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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: Sun, 15 Mar 2020 23:58:27 +0100 (MET)

San Juan, March 15, 2020 (AFP) - The US territory of Puerto Rico on Sunday ordered a 9:00 pm to 5:00 am curfew to stem the spread of the novel coronavirus, the strongest measure yet taken on American soil.   It took effect immediately and lasts until March 30.   "Faced with the possibility of transmission and propagation of the virus, I have ordered the imposition of a curfew for all residents of Puerto Rico," Governor Wanda Vazquez announced in a video message.   "We must take every precaution to ensure that we do not become potential carriers," Vazquez said.

The Caribbean territory of 2.9 million, whose residents are US citizens, also will close many businesses from Sunday until the end of the month, she said.   That includes malls, movie theaters, concert venues, gyms, bars and other businesses that bring together large crowds on the island popular with tourists.   The exceptions will be businesses in the food supply chain, and in the medical care system, as well as drugstores, gas stations, banks and senior citizens' group homes.

At night, only those who are providing or receiving medical care, or carrying out essential duties, will be allowed to be on Puerto Rico's streets.   Anyone defying the curfew faces a six-month jail term and a fine of up to $5,000.   The island declared a state of emergency when its first cases were reported March 12. The island has reported five cases.   On Friday, Vazquez accepted the resignation of Health Secretary Rafael Rodriguez Mercado, who was under fire for his handling the coronavirus emergency.

Recently, island residents were irate when two warehouses were found to be filled with abandoned supplies, apparently never used after Hurricanes Irma and Maria in 2017.   The storms' one-two punch left Puerto Ricans without power for months and killed nearly 3,000 people, according to the local government's official numbers.   President Donald Trump has accused the Puerto Rican government of incompetence and siphoning off hurricane relief money.   The Puerto Rican leaders accused Trump of treating the population of the island like second class citizens.
Date: Thu, 16 Jan 2020 02:45:27 +0100 (MET)
By Ivelisse RIVERA, con Leila MACOR en Miami

Yauco, Puerto Rico, Jan 16, 2020 (AFP) - Living out in the open, their nerves on edge after a series of earthquakes that have shaken Puerto Rico, some 5,000 people are hoping that their president, Donald Trump, will heed the island's plea to be designated a disaster zone and free up much-needed aid.   Since December 28, more than 1,000 tremors have rattled the US island territory in the Caribbean, which just two years ago was devastated by two powerful hurricanes in quick succession.

In Yauco, one of the areas worst hit by the earthquakes, dozens of people were sitting on cot beds Wednesday in the parking lot of a municipal stadium, sheltered from the sun by white tents and blue tarps handed out by the federal disaster management agency, known as FEMA.  "The most difficult thing is the psychological aspect," said Wilfredo Rodriguez, 31. His house had been fractured by the seismic movement and he has spent a week living with his kids, aged six and 10, under an awning.    "We are living in constant fear of another powerful tremor," he said.

He only returns to his house to wash, then hurries back to the shelter. "We worry that there'll be a more powerful tremor while we are inside the house," he said.   Throughout the day, volunteers arrive to hand out food and toys for the children who fill the shelters: schools have been suspended because the buildings are not sturdy enough to withstand another quake.    The island's earthquake detection system has registered 1,104 tremors in the past two weeks alone, of which 186 could be felt by the population. By comparison, during the whole of 2019 there were 6,442 tremors, of which just 62 could be felt by people on the island.

Further south, in Guanico, Juan Santiago decided to move into a shelter on Saturday after a tremor of 5.9 on the Richter scale hit the island. "The mountain shook and rocks and earth started to come down," said the 30-year-old.  "My house has a crack in it and is about to fall down," he added. His home had weathered the Category Five winds of Hurricane Maria in September 2017 and of Hurricane Irma which followed it just two weeks later.   "It's different to a hurricane. What is happening now is much nastier," he said.

As he was talking the earth shook again, a tremor of 5.2 magnitude. Vehicles rocked like hammocks in the wind, but the quake-hardened victims barely reacted.   The houses in this part of the island are mostly rudimentary constructions built by the people who live in them with scant resources available in the mountains, where no regulations stipulate that buildings should be earthquake resistant.    The government of Puerto Rico said that as of Monday, there were 4,924 people living in 28 shelters in 14 municipalities. There were no figures on how many buildings had been damaged or destroyed.

- Seeking disaster designation -
Puerto Rico's governor Wanda Vazquez Garced called on Trump to declare the earthquake a disaster and clear the way for desperately needed aid. Trump had declared an emergency days before, but the governor wanted more.   The declaration of an emergency frees up to $5 million dollars in aid for the island, although Congress can bump that figure up. But if the situation is designated a disaster, there is no ceiling on funding, a FEMA spokesman said.   On Wednesday, the government said it would release $8.2 billion in delayed hurricane relief that had been stalled after the president threatened to divert Puerto Rico's emergency funds to help pay for his wall on the US-Mexico border.

In the past few days there have been growing calls among Democratic lawmakers for Trump to declare the situation in Puerto Rico a disaster.   It is a delicate subject, as Trump has accused the government of Puerto Rico of incompetence and of siphoning off hurricane relief money, triggering a public spat between the president and the mayor of San Juan, Carmen Yulin Cruz, as well as the former governor Ricardo Rossello, who was forced to step down last summer amid massive protests.   The Puerto Rican leaders accused Trump of treating the population of the island like second class citizens.
Date: Sat, 11 Jan 2020 15:43:12 +0100 (MET)

Washington, Jan 11, 2020 (AFP) - A 5.9 magnitude earthquake rocked Puerto Rico Saturday, the latest in a series of powerful tremors that have shaken the US territory in recent days, the US Geological Survey reported.

The latest quake occurred at 8:54 am local time (1254 GMT) around 13 kilometres (eight miles) southeast of Guanica, a town on the island's southern Caribbean coastline that was hard hit by earlier quakes.   The USGS revised its initial report of a 6.0 magnitude quake to 5.9.   It follows a 6.4 magnitude quake Tuesday that killed one person, knocked
out electric power and caused widespread damage.

Puerto Rico Governor Wanda Vazquez declared a state of emergency after Tuesday's quake, which forced an automatic shutdown of the power grid.    Puerto Rico's electric power authority reported outages in the towns of Ponce, Lares, Adjuntas and San German after the latest quake.   The Pacific Tsunami Information Center in Hawaii issued a statement saying there was "no significant tsunami threat" but a small possibility of tsunami waves along coasts nearest the epicentre.

The island is still recovering from Hurricane Maria, which came ashore more than two years ago as a devastating Category 4 storm.   Starting December 28, a wave of tremors have swept the island, putting residents on edge.   The 6.4 quake on January 7 came a day after a 5.8 magnitude quake; it was followed by major aftershocks.   Saturday's quakes were also preceded by a string of smaller tremors.
Date: Tue, 7 Jan 2020 23:44:45 +0100 (MET)
By Ricardo Arduengo

Guayanilla, Puerto Rico, Jan 7, 2020 (AFP) - Puerto Rico's governor declared a state of emergency on Tuesday after a powerful 6.4 magnitude earthquake killed at least one person in the south of the island and caused widespread damage.   Governor Wanda Vazquez said the declaration would allow for the activation of National Guard troops in the US territory still recovering from a devastating 2017 hurricane.   The US Geological Survey said the quake struck at 4:24 am (0824 GMT) with the epicenter off the coast of the southern city of Ponce, and was followed by more than a dozen aftershocks.

Tuesday's quake was the most powerful in a series of tremors that have shaken the island since December 28.   Scientists initially sent out an alert about a potential tsunami but it was later canceled.   The island's electricity authority said the quake had forced an automatic shutdown of the power grid, already severely damaged by Hurricane Maria more than two years ago.   The worst damage appeared to be in towns on the southwest coast, including Ponce, Guayanilla and Guanica.   El Nuevo Dia newspaper said a 73-year-old man died after a wall fell in his home in Ponce. Eight others there were reported injured.

Two power plants in Guayanilla sustained major damage, the Puerto Rico Electric Power Authority said. The city could be without power for two weeks, its mayor Nelson Torres Yordan said.   Celebrity chef Jose Andres announced that a charity he runs, World Central Kitchen, had started serving meals and distributing solar-powered lamps in quake-hit areas.   Vazquez announced that $130 million in emergency aid funding will be disbursed.   On social media, people wrote of being shaken awake by the force of the quake.   One woman on Twitter said she had been "wrenched from sleep."   "Everybody is awake & scared all over," she posted.   In Guayanilla, the Inmaculada Concepcion church, built in 1841, was heavily damaged.   Volunteers salvaged statues and other valuable items from the ruins as a priest consoled distraught parishioners.

- 'Be safe' -
A 5.8 magnitude quake on Monday toppled some structures, caused power outages and small landslides, but did not result in any casualties.   It also destroyed a popular tourist landmark, Punta Ventana, a natural stone arch that crumbled on the island's southern coast.   Vazquez, the governor, said government employees were being given the day off on Tuesday to take care of their families.   "We want everyone to be safe," she said.   She said ports were undamaged and there are several weeks' supply of gasoline, diesel and natural gas stored so people need not worry about shortages.

The White House said President Donald Trump had been briefed and Pete Gaynor, head of the Federal Emergency Management Agency (FEMA), had been in touch with the governor.   Trump's administration came under severe criticism for its response to Hurricane Maria.   The Category 4 storm destroyed the island's already shaky power grid, overwhelmed public services, left many residents homeless and claimed several thousand lives, according to government estimates.
Date: Tue, 7 Jan 2020 12:52:34 +0100 (MET)

Washington, Jan 7, 2020 (AFP) - A strong earthquake struck south of Puerto Rico early Tuesday, the US Geological Survey said, the latest in a series of tremors that have shaken the island since December 28.   The shallow 6.5 magnitude quake struck 13.6 kilometres (8.5 miles) south of the city of Ponce, the USGS said, revising down its initial reading of 6.6.   The quake struck just off the US territory's southern Caribbean coastline at 4:24 am local time (0824 GMT).   "The whole island is without power," the director of Puerto Rico Electric Power Authority, Jose Ortiz, told local media.

Puerto Rico's governor Wanda Vazquez Garced posted on Twitter that the government's security protocols had been activated.   She said government employees were not expected at work, adding: "We want everyone to be safe."   On social media, people wrote of being shaken awake by the force of the quake.   One woman on Twitter said she had been "wrenched from sleep", adding "Everybody is awake & scared all over."

Dramatic images also shared on social media appeared to show widespread damage in the town of Guayanilla, home to around 20,000 people, as well as nearby Guanica.   The mayor of Guayanilla told local news channel NotiUno that the town's church had collapsed in the incident.

An alert issued by the Tsunami Warning Center immediately following the earthquake was later cancelled.   Tuesday's quake was the strongest of a series of tremors that have shaken the island since December 28, topping Monday's 5.8 quake.   That earthquake toppled houses and caused power outages, but there were no reports of casualties.
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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 ...

Dominican Republic

Dominican Republic US Consular Information Sheet
March 13, 2008
COUNTRY DESCRIPTION: The Dominican Republic covers the eastern two-thirds of the Caribbean island of Hispaniola. The capital city is Santo Domingo, located on the south coast of th
island. Tourist facilities vary according to price and location. Spanish is the official language. Though English is widely spoken in major cities and tourist areas, it is much less common outside these areas. Read the Department of State Background Notes on the Dominican Republic for additional information.

ENTRY/EXIT REQUIREMENTS: All Americans traveling by air outside of the United States are required to present a passport or other valid travel document to enter or re-enter the United States. This requirement will be extended to sea travel (except closed loop cruises), including ferry service, by the summer of 2009. Until then, U.S. citizens traveling by sea must have government-issued photo identification and a document showing their U.S. citizenship (for example, a birth certificate or certificate of nationalization), or other WHTI compliant document such as a passport card for entry or re-entry to the U.S. Sea travelers should also check with their cruise line and countries of destination for any foreign entry requirements.

Applications for the new U.S. Passport Card are now being accepted. We expect cards will be available and mailed to applicants in spring 2008. The card may not be used to travel by air and is available only to U.S. citizens. Further information is available on our U.S. Passport Card page at http://travel.state.gov/passport/ppt_card/ppt_card_3926.html and upcoming changes to U.S. passport policy can be found on the Bureau of Consular Affairs web site at http://travel.state.gov/travel/cbpmc/cbpmc_2223.html. We strongly encourage all American citizen travelers to apply for a U.S. passport well in advance of anticipated travel. American citizens can visit travel.state.gov or call 1-877-4USA-PPT (1-877-487-2778) for information on how to apply for their passports.

For information concerning entry and exit requirements, travelers may contact the Embassy of the Dominican Republic at 1715 22nd Street NW, Washington, DC 20008, tel. (202) 332-6280. There are also Dominican consulates in Boston, Chicago (Northfield, IL), Mayaguez, Miami, New Orleans, New York, and San Juan. Visit the Embassy of the Dominican Republic web site at http://www.domrep.org for the most current visa information.

Visas: Visitors who do not obtain a Dominican visa prior to entry must purchase a tourist card upon arrival to enter the country. Tourist cards cost ten U.S. dollars, which must be paid in U.S. currency. Tourist cards may be purchased at the Dominican Embassy in Washington or Dominican Consulates prior to arrival, as well as at Dominican airports at the time of entry. Tourist cards normally permit a legal stay of up to 60 days. Visitors who would like to extend their time in the Dominican Republic should visit the Migration Department in Santo Domingo and request an extension. Failure to request an extension will subject the visitor to a surcharge at the airport upon departure.

Travel of children and EXIT requirements: Strict exit requirements apply to minors under 18 years of age (of any nationality) who are residents in the Dominican Republic. Such children traveling alone, without one parent, or with anyone other than the parent(s), must present written authorization from a parent or legal guardian. This authorization must be in Spanish, and it must be notarized at a Dominican consulate in the United States or notarized and then certified at the Dominican Attorney General’s office (Procuraduria de la Republica) if done in the Dominican Republic. Though not a requirement for non-resident minors (in the Dominican Republic), the U.S. Embassy recommends that any minor traveling to the Dominican Republic without one or both parents have a notarized document from the parent(s). In addition to clarifying the reason for travel, this will facilitate departure from the Dominican Republic.

The specific guidelines on the Dominican regulations governing the travel of children in the Dominican Republic can be found (in Spanish) at http://www.migracion.gov.do.

Visit the Embassy of the Dominican Republic web site at http://www.domrep.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:
American citizens should be aware that foreign tourists are often considered attractive targets for criminal activity, and should maintain a low profile to avoid becoming victims of violence or crime. In dealing with local police, U.S. citizens should be aware that the standard of professionalism might vary. Police attempts to solicit bribes have been reported, as have incidents of police using excessive force.

Protests, demonstrations, and general strikes occur periodically. Previous political demonstrations have sometimes turned violent, with participants rioting and erecting roadblocks, and police sometimes using deadly force in response. Political demonstrations do not generally occur in areas frequented by tourists and are generally not targeted at foreigners. However, it is advisable to exercise caution when traveling throughout the country. Street crowds should be avoided. In urban areas, travel should be conducted on main routes whenever possible. Power outages occur frequently throughout the Dominican Republic, and travelers should remain alert during blackout periods, as crime rates often increase during these outages.

U.S. citizens considering overland travel between the Dominican Republic and Haiti should first consult the Country Specific Information Sheet for Haiti as well as the Internet site of the U.S. Embassy in Port-au-Prince for information about travel conditions in Haiti. Santo Domingo and the majority of tourist destinations within the Dominican Republic are located several hours from the Haitian border, and recent events in Haiti have generally not directly affected these areas.

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 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 Standard 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 continues to be a problem throughout the Dominican Republic. Street crime and petty theft involving U.S. tourists does occur, and precautions should be taken to avoid becoming a target. While pick pocketing and mugging are the most common crimes against tourists, reports of violence against both foreigners and locals are growing. Criminals can be dangerous and visitors walking the streets should always be aware of their surroundings. Valuables left unattended in parked automobiles, on beaches and in other public places are vulnerable to theft, and reports of car theft have increased. Cellular telephones should be carried in a pocket rather than on a belt or in a purse. One common method of street robbery is for at least one person on a moped (often coasting with the engine turned off so as not to draw attention) to approach a pedestrian, grab his or her cell phone, purse or backpack, and then speed away. This type of robbery is particularly dangerous because the motorcyclist reaches the intended victim at 15–20 miles per hour and often knocks the victim to the ground.

Many criminals have weapons and are likely to use them if they meet resistance. Be wary of strangers, especially those who seek you out at celebrations or nightspots. Traveling and moving about in a group is advisable. The dangers present in the Dominican Republic, even in resort areas, are similar to those of many major U.S. cities. Expensive jewelry attracts attention and could prompt a robbery attempt. Limiting the cash and credit cards carried on your person and storing valuables, wallet items, and passports in a safe place is recommended.

Burglaries of private residences continue to be reported as well as crimes of violence. Criminals may also misrepresent themselves in an effort to gain access to your residence or hotel room. In one 2005 homicide, a U.S. citizen was murdered by two men who posed as repairmen to gain access to the apartment. In another, the Dominican police arrested the building’s actual maintenance man and an accomplice for the crime.

The U.S. Embassy continues to receive reports from Americans who have been stopped while driving and asked for “donations” by someone who may appear to be a police officer before they would be allowed to continue on their way. Usually, the person(s) stopping the American drivers had approached from behind on a motorcycle; several of these motorcyclists pulled up alongside the driver's window and indicated that they were carrying a firearm. In some cases, the perpetrators were dressed in the light green uniform of “AMET,” the Dominican traffic police; however, they often seemed too young to be police officers or wore ill-fitting uniforms that might have been stolen. In another incident, individuals dressed in military fatigues told the victim they were police and requested the victim to follow them to the police station prior to robbing him. Such incidents should be reported to the police and the Consular Section. If Dominican police stop an American driver for a traffic violation, the driver should request a traffic ticket rather than paying an on-the-spot fine. The driver also has the right to ask police for identification. New regulations require police to wear a nametag with their last name. While everyone driving in the Dominican Republic should abide by traffic laws and the instructions of legitimate authorities, Americans finding themselves in the aforementioned scenarios should exercise caution. In general, drivers should keep their doors locked and windows closed at all times and leave themselves an escape route when stopping in traffic in the event of an accident or other threat. Incidents involving police may be reported to the Internal Affairs Department of the National Police at 809 688-1777 or 809 688-0777.

In 2006, the U.S. Embassy received reports of Americans and others who were victims of vehicular-armed robberies in the northern provinces of the Dominican Republic. At least three of the reports indicate the victims were intercepted during the morning hours, when there was little other traffic, while driving on rural highways connecting Santiago and Puerto Plata. Drivers should exercise extreme caution when driving at night and use major highways when possible.

Although kidnappings are not common in the Dominican Republic, in 2007, two American citizens were kidnapped and held for ransom, in separate instances.

Many public transportation vehicles are unsafe, especially the route taxis or “carros publicos” in urban areas. These are privately owned vehicles that run along certain routes, can take up to six or more passengers, and are inexpensive. Passengers in “carros publicos” are frequently the victims of pick pocketing, and passengers have on occasion been robbed by “carro publico” drivers. Urban buses (“guaguas”) are only marginally better. The U.S. Embassy is also aware of at least one incident in which the driver of a “motoconcho” (motorcycle taxi) robbed an American passenger. The U.S. Embassy cautions its staff not to use these modes of transportation. As an alternative, some scheduled interurban bus services use modern buses and run on reliable timetables. These are generally the safest means of intercity travel. With respect to taxis, visitors to the Dominican Republic are strongly advised to take only hotel taxis or taxis operated by services whose cabs are arranged in advance by phone and can subsequently be identified and tracked.

Credit card fraud is common and recent reports indicate that its incidence has increased significantly. The U.S. Embassy strongly advises Americans to restrict severely the use of credit/debit cards in the Dominican Republic. The increase in credit card fraud is particularly pronounced in the eastern resort areas of the Dominican Republic. According to reports, store workers, restaurant service staff and hotel employees may conceal devices that can instantly record the credit card information. Often, this device appears to be a normal card reader used by businesses. Credit or debit cards should be carefully protected and never allowed out of the owner’s sight. Stolen cards are often used to the maximum amount before the victims are able to contact the bank. Victims of credit card fraud should contact the bank that issued the credit card immediately. It is advisable to pay close attention to credit card bills following time spent in the Dominican Republic. There have been reports of fraudulent charges appearing months after card usage in the Dominican Republic.

Automated Teller Machines (ATMs) are present throughout Santo Domingo and other major cities. However, as with credit cards, the use of ATMs should be minimized as a means of avoiding theft or misuse. One local ATM fraud scheme involves sticking photographic film or pieces of paper in the card feeder of the ATM so that an inserted card becomes jammed. Once the card owner has concluded the card is irretrievable, the thieves extract both the jamming material and the card, which they then use. There are other ATM scams as well. Exercise caution and be aware of your surroundings when using an ATM card.

The overall level of crime tends to rise during the Christmas season, and visitors to the Dominican Republic should take extra precautions when visiting the country between November and January.

In many countries around the world, counterfeit and pirated goods are widely available. Transactions involving such products may be illegal under local law. In addition, bringing them back to the United States may result in forfeitures and/or fines. More information on this serious problem is available at http://www.cybercrime.gov/18usc2320.htm.

Beaches and Resorts: The Embassy occasionally receives reports of individuals who have become victims of crime, and particularly sexual assault, while at the beach. Vigilance is recommended. The numerous “all-inclusive” resorts serve abundant quantities of alcohol, a practice that encourages inattention and may be a factor in crime or sexual assault.

Tourist Police: The Dominican Republic does have police that are specially trained to assist tourists who require assistance. This public institution is called Politur and represents a cooperative effort between the National Police, Secretary of the Armed Forces, and the Secretary of Tourism. Politur typically has personnel in tourist areas to provide first responder type assistance to tourists. If you are the victim of a crime, Politur can help you get to a police station so that you may file a police report and seek further assistance. For more information on Politur and contact information, use the following link: http://www.politur.gov.do/. Politur is located at the corner of 30 de Marzo and Mexico, Bloque D, Governmental Building, Santo Domingo. The general phone number is 809-686-8639.

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 system and to find an attorney if needed.

See our information on Victims of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION: Medical care is limited, especially outside Santo Domingo, and the quality of care varies widely among facilities. There is an emergency 911 service within Santo Domingo, but its reliability is questionable. Outside the capital, emergency services range from extremely limited to nonexistent. Blood supplies at both public and private hospitals are often limited, and not all facilities have blood on hand even for emergencies. Many medical facilities throughout the country do not have staff members who speak or understand English. A private nationwide ambulance service, ProMed, operates in Santo Domingo, Santiago, Puerto Plata and La Romana; Telephone number is 809-548-7200. ProMed expects full payment at the time of transport. The U.S. Embassy maintains a non-comprehensive list of providers of medical care in the Dominican Republic, which can be found at the following link: http://www.usemb.gov.do/Consular/ACS/medical_assistance-e.htm.

Tap water is unsafe to drink and should be avoided. Bottled water and beverages are safe.
Dengue: Dengue is endemic to the Dominican Republic. To reduce the risk of contracting dengue, the U.S. Center for Disease Control (CDC) recommends wearing clothing that exposes as little skin as possible and applying a repellent containing the insecticide DEET (concentration 30 to 35 percent) or Picaridin (concentration 20 percent or greater for tropical travelers). Because of the increased risk of dengue fever and the ongoing risk of malaria in the Dominican Republic (see below), practicing preventative measures is recommended by the CDC. For further information on dengue fever, please visit the CDC web site at http://www.cdc.gov/ncidod/dvbid/dengue.

Malaria: There are occasional reports of cases of malaria in areas frequented by U.S. and European tourists including La Altagracia Province, the easternmost province in which many beach resorts are located. Malaria risk is significantly higher for travelers who go on some of the excursions to the countryside offered by many resorts. Prior to coming to the Dominican Republic, travelers should consult the CDC web site at http://www.cdc.gov/malaria/index.htm for more information and recommendations on malarial prophylaxis.

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.

The U.S. Embassy in Santo Domingo and the CDC are aware of several cases in which U.S. citizens experienced serious complications or died following elective (cosmetic) surgery in the Dominican Republic. The CDC’s web site at http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5323a4.htm contains a report on patients who suffered postoperative infections following cosmetic surgery in the Dominican Republic. Patients considering travel to the Dominican Republic for cosmetic surgery may also wish to contact the Dominican Society of Plastic Surgeons (tel. 809-688-8451) to verify the training, qualifications, and reputation of specific doctors.

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. Americans traveling in the Dominican Republic should be aware that Dominican hospitals often require payment at the time of service and may take legal measures to prevent patients from departing the country prior to payment. 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 Dominican Republic is provided for general reference only, and may not be totally accurate in a particular location or circumstance.

Traffic in the Dominican Republic moves on the right side of the road. Speed limits vary from 25 mph in the city to 50 mph on rural roads, but they are generally not enforced. Drivers are required to carry liability insurance.

If you do drive in the Dominican Republic, you should be aware that the utmost caution and defensive driving are necessary. Traffic laws are similar to those in the United States, but undisciplined driving is common, due to a lack of adequate traffic controls. Many drivers will not use turn indicators. Rather, it is common for a vehicle operator to stick his hand out the window to signal a turn. Drivers can also be aggressive and erratic, often failing to yield the right-of-way even when road signs or signals indicate that they should. Travel at night on intercity highways and in rural areas should be avoided, due to animals on the road, poor road conditions, and other vehicles being driven at excessive speeds, often with malfunctioning headlights or taillights. Blackouts also increase the danger of night travel. Turning right on red lights is permitted, but should be done with caution.

Traffic accidents often result in serious injury or death. This is often the case when heavy vehicles, such as buses or trucks, are involved. Traditionally, vehicles involved in accidents in the Dominican Republic are not moved (even to clear traffic), until authorized by a police officer. Drivers who violate this norm may be held legally liable for the accident.

Dominican law requires that a driver be taken into custody for driving under the influence or being involved in an accident that causes serious injury or death, even if the driver is insured and appears not to have been at fault. The minimum detention period is 48 hours; however, detentions frequently last until a judicial decision is reached (often weeks or months), or until a waiver is signed by the injured party (usually as the result of a cash settlement).

Visitors to the Dominican Republic might want to consider hiring a professional driver during their stay in lieu of driving themselves. Licensed drivers who are familiar with local roads can be hired through local car rental agencies. In case of accidents, only the driver will be taken into custody.

Pedestrians tend to step out into traffic without regard to corners, crosswalks, or traffic signals. Many pedestrians die every year crossing the street (including major, multi-lane highways) at seemingly random locations. Pedestrians do not have the right-of-way, and walking along or crossing busy streets – even at intersections with traffic lights or traffic police present – can be very dangerous.

Seat belts are required by law, and those caught not wearing them will be fined. There are no child car seat laws. The law also requires the use of hands-free cellular devices while driving. Police stop drivers using cell phones without the benefit of these devices. Penalties for those driving under the influence and those involved in accidents resulting in injury or death can be severe.

Motorcycles and motor scooters are common in the Dominican Republic, and they are often driven erratically. Dominican law requires that motorcyclists wear helmets, but local authorities rarely enforce this law. As noted previously in this report, public transportation vehicles such as the route taxis (“carros publicos”) and urban buses (“guaguas”) are unsafe.

Please see the Crime section of this information sheet for more information regarding crimes involving road safety.

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 the Dominican Republic’s Civil Aviation Authority (CAA) as being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for oversight of the Dominican Republic’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.

SPECIAL CIRCUMSTANCES:
Currency Regulations: It is legal to exchange currency at commercial banks, exchange booths in hotels and exchange houses. The exchange rate is set by the Central Bank, based on prevailing market conditions. The market determines the exchange rate. No more than USD $10,000 or its equivalent in another currency, including Dominican pesos, may be taken out of the Dominican Republic at the time of departure.

Real Estate: Real estate investments require a high level of caution, as property rights are irregularly enforced. Investors often encounter problems in receiving clear title to land, and title insurance is not available. Real estate investments by U.S. citizens have been the subject of both legal and physical takeover attempts. Absentee landlords and absentee owners of undeveloped land are particularly vulnerable. Investors should seek solid property title and not just a “carta de constancia,” which is often confused by foreigners with a title. An official land registry measurement (also known as 'deslinde' or 'mensura catastral') is also desirable for the cautious overseas investor. Squatters, sometimes supported by governmental or non-governmental organizations, have invaded properties belonging to U.S. citizens, threatening violence and blocking the owners from entering their property. In at least one instance, the U.S. citizen landowner was physically assaulted. Several U.S. citizens with long-standing expropriation disputes with the Dominican Government have not received compensation.

Gambling: Many Americans have reported losing large amounts of money at Dominican casinos by playing a game (or variations thereof) known as “Super Keno,” “Caribbean Keno,” “Progressive Keno,” or “Progressive Roulette.” Players have complained that the game’s rules are unclear and/or misleading. Any complaints arising from a casino should be directed to the Office of Casinos at the Secretary of Finance. To register a complaint with this office, call 809-687-5131, ext. 2120.

Divorce: In recent years, there have been a number of businesses, primarily on the Internet, which advertise “Quickie Dominican Divorces.” The services of these businesses should be used with caution, as they may misrepresent the process of obtaining a divorce in the Dominican Republic. While it is relatively simple for foreigners to obtain a divorce in the Dominican Republic, such divorces are only valid if specific steps are taken. Those seeking information regarding divorce should first consult with an attorney in their home state. Additional information is available via the U.S. Embassy's flyer on Divorce in the Dominican Republic at http://www.usemb.gov.do/Consular/ACS/divorce_DR-e.htm.

Alien Smuggling: Dominican authorities may prosecute anyone arrested for organizing the smuggling of aliens into or out of the Dominican Republic. This is in addition to any charges individuals may face in the other country involved, including the United States.

Hurricanes: The Dominican Republic is situated in an area of the Caribbean prone to hurricanes. In the event of a hurricane alert, a notice will be posted on the U.S. Embassy in Santo Domingo's web page at http://www.usemb.gov.do/index.htm. Further information can be obtained by visiting the National Weather Service's web site at http://www.nhc.noaa.gov. General information about natural disaster preparedness is available via the Internet from the U.S. Federal Emergency Management Agency at http://www.fema.gov.

Water Sports: Visitors to the Dominican Republic, including to local resort areas, should carefully assess the potential risk of recreational activities. Some of the swimming areas at popular beaches around the Dominican Republic are subject to dangerous undertows. Many beaches lack life guards and/or warnings of unsafe conditions. Resort managers usually offer current information on local swimming & surf conditions. Americans are cautioned not to swim alone, particularly at isolated beaches.

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 Dominican laws, even unknowingly, may be expelled, arrested, or imprisoned. Penalties for possession, use, or trafficking in illegal drugs in the Dominican Republic are severe, and convicted offenders can expect long jail sentences and heavy fines. For more information on the Dominican judicial system, procedures, and penalties, please visit the Consular Section’s web page at http://www.usemb.gov.do. 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 on international adoption of children and international parental child abduction, see the Office of Children’s Issues web pages. The Dominican Republic is a party to the Hague Convention on the Civil Aspects of International Child Abduction. The United States formally accepted the accession of the Dominican Republic on June 1, 2007.

REGISTRATION / EMBASSY LOCATION:
Americans living or traveling in the Dominican Republic 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 Dominican Republic. 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 Consular Section of the U.S. Embassy is located at the corner of Calle César Nicolás Penson and Avenida Máximo Gómez. The American Citizens Services (ACS) Unit can be reached by telephone at 809-731-4294, or via email at acssantodom@state.gov. ACS Unit office hours are 7:30 a.m. to 4:30 p.m., Monday through Thursday, Friday 7:30-12:15, except on U.S. and Dominican holidays. The Chancery of the U.S. Embassy is located a half-mile away from the Consular Section, at the corner of Calle César Nicolás Penson and Calle Leopoldo Navarro. The telephone number is 809-221-2171.

There is a Consular Agency in the north coast city of Puerto Plata at Calle Villanueva esq. Avenida John F. Kennedy, Edificio Abraxa Libraria, 2nd floor, telephone 809-586-4204, 809-586-8017, 809-586-8023; office hours are 9:00 a.m. to 12:00 p.m., and 2:30 p.m. to 5:00 p.m., Monday through Friday, except holidays.
* * *
This replaces the Country Specific Information dated May 09, 2007 to update Safety and Security, Crime, and Special Circumstances.

Travel News Headlines WORLD NEWS

Date: Fri, 6 Mar 2020 03:09:21 +0100 (MET)

Santo Domingo, March 6, 2020 (AFP) - A Canadian tourist has the second confirmed case of the new coronavirus in the Dominican Republic, the public health ministry said Thursday.    The 70-year-old woman arrived in the Caribbean country on February 25 with her husband, who is not showing symptoms of COVID-19, the disease caused by the virus that first appeared in China late last year.    The couple has been transferred from their hotel in Bayahibe, in the eastern part of the country, to a hospital isolation centre in the capital Santo Domingo.

The first known case of coronavirus infection in the Dominican Republic was discovered Sunday in a 62-year-old Italian tourist, who was also staying in Bayahibe.    The man was hospitalized and is recovering, according to authorities.    The country established airport and border controls to combat the spread of the virus when the outbreak first took hold in China's Hubei province, and has suspended flights from Milan for 30 days as the virus spreads near the Italian city.    There have been nearly 98,000 infections and some 3,300 deaths in 85 countries and territories throughout the world, according to a count by AFP.
Date: Mon 18 Nov 2019
Source: Pan American Health Organization (PAHO) [abridged, edited]

Between 2005 and 2014, there was an overall decreasing trend in the number of cases of malaria in the Region of the Americas; however, since 2015, there has been an increase in the number of malaria cases reported in the Region.

This overall increase is due to the increase in cases over the last 3 years in the Bolivarian Republic of Venezuela along with increased transmission in endemic areas of countries such as Brazil, Colombia, Guyana, Nicaragua, and Panama, as well as outbreaks in countries that were moving towards elimination (Costa Rica, the Dominican Republic, and Ecuador) (Figure 1 [available at the source URL above]).

Despite this, in 2018, Guatemala and Honduras reported a significant decrease in malaria cases compared to the prior year, which has continued as of November 2019. El Salvador has not reported an autochthonous case in almost 3 years, while Paraguay and Argentina were certified by the Pan American Health Organization/World Health Organization (PAHO/WHO) as malaria-free countries in July 2018 and May 2019, respectively.

In Venezuela, between 1 Jan and week 41 [ending 11 Oct] of 2019, a total of 323,392 malaria cases were reported, representing a slight decrease (1.5%) compared to the same period in 2018 (328,373 cases). In contrast, in 2017, there were 321,358 cases reported during the same period.

In Brazil, the Amazon region is characterized by high endemicity of malaria, accounting for nearly 99% of the cases reported nationally. In this region, there was a 24% overall decrease in the number of cases reported during the 1st semester of 2019 (71,549 cases) compared to the 1st semester of 2018 (93,995 cases).

In Colombia, between 1 Jan and week 42 [ending 18 Oct] of 2019, an outbreak has been occurring with 66,581 malaria cases reported, representing a 28.2% increase compared to the same period in 2018 (51,935 cases).

In Nicaragua, in 2019 as of week 41 [ending 11 Oct] of 2019, there were 9358 cases reported, representing a 15% decrease compared to the same period in 2018 (10,988 cases). This is mainly due to the decrease in cases reported in Puerto Cabezas since mid-2019.
=====================
[The complete PAHO summary can be accessed at the source URL above.  The surge of malaria in Venezuela is well known and is due to an almost entire lack of any vector control activities over the past 10 years. - ProMED Mod.EP]

[HealthMap/ProMED-mail maps:
Date: 26 Jun 2019
Source: VOX [edited]

Tourist deaths in the Dominican Republic are sparking concern among travellers.  It's not yet clear whether the deaths of 10 Americans over the past year are connected. [Some sources report as many as 13 deaths. - ProMED Mod.TG] Ten known US tourists have died at Dominican Republic resorts, or at the hospital immediately following resort stays -- including 3 within 7 days, and 2 within 3 days -- in just over a year.

Now over a dozen more visitors who fell dangerously ill on vacation in the Dominican Republic are coming forward. Sicknesses reportedly set in quickly, marked by frequently cited symptoms of abdominal pain, nausea, and sweating; guests' descriptions of a "chemical smell" in hotel rooms; and a pattern of minibar liquor consumption before indicators of illness set in.

The Dominican Republic's Ministry of Tourism attributes these deaths to natural causes; local and US federal authorities, however, are investigating the incidents, having left some American travellers uneasy, and the future of the Dominican Republic's robust tourism industry uncertain.  The incidents occurred at a collection of resorts on the island: the Terra Linda Resort in Sousa, the Excellence Resorts in Punta Cana, the Grand Bahia Principe in Punta Cana, the Grand Bahia Principe in La Romana, and the Hard Rock Hotel & Casino in Punta Cana.

At least 3 of the people who died reportedly began experiencing symptoms after having a drink from the minibar in their rooms. The US Embassy in Santo Domingo confirmed earlier this month [June 2019] that the FBI were dispatched to the island to conduct toxicology reports, and the Dominican Republic's Ministry of Health announced samples from the minibar in the guest room of CD and NH of Maryland, who were both found dead on 30 May 2019 in their room at the Grand Bahia Principe La Romana, were undergoing testing. On Monday [24 Jun 2019], the Hard Rock Hotel & Casino announced it'd be removing liquor from minibars in its guest rooms.

As forensic scientist Lawrence Kobilinsky told the "Cut," many of the victims' symptoms might suggest methanol poisoning. Methanol is a toxic, synthetic chemical normally used in antifreeze, also used, illegally, to create counterfeit alcohol. Consuming even a small amount of pure methanol can lead to pulmonary edema, or fluid in the lungs, and respiratory distress, 2 of the official causes of death listed for CD and NH. They're also 2 of the official causes of death listed for SW of Pennsylvania, who also died at Grand Bahia Principe La Romana, after reportedly having a drink from her hotel room minibar, just 5 days before CD and NH's deaths.

The toxicology reports for CD, NH, and SW have not yet been released; the FBI said in mid-June 2019 that answers could be another 30 days coming.

Some recent travellers, however, suspect they were exposed to fumes emitted from the air conditioners in their rooms. CNN reports one Denver couple, KK and TS sued the Grand Bahia Principe La Romana -- the same resort where CD and NH stayed -- earlier this year [2019] for illnesses occurring during a trip last July 2018. KK and TS described a "chemical smell" overtaking their room, an odor similar to paint or industrial cleaner. [Earlier, reports indicated KK and SW described the smell as chemical or pesticide smell. Some of their clinical signs sound like organophosphates. This couple reported earlier a grounds worker was spraying the trees, which reportedly was over the air conditioner. - ProMED Mod.TG] Soon after, they said they experienced excruciating stomach cramps, diarrhoea, bloody stool, incessant sweats and drool, watery eyes, and dizziness. Back home in Denver, their doctors wondered whether they'd been exposed to organophosphates, chemicals most often used in pesticides.

KK said she thought back on what she had seen days earlier: A maintenance person spraying palm plants covering the air conditioning units just outside their room. "I wondered if someone sprayed our unit. They are always constantly out there taking care of the plants. We saw them out there with bug sprayers."

Other tourists told CNN they too became sick after they inhaled what they described as a chemical, or paint-like smell, at the Majestic Elegance Resort in Punta Cana in 2017, and at the Grand Bahia Principe Punta Cana going back to 2016.

As the New York Times reports, poisoning or pesticide exposure is even more likely when more than one person experiences the same outcome on the same timeline, as was the case with CD and NH. Chemicals like organophosphates, adds the Times, can "seep into a vent not adequately sealed, or be sucked inside by a hotel air conditioner." Current scientific literature indicates organophosphate poisoning can lead to respiratory failure in some cases.

Tourism drives much of the Dominican Republic's economy, employing more than 300 000 people and drawing a reported 6.6 million international travellers in 2018. A report on the Dominican Republic's economy from the Canadian Trade Commissioner Service says the Dominican government aims to draw 10 million tourists -- roughly the size of its current population -- by 2020, "generating estimated revenues of US $7.2 billion."

Preliminary autopsies conducted by Dominican authorities have been released by the resorts for several of the 10 Americans known to have died in the past year. In addition to pulmonary edema and respiratory failure, the causes of death for the tourists have included pneumonia, multiple organ failure, and an exceptionally common one: heart attack. According to Tourism Minister Javier Garcia, 5 of the deaths can be categorized as "natural causes." [While the Tourism Minister may report it as "natural causes," an investigation is necessary, including toxicology reports, to be fully certain of the cause of those individuals' deaths. - ProMED Mod.TG]

The Excellence Resorts in Punta Cana told the family of LC of New York City she died in her room on 10 Jun 2019 of a heart attack. Her son BC remains skeptical, telling WCBS, "I do not believe it was of natural causes."

It's not yet clear what caused this spate of heart attacks, respiratory failures, and food poisoning-like illnesses. And it's also not clear whether these catastrophic events, similar as they are in geographic location, presenting symptoms, and outcome, are connected. Neither the US Embassy nor the Dominican Ministry of Public Health has acknowledged the possibility of a connection; in fact, Garcia has said: "These cases are very regrettable, but isolated" [The deaths are indeed tragic and regrettable, but evidence revealed so far does not seem isolated. - ProMED Mod.TG].

The Dominican Republic's Ministry of Tourism asks the public to look at these recent deaths in context: Many millions of people travel to the Dominican Republic each year and don't fall seriously ill or die. A statement released by the ministry earlier this month [June 2019] references statistics and polls conducted by the Central Bank of the Dominican Republic. The "rate of tourist incidents" in 2018, the ministry says, fell to 1.4 per 100 000 tourists from 1.6 the previous year. It also highlights that 99 percent of American tourists told their survey they'd return to the Dominican Republic for future vacations.

Nevertheless, US travellers are concerned by recent news, to say the least. CNBC cites a survey from the American Society of Travel Advisors revealing that 2/3rds of its members have cancelled trips to the Dominican Republic for clients within one week. CBS News adds flights to the Dominican Republic from the US are down 74.3 percent from this time last year [2018], with cancelled flights up by 51.2 percent in recent weeks, according to data from flight analysis agency. The [US] State Department's most recent Travel Advisory on the Dominican Republic -- from April 2019 -- places the country as a Level 2, with the directive, "Exercise Increased Caution." The rationale: crime.  "Here we are talking about 9 people, but there are countries in the area where 10 times the number of Americans have died there," the Dominican Republic's tourism board reportedly said at a press conference on 21 Jun 2109, as covered by NBC News. (Details on the 10th death, of New York native VC on 17 Jun 2019, hadn't yet been released.) "But all eyes are on us."  [Byline: Stephie Grob Plante]
=====================
[There are several reports of individuals complaining of shortness of breath and an ill feeling after consuming products from the mini bar. There were television reports indicating some drink containers were filled by the hotel, or the pool bar and put back into the mini bar.

This is the 1st article reporting methanol. However, methanol is a common product substituted in alcoholic drinks because it is cheap and easy to make. Frequently, this type of alcohol is associated with blindness. An individual, possibly dehydrated, coming in from the sun who consumes the beverage somewhat quickly may react differently. But pulmonary oedema is certainly associated with methanol consumption.


Airway and lungs:
- Breathing difficulty
- No breathing
Eyes:
- Blindness, complete or partial, sometimes described as "snow
blindness"
- Blurred vision
- Dilation (widening) of the pupils [Organophosphates produce pin
point pupils - Mod.TG]
Heart and blood:
- Low blood pressure
Nervous system:
- Agitated behaviour
- Coma (unresponsiveness)
- Confusion
- Difficulty walking
- Dizziness
- Headache
- Seizures
Skin and nails:
- Bluish-colored lips and fingernails
Stomach and intestines:
- Abdominal pain (severe)
- Diarrhea
- Liver problems, including jaundice (yellow skin) and bleeding
- Nausea
- Pancreatitis (nausea, vomiting, and abdominal pain)
- Vomiting, sometimes bloody
Other:
- Fatigue
- Leg cramps
- Weakness

Compare the clinical signs, as listed by the same source
<https://medlineplus.gov/ency/article/002832.htm> for organophosphate poisoning:

Symptoms of organophosphate or carbamate poisoning:

Heart and Blood
- Slow heart rate
Lungs and Airways
- Breathing difficulty
- Wheezing
Nervous System
- Anxiety
- Coma (decreased level of consciousness and lack of responsiveness)
- Convulsions
- Dizziness
- Headache
- Weakness
Bladder and Kidneys
- Increased urination
Eyes, Ears, Nose, and Throat
- Drooling from increased saliva
- Increased tears in the eyes
- Small pupils
Stomach and Intestines
- Abdominal cramps
- Diarrhea
- Loss of appetite
- Nausea and vomiting
Skin
- Blue-colored lips and fingernails

Note: Serious poisoning can occur if an organophosphate gets on your bare skin or if you don't wash your skin soon after it gets on you. Large amounts of the chemical soak through the skin unless you are protected. Life-threatening paralysis and death can occur very quickly.

While the clinical signs have some differences, it could have been a combination of organophosphates and methanol intoxication. - ProMED Mod.TG]

[HealthMap/ProMED map available at:
Dominican Republic: <http://healthmap.org/promed/p/24>]
Date: Thu 27 Jun 2019
Source: USA TODAY on Yahoo News [edited]

A Denver man is the latest American tourist to die in the Dominican Republic this year [2019]. [KA] died on Tuesday [25 Jun 2019], the State Department confirmed to USA TODAY.

Denver's 9 News and Fox 31 report [KA] was on vacation with his daughter [MA] when he fell ill in the Caribbean vacation destination. [MA] told 9 News her father started to complain about a painful bump on his leg just before her flight home on Sunday [23 Jun 2019]. She said they stopped by their hotel's medical clinic, but decided against treatment unless the pain became worse.

[MA] had already returned to Denver when her father's pain worsened the following day [24 Jun 2019]. He booked an earlier return flight but was forced to disembark due to his symptoms.

His sister-in-law [MS] told Fox 31 he was dripping with sweat and vomited in the plane's lavatory. "They transferred him to Santo Domingo and (said) his breathing is really bad and his kidneys were failing," she said. [MS] noted while her brother-in-law had undergone a kidney transplant several years earlier, he was in perfect health when he left Colorado.

[KA]'s relatives said they were not even told he had died; they found out only after [MA] called the hospital repeatedly Wednesday [26 Jun 2019] morning. "It's been hard," she told 9News. "Not being able to get a hold of them, or them miscommunicating, or simply not knowing information."

Authorities are conducting an autopsy and investigation to determine the official cause of death, according to 9 News. (The family said they did not receive any diagnosis.)

Questions about safety have dogged the Dominican Republic since late May [2019], when the 1st of several Americans died in their hotel rooms and a Delaware woman claimed she was attacked there in January [2019].

Last week, tourism minister Francisco Javier Garcia held a press conference to dispel those concerns, stating, "The Dominican Republic is a safe country." Garcia also said the confirmed deaths -- 9 including [KA] -- are not out of the ordinary and the number is actually lower than in some previous years. Garcia said by this point in 2011 and 2015, 15 tourists had died in the Dominican Republic.  [Byline: Sara M. Moniuszko]
=====================
[The Dominican Republic is a small place compared with the USA, Europe, Russia, Australia, Canada, Brazil and others.  While this article says there were 9 deaths, including this victim, other sources and listed names add up to 13, with other victims being severely ill and reporting their illness and having survived to tell about it. This is a lot for a small place and even more so given that most of them are reporting the same clinical signs.

An autopsy alone is insufficient for determining a cause of death in these cases. We have been waiting weeks for the release of the toxicology report from the first 10 or more victims, which allegedly the US officials and CDC toxicologist are involved with.

If the man had no prior illness and suddenly started having these pains, sweating and vomiting, it seems quite out of the ordinary. His kidneys may well have failed from the toxins (allegedly) in his system, but it does not mean the kidney failure was the primary reason for death.

The excessive sweating, complained about by every victim prior to death, and by a few who managed to survive, as well as reports of vomiting roll together to make me think this is not a plain and simple death or a death from kidney failure.

I am still suspicious of organophosphates. I am also suspicious of the pain from a bump on his leg. This article does not address anything about the bump. I wonder if there was a bite or sting there? Or was he injected with something?

While the minister of tourism is saying it is safe, there is no indication of security being increased around the resorts to prevent others with nefarious motives from entering the area. There is no indication of an investigation from the resorts or the minister of tourism to assess what is really happening. - ProMED Mod.TG]

[It is also possible that the "bump" on his leg was an abscess either insect bit related or small entry wound related and the disease process described could also be consistent with sepsis, remembering that the individual had a history of a kidney transplant and was most likely on immunosuppressive drugs to prevent rejection of the transplanted kidney. - ProMED Mod.MPP]

[HealthMap/ProMED-mail map:
Dominican Republic: <http://healthmap.org/promed/p/24>]
Date: Sat 15 Jun 2019, 1:03 PM
Source: New York Post [edited]

A group of Jimmy Buffett-diehards from Oklahoma were incredibly sick in paradise -- the latest in an ever-growing list of tourists to be sickened during a jaunt to the Dominican Republic, a report said.

DF, a travel agent who vacationed to Punta Cana with the Buffett-loving Central Oklahoma Parrothead Association, said 4 days into their April [2019] trip, he and other members came down with a mysterious illness. "I can't even explain how sick I was," DF told Oklahoma's News 4. "I lost 14 pounds during that time and was really sick."

By the end of the vacation, 47 of the 114 Oklahomans reported becoming ill, DF said, with many of them too sick to leave their rooms at the Hotel Riu Palace Macao.

DF said it's unclear what caused the illnesses -- Punta Cana doctors suggested a parasite might be to blame. Everyone who got sick swam in the resort pool equipped with a swim-up bar, DF recalled.

Some of the sick Parrotheads, the nickname for fans of the "Why Don't We Get Drunk" singer [Jimmy Buffet], tested positive for _Salmonella_ spp, according to DF, who said he did not.

The latest report of illness comes amid a spate of unexplained deaths on the island nation since January [2019]. The death count ticked to 8 on [Fri 14 Jun 2019], when the family of a 78-year-old Ohio man revealed he died suddenly after dinner and drinks at the Dreams Punta Cana Resort & Spa. Authorities are eyeing bootleg liquor from hotel minibars as the potential killer, sources have told The Post.  "I will not be going back to the Dominican any time soon," DF said.  [Byline: Sara Dorn]
=====================
[These people may be lucky they were only sick and not dead. However, _Salmonella_ sp most often causes diarrhoea and cramps along with severe dehydration and weakness. While an individual may develop a fever and be sweating, the sweating reported in the fatal cases is extreme sweating.

There is no report of the deceased individuals testing positive for salmonellosis.

Regardless of the cause, salmonellosis, or poisoning by something other than bacteria, the resorts involved in these reports appear to have a problem. The problem may be lack of awareness of chemicals from spraying trees above air conditioning units, to someone tampering with alcohol bottles, or perhaps uncleanliness at some eating/drinking  establishment. This many illness and deaths seems quite out of the ordinary for these resorts. - ProMED Mod.TG]

[HealthMap/ProMED map available at:
Dominican Republic: <http://healthmap.org/promed/p/24>]
More ...

Pakistan

Pakistan - US Consular Information Sheet
October 02, 2008
COUNTRY DESCRIPTION:
Pakistan is a parliamentary federal republic in South Asia, with a population of nearly 170 million people. Following successful elections in February 2008, Pak
stan has a coalition government led by Prime Minister Yousef Gilani. Pakistan is a developing country, with some tourist facilities in major cities but limited in outlying areas. The infrastructure of areas of Kashmir and the Northwest Frontier Province was devastated as a result of the October 8, 2005 earthquake and is not yet recovered. Read the Department of State Background Notes on Pakistan for additional information.

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ENTRY/EXIT REQUIREMENTS: All U.S. citizens traveling to Pakistan for any purpose are required to have valid U.S. passports and Pakistani-issued visas. Further information on entry requirements can be obtained from the Embassy of Pakistan at 3517 International Court Avenue NW, Washington, DC 20008; telephone: 202-243-6500; e-mail: info@pakistan-embassy.org; web site: http://www.pakistan-embassy.org/.

Travelers may also contact one of the Consulates General of Pakistan in:
Boston: 20 Chestnut Street, Needham, MA 02492; telephone: (781) 455-8000; fax: (617) 266-6666; email: pakistan@tiac.net
Chicago: 333 North Michigan Ave., Suite 728, Chicago, IL, 60601; telephone: (312) 781-1831; fax: (312) 781-1839; email: parepchicago@yahoo.com
Houston: 11850 Jones Road, Houston, TX, 77070; telephone: (281) 890-2223; fax: (281) 890-1433; email: parephouston@sbcglobal.net
Los Angeles: 10850 Wilshire Blvd., Suite 1100, Los Angeles, CA 90024; telephone: (310) 441-5114; fax: (310) 441-9256; email: info@pakconsulatela.org
New York: 12 East 65th St., New York, NY 10021; telephone: (212) 879-5800; fax: (212) 517-6987; web site: www.pakistanconsulateny.org
If a traveler plans to stay longer than the time listed on the visa, he or she must extend the stay with the local passport office of the Ministry of Interior. Visit the Embassy of Pakistan web site at http://www.pakistan-embassy.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:
A number of extremist groups within Pakistan continue to target American and other Western interests and high-level Pakistani government officials. Terrorists and their sympathizers have demonstrated willingness and capability to attack targets where Americans are known to congregate or visit. Terrorist actions may include, but are not limited to, suicide operations, bombing -- including vehicle-borne explosives and improvised explosive devices -- assassinations, carjacking, assault or kidnapping. U.S. Government personnel are not permitted to stay at or frequent major hotels in Islamabad, Karachi, Lahore and Peshawar.

Government personnel have also been advised to restrict the number and frequency of trips to public markets, and to avoid public restaurants in Islamabad, Karachi, and Peshawar.

In September 2008, over fifty people, including three Americans, were killed and hundreds were injured when a suicide bomber set off a truck filled with explosives outside a major international hotel in Islamabad. In August 2008 gunmen stopped and shot at the vehicle of an American diplomat in Peshawar. In March 2008, a restaurant frequented by westerners in Islamabad was bombed, killing one patron and seriously injuring several others, including four American diplomats. On March 2, 2006, an American diplomat, his locally employed driver, and three others were killed when a suicide bomber detonated a car packed with explosives in front of the U.S. Consulate General in Karachi. Fifty-two others were wounded in the attack.

Sectarian and extremist violence has resulted in fatal bomb attacks in Islamabad, Rawalpindi, Karachi, Peshawar, Quetta, Lahore, and other Pakistani cities since 2006. Since 2007, over 1,000 bombings have killed more than 1,000 people throughout Pakistan and injured many more. Rallies, demonstrations, and processions occur from time to time throughout Pakistan on very short notice and have often taken on an anti-American or anti-Western character. Because of the possibility of violence, Americans are urged to avoid all public places of worship and areas where Westerners are known to congregate.

During the Islamic (Shi’a) religious observance of Moharram, rivalries and hostilities often increase.

In 2007 and 2008, several American citizens throughout Pakistan were kidnapped for ransom or for personal reasons. Kidnappings for ransom are particularly common in some parts of Pakistan, such as the Northwest Frontier Province and Sindh Province.

It is best to avoid public transportation. For security reasons, U.S. Mission personnel are prohibited from using taxis or buses. (See the Traffic Safety and Road Conditions section below.)

Women are advised to dress conservatively, with arms and legs covered, and avoid walking around alone. It is unwise for anyone to travel on the streets late at night. Visitors to Pakistan should attempt to maintain a low profile, blend in, be aware of their surroundings, and seek security with their family or sponsoring organization.

Northern Areas – While we continue to discourage non-essential travel to Pakistan, we advise Americans wishing to trek in Gilgit, Hunza or Chitral to use only licensed guides and tourist agencies. While overall crime is low, there have been occasional assaults on foreign visitors.

Northwest Frontier Province - The Federally Administered Tribal Areas (FATA) along the Afghan border, and certain areas within the Northwest Frontier Province (NWFP), are designated as tribal areas and are not subject to normal government jurisdiction. The Government of Pakistan requires all citizens of countries other than Pakistan and Afghanistan to obtain permission from the Home and Tribal Affairs Department prior to visiting these locations. The permit may stipulate that an armed escort must accompany the visitor. Even in the settled areas of the NWFP there is occasional ethnic, sectarian, and political violence. There have been dozens of bombings in Peshawar of varying sophistication since September 2006. Members of the Taliban and Al-Qaida are known to be in the FATA, and may also be in the settled areas.

Kashmir - While direct military hostilities between India and Pakistan across the Line of Control (LOC) are infrequent, militant groups engaged in a long-running insurgency on the Indian side of the LOC are reported to have bases and supporters operating from the Pakistani side. Most of these groups are anti-American, and some have attacked Americans and other Westerners. The Government of Pakistan restricts access to many parts of this region and requires that visitors obtain a permit from the Ministry of Interior before traveling.

Punjab Province - Violence has increased in Punjab Province. Since September 2007, several suicide operations have taken place, including attacks in Rawalpindi and Lahore. As a precaution against these possible dangers, U.S. citizens are cautioned to avoid public transportation and crowded areas. The Wagah border crossing into India near Lahore remains open daily (from 9:30 a.m. to 3:30 p.m.) for travel to and from India if the passport holder has a valid visa for both countries. Visitors are advised to confirm the current status of the border crossing prior to commencing travel.

Sindh Province - In Karachi and Hyderabad, there has been recurring violence characterized by bombings, violent demonstrations and shootings. An October 2007 suicide attack on former Prime Minister Benazir Bhutto killed more than 130 and injured approximately 375 people in Karachi. In the aftermath of her December 2007 death, rioting in Karachi led to multiple deaths and injuries, as well as widespread property damage. In May 2008, clashing groups of lawyers burned buildings and vehicles in several areas of the city, resulting in at least 11 fatalities. Americans and other westerners continue to be a particular target of hostility and occasional anti-Western mob violence. The Consulate General in particular has been the target of several major terrorist attacks or plots in recent years, including the deadly March 2006 suicide attack described above. Non-essential travel to these cities is strongly discouraged. In rural Sindh Province, the security situation is hazardous, especially for those engaged in overland travel. The Government of Pakistan recommends that travelers limit their movements in Sindh Province.

Balochistan Province - The Province of Balochistan, which borders both Iran and Afghanistan, is notorious for narcotics and other forms of cross-border smuggling. Members of the Taliban and Al-Qaida are also believed to be present there. Tribal unrest sometimes turns violent. Because provincial police presence is limited, travelers wishing to visit the interior of Balochistan should consult with the province’s Home Secretary. Advance permission from provincial authorities is required for travel into many areas. Local authorities have detained travelers who lacked proper permission. Quetta, the provincial capital, has experienced an increase in bombings, occasional gun battles in the streets, and the imposition of curfews. Terrorist attacks against Pakistani government installations and infrastructure have been reported throughout 2005 and 2006.

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, including the Travel Warning for Pakistan, 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 pamphlet A Safe Trip Abroad.

CRIME: Crime is a serious concern for foreigners throughout Pakistan. Carjacking, armed robberies, house invasions, and other violent crimes occur in many major urban areas. Petty crime, especially theft of personal property, is common. American travelers to Pakistan are strongly advised to avoid traveling by taxi and other forms of public transportation, and have members of their host organizations or families meet them at the airport.

In many countries around the world, counterfeit and pirated goods are widely available. Transactions involving such products may be illegal under local law. In addition, bringing them back to the United States may result in forfeitures and/or fines. More information on this serious problem is available at http://www.cybercrime.gov/18usc2320.htm
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 Pakistan is: 15
See our information on Victims of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION: Adequate basic non-emergency medical care is available in major Pakistani cities, but is limited in rural areas. Facilities in the cities vary in level and range of services, resources, and cleanliness, and Americans may find them below U.S. standards; facilities in rural areas are consistently below U.S. standards. Medical facilities require prepayment and do not accept credit cards.

Water is not potable anywhere in Pakistan and sanitation in many restaurants is inadequate. Stomach illnesses are common.

Effective emergency response to personal injury and illness is virtually non-existent in Pakistan. Ambulances are few and are not necessarily staffed by medical personnel. Any emergency case should be transported immediately to a recommended emergency receiving room. Many American-brand medications are not widely available, but generic brands from well-known pharmaceuticals usually are. The quality of the locally-produced medications is uneven.

The U.S. Department of State is unaware of any HIV/AIDS entry restrictions for visitors to or foreign residents of Pakistan.
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. As noted above, emergency medical care in Pakistan is very limited. Medical evacuations from Pakistan may cost in excess of $45,000 for uninsured travelers requiring emergency assistance. 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 Pakistan is provided for general reference only, and may not be totally accurate in a particular location or circumstance.

Traffic in Pakistan moves on the left, opposite of U.S. traffic. In addition to this source of potential confusion, travel by road in Pakistan has a variety of other risks. Roads are crowded, drivers are often aggressive and poorly trained, and many vehicles, particularly large trucks and buses, are badly maintained. Donkeys, cattle, horse carts, and even the occasional camel can pose roadside hazards in some areas. Roads, including most major highways, also suffer from poor maintenance and often have numerous potholes, sharp drop-offs and barriers that are not sign-posted. Drivers should exercise extreme caution when traveling at night by road, as many vehicles do not have proper illumination or dimmers nor are most roads properly illuminated or signed. Driving without experienced local drivers or guides is not recommended.

It is best to avoid public transportation. For security reasons, U.S. Mission personnel are prohibited from using taxis or buses. (See Safety and Security section above.)

Please refer to our Road Safety page for more information. Visit the website of Pakistan’s national tourist office at http://www.tourism.gov.pk/ and the national authority responsible for road safety at http://www.nha.gov.pk/.

AVIATION SAFETY OVERSIGHT: The U.S. Federal Aviation Administration (FAA) has assessed the Government of Pakistan’s Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for oversight of Pakistan’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.

SPECIAL CIRCUMSTANCES:
Pakistan is largely a cash economy. Personal checks are not commonly accepted. Most Pakistanis do not use checking accounts for routine transactions. Outside major cities, even credit cards and travelers’ checks are generally not accepted, and there have been numerous reports of credit card fraud. There are bank branches as well as registered moneychangers in all international airports. ATMs can also be found in major airports. English is widely spoken by professional-level airport staff.

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 Pakistani laws, even unknowingly, may be expelled, arrested or imprisoned. Penalties for possession, use, or trafficking in illegal drugs in Pakistan 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 Pakistan are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department’s travel registration web site so that they can obtain updated information on travel and security within Pakistan. 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 in Islamabad is located at Diplomatic Enclave, Ramna 5; telephone: (92-51) 208-0000; Consular Section telephone: (92-51) 208-2700; fax: (92-51) 282-2632; website: http://islamabad.usembassy.gov/
The U.S. Consulate General in Karachi, located at 8 Abdullah Haroon Road, closed its public operations indefinitely due to security concerns. U.S. citizens requiring emergency assistance should call the Consular Section in Karachi; telephone: (92-21) 520-4200; fax: (92-21) 568-0496; web site: http://karachi.usconsulate.gov/
The U.S. Consulate in Lahore is located on 50 Sharah-E-Abdul Hamid Bin Badees (Old Empress Road), near Shimla Hill Rotary; telephone: (92-42) 603-4000; fax: (92-42) 603-4200; web site: http://lahore.usconsulate.gov/; email: amconsul@brain.net.pk
The U.S. Consulate in Peshawar is located at 11 Hospital Road, Cantonment, Peshawar; telephone: (92-91) 526-8800; fax: (92-91) 528-4171; web site: http://peshawar.usconsulate.gov/
* * *
This replaces the Country Specific Information dated August 7, 2008 to update the section on Safety and Security.

Travel News Headlines WORLD NEWS

Date: Thu 26 Mar 2020
Source: The News [edited]

At a time when health authorities are dealing with the threat of coronavirus in the country, cases of Crimean-Congo haemorrhagic fever (CCHF), which is a lethal viral disease, have started surfacing in Sindh, and 2 people have been diagnosed with the tickborne viral ailment within a week.

"Today, we had a 37 year old female patient from Tharparkar, who was bleeding from her nose and mouth. We sent her sample to the lab and the lab test confirmed that she is infected with Crimean-Congo haemorrhagic fever (CCHF)," said Dr Seemin Jamali, the executive director of the JPMC [Jinnah Postgraduate Medical Centre], while talking to The News on Wednesday [25 Mar 2020].

It is the 2nd case of the Congo fever in the current year [2020], she said, adding that earlier a 40 year old person from the Pak Colony of the city had been referred to the JPMC from the Civil Hospital Karachi, who tested positive for the CCHF. Dr Jamali maintained that the previous patient, who was a butcher by trade, had recovered and been discharged from the hospital, but the new patient, a woman from the Tharparkar district of Sindh, was under treatment and in a precarious condition.

Experts say Crimean-Congo haemorrhagic fever is a tickborne viral disease whose mortality rate is over 40 per cent, and it is mostly people who deal with livestock, including butchers and shepherds, who contract the disease after coming into contact with infected animals.
======================
[This is the 2nd case of CCHF from Karachi in 2020. The 1st case has already been reported in an earlier post. The CCHF cases in Pakistan show biannual peaks, between the months of March-May and August-October. Many factors, including poor sanitation, unhygienic transportation, and numerous animal slaughter sites, inefficient tick-control programs, post-slaughter piles of animal remains, nomadic lifestyle, and lack of general awareness contribute to the spread of CCHF.

Pakistan has confirmed cases of CCHF in almost every province: Sindh (Karachi), Punjab (Faisalabad, Multan, and Rawalpindi), Balochistan (Quetta) and Khyber Pakhtunkhwa (Peshawar). There is a need to educate the general public, farmers, and healthcare workers about the causes, transmission, and risks of CCHF and advise on practical preventive measures. - ProMed Mod.UBA]

[Maps of Pakistan:
Date: Sat 21 Mar 2020
Source: Pakistan Today, Pakistan Press International (PPI) report [edited]

A Crimean-Congo haemorrhagic fever (CCHF) case was reported at Jinnah Postgraduate Medical Centre (JPMC) here on Saturday.

Executive Director, JPMC, Dr Seemin Jamali, while talking to PPI, said a 40-year-old man, a resident of Pak Colony, was reported in the emergency department with Congo fever related complications. She informed that the patient is a butcher by profession and he is patient with a positive PCR CCHF.

She informed that the patient was first shifted to Civil Hospital Karachi where the administration refused to get him admitted, and he was later brought to JPMC for treatment. She further informed that this was the 1st Congo patient reported in JPMC this year [2020] so far.

Experts said Congo fever is a fatal viral disease that spreads through a tick bite, which is a parasite and lives in the blood of animals. The [disease is mainly contracted by] people who deal with cattle and livestock.

The major symptoms of [CCHF] include backache, joints pain, pain in the abdomen, high grade fever, and bleeding from any part of the body.
============================
[This is the 1st case of CCHF reported from Pakistan in 2020; the last case was reported in November 2019.

"The hosts of the CCHF virus include a wide range of wild and domestic animals such as cattle, sheep, and goats. Many birds are resistant to infection, but ostriches are susceptible and may show a high prevalence of infection in endemic areas. For example, a former outbreak occurred at an ostrich abattoir in South Africa. "Animals become infected by the bite of infected ticks and the virus remains in their bloodstream for about one week, allowing the tick-animal-tick cycle to continue when another tick bites.

"The CCHF virus is transmitted to people either by tick bites or through contact with infected animal blood or tissues during and immediately after slaughter. The majority of cases have occurred in people involved in the livestock industry such as agricultural workers, slaughterhouse workers, and veterinarians. "Human-to-human transmission can occur resulting from close contact with the blood, secretions, organs, or other bodily fluids of infected persons. Hospital-acquired infections can also occur due to improper sterilization of medical equipment, reuse of needles, and contamination of medical supplies.

"The length of the incubation period depends on the mode of acquisition of the virus. Following infection by a tick bite, the incubation period is usually 1 to 3 days, with a maximum of 9 days. The incubation period following contact with infected blood or tissues is usually 5 to 6 days, with a documented maximum of 13 days.  There are no vaccines available for use in animals or humans. However, steps can be taken to reduce the risk of infection in people. "In the absence of a vaccine, the only way to reduce infection in people is by raising awareness of the risk factors and educating people about the measures they can take to reduce exposure to the virus.

Reducing the risk of tick-to-human transmission:
- wear protective clothing (long sleeves, long trousers);
- wear light coloured clothing to allow easy detection of ticks on the clothes;
- use approved acaricides (chemicals intended to kill ticks) on clothing;
- use approved repellent on the skin and clothing;
- regularly examine clothing and skin for ticks;
- seek to eliminate or control tick infestations on animals;
- wear gloves and other protective clothing while handling animals;
- avoid close physical contact with CCHF-infected people;
- wear gloves and protective equipment when taking care of ill people;
- wash hands regularly after caring for or visiting ill people."

[HealthMap/ProMED-mail map of Pakistan:
Date: Fri, 13 Mar 2020 10:19:08 +0100 (MET)

Lahore, Pakistan, March 13, 2020 (AFP) - Hundreds of thousands of Islamic worshippers gathered in eastern Pakistan this week amid the novel coronavirus pandemic, ignoring government warnings that such events could propagate the disease.   Organisers late Thursday curtailed the annual Tablighi Ijtema congregation, which had drawn people from across the country, but cited rainy weather as the cause.

The early closure came after about 250,000 people had already congregated in camps near Lahore since Wednesday for the five day festival.   "Most of the people have returned to their homes but still tens of thousands of people are here. They will return today," one of the event's organisers Ehsanullah, who goes by one name, told AFP on Friday.   Pakistan has only recorded 21 confirmed cases of the novel coronavirus and no deaths, but officials have tested fewer than 500 potential cases in the country of about 215 million, where health care is frequently inadequate.

Many countries are advising against large gatherings in a bid to slow the spread of the highly communicable virus. Some nations -- like France and Italy -- have banned them altogether.   The federal government has yet to enforce nationwide measures to contain a possible outbreak, leaving provinces to act independently. Organisers of the Tablighi Ijtema were free to ignore government advice to postpone.   "The government asked us to cancel the gathering because of the coronavirus, but our elders and organisers decided that the gathering will proceed as planned," Ehsanullah said.

The movement was founded by religious scholars more than five decades ago and focuses exclusively on preaching Islam.   It usually sees hundreds of camps and sub-camps set up on a dusty site outside Lahore to accommodate people from across Pakistan, giving the gathering a festival feel.   Schools in three of Pakistan's four provinces are closed for March and authorities are conducting basic screenings of passengers arriving by air from overseas.   Prime Minister Imran Khan was set to meet with his national security team later Friday to discuss the global coronavirus crisis.
Date: Wed, 4 Mar 2020 05:47:12 +0100 (MET)
By Kaneez Fatima

Pipli Pahar, Pakistan, March 4, 2020 (AFP) - Pakistan's farmers are struggling to combat the worst locust plague in nearly three decades as insect swarms decimate entire harvests in the country's agricultural heartlands and send food prices soaring.   Heavy rains and cyclones sparked "unprecedented" breeding and the explosive growth of locust populations on the Arabian peninsula early last year, according to the United Nations.

The insects have since fanned out and wreaked havoc on farms from East Africa to India before making their way into Pakistan from the desert on the country's southwestern border with Iran.    The crisis is so severe that the government has declared a nationwide emergency and urgently appealed for help from the international community.

Officials in southern Sindh province fear the infestation will devastate the supply of cotton, the local cash crop, ahead of its harvest in the coming months.    Local surveys of the damage are continuing, but the Sindh Chamber of Agriculture says nearly half of all crops have been destroyed near the port city of Karachi.   "I have not seen an infestation like this one in my career," said Shehbaz Akhtar, an agricultural official charged with locust eradication efforts in the village of Pipli Pahar in central Punjab province.

- 'Combat operation' -
Local authorities had "launched a combat operation" to clear the area of infestation with pesticide sprays, he said.    Clouds of the noxious gas envelop the nearby fields each morning, where villagers gather the husks of dead insects for an official bounty of 20 rupees (13 cents) per kilogramme bag.   "We spray twice a day here," says Fayyaz Azeem, clad in a face mask and thick industrial gloves on top of a tractor discharging pesticide into rows of crops.   But the process is slow and time-consuming, and by the time locusts are killed off in one field they have often already destroyed the next.   The pesticides used by officials are also dangerous for consumption, so even when the locusts are dead the remaining crops have to be discarded.   Some farmers have been forced to opt for more desperate solutions while waiting for their fields to be sprayed and have attempted to scare off the swarms by shouting and banging pots.

A team of Chinese experts has arrived in Pakistan to survey the crisis, food security ministry chief Muhammad Hashim Popalzai told AFP.   Beijing could also offer aerial spraying -- a much faster and more efficient method of pest control -- and Pakistan may also import pesticides from China.   Earlier reports circulating online suggested China was planning to send thousands of ducks to Pakistan to devour the scourge. Pakistani officials said no such plans were being considered.   The UN Food and Agriculture Organization has also set up meetings between India and Pakistan to prevent the swarms from spreading, Popalzai said.

- 'What can I do?' -
Agriculture accounts for 20 percent of Pakistan's GDP but the sector has already struggled for years in the face of drought and dwindling water supplies.   The country is also experiencing 12-year inflation highs, with the cost of sugar nearly doubling and flour prices jumping 15 percent in the past year.   Years without a locust attack meant the government "had become complacent" about the risks of a new infestation, said Pakistan Farmers Bureau president Zafar Hayyat.

Though he applauded the steps being taken to fight the plague, Hayyat warned of the risk that swarms would return mid-year after the next locust breeding season.    For many farmers in Pipli Pahar, the extermination campaign has already come too late.    Sitting in the corner of a wheat field with her cow, Rafiya Bibi watches the flurry of pesticide spraying around her.    The locusts have already destroyed her crops of canola, sunflower, chili and tobacco, which she had bought after borrowing 45,000 rupees from the government.   With no harvest, she has no way to repay the loan.    "What can I do?" she said. "All I can do is cry, what else can I do?"
Date: Thu 20 Feb 2020
Source: MENAFN - Tribal News Network [abridged, edited]

Measles has reared its ugly head in Khyber Pakhtunkhwa again as 104 children have been diagnosed with the disease so far this year [2020], while 218 more suspect cases are under scrutiny.

These figures have been compiled from official data of the Health Department provided by different government hospitals, while the actual number of infected children may be much higher. According to the Health Department, a total of 13 229 measles cases were reported in KP in 2018, among which the virus was confirmed in 1515 children. As many as 20 children died of the disease that year [2018]. The last year [2019] saw marked improvement in measles cases as only 288 cases were reported with 3 deaths.

The administration of Hayatabad Medical Complex (HMC) said 6 children died of measles in the hospital during the last 3 months. This year [2020], 46 confirmed cases of measles have been registered by the hospital. The emergence of 104 new measles cases during the last 1.5 months has left the health authorities and parents extremely concerned.

One man from the Razmak area of North Waziristan said, while talking to TNN, that his one-year-old daughter 1st had a cough and then a high fever. He said he admitted his daughter to Razmak Hospital, where she was diagnosed with measles and died 6 days after diagnosis despite proper treatment. He said that earlier his 2-year-old niece also died from the disease.

Dr Bilal, trainee registrar at HMC Peshawar, said the measles vaccine is 1st administered to children at the age of 9 months, which produces 70% resistance in the body against the disease. However, he said, a one-year-old child can contract measles if resistance in the body decreases.

Some parents said their children contracted measles despite [receiving the] vaccination. Dr Bilal said the wrong management of the vaccination, such as [improper] storage or administration, may render it ineffective. He said some parents don't administer to their children the 2nd measles vaccine, which is given at the age of 15 months and produces 90% resistance against the disease.

A resident of Charsadda said his 8-month-old son died of measles, as it could not be diagnosed timely.

Dr Bilal said an affected child has a high fever and rashes in the mouth. The body of the affected child is also covered by small red-coloured pimples (rash). He said it is an RNA virus, and even doctors cannot diagnose it until the skin of the infected child turns red.

Dr Bilal said the virus becomes active in its season and mostly affects children below one year of age or those who did not get vaccine. He said children with continuous fever and runny nose and eyes must immediately consult a doctor, and such children must be kept separate from other children to avoid spread of the disease.
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Bhutan

Bhutan - US Consular Information Sheet
February 23, 2009
COUNTRY DESCRIPTION:
Bhutan is a small, land-locked Himalayan country that completed its transition from an absolute monarchy to a constitutional monarchy in June 2008.
Bhutan i
one of the world’s smallest and least developed economies.
The United States does not have full diplomatic relations with Bhutan and there is no U.S. diplomatic presence there.
Consular issues relating to Bhutan, including assistance to U.S. citizens, are handled by the U.S. Embassy in New Delhi.
Read the Department of State Background Notes on Bhutan for additional information.
ENTRY/EXIT REQUIREMENTS:
Independent travel is not permitted in Bhutan. Visitors are required to book travel through a registered tour operator in Bhutan. This may be done directly or through a travel agent abroad.
Further information, including a list of authorized tour operators in Bhutan, may be obtained from the Tourism Council of Bhutan, PO Box 126, Thimphu, Bhutan, telephone +975-2-323251, 2-323252, fax +975-2-323695.
Entry by air is available only via India, Bangladesh, Nepal, and Thailand. The border with China is closed. The minimum daily tariff is set by the Bhutanese Department of Tourism and cannot be negotiated. The rate includes all accommodations, all meals, transportation, services of licensed guides and porters, and cultural programs where and when available. The rate is the same for both cultural tours and treks. Travelers should contact the Tourism Council for the latest daily tariff.
At this time, the only carrier servicing Bhutan is Drukair, the Bhutanese government airline. Drukair will board only travelers with visa clearance from the Tourism Authority of Bhutan.

A passport and visa are required for entry into and exit from Bhutan.
Visa applications are available from selected travel agencies.
Travel agencies will usually arrange for a traveler’s entry visa and clearance.
Visitors, including those on official U.S. government business, should obtain visas prior to entering the country.
For additional entry/exit information, please contact the Bhutan Mission to the United Nations (Consul General), 763 First Avenue, New York, NY
10017, telephone (212) 682-2268, fax (212) 661-0551.

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:
Recent efforts to resettle many of the approximately 100,000 Bhutanese refugees of Nepali ethnic origin currently living in Nepalese refugee camps, coupled with the transition to democracy, have given rise to some civil unrest in usually peaceful Bhutan.
Bhutanese Maoists and Communist groups (including the Bhutan Communist Party and the Bhutan Tiger Force operating from the camps in Nepal), who denounce the monarchy and demand that the refugees be repatriated to Bhutan, have been linked to violence in the country.
A series of small bombs were set off between October 2006 and December 2008; most took place in small cities and towns on the southwestern border, near India, except for one in the capital, Thimphu.
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:
There is relatively little crime in Bhutan. Petty crime, such as pick-pocketing and purse snatching, is occasionally reported.
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 in New Delhi.
If you are the victim of a crime while in Bhutan, in addition to reporting to local police, please contact the U.S. Embassy in New Delhi for assistance.
(See the contact information below.)
The Embassy’s consular 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 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 for Bhutan police in Bhutan is 113.
The emergency number for ambulance service is 112.

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 Bhutanese laws, even unknowingly, may be expelled, arrested or imprisoned.
Bhutan recently implemented extremely strict restrictions on the sale or use of cigarettes and other tobacco products.
A traveler caught selling tobacco products could be charged with illegal smuggling and fined or imprisoned.
Smoking is prohibited in public places.
Penalties for possession, use, or trafficking in illegal drugs in Bhutan 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.
SPECIAL CIRCUMSTANCES:
Visitors are advised to carry cash or travelers checks, since credit cards are not widely accepted in Bhutan.
When credit cards are accepted, usually during bank hours, an extra service fee, usually a percentage of the overall purchase, is often charged.

Druk Air, the only carrier servicing Bhutan, has rigid restrictions on the amount and size of luggage passengers may carry into the country. Passengers are advised to book bulky items ahead as unaccompanied baggage, since the aircraft servicing Bhutan have limited space available for large bags, and airline employees may not load large pieces of luggage. Flights into and out of Paro Airport are restricted to daylight hours and are dependent on suitable weather conditions. Flights are sometimes delayed or cancelled, particularly during the monsoon season between June and August. Passengers are advised to allow at least 24 hours' transit time for connecting flights from Paro Airport and to travel on non-restricted air tickets so that they can be rebooked on the first available air carrier if a connecting flight is missed.

Bhutanese customs authorities enforce strict regulations concerning temporary importation into or export from Bhutan of items such as firearms, ammunition, explosives and military stores; narcotics and drugs (except medically prescribed drugs); tobacco products; wildlife products, especially those of endangered species; and antiques. It is advisable to contact the Bhutan Mission to the United Nations (Consulate General), 763 First Avenue, New York, NY
10017, telephone (212) 682-2268, fax (212) 661-0551, for specific information regarding customs requirements.
Please see our Customs Information.
MEDICAL FACILITIES AND HEALTH INFORMATION:
Medical facilities in the populated areas in Bhutan such as Thimphu and Paro are available but may be limited or unavailable in rural areas.
If Americans need urgent medical care, they should try to get to the General Hospital in the capital city, Thimphu.
Medical services may not meet Western standards, and some medicines are in short supply.
Certain emergency medical services are provided free of charge to all tourists.
Visitors planning to trek in Bhutan should pay special attention to the risk of altitude illness.
Treks in Bhutan can take visitors days or weeks away from the nearest medical facility.
Helicopter evacuation from remote areas is available in Bhutan through the registered tour operators, or by contacting the U.S. Embassy in New Delhi.

Some HIV/AIDS entry restrictions exist for visitors to and foreign residents of Bhutan.
There are no disclosure regulations or restrictions for HIV/AIDS patients who enter Bhutan on a tourist visas for a maximum two week visit.
For longer stays applicants must present the results of an HIV/AIDS test completed within the six months prior to their visit.
The test can also be administered by Bhutanese officials upon arrival. Travelers should verify this information with the Bhutan Mission to the United Nations at (212) 682-2268.

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.
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 Bhutan is provided for general reference only and may not be totally accurate in a particular location or circumstance.
General road conditions outside of urban areas are poor, and emergency services generally are not available.
Because of the mountainous terrain, roads tend to have steep drop-offs and blind curves.
However, because tourists to Bhutan are required to arrange their trips through registered tour operators, tourists do not drive themselves, but travel in groups with experienced drivers.
Please refer to our Road Safety page and Bhutan’s Ministry of Economic Affairs for more information.
AVIATION SAFETY OVERSIGHT:
As there is no direct commercial air service to the United States by carriers registered in Bhutan, the U.S. Federal Aviation Administration (FAA) has not assessed Bhutan’s Civil Aviation Authority for compliance with International Civil Aviation Organization (ICAO) aviation safety standards.
For more information, travelers may visit the FAA web site.
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:
There is no U.S. Embassy or Consulate in Bhutan. Although no formal diplomatic relations exist between the United States and Bhutan, informal contact is maintained through the U.S. Embassy in New Delhi, India. Updated information on travel and security in Bhutan may be obtained at the U.S. Embassy in New Delhi, at any other U.S. Consulate in India, or at the U.S. Embassy in Kathmandu, Nepal, as well as at the U.S. Embassy in Bangkok, Thailand.
Americans living or traveling in Bhutan are encouraged to register through the State Department’s travel registration web site or with the U.S. Embassy in New Delhi to obtain updated information on travel and security within Bhutan.
Americans without Internet access may register directly with the U.S. Embassy in New Delhi in person or via mail.
By registering, American citizens make it easier for the Embassy or Consulate to contact them in case of emergency.

The U.S. Embassy in New Delhi is located on Shanti Path, Chanakya Puri, New Delhi 110 021, India, telephone +91-11-2419-8000, fax +91-11-2419-8407.

The following U.S. missions are included as they are Drukair destinations:
The U.S. Consulate in Kolkata is located at 5/1 Ho Chi Minh Sarani, Kolkata 700 071, India, telephone +91-33-3984-2400, fax +91-33-2282-2335.
The U.S. Embassy in Kathmandu is located at Maharajgunj in Kathmandu, Nepal.
The Consular Section can be reached through the Embassy switchboard at (977) (1) 400-7200 or directly by fax at (977) (1) 400-7281 or contacted by email.
The U.S. Embassy in Bangkok is located at 120/22 Wireless Road, Bangkok, Thailand, telephone +66-2-205-4000, fax +66-2-205-4103.
*

*

*
This replaces the Country Specific Information dated April 25, 2008, to update the sections on Country Description, Safety and Security, Traffic Safety and Road Conditions, and Medical Facilities and Health Information.

Travel News Headlines WORLD NEWS

Date: Fri, 6 Mar 2020 05:39:57 +0100 (MET)

Thimphu, Bhutan, March 6, 2020 (AFP) - The isolated Himalayan kingdom of Bhutan has reported its first case of the coronavirus after a US tourist tested positive, the prime minister said Friday.   The tiny, land-locked country, famous for measuring Gross National Happiness has emerged as a popular tourist destination in recent years.   But the government immediately shut borders to foreign visitors for two weeks in an effort to limit the impact of a disease that has wreaked havoc in more developed countries around the world.

The 76-year-old man arrived in Bhutan from India on March 2, and was admitted to hospital on March 5 with a fever, where he tested positive for COVID-19, the office of Prime Minister Lotay Tshering said in a Facebook post.   The post added that there would be "two weeks' restriction on all incoming tourists with immediate effect".   Schools in three areas -- including the capital Thimphu -- will be closed for two weeks from Friday.

The patient, who has not been named, left Washington on February 10, touring India from February 21 to March 1.   Health officials say they have traced roughly 90 people he came into contact with in Bhutan, with his 59-year-old partner, driver and guide all being placed in quarantine. None is currently showing symptoms.   Eight Indian nationals who were on the flight to Bhutan have also been quarantined.   More than 3,000 people have died from novel coronavirus, with nearly 100,000 confirmed infections globally.
National. 7 Sep 2019

Dengue fever cases in Phuentsholing are on the rise 2 months after the outbreak was 1st reported. Public awareness and campaigns have been of little help. Phuentsholing hospital saw a total of 2121 dengue-positive cases as of yesterday [6 Sep 2019], 313 more than the [1 Sep 2019] record. With 894 dengue-positive cases reported from private diagnostic centres in the town, Phuentsholing saw 3015 positive cases as of yesterday [6 Sep 2019].

Figures from the diagnostic centres, however, include both Bhutanese and people from across the border. The chief programme officer with Department of Public Health (DoPH), Ministry of Health, Rixin Jamtsho, said that 77% of the total cases in the country were reported from Phuentsholing hospital." The cases were reported from 19 dzongkhags [administrative district] till yesterday [6 Sep 2019]," Rixin Jamtsho said. "[The] majority of the cases reported from other districts had travelled to Phuentsholing prior to their illness."

[HealthMap/ProMED-mail map of Bhutan:

1 Aug 2019. A total of 138 acute undifferentiated fever or dengue fever cases were reported in Doksum in Trashiyangtse as of yesterday [31 Jul 2019]. Health officials in Doksum tested 64 samples using dengue rapid test kit. Two tested positive for dengue NS1, 4 for dengue IgM, and 21 for 8 dengue IgG antibody.

[Dengue IgG antibody test is not confirmatory of acute infection unless serial serum samples have been tested. - ProMED Mod.UBA]

- National. 9 Aug 2019. The number of people affected by the dengue outbreak in Doksum in Trashiyangtse has increased 4-fold since the outbreak was reported on 26 Jul [2019] with 76 cases. A total of 314 cases were reported from Doksum as of yesterday evening [8 Aug 2019]. Most cases presented fever, joint pain, headache, and generalised body pain as symptoms.

HealthMap/ProMED-mail map of Bhutan:
26th June 2019
http://www.xinhuanet.com/english/2019-06/26/c_138176103.htm

THIMPHU, June 26 (Xinhua) -- Heavy rainfall in Bhutan has killed at least two people, triggered flash floods, landslides and road blocks, and damaged homes, streets and vehicles. The two were buried alive after the landslide washed away their home in southern district of Samtse on Tuesday due to massive landslide that was triggered by heavy rains. The continuous rainfall and flash floods have blocked more than four national highways, damaged bridges and affected many commuters and office goers.

According to the National Center for Hydrology and Meteorology, the southern belt of Bhutan has recorded heavy rainfall on Tuesday. The downpour continued on Wednesday, further affecting the lives of people living in southern part of the country.  People residing in Phuentsholing said that they had to evacuate at early as 3 a.m. due to swollen rivers. The engineering workshops were overflown and drains were invisible due to landslides and flash floods. Falling of boulders and landslides damaged many vehicles, with some being submerged in mud. The schools in Phuentsholing town had to postpone their exams due to the damages caused by the heavy rainfall.

In Gelephu district a highway bridge was damaged. National highways between four districts were blocked. Many public buses and commuters were cancelled due to swollen rivers.  In 2017 a monsoon rainfall washed away an entire town in southern district of Sarpang.

Date: Sat 20 Apr 2019
Source: Kuensel [edited]

The recent [influenza A(H1N1)] outbreak in Bumthang is under control with the number of infected people visiting hospital declining from 30 to 35 a day to about a dozen these days.

Since the 1st case was reported on [8 Apr 2019] about 227 people were reported to have been infected by influenza A(H1N1)pdm09 causing seasonal flu.

Of the total infected, around 90 percent were students of Wangdicholing lower secondary school (WLSS), Bumthang. The 1st incident was reported on [8 Apr 2019] when 45 students did not come to school. Some were sent home and some referred to hospital.

Medical Officer of Wangdicholing hospital Dr Pema Wangchuk said the samples from the infected were sent to the Royal Center for Disease Control for investigation, which confirmed the disease as influenza A(H1N1). However, the doctor said it is a normal seasonal flu that occurs every year, especially during early spring and winter.

Signs and symptoms of influenza are fever, cough, headache, muscle and joint pains, sore throat and runny nose, sometimes with vomiting and diarrhoea.

Students are infected easily mainly because of congestion, lack of hand hygiene practice, and not having preventive measures for cough, according to health officials. The hospital organised advocacy and preventive measures to avoid further spreading of the disease.

As per the report from WLSS, about 64 infected students could not attend regular classes until [15 Apr 2019]. Although the number decreased, there are students not being able to attend classes while some teachers were also infected.

This is the 2nd consecutive outbreak. Last winter more than 350 people were infected by the same virus.

The current outbreak falls under the moderate category, where preventive measure and sensitization programme and treatment could work.  [Byline: Nim Dorji]
==================
[HealthMap/ProMED-mail map of Bumthang, Bhutan:
More ...

World Travel News Headlines

Date: Sat, 4 Apr 2020 16:10:44 +0200 (METDST)

London, April 4, 2020 (AFP) - Britain on Saturday reported 708 more deaths from COVID-19 in a new daily high, as the number of confirmed cases rose to nearly 42,000.   The health ministry said 4,313 people who tested positive for the virus in hospital had died as of 1600 GMT Friday while there were 41,903 confirmed cases as of 0800 GMT Saturday, up 3,735.   The toll has been steadily increasing at more than over 500 deaths a day this week and the country is bracing for an expected peak in the next week to 10 days.   Prime Minister Boris Johnson, who is in self-isolation after developing mild symptoms of the disease, ordered a three-week lockdown of the country on March 23 to try to cut infections.

But there has been concern that warmer weather forecast for this weekend could tempt people from their homes to green spaces and public parks.   "I just urge you not to do that," Johnson said in a video message on Friday. "Please, please stick with the guidance now."   Health Secretary Matt Hancock also warned against any relaxation in social distancing. "If we do, people will die," he told a daily briefing on the government's response on Friday.   A special address on the crisis by Queen Elizabeth II is to be broadcast on Sunday evening.

Imperial College London epidemiologist Neil Ferguson, who is advising the government, told BBC radio on Saturday a peak was expected around the Easter weekend.   "We still think things will plateau but we'll be at quite high levels of infection for weeks and weeks rather than seeing quite a rapid decline as the type seen in China," he said.   But he said that was dependent on people staying at home. If that happened, it could lead to less stringent measures in place "at least by the end of May", he added.

The announcement of another record rise in deaths came after 13 residents at a care home in Glasgow died in one week in a suspected outbreak of coronavirus.   The Burlington Court Care Home in the Cranhill area of the city said those who died had underlying medical conditions and two staff members were being treated for COVID-19.

Tests for coronavirus are currently carried out on the most serious cases that require hospital treatment, suggesting the true extent of confirmed cases and deaths is an under-estimate.   The government meanwhile announced that up to 4,000 low-risk prisoners near the end of their sentence could be release from jails in England and Wales to try to stop the spread of COVID-19.   A total of 88 prisoners and 15 prison staff have tested positive for the virus, and there is concern it could spread rapidly because of shared cells and overcrowding.   The justice ministry said those released would be electronically tagged and temporarily released on licence in stages. High-risk offenders will not be considered for early release.
Date: Sat, 4 Apr 2020 15:38:20 +0200 (METDST)

Madrid, April 4, 2020 (AFP) - Spanish Prime Minister Pedro Sanchez announced Saturday the extension of the country's lockdown until April 25 in order to curb the spread of the novel coronavirus.   "The cabinet on Tuesday will again ask for authorisation from parliament to extend for a second time the state of alert until Saturday April 25 at midnight,' Sanchez said in a televised speech.
Date: Sat, 4 Apr 2020 15:26:30 +0200 (METDST)

Istanbul, April 4, 2020 (AFP) - Turkey stepped up controls Saturday on crowded public spaces including markets and ferries in Istanbul a day after President Recep Tayyip Erdogan imposed the use of face masks to curb the coronavirus outbreak.    Turkey has so far recorded 425 coronavirus-related deaths and nearly 21,000 cases, most of them in the country's economic capital Istanbul, according to official figures.   From Saturday, all those going out to shops or markets must wear a face mask, Erdogan said, calling on the population to maintain a distance of "three paces" from each other when outside.

At an Istanbul bazaar in the Besiktas neighbourhood open every Saturday, police and local municipal employees handled the use of masks and hand disinfectants, while checking the temperature of incoming customers at the entrance.   Veli Yildirim, 50, who sells vegetables including tomatoes, said the measures came "too late."   "We are the latest compared to the rest of the world. Even this is not enough, there should be a complete lockdown" in Istanbul, he told AFP.    A 60-year-old customer in the bazaar, Asuman Karaman wearing a mask, agreed: "If these measures had been taken one or two months earlier, maybe the virus would not have been so widespread."   The bazaar looked quite calm -- in stark contrast to its usual noisy and crowded state.

Vendors complained their business was hit badly.    "This has a had a big impact, there is no one at the market, at this time of the day, we have nothing to do here," said Abbas Kose, who sells vine leaves.   At the ferries in Istanbul, passengers were seen wearing face masks.    The city's mayor Ekrem Imamoglu has been calling for total confinement but authorities have so far stopped short of that.    As part of the measures taken nationwide, authorities suspended international flights, issued a confinement order for everyone aged under 20 and over 65 and shut schools.   Erdogan on Friday also said vehicles would no longer be able to leave or enter 31 towns and cities, including Istanbul, for 15 days.
Date: Sat, 4 Apr 2020 15:22:33 +0200 (METDST)

Geneva, April 4, 2020 (AFP) - Switzerland on Saturday saw the number of cases of the new coronavirus in the country pass 20,000, as its death toll in the pandemic swelled past 500.   The health ministry said 20,201 people in Switzerland had tested positive for COVID-19 as of Saturday morning -- nearly 1,000 more than a day earlier.   The small Alpine country of some 8.5 million people is thus one of the worst hit compared to population size, now counting 236 registered infections per 100,000 people.    At the same time, an additional 76 people died over the past 24 hours, bringing Switzerland's death toll in the pandemic to 540, the health ministry said.   "We have not yet reached the peak," health ministry official Daniel Koch told reporters.

Worldwide, well over 1.1 million cases have been registered across 188 countries, while close to 60,000 people have died, according to a tally compiled by AFP Saturday from official sources.   The high incidence in Switzerland could in part be linked to the fact that it is among the countries that have administered most tests per capita.   Since the first case surfaced in the country on February 24, more than 150,000 tests have been administered with around 15 percent coming up positive.   Drive-in testing stations have been set up in several places, including in the capital Bern, to help simplify safe testing for COVID-19.   In the past 24 hours, the country has conducted nearly 7,000 tests, including 975 that were positive, the health ministry said.

Switzerland's southern canton of Ticino, which borders hard-hit Italy, has registered most cases, followed by Geneva.   As in other countries, men seemed to suffer more from the virus. Slightly more women had tested positive for the virus, but men accounted for 64 percent of the deaths, the ministry found.   Switzerland has unblocked some $60 billion to buffer the harsh blow to its economy from the pandemic and the measures taken to halt the spread of the virus.   The economic affairs ministry said Saturday some 1.3 million people, or a quarter of the country's workforce, have applied for temporary unemployment benefits since the start of the crisis.
Date: Sat, 4 Apr 2020 07:04:32 +0200 (METDST)

Honiara, April 4, 2020 (AFP) - At least 28 ferry passengers were swept overboard in a powerful storm off the Solomon Islands, reports said Saturday, with the captain unaware he had lost anyone until the boat docked.   The passengers were heading from the capital Honiara to West Are'are, more than 120 kilometres (75 miles) away, under a government programme to evacuate people to their home villages during the global coronavirus epidemic.

The MV Taimareho set sail on Thursday night as tropical cyclone Harold bore down on the Solomons, and with weather forecasters warning against any unnecessary voyages.   But the captain ignored advice not to sail, the nation's leader said, as survivors reported dozens of people were swept overboard by huge waves and strong winds. Local media put the death toll at 28.

But police said it was impossible to verify the number.   "Initial reports say the captain of the boat had no knowledge of the missing people until he was informed when the boat arrived at her destination at Are'are," police marine department chief Charles Fox Sau said.    "At this stage we cannot confirm how many people are missing as the investigation into this sad incident continues."

In an address to the nation, Prime Minister Manasseh Sovagare said a search and rescue operation was under way.    "It is with deep regret to learn that a number of passengers are missing at sea after being washed overboard from a passenger vessel which departed ... from Honiara, despite the several weather warnings issued," he said.    Disaster authorities in the Solomons, which has limited healthcare facilities, have been stretched as they prepared for the impact of coronavirus while the region was being battered by tropical cyclone Harold.

The island nation, with a population of just over 600,000, is one of a dwindling number of countries where there have been no reported coronavirus cases so far.   Harold, packing winds of up to 160 kilometres per hour (100 mph), downed trees and damaged homes before heading away and was expected to intensify before reaching Vanuatu late Sunday.   Although the government has not yet completed a damage assessment, Australia has donated Aus$100,000 (US$60,000) in immediate emergency funding.
Date: Sat, 4 Apr 2020 06:20:31 +0200 (METDST)

London, April 4, 2020 (AFP) - The Falklands Islands government has confirmed the territory's first case of the new coronavirus.   A patient tested positive after being admitted to hospital with symptoms on March 31, according to a statement released on Friday that said they were in isolation and in "stable condition".   Located in the southern Atlantic Ocean, the British overseas territory had been among a dwindling number of remote places that have reported no COVID-19 cases during the pandemic.

Health authorities in the Falklands -- home to 3,400 people -- have been sending samples to the UK for testing, the statement said.   "In some respects we are fortunate that we have been COVID-19 free until now, as we have taken this time to plan our approach," Chief Medical Officer Dr Rebecca Edwards said.   "We have reorganised the hospital and staffing arrangements, and put our supplies and pharmaceuticals in place, which many countries were not in a position to do before they identified their first cases."

The disparate group of places to officially remain untouched by the pandemic include Samoa, Turkmenistan, North Korea and bases on the frozen continent of Antarctica.   Argentina, which invaded and briefly occupied the territory in 1982, claims sovereignty over the islands and calls them Las Islas Malvinas.
Date: Fri, 3 Apr 2020 23:54:18 +0200 (METDST)

Kinshasa, April 3, 2020 (AFP) - The Democratic Republic of Congo is prepared to take part in testing of any future vaccine against the coronavirus, the head of the country's taskforce against the pandemic said on Friday.   "We've been chosen to conduct these tests," said the head of the national biological institute, Jean-Jacques Muyembe.    "The vaccine will be produced in the United States, or in Canada, or in China. We're candidates for doing the testing here," Muyembe told a news briefing in comments that sparked controversy in DR Congo amid charges the population was being used as guinea pigs.

Muyembe suggested that clinical trials could begin in July or August.    "At some point, COVID-19 will be uncontrollable," the virologist said.   "The only way to control it will be a vaccine, just like Ebola. It was a vaccine that helped us end the Ebola epidemic."   Muyembe's comments came as two leading French doctors came under a storm of criticism after discussing on a television programme the idea of testing a vaccine for coronavirus in Africa.   Camille Locht, head of research at the National Institute of Health and Medical Research (INSERM) in Lille, and Jean-Paul Mira, head of intensive care at the Cochin hospital in Paris, suggested that Africa offered better conditions for testing the vaccine.

Their remarks sparked furious criticism, with the French anti-racism NGO, SOS Racisme, saying, "No, Africans aren't guinea pigs".    Even former international and Ivory Coast football star Didier Drogba joined in.    "It is inconceivable that we continue to accept this. Africa is not a laboratory. I strongly denounce these very serious, racist and contemptuous words," the former Chelsea and Marseille striker wrote on his Facebook page and on Twitter.   "Help us save lives in Africa and stop the spread of the virus that is destabilising the whole world instead of seeing us as guinea pigs. It is absurd."   The tenth Ebola epidemic in DR Congo is set to be declared over on April 12, after it killed more than 2,200 people in the east of the country since its outbreak on August 1, 2018.    More than 320,000 people were given two different experimental vaccines to stop the spread.
Date: Fri, 3 Apr 2020 21:56:23 +0200 (METDST)

Libreville, April 3, 2020 (AFP) - Gabon on Friday banned the sale and eating of bats and pangolins, which are suspected of sparking the novel coronavirus in China where they are highly prized in traditional medicine.   President Ali Bongo Ondimba also announced the government was planning to lock down the capital Libreville and unveiled an emergency package for those hard hit by the pandemic.   The novel coronavirus is believed to have come from bats, but researchers think it might have spread to humans via another mammal.   Pangolins are critically endangered and have long been protected, but they are sold in the markets of the capital Libreville, as are bats, and their meat is popular.

The central African nation is 88 percent covered in forest and hunting and bush meat have long been a way of life.   The water and forest ministry said the novel coronavirus was a "combination of two different viruses, one close to bats and the other closer to pangolins", and claimed to be quoting a scientific study published in Nature.   Gabon has declared 21 COVID-19 infections, but none from animals, the ministry said.   "A similar decision was taken by the authorities when our country was affected by the Ebola virus -- a ban on eating primates," Forestry Minister Lee White said.

The national parks agency ANPN announced in mid-March that tourists would no longer be allowed to interact with great apes to avoid any risk of contamination by the coronavirus.   The pangolin, the world's most heavily trafficked mammal, also called the scaly anteater, is believed to have possibly been a vector in the leap of the novel coronavirus from animal to human at a market in China's Wuhan city last year.   Its body parts fetch a high price on the black market as they are commonly used in traditional Chinese medicine, although scientists say they have no therapeutic value.

Gabon has also put in place a raft of measures such as grounding international flights, closing schools and ordering a night curfew to stop the spread of the coronavirus.   On Friday, Bongo said Libreville would be put under lockdown "in the coming days" but gave no precise date.   All but one of Gabon's reported 21 cases are in the city, where a large proportion of the country's two million residents live.   Bongo also announced an aid package of 250 billion CFA francs (380 million euros) to help both individuals and businesses whose livelihoods have suffered because of the crisis.
Date: Fri, 3 Apr 2020 20:36:36 +0200 (METDST)

Istanbul, April 3, 2020 (AFP) - Turkish President Recep Tayyip Erdogan on Friday issued a mandatory confinement order for everyone aged under 20 starting from midnight, as part of tougher measures to stem the spread of the coronavirus in Turkey.    In a television address, Erdogan also announced that vehicles would no longer be able to leave or enter 31 towns and cities, including Istanbul and Ankara, for 15 days.   People aged over 65 or those with chronic medical conditions are already subject to mandatory confinement in Turkey.    "Throughout the country, people aged under 20, that is to say born after January 1, 2000, will not be allowed to go out on the street" from midnight on Friday, Erdogan said.

Also, from Saturday, all those going out to shops or markets will be obliged to wear a face mask, the Turkish leader added, calling on the population to maintain a distance of "three paces" from each other when outside.   Turkey has registered over 20,000 coronavirus cases, 425 of which have been fatal.   Health Minister Fahrettin Koca warned on Friday that the country is just at the beginning of the outbreak, which has left over 50,000 people dead worldwide.   More than half of the Turkish cases have been in the economic capital Istanbul, which has a population of around 16 million people.

The city's mayor Ekrem Imamoglu has been calling for total confinement.    Erdogan's announcements on Friday are the latest moves to stem the spread of the virus in Turkey in recent weeks.   Schools have been closed down, flights grounded and gatherings banned.   Next week the Turkish parliament is set to consider a draft law to free 90,000 prisoners, a third of the population of the overcrowded prisons.   It will concern several categories of prisoners, among them pregnant women and older people with medical conditions.   But it excludes convicted murderers, sexual offenders and narcotics criminals, as well as political prisoners charged under Turkey's controversial anti-terrorism laws.
Date: Fri, 3 Apr 2020 11:49:00 +0200 (METDST)

Singapore, April 3, 2020 (AFP) - Singapore will close schools and workplaces while people are being told to stay home, as the city-state ramps up curbs to stem the spread of coronavirus, the premier said Friday.   The country has won praise for its handling of the outbreak, and had largely kept the crisis in check by carrying out large numbers of tests and tracing close contacts of those infected.   Authorities had slowly been introducing curbs, such as closing bars and nightclubs, but had so far avoided the kind of tough restrictions seen in worse-hit nations.

However, after a jump in the number of locally transmitted cases in recent days, Prime Minister Lee Hsien Loong said it was time to apply a "circuit breaker" to halt the virus's spread.   Workplaces except for essential services, such as supermarkets and hospitals, and those deemed to be in key economic sectors will be closed from Tuesday, he said in a televised address.

Schools will also be closed from next week except for children of those who have to continue to work and cannot make alternative arrangements, he said.   People are being told to stay at home as much as possible, and only go out for essentials -- such as buying food and getting exercise.   "Looking at the trend, I am worried that unless we take further steps, things will gradually get worse, or another big cluster may push things over the edge," Lee said.   Singapore has reported 1,114 virus infections including five deaths. Globally, the number of confirmed cases has soared past one million and deaths have topped 50,000.