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Andorra

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

Travel News Headlines WORLD NEWS

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

No Profile is available at present

Travel News Headlines WORLD NEWS

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Please see our information on medical insurance overseas.

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

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

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

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

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

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

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

Travel News Headlines WORLD NEWS

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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


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

Togo

Togo US Consular Information Sheet
September 10, 2008
COUNTRY DESCRIPTION:
Togo is a small West African country with a stagnant economy in a state of political uncertainty.
French is the official language, but Ewe and Mina are commonl
spoken as well.
Tourism facilities are limited, especially outside the capital city, Lomé.
Read the Department of State Background Notes on Togo for additional information.
ENTRY/EXIT REQUIREMENTS:
A passport and visa are required.
Travelers are encouraged to obtain visas prior to arrival due to recent difficulties with requesting them at the airport in Lomé or at some of the land borders.
Visas issued in Togo are limited to 7 days and can take an hour or more to be issued.
Travelers applying for visa extensions can also experience significant delays.
Vaccination against yellow fever is required before entry.
U.S. citizens should carry copies of their U.S. passports and vaccination records with them at all times while traveling in Togo so that, if questioned by local officials, they have proof of identity, U.S. citizenship, and required vaccinations readily available.

Travelers may obtain the latest information and details from the Embassy of the Republic of Togo, 2208 Massachusetts Avenue NW, Washington, DC
20008; telephone (202) 234-4212.
Overseas, inquiries should be made at the nearest Togolese embassy or consulate.

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

SAFETY AND SECURITY:
U.S. citizens are urged to avoid political rallies, street demonstrations, and maintain security awareness at all times.
Togo has experienced periodic violence, strikes, and political tensions since 1990.
Following the death of President Eyadema in February 2005, political activists took to the streets and held demonstrations throughout the country that resulted in more than 500 deaths.
Land borders with Ghana and Benin are routinely shut down during elections. The October 2007 legislative elections were non-violent with only minor incidents reported during the single post-election demonstration. The next major elections are the presidential elections scheduled for 2010.

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 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:
Over the past year, Togo has seen a marked increase in incidents of violent crime throughout the country, including several recent machete attacks in poorly lit areas of Lomé.
Rapid inflation and food shortages have contributed to increases in already critical crime levels in urban areas.
Particular areas for Americans to avoid within Lomé, especially during the hours of darkness, include the Grand Marché area, the beach road, and the Ghana-Togo border areas.
Travelers should avoid the beach even during daylight hours as purse-snatchings and muggings occur there regularly.
Pick pocketing and theft are common in Togo, especially along the beach and in the market areas of Lomé.
While incidents of residential burglary are less common against foreigners, carjacking is on the rise, and even western diplomats have been victims of carjacking. Theft while riding in taxis is also increasing, as thieves steal bags, wallets, and passports.
Taxicabs should not be shared with strangers.
Perpetrators of business fraud often target foreigners, including Americans.
Formerly associated with Nigeria, these fraud schemes are now prevalent throughout western Africa, including Togo, and pose a danger of both financial loss and physical harm.
An increasing number of Americans have been the targets of such scams, losing anywhere from several thousand to several hundred thousand dollars.
Typically, these scam operations begin with an unsolicited communication, usually by e-mail, from an unknown individual who describes a situation that promises quick financial gain, often by assisting in the transfer of a large sum of money or valuables out of the country.
The scenarios vary:
an American must pretend to be the next-of-kin to a recently deceased Togolese who left a fortune unclaimed in a Togolese bank, or a person claiming to be related to present or former political leaders needs assistance in transferring large sums of cash, or even a business deal that appears to be legitimate.
The requests are usually for the payment of advance fees, attorneys’ fees, or down payments on contracts.
The final payoff does not exist; the purpose of the scam is to get any money possible and to gain information about the American’s bank account.
The best way to avoid becoming a victim of advance-fee fraud is common sense – if it looks too good to be true, it probably is.
You should carefully check out any unsolicited business proposals originating in Togo before you commit any funds, provide any goods or services, or undertake any travel.
Please check the Embassy web site at http://togo.usembassy.gov/ for the most current information on fraud in Togo.
For additional information, please see the Department of State brochure on International Financial Scams.

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

The local equivalent to the “911” emergency line in Togo is: 117 or 171 for police, 172 for Gendarmerie, 242 for the Pharmacy on Duty, and 118 for Fire Services.

See our information on Victims of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION:
Medical facilities in Togo are limited and of very poor quality, with no adequate emergency medical care.
Availability of medications through local pharmacies is unreliable, and travelers should carry all necessary medications, properly labeled, with them.
Malaria, a serious and sometimes fatal disease, is prevalent in Togo.
For additional information on malaria, including protective measures, see the CDC travelers’ health web site at http://www.cdc.gov/malaria/.

For information on avian influenza (bird flu), please refer to the Department of State's Avian Influenza Fact Sheet.
According to the Togolese Ministry of Foreign Affairs and Ministry of Health, there are no HIV/AIDS entry restrictions for visitors to or foreign residents of Togo.

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

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

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

While some major thoroughfares in urban parts of Togo are paved, many secondary streets are not, and become severely flooded every time it rains.
Driving conditions are hazardous throughout Togo due to the presence of pedestrians, large numbers of small motorcycles, disorderly drivers (moped, car and truck drivers), livestock on the roadways, and the poor condition of the roads, including deep potholes.
Overland travel off the main network of roads generally requires a four-wheel-drive vehicle.
Many drivers in Togo do not obey traffic laws and most traffic signals do not function properly.
Drivers should be prepared for other vehicles to run red lights or stops signs and drive in the wrong direction on one-way streets.
Nighttime travel on unfamiliar roads is dangerous.
Poorly marked checkpoints, often manned by armed, undisciplined soldiers, exist throughout the country, including in the capital.
Banditry, including demands for bribes at checkpoints, has been reported on major inter-city highways, including the Lomé-Cotonou coastal highway.
Travelers are advised to be aware of their surroundings and to drive defensively.
At official checkpoints, Togolese security officials prefer that you approach with your dome light on, and have your driver’s license, registration, and proof of insurance ready.
Americans should be aware of the staged-accident ploy when driving in Lomé.
In this scam, a motorbike will cut in front of you, cause a collision, and draw a crowd, which can turn hostile if you attempt to leave the scene of the so-called accident.
Such encounters appear designed to extort money from the vehicle driver.
Pedestrians also cause staged accidents.
Genuine accidents can also draw hostile crowds.
Travelers should drive with their car doors locked and windows closed, and have a cell phone in the vehicle.
If you are involved in this kind of accident and can drive away, you should leave the scene, drive to a safe location, and alert both the police and the U.S. Embassy.
Violent carjackings are periodically reported in Togo and tend to increase during the summer months and holiday season. Travelers are advised to exercise caution when using any form of local public transportation.
Never get into a taxi with unknown passengers and always agree on the fare before getting in.

Please refer to our Road Safety page for more information.
Visit the web site of the country’s tourist office at http://www.togo-tourisme.com/.

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

SPECIAL CIRCUMSTANCES:
Power outages, voltage fluctuations, and water shortages are common throughout the country.
Only certain U.S. credit cards are accepted in Togo.
Most major hotels and their restaurants accept American Express, MasterCard, and Visa, while smaller hotels and restaurants do not.
Travelers planning to use credit cards should know which cards are accepted before they commit to any transaction.
Travelers should keep all credit card receipts, as unauthorized card use and overcharging are common.
There are some Automatic Teller Machines that dispense local currency in major banks and they are generally considered safe.
Well-known money transfer firms, including Western Union, operate in Togo.
Photographing places affiliated with the government of Togo, including official government buildings, border crossings, checkpoints, police stations, military bases, utility buildings, airports, government vehicles, and government or military personnel, is strictly prohibited, and local authorities will confiscate film and cameras.
Government buildings are not always clearly identifiable, as they vary from being very well marked to being not marked at all.
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 Togo’s laws, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in Togo 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 Togo 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 Togo.
Americans without Internet access may register directly with the nearest U.S. Embassy or Consulate.
By registering, American citizens make it easier for the Embassy or Consulate to contact them in case of emergency.
The U.S. Embassy is located on Boulevard Eyadema, Neighborhood Lomé II, Lomé; telephone (228) 261-5470, fax (228) 261-5499. The local mailing address is B.P. 852, Lomé.
The web site is http://togo.usembassy.gov/
* * *
This replaces the Country Specific Information for Togo dated March 3, 2008, to update the sections on Crime, Information for Victims of Crime, and Medical Facilities and Health Information.

Travel News Headlines WORLD NEWS

Date: Mon 7 Jan 2019
Source: Outbreak News Today [edited]

The Togo government confirmed last week [week of 1 Jan 2019] a Lassa fever case reported in Doufelgou district [Kara region] in the north of the country, according to a Agence de Presse Africaine report (computer translated).

This was a haemorrhagic fever case according to officials.

Lassa fever is a rare but potentially life-threatening viral haemorrhagic disease. The risk of infection is low but can occur if someone comes into contact with an infected person's blood or bodily fluids. Lassa fever cannot be spread through casual contact, including skin to skin contact, without exchange of bodily fluids. Those at highest-risk would be health care workers treating patients in facilities known to have Lassa fever and family members caring for infected patients.

Early diagnosis and supportive care are essential. One should consult a medical professional if he or she has been in direct contact with an infected person within the past 3 weeks and have symptoms of Lassa fever, which include: fever, chest, stomach or back pain, cough, vomiting, diarrhoea, or mucosal bleeding.
=========================
[Lassa fever virus is endemic in much of northwest Africa, including Benin, Togo, and Burkina Faso. There have been cases of Lassa fever in Togo as recently as 2017. In the 2017 report, health authorities in Togo implemented the following measures to respond to these Lassa fever cases, including:
- deployment of rapid response teams to the affected areas for epidemiological investigation;
- identification of contacts and follow-up;
- strengthening of infection prevention and control measures in health facilities and briefing of health workers;
- strengthening of cross border collaboration and information exchanges between Togo, Burkina, Mali, and Benin.

It seems odd that the case report above does not mention contact with rodent reservoirs of the virus or their excrement as a source of infection. Lassa fever virus is transmitted to humans from contact with food or household items contaminated with excreta of multimammate rats (_Mastomys_ spp), the reservoir host. Public education is an important measure to prevent infections in the home.

Images of the rodent reservoirs of Lassa fever virus can be seen as follows:
_Mastomys natalensis_:
_M. erythroleucus_ and _Hylomyscus pamfi_:

[Maps of Togo:
Date: Mon, 24 Sep 2018 21:11:35 +0200

Lome, Sept 24, 2018 (AFP) - A former lawmaker in Togo was on Monday on hunger strike to call for the release of opposition supporters who were arrested during anti-government demonstrations.   Nicodeme Ayao Habia, head of the Democrats party, began his protest six days ago in front of Ghana's embassy in the Togolese capital, Lome.   "I am on hunger strike to demand the release of all people who were arrested during protests by the opposition coalition who are still languishing in prison," he told AFP.   "I won't move from here as long as these people are in prison," he said, holding a small sign with photos of three of those detained.   "This morning, police tried to move me along but I refused as I am within my rights. They even tried to rough me up."

Habia held a two-day hunger strike previously this month in front of the US Embassy in Lome.   Some 44 people who were arrested during opposition protests against President Faure Gnassingbe and his government remain in prison, according to the coalition.   The oppositions wants the re-introduction of a two-term limit for presidents, applied retroactively, which would prevent Gnassingbe from standing for re-election in 2020.   The government has agreed to the two-term limit but not the retroactive element, which would allow the president to  stand at polls in 2020 and 2025.   He has already been in power since the death of his father, Gnassingbe Eyadema, in 2005. The army general seized power of the West African state in 1967.

As well as the release of opposition detainees, Habia said he also wanted the government to stick to the roadmap set out by leaders of the West African bloc ECOWAS.   "The regime must absolutely respect the recommendations contained in the ECOWAS roadmap," he added.   On Sunday, the government and opposition finally agreed common ground in the composition of the country's independent national electoral commission (CENI).   Lack of agreement about the make-up of the body had delayed an announcement of the date of local and parliamentary elections.    Local polls and a referendum on the proposed constitutional reforms will now take place on December 16, with parliamentary elections four days later.
Date: Wed, 31 Jan 2018 16:22:49 +0100

Lome, Jan 31, 2018 (AFP) - Togo's government was facing fresh turbulence on Wednesday as healthcare workers went on strike, joining thousands of demonstrators holding opposition protests on the streets.   The two-day nationwide strike was called by the National Union of Hospital Practitioners of Togo (SYNPHOT) who are demanding better equipment and more nursing staff.   "The strike is well-followed throughout the country. We will take stock tomorrow evening to know what to do in the coming days," SYNPHOT secretary-general Atchi Walla told AFP.

At Sylvanus Olympio university hospital, the country's largest health care centre, several departments were closed, according to an AFP journalist.   "We are here only for very urgent cases. The other patients will be rescheduled," said a worker at the entrance to the emergency surgery department.   There was a similar situation in the operating room and at reception, where only one person was working.   "This situation is tiring. I came to get treatment but nobody can help because they are on strike," said Albert Kudju, a retired civil servant.    "The authorities should meet the demands of the workers."

Primary and public school teachers are also on strike, demanding an increase in their wages, while students are protesting against a sharp rise in tuition fees.   The walk-outs come against a backdrop of widespread discontent with the government and opposition calls for the resignation of President Faure Gnassingbe.   Gnassingbe has been in power since 2005 and took over from his father, General Gnassingbe Eyadema, who himself ruled Togo for 38 years.   A coalition of 14 opposition parties has been organising almost weekly marches for the past five months.
Date: Wed, 20 Sep 2017 17:23:54 +0200

Lome, Sept 20, 2017 (AFP) - Thousands thronged the streets of Togo's seaside capital Wednesday after the ruling party asked supporters to march at the same time as planned opposition protests demanding the removal of President Faure Gnassingbe, the scion of Africa's oldest political dynasty.   The rival demonstrations in Lome came a day after the opposition boycotted a vote on constitutional reform which would have included a presidential term limit, arguing that it was a ploy to let Gnassingbe remain in power till 2030.

The opposition wanted the limit to apply retroactively so that Gnassingbe, who has been in power since 2005, could not run again in 2020. His father Gnassingbe Eyadema ruled from 1967 till his death in 2005.   The opposition marches began at around 11:00 am (1100 GMT) at three meeting points.   They came after giant rallies on September 6 and 7 seeking the president's ouster that drew more than 100,000 people on the streets -- a record in a country which has been widely criticised for stifling democracy.    The protesters held up posters declaring "Faure must go" and "Free my country, 50 years is enough".

Police and soldiers armed with heavy machine guns flanked the streets in pick-up trucks. Mobile  phone networks and 3G services appeared to have been severed.   "We are not jihadists, we are not rebels," said Abdallah, 42, a supporter of the Panafrican National Party (PNP). "We just want democracy, we are tired."   Communications Minister Guy Lorenzo condemned what he called a "coup d'etat" on the streets.   The government meanwhile asked the opposition to show "responsibility and restraint" and warned that "people of foreign nationalities were looking to participate in acts of violence"  during the marches.

- 'Explosive situation' -
More protests are planned on Thursday against what veteran opposition leader Jean-Pierre Fabre called "the monstrous machine that has been crushing Togo's people for more than 50 years".   He said there would be "no let-up" as long as Gnassingbe remains in power.   Comi Toulabor, head of research at the Institute of Political Studies in Bordeaux, called the counter-rallies by the ruling Union for the Republic (UNIR) party "a strategy to disrupt the opposition protest".   "It's very amateurish but it shows the party isn't ready to give way," he told AFP, calling the situation "explosive".

About one thousand UNIR supporters quietly gathered on the beach in Lome on Wednesday, some sitting in the shade of palm trees.   "It is a pleasure to be here," UNIR supporter Georgia, 34, told AFP. "We are peaceful."   One young protester said he received 5,000 CFA francs (7.50 euros, $9) to participate in the pro-government rally.   "You think we're here for politics?" asked Justin, 17, as his friends nodded approval.   The failure to pass the constitutional reform bill in parliament forced a referendum, which a member of the government said will be held in the coming months.   Gnassingbe has now won three elections, the results of which have been contested by the opposition.   Half of Togo's population lives below the poverty line, according to the United Nations, despite a GDP growth rate of five percent over the last three years.
Date: Thu 23 Feb 2017
Source: WHO Emergencies preparedness, response [edited]

Meningococcal Disease - Togo:
-----------------------------
Since [Sun 1 Jan 2017], 201 suspected cases of meningitis with 17 deaths were reported by 19 health districts. In week 2, the district of Akebou, which is part of the Plateau Region, issued an alert after 4 cases of meningitis were reported. In week 4, the epidemic threshold was reached with 9 cases and an attack rate of 12.4 per 100,000 inhabitants. From 2 January to 12 February 2017, 48 suspected meningitis cases with 3 deaths were reported (case fatality rate of 6.3 percent). Of these, 14 specimens were confirmed as _Neisseria meningitidis_ serogroup W by PCR.

The Plateau Region, together with the other 3 regions in the country benefited from the mass vaccination campaign with MenAfriVac in December 2014. [MenAfriVac is a protein conjugate vaccine developed for use in sub-Saharan Africa for children and adults between 9 months and 29 years of age against _Neisseria meningitidis_ group A (<https://en.wikipedia.org/wiki/MenAfriVac>).]

Togo is part of the African meningitis belt and documents cases and deaths due to meningitis every year. In 2016, the country recorded an epidemic in the northern part caused by _Neisseria meningitidis_ serogroup W. A total of 1975 cases and 127 deaths were reported in 2016.

In response to the outbreak, the following measures are being implemented:
 - 56,000 doses of meningitis vaccines have been requested from the International Coordinating Group (ICG) for the planned vaccination campaign.
 - WHO Field Mission was deployed in the field to strengthen outbreak management.
 - Strengthening of meningitis surveillance at the district level.
 - Training of clinicians at the district level on case management.
 - Conducting cross-border meetings with Ghana and Benin.

WHO risk assessment
------------------
The largest burden of meningococcal disease occurs in the African meningitis belt. Although the successful roll-out of MenA conjugate vaccine has resulted in the decreasing trend of meningitis A, other meningococcal serogroups are shown to have caused epidemics. This report of the _Neisseria meningitidis_ W outbreak in Togo calls for a close monitoring of the changing epidemiology of meningococcal disease. There is a need to ensure that global stocks of vaccines are available, laboratory and epidemiologic surveillance systems are strengthened and outbreak response strategies in the countries are on hand.

The epidemic response consists of prompt, appropriate case management involving reactive mass vaccination of populations, and strengthening of meningitis surveillance.
====================
[Although there are at least 13 _ Neisseria meningitidis_ serogroups, based on the antigenic specificity of their capsular polysaccharides, disease due to serogroups A, B, C, Y, and W are most common. There are vaccines that contain capsular polysaccharide (A, C, Y, W), either alone or conjugated to protein. Conjugate vaccines are preferable, because, unlike the polysaccharide vaccines, conjugate vaccines immunize infants, reduce the carriage of meningococci in the throat and thus its transmission, as well as confer a more sustained immune response, and, therefore, longer-term protection than the polysaccharide vaccines. Serogroup B vaccines are based upon meningococcal B outer membrane vesicle protein antigens, because group B polysaccharide is poorly immunogenic in humans and is a potential auto-antigen.

Immunity following use of a meningococcal vaccine is specific for the type of capsular polysaccharide the vaccine contains in regard to the A, C, Y, and W polysaccharide vaccines or the surface proteins in regard to serogroup B vaccine, with no cross-protection against infection due to other meningococcal groups.

Following the mass introduction into the population of a vaccine specific for one particular meningococcal serogroup, the incidence of disease due to that serogroup has been found to fall dramatically, e.g., serogroup C disease in the UK following the introduction of C vaccine and serogroup A in the African Meningitis Belt following A vaccine, only to be replaced by emergence of disease due to other meningococcal serogroups.

In view of replacement of meningococcal serogroup A with other serogroups, in the current case serogroup W, following mass vaccination of the population with serogroup A conjugate vaccine in Togo, reactive mass vaccination to control this outbreak would require use of a meningococcal vaccine containing serogroup W, e.g., the conjugate ACWY vaccine. However, the news article above fails to say what vaccine is being used.

ProMED-mail would appreciate more information in this regard from knowledgeable sources.

Togo is a country in West Africa on the Gulf of Guinea, between Ghana to the west, Benin to the east. The country is divided into 5 regions; from north to south, the regions are Savanes, Kara, Centrale, Plateaux and Maritime (<https://en.wikipedia.org/wiki/Togo>). - ProMED Mod.ML]

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

Chad

Chad - US Consular Information Sheet
March 29, 2007
COUNTRY DESCRIPTION: Chad is a developing country in north central Africa with one of the lowest per capita incomes in the world. Chad faces challenges in the areas of political stability and
conomic development. Years of war, drought, and lack of economic growth have severely damaged the country's institutions and its infrastructure. Facilities for tourism are limited. The capital is N'Djamena. French and Arabic are the primary languages. Read the Department of State Background Notes on Chad for additional information.
ENTRY/EXIT REQUIREMENTS: A valid passport and visa are required. Visitors must check in with the National Police and obtain a registration stamp within 72 hours of arrival. Further entry information may be obtained from the Embassy of the Republic of Chad, 2002 R St. N.W., Washington D.C. 20009, telephone (202) 462-4009. Overseas, inquiries should be made at the nearest Chadian embassy or consulate. Some travelers originating in countries with no Chadian embassy or consulate can arrange for airport entry visas. This process is generally limited to business or official travelers, and arrangements must be made by the traveler’s local contact in Chad several days in advance of arrival. The U.S. Embassy is not in a position to assist private U.S. citizens with their visa application for travel to Chad.

See our Foreign Entry Requirements brochure for more information on Chad and other countries.

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

SAFETY AND SECURITY: See the Department of State’s Travel Warning for Chad.

For the latest security information, Americans traveling abroad should regularly monitor the Department’s website where the current Travel Warnings and Travel Alerts, including 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., 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: Americans and Europeans are perceived to be wealthy and certain precautions should be taken. Travelers are advised not to leave cash or valuables unsecured in their hotel room and not to wear expensive jewelry or show large amounts of cash. Travelers are also advised to dress modestly, not to walk outside after dark, and to lock their car doors. Petty crimes such as purse snatching, pick-pocketing and theft from vehicles do occur, particularly in areas frequented by expatriates. Violent crime is somewhat rare, but does occur. Burglary and vehicle thefts increase during times of political instability. Expatriate residences have been targeted for armed robbery, and some foreigners have been assaulted in the process. Travelers to northern Cameroon should contact the U.S. Embassy’s Regional Security Officer in N'Djamena prior to crossing the Chad/Cameroon border because of a high incidence of road attacks there.

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

See our information on Victims of Crime.
MEDICAL FACILITIES AND HEALTH INFORMATION: Medical facilities in Chad are extremely limited. Medicines are in short supply or unavailable, including many over-the-counter preparations sold in the United States. Travelers should carry any needed, properly labeled, medicines with them. In the event of major injury or illness, visitors generally will require medical evacuation.

There are two medical clinics in the capital of N’Djamena, International SOS and the Centre Medico-social de l’Ambassade de France. Advance membership is required to access these two clinics.

Malaria is a serious and sometimes fatal disease.
Plasmodium falciparum malaria, the type that predominates in Chad, is resistant to the antimalarial drug chloroquine.
Because travelers to Chad are at high risk for contracting malaria, the Centers for Disease Control and Prevention (CDC) advises that travelers should take one of the following antimalarial drugs: mefloquine (Lariam - TM), doxycycline, or atovaquone/proguanil (Malarone -TM).
Travelers who become ill with a fever or flu-like illness while traveling in a malaria-risk area and up to one year after returning home should seek prompt medical attention and tell the physician their travel history and what antimalarials they have been taking.
For additional information on malaria, including protective measures, visit the CDC Travelers’ Health web site at http://www.cdc.gov/travel/malinfo.htm.

Other widespread diseases in Chad include diarrhea and upper respiratory infections. AIDS is becoming an increasingly serious problem as infection rates have risen to alarming levels (up to 25 percent in high-risk groups). Meningitis outbreaks usually occur annually and several other diseases (cholera, diphtheria, chicken pox, typhoid) periodically appear.

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

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

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

Roads are in poor condition and dangerous. In the capital city of N'Djamena, only the main roads are paved; the rest of the roads are either hard-packed dirt or looser dirt and sand. During the summer rainy season (mid-June to mid-September) many roads become impassable or are restricted by rain barriers, while during the drier season, clouds of dust rising from the roads reduce visibility.

Visitors should take great care while driving. Both paved and unpaved roads are poorly maintained, and often have large ruts and potholes. All drivers should adjust their speed accordingly. At night, streets are not lit; it is imperative to watch for pedestrians, bicyclists, motorcyclists, and livestock, as they may not become visible until they are in very close proximity.

Driving in Chad tends to be erratic both in cities and in rural areas. In cities, particularly N'Djamena, motorists share the roads with bicycles, motor scooters, pedestrians, and non-motorized wheelchairs. Lanes are not marked, and it is not uncommon for a normally two-lane thoroughfare to become a four-lane road during rush hours (generally 7:00 a.m.-9:00 a.m. and 3:00 p.m.-6:00 p.m. Monday-Thursday; 7:00 a.m.-9:00 a.m. and 11:00 a.m.-12:30 p.m. on Friday). Drivers are urged to be particularly observant at these times because motorists often attempt to overtake slower traffic by moving into oncoming lanes, usually at high speeds.There are only a few traffic lights in N'Djamena, and these are often out of service. Drivers yield to traffic on their right, particularly when entering the many traffic circles.

In rural areas, drivers should watch for livestock crossing the roads, and for large hawks that rest on the roads. These birds can be fearless, and cause damage by smashing into drivers' windshields; drivers may avoid this by slowing down when approaching the hawks, and allowing them sufficient time to fly away. Finally, drivers should be alert to older transport trucks traveling between cities, which do not always have functioning headlights.

No emergency services exist, so drivers should exercise extreme caution. Travelers should always wear seat belts. When traveling by car, be sure to carry a spare tire. Roadside service is limited to good Samaritans and children who will help push cars to the side or out of holes. When traveling outside the capital, it is imperative to carry sufficient quantities of drinking water. Drivers should ensure that their gas tanks are at least half-full at all times, as gas stations are not widely available. Gas may be purchased in an emergency in bottles from roadside stands, but it is generally of poor quality.

Travelers on roads in all areas of the country are subject to attack by armed bandits.
Please refer to our Road Safety page for more information.

AVIATION SAFETY OVERSIGHT: As there is no direct commercial air service between the United States and Chad, the U.S. Federal Aviation Administration (FAA) has not assessed Chad’s Civil Aviation Authority for compliance with International Civil Aviation Organization (ICAO) aviation safety standards. For more information, travelers may visit the FAA’s internet website at http://www.faa.gov/safety/programs_initiatives/oversight/iasa.

SPECIAL CIRCUMSTANCES: All photography requires a government permit. Taking photos of military sites, official buildings, and airports is strictly prohibited, even with a permit. Such sites are not always clearly marked. Film and cameras may be confiscated, often by undercover police.

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 Chadian laws, even unknowingly, may be expelled, arrested or imprisoned. Penalties for possession, use, or trafficking in illegal drugs in Chad 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 onCriminal Penalties.

CHILDREN'S ISSUES: Embassy N’Djamena does not issue immigrant visas. Therefore, American citizens who adopt children in Chad are required to travel to the U.S. Embassy in Yaounde, Cameroon, or another Embassy for visa processing before return to the United States.

For information on international adoption of children and international parental child abduction, see the Office of Children’s Issues website.

REGISTRATION / EMBASSY LOCATION:
Americans living or traveling in Chad are encouraged to register with the U.S. Embassy in Chad through the State Department’s travel registration website , Americans withoutInternet access may register directly with the nearest U.S. Embassy or Consulate. By registering, American citizens make it easier for the Embassy to contact them in case of emergency. The U.S. Embassy in Chad is located in N'Djamena on Avenue Felix Eboue; mailing address is B.P. 413; telephone (235) 51-62-11, 51-70-09, 51-77-59, 51-90-52, 51-92-18 and 51-92-33, fax (235) 51-56-54.
* * *
This replaces the Country Specific Information dated July 10, 2006 with no updates.

Travel News Headlines WORLD NEWS

Date: Wed, 14 Aug 2019 15:14:41 +0200 (METDST)

N'Djamena, Aug 14, 2019 (AFP) - A female suicide bomber killed six people after blowing herself up in western Chad early Wednesday, a senior army officer said, in an attack attributed to Nigeria's Boko Haram jihadists.   "Six people died, including a soldier," in the attack in Kaiga-Kindjiria district, said the source, speaking on condition of anonymity.    A number of people were also injured, the officer said, without giving figures.   A provincial security official said a woman wearing an explosives-laden belt "blew herself up near the home of a traditional chief".   Four guards as well as a soldier were among the dead, and five people were wounded, the official said.   The death toll of six was confirmed by Chadian army spokesman Colonel Azem Bermandoa, and by a local NGO.   There was no immediate claim of responsibility.

Kaiga-Kindjiria lies in Lac province, which abuts the vast Lake Chad -- a region shared by Chad, Cameroon, Niger and Nigeria.   Boko Haram launched an insurgency in northeastern Nigeria a decade ago that has since spilled over into neighbouring countries.   It has carried out at least 10 cross-border attacks in Chad since 2018, mainly targeting army positions.   In March, 23 troops were killed when their forward position on the northeastern side of the lake came under attack.   In June, 11 soldiers were killed and six were wounded in clashes at Tchoukoutalia, according to the authorities, who said 26 jihadists were killed.   Boko Haram's campaign has left some 27,000 people dead and displaced around two million in Nigeria alone, according to some estimates.   In 2015, the four Lake Chad countries, together with Benin, set up a combined force to fight Boko Haram with the help of local groups of armed citizens.
Date: Sun, 26 May 2019 12:12:06 +0200

N'Djamena, May 26, 2019 (AFP) - Four Chadian soldiers and a television reporter were killed when their vehicle hit a mine on a road in eastern Chad, security sources said Sunday.   The victims were headed towards an army position that had been attacked by elements of the Boko Haram Islamist group overnight Friday, the sources said.   "This delegation of the Chadian army was headed to Ngounboua (on Lake Chad), where elements of Boko Haram had attacked an army position overnight, illing at least one on our side," a security source told AFP. 

The source said 23 Boko Haram fighters were killed, confirming a toll given by Chadian army spokesman Azem Bermandoa on national television.   Dimouya Soiapebe, the head of Lake Chad Province, said soldiers and a journalist for the national broadcaster had gone to the scene to "raise the morale of the troops" when the bomb went off.   "Terrorists often lay explosive devices on the roads leading to positions they have attacked," Soiapebe said.

In March, 23 soldiers were killed in the Lake Chad region in the deadliest attack yet on the Chadian army by Boko Haram, which launched an insurgency in Nigeria a decade ago.   The revolt has claimed more than 27,000 lives and uprooted some 1.8 million people.
Date: Thu, 11 Apr 2019 05:29:58 +0200
By Amaury HAUCHARD

Adré, Chad, April 11, 2019 (AFP) - Dinar Tchere is fighting time and the sun, and he fears he may be losing.   This morning, the health worker is expected in a remote village of eastern Chad, where he will administer the measles, mumps and rubella vaccine to poor children.   But he's behind schedule -- and there is limited time before his enemy, the blistering Sahelian heat, will destroy his precious drugs.  Tchere takes his gear and the ice-packed cooler that shields the vaccines, puts them in an NGO pickup and heads out from his clinic in Hilouta, in Ouaddai province, on the dusty untarmacked road.

Twenty minutes later he is in Agang, a village of 400 people, and there, another private dread has turned to reality. No-one is there to be vaccinated.   "It's just what I feared -- most of the mums have gone off to the market to do their shopping," groans Tchere, a stocky, shaven-headed man in his fifties.    There is nothing to do but hope that the mothers and their children will return. He stretches out a mat on the soil, under a mango tree.   His luck starts to turn. One by one, mothers with their children make their way to the spot, and soon there is no room on his mat for youngsters waiting for their jab.

- Cold chain -
Always worried by the heat -- the thermometer now reads 40 degrees Celsius (104 degrees Fahrenheit) -- Tchere dips his finger into the cooler to check that the ice has not melted, and starts the vaccination.   "Our biggest headache is ensuring that the vaccines are always kept cold," says Tchere, who heads one of 21 health centres in the region.   "Since the troubles of 2007, we no longer have a solar panel or fridge."   The "troubles" refer to years-long violence by armed groups on the tense border between Sudan and Chad.   Hilouta, which lies less than two kilometres (one mile) from the border, became a combat zone.   With no power, how does Tchere keep his vaccines cool?   "I stock them in Sudan, in a clinic on the other side of the border. They've got a fridge," he explains.

But there's a problem: because of security concerns, Sudan refuses to let people cross the border by motorbike -- Tchere's only form of transport when he cannot use the pickup.   So on the eve of every immunisation session, Tchere walks into Sudan, carrying his cooler, fills it up with vaccines, and walks back into Chad.   His clinic administers to about 60 villages. He says e does four vaccination sessions per month -- two in the clinic, and two in the villages.   Most often, he does the outside trips on his motorbike, always taking care never to take the same route back home, in order to avoid holdups.

The state no longer pays the running costs of his health centre -- a French NGO, Premiere Urgence Internationale (PUI), has stepped in, using financial help provided by the European Union.   In Arkoum, about 50 kilometres (30 miles) from Hilouta, Felix Djembonoudji, a nurse who runs the health centre, says that the stockpile of vaccines -- held in the district's main town of Adre, several hours away by road -- has run out.   "The people (in Adre) sometimes don't receive any -- we've been without MMR (vaccine) for five days," he says.

- Measles threat -
Measles is often dismissed by so-called anti-vaxxers who oppose immunisation as a disease of the past or non-threatening.   Experts say that it is neither -- measles is on the comeback trail.    And out of every 20 children who catch measles, as many as one will suffer from pneumonia, according to the US Centers of Disease Control (CDC). Blindness, encephalitis and severe diarrhoea are also serious complications.   Only one child in five in Chad is fully vaccinated against measles, according to a 2017 survey.   "Measles can also cause malnutrition in non-vaccinated children, which in itself is a cause of premature death," said PUI's mission chief in Chad, Fabienne Mially.

According to UN figures, more than one child in 10 in Chad will die before their fifth birthday.   In Agang, the measles vaccination session comes to an end, and Tchere is packing up his gear when a horse appears on the horizon, its hooves kicking up dust, bearing a man and his six-month-old baby.   The infant needs his second MMR vaccine. "It's important!" pleads the father. The child will get his jab.   Tchere returns to his clinic in Hilouta. There is no water or electricity. Two local people are awaiting him in the gloom, desperate for a medical consultation.    "The working day is long," he sighs, as he welcomes them in.
Date: Tue, 9 Apr 2019 04:47:15 +0200
By Amaury HAUCHARD

Hadjer Hadid, Chad, April 9, 2019 (AFP) - "I've already earmarked a customer for this drum -- I need to get a move on!"   Ali Ahmat,12, flicks his whip to persuade a hard-driven horse to press on with his cart, laden with 200 litres (44 imperial gallons) of freshly-fetched water.   The young entrepreneur is one of the informal but indispensable links in a chain to supply people in Ouaddai, eastern Chad, with water, the stuff of life.

Scorching temperatures, an open sky, a shortage of deep wells and lack of water purification system make this a thirsty part of the world indeed.   "After the rainy season, water becomes scarce," says Mahamat Adoum Doutoum, chief of the Guerri region, where only two deep wells exist for 86,000 inhabitants. "So people go to look for water in the wadi."   Wadis -- "riverbeds" in Arabic -- are watercourses that run strong and fast during the rains and are often dangerous to cross, but largely dry up for the rest of the year. When there is no more rain, people dig wells in the wadis and install pumps to extract groundwater.

Ali and dozens of other water carriers flock to the pumps to collect supplies they plan to sell to people who have no access to the source, often in dusty settlements.   Each refill of his 200-litre drum costs Ali 100 CFA francs (0.15 euros / $0.17), but he can sell the water for five times as much in town. "We do between seven or eight return trips each day, roughly," he says.     Towards the end of a hot Sunday, the blazing sun has set and Ali's cart is heading towards Hadjer Hadid.

The town harbours a refugee camp for people who fled conflict and mass killings in the Darfur region of western Sudan, the far side of the border.   Pascal, a Sudanese refugee and father of five in his 50s, is also used to the return trips between the town, the bed of the wadi and the muddy wells.    He first came to Chad about 15 years ago and says that he "suffered" to be able to buy his own donkey.   The beast of burden was an investment that has paid off, however, enabling Pascal to deliver water to the townsfolk over the past two years and bring a small sum home to his family.

- Add bleach -
But he remains concerned about the quality of the water.   "To drink the water, you also have to add bleach," Pascal says.   While water has become as rare as it is valuable, the kind to be found around wadis is unsafe. Traditional wells dug into the earth at the wadis provide water that is often the same colour as the soil.   "The water can be contaminated at various points, either at the source, which may be unprotected, or during transport, using receptacles which are inappropriate, dirty or uncovered, and during storage and distribution," says Fabienne Mially, mission chief in Chad for the French aid group Premiere Urgence Internationale (PUI).

The NGO supports 11 health centres in the Ouaddai region, where awareness sessions on the importance of proper drinking water are regularly organised.   In Borota, a village several hours' drive from Hadjer Hadid, the head of the local health centre has no illusions. Of the six standpipes in the village, none is working any more.   "They were installed by NGOs," says the official, Koditog Bokassa, who says that wadi water is the only available source of water locally.   He hands out sachets of bleach to dilute in untreated water.   But Bokassa lacks the means to satisfy everybody and PUI has become the sole supplier of bleach in central parts.    The state used to deliver some, but has not done so for more than a year, he says. It is quite common to see young people at the wadis drink directly from their cans.

- 'Barely enough' -
The town has holding basins and water towers designed to retain water during the rainy season.   "But the holding basins are insufficient and the two water towers broke down several years ago," says local resident Hassan.   One trader has bought two barrels of 200 litres apiece, which he leaves in the courtyard of his house. "It's barely enough for the children, but it's better than nothing."   The water deliverer Pascal does not have the money to buy a drum of such munificence. For the seven members of his household, there are seven 20-litre cans on the stoop.    "I haul water every day, but I have the same problem as everyone else," he said.
Date: Sun, 7 Apr 2019 06:19:43 +0200
By Amaury HAUCHARD

Abeche, Chad, April 7, 2019 (AFP) - The chief medical officer at Adre hospital takes a routine phone call: a patient has been admitted with gunshot wounds and needs emergency surgery.   A dusty town in eastern Chad, once part of the proud Ouaddai empire, Adre is caught up in a mounting conflict between local farmers and nomadic camel herders from the north of the sprawling country.   Last year, the hospital treated more than 100 patients with bullet wounds.

In a territory where almost everyone seems to have a gun -- a legacy of rebellions launched from eastern Chad and of the brutal conflict in Sudan's Darfur -- squabbles over grazing land and trampled crops swiftly lead to violence.   Such disputes are tragically familiar in many parts of Africa.    But in arid eastern Chad, near the border with Sudan, the bloodshed is particularly acute, rooted in a bitter drought and population pressure sharpening rivalry over access to land.   The vicious circle of attack and retribution is running full tilt.

- Seasonal -
Admissions in Adre rise sharply during "times of tension", a source at the local hospital said.   Those times mirror the seasons. At the end of the rainy season, in December and January, herders drive their beasts northwards into the Sahel. When water sources start running low, they return south, from about the end of June.   Local chief Abderahim Dahab, who supervises 136 villages in his traditional leadership role, said the modern-day bloodshed contrasted with long-established cohabitation.   "Movement of livestock has always happened peacefully, for decades," he said.   Migratory herders benefit from pasture on which to feed their animals, and farmers benefit from the animals, whose droppings fertilise the soil. And farmers and herders mutually benefit from trading with each other for food.

Historian Mahamat Saleh Yacoub said two factors explained the breakdown between the two communities.   The first is a drought that has gripped the Sahel since the 1970s and seems to be worsening. Everyone who spoke to AFP agreed that the key issue is a lack of water.   "The herders are now coming earlier in the year and going back later. The established ways have broken down," said another district chief.   Saleh Yacoub, who is head of the ENS college of higher education in Abeche, near Adre, said the second cause was a population increase -- "as much among people as among livestock".   Herds are getting larger, straining the fragile ecological resources of the Ouaddai.

- Ethnic friction -
The rivalry has "become intertwined with ethnic problems", added Yacoub.   "The herds all belong to the same people: colonels, generals, people in politics," explained a village elder sitting on his mat with a glass of tea.   "We have had meetings, we write letters to the deputy prefect (district administrator), the prefect himself, but get nothing back," he protested. "The population has no power against them."

Many cattlemen are members of the Zaghawa ethnic group, who come from the northeast of the giant country.    The Zaghawa include President Idriss Deby Itno, who came to power in 1990.    Members of their ethnicity have entered every rank of the Chadian state, although Ouaddai's governor, Ramadan Erdebou, dismisses any suggestion that tribalism is to blame for the region's problems.   "This ethnic question is a false debate. There are Chadian women and Chadian men and one single unity, Chad," said Erdebou, who was formerly the chief of the regime's powerful intelligence services.

- Disarmament -
Erdebou's predecessor was sacked after an explosion of communal violence last October claimed eight lives.   One of his first moves in office was to announce a massive disarmament campaign among the population.   He also warned that a mission would be coming from the capital N'Djamena to chase away "those farmers who have cultivated crops along the corridors (set aside) for livestock movement."

These designated corridors were established by law in 1959, to give nomads and their herds passage of up to one kilometre (more than half a mile) wide for their seasonal migrations.   "But Zaghawa herders feel they can do what they like and don't respect them," said a farmer, who maintains he lost his entire peanut crop in 2016 when hundreds of dromedaries trampled his field.   "How do you expect Ouaddians to agree to be disarmed when you see that the herdsmen have more and more weapons?" asked a local official.

In 2015, the National Assembly in the distant western capital passed a Pastoral Code that led to an outcry from people who found it heavily biased in favour of the cattle breeders. Deby overturned the law.   "It's hard to want national unity when those in power only favour their own," said the local official, who asked not to be named, saying he feared reprisals.   But, Saleh Yacoub observed, when quarrels turn violent, "the Zaghawa become the target for all the grievances, regardless of whether they are legitimate or not."   In a visit to Abeche in February, Deby named no names but acknowledged there was a "serious problem."   He vowed to "take matters in hand".   "The hour for vendettas is past," he declared.
More ...

Singapore

Singapore - US Consular Information Sheet
May 12, 2008
COUNTRY DESCRIPTION:Singapore is a small, stable, highly developed country with an elected parliamentary system of government. Tourist facilities are modern and widely available. Singapore'
resident population of over 4.6 million inhabitants (including permanent residents and foreign workers) comprises 75% Chinese, 14% Malay, 9% Indian and 2% others. English is widely spoken. Criminal penalties are strict and law enforcement rigorous; see sections on “Entry/Exit Requirements,” “Special Circumstances,” and “Criminal Penalties,” below, for further details. Read the Department of State Background Notes on Singapore for additional information.

ENTRY/EXIT REQUIREMENTS: A valid passport is required. U.S. citizens do not need a visa if their visit is for business or social purposes and their stay is for 90 days or less. Travelers to the region should note that Singapore and some neighboring countries do not allow Americans to enter under any circumstances with fewer than six months of validity remaining on their passport. Female U.S. citizens who are pregnant when they apply to enter Singapore for a social visit are no longer required to make prior application through the nearest Singapore overseas mission or to provide documentation from a U.S. embassy concerning the nationality the child will acquire at birth.
Specific information about entry requirements for Singapore may be obtained from the Embassy of the Republic of Singapore at 3501 International Place NW, Washington, DC 20008, tel. (202) 537-3100. Visit the Embassy of Singapore’s web site at http://www.mfa.gov.sg/washington/ for the most current visa information.
Find more information about dual nationality and the prevention of international child abduction on our web site. For further information about customs regulations, please read our Customs Information.

SAFETY AND SECURITY: In 2001, Jemaah Islamiyah (JI), a terrorist organization with links to Al Qaeda, planned attacks in Singapore against government and private targets associated with the United States, Singapore and other countries. These plans were disrupted and the JI organization in Singapore was dismantled. On February 27, 2008 suspected JI leader Mas Selamat Kastari escaped from detention in Singapore. His current whereabouts are unknown. Singapore remains a target of interest for terrorist groups. The Department of State remains concerned because extremist groups in Southeast Asia continue to demonstrate the desire and capability to carry out attacks against locations where Westerners congregate. Terrorist groups do not distinguish between official and civilian targets. Americans residing in or traveling to Singapore and neighboring countries should therefore exercise caution, especially in locations where Americans and other Westerners live, work, congregate, shop or visit. U.S. citizens should remain vigilant about their personal security and surroundings.

For the latest security information, Americans traveling abroad should regularly monitor the Department’s web site at http://travel.state.gov, where the current Worldwide Caution, Travel Warnings and Travel Alerts can be found.
Up-to-date information on safety and security can also be obtained by calling 1-888-407-4747 toll free in the U.S., or for callers outside the U.S. and Canada, a regular toll-line at 1-202-501-4444. These numbers are available from 8:00 a.m. to 8:00 p.m. eastern time, Monday through Friday (except U.S. federal holidays).
The Department of State urges American citizens to take responsibility for their own personal security while traveling overseas. For general information about appropriate measures travelers can take to protect themselves in an overseas environment, see the Department of State’s pamphlet A Safe Trip Abroad.

CRIME: Major crimes against tourists in Singapore are uncommon. Petty crimes such as pick-pocketing and purse or briefcase snatching occur in tourist areas, hotels and at the airport. Travelers should exercise the same caution that they would in any large city.. Visitors should be aware that credit card fraud is on the rise and should practice standard precautions to avoid falling victim of credit card fraud: do not carry multiple credit cards on your person; do not allow credit cards to be removed from your sight; avoid giving credit card information over the phone and use only secure internet connections for financial transactions.

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

MEDICAL FACILITIES AND HEALTH INFORMATION: Good medical care is widely available in Singapore. Doctors and hospitals expect immediate payment for health services by credit card or cash and generally do not accept U.S. health insurance. Recipients of health care should be aware that Ministry of Health auditors in certain circumstances may be granted access to patient medical records without the consent of the patient, and, in certain circumstances, physicians may be required to provide information relating to the diagnosis or treatment without the patient's consent.

Despite vigorous mosquito eradication efforts in Singapore, from time to time Singapore experiences a spike in the number of dengue fever cases. Outbreaks tend to be clustered in residential areas, but there have been no reports of clusters in primary tourist areas, such as the Night Safari, the Singapore zoo, or Orchard Road.

In January 2008, a new strain of the viral disease Chikungunya was detected in Singapore. A dozen cases of the disease, which like Dengue Fever is transmitted by the Aedes aegypti mosquito, were documented. There were no deaths. Unlike prior cases in Singapore, these cases were contracted locally and the outbreak centered around guest worker housing on Clive Street.

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

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

TRAFFIC SAFETY AND ROAD CONDITIONS: While in a foreign country, U.S. citizens may encounter road conditions that differ significantly from those in the United States. The information below concerning Singapore is provided for general reference only, and may not be totally accurate in a particular location or circumstance.
Singapore has a highly developed and well-maintained road and highway network. Driving is done on the left-hand side of the road. Motorists should be particularly aware of motorcyclists, who often ignore lane markings. Lanes are frequently closed without warning due to construction throughout the city. Public transportation and taxis are abundant, inexpensive, and reliable. Visitors should consider using this form of transportation. The Automobile Association of Singapore provides roadside assistance, and the Land Transport Authority has rescue vehicles on the road at all hours. In addition, closed circuit cameras monitor all major roads. As with all laws in Singapore, those involving traffic rules, vehicle registration, and liability in case of accident are strictly enforced, and failure to follow them may result in criminal penalties. Please refer to our Road Safety page for more information.

Singapore has one of the worst road-fatality records among developed countries. In 2007, 2.6 deaths were logged for every 10,000 vehicles in Singapore, compared to 0.8 in Japan, 1.2 in Australia and 1.8 in the United States. For specific information concerning Singaporean driver's permits, vehicle inspection, road tax and mandatory insurance, please contact the Singaporean National Tourist Board located at 590 Fifth Ave., Twelfth Floor, New York, NY 10036, tel. 1-212-302-4861 or fax: 1-212-302-4801.

AVIATION SAFETY OVERSIGHT: The U.S. Federal Aviation Administration (FAA) has assessed the Government of Singapore's Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for oversight of Singapore’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: Singapore customs authorities enforce strict regulations concerning temporary import and export of items such as weapons, illegal drugs, certain religious materials, pornographic material, videotapes, CDs, DVDs, and software. Singapore customs authorities’ definition of "weapon" is very broad, and, in addition to firearms, includes many items which are not necessarily seen as weapons in the United States, such as dive knives, kitchen knives, handcuffs, and expended shell casings. Carrying any of these items without permission may result in your immediate arrest. All baggage is x-rayed at every port of entry, so checked baggage will also be inspected for regulated items.

It is advisable to contact the Embassy of Singapore in Washington, DC at 3501 International Place NW, Washington, DC 20008, tel. (202) 537-3100, http://www.mfa.gov.sg/washington/ for specific information regarding customs requirements. You may also visit Singapore Customs’ web site, http://www.customs.gov.sg/. Singapore customs officials encourage the use of an ATA (Admission Temporaire/Temporary Admission) carnet for the temporary admission of professional equipment, commercial samples, and/or goods for exhibitions and fair purposes. ATA carnet headquarters located at the U.S. Council for International Business, 1212 Avenue of the Americas, New York, N.Y. 10036, issues and guarantees the ATA carnet in the United States. For additional information, please call 1-212- 354-4480, or send an e-mail to atacarnet@uscib.org or visit http://www.uscib.org/ for details.

In many countries around the world, counterfeit and pirated goods are widely available. Transactions involving such products are illegal and bringing them back to the United States may result in forfeitures and/or fines. A current list of those countries with serious problems in this regard can be found at http://www.ustr.gov/Document_Library/Reports_Publications/2004/2004_Special_301/Section_Index.html.
Please see our Customs Information.
Automated teller machines (ATMs) are plentiful in Singapore, and they are the best method of obtaining cash. Bank transfers generally take weeks, and surcharges are steep. Transfers from commercial services such as American Express and Western Union are generally efficient.

Americans may be asked by police, employers or hotels to surrender their passports in lieu of surety (guaranteed) bonds. Americans should carefully consider whether they wish to surrender their passport rather than seek some other type of surety, particularly if the passport is requested by someone who is not a government official (e.g., an employer, or hotel employees).
Note that Singapore does not recognize dual nationality beyond the age of 21, and it strictly enforces universal national service (NS) for all male citizens and permanent residents. Male U.S. citizens who automatically acquired Singaporean citizenship and continue to reside in Singapore are liable for Singapore national service once they reach the age of 18. Travel abroad of Singaporean males may require Singapore Government approval as they approach national service age and may be restricted when they reach sixteen-and-a-half years of age. Under Singaporean law, an individual who acquires Singaporean citizenship at birth retains that status even after acquiring the citizenship of another country, including U.S. citizenship.

Males may renounce Singaporean citizenship only after having completed at least two years of national service. U.S. citizens are subject to this law. Dual nationals, Singapore Permanent Residents, and their parents should contact the Ministry of Defense in Singapore to determine if there will be a national service obligation. For additional information, please see the Bureau of Consular Affairs’ web site for our dual nationality flyer, and contact the Ministry of Defense Central Manpower Base (tel. 65-6373-3127), or visit http://www.ns.sg/nsPortal/appmanager/nsp/default?_nfpb=true&_pageLabel=nsPortal_NSREG_ABT&nsp_community=ENLIST.
National-service-liable males who migrated from Singapore before age 11 and have not enjoyed significant socio-economic benefits of citizenship (e.g., applied for a Singapore identity card or studied in Singapore beyond the age of 11) are allowed to renounce their Singapore citizenship, but not before they turn 21. Until then, they are required to register for national service with Central Manpower Base and apply for a deferment. After turning 21, they are then eligible to renounce their Singapore citizenship and, if successful will not be required to serve NS and may continue to make short social visits to Singapore.

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 in Singapore than for similar offenses in the United States, and persons violating Singapore laws, even unknowingly, may be expelled, arrested or imprisoned.
There are strict penalties for possession and use of drugs as well as for trafficking in illegal drugs. Trafficking charges may be brought based on the quantity of illegal drugs in a subject’s possession, regardless of whether there is any proven or demonstrated intent to distribute the drugs. Convicted offenders can expect long jail sentences and heavy fines. Singapore has a mandatory death penalty for many narcotics offenses. Singapore police have the authority to compel both residents and non-residents to submit to random drug analysis, and do not distinguish between drugs consumed before or after entering Singapore in applying local laws.

Visitors should be aware of Singapore's strict laws and penalties for a variety of actions that might not be illegal or might be considered minor offenses in the United States. These include jaywalking, littering, and spitting. Singapore has a mandatory caning sentence for vandalism offenses, and caning may also be imposed for immigration violations and other offenses. Commercial disputes that may be handled as civil suits in the United States can escalate to criminal cases in Singapore, and result in heavy fines and prison sentences.
There are no jury trials in Singapore. Judges hear cases and decide sentencing. The Government of Singapore does not provide legal assistance except in capital cases; legal assistance may be available in some other cases through the Law Society.

There are strict penalties for those who possess or carry arms, or who commit crimes with arms. Singaporean authorities define “arm” as any firearm, air-gun, air-pistol, automatic gun, automatic pistol and any other kind of gun or pistol from which any shot, bullet or other projectiles can be discharged or from which noxious liquid, flame or fumes can be emitted, and any component part thereof. This definition also includes any bomb or grenade and any component part thereof. The unlawful possession of any arm or ammunition could result in imprisonment and caning. Any person convicted of committing a crime with an arm could receive punishment which could result in the maximum penalty of imprisonment for life and caning.
Engaging in sexual conduct with children or using or disseminating child pornography in a foreign country is a crime, prosecutable in the United States. In Singapore, local law prohibits causing or encouraging prostitution of, or engaging in sexual relations with, a female below the age of 18. An indecent assault against anyone, male or female, regardless of age, is also prohibited. Those convicted of facilitating or abetting the prostitution of any woman or girl could be sentenced to imprisonment of up to 5 years and a fine of $7,100 or both. If the crime involves a female below the age of 16, the offender faces an additional charge carrying a possible sentence of imprisonment of up to 3 years and a fine of $2,000 or both.
Singapore enforces strict laws pertaining to the propriety of behavior between people, and the modesty of individuals. The Singaporean law “Outrage of Modesty” is defined as an assault or use of criminal force on any person, intended to, or knowing it to be likely to, outrage the modesty of that person. Penalties may include imprisonment for up to 2 years, a fine, caning, or a combination thereof. Men are sometimes accused of inappropriately touching other people, often women, resulting in their prosecution and punishment under this Singaporean law.
CHILDREN'S ISSUES: For information on international adoption of children and international parental child abduction, see the Office of Children’s Issues web site.

REGISTRATION / EMBASSY LOCATION: Americans living or traveling in Singapore are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department’s travel registration web site and obtain updated information on travel and security within Singapore. Americans without Internet access may register directly with the nearest U.S. Embassy or Consulate. By registering, American citizens make it easier for the Embassy or Consulate to contact them in case of emergency. The U.S. Embassy is located at 27 Napier Road, Singapore 258508, tel. [65] 6476-9100, fax [65] 6476-9340; web site http://singapore.usembassy.gov/. In case of emergencies after working hours, the duty officer at the Embassy may be contacted by calling tel. [65] 6476-9100.
* * *
This replaces the Country Specific Information dated September 11, 2007, to update sections on Country Description, Safety and Security, and Medical Facilities and Health Information.

Travel News Headlines WORLD NEWS

Date: Thu, 7 Nov 2019 09:57:41 +0100 (MET)

Singapore, Nov 7, 2019 (AFP) - Tourists visiting Singapore can now check in at some hotels using facial recognition technology under a pilot programme that could cut waiting times and help tackle a labour crunch.  The tech-savvy country of 5.7 million people is increasingly turning to automation to speed up services and deal with workforce shortages, with robots deployed for tasks ranging from cleaning to making noodles.

Under the pilot launched Wednesday, visitors will not need to wait to be checked in by hotel staff but can instead use a phone app fitted with facial recognition technology or machines which scan their passports.   The data from the scan is sent to immigration authorities for checks after which the visitor is issued a room key, said the Singapore Tourism Board and Hotel Association, which announced the initiative this week.

The technology, reportedly being trialled at three hotels and is similar to that used in some airports including Singapore's Changi, could reduce check-in times by up to 70 percent, they said.   Singapore welcomed a record high 18.5 million visitors last year, up 6.2 percent from the year before. The city has more than 400 hotels with 67,000 rooms.
Date: Fri 25 Oct 2019
Source: Channel News Asia [abridged, edited]

The number of measles cases in Singapore has hit the highest level since an outbreak in 1997, figures from the Ministry of Health on Thursday [24 Oct 2019] showed. According to the latest weekly infectious diseases bulletin published on Thursday [24 Oct 2019], there were 149 measles cases in Singapore as of 19 Oct [2019]. That is more than 4 times the number of cases for the whole of 2018, when there were 34.

The number of measles cases in Singapore hit 1413 in 1997, before the government introduced the 2-dose MMR vaccination schedule in 1998. The number of cases fell to just 114 that year [1998].  In July this year [2019], MOH urged Singaporeans to remain vigilant, as measles cases around the world have increased substantially.  "As a travel hub, Singapore is likely to see increased cases from importation," it said.

According to the latest Communicable Diseases Surveillance report released by MOH in 2018, the number of reported measles cases has "rapidly declined" since the introduction of compulsory measles vaccination in August 1985. In 1992 and 1997, there was a spike in the number of reported cases across all age groups. The "catch-up" immunisation initiative was implemented between July 1997 and November 1997, and the 2-dose MMR vaccination started in January 1998.

The number of measles cases ranged between 13 and 96 between 2001 and 2010, before an increase in 2011 to 148 cases. Since then the number of cases has fluctuated, with 38 cases in 2012 and 46 cases in 2013, jumping to 142 cases in 2014.

There were 42 measles cases in 2015 and 136 cases in 2016. That dipped to 70 cases for the whole of 2017 and dropped further to 34 cases in 2018.

There have been outbreaks around the world as the virus exploits gaps in vaccination coverage, the World Health Organization (WHO) said this month [October 2019].

The disease, which is, according to the WHO, one of the world's most contagious, rose by 300% globally in the 1st 3 months of 2019, compared to the same period in 2018. There have been consecutive increases over the last 2 years.  [Byline: Michael Yong]
Date: Wed, 18 Sep 2019 12:26:37 +0200 (METDST)
By Sam Reeves

Kuala Lumpur, Sept 18, 2019 (AFP) - Toxic haze from Indonesian forest fires closed schools and airports across the country and in neighbouring Malaysia Wednesday, while air quality worsened in Singapore just days before the city's Formula One motor race.   Illegal fires to clear land for agriculture are blazing out of control on Sumatra and Borneo islands, with Jakarta deploying thousands of security forces and water-bombing aircraft to tackle them.

Indonesian blazes belch smog across Southeast Asia annually, but this year's are the worst since 2015 and have added to concerns about wildfire outbreaks worldwide exacerbating global warming.   On Wednesday, air quality deteriorated to "very unhealthy" levels on an official index in many parts of peninsular Malaysia, to the east of Sumatra, with the Kuala Lumpur skyline shrouded by dense smog.    Nearly 1,500 schools were closed across Malaysia due to the air pollution, with over one million pupils affected, according to the education ministry.

A growing number of Malaysians were suffering health problems due to the haze, with authorities saying there had been a sharp increase in outpatients at government hospitals -- many suffering dry and itchy eyes.   Indonesian authorities said hundreds of schools in hard-hit Riau province on Sumatra were shut, without providing a precise number, while about 1,300 were closed in Central Kalimantan province on Borneo.    Borneo is shared between Indonesia, Malaysia and Brunei.   Poor visibility closed seven airports in the Indonesian part of Borneo, the transport ministry in Jakarta said. Scores of flights have already been diverted and cancelled in the region in recent days due to the smog.

- Singapore smog race? -
Air quality in Singapore worsened to unhealthy levels and a white smog obscured the striking waterfront skyline, featuring the Marina Bay Sands casino resort with its three towers and boat-shaped top level.    The worsening pollution increased fears that this weekend's Formula One race may be affected. Organisers say the possibility of haze is one of the issues in their contingency plan for Sunday's showpiece night race, but have not given further details.

The city-state's tourism board said spectators would be able to buy masks as protection from the haze if conditions did not improve and assistance would be provided for those who feel unwell, the Today news portal reported.   The fires have sparked tensions between Indonesia and Malaysia.    Indonesia's environment minister initially suggested the haze was from Malaysian fires despite satellite data showing hundreds of blazes in Indonesia and only a handful in its neighbour, prompting anger from her Malaysian counterpart.

Indonesia later sealed off dozens of plantations where it said fires were blazing, including some owned by Malaysia-based firms, deepening the row.   But Prime Minister Mahathir Mohamad, who has struck a diplomatic tone throughout the crisis, said Malaysia may pass legislation forcing its companies to tackle fires on plantations abroad.   Malaysia wants its firms with sites overseas to put out blazes contributing to the haze, he said, adding: "Of course, if we find they are unwilling to take action, we may have to pass a law to make them responsible."

The Indonesian government has insisted it is doing all it can to fight the blazes. But this year's fires have been worsened by dry weather and experts believe there is little chance of them being extinguished until the onset of the rainy season in October.   Indonesia's meteorology, climate and geophysics agency said Wednesday that over 1,000 hotspots -- areas of intense heat detected by satellite that indicate a likely fire -- had been sighted, most of them on Sumatra.
Date: Sat, 14 Sep 2019 16:08:47 +0200 (METDST)

Singapore, Sept 14, 2019 (AFP) - Pollution from forest fires in Indonesia pushed Singapore's air quality to unhealthy levels for the first time in three years on Saturday, the government said, a week ahead of the Formula One night race in the city.   The toxic smoke caused by burning to clear land for plantations is an annual problem for Indonesia's neighbours, but has been worsened this year by particularly dry weather.   "There has been a deterioration in the haze conditions in Singapore this afternoon," the National Environment Agency (NEA) said in a statement.   "This was due to a confluence of winds over the nearby region that led to more smoke haze from Sumatra being blown toward Singapore," it said, referring to one of the Indonesian islands where fires are raging.

The NEA said the pollutant standards index (PSI) worsened to 112 in parts of the island Saturday night.   An index reading between 101-200 is considered unhealthy, with residents advised against doing prolonged strenuous exercises outdoors.   Singapore may continue to experience hazy conditions over the next few days, the agency warned.   The city-state of 5.6 million people was shrouded in a thin white haze, with a few residents seen wearing face masks, but there was no major disruption to daily activities.   The F1 race is scheduled from Friday to Sunday on a street circuit in the Marina Bay financial district.

Singapore GP, the Formula One organisers, said the possibility of haze is one of the potential issues covered in their contingency plan for this year's grand prix.   "The plan was formulated and refined with stake holders, government bodies and the Formula One community," Singapore GP said in an emailed statement.   "In the event that the haze causes visibility, public health or operational issues, Singapore GP would work closely with the relevant agencies before making any collective decisions regarding the event."

Neighbouring Malaysia has also been affected by the smoke, with air quality in parts of the country including the capital Kuala Lumpur reaching unhealthy levels over the past few days and triggering a diplomatic row with Jakarta.   In 2015, the index reached "hazardous" levels of more than 300 in Singapore, forcing the closure of schools. Indonesian forest fires were the worst in two decades that year, firing up smog that blanketed large parts of Southeast Asia for weeks.
1 Aug 2019

The number of dengue fever cases and deaths continue to rise in Singapore. According to the latest National Environment Agency (NEA) data, 8946 cases have been reported through 31 Jul [2019], about 5 times more than the total number of dengue cases reported in the same period last year [2018]. In addition, the dengue death total has risen to 9 through 20 Jul [2019], according to local news accounts.

HealthMap/ProMED-mail map of Singapore:
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World Travel News Headlines

Date: Fri, 13 Dec 2019 16:41:23 +0100 (MET)
By Mariëtte Le Roux and Joseph Schmid

Paris, Dec 13, 2019 (AFP) - French commuters gritted their teeth for a ninth day of public transport strikes Friday, with unions vowing to keep up their protest against a pension overhaul through the holidays unless the government backs down.   Officials have said they are ready to negotiate, with Education Minister Jean-Michel Blanquer meeting teachers' representatives on Friday to try and stave off another day of class shutdowns.   "It was an intense and frank meeting... but we still need details, and maintain our call to strike on Tuesday," Stephane Crochet of the SE-Unsa union said.

Unions are hoping for a repeat of 1995, when they forced a rightwing government to back down on pension reforms after three weeks of metro and rail strikes just before Christmas.   The prospect of a protracted standoff has businesses fearing big losses during the crucial year-end festivities, and travellers worried that their Christmas plans may be compromised.   "Right now it's a catastrophe here, but we're hoping there will be a solution before Christmas," Frederic Masse, a foie gras producer at the huge Rungis wholesale food market south of Paris, told AFP on Friday.

The capital city was again choked by huge traffic jams as most metro lines remained shut, only a handful of buses and trams were running, and one in four TGV trains were cancelled.   "I'm sick of this, and I won't be able to keep working if it goes on," Zigo Makango, a 57-year-old security agent, told AFP onboard a bus in the Bobigny suburb northeast of Paris.   To get home at night Makango said he has to use taxis, but "my boss doesn't reimburse me for that".

- 'Historic reform' -
President Emmanuel Macron on Friday expressed his "solidarity" with people impacted by the strike, "but I want the government to continue its work" in forging a single pension system, a key campaign promise.   "It's a historic reform for the country," he told journalists at an EU summit in Brussels. 

The overhaul unveiled by Prime Minister Edouard Philippe would do away with 42 separate regimes, some of which offer early retirement and other benefits to public-sector employees such as train drivers, dockers and even Paris Opera employees.   But Philippe angered unions further by proposing a reduced payout for people who retire at the legal age of 62 instead of a new, so-called "pivot age" of 64.

They have called for new mass demonstrations for next Tuesday, the third since the action started on December 5 in the biggest show of strength in years by France's notoriously militant unions.   Philippe insisted on Twitter that "My door is open and my hand outstretched".   But Laurent Brun of the hard-line CGT union, the largest among public-sector workers including those at rail operator SNCF, has already warned "There won't be any Christmas truce" unless the government drops the plan entirely.

- France divided -
A poll released Thursday by the Elabe institute found France evenly divided on Philippe's plan, with 50 percent for and 49 percent against.  But 54 percent rejected the mooted 64-year cutoff for a full pension, and 54 percent supported the protest.

Staff at four of France's eight oil refineries were on strike Friday, affecting output and raising fears of shortages down the line.   And both Paris operas, the Garnier and the Bastille, again cancelled Friday performances and others through the weekend.   Macron's government insists the changes will make for a fairer system and help erase pension system deficits forecast to reach as much as 17 billion euros ($19 billion) by 2025.   The average French person retires at just over 60, years earlier than most in Europe or other rich OECD countries.
Date: Fri, 13 Dec 2019 14:05:22 +0100 (MET)

Milan, Dec 13, 2019 (AFP) - More than 300 flights were cancelled Friday in Italy due to a planned one-day strike by workers from Alitalia and Air Italy.   Alitalia said in a statement that 315 flights were cancelled on Friday, with another 40 cancelled Thursday night and Saturday morning. It was not immediately clear how many flights were cancelled at Air Italy.   The 24-hours strike, which involves pilots, flight attendants and ground personnel, was called by three unions to draw attention to what they called "the ongoing crisis at Alitalia and Air Italy."

The strike was felt most in Sardinia, with about 30 flights cancelled.    Money-losing Alitalia has been under special administration since 2017 when employees rejected a restructuring plan that would have laid off 1,700 workers out of an approximately 11,000.   The government has so far looked for buyers without success.    Unions plan to meet on Tuesday with Economy Minister Stefano Patuanelli.    A potential consortium of buyers for the ailing carrier fell apart last month after Atlantia, which operates Rome's airports, pulled out.
Date: Fri, 13 Dec 2019 05:24:44 +0100 (MET)
By Neil SANDS

Wellington, Dec 13, 2019 (AFP) - Adventure tourism is a key part of New Zealand's international appeal but the White Island volcano eruption is a tragic reminder that such activities carry genuine risk that must be better explained to travellers, experts say.   The South Pacific nation offers a wealth of adrenaline-fuelled pursuits, from heli-skiiing on snow-capped mountains to ballooning and blackwater rafting through caves.

Some, such as bungee-jumping, jet-boating and zorbing -- where you hurl yourself down a hill inside an inflatable ball -- were invented or popularised in a country that prides itself on catering to intrepid visitors.   The tourism industry as a whole is among New Zealand's biggest earners, generating about NZ$16.2 billion ($10.7 billion) and attracting 3.8 million international visitors annually.     "Adventure tourism is a massive sector in New Zealand. We are promoting ourselves as the adventure capital of the world," professor Michael Lueck, a tourism expert at Auckland University of Technology, told AFP.

New Zealand is also renowned for its rugged landscapes, which feature prominently films such as Kiwi director Peter Jackson's "Lord of the Rings".   Day-trips to White Island combined both, taking tourists including cruise ship passengers to a desolately beautiful island off the North Island coast where they could experience the thrill of standing on an active volcano.   Instead, at least 16 people are believed to have died and dozens suffered horrific burns when 47 tourists and guides were caught on the island during Monday's eruption.

The disaster has raised questions about why tourists were allowed on a volcano where experts had recently raised threat levels, as well as broader issues about the regulation of risky activities in the tourism sector.   "There will be bigger questions in relation to this event," Prime Minister Jacinda Ardern told parliament after the eruption.   "These questions must be asked, and they must be answered."

- 'Slapdash' or world's best? -
The disaster on White Island -- also known as Whakaari -- is not the first mass-fatality accident to affect tourists in New Zealand.   In 2015, seven people were killed when a scenic helicopter flight crashed into Fox Glacier. Two years earlier, a hot-air balloon claimed 11 lives and in 2010 nine died when a plane carrying skydivers plunged into a paddock.

Briton Chris Coker's son Brad, 24, died in the skydive plane crash and since then he has campaigned from afar for tighter regulations in New Zealand's adventure tourism sector.   "In my opinion, the New Zealand authorities... are still slapdash about tourist safety," Coker told news website stuff.co.nz after the White Island eruption.   "To run tourists there is insane. I know they signed a waiver and so on, but it's not really taking care of people."

Trade body Tourism Industry Aotearoa disputes such assessments, saying operators are "working within a world's best regulatory framework", but could not eliminate risk completely.   "Operators put safety first, but adventure activity inherently carries some risk and it's critical that 'adventure' remains in adventure tourism," TIA chief executive Chris Roberts told AFP.   "Operators take all practical actions to minimise the risks and the safety culture of individual operators remains the key factor in preventing accidents."

Roberts said the issue was not tourism operators, but the alert system they relied on at volcanic destinations such as White Island, which attracts about 17,000 visitors a year.   The GeoNet monitoring agency raised White Island's threat level in the week before the eruption but also advised current activity "does not pose a direct hazard to visitors".   "The reviews need to look at the science and specifically the guidance provided about volcanic activity, and whether the operating practices followed for the past 30 years need to change," Roberts said.

- 'Understand the risks' -
Travel companies such as White Island Tours brief customers before setting off and require them to sign a waiver declaring they understand the risk, as well as supplying equipment such as hard-hats and gas masks.   However, some relatives of those affected by the eruption have expressed scepticism that their loved ones truly appreciated the potential danger they faced.   Options for legal redress are limited under New Zealand's Accident Compensation Commission scheme, which covers victims' medical bills and provides modest compensation but does not allow civil suits for damages.

Neither Roberts nor Lueck expected the White Island eruption to hit international arrivals in New Zealand, which have continued to climb despite major earthquakes in 2011 and 2016.   The nature of any review arising from White Island remains uncertain, but Lueck said at the very least tourists needed to be better informed about any risks.   "Operators and tourism boards should have tourists understand what these risks are, and not brush over quickly signing a waiver," he said.   "Only then can tourists make an informed decision and decide whether or not they want to take that particular risk."
Date: Thu, 12 Dec 2019 21:25:36 +0100 (MET)

Kinshasa, Dec 12, 2019 (AFP) - Twenty-three cases of Ebola have been recorded in four days in eastern Democratic Republic of Congo, where deadly violence is hampering efforts to end the 16-month-old epidemic, authorities said on Thursday.   Ten cases were recorded on Tuesday alone in Mabalako in North Kivu province, after six on Monday, according to the Multisectoral Committee for Epidemic Response (CMRE).   Three out of the six were practitioners of traditional medicine, it said.

On Wednesday, three cases were recorded in North Kivu, including one in the Biena neighbourhood -- which has had no new Ebola cases for the last 85 days.   More than 2,200 people have died since the epidemic was declared on August 1, 2018.   As of November 22, the rate of new cases had fallen to 10 per week.   CMRE said "security reasons" -- attacks on Ebola health workers and sites by armed groups and angry youths -- had "paralysed" work in the key zones of Beni, Biakato and Mangina.   The attacks led to a pullout of locally-employed Ebola workers in Biakato by the UN's World Health Organization (WHO) and Doctors Without Borders (MSF).
Date: Thu, 12 Dec 2019 15:59:23 +0100 (MET)

Juba, Dec 12, 2019 (AFP) - Devastating flooding in South Sudan following a fierce drought could tip parts of the country into famine in the next few months, the World Food Programme (WFP) warned on Thursday.   According to the UN refugee agency nearly one million people were affected by floodwaters that submerged entire towns, compounding an already dire humanitarian situation after six years of war.

The WFP said that 5.5 million people are expected to be going hungry in early 2020 -- the time at which the population is generally benefiting from their harvest in October and November of the previous year.   An earlier harvest failed due to drought. This time crops have been washed away.    "The number of people in need is likely to increase because of the catastrophic level of destruction caused by floods since October following a drought that hammered parts of the country earlier in the year," the agency said in a statement.

The floods wiped out 73,000 metric tons of potential harvests as well as tens of thousands of cattle and goats, said the WFP.   "We know the problems that we've been having in South Sudan, but the rains and the floods have led to a national disaster and are much worse than anyone could have anticipated," said WFP Executive Director David Beasley.    "In fact, if we don't get funding in the next few weeks and months, we are literally talking about famine. We need support, we need help and we need it now."   The agency estimated its needs at $270 million (242 million euros) for the first half of 2020.   South Sudan declared a "man-made" famine affecting around 100,000 people in 2017. 

The term "famine" is used according to a scientific system agreed upon by global agencies, when at least 20 percent of the population in a specific area has extremely limited access to basic food; acute malnutrition exceeds 30 percent; and the death rate exceeds two per 10,000 people per day for the entire population.   "Famine in South Sudan was defeated after four months in 2017 by a concerted large-scale humanitarian response," said the WFP.   "Experts now say the country's food security outlook has never been so dire."   Political instability is also high as President Salva Kiir and his rival Riek Machar have again delayed their formation of a power-sharing government, this time by 100 days until February 2020.
Date: Wed, 11 Dec 2019 09:33:13 +0100 (MET)
By Holly ROBERTSON

Sydney, Dec 11, 2019 (AFP) - Up to 20,000 protesters rallied in Sydney on Wednesday demanding urgent climate action from Australia's government, as bushfire smoke choking the city caused health problems to spike.   Sydney has endured weeks bathed in toxic smoke as hundreds of blazes have raged across the countryside, with hospitals recording a 25 percent increase in the number of people visiting emergency departments last week.   On Tuesday smoke alarms rang out across Australia's biggest city, with thick haze triggering smoke alarms and forcing buildings to be evacuated, school children to be kept indoors, and ferries to be cancelled.   The devastating fires have focused attention on climate change, with scientists saying the blazes have come earlier and with more intensity than usual due to global warming and a prolonged drought.   Police estimated the crowd size at 15,000, organisers put the figure at 20,000.

Many of the protestors voiced anger at the government's silence in the face of the crisis.   "The country is on fire" said 26-year-old Samuel Wilkie attending his first climate protest. He described politicians' response as "pathetic".    "Our government is not doing anything about it," said 29-year-old landscape gardener Zara Zoe. "No one is listening, no one is doing anything."   Prime Minister Scott Morrison -- a staunch backer of Australia's vast coal industry -- has said little about the smoke since the crisis began, preferring to focus on fire-hit rural communities.   Organiser Chloe Rafferty said that had created anger at the conservative government's inaction.   "I think the wider public can see that we are not expecting the climate crisis in the future but we are facing the climate crisis now," she told AFP.   "People are experiencing it in their day-to-day lives."   As well as a rise in people visiting hospitals with smoke-related health symptoms, the number of emergency calls for ambulances spiked 30 percent last week.    "For most people, smoke causes mild symptoms like sore eyes, nose and throat," top health department official Richard Broome said.   "However, people with conditions like asthma, emphysema and angina are at greater risk because the smoke can trigger their symptoms."

Smoke from bushfires is one of the biggest contributors to air pollution in Australia, releasing fine particles that can lodge deep within people's lungs and cause "severe" health impacts over time, according to scientist Mick Meyer from government-funded scientific research agency CSIRO.   "The impact of smoke on people remote from the fires may, on occasion, substantially exceed the direct injury to people within the fire zone," he wrote in The Conversation.   "But we currently lack the operational tools to understand the extent of these impacts or to manage them."   Six people have been killed and more than 700 houses destroyed in bushfires this fire season.   Though the human toll has been far lower than the deadliest fire season in 2009 -- when almost 200 people died -- the scale of this year's devastation has been widely described as unprecedented.   Three million hectares (7.4 million acres) of land has been burnt -- the size of some small countries -- and vast swathes of koala habitat scorched.   Official data shows 2019 is on track to be one of the hottest and driest years on record in Australia.
Date: Tue 3 Dec 2019
Source: Trinidad Express [abridged, edited]

The number of local deaths from the influenza virus has risen to 24. At the Health Ministry's update last week, 16 fatalities were reported from the flu, with Health Minister Terrence Deyalsingh appealing to citizens -- especially those considered at-risk -- to get vaccinated.
Date: Sat 30 Nov 2019
Source: The New Indian Express, Express News Service [edited]

According to official data, 14 swine flu [influenza A/H1N1] deaths across the state were recorded this year [2019] till [17 Nov 2019]. The figure is slightly less than the previous year's [2018] toll of 17. The total number of H1N1 swine flu-positive cases [has] also come down this year [2019] compared with 2018 from 402 to 325. Health officials are setting up isolation wards in hospitals as a preventive measure.

As the winter season has set in and the minimum temperatures are coming down, health officials are instructing the public to take precautions in order to stay away from being infected by swine flu. The health department has initiated steps to set up district-[wide] swine flu testing facilities and isolation wards in every district hospital, area hospital, and community health centre.

As per the requirement of treatment procedure, the government has to set up special isolation wards in all government hospitals and provide protection kits to the healthcare staff, especially to those who will attend to the patients suffering from the flu. Across the state, Visakhapatnam registered the highest number of positive swine flu cases and deaths. Out of 325 positive cases, 180 alone were reported from Visakhapatnam, of which 8 died. West Godavari district registered 3 deaths, and Anantapur, East Godavari, and Srikakulam registered one death case each.

All the district health officials have been instructed to intensify awareness camps and screening centres. As part of the action plan, isolation wards with 5-10 beds are to be set up in every teaching, district, and area hospital. A sufficient stock of drugs, masks, and PPE [personal protective equipment] kits are to be made available. Currently, there are 18 labs eligible for conducting confirmation test in the state. "We are creating awareness by distributing pamphlets and putting up screening centres at bus stops and railway stations," DMHO [district medical and health officer] Dr. TSR Murthy said.

Symptoms of swine flu are generally similar to that of seasonal flu. These include cough, fever, sore throat, stuffiness, runny nose, body aches, headache, chills, fatigue, diarrhoea, and vomiting. Later on, breathlessness, chest pain, drowsiness, low blood pressure, sputum mixed with blood, and bluish discoloration of nails also develops.
Date: Thu 28 Nov 2019
Source: GDN Online [edited]

Two expatriates living in Oman died after contracting the seasonal influenza (H1N1) or swine flu in the governorate of Dhofar -- the 1st in July and the 2nd in August [2019]. They were among 78 confirmed cases of swine flu registered at the Sultan Qaboos Hospital over the first 9 months of 2019 in the governorate.

The hospital authorities reported a total of 599 registered suspected cases of H1N1 between January and last September [2019]. Doctors working at Sultan Qaboos Hospital dealt overall with 1779 cases of respiratory infections during the same period.

Patients most vulnerable to the respiratory viruses are those over 18 years, particularly pregnant women; those suffering from chronic illnesses, kidney and heart diseases, liver problems, diabetes, asthma, blood disorders, and HIV/AIDS; and even health workers, according to Muscat Daily.
Date: Wed 11 Dec 2019
Source: UNICEF/WHO Situation report 11 Dec 2019 [edited]

Highlights
- 5 new human cases reported in the past week
- In response to 1st human vaccine-derived poliovirus type 1 (VDPV1) case from the island province of Basilan, in the Bangsamoro Autonomous Region in Muslim Mindanao (BARMM), outbreak immunization was conducted
in Maluso, Basilan, with bivalent oral polio vaccine (bOPV) against polio type 1, vaccinating 13 547 children under 10 years old (102% of the target).
- Currently 9 human cases confirmed with circulating VDPV type 2 (cVDPV2), 1 case with VDPV1, 1 case with cVDPV1, and 1 case with immunodeficiency-related VDPV type 2 (iVDPV2).
- A case with VDPV1 from Sultan Kudarat is pending genetic analysis; 1 case of cVDPV1 from Malaysia was confirmed as genetically linked to the Basilan case.
- Synchronized polio vaccination campaign conducted on [25 Nov 2019 - 10 Dec 2019] (including 2 days of extension) vaccinated 4 309 566 children under 5, which is 98% of the target total of 4.4 million children under 5. A total of 1 395 365 children under 5 were vaccinated in National Capital Region (NCR), which is 109% of the target, and 2 914 201 (94%) in Mindanao.
- DOH planning to conduct outbreak immunization with bOPV targeting 710,296 children under 10 in the Sulu Archipelago, Zamboanga City, and Lambayong, Sultan Kudarat, on [6-12 Jan 2020].
- Current polio outbreak resulting from persistently low routine immunization coverage, and poor sanitation and hygiene.
- Philippines is affected by both cVDPV1 and cVDPV2. cVDPV is considered a public health emergency of international concern (PHEIC).

cVDPV1
---------
- In response to the 1st human case confirmed with VDPV1 from Maluso, Basilan (BARMM), outbreak immunization was conducted in the area with bOPV for children under 10 years old, vaccinating 13,547 children under 10 years of age (102% of the target).
- A cVDPV1 case in Sabah state, Malaysia, was confirmed to be genetically linked to the Basilan case by the Victorian Infectious Diseases Reference Laboratory (VIDRL) in Australia. Since the 2 viruses are genetically linked, they are both classified as circulating.
- A new VDPV1 case from Sultan Kudarat (Region XII) was confirmed on [6 Dec 2019] and is pending further genetic analysis.
- All 13 cVDPV1 environmental samples found in Manila are genetically linked.

cVDPV2
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- All 9 human cases and 17 environmental samples confirmed with cVDPV2 are genetically linked. All human cases were reported from Mindanao (BARMM and Region XII), whereas environmental samples were found in NCR and Davao.
- All samples were tested by the National Polio Laboratory at the Research Institute for Tropical Medicine (RITM), whereas sequencing and genetic analysis is done at the NIID in Japan, and additional genetic characterization is provided by the United States Centers for Disease Control and Prevention (CDC).
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[Given the identification of the cVDPV1 case in Malaysia that is genetically related to the VDPV1 case in Basilan, it is now clear there are at least 2 separate cVDPV outbreaks in the Mindinao region of the Philippines: one of the outbreaks is associated with cVDPV2, and the other with cVDPV1 and one outbreak of cVDPV1 in the Manila Metropolitan area (although only environmental samples have been positive without AFP (acute flaccid paralysis) cases as yet.) What all these areas have in common is pockets of populations with suboptimal vaccination coverages. Clearly, we await further information on the genetic profiling of the newly identified VDPV1 case in Sultan Kudarat, also located in southern Philippines. Note that Basilan Island, Sultan Kudarat, and Sabah state in Malaysia, while all in the same general area, are not contiguous, each being on a different island. In. total, there are 11 cases of AFP in the Philippines that are attributable to infection with a VDPV.

A map showing the provinces in the Philippines can be found at

HealthMap/ProMED-mail map of the Philippines: