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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: 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:
Date: Thu, 19 Oct 2017 16:37:27 +0200
By Ricardo ARDUENGO, con Nelson DEL CASTILLO en San Juan y Leila MACOR en Miami

Utuado, Puerto Rico, Oct 19, 2017 (AFP) - It's been a month since Hurricane Maria ripped through Puerto Rico and Samuel de Jesus still can't drive out of his isolated, blacked-out town.   In fact, much of the US territory in the Caribbean is still a crippled mess four weeks after that fierce Category Four storm.

The bridge connecting Rio Abajo to the rest of the island was swept away when Maria slammed the island on September 20. For two weeks Rio Abajo, located in a mountainous region in central-western Puerto Rico, was cut off and forgotten, without power or phone service.   "We didn't know what to do. We were literally going crazy," said de Jesus, 35.   "Those were difficult, desperate days. We could not find a way out, and the hurricane caused extensive damage," he told AFP.

During the two long weeks following Maria, the 27 families living in Rio Abajo saw their supplies quickly deplete.   De Jesus, who has diabetes, needed to keep his insulin refrigerated. The storm blew away the island's already decrepit power grid, so people resorted to emergency generators.   "But I was running out of gasoline to run the generator," he said.   A helicopter now makes regular deliveries of food, water and medicine because with the bridge washed out, there is no other way in or out of town.

People can't wade across the river because it is contaminated with human waste after a pipe broke when the bridge went.   Some brave souls use a precarious ladder rigged to get across the water, but for most people it is too dangerous.   We need a bridge "to take out our vehicles and leave in case of emergency, or if there is a landslide," he said.   Where the bridge once stood, residents set up a system of ropes, pulleys and buckets to move supplies over the river, which has been contaminated with sewer water since the hurricane.   Over the remains of the bridge locals hung the single-star, red, white and blue flag of Puerto Rico and a sign that reads "the campsite of the forgotten."

- Desperate need for electricity -
Puerto Rico Governor Ricardo Rossello visited the surrounding municipality of Utuado on Wednesday to deliver supplies, but he did not stop in Rio Abajo.   "Utuado is certainly one of the most severely affected municipalities in all of Puerto Rico," Rossello said.   "Our commitment is to give it support and aid during the whole road to recovery."   Eighty-one percent of Puerto Rico remains blacked out one month after Maria struck. Clean water for drinking, cooking and bathing is scarce, too.

Puerto Ricans' main obstacle to getting back to some semblance of normality is the slowness of the Puerto Rico Electric Power Authority in getting the power grid back up and running.   The lack of power has paralyzed a key industry -- pharmaceutical production -- and most businesses including restaurants are closed or operating at great cost through the use of diesel powered generators.

This nightmare comes about a year after the US government established an external fiscal control board for the island after it declared bankruptcy because of 73 billion dollars in debt.   Economist Joaquin Villamil told AFP that damage from Hurricane Maria is estimated at 20 billion dollars -- four times that of Hurricane Georges in 1998, when measured in 2016 dollars.

Villamil said reconstruction money provided by the Federal Emergency Management Agency and from insurance companies will have a positive impact on the island's economy in the second half of fiscal 2018 and in fiscal 2019, but this boost will just be temporary.   "From an economic point of view there is not much net gain," said Villamil, who works for a consulting firm called Estudios Tecnicos.   He said the economy has been shrinking since 2006 and Maria will delay any prospect of recovery.   It will take at least until 2026 to get back to the GDP level of 2006, he added.

Making things worse, people are leaving the island for the mainland US. Forecasts are that the population now at 3.4 million will go down to 3.1 million or even less by 2026, said Villamil.   The government of Florida estimates that since October 3 -- the day a state of emergency to deal with an influx of Puerto Ricans was declared -- more than 36,000 people from the island have poured in.
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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 ...

Tuvalu

Tuvalu US Consular Information Sheet
December 17, 2008
COUNTRY DESCRIPTION:
Tuvalu is a South Pacific island nation consisting of four reef islands and five atolls.
A self governing member of the British Commonwealth, Tuvalu has a par
iamentary system of government.
Read the Department of State Background Notes on Tuvalu for additional information.

ENTRY/EXIT REQUIREMENTS:
A passport, onward/return ticket, and proof of sufficient funds for the stay in Tuvalu are required.
Visitor permits valid for up to three months are issued upon arrival.
For further information about entry requirements, travelers may wish to contact the Tuvalu Permanent Mission to the United Nations in New York, Suite 400 B, 800 2nd Avenue, NY 10017, tel.: (212) 490-0534, fax: (212) 808-4975.
This is particularly true for those persons planning to enter by sea.

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

SAFETY AND SECURITY:
Americans in Tuvalu requiring immediate emergency assistance should call the 24-hour police command center in Tuvalu at (688) 20726.

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:
Tuvalu has a low crime rate.
However, visitors should not be complacent regarding personal safety or the protection of valuables.

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 may 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 and dental care is very limited in Tuvalu, including in the capital, Funafuti.
Serious medical problems are referred to Guam or Hawaii.
Serious medical conditions requiring hospitalization and/or medical evacuation to the United States can cost thousands of dollars.
Doctors and hospitals often expect immediate cash payment for health services.

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.

HIV/AIDS restrictions:
The U.S. Department of State is unaware of any HIV/AIDS entry restrictions for visitors to or foreign residents of Tuvalu.

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 Tuvalu is provided for general reference only, and may not be totally accurate in a particular location or circumstance.

Traffic moves on the left in Tuvalu.
The main roads on Funafuti have been paved, but roads on these tiny islands are generally unpaved.
Animals and unwary pedestrians walking in the road make night driving on unlit secondary roads hazardous.
For specific information concerning Tuvalu driving permits, vehicle inspection, road tax and mandatory insurance, contact the Tuvalu Permanent Mission to the United Nations in New York.

Please refer to our Road Safety page for more information.
Visit the website of the country’s national tourist office and national authority responsible for road safety.

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

SPECIAL CIRCUMSTANCES:
In Tuvalu, the Australian dollar is the legal currency.
Traveler’s checks and all major currencies are accepted by banks and may also be exchanged for local currency at some local hotels.
Although Visa and MasterCard are accepted at most hotels, connectivity problems often make credit card payments impossible.
Travelers should be prepared to pay cash for hotel bills.
Tuvalu’s customs authorities may enforce strict regulations concerning temporary importation into or export from Tuvalu of items such as agricultural products.
It is advisable to contact the Office of the Tuvalu Permanent Representative in New York, for specific information regarding customs requirements.
U.S. citizens are encouraged to carry a copy of their U.S. passports with them at all times, so that, if questioned by local officials, proofs of identity and U.S. citizenship are readily available.
If detained, U.S. citizens are encouraged to request that a consular officer at the U.S. Embassy in Suva, Fiji, be notified.

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 Tuvalu’s laws, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession or, use of, or trafficking in illegal drugs in Tuvalu 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:
There is no U.S. Embassy or diplomatic post in Tuvalu.
The U.S. Embassy in Fiji provides assistance for U.S. citizens in Tuvalu.
Americans living or traveling in Tuvalu are encouraged to register with the U.S. Embassy in Suva through the State Department’s travel registration web site so that they can obtain updated information on travel and security within Tuvalu.
Americans without Internet access may register directly with the U.S. Embassy in Suva, Fiji.
The U.S. Embassy in Fiji is located at 31 Loftus Street in the capital city of Suva.
The telephone number is (679) 331-4466; the fax number is (679) 330-2267.
Information may also be obtained by visiting the Embassy’s home page at http://samoa.usembassy.gov.
By registering, American citizens make it easier for the Embassy or Consulate to contact them in case of emergency.
*

*

*
This replaces the Consular Information Sheet dated June 16, 2008, to update Medical Facilities and Health Information, and Special Circumstances.

Travel News Headlines WORLD NEWS

Date: Fri, 9 Feb 2018 11:06:04 +0100

Wellington, Feb 9, 2018 (AFP) - The Pacific nation of Tuvalu -- long seen as a prime candidate to disappear as climate change forces up sea levels -- is actually growing in size, new research shows.   A University of Auckland study examined changes in the geography of Tuvalu's nine atolls and 101 reef islands between 1971 and 2014, using aerial photographs and satellite imagery.   It found eight of the atolls and almost three-quarters of the islands grew during the study period, lifting Tuvalu's total land area by 2.9 percent, even though sea levels in the country rose at twice the global average.

Co-author Paul Kench said the research, published Friday in the journal Nature Communications, challenged the assumption that low-lying island nations would be swamped as the sea rose.   "We tend to think of Pacific atolls as static landforms that will simply be inundated as sea levels rise, but there is growing evidence these islands are geologically dynamic and are constantly changing," he said.   "The study findings may seem counter-intuitive, given that (the) sea level has been rising in the region over the past half century, but the dominant mode of change over that time on Tuvalu has been expansion, not erosion."   It found factors such as wave patterns and sediment dumped by storms could offset the erosion caused by rising water levels.

The Auckland team says climate change remains one of the major threats to low-lying island nations.   But it argues the study should prompt a rethink on how such countries respond to the problem.   Rather than accepting their homes are doomed and looking to migrate to countries such as Australia and New Zealand, the researchers say they should start planning for a long-term future.   "On the basis of this research we project a markedly different trajectory for Tuvalu's islands over the next century than is commonly envisaged," Kench said.   "While we recognise that habitability rests on a number of factors, loss of land is unlikely to be a factor in forcing depopulation of Tuvalu."

The study's authors said island nations needed to find creative solutions to adapt to climate change that take into account their homeland's evolving geography.   Suggestions included moving populations onto larger islands and atolls, which have proved the most stable and likely to grow as seas rise.   "Embracing such new adaptation pathways will present considerable national scale challenges to planning, development goals and land tenure systems," they said.   "However, as the data on island change shows there is time (decades) to confront these challenges."
Date: Mon 3 Oct 2011
Source: Central News Agency (CNA) report [edited]

The Ministry of Foreign Affairs (MOFA) [of Taiwan] issued a yellow travel alert for Tuvalu Monday 3 Oct 2011, after suspected cases of cholera were reported in the Pacific island nation. The alert, the 2nd-least serious in the MOFA's 4-color travel advisory system, warns travelers there to heighten vigilance over their personal safety and advises would-be visitors to have 2nd thoughts about their travel plans.

The MOFA noted that Tuvalu is suffering from a drought and has declared a state of emergency due to a severe shortage of fresh water. Anyone traveling in Tuvalu should be on guard and should pay close attention to hygiene conditions, the MOFA said.  [Byline: Emmanelle Tzeng, Lilian Wu]
====================
[The Tuvalu Islands are located in the Western Pacific and have had no reported cases of cholera since the early 1990s based on the Weekly Epidemiologic Report (WER) of WHO. In WER, Tuvalu had 27 cases in 1990 and 293 cases in 1992.

The current severe drought involving the islands causes the small population to seek alternative sources of water, which are more likely to be less safe. - ProMed Mod.LL]

[A HealthMap/ProMED-mail interactive map showing the location of Tuvalu can be seen at
<http://healthmap.org/r/1j9Q>. - ProMed Sr.Tech.Ed.MJ]
Date: Mon, 3 Oct 2011 08:49:22 +0200 (METDST)

Wellington, Oct 3, 2011 (AFP) - The tiny Pacific nation of Tuvalu has declared a state of emergency due to severe water shortages, prompting New Zealand to airlift in fresh supplies, officials in Wellington said Monday. New Zealand Foreign Minister Murray McCully said an air force transport plane carrying containers of water and two desalination units arrived in Tuvalu on Monday.

"Tuvalu has declared a state of emergency relating to water shortages in the capital, Funafuti, and a number of outer islands," McCully said in a statement. He said New Zealand officials were working with aid agencies including the Red Cross to ease the crisis in Tuvalu, one of the world's smallest independent nations with about 10,500 residents.

A Red Cross situation report released last week said the former British colony relied mostly on rainwater, which had been scarce this year because of a La Nina weather pattern across the Pacific. La Nina causes extreme weather, including both drought and floods, and was blamed for deluges in Australia, Southeast Asia and South America over late 2010 and early 2011.
Date: Fri, 7 Nov 2008 09:32:32 +0100 (MET)
 
SYDNEY, Nov 7, 2008 (AFP) - A strong earthquake with a magnitude of 6.4 struck off the south Pacific island of Vanuatu on Friday, but there was no immediate tsunami warning or reports of casualties, seismologists said.   The quake struck at 6:19 pm (0719 GMT), 320 kilometres (195 miles) north of the capital Port Vila, the US Geological Survey said.   The quake was registered at a depth of 35 kilometres.   Two aftershocks with magnitudes of 5.4 and 5.3 struck roughly the same spot in the next half-hour.   The Pacific Tsunami Warning Centre in Hawaii did not issue a tsunami alert for the region.   Vanuatu sits on the so-called Pacific Rim of Fire, where the meeting of continental plates causes high volcanic and seismic activity.
Date: Wed, 5 Nov 2008 00:41:09 +0100 (MET)
 
SYDNEY, Nov 4, 2008 (AFP) - A 6.3-magnitude earthquake struck off the south Pacific island of Vanuatu on Wednesday, seismologists said, but there were no immediate reports of casualties or damage.   No tsunami warning was issued after the undersea temblor that the US Geological Survey said struck at 5:35 am (1825 GMT) 75 kilometres (47 miles) north of the capital city of Port Vila.   The USGS initially reported the magnitude of the quake at 5.9, but later upgraded the reading.   Police in Port Vila said no damage or injuries were reported as a result of the earthquake.
More ...

Aruba

Aruba US Consular Information Sheet
April 02, 2008
COUNTRY DESCRIPTION:
Aruba is an autonomous part of the Kingdom of the Netherlands. Tourist facilities are widely available. Read the Department of State Background Notes on Aruba for addi
ional information.

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

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

In addition visitors to Aruba may be asked to show onward/return tickets, proof of sufficient funds and proof of lodging accommodations for their stay. Length of stay for U.S. citizens is granted for thirty days and may be extended to 180 days by the office of immigration.
For further information, travelers may contact the Royal Netherlands Embassy, 4200 Linnean Avenue NW, Washington, DC
20008, telephone (202) 244-5300, or the Dutch Consulate in Los Angeles, Chicago, New York, Houston or Miami.
Visit the web site for the Embassy of the Netherlands at http://www.netherlands-embassy.org and the Aruban Department of Immigration at http://www.aruba.com/about/entryrequirements.php for the most current visa information.

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

SAFETY AND SECURITY: There are no known extremist groups, areas of instability or organized crime on Aruba, although drug trafficking rings do operate on the island.
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 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: The crime threat in Aruba is generally considered low although travelers should always take normal precautions when in unfamiliar surroundings.
There have been incidents of theft from hotel rooms and armed robberies have been known to occur. Valuables left unattended on beaches, in cars and in hotel lobbies are easy targets for theft.
Car theft, especially that of rental vehicles for joy riding and stripping, can occur. Vehicle leases or rentals may not be fully covered by local insurance when a vehicle is stolen or damaged.
Be sure you are sufficiently insured when renting vehicles and jet skis.

Parents of young travelers should be aware that the legal drinking age of 18 is not always rigorously enforced in Aruba, so extra parental supervision may be appropriate. Young female travelers in particular are urged to take the same precautions they would when going out in the United States, e.g. to travel in pairs or in groups if they choose frequenting Aruba’s nightclubs and bars, and if they opt to consume alcohol, to do so responsibly.

Anyone who is a victim of a crime should make a report to Aruban police as well as report it immediately to the nearest U.S. consular office.
Do not rely on hotel/restaurant/tour company management to make the report for you.

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

Please see our information for American Victims of Crime Overseas.

MEDICAL FACILITIES AND HEALTH INFORMATION: Medical care is good in Aruba. There is one hospital, Dr. H.E. Oduber Hospital, whose medical standards can be compared with an average small hospital in the U.S. The hospital has three classes of services and patients are accommodated according to the level of their insurance (i.e. first class: one patient to a room, TV, better food; second class: two to three patients to a room, shared bathroom, etc; third class: 15 to 20 people in one hall). There is a small medical center in San Nicolas. The many drug stores, or “boticas” provide prescription and over the counter medicine. Emergency services are usually quick to respond.
There are no country-specific health concerns.

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

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

Driving in Aruba is on the right-hand side of the road. Local laws require drivers and passengers to wear seat belts and motorcyclists to wear helmets. Children under 5 years of age should be in a child safety seat; older children should ride in the back seat. Right turns on red are prohibited in Aruba.

Aruba's main thoroughfare, L.G. Smith Boulevard, is well lit and most hotels and tourist attractions can be easily located.
There is a speed limit in Aruba and driving while intoxicated may result in the loss of a driver’s license and/or a fine.
However, these are not consistently enforced.
Drivers should be alert at all times for speeding cars, which have caused fatal accidents.
In the interior areas of the island, drivers should be alert for herds of goats or donkeys that may cross the roads unexpectedly.
Buses provide convenient and inexpensive service to and from many hotels and downtown shopping areas.
Taxis, while expensive, are safe and well regulated.
As there are no meters, passengers should verify the price before entering the taxi.
The emergency service telephone number is 911. Police and ambulance tend to respond quickly to emergency situations.

Please refer to our Road Safety page for more information. Also, travelers may wish to visit the web site of the country’s national tourist office and national authority responsible for road safety in Aruba for information: http://www.aruba.com/pages/traffictips.htm.

AVIATION SAFETY OVERSIGHT: The U.S. Federal Aviation Administration (FAA) has assessed the Government of Aruba’s Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for oversight of Aruba’s air carrier operations. For more information, travelers may visit the FAA web site at http://www.faa.gov/safety/programs_initiatives/oversight/iasa.
SPECIAL CIRCUMSTANCES: The time-share industry and other real estate investments are two of the fastest-growing tourist industries in Aruba. Time-share buyers are cautioned about contracts that do not have a "non-disturbance or perpetuity protective clause" incorporated in the purchase agreement.
Such a clause gives the time-share owner perpetuity of ownership should the facility be sold.
Americans have also sometimes complained that the time-share units are not adequately maintained, despite generally high annual maintenance fees.

Potential investors should be aware that failed land development schemes involving time-share investments could result in financial losses. Interested investors may wish to seek professional advice regarding investments involving land development projects. Real estate investment problems that reach local courts are rarely settled in favor of foreign investors.

An unusually competitive fee to rent jet skis or other water sports equipment could indicate that the dealer is unlicensed or uninsured. Visitors planning to rent jet skis or other water sports equipment should carefully review all liability and insurance forms presented to them before signing any contracts or agreements. The renter is often fully responsible for replacement costs and fees associated with any damages that occur during the rental period. Visitors may be required to pay these fees in full before being allowed to leave Aruba, and may be subject to civil or criminal penalties if they cannot or will not make payment.

Dutch law in principle does not permit dual nationality. However, there are several exceptions to the rule. For example, American citizens who are married to Dutch citizens are exempt from the requirement to abandon their American nationality when they apply to become a Dutch citizen by naturalization. For detailed information, contact the Embassy of the Netherlands in Washington, DC, or one of the Dutch consulates in the U.S.
Please see our information on customs regulations.

CRIMINAL PENALTIES: While in a foreign country, a U.S. citizen is subject to that country's laws and regulations, which sometimes differ significantly from those in the United States and may not afford the protections available to the individual under U.S. law.
Penalties for breaking the law can be more severe than in the United States for similar offenses.
Persons violating Aruba’s laws, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in Aruba 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 on international adoption of children and international parental child abduction, see the Office of Children’s Issues web pages.
REGISTRATION / EMBASSY LOCATION: Americans living or traveling in Aruba 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 Aruba. 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. Consulate General is located at J.B. Gorsiraweg 1, Willemstad, Curaçao, telephone number (599-9) 461-3066; fax (599-9) 461-6489; e-mail address: acscuracao@state.gov
* * *
This replaces the Consular Information Sheet dated January 3, 2008, to update Entry/Exit Requirements and Crime sections.

Travel News Headlines WORLD NEWS

Date: Sat, 20 Jun 2009 10:52:09 +0200 (METDST)

MADRID, June 20, 2009 (AFP) - A Spanish cruise ship was turned away from three Caribbean islands after swine flu cases emerged among the crew and the 800-odd passengers finally got off in Aruba, the tour operator said Saturday.   The "Ocean Dream" docked in Aruba late Friday after being denied entry in Grenada, Saint Lucia and Barbados, Pullmantur said. Three swine flu cases were reported among the crew but the passengers were unaffected.

On Thursday, 376 Venezuelan passengers were allowed to disembark on the island of Margarita, which belongs to Venezuela.   The ship's nine-day cruise through the Caribbean was hampered by the flu outbreak and the ship could not dock at three destinations on the itinerary.   The A(H1N1) virus has infected more than 44,000 people around the world, resulting in 180 deaths since late March, WHO figures show.
Date: Wed 14 Jan 2009
Source: Amigoe.com [Dutch, machine trans., edited]

Department of Health has called an urgent press conference on Tuesday [13 Jan 2009] to issue a dengue update. The department has done this following the hundreds of calls that have come into Health, after media reports of a 53-year-old woman who died of dengue [virus infection].

According to Trevor Gellecum, Director of Health, it is still not clear that this woman indeed died of dengue. "First, certain tests can be carried out, and it will be 3 weeks before the results could be known," says Van Gellecum. "These tests should be carried out in a laboratory abroad."

According to Wilmer Salazar, microbiologist at Health, the woman had a fever at the weekend, but on Monday [12 Jan 2009] she felt better and she went to work. "Later that day, she was admitted to the hospital in shock. At night she died, "said Salazar. "Until now, there is no confirmed diagnosis of the cause of death, but dengue is suspected. Today [14 Jan 2009], an autopsy was performed so that the tests to be done abroad can take place."

Maribel Tromp, manager at the department of epidemiology and research of the Infectious Disease Service, has indicated that so far 612 suspected cases of dengue have been registered. "Of these, 218 cases [have been] confirmed as positive by the laboratory, and 394 are still under investigation, reports Tromp. "This does not mean that they are negative" [The dates over which these cases occurred are not specified. - ProMed Mod.TY].

 From the moment the news of a potentially fatal dengue victim arose lately, Charline Koolma, director of the Yellow Fever Fight Unit (GKMB), indicated that they have been overwhelmed with calls from people reporting family members possibly with dengue-like symptoms or who want information about the disease. "It is good that we now receive phone calls, although it also had previously been possible. These kinds of extreme cases can be avoided," according Koolman.

"From November last year [2008], the GKMB made several visits to monitor presence of [the dengue virus vector mosquito _Aedes_] breeding sites and adult mosquitoes. Often, the residents are not home, and then a letter was left with an invitation to make contact with the GKMB for the transmission of important information. But there is never a return call until something bad happens, and then it is often too late."

The more information and reports the GKMB gets, the better the service and their work, said Tromp. Finally, all speakers [at the press conference] called on the population and general practitioners to join forces against breeding of the _Aedes_ dengue vector mosquito. Health officials indicated that is the only way to avoid [virus] infection and prevent dengue.
------------------------
[A map showing the location of Aruba in the Caribbean can be accessed at <http://www.aruba-travelguide.com/map/index.html>. - ProMed Mod.TY]
Date: Sun, 2 Sep 2007 19:04:55 +0200 (METDST) MIAMI, Sept 2, 2007 (AFP) - Hurricane Felix barreled through the Caribban Sunday, with forecasters predicting a brush with Aruba and warning of its potential to strengthen into a devastating storm. Forecasters issued a tropical storm warning and hurricane watch for the islands of Aruba, Bonaire and Curacao -- popular tourist destinations in the Netherlands Antilles. A tropical storm watch also has been issued for Jamaica, which was gearing up for violence-marred elections Monday, after Felix was upgraded overnight to Category Two strength on the Saffir-Sampson scale, which peaks at five. At around 1500 GMT Felix's maximum sustained winds were 105 miles (165 kilometers) per hour, and its trek across the open waters of the Caribbean could allow it to attain "major hurricane" status, US forecasters said. "I see no reason why Felix will not become a major hurricane within 12 hours or so," said Richard Pasch, a hurricane specialist with the National Oceanographic and Atmospheric Administration. On Saturday, a weaker Felix passed close to Grenada, reportedly ripping roofs, downing power lines and knocking radio and TV stations off the air. No injuries were reported. The center of the hurricane around 1600 GMT Sunday was about 50 miles (75 kilometers) north of Aruba and about 550 miles (900 kilometers) southeast of Kingston, Jamaica. Felix was moving in a west-northwesterly direction at around 18 miles (30 kilometers) per hour, and was expected to follow the same course throughout Sunday. The storm was not expected to hit Jamaica directly, but its strong outer squalls could rock the island ahead of the elections on Monday. Jamaican officials had already postponed the general election from August 27, after the island was struck last month by Hurricane Dean. Last week, Dean swept through the southern Caribbean with severe winds and rains, leaving a wide swathe of damage and a death toll of 30 from Martinique to Mexico. Felix's track was expected to take it toward Belize or the Yucatan in Mexico, possibly making landfall as a major Category Three hurricane Wednesday. The storm could dump two to four inches (five to 10 centimeters) of rain over islands off the Venezuela coast and the Netherlands Antilles, US forecasters said. On its current path Felix is expected to graze the coastlines of Nicaragua and Honduras late Tuesday and make landfall in Belize on Wednesday. Felix is the second hurricane of the three-month-old Atlantic season, and the first in September, historically the busiest month for hurricanes.
Date: Thu, 9 Sep 2004 10:12:08 +0200 (METDST) CARACAS, Sept 9 (AFP) - Hurricane Ivan has killed at least 11 people in Tobago, Grenada and Venezuela as the it churned off Venezuela's coast Thursday, strengthening to the top Category 5 storm, officials and local media said. Ivan was 135 kilometers (85 miles) northeast of Aruba and 915 kilometers (570 miles) from Jamaica, the Miami-based National Hurricane Center said at 0600 GMT. Its category was raised to a Category 5 hurricane -the top level on the Saffir Simpson hurricane scale, with maximum sustained winds near 255 kilometers (160 miles) per hour. "Some fluctuations in strength are likely," the center said. The "extremely dangerous" hurricane was moving west-northwest at 28 kilometers (17 miles) per hour with urricane force winds extend outward from Ivan's eye up to 95 kilometers (60 miles). Storm surges of 1.0-1.5 meters (three to five feet) as well as rains of 13-18 centimeters (seven five to seven inches) are to be expected. The center issued hurricane warnings for Aruba, Bonaire and Curacao. A television station in Trinidad and Tobago said nine people had died in Grenada, a tiny island nation of 90,000 inhabitants, which Prime Minister Keith Mitchell said was 85 percent destroyed. Power lines were down and hundreds of persons have taken refuge in shelters. Mitchell, whose own house was destroyed, told a Trinidad radio station that the island is without electricity. Another woman was killed by a falling tree in Tobago, according to local media. Prime Minister Patrick Manning headed to Tobago to view the destruction. His government has promised 1.6 million dollars to St. Vincent to help with the construction. Hundreds were evacuated to shelters. Cuba has also begun preparing for the storm in 11 of its 14 provinces, although the island has not fully recovered from Hurricane Charley, which struck August 13. Children in the Netherlands Antilles were sent home from school, as were many workers. Several Venezuelan airports, including the oil-exporting country's main international airport, Maiquetia, which serves Caracas, suspended operations until conditions improve, Air Force colonel Francisco Paz Freitas told Union Radio. In Venezuela, a man was crushed to death when hurricane-force winds toppled a wall in a coastal town near Caracas, emergency service officials said, adding that another person was hurt and 150 people were affected by flooding. Along the low-lying Caribbean coast, authorities reported mudslides and road closings just as early rain bands from the storm unleashed the first downpours. The storm was expected to be off the central coast later in the day, triggering heavy rains and rough surf. The capital, Caracas, lies just a bit inland from there, protected somewhat by the El Avila mountain range. Though the storm is not expected to make landfall in Venezuela, Interior and Justice Minister Jesse Chacon was urging calm and said heavy winds and rain associated with the storm could last for 72 hours. Ivan was expected to pass just north of Aruba, Bonaire and Curacao on Friday as the Caribbean islands were under a hurricane warning, which means hurricane winds could hit them within 24 hours or less, the US hurricane center said. A hurricane watch and a tropical storm warning remain in effect for the Guajira peninsula of Colombia and for the entire northern coast of Venezuela, it noted. Haiti also issued a hurricane watch, meaning it could experience hurricane conditions within 36 hours.
Date: Wed, 8 Sep 2004 05:03:07 +0200 (METDST) PORT-OF-SPAIN, Trinidad Sept 7 (AFP) - Ivan, an "extremely dangerous" hurricane Tuesday knocked out power in Barbados and threatened eastern Caribbean islands, forecasters and emergency officials said. The eye of the powerful storm moved over Barbados Tuesday afternoon, and headed for the eastern Caribbean, where officials issued a hurricane warning for St Vincent, the Grenadines, Grenada and the Netherlands Antilles islands of Aruba, Bonaire and Curacao. Ivan packed sustained winds of 215 kilometers (135 miles) per hour, which made it "an extremely dangerous category four hurricane," the Miami-based National Hurricane Center (NHC) said. In Barbados, "there is an island-wide power outage, expect for the major health care facility, the Queen Elizabeth Hospital," the Caribbean Disaster Emergency Response Agency (CDERA) said. "There are also reports of roof loss, downed utility poles and trees," the agency said, adding that there were also reports of coastal damage from storm surge. Late Tuesday night, the center of the powerful hurricane, the second in just days, was located 175 kilometers (110 miles) west of Grenada. The Netherlands Antilles Tuesday morning put the islands of Aruba, Bonaire and Curacao under a hurricane watch, which means the storm could hit them within 36 hours. In central and eastern Venezuela, officials suspended all air and maritime traffic. Long-term forecasts, which have a wide margin of error, have the hurricane slamming into Jamaica on Friday and then into Cuba on Sunday. This would bring the storm dangerously close to Florida, which has just been pounded by Frances, the second hurricane to hit the southeastern US state in three weeks. The Bahamas islands also were severely impacted by the passage of Frances last week.
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Tanzania

General
Nowadays there are few areas of our planet where you can really experience the timeless wonder and separation from the hum drum we face in our daily lives. Visiting Africa is fascinating and provides a new perspective on another life, another
world. The vast, untamed and primitive landscape provides a perfect glimpse into a life which many miss as they go about their daily chores. A trip which includes the majestic splendour of Africa’s tallest peak, Mt Kilimanjaro, rates high on the list of the unofficial wonders of the world and one not to be missed if the opportunity arises.
Mt Kilimanjaro
This is the highest peak in all of Africa stretching 5895m above sea level. Actually a few years ago the height of the summit was reassessed and then dropped by approximately 10m with more accurate recording by global positioning satellite. However, this minimal change will not be noticed by most travellers! There are a number of routes up to the summit and obviously which route is taken will make a significant difference to both the difficulty of the trek and any potential medical difficulties. Travelling with sufficient and well experienced guides and porters, and being part of a well organised group, are probably the most important factors in protecting your health.
Travelling to Tanzania
Mt Kilimanjaro is situated just across the border from Kenya in the northern part of Tanzania. You can approach the region by a number of different routes including buses from Nairobi, travelling from Dar es Salaam or flights straight into Moshi. How you travel for your climb of Kilimanjaro makes quite a significant difference to some of the health issues which you may face along the way.
General Health Issues
Before you leave for your trip make sure you are in good enough general health. If you can’t even run up a flight of stairs without collapsing then a trip up Kilimanjaro might not be the best choice! If you are unsure then see your doctor and ask for his or her advice at an early stage - before you commit yourself to the trip.
Long-Haul Flights
Flying to either Nairobi or Dar es Salaam takes between 9 to 10 hours from most Western European centres. This is regarded as a ‘long-haul flight’ so make sure you realise the risks associated with blood clotting in the legs and drink plenty of still fluids (water is the best), walk around the plane and use compression stockings if you are at any particular risk. (DVT in travel - TMB)
Food & Water
In Africa, as in many other areas of the world, what you eat and what you drink are essential for your well being. Being part of a large group has its advantages but you also need to stick with food and water that suits you personally. Don’t take extra risks with what you eat or drink just because others seem to be okay. Have your own sensible rules and remember to care for your stomach! Dehydration is common while climbing in a hot climate just make sure the water you drink is pure. You will also lose salt through perspiration and this will need to be replaced by increasing the amount of salt you put on your food at meal times.
What shoes to wear
Remember this is a walking holiday so prepare well in advance. Obviously increase your walking at home before you leave but remember to also include some significant hill walks to test your shoes. Blisters and corns are regularly associated with poorly fitted and substandard boots so spend that extra to get a pair that suits you and supports both the arch of your foot and also your ankles. A slightly larger pair is essential to lessen the pressure on your feet. Good thick socks will help to absorb perspiration and cushion your feet against friction.
Clothes to bring
This is one of the most difficult areas to sort out. The weather and climate along your climb will vary from a beautiful Irish-like summer day, to a roasting hot, dehydrating scorcher to a chilly or freezing night when the sun retires after about 6 pm. You must pack light cotton clothing but warm enough for the chill of the evenings at altitude. A wide brimmed hat (and sun lotion) is essential to protect against sun burn.
Problems at Altitude
High altitude is defined as over approx 3500m and as you know Kilimanjaro is a whole lot higher. The affects of altitude can hit anybody but most commonly it is the fit younger traveller who experiences the most serious consequences and even death. The doctor who discusses your vaccines and malaria prophylaxis will talk through the issues relating to Altitude sickness and may prescribe a medication to lessen the risks in certain circumstances. But remember, this disease can kill so if you develop any possible symptoms (lightheadedness, headaches, altered gait etc) please report it to your guide immediately. (Altitude sickness - TMB)

Being part of a group
The main advantage of being part of a group is that each member can help look-out for others during the trip. Never get separated from your main party and always report it if you feel one of your group is not quite right medically. This may be the first signs of altitude sickness and you could quite literally save a life by your intervention.
Mosquitoes and Malaria
Mosquitoes do not tend to live above 2000m and so the risk of malaria while climbing Kilimanjaro does not occur. However, you have to get to that altitude first and so protection against mosquito bites and malaria prophylaxis will be essential for this trip. (Malaria protection - TMB)
Rabies Risks in Tanzania
Any warm blooded animal can transmit rabies and so it is extremely important that you avoid any contact with dogs, cats, monkeys, and other animals on the slopes of Mt Kilimanjaro such as hyrats and other beaver like creatures. Report any contact immediately to your group leader.
Vaccinations for visiting Tanzania
As you travel to Tanzania from Western Europe we normally recommend that you have a number of vaccinations to cover against a range of diseases. In certain patients it may also be worth considering further vaccination cover against conditions like Rabies and Hepatitis B. These should be talked through in detail with your vaccinating doctor.
After your visit
When you return home you must remember that certain diseases can present days, weeks or even months afterwards. If you develop any peculiar symptoms (fever, headache, diarrhoea, skin rash etc) please make contact so this can be urgently assessed.
In the vast majority of cases the traveller climbing Kilimanjaro will stay perfectly healthy and well providing they follow the main common sense rules. Have a great safe trip and enjoy some of the splendours that Africa has to provide.

Travel News Headlines WORLD NEWS

Date: Thu 29 May 2019 Source: XinHuaNet [edited] <http://www.xinhuanet.com/english/2019-05/30/c_138100702.htm>
Cholera has killed one and left 32 others hospitalized in Tanzania's commercial capital, Dar es Salaam, Tanzanian health minister Ummy Mwalimu said on Wed 28 May 2019. "The outbreak of the disease has been caused by failure to abide by hygienic regulations," the minister said.
She directed all municipal councils in the commercial capital to enact by-laws that impose stern punishment to people who empty cesspool tanks in the open when it rains. Instructions have been given to municipal council authorities to mete out stern punishment to anybody disposing sewage in their compounds, Mwalimu said.
Dar es Salaam chief medical officer Yudas Ndungile said most cholera patients came from Mchikichini, in Kariakoo, and places hardly reached by sewage vehicles, and that efforts should be put in place to reach those areas. ========================
[With the start of the rainy season in this area of East Africa, the number of cases of cholera will rise. The mortality from cholera and most diarrheal illnesses is related to non-replacement of fluid and electrolytes from the diarrheal illness.
As stated by Lutwick and colleagues (Lutwick LI, Preis J, Choi P. Cholera. In: Chronic illness and disability: the pediatric gastrointestinal tract. Greydanus DE, Atay O, Merrick J, editors. New York: Nova Bioscience; 2018:113-127), oral rehydration therapy can be life-saving in outbreaks of cholera and other forms of diarrhea:
"As reviewed by Richard Guerrant et al. (1), it was in 1831 that cholera treatment could be accomplished by intravenous replacement, and, although this therapy could produce dramatic improvements, not until 1960 was it 1st recognized that there was no true destruction of the intestinal mucosa, and gastrointestinal rehydration therapy could be effective, and the therapy could dramatically reduce the intravenous needs for rehydration. Indeed, that this rehydration could be just as effective given orally as through an orogastric tube (for example, refs 2 and 3) made it possible for oral rehydration therapy (ORT) to be used in rural remote areas and truly impact the morbidity and mortality of cholera. Indeed, Guerrant et al. (1) highlight the use of oral glucose-salt packets in war-torn Bangladeshi refugees, which reduced the mortality rate from 30% to 3.6% (4) and quotes sources referring to ORT as "potentially the most important medical advance" of the 20th century. A variety of formulations of ORT exist, generally glucose or rice powder-based, which contain a variety of micronutrients, especially zinc (5).
"The assessment of the degree of volume loss in those with diarrhoea to approximate volume and fluid losses can be found in ref 6 below. Those with severe hypovolemia should be initially rehydrated intravenously with a fluid bolus of normal saline or Ringer's lactate solution of 20-30 mL/kg followed by 100 mL/kg in the 1st 4 hours and 100 mL/kg over the next 18 hours with regular reassessment. Those with lesser degrees of hypovolemia can be rehydrated orally with a glucose or rice-derived formula with up to 4 L [4.2 qt] in the 1st 4 hours, and those with no hypovolemia can be given ORT after each liquid stool with frequent re-evaluation."
Date: Fri, 17 May 2019 11:42:01 +0200

Nairobi, May 17, 2019 (AFP) - Flooding in Tanzania has killed five people and forced about 2,500 to flee their homes after a week of torrential rain in the country's south, an official said Friday.   Schools have closed in Kyela, a district on the border of Lake Malawi, and families fled to shelters after losing everything in the rising waters.   "The damage from these floods is enormous," Salome Magambo, the district's administrative secretary, told AFP.   "Since the beginning of the week we have reported five people killed and 2,570 homeless, some of whom are staying with friends or in schools and churches."

Food and medical services have been extended to those stranded, she added.   Farming land in the district known for its rice production has also been inundated, destroying crops and raising fears of food shortages in coming months.   In April 2018 at least 14 people were killed in torrential rains and flooding in Dar es Salaam, Tanzania's economic capital.
12th May 2019

Tanzania - National.
23 Apr 2019. The AP (4/11) reports that Tanzanian Deputy Health Minister Faustine Ndugulile announced on Thursday [18 Apr 2019?] that 252 people have been hospitalized in the country's commercial capital Dar es Salaam, and 55 others have been admitted to health facilities in the Tanga region along the coast in an outbreak of the mosquito-borne dengue fever. <https://apnews.com/48f68a56a3b244918fac6b1da25d9e56n>.
Tanzania - National. 11 Apr 2019

Tanzania on Thursday [11 Apr 2019] confirmed an outbreak of dengue fever, saying the business capital, Dar es Salaam, has reported 252 cases and Tanga has 55 diagnosed cases.
Date: 8 Mar 2019
Source: The Citizen [edited]

The government has said that anthrax has been contained in Arusha, Kilimanjaro and Manyara regions, where 3 people died. The director of Livestock Services in the Ministry of Livestock & Fisheries, Dr Hezron Nonga, told reporters that meat from Longido and Moshie butcheries was safe.

Some 28 livestock head and 169 wildlife head were infected in Arusha and Kilimanjaro. "There have been quarantines in slaughterhouses where anthrax has been reported. Any transport of livestock that has not been inspected is prohibited. So, I can guarantee that it is safe to eat meat from all inspected slaughterhouses," he said.

According to Dr Nonga, 18 cattle, 4 goats, 6 sheep, and 196 wild animals have died of anthrax between July 2018 and February this year [2019] in Kilimanjaro and Arusha. The regions have more than 2.5 million cattle, 2.5 million goats, and over 2 million sheep. He said the government in collaboration with stakeholders have provided 100,000 doses of vaccine. Longido Municipality has received 35,000 doses, Moshie 40,000, and Rombo 25,000.  [byline Mussa Juma]
======================
[So far so good, and Dr. Nonga and his team are to be congratulated. And once vaccination this season is done, they must plan for coordinated regional vaccination ahead of next year's (2020) anthrax season, and in the year after. - ProMED Mod.MHJ]

[HealthMap/ProMED map available at:
Kilimanjaro, Tanzania: <http://healthmap.org/promed/p/34109>]
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World Travel News Headlines

Date: Tue, 16 Jul 2019 10:44:51 +0200

Zagreb, July 16, 2019 (AFP) - Some 10,000 tourists were evacuated from a popular party beach on a Croatian island after a forest fire erupted early Tuesday, police said.

Police ordered visitors to night clubs on Zrce beach on the northern island of Pag to leave after the blaze erupted in a pine forest at around 1:00 am (2300 GMT Monday), a police statement said.   No one was injured in the fire which was brought under control, the mayor of the nearby town of Novalja, Ante Dabo, told national radio.  The cause was not immediately known.   Three firefighting planes were rushed to the scene to help extinguish the blaze which spread to a local road that had to be closed.

The island of Pag and its Zrce beach are popular with young tourists, notably British, who party there.  Tourism is a pillar of Croatia's economy, with visitors flocking to hundreds of islands and islets along its stunning Adriatic coast.   Last year the country of 4.2 million people welcomed more than 19 million tourists.
Date: Mon, 15 Jul 2019 01:09:24 +0200

Kinshasa, July 14, 2019 (AFP) - The first case of Ebola has been confirmed in Goma, now the biggest city to have been affected by the disease since its outbreak in eastern DR Congo last August, the health ministry said on Sunday.  A sick man had arrived in Goma early Sunday by bus with 18 other passengers and the driver from Butembo, one of the main towns touched by Ebola in Nord-Kivu province.

The man was tested  "and the results of the laboratory test confirmed that he was positive for Ebola," the ministry said in a statement.   It added that his trip began on Friday after "the first symptoms appeared on July 9 (Tuesday)".   "Given that the patient was quickly identified, as well as all the passengers on the bus from Butembo, the risk of the disease spreading in the city of Goma is low," the ministry said.    The passengers and the bus driver will begin getting vaccinations on Monday, it added.

The Ebola outbreak in eastern Democratic Republic of Congo has so far killed 1,655 people and 694 have been cured, according to a health ministry bulletin on Saturday.  And 160,239 people have been vaccinated, it added.  But efforts to tackle the crisis have been hampered both by militia attacks on treatment centres, in which some staff have been killed, and by the hostility of some local people to the medical teams.
Date: Sun, 14 Jul 2019 13:37:24 +0200

Pamplona, Spain, July 14, 2019 (AFP) - Three men were gored Sunday during the eighth and final bull run of Spain's San Fermin festival, bringing to eight the total number of daredevils injured during this year's fiesta.   Among those who were hospitalised this year after being injured by a bull's horns was an American who was wounded in the neck while taking a selfie.    In the last run, two Australians aged 27 and 30 as well as well as a 25-year-old Spaniard from Madrid were gored by the half-tonne fighting bull, "Rabonero", regional health authorities said.

The three men suffered injuries to the armpit, arm and leg from the bull's horns. Another two men were taken to hospital with bruises.   During Sunday's run in the northern city of Pamplona, Rabonero, the heaviest of the six bulls used in the event, became separated from the pack moments into the run and began charging people in its way.   Isolated bulls are more likely to get disoriented and start charging at people.

The bulls from the Miura ranch in the southwestern province of Seville completed the 848.6-metre (928-yard) course from a holding pen to the city bull ring in two minutes and 45 seconds.   Each morning from July 7 to 14, hundreds of daredevils, many wearing traditional white shirts with red scarves tied around their necks, tested their bravery by running ahead of a pack of bulls through the course set up in the narrow, winding streets of the medieval city.

- Like getting hit by a truck -
The bulls face almost certain death in afternoon bullfights, and earlier this month animal rights activists staged a "die-in" protest in the streets of the city to protest the tradition.   At the end of the festival's first run, a bull ran over and sunk one of its horns deep in the neck of a 46-year-old  American from San Francisco, Jaime Alvarez, narrowly missing key arteries.    He was injured as he was trying to take a video-selfie with his mobile phone.   "It was like a truck or car just hitting me in the side of the head. I put my hand on my neck and I saw blood," he told US television from a Pamplona hospital.   His wife had asked him not to take part in the bull run, he added.    He was released from hospital two days later.

Another 23-year-old American from Kentucky and 40-year-old Spaniard were also gored that day.   In addition to the eight men who were gored, another 27 people were taken to hospital for broken bones and bruises suffered during the bull runs.   About 500 more people were treated at the scene for more minor injuries, according to the Red Cross.   The festival dates back to medieval times and was immortalised in Nobel Prize-winning author Ernest Hemingway's 1926 novel "The Sun Also Rises".   It claims scores of casualties every year although last year just two men were gored.

Although the runs are over, the festival's closing ceremony takes place at midnight Sunday.   People from around the world flock to the city of 200,000 residents to test their bravery and enjoy the festival's mix of round-the-clock parties, religious processions and concerts.   Sixteen people have been killed in the bull runs since records started in 1911.   The last death was in 2009 when a bull gored a 27-year-old Spaniard in the neck, heart and lungs.
Date: Sun, 14 Jul 2019 12:47:38 +0200

Labuha, Indonesia, July 14, 2019 (AFP) - A major 7.3-magnitude earthquake hit the remote Maluku islands in eastern Indonesia Sunday, sending panicked residents running into the streets, but no tsunami warning was issued.   The shallow quake struck about 165 kilometres (100 miles) south-southwest of the town of Ternate in North Maluku province at 6:28 pm (0928 GMT), according to the US Geological Survey.
 
"The earthquake was quite strong, sending residents to flee outside. They are panicking and many are now waiting on the roadside," said local disaster mitigation official Mansur, who like many Indonesians goes by one name.   Officials were assessing the situation but there were no immediate reports of casualties, he told AFP.

In the town of Labuha, one of the closest to the epicentre, panicked residents took to motorcycles in a bid to flee to higher ground, according to an AFP photographer in town when the earthquake hit.   Local disaster official Ihsan Subur told Metro TV that no damage or casualties had been reported there so far, but residents took to the streets and many evacuated to higher ground.   "Electricity went of during the earthquake, but now it's back to normal," ubur said, adding that at least seven big aftershocks were felt after the initial quake.

The province was also hit by a 6.9-magnitude tremor last week.   Indonesia experiences frequent seismic and volcanic activity due to its position on the Pacific "Ring of Fire", where tectonic plates collide.   Last year, a 7.5-magnitude quake and a subsequent tsunami in Palu on Sulawesi island killed more than 2,200 people, with another thousand declared missing.   On December 26, 2004, a devastating 9.1-magnitude earthquake struck off the coast of Sumatra and triggered a tsunami that killed 220,000 across the Indian Ocean region, including around 170,000 in Indonesia.
Date: Sun, 14 Jul 2019 09:02:36 +0200

Sydney, July 14, 2019 (AFP) - A strong 6.6-magnitude earthquake struck off northwest Australia Sunday, shaking buildings over a wide area but causing no immediate reports of damage or injuries.   The shallow quake hit early Sunday afternoon 10 kilometres under the Indian Ocean 203 kilometres (126 miles) west of the West Australian beach resort of Broome, the US Geological Survey said. No tsunami alert was issued.   Sergeant Neil Gordon of the Broome police department said the quake rattled the city for more than a minute.   "The building here was shaking for about a minute and a half ... a steady shaking for that period of time," he told AFP by telephone.   He added that there had been "no reports of any injuries or any damage throughout the district," following the tremor.   The national broadcaster ABC said there were some reports of minor damage from the quake, and no injuries.   Australian media said the tremor was felt across a long stretch of the northwestern coast of Australia, from the West Australian capital of Perth and the mining centres of Karatha and Port Hedland to the south and as far as Darwin to the north.

Thursday 11th July 2019
https://www.who.int/csr/don/11-july-2019-ebola-drc/en/

The outbreak of Ebola virus disease (EVD) in North Kivu and Ituri provinces, Democratic Republic of the Congo continues this past week with a similar transmission intensity to the previous week. While the number of new cases continues to ease in former hotspots, such as Butembo, Katwa and Mandima health zones, there has been an increase in cases in Beni, and a high incidence of cases continues in parts of Mabalako Health Zone. In addition to these re-emerging hotspots, there are a large number of people with confirmed and probable infections moving to other health zones, with the greatest number coming from Beni Health Zone. The movement of cases causes the outbreak to spread to new health zones and re-emerge in health zones with previously controlled infections. Overall, this underscores the importance of robust mechanisms for listing and following up contacts and understanding the motivations for peoples’ decisions to move.

After the first reported case in the Ariwara Health Zone on 30 June, no new cases have been observed in that health zone. A response team deployed to that zone continues to identify contacts, engage the community, and vaccinate individuals at risk. Response personnel from the bordering countries of Uganda and South Sudan continue to support operational readiness activities. Resources are being dedicated to monitoring the Uganda-Democratic Republic of the Congo border in that area.

In the 21 days from 19 June through 9 July 2019, 72 health areas within 22 health zones reported new cases, representing 11% of the 664 health areas within North Kivu and Ituri provinces (Figure 2). During this period, a total of 247 confirmed cases were reported, the majority of which were from the health zones of Beni (41%, n=101), Mabalako (19%, n=48), Lubero (6%, n=16), and Mandima (5%, n=13). As of 09 July 2019, a total of 2437 EVD cases, including 2343 confirmed and 94 probable cases, were reported (Table 1). A total of 1646 deaths were reported (overall case fatality ratio 68%), including 1552 deaths among confirmed cases. Of the 2437 confirmed and probable cases with known age and sex, 57% (1384) were female, and 29% (704) were children aged less than 18 years.

Cases continue to increase among health workers, with the cumulative number infected rising to 132 (5% of total cases). Of the 128 health workers with information available, the greatest proportion is among health workers at health posts [poste de santé] (20%, n = 26) and private health facilities (35%, n = 45). The majority (68%, n = 87) of health worker infections were among nurses.

No new EVD cases or deaths have been reported in the Republic of Uganda since the previous EVD Disease Outbreak News publication on 13 June 2019. As of 3 July, 108 contacts exposed to those cases were identified, and they all completed the 21-day follow-up period. All contacts were asymptomatic. Arua district, located in the north-western part of Uganda near the Uganda-Democratic Republic of the Congo border, is currently stepping up its response readiness to prevent imported cases of Ebola following the case that died on 30 June 2019 in Ariwara Health Zone in neighbouring Democratic Republic of the Congo, located 8 kilometres from the Uganda border. This case is known to have over 200 contacts, some of whom are in the communities bordering the Arua district. As of 9 July 2019, two suspected cases in the Arua district were reported and both tested negative. As of 9 July 2019, the cumulative number of individuals vaccinated in Arua district is 811 out of 1092 targeted front line and healthcare workers.

More information here: https://www.who.int/csr/don/11-july-2019-ebola-drc/en/

Date: Sat, 13 Jul 2019 10:41:55 +0200

Kuala Lumpur, July 13, 2019 (AFP) - Flash floods killed a Dutch tourist in a popular cave located in the rugged Mulu National Park on Malaysia's Borneo island, an official said Saturday, as a search continues for a missing guide.    Local fire and rescue chief Law Poh Kiong identified the dead man as 66-year-old Peter Hans Hovenkamp from Utrecht in the central Netherlands.     "He died due to drowning following flash floods in the caves. His body was found in a river inside the cave and was taken to the Miri public hospital for a post-mortem on Saturday," he told AFP.   Law said a search-and-rescue operation involving 16 officers had been launched to locate 20-year local tour guide Roviezal Robin.   Eight other tourists in the same group "almost become victims" but fled to higher ground and escaped from being washed into the river, Law added.

Hovenkamp was reported missing on Friday while the group was touring the popular "Deer Cave", home to an estimated three million bats which form amazing patterns in the sky when they leave each dusk.   Mulu park, located in the remote Borneo jungle of Sarawak state and famous for its caves, cliffs and gorges, is a UNESCO world heritage site.   It sees thousands of visitors annually, particularly for its cooling rains during the summer months.    Law described the death as "a freak tragedy."
Date: Sat, 13 Jul 2019 09:52:36 +0200

Kathmandu, July 13, 2019 (AFP) - Floods and landslides triggered by torrential monsoon rains have killed at least 40 people across South Asia in the last two days, officials said Saturday.   The monsoon, which lasts from June to September, causes widespread death and destruction across South Asia each year.   In Nepal, 27 people have died in floods and landslides after heavy rains hit the country's eastern region and the southern plains.

Bishwaraj Pokharel, spokesperson for Nepal Police, added that another 11 people were injured and 15 others reported missing.    Three of the victims were killed when a wall collapsed in the capital Kathmandu.   "Our first priority is life saving rescue and all our resources have been deployed," Home Ministry official Umakanta Adhikari told AFP.

Police used boats to bring people to safety as rivers swelled, inundating their settlements, while parents were seen wading across chest-high waters carrying children on their shoulders.    Nepal's weather department issued a high alert for the southern Sapta Koshi river on Saturday and sent SMS warnings to people in the area.

In neighbouring India 11 deaths have been recorded in the north-eastern states of Assam and Arunachal Pradesh, officials said Friday.  Monsoon floods have inundated 21 districts in Assam, affecting thousands, officials said Friday.

In Bangladesh aid groups were providing rations to Rohingya refugees in the southeast of the country with the UN World Food Programme saying Friday that two people including a child had died.   Last year, more than 1,200 people were been killed across South Asia in monsoon storms with India's Kerala suffering its worst floods in nearly 100 years.
Date: Fri, 12 Jul 2019 16:00:57 +0200

Chennai, India, July 12, 2019 (AFP) - A special 50-wagon train carrying 2.5 million litres of water arrived in the Indian city of Chennai Friday, as the southern hub reels under one of its worst shortages in decades.    The wagons were hauled by a special locomotive, decorated with flowers and with a "Drinking Water for Chennai" banner on its front.   Four special trains a day have been called up to bring water to Chennai -- India's sixth most populous city -- from Vellore, some 80 miles (125 kilometres) away, to help battle the drought.    The first consignment will be taken to a water treatment centre, and then distributed in trucks to different parts of the metropolis on Saturday.   Chennai has seen only a fraction of the rain it usually receives during June and July.   The city of 4.9 million people also needed trains to bring water in when it suffered a similar crisis in 2001.

The bustling capital of Tamil Nadu state normally requires at least 825 million litres of water a day, but authorities are currently only able to supply 60 percent of that.   With temperatures regularly hitting 40 degrees Celsius (104 Fahrenheit), reservoirs have run dry and other water sources are dwindling further each day.   The Chennai metro has turned off its air conditioning, farmers have been forced to stop watering their crops, and offices have asked staff to work from home.   The city's economy has also taken a hit as some hotels and restaurants shut shop temporarily, and there have been reports of fights breaking out as people queue for water. 
Date: Fri, 12 Jul 2019 11:42:26 +0200

Sydney, July 12, 2019 (AFP) - A looming ban on climbing Australia's Uluru rock, intended to protect the sacred site from damage, has instead triggered a damaging influx of visitors, tourism operators said Friday.    Clambering up the giant red monolith, also known as Ayers Rock, will be prohibited from October -- in line with the wishes of the traditional Aboriginal owners of the land, the Anangu.   But a rush to beat the ban has led to a sharp increase in tourists and is causing its own problems for the World Heritage Uluru-Kata Tjuta National Park.   Families arriving in campers vans and RVs are a particular problem, chief executive of Tourism Central Australia Stephen Schwer told AFP.   "We have got so much of one particular market coming, we don't have enough infrastructure to handle the number of drive travellers."

While most visitors are doing the right thing, camping venues in the area are at capacity with advance bookings, leaving many less organised arrivals to set up illegally.   "People don't realise when they go off the road they are actually trespassing on pastoral land, or Aboriginal land, or protected land," Schwer said.   "We are getting people that are leaving their rubbish behind and lighting fires," he added.   "Sadly, people are also emptying their toilet waste out of their vans on what they think is unpopulated land, but is actually private land."   In the 12 months to June 2019, more than 395,000 people visited the Uluru-Kata National Park, according to Parks Australia, about 20 percent more than the previous year.   Yet just 13 percent of those who visited also climbed the rock, the government agency said.    Tourism operators say that Australian and Japanese tourists most commonly seek to climb Uluru.

The Aboriginal connection to the site dates back tens of thousands of years and it has great spiritual and cultural significance to them.   "Since the hand back of Uluru and Kata Tjuta to traditional owners in 1985, visitors have been encouraged to develop an understanding and respect for Anangu and their culture," a spokesperson for Parks Australia said.     "This is reflected in the 'please don't climb' message," they added.   Lyndee Severin from Curtin Springs station and roadhouse, one of just a few camping venues within 100 kilometres of Uluru, said "the vast majority of people are doing the right thing" but hundreds were setting up illegally by the side of the road or down a bush track.   "So we have some people that think that the rules don't apply to them," she told AFP.