent communications from U.S. Embassy London to the local American citizen community, called Warden Messages, can be found on the embassy’s web site.
Americans without Internet access may register directly with the nearest U.S. Embassy or Consulate.
The Consular Section also disseminates a newsletter every month.
Those wishing to subscribe to the monthly consular newsletter in London should send a request by email to SCSLondon@state.gov.
The U.S. Embassy is located at 24 Grosvenor Square, London W1A 1AE; telephone: in country 020-7499-9000; from the U.S. 011-44-20-7499-9000 (24 hours); Consular Section fax: in country 020-7495-5012; from the U.S. 011-44-20-7495-5012, and on the Internet at http://london.usembassy.gov.
The U.S. Consulate General in Edinburgh, Scotland, is located at 3 Regent Terrace, Edinburgh EH7 5BW; Telephone: in country 0131-556-8315, from the U.S. 011-44-131-556-8315.
After hours: in country 01224-857097, from the U.S. 011-44-1224-857097.
Fax: in country 0131-557-6023; from the U.S. 011-44-131-557-6023.
Information on the Consulate General is included on the Embassy’s web site at http://london.usembassy.gov/scotland.
The U.S. Consulate General in Belfast, Northern Ireland, is located at Danesfort House, 228 Stranmillis Road, Belfast BT9 5GR; Telephone: in country 028-9038-6100; from the U.S. 011-44-28-9038-6100.
Fax:
in country 028-9068-1301; from the U.S. 011-44-28-9068-1301.
Information on the Consulate General is included on the Embassy’s web site at: http://london.usembassy.gov/nireland.
There is no U.S. consular representation in Gibraltar.
Passport questions should be directed to the U.S. Embassy in Madrid, located at Serrano 75, Madrid, Spain, tel (34)(91) 587-2200, and fax (34)(91) 587-2303.
The web site is http://madrid.usembassy.gov.
All other inquiries should be directed to the U.S. Embassy in London.
* * *
This replaces the Consular Information Sheet dated December 12, 2007, to update the sections on Entry Requirements, Safety and Security, Crime, Victims of Crime, Medical Facilities, Medical Insurance, Traffic Safety and Road Conditions, and Special Circumstances.

Travel News Headlines WORLD NEWS

Date: Thu 24 Aug 2017
Source: Gibraltar Chronicle [edited]
<http://chronicle.gi/2017/08/tiger-mosquito-found-in-gibraltar-but-no-cause-for-concern-officials-say/>

An aggressive species of mosquito known to transmit viral diseases has been detected in Gibraltar, but public health officials insist there is no cause for alarm. Public Health Gibraltar and the Environmental Agency confirmed that the mosquito of the species _Aedes albopictus_, also known as the tiger mosquito, has been found in Gibraltar.

Last June [2017] after 9 months of intensive surveillance, officials said no tiger mosquito had been found in Gibraltar. But this has now changed after the 1st tiger mosquito was found in the urban dome   stic environment within Gibraltar. "This finding alone does not however materially alter any health risks in Gibraltar and there is no immediate cause for public concern," the government said in a statement. Public Health Gibraltar was first alerted in January 2016 to the discovery of the mosquito in Malaga and Algeciras [in Andalusia, Spain]. Since then, together with the Environmental Agency, it began working with international experts to mount surveillance in Gibraltar.

World Health Organization experts visited Gibraltar and gave advice on setting traps and monitoring locations, but no tiger mosquito had been detected until now. The tiger mosquito is not native to Gibraltar and has not been previously found here. It is common in other countries where it transmits viral diseases like Zika, dengue, and chikungunya. It is a domestic species, breeds in water in urban areas -- water butts, blocked drains, rainwater gullies -- and is able to reach high abundance around residential areas.

It is also a day-time mosquito, that aggressively bites humans. "Health risks to the public only arise if the virus causing these diseases is also present, which is not the case in Gibraltar," the government said.  "The virus can, however, be imported by travellers returning from an overseas country and if this happens, there is a risk of spread, but only if the mosquito bites within a small window period of about a week after the fever starts."

Public Health Gibraltar has been raising awareness of travel risk amongst travellers through its publication A Factsheet for Travellers and recommends the following precautions:
- before travelling to affected areas, consult your doctor or seek advice from a travel clinic, especially if you have an immune disorder or severe chronic illness;
- if you are pregnant or are considering pregnancy, consider postponing non-essential travel;
- when staying in a mosquito-prone area, wear mosquito repellents and take mosquito bite prevention measures;
- if you have symptoms within 3 weeks of return from an affected country, contact your doctor;
- if you have been diagnosed with any of the diseases Zika, dengue, or chikungunya, take strict mosquito bite prevention measures for 10 days after the fever starts.
========================== 
[The appearance of _Aedes albopictus_ in Gibraltar is not surprising. A map of the distribution of this species as of April this year (2017) shows it present around the Mediterranean Basin and up to Gibraltar on the west (<https://ecdc.europa.eu/en/publications-data/aedes-albopictus-current-known-distribution-europe-april-2017>).

Now it has been found in Gibraltar. The concerns are real about transmission of dengue, chikungunya, and Zika viruses should populations of _Ae. albopictus_ become established. In 2015 there were a few locally acquired cases of dengue in the south of France. This also happened on a larger scale in Emilia Romagna, Italy, when a viraemic man introduced chikungunya virus into Italy and sparked an outbreak.

One hopes that mosquito surveillance will continue in Gibraltar, perhaps be intensified, and help guide vector control efforts. - ProMED Mod.TY]

[A HealthMap/ProMED-mail map can be accessed at: <http://healthmap.org/promed/p/517>.]
Date: Wed, 1 Jun 2011 01:46:48 +0200 (METDST)

GIBRALTAR, June 1, 2011 (AFP) - A fuel tank exploded and caught fire near a cruise ship in the British territory of Gibraltar Tuesday, injuring at least 15 people, most of them on the vessel, local officials and the ship's owners said. The blast was probably caused by a spark from welding operations, Chief Minister Peter Caruana told Radio Gibraltar. But police were not ruling out any possibility including that of an attack, he added. Flames several metres high could be seen coming out of the tank with dense black smoke billowing across the port as firefighters directed jets of water at the blaze from tugboats. The fire continued late into the night, with Radio Gibraltar reporting more explosions were heard. The tank was close to the giant cruise ship, Independence of the Seas, which had arrived in Gibraltar Tuesday morning. The ship made an emergency departure immediately after the blast Tuesday afternoon.

The Gibraltar government and the ship's owners, Royal Caribbean International, both said 12 people on the ship had been hurt. Gibraltar officials said one of the passengers had suffered a fractured arm. Two Spanish welders working on the tank were injured, including one who was in critical condition in a burns unit at a hospital in the southern Spanish city of Seville, Radio Gibraltar said. A police officer was also slightly injured in the rescue attempt, police said. "The lid of the tank was blown off by the blast," a police spokesman said. The statement from Royal Caribbean International said: "Immediately after the explosion, the ship retracted the gangway and moved a safe distance from the dock. "Twelve guests sustained minor injuries and have received medical treatment onboard." The boat was on a two-week cruise, having left the southern English port of Southampton on Saturday, the company added.

Air services to Gibraltar were suspended and offices in the port area evacuated. The police spokesman said the possibility of adjacent tanks overheating and exploding could not be ruled out. Caruana described it as a serious incident but said there was "no cause for concern". "Once it was established that there were welding operations going on, on top of the very tank at the time it exploded, (that) makes that a frontrunner for a likely explanation, but all possibilities are being kept open," he told Radio Gibraltar. "The police are obviously keeping their minds open to the possibility of maybe a security incident. It's looking unlikely but all possibilities are being looked into if only to be excluded."

"The plan is to allow it to carry on burning itself off," he said later Tuesday, but warned that the wind was due to change during the night, which could bring the smoke over land. Spanish tugs from a private company were helping the local fire services, he added. One witness said he was in his office nearby when he heard three loud explosions. "We started running out and saw one of the main tanks set alight. My concern was the poor people who were working there," he told Radio Gibraltar. The public was being advised to keep away from the area and keep windows closed due to the smoke. Gibraltar is a 6.5-square-kilometre (2.6-square-mile) British territory of around 30,000 people off the tip of southern Spain. Madrid ceded it to London in 1713 under the Treaty of Utrecht, but it has long fuelled tensions between the two countries.
Date: Tue, 10 Aug 2010 20:08:15 +0200 (METDST)

GIBRALTAR, Aug 10, 2010 (AFP) - Gibraltar on Tuesday condemned as "illegal" a proposal by the neighbouring Spanish town of La Linea to impose a tax on cars entering or leaving the tiny British territory by road.   The decision comes amid thorny relations between Madrid and London over the disputed British possession off the tip of southern Spain.

La Linea mayor Alejandro Sanchez on Monday announced the "congestion charge" of no more than five euros (6.5 dollars) on cars crossing into and out of Gibraltar, saying the measure will be imposed in October once it is passed by the town council.   He said lorries carrying debris and other materials used in Gibraltar to reclaim land from the sea will pay more, but the exact amount has not yet been determined.   Sanchez, a member of Spain's conservative opposition Popular Party, said the tax is needed partly to compensate the municipality for austerity measures imposed by the socialist government in Madrid.   La Linea residents would be exempt, but it was not clear if Gibraltarians would also have to pay.

The Gibraltar government reacted angrily and said it has contacted the Spanish authorities over the decision.   "The confused statements by the mayor of La Linea in respect of the proposed toll describe a litany of illegalities under EU Law and probably also under Spanish law," it said in a statement.   "The mayor of La Linea is clearly engaged in a political manoeuvre with his central government, which is unlikely to allow the proposal.

"The mayor's proposals are wholly unacceptable both legally and politically and in the unlikely event that these measures should be introduced, the (Gibraltar) government will take appropriate steps."   Spain ceded Gibraltar to Britain in 1713 under the Treaty of Utrecht but has retained first claim on the tiny peninsula should Britain renounce sovereignty.

"The Rock" has long fuelled tensions between Spain and Britain, with Madrid arguing the 6.5-square-kilometre (2.6-square-mile) territory that is home to roughly 30,000 people should be returned to Spanish sovereignty.   But its people overwhelmingly rejected an Anglo-Spanish proposal for co-sovereignty in a referendum in 2002.   In recent months British and Spanish naval and police boats have engaged in a series of cat and mouse games in the waters off Gibraltar, which lies at the strategic western entrance to the Mediterranean.
Date: Thu 23 Oct 2008
Source: Panorama.gi [edited]
---------------------------------
During the last 10 weeks, Gibraltar has experienced an outbreak of measles. "We have so far been notified of over 250 cases and notifications are still coming in at around 4-6 cases per day," said the Gibraltar Health Authority [GHA], who believe that the actual numbers are greater as many people with mild attacks have chosen not to report them. While the majority of infections in the outbreak have been mild, some have been severe and a few patients including babies have needed intensive care.  Measles is an unpleasant disease with fever, sore throat, streaming eyes, diarrhoea, and rash. Most people recover within a week or so, but complications like fits, bacterial infection, or pneumonia can develop. Long-term complications can also arise in very young children.

Says the GHA: It is important that all persons with symptoms suggestive of measles should report the illness to their doctor to enable complications to be detected at an early stage. In addition to medical advice, persons with the illness should follow general hygiene practices such as limiting contact with other people, carefully discarding soiled tissues, and washing their hands. Anyone who has had measles infection is immune for life and cannot get measles again. There is no basis for the rumour that some people have had measles twice. It is possible that infection with rubella (German measles, a different disease) may have caused the confusion. Vaccination with the MMR [measles, mumps, and rubella] vaccine is the only way to prevent measles infection.

[So far], the 250 cases have been in persons who are unvaccinated or partly vaccinated (one dose only). Not a single case has occurred in a person who has had a full course of MMR vaccine. MMR vaccine has been available free to children [from] Gibraltar's health service since 1989, although the boosters were only introduced in 2002. It is also a very safe and effective vaccine, with an impressive track record," they say. Gibraltar Health Authority adds that it is continuing to advise all parents of children who have not had the MMR vaccine to immunise their children. There had been some difficulties in obtaining vaccine recently due to an international shortage, but fresh supplies have now been received. The course consists of 2 injections, approximately 3 months apart. Please note that BOTH the doses are needed for adequate immunity. They add: If your child has received only one dose, either now or in the past, he or she could still be at risk. Arrangements have been made to offer additional  vaccination to all unimmunised children as follows: During October and November [2008], the Child Welfare Clinics (primary care centre) will be open on Mondays (2:00 pm to 4:00 pm), Wednesdays (9:00 am to 11:00 am) and Fridays (9:00 am to 11:00 am) for immunisations. Appointments are not necessary.
-------------------------------
[The Rock of Gibraltar is located at the entrance of the Mediterranean. Gibraltar is connected to Spain by a sandy isthmus, by a ferry to Morocco, and by flights to London. By virtue of its geographical position and political status Gibraltar is vulnerable to introduction of infectious disease from diverse sources. No information has been provided regarding the source of the measles virus responsible for this outbreak. In this respect it will be relevant to determine the genotype of the measles virus involved (see comment in ProMED-mail "Measles - Gibraltar 20080814.2529"). The outbreak has escalated from the 17 cases reported on 14 Aug 2008 to the current 250 cases. Despite the availability of free MMR vaccination it is clear that there is an appreciable number of unimmunised individuals in the community who remain susceptible to measles virus infection. It is encouraging that efforts are underway to expand vaccine coverage.


and the HealthMap/ProMED-mail interactive map at <http://healthmap.org/promed?g=2411586&amp;v=36.133,-5.35,7>. - ProMed Mod.CP]
Date: Wed, 16 Apr 2008 14:56:40 +0200 (METDST) GIBRALTAR, April 16, 2008 (AFP) - Animal rights groups have expressed outrage over a plan by Gibraltar's government to cull its famous Barbary Apes, which are posing a hazard as they roam the town in search of food. The government of the tiny British territory off Spain's southern coast plans to cull 25 of the simians, whose population has exploded to around 200. The mischievous primates climb over cars and pull out antennas, open rubbish bags and rifle through handbags left unattended in the popular tourist destination. Officially, the management of the apes is the responsibility of the Gibraltar Ornithological and Natural History Society (GONHS), on contract from the government. But the society said it has not approved the cull. "Our policy is that culling can be a population management solution but only in extreme cases when there is no other more suitable option," GONHS general secretary Dr. John Cortes said on Tuesday. "We would only ever recommend a cull after very careful assessment of the situation from a veterinary and a genetic point of view." However, Environment Minister Ernest Britto said a licence has been issued for the cull and two of the apes have already been given lethal injections. Helen Thirlway, the head of Britain's International Primate Protection League, said the government was failing to manage the apes "in a responsible manner." "There have been many advances and pilot studies in recent years on different methods of controlling free-roaming monkeys," she was quoted as saying in the local media Wednesday. "We are more than happy to work with the government of Gibraltar and with GONHS to help them develop more efficient, alternative solutions, but this needless slaughter has to stop." According to legend, if the apes disappear, Britain will lose control of Gibraltar. When wartime British prime minister Winston Churchill heard their population was low, British consuls in North Africa -- from where the apes originally came -- were tasked with sending new young simians to the Rock. At one time, the apes were looked after by the British army stationed in Gibraltar, which selected a place up the Rock where they were fed daily to keep them from loitering downtown. Spain ceded Gibraltar to Britain in 1713, but has retained a constitutional claim should Britain renounce sovereignty. The vast majority of the 30,000 people want to retain their links with Britain.
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Slovenia

Slovenia US Consular Information Sheet
March 02, 2009
COUNTRY DESCRIPTION:
Slovenia operates under a parliamentary democracy.
In May 2004, Slovenia became a member of the European Union.
Tourist facilities are widely available th
oughout the country.
Read the Department of State’s Background Notes on Slovenia for additional information.

ENTRY/EXIT REQUIREMENTS:
Slovenia is a party to the Schengen agreement.
As such, U.S. citizens may enter Slovenia for up to 90 days for tourist or business purposes without a visa.
The passport should be valid for at least three months beyond the period of stay.
For further details about travel into and within Schengen countries, please see our Schegen fact sheet.

Slovene authorities may confiscate passports with signs of damage, such as missing pages, as suspicious documents, potentially causing travel delays.
American citizens entering and exiting Slovenia by personal vehicle are required to have a valid U.S. and International Driver’s License (See our Road Safety page for further information) or they may be refused entry into the country and/or fined.

All non-EU citizens staying longer than 3 days in Slovenia must register with the local police within 3 days of arrival and inform the office about any change in their address. Registration of foreign visitors staying in hotels or accommodations rented through an accommodation company is done automatically by the hotelier or accommodation company, but visitors staying with family members must register themselves.
Registration is available 24 hours a day at police stations and is free of charge. Failure to register can result in a significant fine of up to 400 euros.

For further information on entry requirements for Slovenia, travelers may contact the Embassy of Slovenia at 2410 California Street, NW, Washington, DC
20008, tel. (202) 386-6610; the Consulate General of Slovenia in New York City, tel. (2l2) 370-3006; or the Consulate General in Cleveland, Ohio, tel. (216) 589-9220.
Visit the Embassy of Slovenia’s web site for the most current visa information.

Information about dual nationality or the prevention of international child abduction can be found on our web site.
For further information about customs regulations, please read our Customs Information sheet.

SAFETY AND SECURITY:
Slovenia remains largely free of terrorist incidents.
This assessment takes into account historical data relevant to terrorist activities and recent reporting indicating whether acts could be conducted without prior advance warnings.
However, like other countries in the Schengen area, Slovenia shares open borders with its Western European neighbors, allowing the possibility of terrorist groups entering/exiting the country with anonymity.
Americans are reminded to remain vigilant with regard to their personal security and to exercise caution.

There are occasional political demonstrations in city centers in Slovenia.
They occur most often in central Ljubljana in areas around Kongresni Trg (Congress Square), in front of the Parliament building, around other government facilities, and, at times, near the American Embassy.
These demonstrations are usually peaceful and generally are not anti-American in nature.
However, there have been demonstrations that voiced anti-American sentiments.
American citizens should keep in mind that even demonstrations intended to be peaceful can turn confrontational and possibly escalate into violence.
American citizens are therefore urged to avoid the areas of demonstrations if possible, and to exercise caution if within the vicinity of any demonstrations.
For additional information, Americans are encouraged to check the Embassy’s website or call the Embassy at 386-1-200-5595 or 200-5599 (200-5556 after hours and on weekends/holidays).

For the latest security information, Americans traveling abroad should regularly monitor the Department of State, Bureau of Consular Affairs’ web site, where the current Travel Warnings and Travel Alerts, as well as the Worldwide Caution, can be found.

Up-to-date information on safety and security can also be obtained by calling 1-888-407-4747 toll free in the U.S. and Canada, or for callers outside the U.S. and Canada, a regular toll-line at 1-202-501-4444.
These numbers are available from 8:00 a.m. to 8:00 p.m. Eastern Time, Monday through Friday (except U.S. federal holidays).

The Department of State urges American citizens to take responsibility for their own personal security while traveling overseas.
For general information about appropriate measures travelers can take to protect themselves in an overseas environment, see the Department of State’s A Safe Trip Abroad.

CRIME:
Slovenia’s overall crime rate is low and violent crimes are relatively uncommon.
Most crimes tend to be non-violent and directed towards obtaining personal property, such as purse-snatching, pick-pocketing, and residential and vehicle break-ins.
Visitors should take normal security precautions and are requested to report any incidents to the local police.

Vehicle break-in/theft is a continuous problem in Slovenia.
Individuals should always lock vehicles, use vehicle anti-theft devices, park in well-lighted areas, and secure vehicles in residential or hotel garages.

Residential burglaries occur where there are security vulnerabilities and/or where residents are not implementing residential security practices.
American citizens should ensure their residence is properly secured at all times, as recent burglary reports indicate access was gained when doors were not secured with an appropriate lock.

INFORMATION FOR VICTIMS OF CRIME:
The loss or theft abroad of a U.S. passport should be reported immediately to the local police and the nearest U.S. embassy or consulate.
If you are the victim of a crime while overseas, in addition to reporting to local police, please contact the nearest U.S. embassy or consulate for assistance.
The embassy/consulate staff can, for example, assist you to find appropriate medical care, contact family members or friends and explain how funds could be transferred.
Although the investigation and prosecution of the crime is solely the responsibility of local authorities, consular officers can help you to understand the local criminal justice process and to find an attorney if needed.

The local equivalent to the “911” emergency line in Slovenia is: 113.
Please see our information on Victims of Crime, including possible victim compensation programs in the United States.

CRIMINAL PENALTIES:
While in a foreign country, a U.S. citizen is subject to that country's laws and regulations, which sometimes differ significantly from those in the United States and may not afford the protections available to the individual under U.S. law.
Penalties for breaking the law can be more severe than in the United States for similar offenses.
Persons violating Slovenian laws, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in Slovenia are severe, and convicted offenders can expect long jail sentences and heavy fines.
Engaging in sexual conduct with children or using or disseminating child pornography in a foreign country is a crime, prosecutable in the United States.
Please see our information on Criminal Penalties.

MEDICAL FACILITIES AND HEALTH INFORMATION:
Adequate medical care is readily available.
Travelers to Slovenia may obtain a list of English-speaking physicians at the U.S. Embassy.
Antibiotics, as well as other American-equivalent prescription medications are available at local pharmacies.
In Slovenia all medications, including drugs considered over-the-counter and first aid supplies, are dispensed through pharmacies (“lekarna”).
For those persons who engage in outdoor activities, a vaccine to prevent tick-borne encephalitis is recommended.

The U.S. Department of State is unaware of any HIV/AIDS entry restrictions for visitors to or foreign residents of Slovenia.
Information on vaccinations and other health precautions, such as safe food and water precautions and insect bite protection, may be obtained from the Centers for Disease Control and Prevention’s (CDC) hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747) or via the CDC’s web site.
For information about outbreaks of infectious diseases abroad, consult the World Health Organization’s (WHO) web site.
Further health information for travelers is available from the WHO.

MEDICAL INSURANCE:
The Department of State strongly urges Americans to consult with their medical insurance company prior to traveling abroad to confirm whether their policy applies overseas and whether it will cover emergency expenses such as a medical evacuation.
Please see our information on medical insurance overseas.

TRAFFIC SAFETY AND ROAD CONDITIONS:
While in a foreign country, U.S. citizens may encounter road conditions that differ significantly from those in the United States.
The information below concerning Slovenia is provided for general reference only, and may not be totally accurate in a particular location or circumstance.

Slovenia has a well-developed road network that is safe for travel.
Highways connect to neighboring cities and countries and are clearly sign-posted; road signs and traffic rules are consistent with those used throughout Europe.
As the number of cars in Slovenia continues to rise, roads are becoming more heavily congested during the weekends on major routes and during rush hours.
Parking is difficult and can be expensive in the center of Ljubljana.
Traffic moves on the right.
Third-party liability insurance is required for all vehicles; coverage is purchased locally.
Travelers should be alert to aggressive drivers both in cities and on highways.
Many of the serious accidents in Slovenia occur as a result of high-speed driving.
Emergency roadside help and information may be found by dialing 1-987 for vehicle assistance and towing services, 112 for an ambulance or fire brigade, and 113 for police.
By Slovene law, the maximum legal blood-alcohol content limit for drivers is 0.05%.

U.S. visitors or U.S. residents in Slovenia must be in possession of both a valid U.S. driver’s license and an International Driver’s License in order to drive in Slovenia.
International Driver’s Licenses are valid for a maximum of one year, after which residents of Slovenia are required to obtain a Slovene driver's license.
Current information about traffic and road conditions is available in English by calling (01) 530-5300 and online from the Automobile Association of Slovenia and the Traffic Information Center for Public Roads.

The speed limit is 50kph/30 mph in urban areas, 130 kph/80 mph on expressways (the avtocesta).
Motorists are required to have their headlights on during the daytime; drivers and passengers alike must wear seat belts; motorcyclists and their passengers must wear approved helmets.
The use of handheld cellular telephones while driving is prohibited in Slovenia.

Highway vignettes are obligatory for all vehicles with the permissible maximum weight of 3,500 kg on motorways and expressways in Slovenia.
A one-year vignette costs EUR 55; a half-year vignette costs EUR 35; for motorcycles, the one-year vignette is EUR 27,50 and the half-year vignette is EUR 17,50.

A one-year vignette for the current year is valid from December 1st of the previous year to January 31st of the next year (a total of 14 months). The half-year vignette is valid for six months following the day of its purchase.
Using motorways and expressways without a valid and properly-displayed vignette in a vehicle is considered a violation of the law; violators may be fined between EUR 300 and 800. In addition to this fine, a new sticker must be purchased and displayed on the vehicle.
Vignettes can be purchased in Slovenia at petrol stations, newsstands, automobile clubs, post offices (Posta Slovenije), and some toll stations, and also at petrol stations in neighboring countries.

Please refer to our Road Safety page for more information.
Current information is also available at the website of Slovenia’s national tourist office, which is the national authority responsible for road safety.

AVIATION SAFETY OVERSIGHT:
As there is no direct commercial air service to the United States by carriers registered in Slovenia, the U.S. Federal Aviation Administration (FAA) has not assessed Slovenia’s Civil Aviation Authority for compliance with International Civil Aviation Organization (ICAO) aviation safety standards.
For more information, travelers may visit the FAA’s website.

CHILDREN'S ISSUES:
For information see our Office of Children’s Issues web pages on intercountry adoption and international parental child abduction.

REGISTRATION / EMBASSY LOCATION:
Americans living or traveling in Slovenia are encouraged to register with the U.S. Embassy or through the State Department’s travel registration website so that they can obtain updated information on travel and security within Slovenia.
Americans without Internet access may register directly with the U.S. Embassy.
By registering, American citizens make it easier for the Embassy to contact them in case of emergency.
The U.S. Embassy is located at Presernova 31, Ljubljana 1000, Tel: (386)(1) 200-5500 or Fax: (386)(1) 200-5535.
*

*

*
This replaces the Country Specific Information for Slovenia dated July 29, 2008, to update the
Entry/Exit Requirements and Traffic Safety and Road Conditions sections.

Travel News Headlines WORLD NEWS

Date: Mon, 6 Aug 2018 12:06:36 +0200
By Bojan KAVCIC

Markovec, Slovenia, Aug 6, 2018 (AFP) - When he used to go hunting, Miha Mlakar would dream of killing a bear. But today the 33-year-old from Slovenia makes his living watching the animals, peacefully, in their natural forest environment.   The turnaround to shooting bears with a camera, not a rifle, puts Mlakar, who runs bear observation tours, in step with wider efforts in the small Alpine nation to promote the coexistence of humans and bears.

Once on the verge of extinction, Slovenia's brown bear population is booming, with the number roaming the sprawling forests having doubled in the last decade to around 1,000.   As a result, encounters with bears have increased -- not that it seems to unduly worry everyone.   "If you run into a bear, you have to step back... (But) there is no danger. The bear also prefers to move away," Ljubo Popovic, a 67-year-old pensioner who lives in the village of Banja Loka in the southern Kocevje region, told AFP.   Lying an hour to the west, near Markovec village, Mlakar has built 20 hides in a remote patch of forest reachable only by off-road vehicle and takes visitors, including foreign tourists, to observe the bears.   "I cannot imagine this forest without bears. Bears make the forest wild and pristine, natural, like it was a few hundred or thousand years ago... I feel a connection with bears," he tells AFP.

- Managing bears -
Slovenian bears are even sought after abroad.    Between 1996 and 2006, eight Slovenian bears were released in the French Pyrenees, and France currently has a population of about 40 bears, whose presence divides opinion in regions where they live.   In Slovenia, more than 60 percent of respondents in a 2016 survey carried out in areas where bears live said they were in favour of the bears' presence, even if many also said they would like to see the numbers regulated.   "We have an average of one to three cases of physical contact between bears and humans per year," Rok Cerne, of the Slovenia Forest Service in charge of wildlife, told AFP.

"Fortunately, we haven't registered any serious incident over the last years," he added, stressing they were "very active in preventive measures".   Removing food sources that could attract bears has been one such step.    In villages close to bear habitats, local authorities have replaced regular plastic waste and compost bins, which can be easily opened or flipped by the animals, with containers protected by heavy metal cages.

Meanwhile, damage to cattle from bear forays has remained stable, at up to 200,000 euros ($231,500) a year, despite the bear population increasing, Cerne said.   Farmers are entitled to an 80-percent subsidy for using electric fences to protect flocks and the loss of cattle due to bears is compensated.   If a bear becomes a habitual visitor to a village, special intervention groups step in to kill or relocate the animal with the help of local hunters.   Regular culling also keeps the population under control to ensure long-term cohabitation, Cerne said. This year, authorities have proposed culling 200 bears, twice as many as last year.

- Romania's 'Van Damme' bear -
Slovenia's approach could inspire neighbouring Romania, home to about 6,000 bears or 60 percent of Europe's estimated bear population, where tourists to villages in the Carpathian Mountains often post pictures online of bears waiting to be hand-fed.   Bears rummaging through waste containers on the outskirts of cities, such as Brasov in central Romania, have become a common sight.   And on a central motorway construction site, workmen have christened a regularly spotted sturdy male bear Van Damme after the Hollywood star.

Beyond tourists' anecdotes however, Romania has seen a "growing number of attacks" by bears, highlighted in a conservation plan published last month that recommends hunting to keep numbers at optimum levels.   Use of reinforced bins, as well as a proposal for building work to be limited in regions where bears live, are also included in the government plan.   Since the beginning of last year, 31 people, mostly shepherds, have been attacked, one of them fatally. 

Meanwhile, some 940 forays by bears into populated areas were registered last year, including attacks on sheep flocks and entry into gardens; so far this year, the figure is 120.   But environmental campaigners fear that "hunting will be the main instrument to keep bear populations under control", when other measures could work, said Livia Cimpoeru, of the WWF Romania.   The government has proposed 4,000 bears as the ideal number in the country of 20 million people.   Learning simple rules, such as how to avoid startling bears and not feeding them, as well as efficient management like accurate counting to ascertain trends, is crucial for reducing conflicts with humans, said Mareike Brix, of German-based EuroNatur foundation.   "There is a risk, and there can be problems... But it's also great (to have bears). Wild nature has become so rare in Europe," she tells AFP.
Date: Thu 13 Jun 2018
Source: STA [not open access; edited]

The UKC Maribor hospital has registered 3 new cases of measles infection, including a doctor and a nurse who treated 1 of the 3 patients who got measles earlier.

The rest of this story is by subscription....
===================
[A HealthMap/ProMED-mail map of Slovenia can be found at
Date: Mon 17 Oct 2016
Source: Outbreak News Today [edited]

The vaccine-preventable disease, tetanus, has been considered eradicated among children in the Central European country of Slovenia for the past 20 years; health officials report a case in an unvaccinated child as reported in local media Fri, 14 Oct 2016.

The National Public Health Institute (NIJZ) says while the disease has been considered eradicated among children for the past 2 decades, a few cases are reported every year among the elderly, who grew up before systemic vaccination against the disease was introduced. Tetanus vaccination has been available in Slovenia since 1951.

Tetanus is caused by a very potent toxin produced by the anaerobic bacterium, _Clostridium tetani_. The spores of this organism are very resistant to environmental factors and are found widely distributed in soil and in the intestines and feces of horses, sheep, cattle, dogs, cats, rats, guinea pigs, and chickens. Manure-treated soil may contain large numbers of spores. In agricultural areas, a significant number of human adults may harbor the organism.

These spores are usually introduced into the body through a puncture wound contaminated with soil, street dust, animal bites or animal or human feces, through lacerations, burns or trivial unnoticed wounds or by injecting contaminated drugs. So many times you hear about concern over stepping on a rusty nail; however the rust has nothing to do with tetanus. At this point the spores germinate into bacteria which multiply and produce toxin. Depending on the extent of the wound, the incubation of tetanus is around 10-14 days.

Some of the common symptoms of tetanus are lockjaw, followed by stiffness of the neck, difficulty swallowing, and rigidity of abdominal muscles. Other symptoms include fever, sweating, elevated blood pressure, and episodic rapid heart rate. Spasms may occur frequently and last for several minutes. Spasms continue for 3-4 weeks. The typical features of a tetanus spasm are the position of opisthotonos and the facial expressions known as "risus sardonicus". The death rate for this disease ranges from 10 to 80 percent depending on age and quality of care.

There are really no laboratory findings that are characteristic of tetanus. The diagnosis is entirely clinical and does not depend upon bacteriologic confirmation. This disease in not transmitted from person to person. Even if you had tetanus and recovered, this potent toxin produces no immunity.  [Byline: Robert Herriman]
======================
[Tetanus is a potentially fatal disease characterized by skeletal muscle rigidity and painful convulsive spasms, which are caused by a potent neurotoxin, tetanospasmin, produced by the vegetative form of _Clostridium tetani_, an anaerobic spore-forming Gram-positive bacillus. _C. tetani_ is a member of the normal intestinal flora of animals, including humans. Tetanus usually occurs following contamination of wounds by soil or animal feces in which the spores of _C. tetani_ can be found.

A newly published article demonstrates that the extracellular matrix proteins called nidogens (or entactins) appear to be the receptor for the tetanus neurotoxin to enter the neuromuscular junction (Bercsenyi K, Schmieg N, Bryson JB, et al: Tetanus toxin entry. Nidogens are therapeutic targets for the prevention of tetanus. Science. 2014;346(6213):1118-23. doi: 10.1126/science.1258138, abstract available at:  <http://science.sciencemag.org/content/346/6213/1118.long>).

Abstract:
"Tetanus neurotoxin (TeNT) is among the most poisonous substances on Earth and a major cause of neonatal death in nonvaccinated areas. TeNT targets the neuromuscular junction (NMJ) with high affinity, yet the nature of the TeNT receptor complex remains unknown. Here, we show that the presence of nidogens (also known as entactins) at the NMJ is the main determinant for TeNT binding. Inhibition of the TeNT-n idogeninteraction by using small nidogen-derived peptides or genetic ablation of nidogens prevented the binding of TeNT to neurons and protected mice from TeNT-induced spastic paralysis. Our findings demonstrate the direct involvement of an extracellular matrix protein as a receptor for TeNT at the NMJ, paving the way for the development of therapeutics for the prevention of tetanus by targeting this protein-protein interaction."

Tetanus may follow surgical procedures, burns, deep puncture wounds, crush wounds, otitis media, dental infection, animal bites, abortion, and pregnancy. The presence of necrotic tissue and/or foreign bodies increases risk for tetanus because they favor growth of _C. tetani_. Tetanus can also follow injection of contaminated illicit drugs. Neonatal tetanus occurs usually in developing countries in infants with infection of the umbilical stump who are born to a non-immune mother. Infants of actively immunized mothers acquire passive immunity that protects them from neonatal tetanus. Tetanus is not directly transmitted from person to person.

Tetanus occurs in people who are inadequately immunized, i.e., people who have not completed the primary series and received appropriate boosters. Recovery from tetanus is not necessarily associated with immunity, and primary immunization is indicated after recovery from tetanus. - ProMED Mod.LL]

[A HealthMap/ProMED-mail map can be accessed at:
Date: Tue, 12 Jan 2016 20:27:43 +0100

Ljubljana, Jan 12, 2016 (AFP) - The Slovenian army on Tuesday began removing sections of a razor-wire border fence, erected to control the inflow of migrants from Croatia, due to flooding by the Kolpa river, local media reported.   Slovenian soldiers removed 200-300 metres of the fence in the Griblje and Dragatus areas, villages some 110 kilometres (70 miles) south of Ljubljana, after the Kolpa burst its banks and floodwaters threatened to tear down the fence, the STA news agency reported.

Since mid-November Slovenia has built over 150 kilometres of razor-wire fence along its border with Croatia, hoping to prevent an uncontrolled inflow of migrants across the "green border".   Over 400,000 migrants have crossed into Slovenia since mid-October, most hoping to carry on to Austria or Germany.

The Slovenian government's information office said Monday that the border fence would be removed in areas where the stream of the Kolpa river was strongest and replaced, in the near future, by a more resistant fence.   Situated in one of Slovenia's most attractive natural parks, the Kolpa river marks over 100 kilometres of the 670 kilometre-long Slovenia-Croatia border.   The fence has been criticised by environmentalists and civil groups in Slovenia and Croatia which claim the razor wire is a threat to wildlife.
Date: 4 Jan 2016
From: Maja Socan, M.D. Maja.Socan@nijz.si

In response to the request for information in the ProMED mail post "Undiagnosed gastroenteritis - Slovenia (GO): international athletes, RFI http://promedmail.org/post/20151228.3896510, the following information was received 4 Jan 2016 [edited]:

As a response to the ProMED request for information on 28 Dec 2015 quoting izvestia.ru from 19 Dec [2015] that 3 teams were affected by a viral epidemic during Biathlon World Cup in Pokljuka, Slovenia, an investigation has been carried out. Regional epidemiologists contacted the organizers, the hotel where athletes were staying, local outpatient clinics/emergency teams and both hospitals nearby. 
 
The organizers of the Biathlon World Cup in Slovenia were not aware of any communicable diseases affecting biathlon teams during the cup. One of the athletes was admitted to the hospital but the reason for the admission was non-infectious. Another athlete lost consciousness during the competition.
 
Neither emergency medical teams nor nearby hospitals were contacted for any health intervention except for the above-mentioned situations.
 
The hotel where the teams were staying was not informed about any gastrointestinal problems among its guests during the competition.
 
The findings of our investigation do not preclude that some of the athletes had health problems during the competition but apparently not severe enough to contact local health services. We assume that if high numbers of athletes had become ill with gastrointestinal problems the organizer would have been informed. According to the national algorithm for mass gatherings (with emphasis on the international ones), the National Institute of Public Health is obligated to provide in advance the information to the organizers about possible health issues during mass gatherings and measures which must be taken to stop the spread of communicable diseases or at least to mitigate the outbreak.
 
To conclude, we were not able to identify an outbreak of acute gastrointestinal or respiratory infection among competing athletes during the Biathlon World Cup in Pokljuka, Slovenia.
-------------------------------------------
Maja Socan, M.D.
Senior consultant
Communicable Diseases Centre
National Institute of Public Health
Ljubljana, Slovenia
========================
[ProMED thanks Dr. Socan for the thorough investigation into this report and for sharing the information with the ProMED community.

A HealthMap/ProMED-mail map can be accessed at:
More ...

Bahrain

Bahrain - US Consular Information Sheet
June 27, 2008
COUNTRY DESCRIPTION:
Bahrain is a hereditary kingdom governed by the Al-Khalifa family. In 2002, the country adopted a new constitution that reinstated a parliament, which consists of o
e elected and one appointed chamber. Islamic ideals and beliefs provide the conservative foundation of the country's customs, laws and practices. Bahrain is a modern, developed country and tourist facilities are widely available. The capital is Manama. Read the Department of State Background Notes on Bahrain for additional information.
ENTRY/EXIT REQUIREMENTS:
A passport and a visa are required. Passports should be valid for at least six months after the date of arrival. U.S. passport holders outside of Bahrain may apply and pay for a two-week tourist visa online through the Bahraini government web site at http://www.evisa.gov.bh, or may obtain it upon arrival at the airport. U.S. diplomatic passport holders receive a no-fee two-week visa. Prior to travel, visitors may obtain five-year multiple-entry visas valid for stays as long as one month from Bahraini embassies overseas. Bahrain assesses heavy fines on visitors who fail to depart Bahrain at the end of their authorized stay. The amount of the fine is determined by a formula related to the visa type, duration, and location of issuance. An exit tax is included in the ticket price for flights out of Bahrain, and no additional exit fees are required upon departure. Residents of Bahrain who intend to return must obtain a re-entry permit before departing. For further information on entry/exit requirements, travelers may contact the Embassy of the Kingdom of Bahrain, 3502 International Drive NW, Washington, DC 20008, telephone (202) 342-1111; or the Bahrain Permanent Mission to the U.N., 2 United Nations Plaza, East 44th St., New York, NY 10017, telephone (212) 223-6200. Visit the Embassy of Bahrain web site at www.bahrainembassy.org for the most current visa information.

Information about dual nationality or the prevention of international child abduction can be found on our web site. For further information about customs regulations, please read our Customs Information sheet.
SAFETY AND SECURITY:
Americans in Bahrain should maintain a high level of security awareness. Spontaneous demonstrations take place in Bahrain from time to time in response to world events or local developments. We remind American citizens that even demonstrations intended to be peaceful can turn confrontational and possible escalate into violence. American citizens are therefore urged to avoid the areas of demonstrations if possible, and to exercise caution if within the vicinity of any demonstrations. American citizens should stay current with media coverage of local events and be aware of their surroundings at all times. Information regarding demonstrations in Bahrain can be found on the U.S. Embassy Manama’s web site at http://bahrain.usembassy.gov/information_for_travelers.html.

Visiting U.S. citizens should register with the U.S. Embassy in Manama upon arrival. The Department of State remains concerned about the possibility of terrorist attacks against U.S. citizens and interests throughout the world. Americans should maintain a low profile, vary routes and times for all required travel, and treat mail and packages from unfamiliar sources with caution. In addition, U.S. citizens are urged to avoid contact with any suspicious, unfamiliar objects, and to report the presence of the objects to local authorities. Please report any security concerns to the U.S. Embassy's Regional Security Office at telephone (973) 1724-2700 during office hours or (973) 1727–5126 after hours.
For the latest security information, Americans traveling abroad should regularly monitor the Department’s web site at http://travel.state.gov, where the current Worldwide Caution, Travel Warnings and Travel Alerts can be found.
Up-to-date information on safety and security can also be obtained by calling 1-888-407-4747 toll free in the U.S. and Canada or, for callers outside the U.S. and Canada, a regular toll-line at 1-202-501-4444. These numbers are available from 8:00 a.m. to 8:00 p.m. Eastern Time, Monday through Friday (except U.S. federal holidays).
The Department of State urges American citizens to take responsibility for their security while traveling overseas. For general information about appropriate measures travelers can take to protect themselves in an overseas environment, see the Department of State’s pamphlet A Safe Trip Abroad.
CRIME:
The crime rate in Bahrain is low and violent crime is rare. However, burglary, petty theft, and robberies do occur. Visiting Americans are urged to take the same security precautions in Bahrain that one would practice in the United States. Hotel room doors should be locked when visitors are in their rooms, and travelers are encouraged to store valuables in hotel room safes when they are available. Women are encouraged to keep their purses firmly under their arms, and men should avoid keeping their wallets in their hip pockets while in the old market area. The U.S. Embassy in Manama recommends that travelers using local taxis insist on the use of a meter since unexpectedly high fares may otherwise be charged. Bahrain has a professional police force, and visitors are encouraged to contact the police if problems are encountered.

INFORMATION FOR VICTIMS OF CRIME:
The loss or theft abroad of a U.S. passport should be reported immediately to the local police and the U.S. Embassy. If you are the victim of a crime while overseas, in addition to reporting to local police, please contact the U.S. Embassy for assistance. The Embassy staff can, for example, assist you to find appropriate medical care, contact family members or friends and explain how to transfer funds. Although the investigation and prosecution of the crime is solely the responsibility of local authorities, consular officers can help you to understand the local criminal justice process and to find an attorney if needed.

The local equivalent to the “911” emergency line in Bahrain is 999.
See our information on Victims of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION:
Basic modern medical care and medicines are available in several hospitals and health centers in Bahrain. Two government hospitals, several private hospitals, and numerous private clinics located throughout the country offer a wide range of medical services. Cardiac care, general surgery, internal medicine, obstetrics, gynecology, pediatrics, orthopedics and dentistry services are readily available, as are x-rays, CT-scan and MRI testing. The government hospitals house both trauma and ICU units. Pharmacies are common throughout Bahrain and carry a wide range of medications. Prescriptions are normally required.
Payment at all medical facilities is due at the time of service. Some hospitals have limited direct billing capability for certain insurance carriers. Billing and insurance practices vary among the medical facilities.

Information on vaccinations and other health precautions, such as safe food and water precautions and insect bite protection, may be obtained from the Centers for Disease Control and Prevention’s hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747) or via the CDC’s web site at http://wwwn.cdc.gov/travel/default.aspx. For information about outbreaks of infectious diseases abroad consult the World Health Organization’s (WHO) web site at http://www.who.int/en. Further health information for travelers is available at http://www.who.int/ith/en.
MEDICAL INSURANCE:
The Department of State strongly urges Americans to consult with their medical insurance company prior to traveling abroad to confirm whether their policy applies overseas and whether it will cover emergency expenses such as a medical evacuation. Please see our information on medical insurance overseas.

TRAFFIC SAFETY AND ROAD CONDITIONS:
While in a foreign country, U.S. citizens may encounter road conditions that differ significantly from those in the United States. The information below concerning Bahrain is provided for general reference only, and may not be totally accurate in a particular location or circumstance.

Travel by road in Bahrain is generally safe although unsafe driving practices are common. Highways and major roads in the northern third of Bahrain are four to six lanes wide and well maintained; roads in villages and older parts of Manama and Muharraq are narrow and twisting. As in the United States, traffic in Bahrain moves on the right. Roundabouts (traffic circles) follow the British system, with those automobiles within the traffic circle having right of way over those attempting to enter. Although the Bahraini penal code calls for fines of up to 100 dinars ($270.00) or imprisonment of up to six months for driving above posted speed limits, it is not uncommon for drivers to drive well over the posted speed limits of 50-120 km per hour. The law allows the police to detain drivers for traffic violations until they can appear before a magistrate. It is illegal to use a cell phone while driving.

Under Bahraini law, any sign of having consumed alcohol may be taken as prima facie evidence of driving under the influence, which can lead to imprisonment and/or fines of up to 1,000 Bahraini Dinars (2,700 U.S. dollars). Except for minor accidents, drivers may not move their vehicles after an accident until a report has been filed with the traffic police. This is true even in cases of single-car accidents. Insurance companies may not provide coverage if the cars are moved. However, drivers involved in minor, non-injury accidents no longer need to wait at the scene for the police. Individuals should get their vehicles off the road to avoid further accidents. Drivers can call the accident hotline at 199 (if there are no injuries) or 999 (when someone is injured) where they will be directed to one of five centers to file the accident report. This report must be filed within 24 hours of the accident. Both drivers may be prohibited from leaving the country until the matter is resolved if an accident results in legal proceedings. The main switchboard at the traffic department is 1787-2222.
Emergency numbers are as follows:
Fire/Ambulance/Police: 999
Traffic/Accidents: 199 (no injuries) OR 999 (injuries)
Please refer to our Road Safety page for more information. Visit the web site of Bahrain’s national authority responsible for road safety at http://www.traffic.gov.bh/main.htm.
AVIATION SAFETY OVERSIGHT:
As there is no direct commercial air service to the United States by carriers registered in Bahrain, the U.S. Federal Aviation Administration (FAA) has not assessed Bahrain’s Civil Aviation Authority for compliance with International Civil Aviation Organization (ICAO) aviation safety standards. For more information, travelers may visit the FAA’s web site at http://www.faa.gov/safety/programs_initiatives/oversight/iasa.

SPECIAL CIRCUMSTANCES:
Individuals subject to Bahraini court orders arising from indebtedness, labor disagreements, or other legal disputes may be prevented from departing Bahrain until their cases are resolved. Instances have occurred in which departure was prohibited for several years, since the legal process can be both lengthy and complex. The Consular Section of the U.S. Embassy in Manama maintains a list of local attorneys capable of representing Americans.
Please see our Customs Information.
CRIMINAL PENALTIES:
While in a foreign country, a U.S. citizen is subject to that country's laws and regulations, which sometimes differ significantly from those in the United States and may not afford the protections available to the individual under U.S. law. Persons violating Bahrain’s laws, even unknowingly, may be expelled, arrested or imprisoned. Penalties for breaking the law can be more severe than in the United States for similar offenses. Disrespect to officials in word or deed can result in heavy fines. Travelers who are driving should be aware that one drink may be sufficient grounds for a DUI arrest. Penalties for possession, use, or trafficking in illegal drugs in Bahrain are severe, and convicted offenders can expect long jail sentences and heavy fines. Engaging in sexual conduct with children or using or disseminating child pornography in a foreign country is a crime, prosecutable in the United States. Please see our information on Criminal Penalties.

CHILDREN'S ISSUES:
For information see our Office of Children’s Issues web pages on intercountry adoption and international parental child abduction.

REGISTRATION / EMBASSY LOCATION:
Americans living or traveling in Bahrain are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department’s travel registration web site, and to obtain updated information on travel and security within Bahrain. Americans without Internet access may register directly with the nearest U.S. Embassy or Consulate. By registering, American citizens make it easier for the Embassy or Consulate to contact them in case of emergency. The U.S. Embassy is located at Bldg. 979, Road no. 3119, Zinj District (next to Al Ahli Sports Club). The mailing address is P.O. Box 26431, Manama, Bahrain. The telephone number is (973) 1724-2700. The after-hours number is (973) 1727-5126. The Consular Section’s fax number is (973) 1725-6242. The Embassy's web site, which includes consular information and the most recent messages to the American community in Bahrain is at http://bahrain.usembassy.gov/. The workweek in Bahrain is Sunday through Thursday.
* * *
This replaces the Country Specific Information for Bahrain dated November 23, 2007 without substantive changes.

Travel News Headlines WORLD NEWS

Date: Mon, 2 Oct 2017 19:26:47 +0200

Dubai, Oct 2, 2017 (AFP) - A "terrorist explosion" during a Shiite procession commemorating Ashura lightly wounded five policemen on Monday, the interior ministry in Sunni-ruled Bahrain announced.   "A terrorist explosion caused five light injuries among policemen deployed as security for a procession along Budaiya Avenue" in western Manama, a tweet from the ministry said.

Shiites in the tiny Gulf kingdom mark Ashura with processions in Manama and in villages around the capital.   The annual Ashura commemorations mark the killing of Imam Hussein by the forces of the Caliph Yazid in 680 AD -- a formative event in Shiite Islam.   Imam Hussein's death was part of a dispute over who should succeed the Prophet Mohammed, which eventually developed into a bitter schism between the Sunni and Shiite branches of Islam.

Bahrain, home to the US Fifth Fleet, has seen sporadic violence since the repression in 2011 of a protest movement by the Shiite majority, demanding a constitutional monarchy and an elected prime minister.   Hundreds of protesters, mainly but not all Shiites, were arrested and sentenced to lengthy prison terms for their role in the demonstrations.   Bahrain says it does not discriminate towards the country's Shiites, and regularly accuses Shiite Iran of meddling in its internal affairs, an allegation Tehran denies.
Date: Sun, 26 Feb 2017 20:11:48 +0100

Dubai, Feb 26, 2017 (AFP) - Four Bahraini policemen were wounded in a bomb attack Sunday near the village of Jaw, south of the capital Manama, the interior ministry said.   "Terrorist blast in police bus near Jua village. 4 policemen injured and they are in a stable condition. Necessary steps are being taken," the ministry said on its Twitter account.   It gave no further details.

On January 1, gunmen attacked the prison in Jaw, killing a policeman and allowing 10 inmates to escape.   Shiites convicted over anti-government protests in Sunni-ruled Bahrain were held at Jaw.   Tiny but strategic Bahrain, home to the US Fifth Fleet, has been rocked by unrest since the authorities crushed Shiite-led protests in 2011 demanding a constitutional monarchy and an elected prime minister.

Hundreds of Shiites have been arrested and many have faced trials over their role in the demonstrations.   One of those on trial is Sheikh Issa Qassem, the country's Shiite spiritual leader.   He was stripped of his citizenship last year for "serving foreign interests" -- a reference to Shiite Iran.   On Sunday, clashes broke out between security forces and protesters in several Shiite villages as a new hearing in Qassem's case was underway, witnesses said.   Protesters chanted anti-government slogans and carried portraits of Qassem, they said.
Date: Wed, 15 Feb 2017 11:55:11 +0100

Dubai, Feb 15, 2017 (AFP) - An explosion wounded two civilian passers-by in Bahrain, the interior ministry said early Wednesday, as demonstrators were marking the sixth anniversary of an anti-government uprising that was bloodily suppressed.   The ministry did not say what caused Tuesday evening's blast in a village outside the capital Manama but demonstrators sometimes throw petrol bombs during the sporadic protests that still grip the Sunni-ruled but Shiite-majority kingdom.   "Terrorist blast in Sitra causes minor injuries to a married couple passing the site. Police at the scene," the ministry said on its Twitter account without elaborating.   It also tweeted a picture of a black 4X4 with a shattered windscreen and significant damage to the front bonnet.   The blast came as demonstrators clashed with police in Manama and several nearby villages.   The demonstration in the capital ended when police fired tear gas and stun grenades, witnesses said.

Activists posted pictures of injured protesters online, but the interior ministry has not published any official statements about the reported demonstrations.   The Shiite-led protests of February 2011 sought a constitutional monarchy and an elected prime minister to replace the current government dominated by the ruling Al-Khalifa family.   Authorities crushed them the following month with the support of Saudi-led forces who secured key installations.   Since then, the authorities have banned the Shiite opposition and handed long jail terms to many of its leaders. Some have been stripped of their citizenship.   Tiny but strategic Bahrain lies just across the Gulf from Iran and is home to the US Navy's Fifth Fleet.
Date: Thu, 19 May 2016 21:53:48 +0000
From: Dr Manaf Alqahtani <drmanaf@gmail.com> [edited]
BDF Hospital, Bahrain
-----------------------------------
Measles is a highly infectious virus that spreads easily from person to person through the air, through breathing, coughing and sneezing. Although measles is largely considered a disease of children, we have noticed increasing numbers of adults infected. Since 9 May 2016, we had a total of 7 cases with measles. 4 were adults (30-40 years old) and 3 children (less than 12 months old). All adults were Bahraini (3 originally born in Yemen and one in Pakistan). All of the adults either have no documentation of MMR or received one dose MMR only.

Regarding the 3 children with measles, all were non-vaccinated and got infected from their infected adult family member.

3 out of 7 cases needed to be admitted for hydration and symptomatic treatment. Luckily, all our HCWs [health care workers] have documented 2 doses of MMR.

In the 2014 measles outbreak in Bahrain, 32 cases were registered, of which 27 were among children under 15 years and 5 among adults. Of the total, 14 cases were detected among expatriates.

Bahrain and the other member states of the EMR [Eastern Mediterranean Region] adopted a resolution for elimination of measles from the region by 2010. In 1996, the Ministry of Health (MOH) developed a plan for measles elimination that included a revised measles immunization schedule, introduction of case-based surveillance, and annual immunization campaigns of school children.

Most of recent measles cases are imported.
------------------------------
Dr. Manaf Alqahtani
BDF Hospital
Bahrain
=================
[ProMED thanks Dr. Alqahtani for sending this information.

Also see: JS Jawad et al. Toward Measles Elimination in Bahrain -- A Middle East Country Experience. The Journal of Infectious Diseases 2011;204:S299-S304

"Abstract
---------
Measles was a leading cause of infant and child morbidity and mortality in Bahrain before the introduction of measles vaccine in 1974. With the establishment of the Expanded Program on Immunization (EPI) in 1981 and the introduction of a 2nd dose of measles vaccine in 1985, coverage for 1st and 2nd doses of measles vaccine increased to 94 percent by 1997 and has been sustained greater than 97 percent since 2001. Measles, mumps, and rubella (MMR) immunization campaigns targeting 12-year-old students were conducted annually during 1998-2006 and achieved coverage of greater than 95 percent. As a result, the incidence of measles in Bahrain has declined markedly over the past 4 decades, to 2.7 cases per million persons in 2009. Recent confirmed measles cases have occurred sporadically, in under-vaccinated children or in infants too young or adults too old to receive measles vaccine. Bahrain has made significant progress toward measles elimination by sustaining high immunization coverage and strengthening case-based measles surveillance activities. Further success will depend on improved identification and immunization of under-vaccinated expatriate workers and their families."

A map of Bahrain can be accessed at <http://healthmap.org/promed/p/127>.
Bahrain is an archipelago in the middle of the Arabian Gulf encompassing 33 islands, the largest of which is Bahrain Island. - ProMED Mod.LK]
Date: Fri 6 Nov 2015
Source: Reuters [edited]

A cholera outbreak in Iraq has spread to Kuwait and Bahrain, and risks turning into a region-wide epidemic as millions of pilgrims prepare to visit the country, UNICEF's Iraq director has said. The disease, which can lead to death by dehydration and kidney failure within hours if left untreated, was detected west of Baghdad in September 2015 and has since infected at least 2200 people in Iraq and has killed 6.

"It [the outbreak] already has a regional dynamic and the risk of that can only be increased by people from all over the region coming into Iraq," UNICEF country director, Peter Hawkins, said on Thu 5 Nov 2015. Hawkins said cholera had spread to Bahrain, Kuwait and Syria, but in a later statement, UNICEF said the cases in Syria were not confirmed: "However, given the scale of the outbreak in Iraq the risk of cholera spreading across Iraq's borders remains high," it said.

Millions of Shi'ite Muslims are due to visit Iraq in December for Arbaeen, a religious ritual marking the end of an annual mourning period for the Prophet Mohammad's grandson Hussein, whose death in 680 AD entrenched the schism between Shi'ites and Sunnis.

Hawkins said UNICEF was working with clerics in the Shi'ite shrine cities of Najaf and Kerbala to convey information about how to guard against cholera, which is endemic in Iraq and the wider region. The outbreak can be traced to a number of factors including low water levels in the Euphrates and winter flooding that has contaminated the river and shallow wells with sewage water.

The war against [the so-called] Islamic State militants who control large swathes of territory in northern and western Iraq has also contributed to the outbreak. The conflict has displaced more than 3 million people, with many living in camps where conditions are conducive to the spread of cholera -- a bite of contaminated food or a sip of contaminated water is enough to cause infection.

Hawkins said UNICEF has only limited access to areas controlled by Islamic State, which swept across the Syrian border in mid-2014 in a bid to establish a modern caliphate.

Higher military expenditure and other costs associated with the battle against Islamist militancy has aggravated a cash crunch for Iraq, a major OPEC oil producer that has suffered from the drop in global crude prices over the past year. A higher proportion of the government budget is also being spent on security at the expense of other services and infrastructure such as water supply, Hawkins said.

1 in 5 of the confirmed cases in Iraq is among children, and in large parts of the country the start of the school year was delayed by a month as a precaution, UNICEF said in a statement. In response to the outbreak, UNICEF is providing bottled water, oral rehydration salts and installing community water tanks, but like most humanitarian operations in Iraq it is severely underfunded.  [byline: Isabel Coles]
=====================
[The conflicts in the Middle East have exacerbated the endemic cholera in Iraq, and it has spread beyond Iraq's borders. The number of cases of cholera in Kuwait and Bahrain are not reported, nor is it clear whether the cases were acquired in these countries or imported. UNICEF has not confirmed any cases in war-torn Syria, but there are informal reports circulating. - ProMED Mod.LL]

[A HealthMap/ProMED-mail map can be accessed at:
More ...

Papua New Guinea

Papua New Guinea - US Consular Information sheet
October 17, 2008
COUNTRY DESCRIPTION:
Papua New Guinea is a developing country in the Southwest Pacific. The capital is Port Moresby. Tourist facilities outside major towns are limited. Crim
is a serious concern throughout Papua New Guinea (please see the section on crime below). Read the Department of State Background Notes on Papua New Guinea for additional information.
ENTRY/EXIT REQUIREMENTS: Travelers must possess a valid passport, onward/return airline ticket, and proof of sufficient funds for the intended visit. Travelers may obtain business or tourist visas (valid for stays of up to 60 days, with extensions available for an additional 30 days) upon arrival at Jacksons International Airport in Port Moresby. All persons boarding international flights originating from Papua New Guinea pay a departure fee, which should be included in airline fares. Travelers may obtain more information on entry and exit requirements from the Embassy of Papua New Guinea, 1615 New Hampshire Avenue NW, Suite 300, Washington, DC 20009, tel. 202-745-3680, fax 202-745-3679, e-mail kunduwash@aol.com, or via the Papua New Guinea Embassy web site at http://www.pngembassy.org/
Travelers who plan to transit or visit Australia must enter with an Australian visa or, if eligible, an Electronic Travel Authority (ETA). The ETA replaces a visa and allows a stay of up to three months. It may be obtained for a small service fee at http://www.eta.immi.gov.au/. Airlines and many travel agents in the United States are also able to issue ETA’s. Travelers may obtain more information about Australian entry requirements from the Australian Embassy at 1601 Massachusetts Avenue NW, Washington, DC 20036, tel. 202-797-3000, or via the Australian Embassy's web site at http://www.austemb.org/.

Information about dual nationality or the prevention of international child abduction can be found on our web site. For further information about customs regulations, please read our Customs Information sheet.

SAFETY AND SECURITY:
For the latest security information, Americans traveling abroad should regularly monitor the Department of State, Bureau of Consular Affairs’ web site at http://travel.state.gov, where the current Travel Warnings and Travel Alerts, as well as the Worldwide Caution, can be found.
Civil Unrest/Political Tension: Tension between communal or clan groups, particularly in the Highlands region, occasionally leads to outbreaks of tribal fighting, often involving the use of firearms. Travelers should consult with their tour operator, the U.S. Embassy in Port Moresby, or with Papua New Guinean authorities before visiting the region.

Visitors intending to travel to the autonomous region of Bougainville Island should contact the U.S. Embassy in Port Moresby for updated security information. Bougainville Island is not peaceful, law enforcement is weak, and tourist and transportation facilities are limited. We advise travelers to Bougainville, as in other parts of Papua New Guinea, to exercise a high degree of caution. Areas near the Panguna mine, located on the southern part of the Island of Bougainville, have been officially designated “no go zones” by the Autonomous Government of Bougainville; Americans should avoid those areas.
Up-to-date information on security can also be obtained by calling 1-888-407-4747 toll-free in the U.S. and Canada, or for callers outside the U.S. and Canada, a regular toll line at 1-202-501-4444. These numbers are available from 8:00 a.m. to 8:00 p.m. Eastern Time, Monday through Friday (except U.S. federal holidays).
The Department of State urges American citizens to take responsibility for their own personal security while traveling overseas. For general information about appropriate measures that travelers can take to protect themselves in an overseas environment, see the Department of State's pamphlet A Safe Trip Abroad.
CRIME: Papua New Guinea has a high crime rate. Numerous U.S. citizen residents and visitors have been victims of violent crime in recent years, and they have sometimes suffered severe injuries. Carjackings, armed robberies, and stoning of vehicles are problems in and around major cities such as Port Moresby, Lae, Mount Hagen, and Goroka, but can happen anywhere. Pickpockets and bag-snatchers frequent crowded public areas. Hiking or other travel in rural areas and visiting isolated public sites such as parks, golf courses, beaches, or cemeteries can be dangerous. Individuals traveling alone are at greater risk for robbery or gang rape than are those who are part of an organized tour or under escort. Visitors to Papua New Guinea should avoid using taxis or buses, known as Public Motor Vehicles (PMV's), and should instead rely on their sponsor or hotel to arrange for taxi service or a rental car.
Road travel outside of major towns can be hazardous because criminals set up roadblocks near bridges, curves in the road, or other features that restrict vehicle speed and mobility. Visitors should consult with the U.S. Embassy or with local law enforcement officials concerning security conditions before driving between towns. (See also Traffic Safety and Road Conditions below). Travel to isolated places in Papua New Guinea is possible primarily by small passenger aircraft; there are many small airstrips throughout the country. Security measures at these airports are rare. Organized tours booked through travel agencies remain the safest means to visit attractions in Papua New Guinea. The Embassy recommends that prospective visitors consult a Primer on Personal Security for Visitors to Papua New Guinea at http://travel.state.gov/travel/cis_pa_tw/cis/cis_1757.html
Kokoda Track: Americans should exercise a high degree of caution when walking the Kokoda Track and traveling through the areas adjacent to each end of the track. Travelers should travel with guides from a reputable tour company. This is particularly important given occasional threats by villagers to close parts of the track because of local land and compensation disputes. Trekkers should ensure that their tour company provides a permit in return for fees paid for this purpose. The Kokoda Track Authority (KTA) has stationed rangers along the track and at airports to collect fees from trekkers who have not obtained a valid trekking permit. The KTA can be contacted on telephone (675) 325 6165 regarding payment of the applicable fee.
INFORMATION FOR VICTIMS OF CRIME: The loss or theft abroad of a U.S. passport should be reported immediately to the local police and the nearest U.S. embassy or consulate. If you are the victim of a crime while overseas, in addition to reporting to local police, please contact the nearest U.S. embassy or consulate for assistance. The embassy/consulate staff can, for example, assist you to find appropriate medical care, to contact family members or friends and explain how funds may be transferred. Although the investigation and prosecution of the crime is solely the responsibility of local authorities, consular officers can help you understand the local criminal justice process and to find an attorney, if needed.
The local equivalent to the “911” emergency line in Papua New Guinea is: 000
See our information on Victims of Crime.
MEDICAL FACILITIES AND HEALTH INFORMATION: Medical facilities in Papua New Guinea vary from hospitals in Port Moresby and the larger towns to aid posts (including some missionary stations) in remote areas. Medical facilities vary in quality, but those in the larger towns are usually adequate for routine problems and some emergencies. However, equipment failures and sudden shortages of common medications can mean that even routine treatments and procedures (such as X-rays) may become unavailable. A hyperbaric recompression chamber for diving emergencies is available in Port Moresby. Pharmacies in Papua New Guinea are found only in urban centers and at missionary clinics. They are small and may be inadequately stocked. Doctors and hospitals often expect immediate cash payment for medical services.
Medical conditions arising as a result of diving accidents will almost always require medical evacuation to Australia, where more sophisticated facilities are available. Medical evacuation companies could charge thousands of dollars to transport a victim to Australia or the U.S. A last-minute, one-way commercial ticket from Port Moresby to Brisbane or Cairns costs upwards of US$250 for economy class and upwards of US$550 for business class. The most commonly used facilities are in Brisbane and Cairns, both in the Australian State of Queensland. Travelers who anticipate the possible need for medical treatment in Australia should obtain entry permission for Australia in advance. Entry permission for Australia can be granted by the Australian Embassy in Port Moresby, but it is easier to obtain it prior to leaving the United States (see section above on Entry/Exit Requirements).
The U.S. Department of State is unaware of any HIV/AIDS entry restrictions for visitors to or foreign residents of Papua New Guinea. The Government of Papua New Guinea does not currently have any policy guidelines that prevent entry into the country by short- and long-term travelers and/or residents.

Information on vaccinations and other health precautions, such as safe food and water precautions and insect bite protection, may be obtained from the Centers for Disease Control (CDC) and Prevention's hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747) or via the CDC's web site at http://wwwn.cdc.gov/travel/default.aspx. For information about outbreaks of infectious diseases abroad consult the World Health Organization's (WHO) web site at http://www.who.int/en. Further health information for travelers is available at http://www.who.int/ith/en
MEDICAL INSURANCE: The Department of State strongly urges Americans to consult with their medical insurance company prior to traveling abroad to confirm whether their policy applies overseas and if it will cover emergency expenses such as a medical evacuation. Please see our information on medical insurance overseas.
TRAFFIC SAFETY AND ROAD CONDITIONS: While in a foreign country, U.S. citizens may encounter road conditions that differ significantly from those in the United States. The information below concerning Papua New Guinea is provided for general reference only, and may not be totally accurate in a particular location or circumstance.
Traffic in Papua New Guinea moves on the left. Travel on highways outside of major towns can be hazardous. Motor vehicle accidents are a common cause of serious injury in Papua New Guinea, especially when passengers are sitting in the open bed of a pickup truck. Drivers and passengers are advised to wear seatbelts. There is no countrywide road network. Roads are generally in poor repair, and flat tires occur routinely as a result of potholes and debris on the roadways. During the rainy season landslides can be a problem on some stretches of the Highlands Highway between Lae and Mount Hagen. Criminal roadblocks have occurred during the day and more widely after dark on the Highlands Highway. Visitors should consult with local authorities or the U.S. Embassy before traveling on the Highlands Highway.
Crowds can react emotionally and violently after road accidents. Crowds form quickly after an accident and may attack those whom they hold responsible, stoning and/or burning their vehicles. Friends and relatives of an injured party may demand immediate compensation from the party they hold responsible for injuries, regardless of legal responsibility. Persons involved in accidents usually should proceed directly to the nearest police station rather than stop at the scene of the accident.
Please refer to our Road Safety page for more information. Visit the website of Papua New Guinea’s national tourism office and national authority responsible for road safety. For specific information concerning Papua New Guinea driving permits, vehicle inspection, road tax and mandatory insurance, please contact Papua New Guinea’s Tourist Promotion Authority via the Internet at http://www.pngtourism.org.pg/.
AVIATION SAFETY OVERSIGHT: As there is no direct commercial air service to the United States by carriers registered in Papua New Guinea, the U.S. Federal Aviation Administration (FAA) has not assessed Papua New Guinea’s Civil Aviation Authority for compliance with International Civil Aviation Organization (ICAO) aviation safety standards. For more information, travelers may visit the FAA’s web site at http://www.faa.gov/safety/programs_initiatives/oversight/iasa.
SPECIAL CIRCUMSTANCES:
Customs: Papua New Guinean and Australian customs authorities enforce strict regulations concerning temporary importation into or export from Papua New Guinea and Australia of items such as firearms, certain prescription drugs, wooden artifacts, exotic animals, food, and sexually explicit material. Other products may be subject to quarantine. It is advisable to contact the Embassies of Papua New Guinea and Australia in Washington, D.C. for specific information regarding each country’s customs requirements. (See the contact information in the section on Entry/Exit Requirements above.)
Natural Disasters: Papua New Guinea is prone to earthquakes, volcanic eruptions, and sudden tidal movements. There are numerous active volcanoes throughout Papua New Guinea. General information about natural disaster preparedness is available via the Internet from the U.S. Federal Emergency Management Agency (FEMA) at http://www.fema.gov/.
Documentation: U.S. citizens are encouraged to carry a copy of their U.S. passports with them at all times, so that if questioned by local officials, proof of identity and U.S. citizenship is readily available.

Please see our Customs Information.
CRIMINAL PENALTIES: While in a foreign country, a U.S. citizen is subject to that country's laws and regulations, which sometimes differ significantly from those in the United States and may not afford the protections available to the individual under U.S. law. Penalties for breaking the law can be more severe than in the United States for similar offences. Persons violating Papua New Guinea‘s laws, even unknowingly, may be expelled, arrested, or imprisoned. Penalties for possession or use of, or trafficking in illegal drugs in Papua New Guinea are severe, and convicted offenders can expect long jail sentences and heavy fines. Engaging in sexual conduct with children or using or disseminating child pornography in a foreign country is a crime, prosecutable in the United States. Homosexual activity is illegal in Papua New Guinea. Please see our information on Criminal Penalties.
CHILDREN'S ISSUES: For information see our Office of Children’s Issues web pages on intercountry adoption and international parental child abduction.
REGISTRATION / EMBASSY AND CONSULATE LOCATIONS: Americans living or traveling in Papua New Guinea are encouraged to register with the nearest U.S. embassy or consulate through the State Department's travel registration web site, and to obtain updated information on travel and security within Papua New Guinea. The U.S. Embassy website is http://portmoresby.usembassy.gov. Americans without Internet access may register directly at the Consular Section of the U.S. Embassy in Port Moresby and obtain updated information on travel and security within Papua New Guinea. The U.S. Embassy is located on Douglas Street, adjacent to the Bank of Papua New Guinea, in Port Moresby, Papua New Guinea. That address should be used for courier deliveries. The mailing address is P.O. Box 1492, Port Moresby, NCD 121, Papua New Guinea. The Embassy's telephone number is (675) 321-1455; after hour’s duty officer telephone number is (675-601-9689); fax (675) 321-1593. Americans may submit consular inquiries by e-mail to ConsularPortMoresby@state.gov
****
This replaces the Country Specific Information for Papua New Guinea dated July 18, 2008 to update the section on Safety and Security.

Travel News Headlines WORLD NEWS

Date: Tue, 1 Oct 2019 06:39:06 +0200 (METDST)

Kokopo, Papua New Guinea, Oct 1, 2019 (AFP) - Papua New Guinea's volatile Ulawun volcano erupted early Tuesday, sending a column of red lava shooting up into the sky and forcing the evacuation of recently returned residents.   Mount Ulawun, situated on the remote Bismarck Archipelago chain, displaced between 7,000 and 13,000 people from their homes when it last erupted in June.   Seismic activity started at midday on Monday before the volcano erupted at about 4:30am Tuesday, according to Rabaul Volcano Observatory assistant director Ima Itikarai.   "It was noiseless and in the dark just before dawn; the eruption was visible (with) a distinct shard (of) red incandescent glow shooting up less than 100 metres from the base," he told AFP.

As light dawned, billowing clouds of grey ash could be seen rising several hundred metres into the sky, he said, while local Chris Lagisa said residents could hear the noise of gushing gas and flowing lava.   Ulamona Volcano Observatory staffer Herman Volele said ash falls could affect Kimbe, the nearby capital of West New Britain province, while regular earthquakes were also occurring in the vicinity of the volcano.   While most people affected by the previous eruption had remained at evacuation centres, an official with the West New Britain Disaster Office said a number who had returned to tend to their homes and gardens at the base of the volcano had to be evacuated again.   The volcano is one of the world's most hazardous, featuring on a list of 16 "Decade Volcanoes" targeted for research because they pose a significant risk of large, violent eruptions.
Date: Thu 1 Aug 2019 12:55 PM NZST
Source: Radio New Zealand (RNZ) [edited]

Papua New Guinea health officials have been dispatched to the Eastern Highlands after dozens of people reportedly died in a disease outbreak. The provincial governor, Peter Numu, told local media 35 people at the local hospital died from curable diseases. He said 11 died over the weekend [27-28 Jul 2019], although he didn't specify when the others died.

PNG's Health Minister, Elias Kapavore, said health department officials alongside the World Health Organisation will arrive in Goroka town today [1 Aug 2019].  "I think it is to do with the lack of infection control monitoring and prevention in the hospital that has led to this particular unfortunate scenario that has affected the lives of many of our people there." Mr Kapavore, who said he would fly to Goroka to look at the situation, noted that media reports linked the deaths to _Klebsiella_, a rare disease often caused by poor infection control.

But according to him, the National Emergency Operations Centre hadn't received a formal report by the hospital or Provincial Health Authority regarding a disease outbreak. However the minister said the situation warranted investigation.
======================
[_Klebsiella pneumoniae_ is an enteric Gram-negative bacillus that has been known to cause hospital-acquired infections and infections in debilitated or immunocompromised patients. However, a distinctive syndrome caused by _K. pneumoniae_ was first seen in Taiwanese patients in the 1980's (<https://www.ncbi.nlm.nih.gov/pubmed/7613255>). Cases have since been reported worldwide.

The syndrome is characterized by life-threatening community-acquired _K. pneumoniae_ infection in relatively healthy hosts that includes liver abscess and bacteremia complicated by the ability of the responsible _K. pneumoniae_ to spread hematogenously to the lungs, brain, meninges, eyes, prostate, bones, joints, and psoas (<https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2732457/>).

Approximately half of the reported patients had diabetes mellitus, with the remainder displaying no apparent underlying diseases. The _K. pneumoniae_ strains were susceptible to many antibiotics, but mortality rates were as high as 10% for liver abscess and 30-40% for those with metastatic meningitis.

Colonies of the strains causing this illness were noted to be unusually mucoviscous with a positive "string test," defined as the formation of a mucoviscous string of over 5 mm in length when using a bacteriology inoculation loop to touch and stretch a colony grown overnight on an blood agar plate at 35 C [95 F] (<https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4685062/>). The strains were called hypervirulent _K. pneumoniae_ or hvKP, and their capsular polysaccharide serotypes were found to be either K1 or K2. Whole genome sequencing indicated that the hypervirulent K1 isolates belonged to clonal complex 23 (CC23) that grouped into a distinct monophyletic clade, with global spread by multiple international transmissions (<https://www.ncbi.nlm.nih.gov/pubmed/26199326>). The hvKP carried siderophores, which confer the ability to more efficiently acquire iron in iron poor environments. A large virulence plasmid, which encodes the siderophores and a regulator of the mucoid phenotype, was detected in all hvKP clonal lineages (<https://www.ncbi.nlm.nih.gov/pubmed/26199326>). The latest development was the acquisition of the virulence plasmid by multidrug resistant hospital-associated ST11 _K. pneumoniae_.

_Klebsiella_ have been known to develop multiple antimicrobial drug resistance, commonly due to production of beta-lactamases that destroy the class of beta-lactam antibiotics known as carbapenems, as well as all other beta-lactam antibiotics. These carbapenemases are referred to as KPCs, that is, _K. pneumoniae_ carbapenemases. Some multidrug resistant strains have also been found to produce extended-spectrum beta-lactamases (ESBLs). The genes that encode KPCs and ESBLs are plasmid-mediated, which readily facilitates horizontal gene transfer between bacteria. The genes that encode these beta-lactamases are often linked to genes that encode resistance to multiple other classes of antibiotics. The principal reservoir for these organisms is the gastrointestinal tract, and spread occurs from there on the contaminated hands of healthcare workers and environment.

More information on this fatal outbreak would be appreciated from knowledgeable sources.

The eastern part of the island of New Guinea forms the mainland of Papua New Guinea, which has been an independent country since 1975. The outbreak is said to be occurring in the Eastern Highlands. Goroka, with a population of about 19 000 residents, is the capital of the Eastern Highlands Province (<https://en.wikipedia.org/wiki/Goroka>). A map showing the location of Goroka can be found at <https://goo.gl/maps/f1PxnS7c9vCogDtw8>. - ProMED Mod.ML]

[HealthMap/ProMED-mail map of Papua New Guinea:
Date: Thu, 27 Jun 2019 07:13:48 +0200

Kokopo, Papua New Guinea, June 27, 2019 (AFP) - An erupting volcano in Papua New Guinea that has blanketed a town in ash has forced around 5,000 people from their homes, officials said Thursday.   Mount Ulawun -- one of the world's most hazardous volcanoes -- began spewing lava and smoke high into the air on Wednesday.   Chris Lagisa, a community elder, said people had gathered at a church hall to flee on lorries, trucks and 4x4s, clutching sacks filled with belongings.   In the nearby provincial capital of Kimbe, grey ash that had been shot more than 13 kilometres (8 miles) into the air, turning day to night, began to fall on cars and homes.   People downwind from the volcano were advised to take precautions to avoid the ashfall, which can cause respiratory ailments, eye irritation and skin problems.   Images of the volcano early Thursday appeared to show the ash flow easing.   "Parts of (the) erupting column collapsed, sending block and ash flows down the flanks," said Rabaul Volcano Observatory chief geodetic surveyor Steve Saunders.   Initial reports from the provincial disaster committee indicate lava flows had cut through the main coastal road.

Ulawun, on the remote Bismarck Archipelago chain, is listed as one of 16 "Decade Volcanoes" targeted for research because they pose a significant risk of large, violent eruptions.   Saunders said they will be deploying staff today to Ulamona to assess the situation as the eruption continues.   "We are monitoring instrumentally from Rabaul Volcano Observatory and have access to satellite data," he said.   "However due to the continuing eruption (and) the potential for unexpected resurgence, it is recommended that the alert be raised to Stage 2," Saunders said.   National airline Air Niugini cancelled all flights into Hoskins Airport in Kimbe for an indefinite period, and the Darwin Volcanic Ash Advisory Centre issued a "red" warning to international airlines.   Thousands of people live in the shadow of Ulawun, despite its being one of the most active volcanoes in the country.
Date: Wed, 26 Jun 2019 10:37:11 +0200
By Elizabeth Vuvu

Kokopo, Papua New Guinea, June 26, 2019 (AFP) - Papua New Guinea's volatile Ulawun volcano -- designated one of the world's most hazardous -- erupted Wednesday, spewing lava high in the air and sending residents fleeing.   A pilot for Niugini Helicopters flying near the crater witnessed a column of lava spurting vertically into the equatorial sky, along with ash that has been belching since early morning.   Ulawun, on the remote Bismarck Archipelago chain, is listed as one of 16 "Decade Volcanoes" targeted for research because they pose a significant risk of large, violent eruptions.   Witnesses said lava had cut off the main highway in north of the island.   "The volcanic activity at Mt Ulawun began at 7:00 am this morning after slight rumbling and light emission," Leo Porikura, an official with the West New Britain Disaster Office, told AFP earlier.   "The Rabaul Volcano Observatory has declared a stage one alert warning of a possible eruption."

Witnesses had reported ash spewing out of the 2,334 metre (7,657 foot) summit, sending trails spanning high overhead.    "The sky has turned black," said Kingsly Quou, manager of the nearby Mavo Estates palm plantation.   Quou said that villagers living at the base of the volcano had already been evacuated and he and his colleagues were gathering their belongings.   Japanese satellite imagery and sources on the ground had shown sulphur dioxide and now volcanic ash drifting from the crater.   Australia's Bureau of Meteorology said the ash reached more than 13 kilometres (44,000 feet) into the air.   The bureau's Darwin Volcanic Ash Advisory Centre issued a "red" warning to airlines, indicating the eruption was imminent, although there is not believed to be an immediate threat for flight routes.   Thousands of people live in the shadow of Ulawun, despite it being one of the most active volcanoes in the country.

Porikura said people living in the vicinity of the volcano had been instructed to move away to safer areas and a disaster team had been dispatched.   "The disaster team will liaise with the local community, local businesses and local level government authorities to prepare for a possible eruption," he said.   "Three crucial priority areas being addressed include transport plan, care centre preparations and getting the communities in the high-risk areas to prepare for an evacuation," Porikura said.   The nearby Rabaul Volcano Observatory said emissions from the volcano were getting darker, indicating a higher ash content -- which can cause breathing problems, eye irritation and skin irritation because of the high acid content.   A team of experts had visited earlier this month and reported the volcano was "quiet" adding "there is no indication of any change in its state of unrest."   The ash emissions had been proceeded by an increase in seismic activity, Porikura said.
Date: Tue, 7 May 2019 01:11:25 +0200

Port Moresby, May 6, 2019 (AFP) - A powerful but deep 7.2-magnitude earthquake rocked Papua New Guinea on Tuesday, officials said, cutting power and knocking items off shelves though there were no immediate reports of serious damage.

The quake struck at a depth of 127 kilometres (80 miles) about 30 kilometres (20 miles) from the town of Bulolo at 2119 GMT Monday according to the US Geological Survey, and was felt in the capital Port Moresby about 250 kilometres away.   Officials said there were no immediate reports of major damage and the depth of the tremor meant there was no tsunami threat.   "We have no reports as yet" of serious damage, Inspector Leo Kaikas, Bulolo police station commander, told AFP. "We are still assessing the situation," he said.

Staff at Bulolo's Pine Lodge hotel said there was very minor damage from objects falling off tables, but nothing more serious.   Residents in Lae, more than 100 kilometres away, said the quake knocked things off shelves and worktops and cut electricity in some areas.   "I had just woken up," Christopher Lam, a designer who lives in the city, told AFP. "It lasted a little more than 30 seconds. We had household items knocked off their shelves and the power got cut.   "Things seem to have returned to normal. No structural damage here, though I'm not sure about other buildings in the city."   There are estimated to be around 110,000 people living within 50 kilometres of the epicentre, according to UN data.

The Moresby-based National Disaster Management office said while there were no early reports of damage, but news from the quake zone could take time to trickle in.  "We are awaiting assessments," a spokesman told AFP.   The country's rugged highlands region was hit by a 7.5-magnitude quake in February last year that buried homes and triggered landslides, killing at least 125 people.

The scale of that disaster did not become apparent for days due to PNG's poor communications and infrastructure.   There are regular earthquakes in Papua New Guinea, which sits on the so-called Pacific Ring of Fire -- a hotspot for seismic activity due to friction between tectonic plates.   Along the South Solomon trench, an area of the Pacific that includes PNG, there have been 13 quakes of magnitude 7.5 or more recorded since 1900, according to USGS data.
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Finland

Finland - US Consular Information Sheet
January 13, 2009
COUNTRY DESCRIPTION:
Finland is a highly developed democracy with a modern economy.
It is a member of the European Union.
Tourist facilities are widely available.
Read
the Department of State Background Notes on Finland for additional information.
ENTRY REQUIREMENTS:
Finland is a party to the Schengen agreement.
As such, U.S. citizens may enter Finland for up to 90 days for tourist or business purposes without a visa.
The passport should be valid for at least three months beyond the period of stay.
For further details about travel into and within Schengen countries, please see our Schengen fact sheet.

Travelers can contact the Embassy of Finland at 3301 Massachusetts Avenue, N.W., Washington, DC 20008, tel: (202) 298-5800, or the Finnish Consulates General in Los Angeles or New York.
Additional information is available via the Internet at http://www.finland.org.
The U.S. Embassy in Helsinki is not able to assist private U.S. citizens in obtaining any necessary visas for neighboring countries, including Russia and other countries of the former Soviet Union.

Information about dual nationality or the prevention of international child abduction can be found on our web site.
For further information about customs regulations, please read our Customs Information sheet.

SAFETY AND SECURITY:
Finland remains largely free of terrorist incidents.
However, like other countries in the Schengen area, Finland’s open borders with its Western European neighbors allow the possibility of terrorist groups entering/exiting the country with anonymity.
Elements of organized crime groups operating in the former Soviet Union and Eastern Europe are present in Finland, but these do not represent a specific danger to U.S. citizen residents or tourists.
Americans are reminded to remain vigilant with regard to their personal security and to exercise caution.
For the latest security information, Americans traveling abroad should regularly monitor the Department of State, Bureau of Consular Affairs’ web site at http://travel.state.gov, where the current Travel Warnings and Travel Alerts, as well as the Worldwide Caution, can be found.
Up to date information on safety and security can also be obtained by calling 1-888-407-4747 toll-free in the United States and Canada, or for callers outside the United States and Canada, a regular toll line at 1-202-501-4444.
These numbers are available from 8:00 a.m. to 8:00 p.m. Eastern Time, Monday through Friday (except U.S. federal holidays).

The Department of State urges American citizens to take responsibility for their own personal security while traveling overseas.
For general information about appropriate measures travelers can take to protect themselves in an overseas environment, see the Department of State’s A Safe Trip Abroad.

CRIME:
Although the crime rate in Finland is low compared to the U.S. and most European countries, it has increased in recent years; however, Finland remains a relatively safe environment.
Americans visiting Finland are seldom victims of crime, but visitors should not be complacent regarding personal safety or the protection of valuables.
The same precautions employed in the U.S. should be followed in Finland.
Finnish police services are excellent. Travelers should be aware that some police officers speak little English.
Due to the low crime rate, Finland has one of the lowest numbers of police officers of any European nation.
Outside of key sites in major urban centers, they rarely project a visible presence; consequently, response times to crisis situations may be unpredictable.
All forms of public transportation are considered safe.
Street crimes, such as muggings and pick-pocketing, remain uncommon, but do occur.

INFORMATION FOR VICTIMS OF CRIME:
The loss or theft abroad of a U.S. passport should be reported immediately to the local police and the nearest U.S. Embassy or Consulate.
If you are the victim of a crime while overseas, in addition to reporting to local police, please contact the nearest U.S. Embassy or Consulate for assistance.
The Embassy/Consulate staff can, for example, assist you to find appropriate medical care, to contact family members or friends and explain how funds could be transferred.
Although the investigation and prosecution of the crime is solely the responsibility of local authorities, consular officers can help you to understand the local criminal justice process and to find an attorney if needed.

Finland has a program to provide financial compensation to victims who suffer serious criminal injuries.
According to existing regulations, the victim must report the incident to the police and file an application for compensation within 10 years of the date of the crime.
Finnish police routinely inform victims of serious crime of their right to seek compensation.
The relevant forms and further information can be obtained from http://www.treasuryfinland.fi.
The local equivalent to the “911” emergency line in Finland is 112.
Please see our additional information for Victims of Crime, including possible victim compensation programs in the United States.

CRIMINAL PENALTIES:
While in a foreign country, a U.S. citizen is subject to that country’s laws and regulations, which sometimes differ significantly from those in the United States and may not afford the protections available to the individual under U.S. law.
Penalties for breaking the law can be more severe than in the United States for similar offenses.
Persons violating Finland’s laws, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in Finland are strict and convicted offenders can expect jail sentences and heavy fines.
Engaging in illicit sexual conduct with children or using or disseminating child pornography in a foreign country is a crime, prosecutable in the United States.
Please see our information on Criminal Penalties
SPECIAL CIRCUMSTANCES:
Commercial and financial transactions in Finland are increasingly automated and on-line.
Cash is almost always acceptable (the currency is the euro), but most major credit cards are widely recognized.
Automatic Teller Machines are very common and many U.S.-issued bankcards are compatible with them.

MEDICAL FACILITIES and Health information:
In Finland, medical facilities and their staff are generally excellent and are widely available for emergency services.
English is commonly spoken by Finnish medical personnel.
Helsinki is a frequent medical evacuation point for emergency cases from the countries of the former Soviet Union.
The public hospital system and many private hospitals honor foreign credit cards.
Most pharmacies (“apteekki” in Finnish) are open during normal shopping hours and major cities have at least one 24-hour service pharmacy.
If you are a tourist or temporary visitor to Finland and you require immediate emergency medical assistance, you may visit a local medical center or clinic, called “ensiapuasema” (first-aid station) in Finnish.
Usually these stations are located at hospitals and provide a full range of services.
The emergency telephone number, 112, can be used throughout Finland to contact emergency medical services.
For more detailed information on medicines and medical issues, please visit the website of the Finnish Embassy in Washington, DC at http://www.finland.org.
Travelers with special medical needs should consult with their personal physicians and take appropriate precautions, including bringing adequate supplies of necessary medication.
Medicines may be brought into the country as long as they are intended for the traveler’s personal use, however, there are special requirements concerning the quantity.
Medications categorized as narcotics may only be brought into the country to cover the traveler’s personal use for a maximum of 14 days and must be accompanied by a medical certificate stating why the traveler needs them.
For more detailed information, please contact the Finnish Embassy in Washington, DC at http://www.finland.org
In addition, stringent Finnish customs regulations prohibit travelers from receiving drugs from abroad after having arrived in the country.
Travelers may also find local physicians reluctant to prescribe equivalent quantities of dosages.

The U.S. Department of State is unaware of any HIV/AIDS entry restrictions for visitors to or foreign residents of Finland.
Information on vaccinations and other health precautions, such as safe food and water precautions and insect bite protection, may be obtained from the Centers for Disease Control and Prevention’s hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747) or via the CDC’s web site at http://wwwn.cdc.gov/travel/default.aspx.
For information about outbreaks of infectious diseases abroad consult the World Health Organization’s (WHO) web site at http://www.who.int/en.
Further health information for travelers is available at http://www.who.int/ith.
MEDICAL INSURANCE:
The Department of State strongly urges Americans to consult with their medical insurance company prior to traveling abroad to confirm whether their policy applies overseas and whether it will cover emergency expenses such as a medical evacuation.
Please see our information on medical insurance overseas.

TRAFFIC SAFETY AND ROAD CONDITIONS:
While in a foreign country, U.S. citizens may encounter road conditions that differ significantly from those in the United States.
The information below concerning Finland is provided for general reference only and may not be totally accurate in a particular location or circumstance.
Finnish roads are comparable to those in the U.S., though secondary roads may be less heavily traveled due to Finland’s sparse population outside the major urban areas.
These secondary routes often narrow to two lanes with a wider shoulder.
Slower vehicles are expected to move onto the shoulder to allow faster moving vehicles to pass.
Finland has an extensive network of highways throughout the country, as well as excellent public transportation services.
A valid U.S. driver’s license may be used while visiting Finland, but drivers must be at least 18 years of age.
Driving in Finland is on the right.
Traffic approaching from the right usually has priority, even if entering a primary roadway from a secondary one.
Road signs use standard international symbols and Finnish text.
Many urban streets have traffic lanes reserved for public transportation only.
Unless otherwise noted on traffic signs, the speed limit is 50 km/h in urban areas, 80 km/h on open roads, and 120 km/h on expressways during summer (reduced to 100 km/h during winter).
Vehicles must use headlights at all times.
Use of seatbelts is mandatory for drivers and all passengers.
Minor children must be seated in approved child or booster seats.

Public transport in Finland is of good quality and is the recommended method of travel.
Passenger trains, intercity buses, and air flights provide regular service over longer distances.
Public transportation in urban centers includes buses, subways, trams, suburban trains, and taxis.
Taxis are more expensive than in major U.S. cities.
Most local residents use public transport in Helsinki as parking can be hard to find and expensive.
The bus, train, and subway systems are relatively safe.
Travelers should be aware that drunk-driving laws are strict and acceptable blood alcohol levels are much lower in Finland than in the U.S.
Police strictly enforce all traffic laws and institute random roadside breath analyzer tests.
Drivers who register .05 or above alcohol content are subject to immediate arrest.
Drivers should be aware that regulations and traffic signs differ significantly from those in the U.S.
Visitors should be familiar with both prior to operating a vehicle in Finland.
Driving in Finland during the winter months can be hazardous.
Daylight hours are very short and one should be comfortable with driving in darkness.
Icy road conditions are common.
If driving in Finland, the vehicle must be winterized with studded snow tires and engine heaters are strongly recommended.
When driving at night, drivers must be alert to moose wandering onto major roadways.
There have been incidents of moose being struck by vehicles, causing severe damage to the vehicle and injury, sometimes fatal, to the occupants.
For real-time updates on road conditions throughout Finland, see the Finnish Road Administration’s travel and traffic information web site at http://www.finnra.fi
Please refer to our Road Safety page for more information.
Visit the website of the country’s national tourist office and national authority responsible for road safety at http://www.mek.fi
AVIATION SAFETY OVERSIGHT:
The U.S. Federal Aviation Administration (FAA) has assessed the Government of Finland’s Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for oversight of Finland’s air carrier operations.
For more information, travelers may visit the FAA’s web site at http://www.faa.gov/safety/programs_initiatives/oversight/iasa
Please see our information on customs regulations.

CHILDREN’S ISSUES:
For information, see our Office of Children’s Issues web pages on intercountry adoption and international parental child abduction.

REGISTRATION AND EMBASSY LOCATION:
Americans living or traveling in Finland are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department’s travel registration website, https://travelregistration.state.gov, so that they can obtain updated information on travel and security within Finland.
Americans without Internet access may register directly with the nearest U.S. Embassy or Consulate.
By registering, American citizens make it easier for the Embassy or Consulate to contact them in case of emergency.
The U.S. Embassy is located at Itainen Puistotie 14B.
The telephone number for the American Citizens Services unit is 358-9-616-25-701, 0830 to 1700 Monday to Friday (after hours, 358-9-616-25-0); the fax number is 358-9-616-25-800; e-mail:
HelsinkiACS@state.gov.
The address of the Embassy’s Internet home page is http://www.usembassy.fi
*

*

*
This replaces the Consular Information Sheet dated May 23, 2008 to update the sections on Information for Victims of Crime and Medical Facilities and Health Information.

Travel News Headlines WORLD NEWS

Date: Fri 14 Dec 2018
Source: UUTISET [edited]

An unvaccinated individual, who caught the contagious disease in Poland, attended a large church service in Tampere and infected at least 2 other people. Three adults have been diagnosed with measles in Tampere after attending a Catholic parish church event in late November along with more than 100 people, according to the Pirkanmaa Hospital District.

Two of the adults diagnosed have been vaccinated, so they are not contagious. The source of the outbreak is an unvaccinated person, who caught the measles in Poland. But according to the Pirkanmaa Hospital District, further cases may still arise.

In 1975 Finland began to administer a single dose of the measles vaccine to all one-year-olds and by 1982 Finland began administering the vaccine in 2 doses between the ages of 1 and 6. However some people born in the 1970s are among those who received only one jab. MMR is a triple-dose vaccine that provides protection against measles, mumps and rubella.

Measles spread at religious event
---------------------------------
The event in question was Tampere's Pyhan Ristin (Sacred Cross) Catholic Parish church mass on 25 Nov 2018. It was attended by more than 100 people, including children. Pirkanmaa Hospital District doctor Kirsi Valve, a specialist in infectious diseases, confirmed that the infected individual who caught the measles in Poland was at the church event. The cases came to light when 2 vaccinated individuals contracted high fevers and came down with skin rashes. The unvaccinated person, who infected the others, has had more severe symptoms than the vaccinated individuals.

"The individuals quickly got in touch with healthcare services owing to high fevers, and skin rashes that rapidly spread all over their bodies," says Valve. "It was confirmed that on 25 Nov 2018 the unvaccinated individual who caught the measles in Poland and brought it back to Finland was at the parish event and is the source of the outbreak."

As the source of the outbreak is known, healthcare officials are also looking into whether the person could have possibly exposed others.

Measles in the news
-------------------
Measles has been on the agenda this winter after an unvaccinated child in Ostrobothnia took ill with measles. Meanwhile, it also came to light that many adults in Finland may not have been vaccinated against measles during the early 1970s.

Measles is a rare disease. The previous outbreak was 2 summers ago when 4 vaccinated children caught measles in Italy and started showing symptoms after returning to Finland. The Pirkanmaa Hospital District recommends that anyone who attended the Catholic parish event in late November 2018 and exhibits symptoms that suggest measles or anyone who hasn't been vaccinated with the MMR vaccine contact their healthcare centre.

If those who attended the parish event are healthy, but have not been vaccinated, the Pirkanmaa Hospital District recommends that they contact their healthcare centre to be vaccinated. The measles vaccine is free and administered as part of the MMR shot, which also provides protection against rubella and the mumps.
Date: Fri 2 Nov 2018
Source: UUTISET [edited]

Around 1/3 of the ticks in Finland -- mostly found in the south -- carry at least one pathogen, and 2 percent of the persistent arachnids carry several disease-causing agents, researchers at Turku University said.

About 30 percent of common ticks and 24 percent of taiga tick populations have been found to carry one disease pathogen. Common ticks more commonly carry several disease-causing pathogens than taiga ticks, according to the researchers.

The most common pathogen found in the ticks was _Borrelia burgdorferi_, the bacterial species that causes Lyme disease in humans, an illness referred to locally as borreliosis. The pathogen was found in 17 percent of the ticks at the university's growing tick database bank.

Lyme disease cases are treated with aggressive antibiotics without necessarily determining which specific bacterium is responsible for the infection.

Thanks to a growing tick database at the University of Turku, researchers have new insights into the disease pathogens that the tiny, blood-sucking arachnids carry.

New research has revealed that ticks on the south coast carry the most pathogens, but the region is almost exclusively home to the most common ticks: _Ixodes ricinus_, or castor bean ticks).

Both castor bean ticks and taiga ticks [_Ixodes persulcatus_] are now commonly found in areas across central Finland, the researchers said. Even further north, the tick populations are quite similar to ones in central areas, but the taiga has become more common in the north.

About 3 years ago, researchers at the university asked members of the public to send in ticks they had found, and now the institution has received more than 20 000 ticks. The researchers say that they want to take advantage of the significant amount of information they can learn from the specimens.

Examination of those thousands of tiny arachnids have uncovered many types of disease-causing bacteria, and researchers have new insights into the arachnids themselves and the potential illnesses they carry.

The researchers said they hope to learn more about ticks, saying that their research has only begun, and that their study of the ticks will continue for several years. Ultimately, their goal is to find how tick-borne illnesses are transmitted, they said.
======================
[This is an interesting example of how a large group of people, many undoubtedly non-scientists, can contribute to an effort that requires many hours of collection effort. Although _Borrelia burgdorferi_ is endemic in Finland, finding it and possibly other bacterial pathogens in about 1/3 of the 20 000 ticks collected is of public health significance. _Ixodes ricinus_ is also the tick vector of European tick-borne encephalitis virus, but no mention is made of it in the above report. Perhaps it was not tested for. Images of both ticks can be found in the above report. - ProMED Mod.TY]

[HealthMap/ProMED-mail map:
Date: Thu, 1 Nov 2018 16:46:12 +0100
From: topic@afp.com

Helsinki, Nov 1, 2018 (AFP) - Santa Claus has already begun his preparations in Lapland -- by protecting himself from winter viruses and making sure he hires enough elves.   On Thursday nurse Tiia Kahkonen administered an anti-influenza vaccine to Santa, at his village in the Arctic Circle town of Rovaniemi, northern Finland. 

The jab is likely to be a sensible precaution, as the flu season coincides with the busiest time of the year by far in Lapland.    In December last year 390,000 foreign visitors spent a night in Finnish Lapland, an increase of almost ten percent on the previous Christmas.    By far the largest group of Christmas holidaymakers were Brits, followed by Russian, French and German tourists, according to official statistics.

Meanwhile a recruitment agency in Finnish Lapland, inside the Arctic circle, has put out a call for Christmas elves to look after the hordes of tourists who come to visit Santa in his natural habitat during the winter months.   Prior experience is not essential as the advert, posted by the firm Lapland Staff, promises that training will be provided in "the required elfing and communication skills."   Successful applicants will also be given tips on how to deal with the cold in northern Finland where temeratures rarely rise above zero degrees Celsius, and can drop as low as minus 40.

Although handling Santa's reindeer is not listed among the job's duties, elves will need to herd groups of visitors on and off buses, as well as keep tourists entertained. "Looking after the fireplace and pouring hot juice" are also required, as is supervising the toboggan hill.   Tourism to Lapland has reached an all-time high in recent years, with visitors spending 3.5 million nights in Lapland across the whole year, up from 2.6 million a decade earlier, according to Statistics Finland.    Much of the recent growth has been driven by tourism from Asia.
Date: Sun, 17 Dec 2017 04:43:36 +0100
By Camille BAS-WOHLERT

Rovaniemi, Finland, Dec 17, 2017 (AFP) - In the run up to Christmas tourists from around the world flock to the Santa Claus Village, an amusement park in Finnish Lapland, where temperatures can hit nearly -15 degrees Celsius (5 Fahrenheit).    They buy soft toys and souvenirs from pricey gift shops while a bearded Santa receives hundreds of admirers a day throughout December before embarking on his world tour from the valleys of Finland to the skyscrapers of New York and beyond to deliver gifts.

Holding their winter beanie hats in their hands, visitors wait patiently in line for a brief encounter with "Joulupukki" -- the Finnish word for Santa Claus -- and a photo opportunity in exchange for hard currency.    "We've seen other Santas but that wasn't the real one. But we're told that is the real one," said Mary Gleadall, an eight-year-old tourist from Southampton in the UK, visiting the amusement park with her parents, brother and sister.    According to Christmas lore, Santa lives in a secret place in the middle of the snowy pines of the North Pole. But the question is where?     Since 2010, Rovaniemi, the capital of Finnish Lapland, has marketed itself as Santa's "official home".    Situated a few miles from the city, the Santa Claus Village is located in front of a huge gas station. 

Tourists rush to cross the Arctic Circle, marked by a white line, to meet Santa Claus in his wooden home with a pointed roof.    But entering his private cottage is out of the question as Mother Claus is reportedly protective of their privacy.    In a large room, the white-bearded old man sits in an armchair next to a chest full of letters.    Each year, he receives more than 300,000 visitors, a deluge he embraces with humility.    "I'm very happy. I'm not exhausted but, of course, I get tired once in a while" he says.    And how does Santa Claus regain his energy?    "I love to take nap every once and then. Fifteen minutes sleeping and then all is very good." he says.

- Exalted tourists -
Shizuka Kawahara and Saki Itoi, Japanese tourists in their thirties, flew for more than 24 hours to hug Santa for a few seconds in a precious moment immortalised with a photograph taken by an elf.    The price for one shot starts at 30 euros ($35). Photographing with one's own camera is forbidden as it would ruin the magic of the moment, says the staff of the house.     Four-year-old Harry Gleadall, Mary's brother, approaches Santa without fear.    He quickly states his list of what he wants for Christmas: Transformers and some more Transformers before he skeptically shakes Santa's hand.    "But what if it wasn't the real Santa Claus?" Harry asks with concern.    Eager to set the record straight -- and justify the long trip -- his mother quickly assures him that the chubby red-clothed man is indeed the real deal.    After a tour around the shop which sells hand-made "Lapland" emblems and tons of souvenirs, the family is back in the village square, surrounded by wooden homes, Christmas carols piped out of nearby speakers.

- Polar safari -
In this winter wonderland, tourists have the opportunity to go on a reindeer sleigh ride.    A snow "safari" of 400 metres costs 14 euros per child and 18 euros per adult, an exotic experience for many foreigners who seek to discover the arctic landscapes steeped in pink light.    The -13 degrees Celsius does not discourage the plucky visitors bundled up in their ski suits.    "Everything that have been told to me during childhood, it's come true," said Perpetua, a tourist from Dubai, describing the break from the year round desert climate as "heaven".   "We expected magic and this is what we found," added Max, an Italian tourist. "Everything seems to be magic, the lights, the place, everything here".   But Miriana, a 24-year-old Italian on a university exchange programme in southern Finland, was less convinced.   "The place is really nice. But I think nevertheless that it's a bit commercial," she said.
Date: Tue 18 Oct 2016
From: Tiina Nokireki <tiina.nokireki@evira.fi> [edited]

The Finnish Food Safety Authority (Evira) received a bat (Daubenton's bat, _Myotis daubentonii_) for laboratory analyses. The bat was found by a private person. The bat had neurological signs and then died.

Laboratory analyses conducted during the 13 and 14 Oct 2016, confirmed the presence of rabies by FAT. The virus was then identified as European Bat Lyssavirus type 2 (EBLV-2) by RT-PCR and partial sequencing of the gene for the nucleoprotein. Also cell culture is positive.

The bat originated from Inkoo in the province of Southern Finland and is part of the Uusimaa region. This is the 2nd case of EBLV-2 in a bat in Finland.
-----------------------------------------
Tiina Nokireki
Head of Section, DVM, Specialist in Veterinary Medicine, Infectious
Diseases
Finnish Food Safety Authority Evira
Research Department, Veterinary Virology
Mustialankatu 3,
FI-00790 Helsinki,
Finland
=========================
[Special thanks to Dr. Nokireki for this important contribution. Infections by European Bat Lyssavirus type 2 (EBLV-2) have been previously reported in Northern Europe, not only in bats, but also in humans. EBLV-1 appears to be more prevalent, accounting for the vast majority of all EBLV-infected bats. Reports of EBLV-2 correspond to Daubenton's bats (_Myotis daubentonii_), indicating that this bat species is the reservoir of this _Lyssavirus_ strain.

For a picture of a Daubenton's bat go to

[A HealthMap/ProMED-mail map can be accessed at:
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Rwanda

Rwanda US Consular Information Sheet
May 19, 2008
COUNTRY DESCRIPTION:
Rwanda is a landlocked developing country in central Africa which has made considerable progress in rebuilding its infrastructure and establishing security since the 19
4 civil war and genocide in which at least 800,000 people were killed. Economic activity and tourism are on the rise in Rwanda. Hotels and guesthouses are adequate in Kigali, the capital, and in major towns, but are limited in remote areas. Read the Department of State Background Notes on Rwanda for additional information.

ENTRY/EXIT REQUIREMENTS: A passport and evidence of yellow fever immunization are required. Visas are not required for American citizens entering Rwanda for less than 90 days. U.S. citizens planning on working in Rwanda should apply for a work permit at the Directorate of Immigration as soon as possible after arrival in Rwanda. Detailed entry information may be obtained from Rwanda’s Directorate of Immigration at: http://www.migration.gov.rw/ or from the Embassy of the Republic of Rwanda, 1714 New Hampshire Avenue NW, Washington DC 20009, telephone 202-232-2882, fax 202-232-4544, web site http://www.rwandaembassy.org. Overseas, inquiries may be made at the nearest Rwandan Embassy or Consulate.
Information about dual nationality or the prevention of international child abduction can be found on our web site. For further information about customs regulations, please read our Customs Information sheet.

SAFETY AND SECURITY:
There are currently no travel restrictions in place within Rwanda, but travelers should use caution when traveling near or crossing the border into Burundi, eastern Democratic Republic of the Congo (DRC), and Uganda.

In March 2005, the Congo-based Democratic Forces for the Liberation of Rwanda (FDLR), comprising ex-Rwandese Armed Forces, Interahamwe, and other extremists, announced it would end its armed struggle against the Government of Rwanda, but thousands of combatants are estimated to remain in eastern Congo. The combatants currently are not well-organized or funded, nor do they pose a serious threat to Rwandan security. However, in early March 2007, in Gisenyi Province (near the Volcanoes National Park in northwestern Rwanda) they launched a mortar round and rocket into Rwandan territory. There were no casualties, and it appears to have been an isolated incident. While visitors may travel freely to Volcanoes National Park, they are not permitted to visit the park without permission from Rwanda's Office of Tourism and National Parks (ORTPN). ORTPN stipulates that the park can only be used for gorilla tours and nature walks. Since December 2006, all restrictions have been lifted in the Nyungwe Forest near the Burundian border in southwestern Rwanda. In the past, the FDLR infiltrated Rwanda from Burundi through the Nyungwe Forest, but the last reported incident in the park was in November 2003. However, FDLR rebel factions are known to operate in northeastern DRC, Burundi, Tanzania, and Uganda, including near the popular tourist area of Bwindi Impenetrable Forest National Park. For information on travel to those and other countries, and for the latest security information, American citizens traveling abroad should regularly monitor the Department of State, Bureau of Consular Affairs web site at http://travel.state.gov, where the current Travel Warnings and Travel Alerts, as well as the Worldwide Caution, can be found.
From time to time, travel by U.S. Embassy personnel may be restricted based on changing security conditions. Visitors are encouraged to contact the appropriate U.S. Embassy Regional Security Office or Consular Section for the latest security information, including developments in eastern Congo, Uganda and Burundi. (See Registration/Embassy Location section below.)

Up-to-date information on safety and security can also be obtained by calling 1-888-407-4747 toll free in the U.S. and Canada, or for callers outside the U.S. and Canada, a regular toll-line at 1-202-501-4444. These numbers are available from 8:00 a.m. to 8:00 p.m. Eastern Time, Monday through Friday (except U.S. federal holidays).

The Department of State urges American citizens to take responsibility for their own personal security while traveling overseas. For general information about appropriate measures travelers can take to protect themselves in an overseas environment, see the Department of State’s pamphlet A Safe Trip Abroad.

CRIME: Pick-pocketing in crowded public places is common, as is petty theft from cars and hotel rooms. Although violent crimes such as carjacking, robbery, and home invasion occur in Kigali, they are rarely committed against foreigners. Americans are advised to remain alert, exercise caution, and follow appropriate personal security measures. Although many parts of Kigali are safe at night, walking alone after dark is not recommended since foreigners, including Americans, have occasionally been the targets of robbery.

INFORMATION FOR VICTIMS OF CRIME: The loss or theft abroad of a U.S. passport should be reported immediately to the local police and the nearest U.S. Embassy or Consulate. If you are the victim of a crime while overseas, in addition to reporting to local police, please contact the nearest U.S. Embassy or Consulate for assistance. The Embassy/Consulate staff can, for example, assist you to find appropriate medical care, contact family members or friends and explain how funds could be transferred. Although the investigation and prosecution of the crime is solely the responsibility of local authorities, consular officers can help you to understand the local criminal justice process and to find an attorney if needed.

See our information on Victims of Crime. The U.S. Embassy provides some information on its web site about criminal justice in Rwanda at http://rwanda.usembassy.gov/criminal_justice_in_rwanda.html.

MEDICAL FACILITIES AND HEALTH INFORMATION: Medical and dental facilities are limited, and some medicines are in short supply or unavailable. Travelers should bring their own supplies of prescription drugs and preventive medicines. In Kigali, Americans may go to King Faisal Hospital, a private facility that offers limited services and dental facilities. There is also a missionary dental clinic and a few private dentists. American-operated charitable hospitals with some surgical facilities can be found in Kibagora, in southwestern Rwanda, in Ruhengeri, near the gorilla trekking area, and in Rwinkavu, near the entrance to Akagera National Park. The U.S. Embassy maintains on its website a current list of healthcare providers and facilities in Rwanda at http://rwanda.usembassy.gov/medical_information.html; this list is also included in the Consular Section’s welcome packets for American citizens. There are periodic outbreaks of meningitis in Rwanda. Yellow fever can cause serious medical problems, but the vaccine, required for entry, is very effective in preventing the disease. Malaria is endemic to Rwanda. All visitors are strongly encouraged to take prophylactic medications to prevent malaria. These should be initiated prior to entry into the endemic area. Because of possible counterfeit of antimalarial medications, these should be obtained from a reliable pharmaceutical source. Multiple outbreaks of ebola have been reported in neighboring Democratic Republic of Congo and Uganda in the past year, but none within Rwanda.
Information on vaccinations and other health precautions, such as safe food and water precautions and insect bite protection, may be obtained from the Centers for Disease Control and Prevention’s hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747) or via the CDC’s website at http://wwwn.cdc.gov/travel/default.aspx. For information about outbreaks of infectious diseases abroad consult the World Health Organization’s (WHO) web site at http://www.who.int/en. Further health information for travelers is available at http://www.who.int/ith/en.

MEDICAL INSURANCE: The Department of State strongly urges Americans to consult with their medical insurance company prior to traveling abroad to confirm whether their policy applies overseas and whether it will cover emergency expenses such as a medical evacuation. Please see our information on medical insurance overseas.
TRAFFIC SAFETY AND ROAD CONDITIONS: While in a foreign country, U.S. citizens may encounter road conditions that differ significantly from those in the United States. The information below concerning Rwanda is provided for general reference only, and may not be totally accurate in a particular location or circumstance.
Due to safety concerns, the use of motorbikes or van taxis for transportation is not recommended. Regulated orange-striped (along the base of the vehicle) sedan auto taxis are safer, but be sure to agree on a fare before beginning the trip. Public transportation can be dangerous due to overloading, inadequate maintenance, and careless drivers.
While the main roads in Rwanda are in relatively good condition, during the rainy season many side roads are passable only with four-wheel drive vehicles. Nighttime driving, particularly outside major cities, is hazardous and is discouraged. Often, roadways are not marked and lack streetlights and shoulders. Many sections have deteriorated surfaces. Due to possible language barriers and lack of roadside assistance, receiving help may be difficult. Travelers may be stopped at police roadblocks throughout the country, where their vehicles and luggage may be searched. Service stations are available along main roads.
In Rwanda, as in the U.S., traffic moves on the right-hand side of the road. Cars already in a traffic circle have the right of way. Until 2004, cars entering traffic circles had the right-of-way. Drivers should exercise caution at traffic circles, since some drivers might forget this change. Excessive speed, careless driving, and the lack of basic safety equipment on many vehicles are hazards on Rwanda's roads. Many vehicles are not well maintained, and headlights are either extremely dim or not used. Drivers also tend to speed and pass other cars with little discretion. Some streets in Kigali have sidewalks or sufficient space for pedestrian traffic; others do not, and pedestrians are forced to walk along the roadway. With the limited street lighting, drivers often have difficulty seeing pedestrians. Drivers frequently have unexpected encounters with cyclists, pedestrians and livestock.
Third-party insurance is required and will cover any damages from involvement in an accident resulting in injuries, if one is found not to have been at fault. The driver’s license of individuals determined to have caused an accident may be confiscated for three months. Causing a fatal accident could result in three to six months' imprisonment. Drunk drivers are jailed for 24 hours and fined Rwandan Francs 20,000 (approximately $35). In the city of Kigali, contact the following numbers for police assistance in the event of an accident: Kigali Center, 08311112; Nyamirambo, 08311113; Kacyiru, 08311114; Kicukiro, 08311115; Remera, 08311116. Ambulance assistance is very limited. Wear seat belts and drive with care and patience at all times. In case of an emergency, American citizens can contact the Embassy duty officer at 0830-0345.
For specific information concerning Rwandan driving permits, vehicle inspection, road tax, and mandatory insurance, please contact the Rwandan Office of Tourism and National Parks, B.P. 905, Kigali, Rwanda, telephone 250-76514, fax 250-76512.
Please refer to our Road Safety page for more information. Visit the web site of the country’s national tourist office and national authority responsible for road safety at http://www.gov.rw/.
AVIATION SAFETY OVERSIGHT: As there is no direct commercial air service to the United States by carriers registered in Rwanda, the U.S. Federal Aviation Administration (FAA) has not assessed Rwanda’s Civil Aviation Authority for compliance with International Civil Aviation Organization (ICAO) aviation safety standards. For more information, travelers may visit the FAA’s web site at http://www.faa.gov/safety/programs_initiatives/oversight/iasa.

In recent months, Rwandair, which charters aircraft to fly its routes, has had difficulties maintaining its schedule, resulting in delayed and cancelled flights which have left passengers stranded for extended periods.

SPECIAL CIRCUMSTANCES:
Telephone communication to and from Rwanda is generally reliable. Cellular telephones and Internet connections are available in Kigali and large towns.
Non-biodegradable plastic bags have been banned in Rwanda, and travelers carrying them upon arrival at the Kayibanda International airport may have them confiscated and have to pay approximately $4 for a reusable cloth replacement.
International ATMs are not available in Rwanda. The Rwandan franc is freely exchangeable for hard currencies in banks and the Bureaux de Change. Several Kigali banks can handle wire transfers from U.S. banks, including Western Union. Credit cards are accepted at only a few hotels in Kigali and only to settle hotel bills. Hotels currently accepting credit cards for payment include the Kigali Serena (formerly Intercontinental) Hotel, the Hotel des Mille Collines, the Novotel Umubano, Stipp Hotel and the Kivu Sun Hotel. Note that there may be an added fee for using a credit card. Travelers should expect to handle most expenses, including air tickets, in cash.

Traveler's checks can be cashed only at commercial banks. Because some travelers have had difficulty using U.S. currency printed before the year 2000, the Embassy recommends traveling with newer U.S. currency notes.
Please see our Customs Information.
CRIMINAL PENALTIES: While in a foreign country, a U.S. citizen is subject to that country's laws and regulations, which sometimes differ significantly from those in the United States and may not afford the protections available to the individual under U.S. law. Penalties for breaking the law can be more severe than in the United States for similar offenses. Persons violating Rwandan laws, even unknowingly, may be expelled, arrested or imprisoned. Penalties for possession, use, or trafficking in illegal drugs in Rwanda are severe, and convicted offenders can expect long jail sentences and heavy fines. Engaging in sexual conduct with children or using or disseminating child pornography in a foreign country is a crime, prosecutable in the United States. Please see our information on Criminal Penalties.
The U.S. Embassy provides some information on its website about criminal justice in Rwanda.

CHILDREN'S ISSUES: For information see our Office of Children’s Issues web pages on intercountry adoption and international parental child abduction. Both foreigners and Rwandans taking Rwandan children to live outside Rwanda, e.g., after adoption, must obtain an exit permission letter from the Ministry of Family and Gender located within the Primature complex at P.O. Box 969, Kigali, Rwanda; Tel: 011-250-587-128; Fax: 011-250-587-127.

REGISTRATION / EMBASSY LOCATION:
Americans living or traveling in Rwanda are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department’s travel registration website so that they can obtain updated information on travel and security within Rwanda. Americans without Internet access may register directly with the nearest U.S. Embassy or Consulate. By registering, American citizens make it easier for the Embassy or Consulate to contact them in case of emergency. The U.S. Embassy is located at 2657 Avenue de la Gendarmerie; the mailing address is B.P. 28, Kigali, Rwanda; tel. (250) 596-400,; fax: (250) 596-591. The Consular Section’s email address is consularkigali@state.gov. The Embassy's web site is http://rwanda.usembassy.gov/. American Citizen Services hours are Tuesdays from 9:00 -17:00 and Fridays from 9:00 - 12:00 except on U.S. and Rwandan holidays.
* * *
This replaces the Country Specific Information for Rwanda dated October 4, 2007, to update sections on Country Description, Entry/Exit Requirements, Safety and Security, Information for Victims of Crime, Medical Facilities and Health Information, Traffic Safety and Road Conditions, Aviation Safety Oversight, Criminal Penalties, Children’s Issues, and Registration/Embassy Location.

Travel News Headlines WORLD NEWS

Date: Sun, 8 Dec 2019 17:30:45 +0100 (MET)

Kigali, Dec 8, 2019 (AFP) - Rwanda on Sunday started a voluntary Ebola vaccination programme at its border with the Democratic Republic of Congo in a bid to prevent the spread of the deadly virus from its neighbour.   All countries in high-risk areas, even if not hit by Ebola, had been advised by the WHO to use a new vaccine developed by US group Johnson & Johnson, the country's health minister, Diane Gashumba, told journalists.   The idea was "to protect those with high chances of getting in contact with people living in areas where Ebola has been reported to be active", she said.

The vaccine, Ad26-ZEBOV-GP, is an experimental drug produced by US pharmaceuticals giant, Johnson & Johnson. It was used for the first time in mid-November in Goma in DR Congo, on the other side of the border.    So far, there have no confirmed cases of Ebola in Rwanda.   The epicentre of the outbreak in DR Congo, which has killed more than 2,200 people since August 2018, is located 350 kilometres (217 miles) north of Goma, in the Beni-Butembo region.   That region sits on the DR Congo border with Uganda.   More than 250,000 people in DR Congo have already been vaccinated using another product, rVSV-ZEBOV, made by US drug company, Merck Shape and Dohme.

- Ebola in Goma -
People working in the health sector, at border crossings, police officers, and business executives who frequently travel between the two countries are being given priority in the vaccination campaign.   But all residents in the border districts can ask to be vaccinated if they wish.    The first volunteers expressed relief at the measure.    "We lived in a life of worry because of what was going on in DR Congo," Joel Ntwari Murihe, one of the first Rwandans to be vaccinated, told AFP.   "It caused a lot of border disruptions as we were restricted to buying or selling with DR Congo residents who live in Goma.    "The vaccine is an assurance to the safety for our lives and our children's lives."

The head of DR Congo's anti-Ebola efforts, Jean-Jacques Muyembe, and the WHO's representative in Rwanda, Kasonde Mwinga, were present at the campaign launch.    In August, Rwanda briefly closed its border with DR Congo and ordered its citizens not to visit the country when the first Ebola cases were recorded in Goma.   The city, which is the regional capital of the Congolese province of North Kivu, sits on the border with Rwanda.    The border has since been reopened, but strict medical checks are being enforced.
Date: Tue 6 Aug 2018
Source: New Times (Kigali, Rwanda) [summ., edited]
<https://www.newtimes.co.rw/news/livestock-vaccinations>

Livestock farmers have appealed to the government to ensure that cows get timely vaccination in order to effectively control deadly epidemics in cattle. The appeal comes after an outbreak of Rift Valley Fever [RVF] -- a deadly and infectious viral disease -- killed 154 cows countrywide since May [2018], according to figures from Rwanda Agricultural Board (RAB). Gahiga Gashumba, the chairman of Rwanda National Dairy Farmers' Federation, told The New Times that in their performance contracts, districts set themselves targets to inoculate cows, which leaves a gap in achieving effective vaccination.

Efforts to contain the recent outbreak of RVF included vaccinating 257 902 cows countrywide of which 119 520 were from Ngoma, Kirehe, and Kayonza -- the hardest hit by the disease. "All cows should be vaccinated at least in areas prone to given diseases," Gashumba said adding, "We need a clear vaccination calendar detailing the cows that should be immunised in a given period of time. When there are heavy rains, we should be prepared of [immunising cows against] East Coast fever."

Also known as theileriosis, East Coast fever is a deadly tickborne disease in cattle. Ngoma district vice mayor for Finance and Economic Development, Jean Marie Vianney Rwiririza, said that this year [2018], they want many cows to get vaccines against different diseases, including RVF and foot and mouth disease [FMD]. "With using funds from the district's budget alone, we cannot manage to give vaccines to all cows.

We request farmers' cooperatives and the farmers themselves to partake in the activity so that all the cows can be inoculated," he told The New Times. In Kirehe district, there are over 52 000 cows and over 30 000 of them were vaccinated against different diseases, including Rift Valley fever in the 2017/2018 financial year, according to Jean Damascane Nsengiyumva, Kirehe district vice mayor for Finance and Economic Development. "We have increased funding for the vaccination activity so that we inject all cows which we should vaccinate because we do not want the recurrence of such a problem," he said referring to RVF.

Rwanda Agriculture Board (RAB) said that they do not vaccinate all the cows because it can be wastage of resources or poor management when vaccination is done in areas where a disease has not been reported while it can be contained by vaccinating livestock in the risk zone. Instead of spending money on vaccinating all cows, currently estimated at over a million countrywide, appropriate strategies are devised to control the spread of outbreaks, said RAB director general Dr Patrick Karangwa. "We give more attention to diseases that spread faster than others. We do impact assessment based on spread pattern of a disease.

If a disease can be transmitted through air, measures taken to prevent its spreading should be different from the disease that cows or people catch through contact," Karangwa said. He cited FMD which often affects cattle on areas bordering Tanzania, such as Gatsibo, Kayonza, and Nyagatare, observing that when the disease has been checked in those areas, it dose spread elsewhere, pointing out that if all cows in the country are vaccinated, all the funds used [for the development of the livestock] sector might be consumed by such a single activity. Some vaccines are given free of charge, while others have to be paid for by farmers with government subsidy. [byline: Emmanuel Ntirenganya]
=======================
[RVF has become, according to local media, active in Rwanda in April 2018, as reported from the districts of Ngoma, Kirehe, and Kayonza, in the south west of the Eastern province. It was expressed mainly by cattle death and abortions. Later, Kamonyi, a southern province was added. The Rwandan Ministry of Agriculture and Animal Resources announced on [Mon 30 Jul 2018] the lifting of the ban imposed since mid-June [2018] on the movement of cattle in several parts of Eastern province. According to the ministry, 99 of the 147 604 cows in the affected districts died, and 452 aborted. This differs from other statistics from various sources, including the 154 deaths in cattle, as mentioned in the above media report, quoting the Rwanda Agricultural Board.

Official statistics are expected to be included in Rwanda's RVF report to the OIE, which all member countries are obliged to submit. In the absence of data on the number of susceptible animals on the affected holdings, the mortality rate in cattle is not known. Based on accumulated field observations and experimental RVF infection trials, the mortality in adult cattle would, generally, not exceed 10 per cent. No human cases have been reported in Rwanda during the recent event. Vaccination of livestock against RVF can be applied either with a live attenuated (Smithburn) vaccine (relatively cheap, several years immunity rendered, but may cause foetal abnormalities or abortion in pregnant animals).

Alternatively, particularly in pregnant animals, an inactivated (formalin-killed) RVF vaccine can be selected (more costly, safer in all breeds/ages/reproductive stages of cattle, sheep, and goats, but requires a booster 3-6 months after the initial vaccination, then followed by yearly boosters). For the considerations related to vaccine policies, vaccines to be selected, and other tools for the prevention and control of RVF under various epidemiological situations, please refer to references 1-3.

References
------------------------------
1. Consultative Group for RVF Decision Support. Decision-support tool for prevention and control of Rift Valley fever epizootics in the Greater Horn of Africa. Am J Trop Med Hyg. 2010. 83(2 Suppl): 75-85. DOI: 10.4269/ajtmh.2010.83s2a03; <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2913494/>.

2. Anonymous. Risk-based decision-support framework for prevention and control of Rift Valley fever epidemics in eastern Africa. EU Collaborative Project, Seventh Framework Programme. 2015. (Grant Agreement no. 266327); <http://www.healthyfutures.eu/images/healthy/deliverables/d5.4%20risk-based%20decision-support%20framework.pdf>.

3. Mariner J. Rift Valley fever surveillance. FAO animal production and health manual no. 21. Rome: FAO. 80 pages; <http://www.fao.org/3/i8475en/I8475EN.pdf>. - ProMED Mod.AS]

[Maps of Rwanda: <http://www.geographicguide.com/pictures/map-rwanda.jpg>
and <http://healthmap.org/promed/p/173>.]
Date: Mon 30 Jul 2018
Source: Journalducameroun.com, APA News report [summ., edited]
<https://www.journalducameroun.com/en/rift-valley-fever-rwanda-lifts-quarantine-on-cattle-movement/>

The Rwandan Ministry of Agriculture and Animal Resources, on [Mon 30 Jul 2018] announced it was lifting the quarantine on the movement of cattle that was imposed to control the deadly Rift Valley fever [RVF] in several parts of Eastern province. A quarantine on cattle in the country's 4 affected eastern districts has been imposed since mid-June [2018] after about 100 heads of cattle were killed by the virus. In a notice issued [Mon 30 Jul 2018], the minister Ministry of Agriculture and Animal Resources, Gérardine Mukeshimana, said the quarantine is no longer serving the purpose of slowing the spread of the deadly Rift Valley fever.

Reports indicate that the outbreak was first detected on 18 May 2018 in 4 districts in Eastern Rwanda including Ngoma, Kirehe, Rwamagana, and Kayonza. Of the 147 604 cows in the affected districts, the ministry says 99 died while 452 aborted. The ministry says it has treated 1638 cows, with 36 930 sheep and 245 goats vaccinated against the disease. To combat further deaths among animals, the ministry says it has dispatched veterinary doctors across the affected districts. Official reports indicate that no human case has been reported so far in Rwanda, yet the number of affected livestock is thought to be much higher.

According to the Director General of Rwanda Agriculture Board (RAB), Dr Patrick Karangwa, the cause of the outbreak is unusually heavy rains, which have created ponds and lakes where mosquitoes can breed, in this region which is normally dry. "Most human infections result from contact with the blood or organs of infected animals", Dr Karangwa said.
========================
[RVF, expressed mainly by cattle death and abortions, became active in Rwanda in April 2018, in the districts of Ngoma, Kirehe and Kayonza, in the southwest of the Eastern Province. Later, Kamonyi, a southern province was added.

An administrative map of Rwanda and detailed districts maps are available at
<https://en.wikipedia.org/wiki/Districts_of_Rwanda#Eastern_Province>.

In the absence of data on the number of susceptible animals on the affected holdings, the mortality rate in cattle is not known. Based on accumulated field observations and experimental RVF infection trials, the mortality in adult cattle would, generally, not exceed 10 percent. No human cases have been reported in Rwanda during the recent event. The tests upon which RVF, an OIE-listed disease, has been confirmed and statistics pertaining to the number, locations, morbidity, and mortality rates in Rwanda's animal population, are expected to be included in an official report to the OIE, as anticipated from all OIE member countries. - ProMED Mod.AS]

[HealthMap/ProMED-mail map of Eastern Province, Rwanda:
<http://healthmap.org/promed/p/15277>]
Date: Sun, 11 Mar 2018 11:43:19 +0100

Kigali, March 11, 2018 (AFP) - At least 16 people were killed and dozens more injured after lightning struck a Seventh-Day Adventist church in Rwanda, a local official said Sunday.   Fourteen victims were killed on the spot as lightning hit the church in the Nyaruguru district in the Southern Province on Saturday, local mayor Habitegeko Francois told AFP over the phone.

Two others died later from their injuries, he said.   He added that 140 people involved in the incident had been rushed to hospital and district health centres, but that many had already been discharged.   "Doctors say that only three of them are in critical condition but they are getting better," he said.   According to the mayor, a similar accident took place on Friday when lightning struck a group of 18 students, killing one of them.
Date: Wed, 26 Jul 2017 11:31:06 +0200
By Fran BLANDY

Volcanoes National Park, Rwanda, July 26, 2017 (AFP) - Nicaraguan singer Hernaldo Zuniga brought his entire family to trek through the lush forests and mist-shrouded volcanoes of northwestern Rwanda in search of mountain gorillas.   He described their encounter with the critically endangered primates as "an almost spiritual" experience, and said it was the only reason they made Rwanda a stop on a trip taking in a safari in Kenya, and a tour of South Africa.

But Rwanda is no longer content with being a whirlwind stop on a tourist's itinerary, and is working hard to broaden its appeal beyond its world-famous mountain gorillas while narrowing its niche market to the wealthiest of visitors.   Zuniga counts himself lucky that his family of five scored their permits to see the gorillas before Rwanda's eyebrow-raising move to double the cost to $1,500 (1,300 euros) per person in May.   "I think that is going to be a drawback for many people. It is just going to be an elite group of people who can pay that," said Zuniga, a well-known star in Latin America.

For Rwanda however, the price hike is part of a careful strategy to boost conservation efforts while positioning itself as a luxury tourist destination.   "The idea behind (the increase) is that it is an exclusive experience which also needs to be limited in numbers. Our tourism is very much based on natural resources and we are very serious about conservation," said Clare Akamanzi, the chief executive of the Rwanda Development Board.   It is a high-value, low-impact strategy that has worked well for countries such as Botswana and Bhutan.

- Safe and clean -
The remote, mountainous border area straddling Rwanda, the Democratic Republic of Congo and Uganda is the only place in the world where one can see the gorillas, whose numbers have slowly increased to nearly 900 due to conservation efforts.   Permits in the DRC ($400) and Uganda ($600) are far cheaper, but Rwandan officials are not concerned that they will lose tourists to their neighbours, arguing the country offers an experience that is rare in the region.   Ever since the devastating 1994 genocide in which 800,000 mainly Tutsis were killed, the country has been praised for a swift economic turnaround.   "When you come to Rwanda it is a clean, organised, safe country with zero tolerance for corruption. We have concentrated on creating a good experience," said Akamanzi, also highlighting a quick visa process.

The challenge is getting tourists to make Rwanda their main destination, and spend more than the usual four days it takes to visit the gorillas and maybe the genocide museum before heading elsewhere.   "We want to keep it high-end as an anchor for tourism but provide other offerings," said Akamanzi. She said tourism is already the country's top foreign exchange earner, but believes they "have only scratched the surface".   So the country, known as the Land of a Thousand Hills is looking into sports tourism such as cycling, cultural tourism and becoming a Big Five safari destination in its own right.   In the past two years Rwanda has re-introduced both lions and rhino to its Akagera National Park -- which had gone extinct due to poor conservation -- and visitor numbers to the reserve have doubled, said Akamanzi.

- 'There will be an impact' -
However gorillas remain the main lure, and industry players are concerned about the impact the price increase could have on the whole tourism chain.   "We risk losing substantial revenue for the industry and government as a whole. Currently a number of gorilla permits are already not sold in the low season," the Rwanda Tours and Travel Association (RTTA) said in a statement after the decision was announced.   Mid-range hotels around the Volcanoes National Park say it is too soon to tell what the fallout will be, but several managers expressed concerns they would lose their main clientele.   "Either way there will be an impact," said Fulgence Nkwenprana, who runs the La Palme hotel.

Aloys Kamanzi, a guide with Individual Tours, acknowledged there has been an initial slowdown in reservations, but is convinced people will keep coming, adding his clients are mostly "retired tourists who have saved their whole lives", some of whom come three or four times.   The singer Zuniga said coming to Rwanda was a hard decision, as he had not heard much about what the country was like today from Mexico, where he lives with his family.   "Rwanda has a lot of sensitive echoes in my generation, the genocide ... we had to cross over all these personal obstacles to make the decision to come here," he said.   "They have to do better in promoting their tourism. Once you are here it is amazing, the people are unique, the country is beautiful. I would like to stay longer."
More ...

Cote d'Ivoire

Cote d'Ivoire - US Consular Information Sheet
May 21, 2007
COUNTRY DESCRIPTION: Cote d'Ivoire (Ivory Coast) is a developing country on the western coast of Africa.
The official capital is Yamoussoukro, but Abidjan is the largest city, the
ain commercial center, and where the Ivorian government and the U.S. Embassy are located.
Cote d'Ivoire is a republic whose constitution provides for separate branches of government under a strong president.

The country has been divided since a 2002 coup attempt developed into a civil war.
Despite several peace agreements and the establishment of a transitional government, key issues remain unresolved, elections have been delayed, and tensions persist throughout the country.

Tourist facilities in and near Abidjan, the commercial capital, are good; accommodations in many other locations are limited in quality and availability.
Read the Department of State Background Notes on Cote d’Ivoire for additional information.

ENTRY/EXIT REQUIREMENTS:
A passport is required, but U.S. citizens traveling to Cote d'Ivoire for business or tourism do not require visas for stays of 90 days or less.
To stay longer than 90 days, the visitor may still enter without a visa, but then must apply for a "carte de sejour" within 90 days of arrival.
(Note: "Cartes de sejour" are not issued to children under the age of 16, who are documented on their parents' visas).
An international health certificate showing current yellow fever immunization is required for entry into Cote d'Ivoire.
Without it, the traveler may be required to submit to vaccination at the airport health office before clearing immigration, at a cost of 5,000 CFA (a little less than $10).

Travelers may obtain the latest information and details on entry requirements from the Embassy of the Republic of Cote d'Ivoire, 3421 Massachusetts Avenue, NW, Washington, D.C. 20007, telephone (202) 797-0300.
There are honorary consulates for Cote d'Ivoire in San Francisco, Stamford, Orlando, Houston and Detroit.
Overseas, travelers should inquire at the nearest Ivorian embassy or consulate.
See our Foreign Entry Requirements brochure for more information on Cote d’Ivoire and other countries.
Visit the Embassy of Cote d'Ivoire web site at http://www.cotedivoireembassy.com/ for the most current visa information.

Foreign travelers are sometimes approached at ports of entry by individuals with offers to expedite passport control and customs, and are then asked to pay an exorbitant fee, both for the service and for the passport and customs officers.
Travelers to Cote d'Ivoire are advised that there is no need to pay a police officer or customs officer at the airport for any service rendered during an arrival or departure, and they should not surrender their passports or other important documents to anyone except easily identifiable government officials in uniform.

See Entry and Exit Requirements for more information pertaining to dual nationality and the prevention of international child abduction.
Please refer to our Customs Information to learn more about customs regulations.

SAFETY AND SECURITY:Cote d'Ivoire has been unstable since the coup in 1999, and territorially divided since 2002.
The New Forces control the northern and some western parts of the country.
There are many road checkpoints manned by security forces and militia in both the government-controlled and New Forces-controlled portions of the country.
Soldiers and militia members check documents and frequently demand cash for permission to pass.
Cote d'Ivoire's border with Liberia is open, but border controls are extensive.

Political instability has contributed to economic stagnation and high unemployment, exacerbating social tensions and creating the potential for labor unrest and civil disorder.
There have been recurring episodes of violence, some of them severe.
In November 2004, there was a brief resumption of hostilities between the two sides followed by widespread attacks against people and property in Abidjan and elsewhere.
Many of these attacks were directed against French and other expatriates, and thousands fled the country.
Americans should avoid crowds and demonstrations, be aware of their surroundings, and use common sense to avoid situations and locations that could be dangerous.
While diplomatic efforts to end the crisis are ongoing, further civil unrest, coup attempts or the resumption of hostilities are possible.

Swimming in coastal waters is dangerous and strongly discouraged, even for excellent swimmers.
The ocean currents along the coast are powerful and treacherous, and numerous people drown each year.

For the latest security information, Americans traveling abroad should regularly monitor the Department’s Internet web site where the current Travel Warnings and Public Announcements, including the Worldwide Caution Public Announcement, can be found.

Up-to-date information on safety and security can also be obtained by calling 1-888-407-4747 toll free in the U.S., or for callers outside the U.S. and Canada, a regular toll-line at 1-202-501-4444.
These numbers are available from 8:00 a.m. to 8:00 p.m. Eastern Time, Monday through Friday (except U.S. federal holidays).

The Department of State urges U.S. citizens to take responsibility for their own personal security while traveling overseas.
For general information about appropriate measures travelers can take to protect themselves in an overseas environment, see the Department of State’s pamphlet A Safe Trip Abroad.
CRIME:
Crime continues to be a major security threat for Americans living in Cote d'Ivoire.
Grab-and-run street crime and pick pocketing in crowded areas are widespread.
Armed carjacking, robberies of businesses and restaurants, and home invasions are common, and they often target expatriate residents who are perceived as wealthy.
Armed criminals use force when faced with resistance.
Travelers displaying jewelry and carrying cameras are especially at risk.
Travelers are advised to carry limited amounts of cash and only photocopies of key documents.
While there have been relatively few reported cases of sexual assault, given the general climate of criminality, the actual rate of assault may be much higher than that which is reported.
There were allegations of sexual assaults during the November 2004 civil strife.
Given the strong anti-French sentiment, people of non-African appearance may be specifically targeted for violence.
Avoid large gatherings and political demonstrations, as they can turn violent quickly.

Travel outside of Abidjan or at night is strongly discouraged, and it is particularly dangerous to visit Abidjan's Treichville, Adjame, Abobo, and Plateau districts after dark.
The DeGaulle and Houphouet-Boigny bridges in Abidjan are dangerous areas for pedestrians.
Inadequate resources and training limit the ability of the police to combat crime.
Many hotels, restaurants, nightclubs and supermarkets provide security guards to protect clients and vehicles.

Travelers should take the same common sense precautions in Abidjan that they would in any metropolitan area in the United States.
Travelers should stay in well-lit areas and walk confidently at a steady pace on the side of the street facing traffic close to the curb.
Travelers should avoid crowds, mass transit, doorways, bushes, alleys and sparsely populated areas.
Travelers who need transportation at night should take an Orange metered taxi.
Travelers should be discreet about your transactions, especially in sight on the street.
Normal spending habits of Westerners appear extravagant.

Credit card use in Cote d'Ivoire is limited, particularly outside Abidjan, but credit card fraud is an increasing problem.
Travelers should not use credit cards in paper transactions unless the credit card transaction is electronically performed in view of the individual.

Business fraud is rampant and the perpetrators often target foreigners, including Americans.
Schemes previously associated with Nigeria are now prevalent throughout West Africa, including Cote d'Ivoire, and pose a danger of grave financial loss.
Typically these scams begin with unsolicited communication (usually e-mails) from strangers who promise quick financial gain, often by transferring large sums of money or valuables out of the country, but then require a series of "advance fees" to be paid, such as fees for legal documents or taxes.
Of course, the final payoff does not exist; the purpose of the scam is simply to collect the advance fees.
A common variation is the scammer’s claim to be a refugee or émigré of a prominent West African family, or a relative of a present or former political leader who needs assistance in transferring large sums of cash.
Still other variations appear to be legitimate business deals that require advance payments on contracts.
Sometimes victims are convinced to provide bank account and credit card information and financial authorization that drains their accounts, incurs large debts against their credit, and takes their life savings.

The best way to avoid becoming a victim of advance-fee fraud is common sense — if a proposition looks too good to be true, it probably is a scam, particularly if one has never met the correspondent.
Travelers should carefully check and research any unsolicited business proposal before committing any funds, providing any goods or services, and undertaking any travel.
A good clue to a scam is the phone number given to the victim; legitimate businesses and offices provide fixed line numbers, while scams typically use only cell phones.
In Cote d'Ivoire, all cell phone numbers start with zero.

It is virtually impossible to recover money lost through these scams.
For additional information please consult the Department of State's brochure Advance Fee Business Scams.

INFORMATION FOR VICTIMS OF CRIME:
The loss or theft abroad of a U.S. passport should be reported immediately to the local police and the nearest U.S. Embassy or Consulate.
If you are the victim of a crime while overseas, in addition to reporting to local police, please contact the nearest U.S. Embassy or Consulate for assistance.
The Embassy/Consulate staff can, for example, assist you to find appropriate medical care, contact family members or friends and explain how funds could be transferred.
Although the investigation and prosecution of the crime is solely the responsibility of local authorities, consular officers can help you to understand the local criminal justice process and to find an attorney if needed

See our information on Victims of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION:
Abidjan has privately-run medical and dental facilities that are adequate but do not fully meet U.S. standards.
Good physician specialists can be found, though few speak English.
While pharmacies are well stocked with medications produced in Europe, newer drugs may not be available.
Medical care in Cote d'Ivoire outside of Abidjan is extremely limited.
Malaria is a serious health problem in Cote d’Ivoire.
For more information on malaria, including protective measures, see the Centers for Disease Control Travelers’ Health web site at http://www.cdc.gov/malaria/.

The avian influenza or “Bird Flu” virus (H5N1) has been confirmed in animals in Cote d’Ivoire as of June 2006.
For more information regarding Avian Influenza, please visit the CDC’s internet site at http://www.cdc.gov/travel/other/avian_flu/ and the State Department’s Avian Influenza Fact Sheet.

Information on vaccinations and other health precautions, such as safe food and water precautions and insect bite protection, may be obtained from the Centers for Disease Control and Prevention’s hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747) or via the CDC’s internet site at http://www.cdc.gov/travel.
For information about outbreaks of infectious diseases abroad consult the World Health Organization’s (WHO) website at http://www.who.int/en.
Further health information for travelers is available at http://www.who.int/ith.

MEDICAL INSURANCE:
The Department of State strongly urges Americans to consult with their medical insurance company prior to traveling abroad to confirm whether their policy applies overseas and whether it will cover emergency expenses such as a medical evacuation.
Please see our information on medical insurance overseas.
TRAFFIC SAFETY AND ROAD CONDITIONS:
While in a foreign country, U.S. citizens may encounter road conditions that differ significantly from those in the United States.
The information below concerning Cote d’Ivoire is provided for general reference only, and may not be totally accurate in a particular location or circumstance.

Serious traffic accidents, one of the greatest threats to U.S. citizens in Cote d’Ivoire, occur regularly in Abidjan.
Unsafe road conditions, unskilled drivers, and poorly maintained and overloaded vehicles create very poor driving conditions.
Speed limits, signals, and yielding for pedestrians and cyclists are not respected.
Travelers should drive defensively, watch out for public transportation vehicles that stop and start without warning, and be especially cautious at intersections because traffic lights often malfunction.
Travelers who must travel at night should beware of vehicles without headlights and/or taillights, and pedestrians and bicycles along the roadside.
In case of an accident, travelers are advised not to move their vehicle until a police officer authorizes.
Travelers should go to the nearest hospital or police station if there is no other vehicle to take the injured to a hospital, or if there is reason to believe that their life is in danger from others at the site of the accident.

Abidjan has a poor public transportation system; if traveling by bus, use only the “Express” line.
In Abidjan, taxis are readily available, inexpensive (metered), but poorly maintained and notorious for not respecting the rules of the road.
Communal taxis (“woro-woros”), used only within the limits of each commune, are not metered and are dangerous.
Local vans ("Gbaka") should not be used because they are frequently involved in accidents.

Criminals usually steal vehicles when the driver is in or near the vehicle, so car doors and windows should be kept locked.
While stopped in traffic, travelers should remember to allow enough room between your car and the one in front to maneuver out if needed.
Travelers should look around to see if there is anyone paying unusual attention or if someone appears to be watching, before entering their vehicles. Travelers should not attempt to enter their vehicles, and should go get assistance.
Travelers should enter and exit their vehicles as quickly as possible, to limit their vulnerability to carjacking.

Victims of carjacking should not resist.
Victims should try to remain calm and give the carjackers what they want, which is usually the vehicle and any valuables.
Experience shows that criminals usually don’t use violence unless they are confronted with resistance.
Furthermore, it is not uncommon to take an occupant, usually a woman or child, as hostage to ensure their safe escape; the hostage is usually released unharmed.
This is a very difficult situation; victims should use their best judgment in deciding a course of action.

A newer phenomenon is the staged accidental "bumping" accident.
If your vehicle is "bumped" from the rear or the side, stay locked inside because this ruse is used to get the driver out and leave the vehicle free for carjacking.
Travelers with cell phones should call for assistance.
Victims should report the accident at the nearest police station as soon as possible if they feel their safety is in jeopardy and try to get the license number for any other vehicle involved.

Emergency services such as ambulance service (SAMU) exist in Abidjan and larger towns.
Call 185 or 22-44-55-53.
In smaller towns there is usually no ambulance service available, but ambulances will be dispatched from larger towns

Please refer to our Road Safety page for more information.

AVIATION SAFETY OVERSIGHT: The U.S. Federal Aviation Administration (FAA) has assessed the Government of Cote d'Ivoire’s Civil Aviation Authority as not being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for the oversight of Cote d'Ivoire's air carrier operations.
For more information, travelers may visit the FAA’s internet web site at http://www.faa.gov/safety/programs_initiatives/oversight/iasa.

SPECIAL CIRCUMSTANCES:
Ivorian customs authorities encourage the use of an ATA (Admission Temporaire/Temporary Admission) Carnet for the temporary admission of professional equipment, commercial samples, and/or goods for exhibitions and fair purposes.
ATA Carnet Headquarters, at the U.S. Council for International Business, 1212 Avenue of the Americas, New York, NY 10036, issues and guarantees the ATA Carnet in the United States.
For additional information, call (212) 354-4480, e-mail atacarnet@uscib.org, or visit http://www.uscib.org.

If traveling to another West African Economic and Monetary Union (WAEMU) country, expatriate residents leaving Cote d’Ivoire must declare the amount of currency being taken out of the country; if going to any other country, tourists are prohibited from taking more than 500,000 CFA francs (approximately $1,000), and business operators two million CFA francs (approximately $4,000), without government approval.
Even with authorization, there is a cash limit of $4,000 for tourists and $5,500 for business people, with any surplus in travelers or bank checks.

Travelers should carry a photocopy of your U.S. passport, visa, and entry stamps.
Travelers should also, carry their international driver's licenses if planning to drive.

Government corruption remains a serious problem in Cote d'Ivoire, and has an impact on judicial proceedings, contract awards, customs, and tax issues.
Security forces (police, military, gendarmes) routinely stop vehicles for traffic violations and security checks. Travelers should politely present identification if stopped.
Travelers who are stopped at one of these check points for any reason and asked to pay a "fine" to these uniformed officials, should politely refuse and present a photocopy of their U.S. passport, visa, and entry stamp.

Taking pictures is prohibited near sensitive installations, including military sites, government buildings such as the radio and television stations, the Presidency building, the airport, and the DeGaulle and Houphouet-Boigny bridges in Abidjan.

Cote d’Ivoire recognizes dual nationality if acquired at birth.
Americans who also are Ivorian nationals may be subject, while in Côte d'Ivoire, to certain aspects of Ivorian law that impose special obligations on citizens of that country.
Please see our information on Customs Regulations.
CRIMINAL PENALTIES:
While in a foreign country, a U.S. citizen is subject to that country's laws and regulations, which sometimes differ significantly from those in the United States and may not afford the protections available to the individual under U.S. law.
Penalties for breaking the law can be more severe than in the United States for similar offenses.
Persons violating Cote d'Ivoire's laws, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in Cote d'Ivoire are severe, and convicted offenders can expect long jail sentences and heavy fines.
Engaging in sexual conduct with children or using or disseminating child pornography in a foreign country is a crime, prosecutable in the United States.
Please see our information Criminal Penalties.

CHILDREN'S ISSUES:
For information on international adoption of children and international parental child abduction, see the Office of Children’s Issues web site.

REGISTRATION / EMBASSY LOCATION:
Americans living or traveling in Cote d'Ivoire are urged to register with the nearest U.S. Embassy or Consulate through the State Department’s travel registration website and to obtain updated information on travel and security within Cote d’Ivoire.
Americans withoutInternet access may register directly with the nearest U.S. Embassy or Consulate.
By registering, American citizens make it easier for the Embassy to contact them in case of emergency.
The U.S. Embassy is located in the Riviera Golf neighborhood of the Cocody section of Abidjan, east of the downtown area.
The Embassy's postal address is 01 B.P. 1712 Abidjan 01, and the main telephone number is 22-49-40-00.
The Consular Section fax number is 22-49-42-02, and more information is on the Consular pages of the Embassy's web site at http://Abidjan.usembassy.gov/
*

*

*
This replaces the Consular Information Sheet dated November 21, 2006, with no major changes.

Travel News Headlines WORLD NEWS

Date: Thu, 24 Oct 2019 11:46:08 +0200 (METDST)
By David ESNAULT

Bouake, Ivory Coast, Oct 24, 2019 (AFP) - Once the bane of sub-Saharan Africa, sleeping sickness is agonisingly close to being wiped out, but only if countries -- and donors -- keep up their guard, say scientists.   The disease, transmitted to humans by the tsetse fly, was once a curse in 30 countries.   But a coordinated global fight to eradicate it has borne fruit, leading to a 95-percent fall in cases over the past 15 years, according to the World Health Organization (WHO).

Last year, the agency recorded only 977 cases, compared to a peak of some 300,000 in the 1990s. Its hope is that sleeping sickness will enter the history books by 2030.   Sleeping sickness -- human African trypanosomiasis -- is caused by the trypanosoma parasite, which is transmitted to humans by the tsetse when it takes a blood meal.   The disease is fatal unless diagnosed and treated rapidly. Early symptoms are severe headaches and muscle aches and fever.

Sufferers feel lethargic and sleepy by day then awake and exhausted at night. Neuropsychiatric and sensory disorders follow, then a coma before death ensues within months or sometimes even years later.   "Sleeping sickness is scary -- when someone has it, it makes them mad," said Emile Gouribitiali, 56, a villager in central Ivory Coast whose mother and younger brother both fell ill.   But scientists say this dreaded disease is on the ropes.   "After a century of fighting it, sleeping sickness is on the verge of being eradicated," said Dr Dramane Kaba, an entomologist and director of the Pierre Richet Institute (IPR) at Bouake in central Ivory Coast.   "Sleeping sickness has almost stopped being a public health problem in Africa," he said. "But we have to maintain our efforts."   The institute, founded in 1970, specialises in insect-transmitted diseases including malaria, dengue, zika and chikungunya.

- Meticulous task -
Despite the progress, "pockets of resistance" remain, says Kaba.   They include the Democratic Republic of Congo -- home to 80 percent of cases -- and Guinea, where health programmes have been ravaged by the Ebola crisis.   It is also difficult to gain an accurate assessment in areas of armed conflict.   If the overall outlook is relatively favourable, there must be no let-up towards eradication, Kaba insists.

He points to the fact that, after a campaign against the illness from the 1920s through to the 1960s "vigilance then dropped off and the illness returned".   Combatting the spread of the disease requires meticulous work to break the chain of transmission and kill the parasite, said Vincent Jamonneau at France's Research Institute for Development (IRD).   Teams on the ground, working with lab-based researchers, comb rural areas to uncover possible cases of the disease and beef up control of the tsetse fly, which favours a hot, humid habitat.

- Fly traps -
They log symptoms that point to a possible infection and then carry out a quick diagnostic blood test, obtaining results confirmed in a lab.   Patients identified in this way can be cured through hospitalisation of seven to 10 days, which the WHO provides free of charge across Africa. A revolutionary treatment, which involves taking a one-off pill, is being tested.

Ironically, as the disease is rolled back, it becomes more and more difficult to encourage villagers to come forward and get tested, said Jammoneau.   "People no longer feel that the disease is a threat," he said.   The researchers also test cattle, another tsetse target who suffer a different strain of the virus -- animal trypanosomiasis. They lose weight, their milk production slumps, then they die.   IPR teams set tsetse traps in villages where they operate. The traps comprise blue screens impregnated with insecticide -- the flies find the colour attractive. 

Another trap variant permits capture to assess their number and then dissection to determine if they are infected.   The IPR hosts research at its lab as the scientific community hones its battle to eradicate sleeping sickness.    The lab can draw on some state-of-the-art equipment as well as some 100 employees, including 16 researchers, but needs renovating, said Kaba.    For Jamonneau, "the means to eradicate trypanosomiasis are there.   "But this disease raises scant interest among fundraisers. So we still need their support as the challenge is to track down and treat the last cases in order to finish off the illness."
Date: Tue, 22 Oct 2019 16:24:07 +0200 (METDST)

Abidjan, Oct 22, 2019 (AFP) - Ivory Coast announced Tuesday that Arab investors had pledged $5 billion to support its programme to attract foreign tourists to the West African nation.   The tourism ministry said "a round table of investors in Dubai" on Sunday and Monday expressed interest In Ivory Coast and in total, the minister for tourism and leisure, Siandou Fofana, "enlisted from them pledges worth just over $5 billion" (4.49 billion euros).   Ivory Coast's charm offensive in the United Arab Emirates included a delegation with recently retired star footballer Didier Drogba and A'Salfo, lead singer with the pop group Magic System, who gave two concerts.

The initiative, dubbed "Sublime Cote d'Ivoire" (Magnificent Ivory Coast), was launched in May.   "Our goal is to become the fifth biggest destination for tourism in Africa by 2025," Fofana said in the ministry's statement.   If objectives are reached, tourism would account for 12 percent of GDP compared with 5.5 percent today, and jobs in the tourism sector would grow from 270,000, as of 2016, to 365,000.   The economy today is hugely dependent on rural earnings, especially cacao and coffee. The plan is to attract tourists to the remote west of the country, a region of unspoiled mountains and beaches.
Date: Tue, 27 Aug 2019 15:33:42 +0200 (METDST)

Bouake, Ivory Coast, Aug 27, 2019 (AFP) - The main market in Bouake, Ivory Coast's second biggest city, was largely destroyed Tuesday in an overnight blaze, although there were no known casualties, an AFP correspondent reported.   The fire broke out around 2:00 am (0200 GMT) and spread fast, market watchmen said.   It took around seven hours to bring under control, mobilising several hundred firefighters, police and troops, partly to put out the blaze but also to secure the area.   "This tragedy has most fortunately caused no loss of life," Bouake mayor Nicolas Djibo said, adding though that he was "dumbstruck by the scale of the damage".

Djibo said the fire had begun in the butchers' area of the market, which hosts hundreds of stalls and is a hub of social activity in Bouake, a city of one million people in the centre of Ivory Coast.   Some traders had been able to remove their wares in time but others wept at the sight of their loss.   Koffi Rachelle, who sold children's toys and various gadgets, told AFP she had lost everything. "I can"t even get into my shop, the fire has destroyed everything over there," she said in tears.

An inquiry into the fire has been opened, according to a police source who asked not to be named.   The market, which had an area of between eight and nine hectares (about 22 to 22 acres), had been razed by a fire in 1998.   Experts had been studying a proposal to house the stalls in a large modern building before the latest blaze.
Date: Tue, 30 Jul 2019 21:28:27 +0200

Abidjan, July 30, 2019 (AFP) - Eighty-nine people have contracted yellow fever and one person has died in recent weeks during an outbreak in Ivory Coast, the health ministry said Tuesday.   Most of the confirmed cases were in the West African country's economic capital Abidjan, the ministry said in a statement.

It recommended that any unvaccinated people be vaccinated against yellow fever.   "The outbreak occurs in the context of a dengue outbreak," the ministry said, adding that dengue and yellow fever are viral diseases transmitted by the same mosquito.    "The vector control measures that have been implemented to deal with dengue also work for the yellow fever outbreak."   In early June, 130 cases of dengue were reported including two deaths, with the authorities launching a major mosquito-control campaign.   Abidjan is going through the end of its rainy season, which spurs mosquito breeding.

Symptoms of yellow fever -- including high fever, vomiting and muscle aches -- usually manifest themselves three to six days after a person is bitten by an infected mosquito.   The infection caused by yellow fever is usually mild, but in some cases can be life-threatening and result in kidney and liver failure.   Yellow fever is found only in parts of South America and Africa.
Date: Tue 30 Jul 2019
Source: Medical Xpress [edited]

In recent weeks, 89 people have contracted yellow fever, and one person has died during an outbreak in Ivory Coast, the health ministry said Tuesday [30 Jul 2019].

Most of the confirmed cases were in the West African country's economic capital Abidjan, the ministry said in a statement. It recommended that any unvaccinated people be vaccinated against yellow fever.  "The outbreak occurs in the context of a dengue outbreak," the ministry said, adding that dengue and yellow fever are viral diseases transmitted by the same mosquito.

"The vector control measures that have been implemented to deal with dengue also work for the yellow fever outbreak."  In early June [2019], 130 cases of dengue were reported, including 2 deaths, with the authorities launching a major mosquito-control campaign.  Abidjan is going through the end of its rainy season, which spurs mosquito breeding.

Symptoms of yellow fever -- including high fever, vomiting and muscle aches -- usually manifest themselves 3-6 days after a person is bitten by an infected mosquito.  The infection caused by yellow fever is usually mild, but in some cases can be life-threatening and result in kidney and liver failure.  Yellow fever is found only in parts of South America and Africa.
=====================
[Yellow fever (YF) is a serious disease and has a case fatality rate of about 30%. It is surprising that there has been only one death so far among the 89 infected individuals. It is not stated that all 89 individuals were laboratory confirmed YF cases. The above report does not indicate the proportion of the population that has been vaccinated against YF.

YF virus can spread rapidly in a largely unvaccinated population, as it did in Angola in 2016. _Aedes aegypti_ vector control is of limited effectiveness in the face of a YF outbreak. Vaccination is the best preventive measure.

There have been YF cases in Cote d'Ivoire in the past, the most recent in 2011. At that time, more than 700 000 people were vaccinated against yellow fever [YF] in an emergency campaign in the country. There were YF cases in Abidjan in 2008, when the estimated vaccination coverage of the population was around 60 percent after a vaccination campaign. Now, time is of the essence to quickly halt the spread of YF, as it rapidly did in Angola and the DR Congo in that large outbreak. - ProMED Mod.TY]

[Maps of Cote d'Ivoire can be accessed at <http://bit.ly/2uHz53s>
and <http://healthmap.org/promed/p/52>.]
More ...

Iran

Iran - US Consular Information Sheet
July 1, 2008
COUNTRY DESCRIPTION:
Iran is a constitutional Islamic republic with a theocratic system of government where ultimate political authority is vested in a religious scholar, the Supreme Leader

Shia Islam is the official religion of Iran, and Islamic law is the basis of the authority of the state.
The Iranian Constitution guarantees freedom of worship to Jews, Christians and Zoroastrians, though they are sometimes the subject of discrimination and repression.
The workweek in Iran is Saturday through Thursday; however, many government offices and private companies are closed on Thursdays.
Friday is the day of rest when all establishments are closed.
Offices in Iran are generally open to the public during the morning hours only.
Read the Department of State Background Notes on Iran for additional information.
ENTRY/EXIT REQUIREMENTS:
Should you decide to travel to Iran despite the current Travel Warning, a passport and visa are required, except for travel to Kish Island.
To obtain a visa, contact the Iranian Interests Section of the Embassy of Pakistan located at 2209 Wisconsin Avenue NW, Washington, DC
20007; tel. 202-965-4990, 91, 92, 93, 94, 99, fax 202-965-1073, 202-965-4990 (Automated Fax-On-Demand after office hours).
Their web site is http://www.daftar.org/Eng/default.asp?lang=eng.

U.S. citizens traveling to Iran are being fingerprinted upon entry.
The Iranian press has reported that foreign tourists may obtain seven-day tourist visas at the airport in Tehran.
However, U.S. citizens are not eligible to receive these visas and have to obtain valid visas from the Iranian Interests Section in Washington.
Note:
possession of a valid Iranian visa will not guarantee entry into the country.
Some American travelers with valid visas have been refused entry at the border without explanation.
U.S. citizens do not have to obtain a visa for travel from Dubai, United Arab Emirates, to Kish Island.
U.S. passports are valid for travel to Iran.
However, the Iranian government does not recognize dual nationality and will treat U.S.-Iranian dual nationals solely as Iranian citizens.
Thus, U.S. citizens who were born in Iran, who became naturalized citizens of Iran (e.g. through marriage to an Iranian citizen), and children of such persons—even those without Iranian passports who do not consider themselves Iranian—are considered Iranian nationals by Iranian authorities.
Therefore, despite the fact that these individuals hold U.S. citizenship, under Iranian law, they must enter and exit Iran on an Iranian passport, unless the Iranian government has recognized a formal renunciation or loss of Iranian citizenship.
Dual nationals may be subject to harsher legal treatment than a visitor with only American citizenship.
(See section on Special Circumstances below.)
In the past, U.S.-Iranian dual nationals have been denied permission to enter/depart Iran using their U.S. passport; they have also had their U.S. passports confiscated upon arrival or departure.
(Depending on the circumstances, the individuals were sometimes able to retrieve their U.S. passports after renouncing their Iranian citizenship.)
Recently, Iranian authorities have prevented a number of Iranian-American citizen academics, journalists, and others who traveled to Iran for personal reasons from leaving, and in some cases have detained and imprisoned them on various charges, including espionage and being a threat to the regime.
Americans of Iranian origin should consider the risk of being targeted by authorities before planning travel to Iran.
Iranian authorities may deny dual nationals’ access to the United States Interests Section in Tehran, because they are considered to be solely Iranian citizens.

As a precaution, however, it is advisable for U.S.-Iranian dual nationals to obtain in their Iranian passports the necessary visas for the country which they will transit upon their return to the U.S. so that, if their U.S. passports are confiscated in Iran, they may depart Iran with their Iranian passport.
These individuals can then apply for a new U.S. passport in that third country.

Dual nationals whose U.S. passports are confiscated may also obtain a “Confirmation of Nationality” from the U.S. Interests Section of the Embassy of Switzerland, which is the U.S. protecting power.
This statement, addressed to the relevant foreign embassies in Tehran, enables the travelers to apply for third-country visas in Tehran.
Dual nationals finding themselves in this situation should note in advance that the Swiss Embassy would issue this statement only after the traveler's U.S. nationality is confirmed and after some processing delay.
Dual nationals must enter and depart the United States on U.S. passports.

Visa extensions are time-consuming and must be filed at least one week in advance of the expiration date.
As of March 21, 2006, a foreign national and anyone accompanying him/her will pay a fine of 300,000 rials or 30,000 ottomans per day for each day of unauthorized stay in Iran.

All Iranian nationals, including U.S.-Iranian dual nationals, must have an exit permit stamped in their Iranian passports in order to depart Iran.
The stamp is affixed to the Iranian passport when it is issued and remains valid until the expiration date of the passport.
All Iranian nationals residing abroad and in Iran, including U.S.-Iranian dual nationals, are now required to pay an exit tax regardless of the duration of their stay in Iran.
More specific information on Iranian passport and exit visa requirements may be obtained from the Iranian Interests Section of the Embassy of Pakistan in Washington, D.C.
Non-Iranian-national women who marry Iranian citizens gain Iranian nationality upon marriage.
If the marriage takes place in Iran, the woman’s American passport will be confiscated by Iranian authorities.
They must have the consent of their husbands to leave Iran or, in his absence, must gain the permission of the local prosecutor.
Iranian law combined with the lack of diplomatic relations between the United States and Iran means that the U.S. Interests Section in Tehran can provide only very limited assistance if an American woman married to an Iranian man has marital difficulties and/or encounters difficulty in leaving Iran.

After divorce or death of the husband, a foreign-born woman has the choice to renounce her Iranian citizenship but any of the couple’s children will automatically be Iranian citizens and their citizenship is irrevocable.
They will be required to enter and depart Iran on Iranian passports.
For a divorce to be recognized it should be carried out in Iran or, if outside Iran, in accordance with Sharia law.
Upon divorce, custody of the children normally goes to the mother until the child reaches age 7, at which point custody is automatically transferred to the father.
However, if the courts determine that the father is unsuitable to raise the children, they may grant custody to the paternal grandfather or to the mother, if the mother has not renounced her Iranian citizenship and is normally resident in Iran.
If the courts grant custody to the mother, she will need permission from the paternal grandfather or the courts to obtain exit visas for the minor children (under age 18) to leave the country.
Iran is not a signatory to the Hague Convention on the Civil Aspects of International Child Abduction.
Please see the Department of State’s International Parental Child Abduction flyer on Iran for further information.
Information about dual nationality or the prevention of international child abduction can be found on our web site.
For further information about customs regulations, please read our Customs Information sheet.
SAFETY AND SECURITY:
U.S. citizens who travel to Iran despite the Travel Warning should exercise caution throughout the country, but especially in the southeastern region where westerners have been victims of criminal gangs often involved in the smuggling of drugs and other contraband.
American citizens should avoid travel to areas within 100 kilometers of the border with Afghanistan, within 10 kilometers of the border with Iraq, and generally anywhere east of the line from Bam and Bandar Abbas toward the Pakistan border.

Terrorist explosions have killed a number of people since 2005.
Be aware that the Iranian government has blamed the U.S. and/or UK governments for involvement in the February 2007 bombing that killed Iranian military forces in Zahedan in the southeast and the 2005/2006 bombings in Ahvaz/Khuzestan in the southwest.
A number of British firms were damaged in attacks in August and November 2005.

U.S. citizens are advised to avoid demonstrations and large public gatherings.
Increased tension between Iran and the West over the past several years is a cause of concern for American travelers.

Iranian security personnel may at times place foreign visitors under surveillance.
Hotel rooms, telephones and fax machines may be monitored, and personal possessions in hotel rooms may be searched.
Photography near military and other government installations is strictly prohibited and could result in serious criminal charges, including espionage, which carries the death penalty.

For the latest security information, Americans traveling abroad should regularly monitor the Department of State, Bureau of Consular Affairs’ web site at http://travel.state.gov, where the current Travel Warnings and Travel Alerts, including the Travel Warning for Uzbekistan and the Worldwide Caution can be found.

Up-to-date information on safety and security, including safety and security in Iran, can also be obtained by calling 1-888-407-4747 toll free in the U.S. and Canada or, for callers outside the U.S. and Canada, a regular toll-line at 1-202-501-4444.
These numbers are available from 8:00 a.m. to 8:00 p.m. Eastern Time, Monday through Friday (except U.S. federal holidays).

The Department of State urges American citizens to take responsibility for their own personal security while traveling overseas.
For general information about appropriate measures travelers can take to protect themselves in an overseas environment, see the Department of State’s pamphlet A Safe Trip Abroad.
CRIME:
Major crime is generally not a problem for travelers in Iran, although foreigners occasionally have been victims of petty street crime.
Young men in unmarked cars have robbed foreigners and young men on motor bikes have snatched bags.
There have been reports of robberies by police impersonators, usually in civilian clothing.
Insist on seeing the officer’s identity card and request the presence of a uniformed officer/marked patrol car.
Travelers should not surrender any documents or cash.

Travelers should not carry large amounts of hard currency.
In view of the possibility of theft, passports, disembarkation cards, other important documents and valuables should be kept in hotel safes or other secure locations.
Pre-booked taxis are safer than those hailed from the street.
Americans should check with their hotel or tour guide for information on local scams.
INFORMATION FOR VICTIMS OF CRIME:
The loss or theft abroad of a U.S. passport should be reported immediately to the local police and the U.S. Interests Section at the Swiss Embassy in Tehran or the nearest U.S. Embassy or Consulate.
Because of the lack of a U.S. Embassy in Iran, the processing time for a replacement passport takes longer at the U.S. Interests Section at the Swiss Embassy than elsewhere.

If you are the victim of a crime while overseas, in addition to reporting to local police, please contact the U.S. Interests Section for assistance.
The staff can, for example, assist you to find appropriate medical care, contact family members or friends and explain how funds could be transferred.
Although the investigation and prosecution of the crime is solely the responsibility of local authorities, Swiss Embassy officers can help you to understand the local criminal justice process and to find an attorney if needed.

The local equivalent of the “911” emergency line in Iran is as follows:
115 for ambulance service, 125 for fire and 110 for police.
English speakers, however, are generally unavailable. See our information on Victims of Crime.
MEDICAL FACILITIES AND HEALTH INFORMATION:
Basic medical care and medicines are available in the principal cities, but may not be available in rural areas.
Medical facilities do not meet U.S. standards and sometimes lack medicines and supplies.

Information on vaccinations and other health precautions, such as safe food and water precautions and insect bite protection, may be obtained from the Centers for Disease Control and Prevention’s hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747) or via the CDC’s web site at http://wwwn.cdc.gov/travel/default.aspx.
For information about outbreaks of infectious diseases abroad consult the World Health Organization’s (WHO) web site at http://www.who.int/en.
Further health information for travelers is available at http://www.who.int/ith/en.
In 2006, there were reports of Crimean Congo Hemorrhagic Fever, mostly in the southeastern Sistan va Baluchistan province.
See www.who.int/mediacentre/factsheets/fs208/en for more information.
Iranian authorities have confirmed outbreaks of avian influenza (bird flu) in January 2008 in northern Iran, as well as earlier reports among wild swans in the Anzali Wetlands and in domestic poultry in the northern provinces of Azerbaijan and Gilan.
There have been a number of fatalities from avian flu reported in eastern Turkey, 45 kilometers from the Iranian border.
MEDICAL INSURANCE:
The Department of State strongly urges Americans to consult with their medical insurance company prior to traveling abroad to confirm whether their policy applies overseas and whether it will cover emergency expenses such as a medical evacuation.
Please see our information on medical insurance overseas.
TRAFFIC SAFETY AND ROAD CONDITIONS:
While in a foreign country, U.S. citizens may encounter road conditions that differ significantly from those in the United States.
The information below concerning Iran is provided for general reference only, and may not be totally accurate in a particular location or circumstance:
Travelers in possession of International Driver’s Permits may drive in Iran, though the U.S. Interests Section in Iran does not recommend that tourists drive in Iran.
Iran has a very high rate of traffic accidents, the second highest cause of mortality in the country.
Drivers throughout Iran tend to ignore traffic lights, traffic signs and lane markers.
Urban streets are not well lit.
It is therefore particularly dangerous to drive at night.
Sidewalks in urban areas only exist on main roads and are usually obstructed by parked cars.
In the residential areas, few sidewalks exist.
Drivers almost never yield to pedestrians at crosswalks.
If you are involved in an accident, no matter how minor, do not leave the scene.
Wait until the police arrive to file a report.

Iranian authorities sometimes set up informal roadblocks, both in cities and on highways, often manned by young, inexperienced officers.
They are often suspicious of foreigners.
Ensure you carry a form of identification with you and avoid getting into disputes.
Pollution levels from cars are very high, particularly in Tehran, which can trigger respiratory problems. Please refer to our Road Safety page for more information.
AVIATION SAFETY OVERSIGHT:
As there is no direct commercial air service to the U.S. by carriers registered in Iran, the U.S. Federal Aviation Administration (FAA) has not assessed the Government of Iran’s Civil Aviation Authority for compliance with International Civil Aviation Organization (ICAO) aviation safety standards.
For more information, travelers may visit the FAA’s web site at http://www.faa.gov/safety/programs_initiatives/oversight/iasa.
Civil aviation in Iran continues to experience air incidents and accidents, including five crashes with fatalities between April 20, 2005, and November 27, 2006.
Incidents have included engine failure and planes veering off the runway.

SPECIAL CIRCUMSTANCES:
The Iranian Government has seized the passports and blocked the departure of foreigners who work in Iran on tax/commercial disputes.

In addition to being subject to all Iranian laws, U.S. citizens who also possess Iranian citizenship may also be subject to other laws that impose special obligations on citizens of Iran, such as military service or taxes. Iranian-citizen males aged 18-34 are required to perform military service, unless exempt.
Iranian-Americans, even those born in the U.S., are included.

Dual nationals sometimes have their U.S. passports confiscated and may be denied permission to leave Iran, or encounter other problems with Iranian authorities.
Likewise, Iranian authorities may deny dual nationals’ access to the U.S. Interests Section in Tehran, because they are considered to be solely Iranian citizens.
Refer to the above section entitled "Entry/Exit Requirements" for additional information concerning dual nationality.

U.S. citizens who are not dual U.S.-Iran nationals are encouraged to carry a copy of their U.S. passport (biodata page and page with Iranian visa) with them at all times, so that if questioned by local officials, proof of U.S. citizenship is readily available.
Carry some other form of identification with you, such as a drivers license or other photo identification at all times as well.
Credit cards and bank cards are not widely accepted in Iran.
It is difficult to change dollars to rials in Iranian banks and you may not be able to access your U.S. bank accounts via the Internet from Iran.
You will not be able to access your U.S. bank accounts using ATMs in Iran.
Travelers checks can be difficult to exchange.
Bring enough hard currency to cover your stay, but make sure you declare this currency upon entry.
There is no Western Union or similar institution and bank transfers may not be possible.
Exchange money only at banks or an authorized currency exchange facility, not on the street, and keep your exchange receipts.

Pre-paid overseas calling cards are available at most newsagents.
The Internet is widely used in Iran.
There are Internet cafes in most hotels.
Usage may be monitored.

Do not work illegally.
You will be deported, fined and/or imprisoned.
You may also be prevented from entering the country again.
Islamic law is strictly enforced in Iran.
Alcohol is forbidden. Importation of pork products is banned.
Consult a guide book on Iran to determine how to dress and behave properly and respectfully.
Women should expect to wear a headscarf and jacket that covers the arms and upper body while in public.
There may be additional dress requirements at certain religious sites, e.g., women might need to put on a chador (which covers the whole body except the face) at some shrines.
During the holy month of Ramadan, you should in general observe the Muslim tradition of not eating, drinking or smoking in public from sunrise to sunset each day, though there are exemptions for foreign travelers who eat in hotel restaurants.
(See the Criminal Penalties section below for more information.)
In general, it is best to ask before taking photographs of people.
Hobbies like photography and those involving the use of binoculars (e.g., bird-watching) can be misunderstood and get you in trouble with security officials.
(See the Safety and Security section above for warnings on photography.)
For specific information regarding Iranian customs regulations, contact the Iranian Interests Section of the Embassy of Pakistan in Washington, DC.
Please see our Customs Information for U.S. regulations.
Most laptops are controlled items.
It is unlawful to bring controlled items into Iran, even on a temporary basis, unless specifically authorized by the Office of Foreign Assets Control (OFAC) in a manner consistent with the Iran-Iraq Arms Nonproliferation Act of 1992 and other relevant law.
U.S. Government economic sanctions still govern imports of Iranian-origin goods and services and exports to Iran.
Except for carpets and foodstuffs, and information or informational materials and gifts valued at $100 or less, the importation of Iranian-origin goods or services into the United States is prohibited.
The exportation or re-exportation of goods, technology or services directly or indirectly from the United States or by a U.S. person to Iran also is prohibited, except in the following cases: articles donated to relieve human suffering (such as food, clothing and medicine), gifts valued at $100 or less, licensed exports of agricultural commodities, medicine and medical devices, and trade in informational materials.
The Office of Foreign Assets Control (OFAC), Department of Treasury, provides guidance to the public on the interpretation of the current economic sanctions.
For further information, consult OFAC’s Compliance Programs Division, at 202-622-2490, visit the OFAC web site at http://www.treas.gov/offices/enforcement/ofac/, or obtain information via fax at 202-622-0077.
For information concerning licensing of exports, contact OFAC’s Licensing Division at:

Licensing Division
Office of Foreign Assets Control
U.S. Department of the Treasury
1500 Pennsylvania Avenue NW
Treasury Annex
Washington, DC 20220
Telephone (202) 622-2480; Fax (202) 622-1657

Iran is prone to earthquakes.
Many people have died in recent years, most notably in the city of Bam in 2003, killing 30,000.
In February 2005, an earthquake measuring 6.4 on the Richter scale struck Zarand in southeast Iran.
In March 2006, several earthquakes occurred in Restan province, western Iran, killing around 100 and injuring 1200.
CRIMINAL PENALTIES:
While in a foreign country, a U.S. citizen is subject to that country's laws and regulations, which sometimes differ significantly from those in the United States and may not afford the protections available to the individual under U.S. law.
Penalties for breaking the law can be more severe than in the United States for similar offenses.
Persons violating Iranian laws, even unknowingly, may be expelled, arrested or imprisoned.
Fines, public floggings, and long prison terms are common.
Former Muslims who have converted to other religions, as well as persons who encourage Muslims to convert, are subject to arrest and possible execution.
Drinking, possession of alcoholic beverages and drugs, un-Islamic dress, as well as public displays of affection with a member of the opposite sex are considered to be crimes.
Relations between non-Muslim men and Muslim women are illegal.
Adultery, sex outside of marriage and gay sex are all illegal under Iranian law and carry the death penalty.
DVDs depicting sexual relations and magazines showing unveiled women are forbidden.
Penalties for possession, use, or trafficking in illegal drugs in Iran are severe and convicted offenders can expect long jail sentences and heavy fines.
Iran executes many people each year on drug-related charges.
Engaging in sexual conduct with children or using or disseminating child pornography in a foreign country is a crime, prosecutable in the United States.
Please see our information on Criminal Penalties.

U.S. citizens in Iran who violate Iranian laws, including laws that are unfamiliar to Westerners (such as those regarding the proper wearing of apparel,) may face severe penalties.

The Iranian Government reportedly has the names of all individuals who filed claims against Iran at the Iran-U.S. Claims Tribunal at The Hague pursuant to the 1981 Algerian Accords.
In addition, the Iranian Government reportedly has compiled a list of the claimants who were awarded compensation in the Iran Claims Program administered by the Foreign Claims Settlement Commission.
The Iranian government is allegedly targeting award-holders who travel to Iran.
It is reported that upon some claimants' entry into Iran, Iranian authorities question them as to the status of payment of their respective awards with a view to recouping the award money.
It is also reported that the Iranian Government has threatened to prevent U.S. claimants who visit Iran from departing the country until they make arrangements to repay part or all of their award.
CHILDREN'S ISSUES:
For information see our Office of Children’s Issues web pages on intercountry adoption and international parental child abduction.

REGISTRATION/U.S. INTERESTS SECTION LOCATION:
There is no U.S. Embassy or Consulate in Iran.
The Embassy of Switzerland serves as the protecting power for U.S. interests in Iran.
The U.S. Interests Section at the Swiss Embassy is currently located at Afrika Avenue, West Farzan Street, no. 59, Tehran.
The telephone numbers for the U.S. Interests Section are (98) 021-8878-2964 and 98-021-8879-2364, fax 98-021-8877-3265, email: tie.vertretung@eda.admin.ch.
The workweek is Sunday through Thursday.
Public service hours are 8:00 a.m. – 12:00 noon.
The Interests Section does not issue U.S. visas or accept visa applications.
The limited consular services provided to U.S. citizens in Tehran include:
(a) registering U.S. citizens;
(b) answering inquiries concerning the welfare and whereabouts of U.S. citizens in Iran;
(c) rendering assistance in times of distress or physical danger;
(d) providing U.S. citizens with passport and Social Security card applications and other citizenship forms for approval at the U.S. Embassy in Bern, Switzerland;
(e) performing notarial services on the basis of accommodation; and,
(f) taking provisional custody of the personal effects of deceased U.S. citizens.
Americans living or traveling in Iran are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department’s travel registration website so that they can obtain updated information on travel and security within Iran.
They may also register on the web site of the U.S. Interests Section at www.eda.admin.ch/tehran.
Americans without Internet access may register directly with the nearest U.S. Embassy or Consulate before flying to Iran.
By registering, American citizens make it easier for the U.S. Interests Section to contact them in case of emergency.
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This replaces the Consular Information Sheet dated June 5, 2007, to update the sections on Entry/Exit Requirements, Safety and Security, Crime, Information for Victims of Crime, Medical Facilities and Health Information, Traffic Safety and Road Conditions, Special Circumstances, Criminal Penalties and Registration/U.S. Interests Section Location.

Travel News Headlines WORLD NEWS

Date: Fri, 8 Nov 2019 12:35:08 +0100 (MET)

Tehran, Nov 8, 2019 (AFP) - An earthquake rocked northwestern Iran before dawn on Friday, killing at least five people and injuring more than 300 in crumbling and collapsed buildings.   The 5.9-magnitude quake struck at 1:17 am (2247 GMT Thursday) about 120 kilometres (75 miles) southeast of the city of Tabriz, in East Azerbaijan province, the Iranian Seismological Centre said.

Described as "moderate", the quake was eight kilometres (five miles) deep and was followed by five aftershocks.    The provincial governor, Mohammad-Reza Pourmohammadi, told Iranian media that rescue operations were underway in 41 villages, but the damage was largely concentrated in two, Varnakesh and Varzaghan.   According to the emergency services, nearly 340 people were admitted to hospital for treatment, but all but 17 were discharged by Friday noon.   Some 40 homes were levelled by the quake and over 200 head of cattle killed.

Around 100 injured residents were pulled out of the rubble of their damaged or flattened homes.   Around noon, emergency teams distributed survival kits, stoves, blankets and tents in 78 villages.   In Varnakesh, an emergency shelter was set up.   State television broadcast images of people who had fled their homes warming themselves around a fire lit on a public highway.   But the damage appeared to be less widespread than initially feared.   The United States Geological Survey (USGS) had issued an alert warning that "significant casualties are likely and the disaster is potentially widespread".

In many areas people had returned to their homes by daybreak after the initial panic subsided and the aftershocks petered out.   The gas supply was restored to all but one of the affected villages.   The quake was felt in the provincial capital Tabriz and as far away as the city of Rasht, near the Black Sea coast 200 kilometres (125 miles) from the epicentre.   Tabriz, which has a population of more than a million, is a historic city which served as Iran's capital several times between the 13th and 16th centuries. Its bazaar is a UNESCO world heritage site.   Iran sits where two major tectonic plates meet and experiences frequent seismic activity.

The country has suffered a number of major disasters in recent decades, including at the ancient city of Bam, which was decimated by a catastrophic earthquake in 2003 that killed at least 31,000 people.     In 1990, a 7.4-magnitude quake in northern Iran killed 40,000 people, injured 300,000 and left half a million homeless, reducing dozens of towns and nearly 2,000 villages to rubble.   Iran has experienced at least two other significant quakes in recent years -- one in 2005 that killed more than 600 people and another in 2012 that left some 300 dead.
Date: Fri 26 Jul 2019
Source: Tehran Times [edited]

More than 16,000 cases of brucellosis were diagnosed in Iran during the past Iranian calendar year (March 2018-March 2019), said Behzad Amiri, the head of the zoonotic diseases department at the Ministry of Health.

According to the WHO, brucellosis is a bacterial disease caused by various _Brucella_ species, which mainly infect cattle, swine, goats, sheep, and dogs. Humans generally acquire the disease through direct contact with infected animals, by eating or drinking contaminated animal products, or by inhaling airborne agents. Consumption of unpasteurized milk and dairies as well as contact with an animal or animal product infected with the _Brucella_ bacterium are the main causes of brucellosis, Amiri said.

Western, north-western, and north-eastern provinces are the most affected regions in Iran, he added. "Information dissemination to animal farmers as well as vaccination of livestock have been conducted in this region," he noted.

The disease has been reported in more than a half-million people each year in 100 countries, according to the WHO.

General symptoms of brucellosis are often vague and similar to influenza. They may include fever, back pain, body-wide aches and pains, poor appetite and weight loss, headache, night sweats, weakness, abdominal pain, and cough.
=====================
[This infection, a bacterial zoonosis, is classified among the category B biowarfare agents. Natural transmission to humans occurs after occupational exposure or through ingestion of contaminated food products. Although brucellosis has become a rare entity in the United States and many industrialized nations because of animal vaccination programs, this condition remains a significant health problem in many developing countries.

Each species of _Brucella_ has a specific animal reservoir in which chronic disease is present. The bacilli tend to localize in the reproductive organs of the animals, causing sterility and abortions, and are shed in large numbers in the animal's urine, milk, and placental fluid. This localization allows for efficient spread to farmers, veterinarians, slaughterhouse workers, and consumers.

Among the 4 species known to cause disease in humans, _Brucella melitensis_ (from goats, sheep, or camels) may be the most virulent, producing the most severe and acute cases of brucellosis with disabling complications. A prolonged course of illness, which may be associated with suppurative destructive lesions, is associated with _B. suis_ (from feral or commercially raised pigs) infection. _B. abortus_ (from cattle, buffalo, and camels) is associated with mild-to-moderate sporadic disease that is rarely associated with complications.

In the Maghreb and the Middle East, human brucellosis is usually contracted through consumption of raw goat/ewe's milk or local artisanal cheese made from raw milk, and _Brucella melitensis_ is responsible for the great majority of the reported cases, with a marked predominance of its biovar 3, as in other Mediterranean countries. - ProMED Mod.LL]

[HealthMap/ProMED-mail map:
Date: Mon, 8 Jul 2019 13:54:29 +0200

Tehran, July 8, 2019 (AFP) - A 5.7-magnitude earthquake struck southwest Iran near the border with Iraq on Monday, causing one death due to a heart attack and dozens of injuries, the country's relief and rescue organisation said.

The quake, whose epicentre was in the Masjed Soleiman area of Khuzestan province, hit at 11:30 am (0700 GMT) at a depth of 17 kilometres, the national seismological centre reported.   The region was rattled by seven aftershocks, the strongest of which measured 4.7 magnitude, it said.   At least 45 people were injured, the head of Iran's relief and rescue organisation, Morteza Salimi, told state TV.   "One citizen at Masjed Soleiman also passed away due to a heart-attack after the earthquake," Salimi said.   In nearby cities and villages affected by the quake, there were "only minor cracks in buildings" and roads to some villages were cut off.

Iran sits on top of major tectonic plates and sees frequent seismic activity.  In November 2017 a 7.3-magnitude tremor in the western province of Kermanshah killed 620 people.   In 2003, a 6.6-magnitude quake in southeast Iran decimated the ancient mud-brick city of Bam and killed at least 31,000 people.   Iran's deadliest quake was a 7.4-magnitude tremor in 1990 that killed 40,000 people in northern Iran, injured 300,000 and left half a million homeless.
Date: Sun, 30 Jun 2019 18:55:01 +0200

Tehran, June 30, 2019 (AFP) - Iran will no longer require Chinese visitors to obtain visas, state media reported Sunday, as the sanctions-hit country attempts to boost tourism in the face of an economic crisis.   "The cabinet has agreed to waive visa requirements for Chinese nationals entering the Islamic Republic of Iran," state news agency IRNA said.   Tourism board chief Ali Asghar Mounesan told IRNA that "we aim to host two million Chinese tourists per year using our country's numerous attractions."   He said the sector is "unsanctionable" and could help offset the economic hardships caused by tough sanctions Washington reinstated after withdrawing from a multilateral nuclear deal last year.   The sanctions have particularly targeted Iran's vital oil exports and international financial transactions, and were a major factor in the country's ongoing recession.

According to IRNA, some 52,000 Chinese tourists visited Iran during the 12 months to March.   In another bid to boost tourist arrivals, Iran recently announced it would no longer stamp visitors' passports, allowing them to bypass a US entry ban on travellers who have visited the Islamic Republic.   China is one of the remaining partners in the nuclear deal and has rejected the Trump administration's policy of seeking to cut Iranian oil exports to zero.   Tehran has threatened to abandon some of its commitments under the nuclear deal unless the remaining partners -- Britain, China, France, Germany and Russia -- help it circumvent US sanctions, especially on oil sales.
Date: Sun 2 Jun 2019
Source: Tehran Times [edited]

Since the beginning of the current Iranian calendar year [21 Mar 2019], 12 people have been diagnosed with Crimean-Congo haemorrhagic fever and 2 of them lost their lives, said Mohammad Mahdi Guya, the Director of Communicable Diseases Department at the Ministry of Health, ISNA reported on [Sat 1 Jun 2019].

The prevalence of Crimean-Congo haemorrhagic fever in the country has decreased to half in comparison to the same period during the last year, however the disease happens more in hot weather hence more precise statistics will be revealed in late summer, he explained.  The disease was spotted in the cities of Iranshahr, Zabol, Kermanshah, and Bandar Abbas as well as Gilan province, he said.  Those who work in slaughterhouses or keep livestock at their home and those who live in rural places are more endangered, he said.

The virus is primarily transmitted to people from ticks and livestock animals. Human-to-human transmission can occur resulting from close contact with the blood, secretions, organs, or other bodily fluids of infected persons.

The contact with meat which is frozen for more than 24 hours does not transmit the virus, he explained.  He also warned about nurses and medical staff who may [care for] a patient with Crimean-Congo hemorrhagic fever, he said.  Well-cooked meat does not transmit the virus, however, eating raw meat may transmit the virus, he warned.

According to health ministry, annually, some 100 to 150 cases of Crimean-Congo fever are reported in Iran.

According to World Health Organization, the Crimean-Congo haemorrhagic fever virus causes severe viral hemorrhagic fever outbreaks. The CCHF is a widespread disease caused by a tick-borne virus. The CCHF virus causes severe viral hemorrhagic fever outbreaks, with a case fatality rate of 10-40 percent.
======================
[The report above mentions Crimean-Congo hemorrhagic fever (CCHF) case numbers for 2019, beginning 21 Mar 2019 according to the Iranian calendar. Iran is one of the countries where CCHF has been endemic for many years and cases are reported form many provinces on a regular basis.

CCHF is a tick-borne zoonotic disease with high case fatality rates in humans and the potential to cause outbreaks. Of the epidemic-prone diseases prioritised by the WHO Research & Development (R&D) Blueprint; CCHF is the most widespread, found in around 30 countries across Europe, Asia, Africa, the Middle East, and the Indian subcontinent and is expected to continue to expand its range (<https://www.who.int/blueprint/priority-diseases/key-action/crimean-congo-haemorrhagic-fever/en/>).

Although this roadmap focuses on the development of new or improved products and medical 36 countermeasures, other public health preparedness actions are also critical for successful prevention of CCHF epidemics. Foremost amongst these is the need for regional, national, and international surveillance, reporting not only human CCHF cases but also monitoring tick and animal reservoirs for evidence of CCHFV or seroconversion. This will require agreements and mechanisms 40 for data sharing in real time and cooperation and coordination between the human, animal, and environmental health sectors for the good of public-health disease control. - ProMED Mod.UBA]

[HealthMap/ProMED-mail map of Iran:
More ...

Honduras

Honduras - US Consular Information Sheet
May 19, 2008

COUNTRY DESCRIPTION:
Honduras is a democracy with a developing economy. The national language is Spanish, although English is often spoken in the Bay Islands. The climate is genera
ly pleasant and temperate, with dry and wet seasons. During the dry season from February into May, widespread forest fires and agricultural burning can lead to severely degraded air quality throughout the country possibly causing respiratory problems and airport closures. The terrain includes mountainous areas, coastal beaches, and jungle lowlands. Facilities that would normally be used by tourists, including hotels and restaurants, are generally adequate in the capital city of Tegucigalpa, in San Pedro Sula, Tela, La Ceiba, the Bay Islands, and near the Copan ruins. Large sections of the country, however, lack basic public services or even a governmental presence. Currency exchange is readily available at banks and hotels in the major cities. Read the Department of State Background Notes on Honduras for additional information.

ENTRY/EXIT REQUIREMENTS: A U.S. passport valid for at least three months from the date of entry is required to enter Honduras. Though not required by law, some travelers have reported difficulty departing Honduras using a passport with less than three months of validity beyond the date of departure. A visa is not required, but tourists must provide evidence of return or onward travel. Parents should not rely on birth certificates for their children’s travel; rather, prior to travel they should obtain U.S. passports for infants and minors born in the United States. U.S. citizens are encouraged to carry a photocopy of their U.S. passports with them at all times, so that if questioned by local officials proof of identity and U.S. citizenship are readily available.

In June 2006, Honduras entered a “Central America-4 (CA-4) Border Control Agreement” with Guatemala, El Salvador, and Nicaragua. Under the terms of the agreement, citizens of the four countries may travel freely across land borders from one of the countries to any of the others without completing entry and exit formalities at Immigration checkpoints. U.S. citizens and other eligible foreign nationals who legally enter any of the four countries may similarly travel among the four without obtaining additional visas or tourist entry permits for the other three countries. Immigration officials at the first port of entry determine the length of stay, up to a maximum period of 90 days. Foreign tourists who wish to remain in the four country region beyond the period initially granted for their visit are required to request a one-time extension of stay from local immigration authorities in the country where the traveler is physically present, or travel outside the CA-4 countries and reapply for admission to the region. Foreigners “expelled” from any of the four countries are excluded from the entire “CA-4” region. In isolated cases, the lack of clarity in the implementing details of the CA-4 Border Control Agreement has caused temporary inconvenience to some travelers and has resulted in others being fined more than one hundred dollars or detained in custody for 72 hours or longer.

Dual Nationality: Honduran law permits dual nationality only for minors under the age of 21 and those Honduran-born citizens who have become naturalized citizens of other countries. U.S. citizens who become Honduran citizens by naturalization are not considered to have dual nationality under Honduran law. However, becoming a Honduran citizen will not cause U.S. citizens to lose their U.S. citizenship and all the accompanying rights and privileges. Dual nationals, in addition to being subject to all Honduran laws affecting U.S. citizens, may be subject to other laws that impose special obligations on Honduran citizens. For more information, please contact Honduran Immigration in Tegucigalpa (telephone 504-238-5613), San Pedro Sula (telephone 504-550-3728), Roatan (telephone 504-445-1226), La Ceiba (telephone 504-442-0638), or Puerto Cortes (telephone 504-665-0582).

For further information on dual nationality for U.S. citizens, see the Bureau of Consular Affairs dual nationality flier.

SAFETY AND SECURITY:
Political demonstrations sometimes disrupt traffic, but they are generally announced in advance and are usually peaceful. Travelers should avoid areas where demonstrations are taking place, and they should stay informed by following the local news and consulting hotel personnel and tour guides. Demonstrators frequently block public roads to press for concessions from the government of Honduras. These demonstrations may last several hours and the government rarely seeks to disperse the demonstrators. U.S. citizens should never try to pass such roadblocks. While the Honduran side of the Honduras-Nicaragua border has been largely cleared of land mines, travelers should exercise caution there. For more information, we strongly encourage travelers to visit the U.S. Embassy's web site at http://honduras.usembassy.gov/ and click on Crime and Security Matters. For the latest security information, American citizens traveling abroad should regularly monitor the Department of State, Bureau of Consular Affairs’ web site at http://travel.state.gov, where the current Travel Warnings and Travel Alerts, as well as the Worldwide Caution, can be found.

Up-to-date information on safety and security can also be obtained by calling 1-888-407-4747 toll free in the United States, or for callers outside the United States and Canada, a regular toll-line at 1-202-501-4444. These numbers are available from 8:00 a.m. to 8:00 p.m. Eastern Time, Monday through Friday (except U.S. federal holidays). The Department of State urges American citizens to take responsibility for their own personal security while traveling overseas. For general information about appropriate measures travelers can take to protect themselves in an overseas environment, see the Department of State’s pamphlet A Safe Trip Abroad.

CRIME: Crime is endemic in Honduras and requires a high degree of caution by U.S. visitors and residents alike. U.S. citizens have been the victims of a wide range of crimes, including murder, kidnapping, rape, assault, and property crimes. Sixty-two U.S. citizens have been murdered in Honduras since 1995; only twenty cases have been resolved. Four U.S citizens were murdered in Honduras in 2007, six in 2006, and ten in 2005. Kidnappings of U.S. citizens have occurred in Honduras, including two incidents in 2007. Poverty, gangs, and low apprehension and conviction rates of criminals contribute to a critical crime rate, including horrific acts of mass murder. With a total of 3,855 murders in 2007, and a population of approximately 7.3 million people, Honduras has one of the world’s highest per capita murder rates.

U.S. citizens are encouraged to follow local news reports and seek additional information in the resources listed above. Criminals and pickpockets also target visitors as they enter and depart airports and hotels, so visitors should consider carrying their passports and valuables in a concealed pouch. Two-man teams on medium-size motorcycles often target pedestrians for robbery. There have also been reports of armed robbers traveling in private cars targeting pedestrians on isolated streets. The Honduran government conducts occasional joint police /military patrols in major cities in an effort to reduce crime. Problems with the judicial process include corruption and an acute shortage of trained personnel, equipment, staff, and financial resources. The Honduran law enforcement authorities' ability to prevent, respond to, and investigate criminal incidents and prosecute criminals remains limited. Honduran police generally do not speak English. The government has established a special tourist police in the resort town of Tela and other popular tourist destinations, including Tegucigalpa, San Pedro Sula, La Ceiba, and Roatan, but the number deployed is small and coverage is limited. The San Pedro Sula area has seen occasional armed robberies against tourist vans, minibuses, and cars traveling from the airport to area hotels, even sometimes targeting the road to Copan. Armed men have forced vehicles transporting tourists off the road and robbed the victims, occasionally assaulting the driver or passengers. In past years, several U.S. citizens have been murdered in San Pedro Sula and La Ceiba shortly after arriving in the country. Assaults in these areas may be based on tips from sources at airport arrival areas, so visitors are strongly urged to exercise caution in discussing travel plans in public.

Copan, Roatan/Bay Islands, and other tourist destinations have a lower crime rate than other parts of the country, but thefts, break-ins, assaults, and murders do occur. Exercise particular caution walking on isolated beaches, especially at night. Coxen Hole on the island of Roatan should be avoided after dark.

The Government of Honduras has a very limited presence in Northern Olancho, Colon and Gracias a Dios Departments, which are well known for lumber and narcotics smuggling and violence. Travelers in those areas should use extra caution. See the description of highways/areas to be avoided in the Traffic Safety and Road Conditions section below for details.

Incidents of crime along roads in Honduras are common, including carjacking and kidnapping. There have been frequent incidents of highway robbery on a number of roads including Limones to La Union, Olancho (route 41) via Salama and northward to Esquipulas Del Norte. For more information, please see the section below on Traffic Safety and Road Conditions.

Travelers should always drive with their doors locked and windows rolled up to avoid potential robberies at traffic lights and other places, such as congested downtown streets. Avoid driving at night. All bus travel should be during daylight hours and on first-class conveyances, not on economy buses. Please choose taxis carefully, and note the driver's name and license number. Instruct the driver not to pick up other passengers, agree on the fare before you depart, and have small bills available for payment, as taxi drivers often do not make change.

Do not resist a robbery attempt. Most criminals have weapons, and most injuries and deaths have resulted when victims have resisted. In 2004, an American citizen was murdered while attempting to flee an armed robbery in progress and another American was shot while resisting a carjacking. Two American citizens were murdered while resisting armed robberies in 2005.

Do not hitchhike or go home with strangers, particularly from nightspots. Whenever possible, travel in groups of two or more persons. Use the same common sense while traveling in Honduras that you would in any high crime area in the United States: do not wear excessive jewelry; do not carry large sums of money, or display cash, ATM/credit cards, or other valuables you do not need.

Avoid walking at night in most areas of Honduras. Do not hike alone in backcountry areas, or walk alone on beaches, historic ruins, or trails.

Individuals and groups should register their travel plans with the State Department via the Internet at the Department’s secure travel registration web site, https://travelregistration.state.gov/. Travelers may also register by sending passport, date of birth, and emergency contact information to the American Citizens Services Unit of the U.S. Embassy in Tegucigalpa via fax at 011-504-238-4357, or e-mail at usahonduras@state.gov prior to travel. Individuals as well as groups should always keep in their possession a photocopy of their U.S. passport data page, carry an additional copy in their suitcase, and leave a copy at home with a friend or family member.

INFORMATION FOR VICTIMS OF CRIME: If you are the victim of a crime while in Honduras, contact local authorities immediately, either directly or through the national police emergency number: *199. In addition to reporting to the local police, please contact the U.S. Embassy in Tegucigalpa or the Consular Agency in San Pedro Sula for assistance. The theft of a U.S. passport should be reported immediately. The Embassy and Consular Agency staff can provide you with information about medical care, contacting family members or friends and explaining how funds could be transferred. Although the investigation and prosecution of most crimes are solely the responsibility of local authorities, Consular staff can provide you with a list of attorneys if needed. See our information on Victims of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION: Medical care in Honduras varies greatly in quality and availability. Outside Tegucigalpa and San Pedro Sula, medical care is inadequate to address complex situations. Support staff facilities and necessary equipment and supplies are not up to U.S. standards anywhere in Honduras. Facilities for advanced surgical procedures are not available. Wide areas of the country, including the popular tourist areas of the Bay Islands, do not have a general surgery hospital. Ambulance services are limited in major cities and almost non-existent elsewhere. Emergency services may be contacted directly through their local numbers.

Scuba diving is popular in the Bay Islands, but the limited medical facilities there pose a special risk in the event of an emergency. There is a decompression chamber on Roatan and Utila for divers, but no advanced medical care on either island for diving related accidents.

MEDICAL INSURANCE: The Department of State strongly urges American citizens to consult with their medical insurance company prior to traveling abroad to confirm whether their policy applies overseas and whether it will cover emergency expenses such as a medical evacuation. Please see our information on medical insurance overseas. U.S. medical insurance plans seldom cover health costs incurred outside the U.S. unless supplemental coverage is purchased. Furthermore, U.S. Medicare and Medicaid programs do not provide payment for medical services outside the United States. However, many travel agents and private companies offer insurance plans that will cover health care expenses incurred overseas including emergency services such as medical evacuations. It is important to ensure that you have adequate medical evacuation coverage prior to your trip to Honduras.

When making a decision regarding health insurance, American citizens should consider that many foreign doctors and hospitals require payment in cash prior to providing service and that a medical evacuation to the U.S. may cost tens of thousands of dollars. Uninsured travelers who require medical care overseas often face extreme difficulties. When consulting with your insurer prior to your trip, ascertain whether payment will be made to the overseas healthcare provider or whether you will be reimbursed later for expenses you incur. Some insurance policies also include coverage for psychiatric treatment and for disposition of remains in the event of death.

Useful information on medical emergencies abroad, including overseas insurance programs, is provided in the Department of State's Medical Information for Americans Traveling Abroad.

OTHER HEALTH INFORMATION: Mosquito-borne illnesses are an ongoing problem in Honduras. All persons traveling in Honduras, even for a brief visit, are at risk of contracting malaria. Take a prophylactic regimen best suited to your health profile. The country regularly suffers from outbreaks of dengue fever. Unlike traditional mosquito-borne illnesses, there is no medicinal prophylactic or curative regimen for dengue fever. Travelers should take precautions against being bitten by mosquitoes to reduce the chance of contracting such illnesses, such as avoiding standing water even in the home, wearing long sleeves and pants in both day and night, and applying insect repellent regularly.

Severe air pollution, which can aggravate or lead to respiratory problems, is common throughout the country during the dry season due in large part to widespread forest fires and agricultural burning. Travelers with respiratory or cardiac conditions and those who are elderly or extremely young are at greatest risk for complications from air pollution, which may include coughing, difficulty breathing, wheezing, or chest pain. Acute respiratory infections are also widespread; more than 100,000 cases are reported annually.

Individuals traveling to Honduras should ensure that all their routine vaccinations are up to date. Vaccination against Hepatitis A, Hepatitis B, and Typhoid is strongly recommended for those traveling to Honduras from the United States. Honduras requires vaccination against Yellow Fever for those traveling to Honduras from countries where there is the risk of transmission. Travelers taking prescription medications should bring an adequate supply with them when coming to Honduras and ensure that they are properly labeled.

Honduras also has the highest adult HIV/AIDS prevalence rate in the region. Over 63,000 people in Honduras have HIV/AIDS.

Honduras lacks a substantial infrastructure for maintaining water purity. Travelers are strongly encouraged to avoid drinking tap water or a beverage that contains ice from an unknown source (even alcoholic drinks). Bottles and bags of purified water are widely available. It is also recommended that individuals traveling to Honduras avoid eating untreated raw vegetables, fruits that can’t be peeled on the spot, raw fish like ceviche and undercooked shellfish and products containing mayonnaise, pastry icing, and unpasteurized dairy products. Hot cooked food, fresh bread, dry foods such as crackers, bottled carbonated beverages, coffee, tea, and beer are usually safe, provided such food items are not purchased from street vendors. All fruits and vegetables should be washed thoroughly with detergent and running water. Those that will be cooked or peeled can then be stored in a sealed container until used. Those that will be eaten raw and will not be peeled should be soaked for 15 minutes in a solution of chlorine bleach (or 5% household bleach) in water (one tablespoon of Clorox per gallon of water), rinsed with potable water, and allowed to air dry.

Information on vaccinations and other health precautions, such as safe food and water precautions and insect bite protection, may be obtained from the Centers for Disease Control and Prevention’s hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747); fax 1-888-CDC-FAXX (1-888-232-3299), or via the CDC’s web site at http://wwwn.cdc.gov/travel/default.aspx. For information about outbreaks of infectious diseases abroad consult the World Health Organization’s web site at http://www.who.int/en. Further health information for travelers is available at http://www.who.int/ith.

TRAFFIC SAFETY AND ROAD CONDITIONS: While in a foreign country, U.S. citizens may encounter road conditions that differ significantly from those in the United States. The information below concerning Honduras is provided for general reference only, and may not be totally accurate in a particular location or circumstance.

Because of crime and poor road conditions, driving can be very dangerous, and travelers should carry a cellular phone in case of an emergency. Travelers should exercise extreme caution while driving on isolated stretches of road and passing on mountainous curves. Rockslides are common, especially in the rainy season (May through December). Traffic signs, even on major highways, are often inadequate, and streets in the major cities are often unmarked. Travelers should always drive with their doors locked and windows rolled up to avoid potential robberies at traffic lights and other places such as congested downtown streets. Please refer to our Road Safety page for more information.

Honduran roads are poorly lit and marked. Vehicles are often driven at night without adequate illumination, and animals and people wander onto the roads at all hours. For these reasons, and because of the high incidence of crime, the U.S. Embassy strongly discourages car and bus travel after dark.

Major cities are connected by an inconsistently maintained, two-lane system of paved roads. Many secondary roads in Honduras are unpaved. During the rainy season, even major highways are often closed due to rockslides and flooding from heavy rains. In the event of an accident, contact the Honduran Transit Authority (“Transito”) immediately. They may be contacted either directly through their local numbers, or through their national emergency number, *189. Honduran law requires that no vehicles involved in an accident be moved until Transit Agents arrive, not even to clear a traffic obstruction, unless you are in serious physical danger.

Some of the most dangerous stretches for road travel include: Tegucigalpa to Choluteca, because of dangerous mountain curves; El Progreso to La Ceiba, because of animal crossings and the poor condition of bridges from flooding; Route 39 through northern Olancho Department between Gualaco and San Esteban; and Limones to La Union, Olancho (route 41) via Salama and northward to Saba. Locals also refer to this latter stretch of road as the “Corridor of Death” because of frequent incidents of highway robbery. In March of 2008, 27 persons died when a bus overturned and rolled down a ravine in La Esperanza, Intibuca, on another infamous stretch of road called “Flight of the Angel.”

The Embassy has received reports of robberies on the road from Tegucigalpa to Danlí. The only recommended route to the north coast from the south is CA-5 to route 21 to CA-13 via Tela to La Ceiba and Trujillo. Hijackings of private and commercial vehicles from the United States to Honduras have occurred. While Honduras and the United States have signed and ratified a Stolen Vehicle Treaty, existing Honduran laws protect good faith buyers (even of stolen vehicles) so the recovery and return of these vehicles to their original owners is not guaranteed. Vehicle insurance may mitigate loss; please check with the National Insurance Crime Bureau at https://www.nicb.org, private insurance carriers, and our Embassy web site information on Commercial Vehicle Hijackings at http://honduras.usembassy.gov/english/mission/sections/RSO/comveh_highsec.htm for more information.

For additional general information about road safety, please see our Road Safety page, which includes links to foreign government sites. For specific information concerning Honduran driving permits, vehicle inspection, road tax, and mandatory insurance, please contact the Honduran National Tourist Organization offices in New York via the Internet at http://www.hondurastips.honduras.com/.

MARINE SAFETY AND OVERSIGHT: The areas off both coasts of Honduras are the subject of maritime border disputes between Honduras and its neighbors. The Honduran Navy patrols these areas, and all private vessels transiting Honduran territorial waters should be prepared to be hailed and possibly boarded by Honduran military personnel to verify documentation. While the Honduran Navy previously used private vessels as patrol vessels, this is no longer the case. In the event that any vessel is hailed in Honduran waters in the Caribbean by a non-military vessel or any suspicious vessel and directed to prepare for boarding, the vessel should immediately contact the U.S. Coast Guard Operations Center by radio or INMARSAT at 305-415-6800. Anyone needing more information can also contact the U.S. Embassy during working hours and request to speak with the U.S. Military Group (USMILGP) office.

There have been incidents of armed assaults against private sailing vessels by criminals posing as fishermen off the northeast coast of Honduras, particularly in the numerous small islands northeast of the Department of Gracias a Dios. Sailors should contact the Coast Guard and yacht facility managers in their areas of travel for current information.

AVIATION SAFETY OVERSIGHT: The U.S. Federal Aviation Administration (FAA) has assessed the Government of Honduras’ Civil Aviation Authority as not being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for the oversight of Honduras’ air carrier operations. For more information, travelers may visit the FAA’s web site at http://www.faa.gov/safety/programs_initiatives/oversight/iasa.

Severe air pollution often leads to the closing of some or all of Honduras’ four international airports during the dry season. Some travelers have been compelled to travel by bus to neighboring countries in order to catch onward flights.

SPECIAL CIRCUMSTANCES:

Real Estate Investment: U.S. citizens should exercise extreme caution before entering into any form of commitment to invest in real property, particularly in coastal areas and the Bay Islands. Honduran laws and practices regarding real estate differ substantially from those in the United States, and fraudulent deeds and titles are common; U.S. citizens considering investing or buying real estate in Honduras should be aware that rights to such property do not enjoy the same level of protection as in the United States. Historically, title insurance has not been available in Honduras. Recently, some American insurance companies have begun offering title insurance in cooperation with Honduran attorneys. However, approximately 80 percent of privately held land is untitled. In addition, there are complaints that the Honduran judicial system often prolongs disputed cases for many years before resolution. American citizens have spent thousands of dollars in legal fees and years of frustration trying to resolve property disputes, even in cases in which local attorneys and Honduran and U.S. real estate agents had given assurances to the investor. Violence has been used against American citizens involved in disputed property cases. Potential investors should engage competent local legal representation before making any commitments. Investors should thoroughly check references of attorneys and real estate agents.

Honduran law places certain restrictions on land ownership by foreigners in coastal and border areas. Squatters claim a number of properties owned by U.S. citizens. U.S. Government officials may not act as agents, attorneys, or in a fiduciary capacity. U.S. citizens who own property abroad and who thereby have assumed responsibilities concurrent with ownership of property in a foreign country should take steps on their own initiative to safeguard their interests and to employ private legal counsel when the need arises. For further information on investing in property in Honduras, please review the State Department’s Investment Climate Statement, part of the Country Commercial Guide at http://www.buyusa.gov/honduras/en/14.html. For information on contracting Honduran legal representation, please check with other investors. You may also refer to the list of attorneys available on the Embassy's home page at http://honduras.usembassy.gov/attorneylistoct07.pdf.

Financial Market Investment: Due to poor regulation and lack of guarantees, investment in the Honduran "Bolsa de Valores," or securities market, as well as banking institution bonds, “fideicomisos” (trusts), and certificates of deposit from uninsured financial institutions pose high risk to investors. Extreme caution should be exercised before and while undertaking such activities, as American citizens have lost large sums of money through investments in such precarious markets. For further information on investing in Honduras, please review the State Department’s Investment Climate Statement, part of the Country Commercial Guide at http://www.buyusa.gov/honduras/en/14.html.

Corruption: Many U.S. firms and citizens operating in Honduras have found corruption to be a serious problem and a constraint to successful investment. While some U.S. firms have satisfactorily resolved cases through the courts, the majority have difficulty navigating the legal system. There are complaints that the Honduran judicial system caters to favoritism, external pressure and bribes. Corruption appears to be most pervasive in government procurement, government permits, and in the buying and selling of real estate (land titling).

Customs Regulations: U.S. citizens who intend to stay in Honduras for an extended period of time and who bring vehicles or household goods into the country should consult Honduran customs officials prior to shipment. With the exception of “antique” cars, all vehicles imported into Honduras by foreigners must be less than ten (10) years old. For specific information regarding customs requirements, please contact the Embassy of Honduras in Washington, DC at http://www.hondurasemb.org/ for more information.

Honduran customs authorities may enforce strict regulations concerning temporary import and export of items such as antiquities, medications, and business equipment. For example, Honduran law prohibits the export of antiques and artifacts from pre-colonial civilizations. To protect the country's biodiversity, it is illegal to export certain birds, feathers, and other flora and fauna. For specific information regarding exportation requirements, please contact the Embassy of Honduras in Washington, DC at http://www.hondurasemb.org/.

The Government of Honduras is strictly enforcing the law that requires a Honduran permit for the importation of firearms into Honduras. Travelers must obtain a firearm importation permit from a Honduran Embassy, Consulate General, or Consulate located in the United States prior to bringing firearms into the country. Please note that a U.S. government-issued or airline-issued permit is not valid for importation of firearms into Honduras. Firearms that arrive without the requisite Honduran permit will be confiscated and the bearer will be prosecuted to the full extent of Honduran law.

For further information about customs regulations, please read our Customs Information sheet.

CRIMINAL PENALTIES: While in a foreign country, a U.S. citizen is subject to that country's laws and regulations, which sometimes differ significantly from those in the United States and may not afford the protections available under U.S. law. Penalties for breaking the law can be more severe than in the United States for similar offenses. Persons violating Honduran laws, even unknowingly, may be fined, expelled, arrested, or imprisoned. Penalties for possession, use, or trafficking in illegal drugs in Honduras are severe, and convicted offenders can expect long jail sentences and heavy fines. Assisting or participating in the distribution of illegal drugs is also a crime prosecutable in the United States, and may lead to fines, property seizure, or imprisonment. Anyone offering you illegal drugs should be considered extremely dangerous – there is no “safe” source of illegal drugs.

"Sexual tourists" travel alone or in groups to Honduras for the purpose of purchasing sexual favors from minors. This activity violates Honduran law, and American citizens are imprisoned in Honduras for sexual offenses involving minors. In addition, U.S. citizens and residents charged with these crimes are subject to prosecution upon their return to the United States, regardless of the outcome of the judicial proceedings overseas. Moreover, the prevalence of HIV/AIDS in sex workers in Honduras is estimated to be in excess of 10%. Using or disseminating child pornography in a foreign country is also a crime prosecutable in the United States. Please see our information on Criminal Penalties.

CHILDREN'S ISSUES: International adoptions from Honduras are very complex. Current information on Honduran adoption procedures and the immigrant visa application process is available from the Consular Section of the U.S. Embassy. Prospective adoptive parents are urged to check with the Consular Section to ensure that all required documentation has been approved by the U.S. Bureau of Citizenship and Immigration Services (USCIS) of the Department of Homeland Security and to confirm that their child's adoption is complete before traveling to Honduras to apply for their child's immigrant visa. Adoptive parents are also urged to carry with them complete adoption paperwork when traveling with their adopted child to, from, and within Honduras.

Honduras is a signatory to the Hague Convention on the Civil Aspects of International Child Abduction, but the U.S. Department of State has determined that Honduras has failed to comply with its obligations under the Convention. No child has ever been returned to the United States from Honduras under the provisions of the Convention.

For information on international adoption of children and international parental child abduction, please refer to the Office of Children’s Issues web pages on intercountry adoption and international parental child abduction, or telephone Overseas Citizens Services at 1-888-407-4747. This number is available from 8:00 a.m. to 8:00 p.m. Eastern Standard Time, Monday through Friday (except U.S. federal holidays). Callers who are unable to use toll-free numbers, such as those calling from overseas, may obtain information and assistance during these hours by calling 1-202-501-4444.

REGISTRATION / EMBASSY LOCATION:
American citizens residing or traveling in Honduras are encouraged to register their presence through the State Department’s travel registration web site, and to obtain updated information on travel and security within Honduras. American citizens without Internet access may register directly with the U.S. Embassy in Tegucigalpa. By registering, whether via the Internet or in person at the Embassy, American citizens make it easier for the Embassy to contact them in case of emergency.

U.S. Embassy location:
Avenida La Paz in Tegucigalpa, Honduras
Internet site: http://honduras.usembassy.gov/
Telephone: 011-504-236-9320 or 011-504-238-5114
Office hours are Monday through Friday from 8:00 a.m. to 11:30 am.
American Citizens Services Unit Fax: 011-504-238-4357

Consular Agency in San Pedro Sula location:
Banco Atlantida Building – 11th Floor
San Pedro Sula, Honduras
Telephone: 011-504-558-1580
Office hours are Mondays, Wednesdays and Fridays from 1:00 p.m. to 4:00 p.m.

The Consular Agent is available during limited hours to perform notarial services, assist U.S. citizens with emergencies, and accept U.S. passport and U.S. Report of Birth applications for adjudication at the Embassy in Tegucigalpa. The Consular Agent does not provide visa information or services. For more details about all U.S. Embassy and consular services in Honduras, please see the Embassy web site at http://honduras.usembassy.gov/ or visit the Bureau of Consular Affairs web site at http://travel.state.gov/.
* * *
This replaces the Country Specific Information dated October 12, 2007, to update sections on
Entry/Exit Requirements, Crime, Medical Facilities and Health Information, Other Health Information, and Traffic Safety and Road Conditions.

Travel News Headlines WORLD NEWS

Date: Fri, 26 Jul 2019 03:36:47 +0200
By Noe LEIVA

La Paz, Honduras, July 26, 2019 (AFP) - Of Honduras' 32 public hospitals, 26 are overflowing with patients due to what health authorities are calling the worst dengue fever epidemic in the past half century.   The disease has struck 28,000 people this year, of which 54, mostly children, have died.   The enormous case flow is evident in the western city of La Paz. Inside the local hospital's chapel, two tables are piled high with patient folders, which sit in front of a wooden depiction of Christ.   Even more telling are the beds lining the room, protected by red and blue mosquito nets, from which 10 women are being treated for some of dengue's typical symptoms: bone and joint pain, high fever, vomiting and dehydration.#

Officials have called a national emergency to fight the dengue-causing aedes aegypti mosquito and a fumigation program has been launched in homes and public buildings.   And yet the hospital bursts at the seams. On top of those housed in the chapel, six of the facility's eight rooms are taken up by those stricken by dengue, with some beds even in the corridors.   Three of the rooms house a total of 26 children, age two to 14 -- the most vulnerable group to dengue -- who are connected to IV bags and monitored by concerned parents.   "They're not all out of danger," said a nurse as she looked over the patients.

- 'We're overrun' -
Crista Alexandra Pineda, age seven, is one of the children whose health is worrying hospital staff the most.   She was admitted on Sunday suffering from bleeding, accompanied by her 59-year-old grandmother, Josefina Velasquez.   "We're overrun," hospital spokesman Marco Antonio Rodas told AFP.   "We had to postpone planned operations" to concentrate on the emergencies.   "In 20 years working here, I've never seen this," he added.

Over the last week, the number of patients rose from 53 to 78. The most serious cases were transferred by ambulance to the University Hospital in the capital Tegucigalpa, where already two have died, Rodas said.   He hasn't ruled out the possibility of taking over schools to accommodate patients who are "arriving in ever greater numbers."   Marta Zoila Lopez, 58, told AFP she was at home in Guajiquiro, close to a La Paz, on Sunday when she started feeling symptoms.   "At first I had pain in my stomach, head and bones, vomiting and bleeding" from her nose and gums. She was immediately taken to the hospital where nurses say she's still in a delicate condition.   President Juan Orlando Hernandez summoned all 298 municipal mayors to the capital on Monday and announced a special fund to combat the outbreak.

The only effective measure to halt the epidemic "is to destroy the mosquito's breeding grounds and this is something that every one of us has to do in our homes, where we work and also in every public area," said Hernandez.   He also announced a "massive mobilization" to fumigate and destroy those breeding grounds. Churches, press organizations and business leaders have committed to assisting the effort.   It's a critical situation with the three-month long rainy season about to begin, meaning that breeding grounds will soon proliferate and the mosquito's numbers could soar.
Date: Thu, 20 Jun 2019 09:02:06 +0200

Tegucigalpa, June 20, 2019 (AFP) - Thousands of Hondurans blocked streets across the country Wednesday night demanding the resignation of President Juan Orlando Hernandez as tensions mount over strikes by police and truckers.   Police spokesman Jair Meza told AFP that street occupations were reported in several areas of the country, but the force was working to restore order despite a sit-down strike by special operations units.

Meza said looters had raided and torched businesses in the capital, Tegucigalpa, while others blocked streets with bonfires made from tires and rocks.   He added that the police were receiving reinforcements from the armed forces to control the groups that, in their opinion, are made up of gangs and opponents demanding the resignation of President Hernandez.   Mezo said the striking officers -- mostly riot police -- claim "harassment in the workplace and abuse of authority by many chiefs," according to a statement.   The special forces police officers say they are given "terrible food," that they are sent on missions without their expenses being covered and that they are denied labour rights and salary increases.

The Ministry of Security responded in a statement that police bosses "ordered the review of work days," while recognizing that there had been extra shifts to address the demonstrations.   The conflict deepened when police chief Jose Aguilar visited the area where the strikers were holed up but had to flee after a tear gas canister was thrown at him, another police spokesman Orlin Cerrato told a press conference.

Meza said that there was also a strike by truck drivers, who since Monday have parked their rigs on roads near the capital, demanding a pay rise.    The blockage caused a shortage of fuel in some areas of the country, which in turn led to long lines of vehicles at gas stations, the spokesperson said.
Date: Sun, 19 May 2019 05:17:37 +0200

Tegucigalpa, May 19, 2019 (AFP) - Four Canadians and an American pilot died Saturday when their small plane plunged into the sea off the Honduran island of Roatan where they were vacationing, firefighters said.   The plane crashed near the town of Dixon Cove, a few minutes after taking off from the island's airport, rescuers said.   The dead were identified as Bradley Post, Bailey Sony, Tomy Dubler and pilot Patrick Forseth.

The other Canadian pilot, Anthony Dubler, briefly survived the crash but died at the Roatan hospital of his injuries.   The causes of the crash and the registration information for the aircraft were not immediately available.   It occurred as the tourists were headed toward the city of Trujillo, about 77 kilometres (48 miles) from Roatan.
Honduras. 21 Mar 2019. (Reported)

39 cases with 54% in children under 18 years; DHF/serious 12 cases in past week.

[An 18 Mar 2019 report indicates that there are 789 serious dengue cases with 12 deaths.
Date: Fri 18 May 2018 10:14 HS CST
Source: TVP [in Spanish, machine trans., edited]
<https://tvpacifico.mx/noticias/209149-honduras-acumula-diez-muertos-y-172-casos-confirmados-de-gripe-a>

Honduras has registered 10 deaths and 172 cases of influenza A, with 22 new infections confirmed in the last hours, reported today [18 May 2018] the national coordinator of Health Surveillance, Homer Meja. He also noted that 9 of the deceased patients had "more than one underlying disease, such as diabetes, hypertension, and heart disease." He added that the majority of these infections occurred in San Pedro Sula and Tegucigalpa, the 2 most important cities of the Central American country.

Meja indicated that there are also 2 people who are suspected of having contracted the disease in Comayagua, in the central region of Honduras, so they are being kept under surveillance. The official stressed that the influenza vaccination campaign began on [Mon 14 May 2018] in the main cities of the country, and recommended all pregnant women to be vaccinated because very few do so despite being at risk for the health of the baby. The official said that pregnant women should know that the disease can directly affect the baby, and insisted that these women should be vaccinated, regardless of the time of gestation.

People aged 59 and over, health workers, children under 5, the chronically ill, and pregnant women, are the most vulnerable groups who are receiving the dose first, he added. Mejía said that the vaccination centers have more than one million doses to vaccinate groups at risk and announced that in the 1st week of June [2018] the rest of the population will be vaccinated.

The main symptoms are fever of up to 39 deg C [102.2 deg F], chills, headache, muscle, sneezing, intense and persistent cough, runny nose, tearing, and mild pharyngitis, according to the authorities.
=========================
[There have been reports of increased influenza activity in various countries during the official influenza season in the southern hemisphere. The severity of the current season is similar to the trend seen in the northern hemisphere during the 2017-18 season. Vaccination, particularly for high risk groups, can help reduce morbidity and mortality, provided the vaccine strains are a close match to the circulating viruses. - ProMED Mod.UBA]

[HealthMap/ProMED-mail map Honduras:
<http://healthmap.org/promed/p/22>]
More ...

World Travel News Headlines

Date: Tue, 10 Dec 2019 10:50:09 +0100 (MET)

Sydney, Dec 10, 2019 (AFP) - The death toll from New Zealand's White Island volcano eruption rose to six late Tuesday, after an injured person died in an Auckland hospital, police said.   "Police can confirm a further person has died following the eruption on Whakaari/White Island, bringing the official toll to six," a police statement said.   Eight more people who remain missing are presumed dead after the volcano erupted Monday.
Date: Tue, 10 Dec 2019 09:27:57 +0100 (MET)
By Andrew BEATTY, with Daniel de Carteret in Gosford

Sydney, Dec 10, 2019 (AFP) - Toxic haze blanketed Sydney Tuesday triggering a chorus of smoke alarms to ring across the city and forcing school children inside, as "severe" weather conditions fuelled deadly bush blazes along Australia's east coast.   Fire engines raced office-to-office in the city centre with sirens blaring, as inland bushfires poured smoke laden with toxic particles into commercial buildings.   Emergency services responded to an "unprecedented" 500 automatic call-outs inside a few hours according to New South Wales Fire and Rescue's Roger Mentha.

A regional fire headquarters miles from the nearest blazes was itself evacuated while throngs of mask-wearing commuters choked their way through thick acrid air and the organisers of a harbour yacht race declared it was unsafe to proceed.   "The smoke from all the fires is just so severe here on the harbour that you just can't see anything, so it's just too dangerous," said spokeswoman Di Pearson of an event that normally foreshadows the famed Sydney-Hobart yacht race. "The vision is just so poor."   Some of the city's commuter ferries were also cancelled "due to thick smoke" and school kids were kept inside at breaktime and sent home early as pollution levels soared far above "hazardous" levels.

For weeks the east of the country has been smothered in smoke as drought and climate-fuelled bushfires have burned. But the scale of the problem on Tuesday shocked even hardened residents.   Bruce Baker -- an 82-year-old who lives in Gosford, north of Sydney -- said he was skipping his daily morning walk because of the smoke.   "This is the worst it's been, for sure," he told AFP. "It dries your throat. Even if you're not asthmatic, you feel it."   Authorities recommended that the vulnerable cease outdoor activity altogether and that everyone stay inside as much as possible, although one couple braved the toxic air to get married on the waterfront in front of Sydney Harbour Bridge shrouded in smog.

A cricket match between New South Wales and Queensland also went ahead, despite a barely visible ball.   Tuesday had been expected to bring strong winds and high temperatures that made for "severe conditions where embers can be blown ahead of the fire into suburbs and threaten properties."   But New South Wales Rural Fire Service said "deteriorating fire conditions have been delayed by a thick blanket of smoke" over the east of the state.   As the day developed there were nearly 100 bushfire incidents in the state of New South Wales alone and dozens more in Queensland.   Total fire bans were put in place across much of the east of the country and in large parts of western Australia.   Temperatures in some inland areas eased past 44 degrees Celsius (111 Fahrenheit).

- The 'big dry' -
To the northwest of Sydney, several fires already burning for weeks have combined to create a "megafire" that has already destroyed 319,000 hectares (788,000 acres) of land, mostly inside national parks.   Prime Minister Scott Morrison  -- who for weeks has not commented on the smoke haze -- defended his government's handling of the fires and said there were no plans to professionalise the countryside's largely volunteer force.    "Our policy is sensible when it comes to addressing and taking action on climate change. Our actions on climate change are getting the results they're intended to get," he said.   Morrison's conservative coalition has been criticised by former fire chiefs for failing to heed warnings about climate change.   The crisis has been propelled by a prolonged drought that has made vegetation tinder dry.

The Bureau of Meteorology has reported that Australia experienced its driest November on record this year.   The "big dry" has left farmers desperate and small towns facing the prospect of running out of water completely.   A swathe of the east of the country has seen "rainfall deficiencies" since early 2017 -- almost three years.   Many dams in New South Wales are empty and almost all are well below capacity.   Firefighters south of Brisbane recently reported 1,000 litres of water were stolen from tanks at their station.   Amid the shortage, Tuesday also saw the toughest water restrictions in a decade being introduced for Sydney -- with curbs on everything from hosepipe use to washing cars.
Date: Tue, 10 Dec 2019 03:09:17 +0100 (MET)
By Allison JACKSON

Sao Paulo, Dec 10, 2019 (AFP) - Gripping the deadly snake behind its jaws, Fabiola de Souza massages its venom glands to squeeze out drops that will save lives around Brazil where thousands of people are bitten every year.   De Souza and her colleagues at the Butantan Institute in Sao Paulo harvest the toxin from hundreds of snakes kept in captivity to produce antivenom.    It is distributed by the health ministry to medical facilities across the country.

Dozens of poisonous snake species, including the jararaca, thrive in Brazil's hot and humid climate.    Nearly 29,000 people were bitten in 2018 and more than 100 died, official figures show.   States with the highest rates of snakebite were in the vast and remote Amazon basin where it can take hours to reach a hospital stocked with antivenom.   Venom is extracted from each snake once a month in a delicate and potentially dangerous process.

Using a hooked stick, de Souza carefully lifts one of the slithering creatures out of its plastic box and maneuvers it into a drum of carbon dioxide.    Within minutes the reptile is asleep.    "It's less stress for the animal," de Souza explains.    The snake is then placed on a stainless steel bench in the room where the temperature hovers around 27 degrees Celsius (80 degrees Fahrenheit).    De Souza has a few minutes to safely extract venom before the snake begins to stir.      "It's important to have fear because when people have fear they are careful," she says.

- Antivenom 'crisis' -
The snakes are fed a diet of rats and mice that are raised at the leafy institute and killed before being served up once a month.   After milking the snake, de Souza records its weight and length before placing it back in its container.    The antivenom is made by injecting small amounts of the poison into horses -- kept by Butantan on a farm -- to trigger an immune response that produces toxin-attacking antibodies.

Blood is later extracted from the hoofed animals and the antibodies harvested to create a serum that will be administered to snakebite victims who might otherwise die.   Butantan project manager Fan Hui Wen, a Brazilian, says the institute currently makes all of the country's antivenom -- around 250,000 10-15 millilitre vials per year.

Brazil also donates small quantities of antivenom to several countries in Latin America.    There are now plans to sell the life-saving serum abroad to help relieve a global shortage, particularly in Africa.    About 5.4 million people are estimated to be bitten by snakes every year, according to the World Health Organization (WHO). 

Between 81,000 and 138,000 die, while many more suffer amputations and other permanent disabilities as a result of the toxin.   To cut the number of deaths and injuries, WHO unveiled a plan earlier this year that includes boosting production of quality antivenoms.   Brazil is part of the strategy. It could begin to export antivenom as early as next year, Wen says.   "There is interest for Butantan to also supply other countries due to the global crisis of antivenom production," she says.
Date: Mon, 9 Dec 2019 14:14:15 +0100 (MET)

Dec 9, 2019 (AFP) - New Zealand, struck by a deadly volcanic eruption Monday, lies in a zone where Earth's tectonic plates collide, making it a hotspot for earthquakes and volcanic activity.   In one of its worst natural disasters, a huge mass of volcanic debris from the eruption of Mount Ruapehu triggered a mudslide in 1953 that washed away a bridge and caused a passenger train to plunge into a river with the loss of 151 lives.  After Monday's eruption on New Zealand's White Island, here is a recap of some of the deadliest volcanic eruptions around the world in the past 25 years.

- 2018: Indonesia -
In December the Anak Krakatoa volcano, a small island in the Sunda Strait between Java and Sumatra, erupts and a section of its crater collapses, sliding into the ocean and generating a tsunami. More than 420 people are killed and 7,200 wounded.

- 2018: Guatemala -
The June eruption of the Fuego volcano, about 35 kilometres (22 miles) from the capital, unleashes a torrent of mud and ash that wipes the village of San Miguel Los Lotes from the map. More than 200 people are killed.

- 2014: Japan -
The sudden eruption in September of Mount Ontake, in the central Nagano region, kills more than 60 people in Japan's worst volcanic disaster in nearly 90 years. The mountain is packed with hikers at the time. In 1991 an eruption of the southwestern Unzen volcano kills 43.

- 2014: Indonesia -
At least 16 people are killed on the island of Sumatra in February by a spectacular eruption of Mount Sinabung, which had lain dormant for 400 years before roaring back to life five months earlier. In 2016 villages are scorched and farmland devastated after another eruption kills seven.

- 2010: Indonesia -
Indonesia's most active volcano, Mount Merapi on Java island, starts a series of explosions in October, eventually killing more than 320 people. An 1930 eruption of the volcano killed 1,300 people and one in 1994 claimed more than 60 lives.

- 2002: DR Congo -
The eruption in July of Mount Nyiragongo in the eastern Democratic Republic of Congo destroys the centre of Goma town, along with several residential areas, and kills more than 100 people.

- 1997: Montserrat -
The capital of the small British colony, Plymouth, is wiped off the map and 20 are killed or left missing in avalanches of hot rock and ash clouds when its volcano erupts in June.

- 1995: The Philippines -
At least 70 are killed and another 30 missing after the crater of the Parker volcano in the south of the island of Mindanao collapses. Five years earlier the eruption of Mount Pinatubo, 80 kilometres north of the capital Manila, kills more than 800 people.

- Worst ever -
The explosion of Indonesia's Krakatoa volcano in 1883 is considered the worst ever seen. The eruption sent a jet of ash, stones and smoke shooting more than 20 kilometres (12 miles) into the sky, plunging the region into darkness, and sparking a huge tsunami that was felt around the world. The disaster killed more than 36,000 people.

The most famous eruption in history is that of Mount Vesuvius in modern-day Italy in 79 AD, which destroyed the towns of Herculaneum, Stabiae and Pompeii, wiping out an estimated 10 percent of the population of the three cities.
Date: Mon 9 Dec 2019
Source: Fox 29 Philadelphia [edited]

A total of 31 people have been sickened by salmonellosis at 4 health care facilities in south-eastern Pennsylvania. A majority of those cases occurred after individuals ate pre-cut fruit from New Jersey-based Tailor Cut Produce. The Food and Drug Administration (FDA) announced the salmonellosis outbreak in conjunction with the Pennsylvania Department of Health (DOH) on [Fri 6 Dec 2019]. The North Brunswick distributor has recalled its fruit mix with cantaloupe, honeydew, pineapple and grapes as a result.

Tailor Cut Produce reports that its products may be found in restaurants, banquet facilities, hotels, schools and institutional food service establishments in Pennsylvania, New Jersey and New York. "We recommend that any facility who use Tailor Cut Produce pre-cut fruit to immediately stop and throw it away," Pennsylvania Secretary of Health Dr. Rachel Levine said.

Salmonellosis is an infection caused by _Salmonella_ bacteria that generally affects the intestinal tract. People usually become infected by either eating or drinking contaminated food or water, by contact with infected people or animals, or through contact with contaminated environmental sources.
Date: Mon 9 Dec 2019
Source: Sixth Tone [edited]

Dozens of researchers in northwestern China's Gansu province have been infected with brucellosis, an animal-borne disease that causes flu-like symptoms and, potentially, lingering problems. In a statement [Fri 6 Dec 2019], the Lanzhou Veterinary Research Institute, an affiliated institute of the Chinese Academy of Agricultural Sciences, said that the 1st few grad students from the institute's foot-and-mouth disease prevention team tested positive for brucellosis antibodies on [28 Nov 2019]. The labs affected have been closed, the institute said, and national and local health authorities have assembled a team to investigate the outbreak.

Li Hui, an official at the health commission in Lanzhou, the provincial capital, told Sixth Tone on [Mon 9 Dec 2019] that the total number of brucellosis cases at the institute had climbed to 96. None have shown clinical symptoms, according to domestic media, and it remains unclear how they were exposed to the bacteria.

Brucellosis -- also known as Malta, Mediterranean, or undulant fever -- is a zoonotic disease that mainly affects animals, including livestock and dogs, which can in turn transmit the bacteria to humans through direct contact. Symptoms include fever, chills, sweating, lethargy, and aches and pains, according to the WHO. In the absence of early diagnosis and treatment, brucellosis can become a chronic condition that is difficult to cure.

In China, brucellosis is a Class B disease, ranking below a more serious category that includes cholera and plague. Human-to-human transmission has only been known to occur between lactating mothers and their babies. According to state broadcaster China National Radio, the brucellosis outbreak at the Gansu veterinary institute has prompted health checks among local students and staff who fear that they may have come into contact with infected animals.

One of the last brucellosis outbreaks in China occurred in 2011, when an agricultural university in the northeastern Heilongjiang province reported 28 cases stemming from infected goats being used in lab research. The school publicly apologized, fired 2 administrators, and offered each of the students' affected monetary compensation.

Scientific labs are subject to different experimental standards depending on their biosafety level, according to a researcher surnamed Yang at the Shanghai Institutes for Biological Sciences, an affiliate of the Chinese Academy of Sciences.

"If the protection levels don't keep pace (with biosafety levels), there will be a risk of infection," Yang, who studies viruses and works in a Biosafety Level 2+ lab, told Sixth Tone. As a result, labs generally require researchers to undergo safety training or even pass an exam to earn a certification, said Yang, who only used her surname because she was not authorized by her employer to speak to media.

The Lanzhou Veterinary Research Institute describes itself as "China's only authorized research center for working with the live virus that causes foot-and-mouth disease," a highly contagious disease affecting livestock. The institute is reportedly also one of the few in China with Biosafety Level 3 labs, which are required for _brucella_ pathogen studies, according to the National Health Commission.

As the local agriculture department tries to ascertain the source of the recent infections, Lanzhou's health commission said [Fri 6 Dec 2019], it is implementing precautionary measures so that brucellosis does not pose a threat to neighbouring communities. [Byline: Yuan Ye]
=================
[An earlier report suggested that 4 persons were clinically ill but this is not confirmed here.  Brucellosis (<http://www.medicinenet.com/brucellosis/article.htm>) is a disease that is thought to have existed since ancient times, as it was 1st described more than 2000 years ago by the Romans and Hippocrates. It was not until 1887 that a British physician, Dr. David Bruce, isolated the organism that causes brucellosis from several deceased patients from the island of Malta. This disease has had several names throughout its history, including Mediterranean fever, Malta fever, Crimean fever, Bang's disease, and undulant fever (because of the relapsing nature of the fever associated with the disease).

The symptoms and signs of brucellosis may develop from days to months after the initial exposure to the organism. While some individuals may develop mild symptoms, others may go on to develop long-term chronic symptoms. The signs and symptoms of brucellosis are extensive, and they can be similar to many other febrile illnesses, so recognition of potential exposure -- from ingestion of unpasteurized milk or cheese, employment as a veterinarian or veterinary student, in a slaughter house or meat processing plant, or working in a microbiology lab -- is vital. In this outbreak, it is not clear what symptoms the students had or whether they were just seropositive. ProMED would like more information about this episode. - ProMED Mod.LL]

[HealthMap/ProMED map available at:
Gansu Province, China: <http://healthmap.org/promed/p/333>]
Date: Tue 3 Dec 2019
Source: Outbreak News Today [edited]

In late November [2019], Uganda health authorities notified the World Health Organization of a fatal Rift Valley fever (RVF) case from Obongi district.  The case was a 35-year-old man from South Sudan who was living in the Palorinya Refugee camp in Obongi district, Uganda. The case had travel history to South Sudan between 12 and 19 Nov 2019 to harvest cassava. While in his home country, he developed fever and other symptoms and was treated for malaria; however, his condition got worse.  He later returned to the refugee camp in Uganda and his symptoms progressed and he was hospitalized. Viral hemorrhagic fever was suspected. Samples were collected and sent to the Uganda Virus Research Institute; however, the patient died. A safe and dignified burial was performed on 22 Nov 2019. As of 24 Nov 2019, a total of 19 contacts were recorded during the active case search including 10 healthcare workers.
===================
[The circumstances and specific location under which the man became infected with Rift Valley fever (RVF) virus in South Sudan is not mentioned. It is worth noting that there was an RVF outbreak in the Eastern Lakes region of South Sudan during the 1st 3 months of last year (2018). At the end of that outbreak, the OIE's follow-up report no. 3 reported: "The event cannot be considered resolved, but the situation is sufficiently stable. No more follow-up reports will be sent. Information about this disease will be included in the next 6-monthly reports."

There were more human cases than animal ones in that outbreak, prompting Mod.AS to comment: "Unfortunately, during the recent South Sudan RVF event, as in most -- if not all -- previous RVF events in other African countries, humans served as sentinels. Improved surveillance in animals is desperately needed in Africa, to allow timely measures applied, predominantly preventive vaccination, before the development of a full-blown epizootic involving secondary infection in humans." Intensified surveillance is needed in South Sudan in those localities where the affected man had been prior to his return to Uganda.

It is likely that RVF virus has persisted in this area in transovarially infected eggs of _Aedes_ mosquito vectors. These eggs can remain viable for long periods of time and hatch when flooded during future rain events, with the subsequent emergence of infected females ready to transmit the virus. This risk provides justification for maintaining livestock of the area well vaccinated into the future. This may have accounted for the reappearance of RVF in South Sudan in 2018, after nearly 2 years without additional reported cases in humans or livestock and again with this human case in 2019. - ProMED Mod.TY]

Obongi district, Uganda is located approximately 50 km (30 mi) from the South Sudan border.
HealthMap/ProMED-mail maps:

According to OIE's data, a total of 2 outbreaks of RVF affecting animals have been reported from Sudan during the event. The 1st outbreak started in the Arabaata dam area, Red Sea state, on 25 Sep 2019, affecting goats. The 2nd (and, so far, last) outbreak started 10 Oct 2019 in the River Nile state, affecting sheep and goats. Both outbreaks have been declared as 'resolved' on 14 Nov 2019.

Outbreak summary:
Total outbreaks = 2 (Submitted)
Species / Susceptible / Cases / Deaths / Killed and disposed of / Slaughtered
Goats / 1700 / 37 / 7 / 0 / 0
Sheep / 1550 / 37 / 5 / 0 / 0

According to the recent (5 Dec 2019) OCHA (UN Office for the Coordination of Humanitarian Affairs) update, the (human) RVF situation in Sudan, as of 26 Oct 2019, was the following: "a total of 345 suspected RVF cases -- including 11 related deaths -- reported in the states of Red Sea (128), River Nile (212), Khartoum (1), White Nile (1), Kassala (2), and Gedaref (1). The most affected age group is 15 to 45 years, which accounts for 83% of the total suspected cases. The male to female ratio is 2.6, with a high proportion of the cases being farmers (37.5 per cent). RVF is endemic in Sudan and 3 outbreaks affecting people have been documented in 1973, 1976, and 2008. During the outbreak in 2008, a total of 747 laboratory-confirmed cases were reported, including 230 deaths."

Egypt suffered its 1st RVF outbreak in 1977/78 with serious human disease and death as well as severe losses in livestock; several additional events have been recorded since. A recent historical review paper [1] concluded: "due to the availability and abundance of the potential vectors, the suitability of environmental conditions, continuous importation of livestock's from Sudan, and the close association of susceptible domestic animals with humans, the RVF virus could possibly occur and circulate in Egypt."   (https://tinyurl.com/whz3pz5)

Reference
---------
1. Kenawy MA, Abdel-Hamid YM, Beier JC. Rift Valley fever in Egypt and other African countries: Historical review, recent outbreaks, and possibility of disease occurrence in Egypt. Acta Trop. 2018; 181: 40-49; <https://doi.org/10.1016/j.actatropica.2018.01.015>  - ProMED Mods.AS/TY]
Date: Fri 6 Dec 2019 5:53 PM MST
Source: CTV News [edited]

A syphilis outbreak is worsening in Alberta [Canada], and the majority of new cases are in the Edmonton zone. Edmonton saw 1186 of the 1753 infectious syphilis [primary, secondary and early latent syphilis] cases reported in Alberta in 2019, a total of 68 per cent.

Alberta Health Services [AHS] declared an outbreak in July 2019, saying cases had 'increased dramatically' in the province since 2014. The number increased again in July [2019]  [<https://edmonton.ctvnews.ca/alberta-declares-province-wide-syphilis-outbreak-1.4510737>].

AHS sent a new public health alert to doctors on [27 Nov 2019], asking for their help to control the outbreak [<https://www.albertahealthservices.ca/assets/info/hp/phys/if-hp-phys-moh-ez-syphilis-outbreak.pdf>]. "It's very significant," said Dr Ameeta Singh, a clinical professor in infectious diseases. "That's an alarming rise in new syphilis cases in Alberta." She said it's the highest number of cases the province has seen since the 1940s.

According to Dr Singh, the increase in cases being reported is partially due to a greater number of people getting tested. "We know more people are coming in to get tested, but if we look a bit closer at the data we have, we do see there's, in fact, a [bigger] rise in the number of cases than we would expect to see," said Singh.

Another factor could be the rise in methamphetamine use in Edmonton. "I believe this is a major factor. Meth also stimulates risky sexual behaviour and increases the chance people will engage in multiple, usually casual or anonymous partners as well and not use precautions such as condoms to protect themselves during sex," she said.

What's also alarming, Singh said, is the spike in cases of congenital syphilis, where the disease is passed on to newborns. According to AHS, there have been 38 cases of congenital syphilis in 2019, 31 of which were in the Edmonton area. That accounts for more than half of the 61 cases of congenital syphilis reported since 2014.

"Those are not numbers we should be talking about in Canada ever...in a country that has universal access to health care, in a major city in Canada where syphilis testing is offered to all pregnant women who access prenatal care," she said. "What we're seeing with the congenital syphilis cases is many of the women are not accessing prenatal care until they come into the hospital to deliver and then the tests are being done."
===================
[A recent ProMED-mail post (Syphilis - Canada (04): (AB) RFI http://promedmail.org/post/20190718.6574300) reported a rise in "infectious syphilis" cases over a 4-year period: from 2014 to 2018 but made no mentioned of contributing factors. As illicit drug use has been cited as a contributing factor to recent increases in syphilis cases in the Canadian provinces of Ontario and Manitoba, I questioned in this prior ProMED-mail post if use of illicit drugs, in particular, methamphetamine, could similarly be contributing to the rise of syphilis cases in Alberta. The news article above reports that the rise in methamphetamine use in Edmonton, as well as increased testing for syphilis, are thought to be contributing factors in Alberta.

Methamphetamine can be swallowed, snorted, smoked or injected by needle and syringe

When methamphetamine is injected, transmission of syphilis may occur as a consequence of sharing a needle/syringe contaminated with infected blood from somebody who has primary or secondary syphilis (<https://ucsdnews.ucsd.edu/archive/newsrel/health/04-28TransmissionSyphilis.asp>); but syphilis can also be acquired by direct contact with an infected lesion during oral, vaginal, or anal sex when the drug is taken by any route of administration. Methamphetamine use is associated with sexual behaviors that increase the risk for acquiring syphilis and other sexually transmitted diseases, including having multiple sex partners, inconsistent condom use, and exchange of sex for drugs or money (<https://www.cdc.gov/mmwr/volumes/68/wr/mm6806a4.htm>).

The linkage of methamphetamine use and syphilis transmission is reminiscent of the increase in syphilis among heterosexuals during the crack cocaine epidemic of the 1980s and 1990s, when the practice of trading sex with multiple partners for drugs, especially crack cocaine, played a major role in the transmission of syphilis. Under these circumstances, the identities of sex partners are often unknown, which weakens the traditional syphilis-control strategy of partner notification.

Bacteremia due to _Treponema pallidum_, the cause of syphilis, which occurs during primary, secondary, and latent syphilis, can result in transplacental transmission of this organism to the fetus during pregnancy and cause congenital syphilis. An increase in the incidence of syphilis in women in the population is commonly accompanied by increasing rates of congenital syphilis.

Edmonton, with a population of 932 546 residents in 2016, is the capital of the Canadian province of Alberta
(<https://en.wikipedia.org/wiki/Edmonton>).

A map showing the location of Edmonton can be found at
<https://goo.gl/maps/Rfq6XC2vvwi19ypb6>. - ProMED Mod.ML]

[HealthMap/ProMED-mail map of Alberta, Canada:
9 December 2019
https://www.who.int/bangladesh/news/detail/09-12-2019-cholera-vaccination-campaign-launched-to-protect-635-000-people-in-cox-s-bazar

Cox’s Bazar, Bangladesh

Over 635,000 Rohingya refugees and Bangladeshi host community will be vaccinated against cholera in a 3-week-long campaign beginning today at the refugee camps in Cox’s Bazar and nearby areas, to protect vulnerable population against the deadly disease amidst increasing number of cases of acute watery diarrhoea (AWD).


The Oral Cholera Vaccination (OCV) campaign will be implemented in the refugee camps from 8-14 December to reach 139,888 Rohingya aged 1 year and less than 5 years. In the host community, the campaign will take place from 8-31 December and aims to reach any person older than 1 year (495,197). In total, 635,085 people are expected to be reached.

Led by the Ministry of Health and Family Welfare, with support of the World Health Organization (WHO), UNICEF and other partners, the campaign aims to reach people who missed some or all previous cholera vaccination opportunities. The campaign, including operational costs, is funded by Gavi, the Vaccine Alliance.

“We want to equip these populations with more protection against diarrheal diseases. Despite the progresses made to ensure access to quality water and sanitation, such diseases remain an issue of concern: approximately 80% of host community living near the camps have not been targeted in previous OCV campaigns and are still vulnerable”, says Dr Bardan Jung Rana, WHO Representative in Bangladesh.

Earlier rounds of cholera vaccination, which have taken place since the beginning of the emergency response in 2017, have helped prevent outbreaks of the disease. To this date, over 1 million people were vaccinated against cholera.
6th December 2019
https://www.theguardian.com/world/2019/dec/06/flooding-hits-new-zealand-tourist-hubs-of-wanaka-and-queenstown

Heavy rain has led to rivers bursting their banks, forcing the closure of shops and restaurants

Streets in the South Island tourist towns of Wanaka and Queenstown were slowly going under water on Friday, after Lake Wanaka and Lake Wakatipu burst their banks earlier in the week, flooding businesses and sewerage systems.

Water and large debris closed the main street of Wanaka, a popular spot with Instagrammers thanks to its famous tree that appears to have grown out of the lake. On Friday businesses were sandbagging as heavy rain continued to fall.

Sewerage systems in the town were also at risk of contaminating the lake, with the Queenstown Lakes District council taking the precautionary measure of shutting down the sewer connection to a handful of premises.

Wanaka residents were told to be on “high alert” with heavy rain predicted all weekend.

The streets of the usually bustling tourist town were largely empty, and the popular cafes and restaurants on the lake shore were closed.