WORLD NEWS

Getting countries ...
Select countries and read reports below or

Andorra

General
************************************
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
**************
*********************
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
***************************************
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
************************************
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
************************************
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
************************************
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
************************************
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]
=====================
[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]
More ...

Puerto Rico

No Profile is available at present

Travel News Headlines WORLD NEWS

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

"These diseases are everywhere, and there's a way to prevent them," she said.
=====================
[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:
More ...

Lithuania

Lithuania US Consular Information Sheet
May 19, 2008
COUNTRY DESCRIPTION:
Lithuania is a stable democracy undergoing rapid economic growth. Tourist facilities in Vilnius, the capital, and to a lesser extent in Kaunas and Klaipeda, are simi
ar to those available in other European cities. In other parts of the country, however, some of the goods and services taken for granted in other countries may not be available. Read the Department of State Background Notes on Lithuania for additional information.
ENTRY/EXIT REQUIREMENTS: A valid passport is required to enter Lithuania. As there are no direct flights from the U.S. to Lithuania, U.S. citizens should be aware of passport validity requirements in transit countries. American citizens do not need a visa to travel to Lithuania for business or pleasure for up to 90 days. That 90-day period begins with entry to any of the “Schengen Group” countries: Austria, Belgium, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Iceland, Italy, Latvia, Lithuania, Luxembourg, Malta, the Netherlands, Norway, Poland, Portugal, Slovakia, Spain, and Sweden. Multiple visits to Schengen countries may not exceed 90 days in any 6 month period. Travelers remaining in Lithuania for more than 90 days within any six-month period must apply for temporary residency.

Lithuanian authorities recommend applying or a residency permit through a Lithuanian embassy or consulate before initial entry into Lithuania, as processing times can run beyond 90 days. All foreigners of non-European Union countries seeking entry into Lithuania must carry proof of a medical insurance policy contracted for payment of all costs of hospitalization and medical treatment in Lithuania. Visitors unable to demonstrate sufficient proof of medical insurance must purchase short-term insurance at the border from a Lithuanian provider for roughly $1.00 per day. The number of days will be calculated from the day of entry until the date on the return ticket. Children residing in Lithuania must have written permission to travel outside the country from at least one parent if their parents are not accompanying them on their trip. This policy is not applicable to temporary visitors. See our Foreign Entry Requirements brochure for more information on Lithuania and other countries. Visit the Embassy of Lithuania web site at www.ltembassyus.org for the most current visa information.
Note: Although European Union regulations require that non-EU visitors obtain a stamp in their passport upon initial entry to a Schengen country, many borders are not staffed with officers carrying out this function. If an American citizen wishes to ensure that his or her entry is properly documented, it may be necessary to request a stamp at an official point of entry. Under local law, travelers without a stamp in their passport may be questioned and asked to document the length of their stay in Schengen countries at the time of departure or at any other point during their visit, and could face possible fines or other repercussions if unable to do so.
Information about dual nationality or the prevention of international child abduction can be found on our web site. For further information abut customs regulations, please read our Customs Information sheet.
SAFETY AND SECURITY: Civil unrest is not a problem in Lithuania, and there have been no incidents of terrorism directed toward American interests. Incidents of anti-Americanism are rare.

For the latest security information, Americans traveling abroad should regularly monitor the Department of State, Bureau of Consular Affairs’ web site, where the current Travel Warnings and Travel Alerts, including the Worldwide Caution, can be found.
Up-to-date information on safety and security can also be obtained by calling 1-888-407-4747 toll free in the U.S., or for callers outside the U.S. and Canada, a regular toll-line at 1-202-501-4444. These numbers are available from 8:00 a.m. to 8:00 p.m. Eastern Time, Monday through Friday (except U.S. federal holidays).
The Department of State urges American citizens to take responsibility for their own personal security while traveling overseas. For general information about appropriate measures travelers can take to protect themselves in an overseas environment, see the Department of State’s pamphlet A Safe Trip Abroad.
CRIME: Lithuania is a relatively safe country. Visitors should maintain the same personal security awareness that they would in any metropolitan U.S. city. Large amounts of cash and expensive jewelry should be secured in a hotel safe or left at home. Crimes against foreigners, while usually non-violent, do occur. Pickpocketing and thefts are problems, so personal belongings should be well protected at all times. Theft from cars and car thefts occur regularly. Drivers should be wary of persons indicating they should pull over or that something is wrong with their car. Often, a second car or person is following, and when the driver of the targeted car gets out to see if there is a problem the person who has been following will either steal the driver’s belongings from the vehicle or get in and drive off with the car. Drivers should never get out of the car to check for damage without first turning off the ignition and taking the keys. Valuables should not be left in plain sight in parked vehicles, as there have been increasing reports of car windows smashed and items stolen. If possible, American citizens should avoid walking alone at night. ATMs should be avoided after dark. In any public area, one should always be alert to being surrounded by two or more people at once. Additionally, criminals have a penchant for taking advantage of drunken pedestrians. Americans have reported being robbed and/or scammed while intoxicated.
Following a trend that has spread across Eastern and Central Europe, racially motivated verbal, and sometimes physical, harassment of foreigners of non-Caucasian ethnicity has been reported in major cities. Incidents of racially motivated attacks against American citizens have been reported in Klaipeda and Vilnius.
In many countries around the world, counterfeit and pirated goods are widely available. Transactions involving such products may be illegal under local law. In addition, bringing them back to the United States may result in forfeitures and/or fines. More information on these serious problems is available at http://www.cybercrime.gov/18usc2320.htm.
INFORMATION FOR VICTIMS OF CRIME: The loss or theft abroad of a U.S. passport should be reported immediately to the local police and the nearest U.S. Embassy or Consulate. If you are the victim of a crime while overseas, in addition to reporting to local police, please contact the nearest U.S. Embassy or Consulate for assistance. The Embassy/Consulate staff can, for example, assist you to find appropriate medical care, contact family members or friends and explain how funds could be transferred. Although the investigation and prosecution of the crime is solely the responsibility of local authorities, consular officers can help you to understand the local criminal justice process and to find an attorney if needed. For more information about assistance for victims of crime in Lithuania, please visit the Embassy’s web site at http://vilnius.usembassy.gov/service/crime-victim-assistance.html.
See our information on Victims of Crime.
MEDICAL FACILITIES AND HEALTH INFORMATION: Medical care in Lithuania has improved in the last 15 years, but medical facilities do not always meet Western standards. There are a few private clinics with medical supplies and services that nearly equal Western European or U.S. standards. Most medical supplies are now widely available, including disposable needles, anesthetics, antibiotics and other pharmaceuticals. However, hospitals and clinics still suffer from a lack of equipment and resources. Lithuania has highly trained medical professionals, some of whom speak English, but their availability is decreasing as they leave for employment opportunities abroad. Depending on his or her condition, a patient may not receive an appointment with a specialist for several weeks. Western-quality dental care can be obtained in major cities. Elderly travelers who require medical care may face difficulties. Most pharmaceuticals sold in Lithuania are from Europe; travelers will not necessarily find the same brands that they use in the United States. Serious medical problems requiring hospitalization and/or medical evacuation can cost thousands of dollars or more. Doctors and hospitals often expect immediate cash payment for health services, particularly if immigration status in Lithuania is unclear.

Tick-borne encephalitis and lyme disease are widespread throughout the country. Those intending to visit parks or forested areas in Lithuania are urged to speak with their health care practitioners about immunization. Rabies is also increasingly prevalent in rural areas.
The Lithuanian Government does not require HIV testing for U.S. citizens. However, sexually transmitted diseases are a growing public health problem.
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. All foreigners of non-European Union countries seeking entry into Lithuania must carry proof of a medical insurance policy contracted for payment of all costs of hospitalization and medical treatment in Lithuania (please see entry/exit requirements above). 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 Lithuania is provided for general reference only, and may not be totally accurate in a particular location or circumstance.
The Police allow Americans to drive in Lithuania with an American driver’s license for up to 90 days. Americans who reside in Lithuania for 185 days or more in one calendar year and who wish to continue driving in Lithuania must acquire a Lithuanian driver's license. The foreign license must be given to the Lithuanian Road Police to be processed by the Consular Department of the Lithuanian Ministry of Foreign Affairs, which in turn sends it to the U.S. Embassy’s Consular Section, where the owner is expected to claim it.
Roads in Lithuania range from well-maintained two- to four-lane highways connecting major cities to small dirt roads traversing the countryside. Violation of traffic rules is common. It is not unusual to be overtaken by other automobiles, traveling at high speed, even in crowded urban areas. Driving at night, especially in the countryside, can be particularly hazardous. In summer, older seasonal vehicles and inexperienced drivers are extra hazards. Driving with caution is urged at all times. Driving while intoxicated is a very serious offense and carries heavy penalties. The speed limit is 50 km/hr in town and 90 km/hr out of town unless otherwise indicated. The phone number for roadside assistance is 8-800-01414 from a regular phone and 1414 from a GSM mobile phone.
Seatbelts are mandatory for the driver and all passengers except children under the age of 12. During the winter, most major roads are cleared of snow. Winter or all-season tires are required from November 10th through April 1st. Studded tires are not allowed from April 10th through October 31st. Drivers must have at least their low beam lights on at all times while driving. Public transportation is generally safe.
Please refer to our Road Safety page for more information. Visit the website of the country’s national tourist office and national authority responsible for road safety at www.tourism.lt and at www.lra.lt/index_en.html.
AVIATION SAFETY OVERSIGHT: As there is no direct commercial air service to the United States by carriers registered in Lithuania, the U.S. Federal Aviation Administration (FAA) has not assessed Lithuania’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 www.faa.gov/safety/programs_initiatives/oversight/iasa.
SPECIAL CIRCUMSTANCES: Lithuanian customs authorities may enforce strict regulations concerning the temporary importation into or export from Lithuania of items such as firearms and antiquities. Please see our Customs Information.
Telephone connections are generally good. American 1-800 numbers can be accessed from Lithuania but not on a toll-free basis; the international long distance rate per minute will be charged. Local Internet cafes offer computer access. ATMs are widely available. Most hotels and other businesses accept major credit cards.
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 Lithuanian laws, even unknowingly, may be expelled, arrested or imprisoned. Penalties for possession, use, or trafficking in illegal drugs in Lithuania are severe, and convicted offenders can expect long jail sentences and heavy fines. Engaging in sexual conduct with children or possessing or disseminating child pornography in a foreign country is a crime prosecutable in the United States. For more information about arrest procedures in Lithuania, please visit the Embassy’s web site at http://vilnius.usembassy.gov/arrests.html. 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 page.
REGISTRATION / EMBASSY LOCATION: Americans living or traveling in Lithuania 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 Lithuania. Americans without Internet access may register directly with the nearest U.S. Embassy or Consulate. By registering, American citizens make it easier for the Embassy or Consulate to contact them in case of emergency. The U.S. Embassy is located at Akmenu Gatve 6, tel. (370) (5) 266-5500 or 266-5600; fax (370) (5) 266-5590. Consular information can also be found on the Embassy Vilnius web site at http://vilnius.usembassy.gov/.
* * *
This replaces the Consular Information Sheet dated November 5, 2007 to update sections on Crime and Medical Facilities and Health Information.

Travel News Headlines WORLD NEWS

Date: Wed 7 Aug 2019 01:17:58 EEST
Source: Xinhua News Agency [edited]

The rate of tick-borne encephalitis in Lithuania remains the highest in Europe, announced the country's Center for Communicable Diseases and AIDS (ULAC) on [Tue 6 Aug 2019].

According to ULAC, the rate of tick-borne encephalitis cases was 16.6 cases per 100 000 population in 2017, based on the latest data provided by the European Center for Disease Prevention and Control (ECDC) in its latest annual epidemiological report.  "In Lithuania the rate of encephalitis remains the highest in Europe," said ULAC.

Lithuania was followed by the Czech Republic and Estonia with the rate of 6.4 cases per 100 000 population, according to ULAC.  ULAC notes the largest proportion of tick-borne encephalitis cases is at the age group of 45-64 years and the lowest among the children of the age of 0-4 years.  "ULAC medics remind vaccination is the most reliable protection from tick-borne encephalitis," said ULAC in the announcement, noting vaccines have a reliability rate of 98 percent.

ULAC's warning comes amid increasing number of tick-borne encephalitis cases this year [2019] in Lithuania, a Baltic country with a population of around 3 million.  More than 90 cases of tick-borne encephalitis were reported during the 1st half of the year [2019] in Lithuania, 1/3 more compared to the same period last year [2018], according to local data by ULAC.

According to the ECDC's report, the highest prevalence of tick-borne encephalitis historically is found in the Baltic countries. Tick-borne encephalitis usually reaches its seasonal peak during the warmest months -- July and August.

Tick-borne encephalitis is a human viral infectious disease of central nervous system caused by infected ticks, usually found in woodland habitats. The disease manifests itself with symptoms similar to fever, fatigue, headache, nausea, and can cause meningitis.
=====================
[Cases of tick-borne encephalitis (TBE) have been reported before (see ProMED mail archive Tick-borne encephalitis - EU (Czech Rep., Latvia, Lithuania) http://promedmail.org/post/20040624.1677). Given the high rate of TBE cases in Lithuania reported above, there doubtless have been cases occurring there annually in recent years.

A report in Eurosurveillance Weekly in 2004 stated, "Tick-borne encephalitis (TBE) is endemic in virtually all countries in Central and Eastern Europe. It is caused by several closely related but distinct flaviviruses. 3 subtypes are recognised at present: a Far-Eastern subtype, a Siberian subtype and a European subtype. The Siberian subtype is associated with Russian spring-summer encephalitis and is transmitted predominantly by the tick _Ixodes persulcatus_, whereas the European subtype causes central European encephalitis and is transmitted by _Ixodes ricinus_.

The clinical spectrum of acute TBE ranges from symptoms of mild meningitis to severe meningoencephalitis with or without myelitis. The incubation period of central European TBE is 7-14 days. Onset is generally biphasic. The 1st phase involves a non-specific influenza-like illness with fever, headache, nausea, and vomiting, lasting about a week. After a period of remission lasting a few days, the fever returns with aseptic meningitis or encephalomyelitis. The case fatality rate is 1-5 percent and about 20 percent of survivors have neurological sequelae. Residual motor defects are rare." - ProMED Mod.TY]

[HealthMap/ProMED-mail map of Lithuania:
Date: Wed, 3 Jul 2019 15:49:43 +0200

Vilnius, July 3, 2019 (AFP) - Lithuania declared an emergency on Wednesday as a severe drought hit the Baltic EU state, threatening to slash this year's harvest by up to half.   Apart from jeopardising crops, scant rainfall has also drastically reduced water levels in some rivers, threatening fish stocks and shipping activities.

The formal declaration of an "emergency situation" will allow the government to compensate farmers for some losses as well as help them to avoid EU financial sanctions should they fail to reach production goals.   "Farmers believe their harvest can be slashed by 40 percent or 50 percent, while fish stocks are also endangered," environment minister Kestutis Mazeika told AFP.

Mazeika said "nobody has any doubt" that global climate change is behind the prolonged and more intensive dry spells and heatwaves in recent years.   He also appealed to neighbouring Belarus to increase the water level in the Neris river by allowing more water to flow from its reservoirs.   Last month was the hottest June ever recorded with soaring temperatures worldwide capped off by a record-breaking heatwave across Western Europe, satellite data showed Tuesday.   Lithuania also registered its hottest-ever June, with a peak of 35.7 degrees Celsius (96.2 degrees Fahrenheit) recorded on June 12.

Over the last week, firefighters have fought wildfires triggered by the heat in peat bogs in western Lithuania and neighbouring Latvia.   Elsewhere in Central Europe, Polish authorities said this week that varying degrees of drought have put grain crops at risk in 14 of the EU country's 16 regional districts.   The Czech Academy of Sciences said it expects drought to affect the entire country, with 80 percent of the territory facing "exceptional to extreme drought".
Date: Thu, 13 Jun 2019 15:12:32 +0200

Vilnius, June 13, 2019 (AFP) - Lithuanian temperatures have hit record June highs, meteorologists said Thursday, as a heatwave forced school closures and threatened to reduce harvests in the draught-hit Baltic region.   Kaisiadorys in central Lithuania was the hottest place at 35.7 degrees Celsius (96.2 degrees Fahrenheit) on Wednesday, the highest-ever temperature recorded for June in the country, weather forecaster Paulius Starkus told AFP.   Six people drowned in the Baltic EU state on Wednesday, the deadliest day of the year to date, while some schools put classes on hold or cut lessons short due to the heatwave.

Scientists say the extreme weather is in part a result of climate change.   "Lithuania used to have heatwaves but now they occur more often and are more intense due to climate change," Vilnius University climatologist Donatas Valiukas told AFP.   Starkus said a downpour with thunder and hail could follow in some areas on Thursday afternoon.   Agriculture Minister Giedrius Surplys told lawmakers that some areas were experiencing "a real climatic draught" threatening harvests, while hydrologists warned that river water levels posed a threat to fish.   Demand for air-conditioning has also soared in recent weeks.   Lithuania's hot weather is expected to last through the week, then temperatures may ease below 30 degrees Celsius starting Monday.   Fellow Baltic state Latvia is also experiencing unusual heat for June, with temperatures over 32 degrees Celsius.

In recent days, Latvia's western region of Kurzeme saw thunderstorms with hail damaging buildings, smashing greenhouses and tearing power lines.   Two people have been hospitalised in the northern Latvian town of Cesis after a tree fell on their camper van while they were inside.    Fellow Baltic state Estonia had a heatwave last week and is now experiencing rainy and windy weather.   Poland has also been experiencing high temperatures this month, which has resulted in increased air-conditioner use. The power transmission system operator PSE said that on Wednesday there was record electricity demand for a summer morning at nearly 24.10 gigawatts (GW).   Forty-two people have already drowned in Poland this month, according to the government security centre RCB.
Date: Sat 30 Mar 2019
Source: PM News Nigeria [abridged, edited]

Measles in Lithuania is up to 310 cases this year [2019] compared to 30 cases for 2018 in total. The number of measles cases is projected to increase further in Lithuania, as people have lost their collective immunity to this highly contagious viral disease, Director of Lithuania's Centre for Communicable Diseases and AIDS (ULAC), Saulius Caplinskas, said on Fri [29 Mar 2019].  "The collective immunity has been lost, as a 95 per cent measles vaccination coverage rate is considered as minimum to prevent an outbreak. There are new suspected cases of measles; blood samples are being examined. I have no doubt that in the nearest future, there will be new cases,'' Caplinskas was quoted as saying by local news website lrt.lt.

Recent data from ULAC shows that the proportion of children vaccinated against measles in the country has decreased from 97 per cent in 2009 to 92.2 per cent in 2018 due to parents' reluctance to vaccinate their kids.  According to ULAC, every year, some 5000 children are not vaccinated in Lithuania. "Measles outbreaks feature certain upswings and descents, yet we will have to live under the threat of measles for a while,'' Caplinskas said.

In total, 310 cases of measles have been registered as of Fri [29 Mar 2019] in Lithuania this year [2019], compared to 30 cases for the whole of 2018, ULAC data showed.  The largest number of cases, 149, was registered in Kaunas, Lithuania's 2nd largest city. In Vilnius, the capital, 39 measles cases have been registered to date. Measles is a highly contagious, serious disease caused by a virus, says the World Health Organization.
Date: Thu, 11 Oct 2018 13:38:41 +0200

Vilnius, Oct 11, 2018 (AFP) - Lithuania's parliament on Thursday passed a law that will allow doctors to prescribe marijuana-based medicine in the Baltic EU state.   The lawmakers voted 90-0 with three abstentions in favour of the legislation that will now go to President Dalia Grybauskaite to be signed into law.   "It is a historic decision to ensure that patients can receive the best possible treatment," said lawmaker Mykolas Majauskas who tabled the bill.

Other European countries have legalised cannabis for medical purposes including Austria, Britain, Croatia, Finland, France, Germany, Greece and Italy among them.   "Of course, it does not mean cannabis will be available to get at a drugstore to smoke before going to a nightclub," Majauskas said.   The law will come into force in May next year. Selling the drugs will require a licence from the state regulator.    Recreational use of marijuana remains illegal in Lithuania, a Baltic state of 2.8 million people.
More ...

Australia

Travelling to Australia
===========================
Introduction
********************************************
Travelling to Australia for business or pleasure can be a most memorable experience and each year many Europeans travel this
route to experience something of life ‘down-under’. Staying healthy and well is essential if you want to enjoy your trip to its fullest extent. Australia is a huge continent and the climatic conditions vary considerably throughout. The main southern cities have a temperate climate similar to North West Europe, Perth enjoys a Mediterranean climate while Queensland and the Northern Territories have a sub-tropical weather pattern.
Preparation
********************************************
It is important that all travellers are in good general health before undertaking any long-haul trip. Patients who tire easily on light exercise or who have a significant underlying medical condition will need to take extra care. If you are concerned about this aspect of your proposed trip arrange for a meeting with a doctor at an early stage in your preparations.
Long Haul Flights
********************************************
On these long flights you will be travelling across many time zones. You will lose or gain hours depending on the direction of your flight. Your body will take time to adjust to the new time zone and so it is important to allow this to occur naturally. If you arrive during the daylight hours try to stay out in the sun for a period of time as this will help your body release a hormone which counteracts jet lag. (Watch you don’t get sun burnt!) Don’t plan to be too energetic during the first day or two after you arrive. Be sensible. If this is a business trip try not to make any major decisions over the first 24 hours. Even the relatively short flight from South East Asia down to Australia crosses time zones and again it will be important to allow your body to settle.
Stop-Overs in SE Asia
********************************************
Frequently travellers will stop-over in Singapore, Bali, Hong Kong or Bangkok on their way to or from Australia. During these short stops it is essential that travellers take all possible precautions to ensure that they rest and are careful about what they eat or drink as contaminated food or water is more common in some of these regions.

Mosquito protection in SE Asia
********************************************
Mosquito borne diseases are present depending on the location (Malaria, Dengue Fever, Japanese B Encephalitis etc) One of particular concern is Dengue Fever, which is a viral disease transmitted by the bite of an infected mosquito. These mosquitoes tend to bite during the day time. This is in contrast to the mosquitoes which transmit malaria which mainly bite at night. Many of the main tourist destinations throughout SE Asia are malaria free and so tablets to protect against the disease are not usually required. Those going off the usual routes will need to talk this through in depth before leaving.
Road Traffic Accidents
********************************************
Frequently, cars are purchased by tourists to Australia for the duration of their stay. Often the cost is low and the maintenance and safety of the vehicle may be somewhat questionable! Long monotonous driving associated with a lack of concentration can cause serious accidents. Car breakdown in the middle of ‘nowhere’ may lead to the risk of dehydration and potential animal attack (kangaroo, dingos, snakes etc). Make sure you always have sufficient food and water and some means of communication (fully charged mobile phone) before leaving to travel across the continent. Make sure other responsible friends or relations back home know of your intended route and inform them of any changes. Get contact numbers for essential services for your journey.

Health Concerns in Australia
********************************************
Many travellers feel that Australia is the same as at home in Europe and so little care with personal health needs be taken. This is not always the case as there are many local health variations throughout the country which should be considered.
Sun Exposure
********************************************
The northern European skin is usually unaccustomed to intensity of the sun exposure experienced in many parts of Australia. Unfortunately this regularly leads to sun burn among tourists but, more seriously, it also significantly increases the risk of potentially fatal skin cancers. Always use plenty of adequate sun block, cover exposed areas of your body where possible (especially by wearing a wide brimmed hat) and drink plenty of water. (You may also need to replace salt lost through increased perspiration ~ assuming no underlying blood pressure problem)
Northern Australia
********************************************
As mentioned previously, the northern parts of Australia are sub-tropical and mosquito borne diseases are more common. Malaria transmission does not occur and many of the diseases transmitted by mosquitoes or other insects cause mild discomfort. Unfortunately some are which are much more severe and can cause long term difficulties.
Ross River Fever
This viral disease is transmitted by mosquitoes and causes a severe arthritic type condition. The disease is often short lived but in some patients the disease may continue to cause arthritis for months and even years. There is no specific treatment and travellers need to be careful about avoiding bites.
Typhus
This disease occurs in isolated parts of Northern Australia through the bite of infected ticks. The disease can cause a skin rash, fever and general unwellness. Antibiotics can help to ease the symptoms but avoiding bites is essential at all times.
Dengue
This mosquito borne disease also occurs in parts of Northern Australia usually by day-biting mosquitoes. (See Dengue leaflet - TMB)
Other Risks
********************************************
The sea waters in parts of Australia are infested by sharks and jelly fish. Always take competent local advice before undertaking any sea activities. Drowning occurs regularly each year among tourists who disregard some of the basic rules of water safety. If in desert regions, take care with disturbing rocks in case you awaken a peaceful snake or scorpion.
Medical Care for Travellers
********************************************
If travellers have stopped in South East Asia and then become ill on arrival in Australia, they should make contact with a medical centre dealing with Tropical Medicine. Details of the centres in the major cities throughout Australia are available from the Tropical Medical Bureau.
Vaccinations for Stop-Overs
********************************************
Usually travellers will have vaccination cover for Typhoid, Poliomyelitis, Tetanus and Hepatitis A. Malaria prophylaxis may not be required depending on your actual itinerary. There is a higher risk of Hepatitis B in central Australia and so this may need to be considered if the risk of contact (mainly blood following accidents) is thought to be higher than usual. Rabies risk in Australia is almost non existent though obviously contact with all warm blooded animals should be avoided at all times.

Travel News Headlines WORLD NEWS

Date: Thu, 10 Oct 2019 06:51:42 +0200 (METDST)
By Holly ROBERTSON

Sydney, Oct 10, 2019 (AFP) - Large numbers of tourists are rushing to scale Uluru -- also known as Ayers Rock -- ahead of a looming ban on climbing a site sacred to indigenous Australians.   Photographs of hundreds of people clambering up the giant red monolith have provoked a social media backlash, with critics lashing as "ignorant" those going against the wishes of the traditional Aboriginal owners of the land, the Anangu.   "A mass of morally and ethically bankrupt people," indigenous woman Laura McBride tweeted alongside an image showing a queue of people snaking up the side of Uluru.    "One even hiking a toddler up, teaching the next generation how to be ignorant."   "Imagine rushing to climb Uluru before it closes just so you could brag about disrespecting the oldest living culture in the world," tweeted National Indigenous Television journalist Madeline Hayman-Reber, who called the scenes "embarrassing".

Officials say the ban, which comes into effect on October 26, is intended to show respect for cultural practices, protect the site from further environmental damage and to ensure visitors' safety.    More than 395,000 people visited the Uluru-Kata National Park in the 12 months to June 2019, according to Parks Australia, about 20 percent more than the previous year. Around 13 percent of those who visited during that period made the climb, park authorities said.    More recent figures are not available but Tourism Central Australia CEO Stephen Schwer said there had been a "significant jump" in the number of people visiting in recent weeks, with the period leading up to the ban coinciding in part with school holidays.   "Its been very busy, particularly down in the national park precinct itself," he told AFP.   "We've had quite an issue with accommodation availability, because there's a lot of people want to climb Uluru before it closes. It's been a busier than normal holiday period."   Japanese visitors and Australians on driving holidays were most likely to want to scale Uluru, Schwer said, though he urged them not to do so.

Australian tourist Belinda Moore, 33, drove to Uluru from her home in central Queensland state to ascend the rock, an experience she said she "absolutely loved".   "It's always been something to tick off the bucket list and when we heard it was closing, we knew it was now or never," she told AFP.   Moore said she did not think her climb was disrespectful to traditional owners as she was not Aboriginal.    "It may be for their own people, because it's their sacred site," she said.   "I'm pretty sad that they're closing it, but it's still amazing just to see it. I would still recommend it."   The climb will be permanently closed as of October 26, the anniversary of ownership being handed back to the Anangu people.

Uluru has great spiritual and cultural significance to indigenous Australians, with their connection to the site dating back tens of thousands of years.   Though visitor numbers were expected to decline once the ban was in place, Schwer said local tourism operators were "not particularly concerned" as it would return the area to normality.   "People need to remember that in central Australia we're a very interconnected community," he said. "The people who are requesting the climb closure are our friends and colleagues.   "We're just looking forward to being able to have the climb consigned to the annals of history."
Date: Tue 8 Oct 2019
Source: Central Telegraph [abridged, edited]

Another measles case has flown into the Gold Coast from New Zealand, which is experiencing an epidemic of the highly contagious virus.

The case is the 3rd reported on the Gold Coast and the 6th measles case diagnosed in Queensland in the past fortnight. It takes the number of cases in Queensland so far this year to 31, more than double the 14 recorded for the whole of 2018.

The traveller was exposed to measles while visiting New Zealand, which has recorded more than 1600 cases this year [2019].  [Byline: Janelle Miles]
Date: Wed 2 Oct 2019 7:54 AM AWST
Source: 10 Daily [edited]

Western Australia [WA] has been hit with an unprecedented outbreak of measles, with 8 confirmed cases in Perth.

The state's health department confirmed there have been 5 cases alone in the Rockingham area, in Perth's south. One of those cases included a baby. A further 3 cases have now been confirmed across the city.

The rare outbreak has been linked to a much bigger one in New Zealand.

Health authorities believe the WA outbreak started with a New Zealand visitor, that man has since returned home.

There have been more than 1300 cases of measles in New Zealand recently.

WA health authorities are in the process of providing information to people who were potentially exposed to offer treatment and immunisations if appropriate.

But they say it's not possible to identify people who may have been exposed in public places.

Acting Director of the Communicable Disease Control Directorate, Paul Effler, said measles was a serious and highly contagious virus spread by tiny droplets released when infected people cough and sneeze.  "Every measles case is treated as a public health emergency because of the risk of local spread," Dr Effler said on [Tue 1 Oct 2019].

"With high vaccination coverage, naturally occurring measles has been eliminated from WA for around 20 years, but occasional cases and small outbreaks still occur, usually associated with tourists or Western Australia residents who are infected overseas."  [Byline: Peter Devlin]
========================
[HealthMap/ProMED-mail map of Australia:
Date: Thu 19 Sep 2019
Source: Food Safety News [edited]

The New South Wales (NSW) Food Authority advised consumers who bought salted or pickled clams from Koryo Food Co. or Byul Mi Kim Chi to destroy any remaining product or return it to the place of purchase for a refund. Koryo Food Co. and Byul Mi Kim Chi recalled the items because of the potential link with hepatitis A from the salted or pickled clams imported from South Korea.

Authorities in South Korea recently warned domestic consumers to avoid certain types of salted or pickled clams due to a link with hepatitis A infection. Australian-grown clams are not implicated in the outbreak. South Korea, where hepatitis A is usually rare, is experiencing a large outbreak with more than 11,000 cases reported [in 2019].

Lisa Szabo, NSW Food Authority CEO, said testing was underway on a number of products, but results may take several weeks. "Although a contamination has not yet been confirmed, we have advised the companies of a potential link to 8 cases of hepatitis A in NSW, and they have both undertaken a recall of the product," she said. "We want to ensure all consumers who may have these products are aware of the possible link between the product and hepatitis A. While the affected products have been recalled from participating retailers, consumers may still have product they have already purchased in their fridges."

Koryo Food Co. is recalling pickled clams sold at independent Korean and Asian Grocery Stores in New South Wales. The 180-gram pack has "use by" dates of 19 Nov and 28 Nov 2019. Byul Mi Kim Chi salted clams come in a 150-gram plastic container and were sold at Korean Grocery Shops in New South Wales with a "best before" date ranging from 31 Oct to 31 Dec 2019.

[In August 2019], the Australian Capital Territory (ACT) Health Directorate and NSW Health revealed they were investigating a cluster of hepatitis A infections in the South Korean community. Eight adults of South Korean heritage have been affected since June [2019]. Most did not have recent overseas travel and lived in south-eastern Sydney, northern Sydney, and western Sydney. The ACT Health Directorate reminded anyone traveling to South Korea of the importance of vaccination prior to travel and good hand hygiene to reduce the risk of spread.
========================
[Outbreaks of hepatitis A in the developed world are generally, like these, related to a contaminated food. The huge epidemic of hepatitis A ongoing in many states of the USA is, however, paralleling the developing world with cases related to appalling sanitation and living conditions. - ProMED Mod.LL]

[HealthMap/ProMED-mail maps:
New South Wales, Australia: <http://healthmap.org/promed/p/284>]
Date: Fri 30 Aug 2019
Source: Esperance Express (abridged, edited)

Esperance residents need to be alert to the risk of measles following confirmation of measles in a person who visited the region. [See URL for time and locations of possible exposure. - ProMED Mod.LK]

"With high vaccination coverage, naturally occurring measles has been eliminated from WA [Western Australia] for around 20 years, but occasional cases and small outbreaks occur, sparked by residents or visitors who were infected overseas," WA County Health Service's Dr Charles Douglas said.  [Byline: Jake Dietsch]
More ...

Malaysia

General
**************************************
Malaysia consists of two separate components; peninsular Malaysia (which is situated between Thailand and Singapore) and Borneo (which has the states of Sabah and Sarawak.) The total population is o
er 20 million and it has a very diverse cosmopolitan culture. Bahasa Malaysia is the official language though English is very widely spoken. The entire country has an equatorial climate with rainfall throughout most of the year. However there are two distinct rainy seasons – March to May and September to November. The costal regions may also experience monsoon conditions. Info: http://www.visitmalaysia.com
Safety & Security
**************************************
Violent crime against tourists is rare though petty incidents like bag snatching, burglaries and car break-in crimes are increasing. It is wise to take special care of your personal belongings when walking through some of the crowded market places or along the curb. Credit card fraud is becoming a serious problem so don’t let your card out of your sight at any time. Travelling out from the main tourist destinations on Borneo may lead to a higher risk of personal danger. Kidnapping from Pandanan Island and Sipadan (both diving resorts) show how there is a need for increased vigilance when visiting parts of coastal Sabah near to the islands. Drug offences of any kind are treated very seriously in Malaysia and may result in disruption of travel plans or imprisonment. Never carry drugs for another individual unless you are certain that there is no risk involved whatsoever.
Climate
**************************************
All over Malaysia the climate tends to be very humid though this can vary from location to location and throughout the year. Being so close to the equator, the sun is strong and proper care against sun burn must be constantly taken. Dehydration and loss of salt through perspiration are two other common problems for the unprepared traveller. Drink plenty of fluids and replace your salt loss. Make sure you pack clothing suitable for a warm humid climate.
Long Haul Flight & Jet Lag
**************************************
On the plane make sure you exercise your calf muscles and drink plenty of fluids. Female travellers on the contraceptive pill should be aware of the higher risk of venous clotting. After your long haul flight it is essential to allow your body catch up and so try to ensure that you have sufficient time to rest on the first day after arrival. (Make sure you don’t fall asleep beside the pool after arrival and then awaken with sunburn.)
Food & Water
**************************************
Generally the level of food hygiene throughout the country is high. Nevertheless avoidance of bivalve shellfish meals is a wise precaution. Food from street vendors should also be treated with suspicion though unpeeled fresh fruit or various well-cooked foods should be fine. Adding ice to your drinks is probably unnecessary and potentially harmful and should be avoided. The menus will usually be in English so that should make meal selection somewhat easier!
Mosquitoes
**************************************
Due to the constant humid climate mosquitoes tend to be present throughout the year. In Malaysia there are a number of diseases transmitted by mosquitoes and so care to avoid their bite is to be encouraged at all times. The three most significant diseases transmitted by mosquitoes are Malaria, Dengue Fever and Japanese B Encephalitis. In the case of Dengue Fever the mosquito responsible tends to prefer to live in the towns and cities throughout both Borneo and Peninsular Malaysia. This mosquito usually bites during the day-light hours. The transmission of Japanese B is usually in the rural regions of the country seldom visited by tourists. Most cases occur in Sarawak. Both of these viral diseases can be very serious and even life threatening and so avoidance of mosquito bites is essential.
Malaria Risk
**************************************
The risk of malaria for most tourists visiting Peninsular Malaysia is extremely small. There is insignificant risk in Kuala Lumpur, Penang etc and so many tourists opt not to use prophylaxis. However in Sarawak and Sabah the risk of malaria is present throughout the year. Even in these regions the risk is mainly off the coastal plains and towards the border areas. Generally prophylaxis is recommended for those visiting Sabah or Sarawak.
Water Sports in Malaysia
**************************************
Many tourists will undertake some water sports while in Malaysia and so make sure your insurance policy will cover this eventuality. Before you agree a contract with a provider check that their equipment appears to be well maintained and that they have good safety instructions. If you are unsure do not take part. Never swim alone or after a heavy meal (or excess alcohol intake) and always listen to local advice regarding sea currents etc.
Vaccinations for Malaysia
**************************************
Travelling directly from Ireland there are no vaccines which are essential for entry into Malaysia. However for most tourists the following vaccines are recommended for personal protection.
*
Poliomyelitis (childhood booster)
*
Tetanus (childhood booster)
*
Typhoid (food & water borne disease)
*
Hepatitis A (food & water borne disease)
For those undertaking a more adventurous trip further vaccines may need to be considered such as Hepatitis B, Rabies, Japanese B Encephalitis and Meningitis. The need for Malaria prophylaxis will depend on your proposed itinerary.
Summary:
**************************************
Malaysia is becoming a more common destination for holidays and also as a stop-off for those travelling on to Australia. With commonsense and care you should be able to have a very enjoyable safe time. If you do develop any unusual health problem after your trip (skin rash, bowel disturbance, influenza symptoms etc) make sure you attend for urgent medical attention.

Travel News Headlines WORLD NEWS

Date: Thu 3 Oct 2019
Source: European Centre for Disease Prevention and Control (ECDC) News & events [edited]

[Authorities in] Denmark has reported a travel-related case of malaria caused by _Plasmodium cynomolgi_ in a Danish traveller returning from a visit to forested areas in peninsular Malaysia and Thailand during August-September 2018.

_P. cynomolgi_ is a parasite causing disease among macaque monkeys across Southeast Asia but rarely infects humans.

The traveller was admitted to hospital with the suspicion of malaria. Routine initial tests for malaria (rapid diagnostic test and microscopy) and more in-depth tests (malaria-specific loop-mediated isothermal amplification test and Sanger sequencing) were required to diagnose malaria caused by _P. cynomolgi_. After receiving treatment, symptoms resolved on the 2nd day and the patient recovered fully.

ECDC wants to raise awareness about the possibility of more human cases due to the presence of _P. cynomolgi_ in macaques across Southeast Asia and the volume of tourists visiting these areas, including national parks. Since the diagnosis is challenging, advanced detection and identification techniques should be performed when all other tests show negative results.

Travellers to the region are advised to apply preventive measures against malaria such as taking chemoprophylaxis and using mosquito nets and insect repellents, wearing long sleeved shirts and trousers, and sleeping in air-conditioned rooms.
=====================
[It is well known that _P. cynomolgi_ can be transmitted from monkeys to humans just as it is seen for _P. knowlesi_ (Eyles DE, Coatney GR, Getz ME. _Vivax_-type malaria parasite of macaques transmissible to man. Science. 1960; 131: 1812-3; Coatney GR et al. Transmission of the M strain of _Plasmodium cynomolgi_ to man. Am J Trop Med Hyg. 1961; 10: 673-8). Thus, it is not surprising that _P. cynomolgi_ is seen in humans visiting areas where the simian host is abundant and the _Anopheles_ vectors are present, as is the case for _P. knowlesi_. As far as we know, neither _P. cynomolgi_ nor _P. knowlesi_ can be transmitted between humans. - ProMED Mod.EP]

[HealthMap/ProMED-mail maps:
Date: Tue, 17 Sep 2019 15:38:37 +0200 (METDST)

Jakarta, Sept 17, 2019 (AFP) - Massive forest fires in Indonesia that have caused a toxic haze to spread as far as Singapore and peninsular Malaysia are also seriously affecting endangered orangutans and their habitat, a rescue foundation said Tuesday.   Jakarta has deployed thousands of troops as temporary fireman and deployed dozens of water-bombing aircraft to battle blazes that are turning pristine forest into charred landscape in Sumatra and Borneo islands.   The fires -- usually started by illegal burning to clear land for farming -- have unleashed a choking haze across parts of southeast Asia.

The Borneo Orangutan Survival Foundation said Tuesday that the haze was affecting hundreds of great apes in its care at rescue centres and wildlife re-introduction shelters.   "The thick smoke does not only endanger the health of our staff... but also it affects the 355 orangutans we currently care for", the foundation said in a statement, referring to just once cetre in Kalimantan   "As many as 37 young orangutans are suspected to have contracted a mild respiratory infection," it added.   Conditions were so bad at their Samboja Lestari facility in East Kalimantan that outdoor activities for the animals had been restricted to a few hours a day.

Orangutans have been particularly vulnerable to commercial land clearances and have seen their natural habitat shrink dramatically in the last few decades.   The population of orangutan in Borneo has plummeted from about 288,500 in 1973 to about 100,000 today, according to the International Union for Conservation of Nature.   The toxic smoke caused by the forest fires is an annual problem for Indonesia and its neighbours, but has been worsened this year by particularly dry weather.   On Borneo island, which Indonesia shares with Malaysia and Brunei, pollution levels were "hazardous", according to environment ministry data.   Hundreds of schools across Indonesia and Malaysia were shut.
Date: Mon, 9 Sep 2019 11:49:46 +0200 (METDST)

Kuala Lumpur, Sept 9, 2019 (AFP) - Malaysia prepared to seed clouds after air quality in parts of the country reached unhealthy levels due to smog from forest fires in neighbouring Indonesia, an official said Monday.   Smog regularly blankets parts of Southeast Asia during the dry season when burning is used to clear Indonesian land for palm oil, paper plantations and other crops, sparking ire from regional neighbours.   In the latest outbreak, parts of Malaysia's eastern state of Sarawak on Borneo island have been blanketed over the past few days.

The pollutant index in some places has reached "very unhealthy levels", said Gary Theseira, special functions officer with the environment ministry.   "It is extremely severe in Kuching," Theseira told AFP, referring to a city of half a million people.   He said Malaysia is prepared to carry out cloud seeding to induce rain in an effort to ease the smog.   "The moment the cloud situation is right, the chemicals will be loaded and the aircraft will take off and proceed with the seeding," he said.

Some countries conduct seeding during prolonged dry spells to induce rain and clear the air by releasing certain chemicals into the clouds, although some experts have questioned its efficacy.   Boo Siang Voon, a 47 year-old engineer in Kuching described the skies as "hazy, hot with smoky smell".   "This year the smog is getting worse. Residents are using face masks. We should not pay the price of our health for the open burning. We want a solution," he told AFP.   The Malaysian capital Kuala Lumpur and neighbouring Singapore were also experiencing hazy conditions on Monday, with the air laced with the smell of burning foliage, although the pollutant index remained at moderate levels.   Some Kuala Lumpur residents complained about eye and throat irritation.

Malaysia's meteorological department Sunday warned that hot conditions will prevail for another week, and the monsoon season is only expected to arrive at the end of September or early October.   The ministry of science, technology and innovation on Friday said it would lodge a complaint with Indonesia for the haze and called for quick action to be taken to put out the fires.   Indonesian authorities have deployed thousands of extra personnel since last month to prevent a repeat of the 2015 fires, which were the worst for two decades and choked the region in haze for weeks.   Under pressure from neighbours, Indonesian leader Joko Widodo last month warned that officials would be sacked if they failed to stamp out forest fires.
Date: Tue 16 Jul 2019 3:34 PM MYT
Source: The Star [abridged, edited]

The Japanese encephalitis (JE) virus has been detected in Tambunan [Sabah], about 100 km (62 mi) from [the state capital, Kota Kinabalu], says the state agriculture and food industries minister Datuk Junz Wong on [Tue 16 Jul 2019]. He said Health Department officials in Sabah had detected the virus in a pig farm in Kampung Lubang, Tambunan on [11 Jul 2019].

On being informed, the Department of Veterinary Services started inspection at all 7 pig farms within the vicinity. "My officers are still on the ground and taking samples from the pigs in the area."

Wong's confirmation came after an internal memo from the Veterinary Department informing the department that health officials had found a [presumably human] case of JE in Tambunan.

There is no cure for JE, but vaccinations [for people] are encouraged by health officials as they provide a form of protection. JE is a type of viral brain infection that can affect both humans and animals. It can be passed on to humans by infected animals through the bite of an infected culex mosquito.

An infected person develops inflammation of the brain (encephalitis) and suffers symptoms such as sudden onset of headache, high fever, neck stiffness, convulsions and muscle weakness, and might even fall into a coma.

Last month [June 2019], the Sarawak Health Department urged public to be cautious after confirming 5 JE cases in the state.  [byline: Muguntan Vanar]
===================
[JE virus is endemic in Malaysia's Borneo, including Sabah and its neighbouring state, Sarawak. Pigs are susceptible to JE virus infection, develop high viremias that serve as infectious blood meals for culex vector mosquitoes. The report above does not indicate which tests were done to determine JE virus infection in the pigs, whether by virus isolation, PCR demonstration of JE virus genomic segments or development of antibodies. Pregnant sows may have transplacental infection of their foetal piglets with teratogenic effects. Piglets and very young pigs may develop encephalitis when infected by JE virus. Infected adult male pigs may develop orchitis with a loss of libido and reduced fertility. Since pigs are JE virus amplifying hosts, people in the areas where pigs are infected should be especially careful to avoid mosquito bites. Vaccination may be the best measure for avoiding JE. - ProMED Mod.TY]

[Maps of Malaysia:
Date: Mon 15 Jul 2019
Source: Outbreak News Today [edited]

Health officials in Malaysia are investigating a malaria cluster in Kuala Lipis, Pahang state. On [Thu 11 Jul 2019], 4 confirmed cases of malaria were reported to Kuala Lipis District Health Office (PKD) from Betau Health Clinic. All cases involve Orang Asli children aged 4-10 from 2 villages, 2 cases [each] from Kampung Pagar and Kampung Serdang. All cases have been taken to the Kuala Lipis Hospital ward and given treatment.

Kuala Lipis has not reported a malaria case for the past 8 years; the last case was reported in 2011.

The Pahang State Health Department has activated the epidemic room on [12 Jul 2019] and control activities and case detection (active case detection) conducted by Kuala Lipis PKD Team in Kampung Pagar and Kampung Serdang. A total of 393 blood slides have been taken from residents in both villages for microscopic testing. [Based on] initial examination of the slides, PKD found 11 more malaria infections in Kampung Serdang.

>From [11-15 Jul 2019], there have been 15 cases reported from these 2 villages. All cases have been diagnosed with _Plasmodium vivax_, hospitalized for treatment and are in a stable condition.

PKD has also carried out malaria control activities by conducting indoor residual spraying and distribution of mosquito nets in the affected locality. At this point, the PKD team is in the process of tracking cases and vector control activities.

Residents in the locality have been given health education to take preventive measures by wearing clothing that covers the limbs and using repellents to prevent mosquito bites. In addition, residents are advised to sleep in the mosquito nets and avoid activities that take place in or near the forest area at night.

The Ministry of Health is monitoring the occurrence of this malaria case cluster, and the collaboration of the public is very much needed to ensure that the incidence of malaria can be controlled.
=====================
[Along with China and the Republic of Korea, Malaysia is one of the 3 countries of the WHO Western Pacific Region, and it's also among 21 countries in total across the globe identified by WHO in 2016 as having the potential to eliminate malaria by 2020. The selection was based on an analysis that looked at the likelihood of elimination across key criteria. Reaching malaria-free status is a critically important public health and sustainable development goal. It is also a core objective of the WHO Global Technical Strategy for Malaria 2016-2030, which calls for the elimination of malaria in at least 10 countries by the year 2020.

It is also worth noting that the dominant local human malaria species in Malaysia is _Plasmodium vivax_ (69%) with 33 areas (foci) with active malaria transmission; the populations at greater risk are labourers, including foreign workers, in agriculture, farming, and forestry sectors in East Malaysia. There are 8666 people at risk of malaria in these areas.

As "an important aspect of the disease in the country is the presence of _P. knowlesi_ malaria, a parasite normally found in monkeys, and now accounting for the majority of local cases", the 3 main activities to keep Malaysia on the course of malaria elimination by 2020 are as follows:
- increase surveillance of _P. knowlesi_ zoonotic infections and strengthen elimination efforts;
- intensify surveillance activities to address the threat of malaria importation and better target foreign and migrant workers engaged in activities such as agriculture, forestry, and mining; and
- continue to invest in its national malaria strategy to ensure the financing of programmes targeting elimination and prevention of reintroduction. (<https://apps.who.int/iris/bitstream/handle/10665/273633/WHO-CDS-GMP-2018.13-eng.pdf>)

The resurgence of _P. vivax_ among this specific group of people (aged 4-10 years old) is worrisome, and further investigation will elucidate the specific contextual situation to support the national effort to eliminate malaria by 2020. - ProMED Mod.ST]

[_Plasmodium vivax_ are seen in 2 isoforms, one with a long incubation time of up to 8 months (White NJ. The rise and fall of long-latency _Plasmodium vivax_. Trans R Soc Trop Med Hyg. 2019 Apr 1; 113(4):  163-168. doi: 10.1093/trstmh/trz002.  <https://www.ncbi.nlm.nih.gov/pubmed/30809676>).

Outbreaks like this one is common in areas where there is a transmission potential due to the presence of anopheles mosquitoes, and a limited local transmission is started from an introduced case, usually an asymptomatic carrier from an endemic area. It is important to know which isoform is found in this outbreak to understand the transmission dynamics and when it was introduced. Thus, genotyping should be performed. - ProMED Mod.EP]

[HealthMap/ProMED-mail map of Pahang, Malaysia:
More ...

World Travel News Headlines

Date: Mon, 14 Oct 2019 11:08:10 +0200 (METDST)

Manila, Oct 14, 2019 (AFP) - Parents lined up from sunrise holding sleeping infants as the Philippines launched a campaign on Monday to vaccinate millions of children against polio, which has re-emerged nearly two decades after the nation's last cases.   Years of falling vaccination rates, made worse by the botched rollout of a dengue vaccine, culminated in an outbreak of the preventable disease in September.   "This is for the welfare of my child," Ruth Miranda told AFP after the vaccine was squirted into her child's mouth at the Manila slum they call home.

Miranda's child is among scores who are unprotected in the capital of about 13 million people, where vaccination rates of young children plunged from 77 percent in 2016 to a mere 24 percent in June.   The atmosphere at the event in Manila was festive -- with ice cream vendors and music -- but the stakes for the campaign are high.

Polio, which can cause paralysis and can be fatal in rare cases, has no cure and can only be prevented with several doses of oral and injectable vaccines.   Two cases were detected in September, the first polio infections in the Philippines since 2001, adding to the woes of a country already hit by deadly measles and dengue epidemic.   The risk of the disease spreading within the Philippines is high, according to World Health Organization, due to low immunisation coverage partly blamed to a dengue vaccine scandal.

The Philippines was the first nation to use Dengvaxia in a mass programme in 2016, but a botched rollout led to claims that children had died after being vaccinated.   A dramatic drop in vaccine confidence followed, with trust plunging from 93 percent in 2015 to 32 percent in 2018, according to a study led by the London School of Hygiene and Tropical Medicine.   The Philippines polio outbreak has been traced back to the weakened form of the virus used in vaccines, which is excreted by people for a time after they receive it.   According to the WHO, that form can mutate and spread in the surrounding community when immunisation rates get too low.
Date: Mon, 14 Oct 2019 10:25:38 +0200 (METDST)
By Shingo ITO, Sara HUSSEIN

Tokyo, Oct 14, 2019 (AFP) - Tens of thousands of rescue workers in Japan battled on Monday to find survivors of a powerful typhoon that killed at least 43 people, as fresh rain threatened to hamper efforts.   Typhoon Hagibis crashed into the country on Saturday night, unleashing high winds and torrential rain across 36 of the country's 47 prefectures, and triggering landslides and catastrophic flooding.   "Even now, many people are still unaccounted for in the disaster-hit area," Prime Minister Shinzo Abe told an emergency disaster meeting on Monday.   "Units are trying their best to search for and rescue them, working day and night," Abe said.

But even as rescuers, including troops, combed through debris, the country's weather agency forecast rain in central and eastern Japan that it warned could cause further flooding and new landslides.   "I would like to ask people to stay fully vigilant and continue watching for landslides and river flooding," Chief Cabinet Secretary Yoshihide Suga told a news conference.   In Nagano, one of the worst-hit regions, rain was already falling and was expect to intensify.   "We are concerned about the impact of the latest rain on rescue and recovery efforts," local official Hiroki Yamaguchi told AFP.   "We will continue operations while watching out for secondary disasters due to the current rain."

- 43 dead, 16 missing: NHK -
By late Monday afternoon, national broadcaster NHK said the toll had risen to 43 dead, with 16 others missing and over 200 people injured. The government gave lower figures but was continuing to update its information.   The dead included a municipal worker whose car was overcome by floodwaters and at least seven crew from a cargo ship that sank in Tokyo Bay on Saturday night, a coast guard spokesman said.   Four others, from China, Myanmar and Vietnam, were rescued when the boat sank and the coast guard was still searching for a last crew member.   While Hagibis, one of the most powerful storms to hit the Tokyo area in decades, packed wind gusts of up to 216 kilometres (134 miles) per hour, it was the heavy rains that caused most damage.

A total of 142 rivers flooded, mainly in eastern and northern Japan, with river banks collapsing in two dozen places, local media said.   In central Nagano, a levee breach sent water from the Chikuma river gushing into residential neighbourhoods, flooding homes up to the second floor.   As water slowly receded Monday, television footage showed patients being transferred by ambulance from a Nagano hospital where some 200 people had been cut off by flooding.   Elsewhere, rescuers used helicopters to winch survivors from roofs and balconies, or steered boats through muddy waters to reach those trapped.

- Japan dedicates rugby win to victims -
By Monday afternoon, some 75,900 households remained without power, with 120,000 experiencing water outages.   The disaster left tens of thousands of people in shelters, with many unsure when they would be able to return home.   "Everything from my house was washed away before my eyes, I wasn't sure if it was a dream or real," a woman in Nagano told NHK.   "I feel lucky I'm still alive."   The storm brought travel chaos over the holiday weekend, grounding flights and halting commuter and bullet train services.

By Monday, most subway trains had resumed service, along with many bullet train lines, and flights had also restarted.   The storm also brought havoc to the sporting world, forcing the delay of Japanese Grand Prix qualifiers and the cancellation of three Rugby World Cup matches.   But a crucial decider pitting Japan against Scotland went ahead, with the hosts dedicating their stunning 28-21 win to the victims of the disaster.   "To everyone that's suffering from the typhoon, this game was for you guys," said Japan captain Michael Leitch.
Date: Sun, 13 Oct 2019 23:31:57 +0200 (METDST)

Kinshasa, Oct 13, 2019 (AFP) - Doctors will use a second Ebola vaccine from November in three eastern provinces in the Democratic Republic of Congo to fight the deadly virus, medical officials said Sunday.   "It's time to use the new Ad26-ZEBOV-GP vaccine, manufactured by Johnson & Johnson's Belgian subsidiary," said Dr. Jean-Jacques Muyembe, who leads the national anti-Ebola operation in the DRC.    It will arrive in the eastern city of Goma, in North Kivu province, on October 18 and be used from the beginning of next month, he added.   DRC's latest Ebola epidemic, which began in August 2018, has killed 2,144 people, making it the second deadliest outbreak of the virus, after the West Africa pandemic of 2014-2016.

Muyembe said the communes of Majingo and Kahembe had been selected to receive the vaccine as they were considered the epicentres of the epidemic.   "We will extend this vaccination to our small traders who often go to Rwanda to protect our neighbours," he added.   "If it works well, we will expand vaccination in South Kivu and Ituri."   DR Congo's eastern provinces of Ituri, North Kivu and South Kivu sit on the borders with Uganda, Rwanda and Burundi.   The Belgian laboratory will send a batch of 200,000 doses to neighbouring Rwanda and 500,000 doses in the DRC, Muyembe said.   More than 237,000 people living in active Ebola transmission zones have received a vaccination produced by the pharma company Merck Sharpe and Dohme since August 8, 2018. 

The J&J vaccine had been rejected by DRC's former health minister Oly Ilunga, who cited the risks of introducing a new product in communities where mistrust of Ebola responders is already high.   But Ilunga's resignation in July appears to have paved the way for approval of the second vaccine. He currently faces charges that he embezzled funds intended for the fight against Ebola.   In his letter of resignation Ilunga said "actors who have demonstrated a lack of ethics" want to introduce a second vaccine, but did not elaborate.    Muyembe, who took over the Ebola fight in the DRC in July, said "The Johnson & Johnson vaccine has the most science-based data."
Date: Thu, 10 Oct 2019 20:02:59 +0200 (METDST)
By Robbie COREY-BOULET

Addis Ababa, Oct 10, 2019 (AFP) - A palace that once housed Ethiopia's emperors and also served as a torture site under the communist Derg regime is to open to the public in a controversial government tourism project.    The palace compound in Addis Ababa, which Prime Minister Abiy Ahmed's government has rebranded "Unity Park", was formally launched Thursday and will be open from Friday.    Abiy's office said on Twitter Thursday that the project "symbolises our ability to come together".

But critics have dismissed it as vanity project for Abiy that could prove divisive.   Backed by the United Arab Emirates, the project cost more than $160 million (145 million euros), Ethiopian officials told reporters at a briefing earlier this week.    Built in the late 1800s by Emperor Menelik II, who founded Addis Ababa, the palace was the residence of Ethiopia's rulers for more than a century.   Abiy himself does not live there, and it has seen little activity in recent years.    Abiy's advisers say he has taken a keen interest in transforming the palace into a tourist attraction since coming to power in April 2018 -- visiting the site every day in recent weeks to monitor progress.

The government's "Home-Grown Economic Reform" agenda, unveiled last month, describes tourism as a primary engine of potential job creation.    On Thursday, government officials and the diplomatic corps toured the expansive site before attending a banquet that was expected to draw five regional heads of state and other dignitaries.    The restored rooms feature items like Menelik's sword and a life-size wax replica of former Emperor Haile Selassie, who lived at the palace and was then etained there after the Derg overthrew him in 1974.

The site also includes a sculpture garden with installations representing Ethiopia's nine regions, and a zoo is expected to open by the end of the year.    Aklilu Fikresilassie, an Ethiopian employee of the United Nations who attended the launch Thursday, said he was "really fascinated" to set foot inside a place that had been closed to the public his entire life.    "For us it's like a government house, so now when you enter that palace it tells you that we are getting somehow closer to our leaders," he said.

But not everyone is convinced the palace will succeed in bringing Ethiopians together.   In a country grappling with ethnic divisions, some worry that the palace could alienate ethnic Oromos who contend that their ancestors were forced off their land when Addis Ababa was built.    Journalist and former political prisoner Eskinder Nega said the renovations were undertaken "without consultation from the public", which he called "a huge mistake."    "This is all about heritage, about preserving heritage. The people should have had a say in it," he said.    "Like everything else this was decided from the top and implemented only by the decision of the prime minister."
Date: Thu, 10 Oct 2019 13:13:57 +0200 (METDST)

Hanoi, Oct 10, 2019 (AFP) - Selfie-snapping tourists railed against the closure of Hanoi's 'train street' on Thursday after police blocked off the Instragram-famous tracks for safety reasons.   The narrow railway corridor in central Hanoi has become a hotspot among visitors seeking the perfect holiday snap on the tracks -- often dodging trains that rumble through daily.    But Hanoi authorities said this week they would block people from the tracks to avoid accidents, and police on Thursday erected barricades to keep out disappointed visitors.    "I'm very frustrated because today I can't go in and take a picture," Malaysian tourist Mustaza bin Mustapha told AFP, vowing to come back later.

Dozens of other tourists were turned away, though some managed to get onto still-open sections of the railway, moving out of the way as an afternoon train chugged past.    Built by former colonial rulers, the railway once shipped goods and people across France's former Indochina colony and remains in use today by communist Vietnam's state-run railway company.    The stretch of the tracks was once known as a rough part of town, occupied by drug users and squatters until their recent discovery by camera-wielding holidaymakers who have splashed images of the area across social media.

Cafe owners complained that business would be hurt thanks to the new regulations, and that tourists always moved out of the way for oncoming trains.   "There has never been any regretful accidents here," said Le Tuan Anh, who runs a cafe from his home along the tracks.   "Compared to traffic density elsewhere in the city, this is much safer," he said, referring to Hanoi's chaotic, motorbike-clogged streets.   New signs were installed in the area Thursday, warning passersby not to take photos or videos in the "dangerous area", much to the chagrin of British tourist Harriet Hayes.   "People come from all over the world to Hanoi just to see the train go past," she told AFP.   "It's such a shame that we come and have been told that we have to leave."
Date: Thu, 10 Oct 2019 06:51:42 +0200 (METDST)
By Holly ROBERTSON

Sydney, Oct 10, 2019 (AFP) - Large numbers of tourists are rushing to scale Uluru -- also known as Ayers Rock -- ahead of a looming ban on climbing a site sacred to indigenous Australians.   Photographs of hundreds of people clambering up the giant red monolith have provoked a social media backlash, with critics lashing as "ignorant" those going against the wishes of the traditional Aboriginal owners of the land, the Anangu.   "A mass of morally and ethically bankrupt people," indigenous woman Laura McBride tweeted alongside an image showing a queue of people snaking up the side of Uluru.    "One even hiking a toddler up, teaching the next generation how to be ignorant."   "Imagine rushing to climb Uluru before it closes just so you could brag about disrespecting the oldest living culture in the world," tweeted National Indigenous Television journalist Madeline Hayman-Reber, who called the scenes "embarrassing".

Officials say the ban, which comes into effect on October 26, is intended to show respect for cultural practices, protect the site from further environmental damage and to ensure visitors' safety.    More than 395,000 people visited the Uluru-Kata National Park in the 12 months to June 2019, according to Parks Australia, about 20 percent more than the previous year. Around 13 percent of those who visited during that period made the climb, park authorities said.    More recent figures are not available but Tourism Central Australia CEO Stephen Schwer said there had been a "significant jump" in the number of people visiting in recent weeks, with the period leading up to the ban coinciding in part with school holidays.   "Its been very busy, particularly down in the national park precinct itself," he told AFP.   "We've had quite an issue with accommodation availability, because there's a lot of people want to climb Uluru before it closes. It's been a busier than normal holiday period."   Japanese visitors and Australians on driving holidays were most likely to want to scale Uluru, Schwer said, though he urged them not to do so.

Australian tourist Belinda Moore, 33, drove to Uluru from her home in central Queensland state to ascend the rock, an experience she said she "absolutely loved".   "It's always been something to tick off the bucket list and when we heard it was closing, we knew it was now or never," she told AFP.   Moore said she did not think her climb was disrespectful to traditional owners as she was not Aboriginal.    "It may be for their own people, because it's their sacred site," she said.   "I'm pretty sad that they're closing it, but it's still amazing just to see it. I would still recommend it."   The climb will be permanently closed as of October 26, the anniversary of ownership being handed back to the Anangu people.

Uluru has great spiritual and cultural significance to indigenous Australians, with their connection to the site dating back tens of thousands of years.   Though visitor numbers were expected to decline once the ban was in place, Schwer said local tourism operators were "not particularly concerned" as it would return the area to normality.   "People need to remember that in central Australia we're a very interconnected community," he said. "The people who are requesting the climb closure are our friends and colleagues.   "We're just looking forward to being able to have the climb consigned to the annals of history."
Date: Wed, 9 Oct 2019 22:01:17 +0200 (METDST)

Kinshasa, Oct 9, 2019 (AFP) - Six people were killed in the Democratic Republic of Congo after torrential rains hit the capital Kinshasa, flooding several neighbourhoods. a local official said.    The bodies were found between Tuesday night and Wednesday morning.    Five people were killed in the capital's Selembao municipality where around 30 houses collapsed, local mayor Augustin Mankesi told Top Congo radio station.   One woman died in the Pelende district after she was electrocuted, he added.    "Our community is stricken," Mankesi added, calling on the Congolese authorities for help.   Fatal floods and rains are frequent in Kinshasa. In January last year 48 people were killed in landslides, floods and after houses collapsed, according to authorities.    Residents told AFP the road from the sea port district of Matadi to the Kinshasa turnoff has been closed due to erosion caused by the rain.    The passage is Kinshasa's main supply route for imported goods and also serves as an exit point for exports.
Date: Tue, 8 Oct 2019 04:13:25 +0200 (METDST)
By Margioni BERMÚDEZ

Caracas, Oct 8, 2019 (AFP) - The small waiting room at the home of self-styled healer "Brother Guayanes" in Caracas' rundown Petare district fills up quickly with patients -- business has never been better.   With Venezuela's chronic medicine shortages and hyperinflation, more and more people are turning to alternative medicine to treat common ailments in the crisis-wracked South American country.   "We go to the hospital and there's nothing there. They don't have medicines, or they're too expensive, what are we to do?" said Rosa Saez, 77, who has come to get treatment for a painful arm.   Carlos Rosales -- he uses the more ceremonious "Brother Guayanes" for his business -- is finishing up a "spiritual intervention" on a patient in what passes for his surgery.   The patient lies, eyes closed, on a cot as, in a series of swishes and clicks, the healer waves five pairs of scissors one after another over his prone body.    The healer says he performs 200 such interventions a week in a dim, candle-lit room that features two camp beds and an array of plaster statues that Rosales says represent "spiritual entities".   A regular visitor to the spiritual center, Saez says she has faith in Rosales' methods: "He healed my kidneys."

- Natural healing -
All across Venezuela, but particularly in poor areas like Petare, patients cannot hope to afford the price of medicines that due to the economic crisis, have become exceedingly rare.  Venezuela's pharmacists' federation say pharmacies and hospitals have on average only about 20 percent of the medicine stock needed.   Rosales' clinic is muggy with the smell of tobacco. A crucifix suspended from a chain around his neck, he practices a seeming mixture of smoke-blowing shamanism, plant-based medicine and mainstream religion.    Posters hung near the entrance remind clients to arrive with a candle and tobacco and "Don't forget that payment is in cash".   Much like a general practitioner, Rosales spends time consulting with his patients, examining them with a stethoscope, before offering a diagnosis. Often he prescribes potions based on plants and fruit, such as pineapple and a type of local squash known as chayote.   "We know medicines are necessary," he says. "I'm not against medicine, but my medicine is botany."

- Plants replace drugs -
At her stall in a downtown Caracas market, 72-year-old Lilia Reyes says she has seen her trade in medicinal plants flourish.   "I can't keep up with the demand," she said at her stall, bathed in the aroma of camomile, one of the 150 plants she sells.   Careless consumption of some herbs can be deadly, warns Grismery Morillo. A doctor at a Caracas public hospital, she says she has seen many cases of acute liver failure in people who have eaten certain roots.   According to Venezuela's opposition parties, some 300,000 chronically ill people are in danger of dying from the shortages of medicines.

But despite the risks, people like Carmen Teresa say they have no alternative.    In the kitchen of her restaurant which closed down three years ago as the economic crisis took hold, the 58-year-old Colombian prepares an infusion of fig leaves to treat "diabetic neuropathy".   The painkillers needed for the condition are "too expensive" and prices are going up due to hyperinflation, so she is cutting back on the pills and supplementing her treatment with herbal infusions.   She needs at least four tablets a day to keep her diabetes at bay. Her mother, bedridden since breaking a leg a year ago, suffers from Alzheimer's disease and needs five pills a day for hypertension.   "I'm still taking my pills, but I reduced the dose," says Teresa, who is also replacing cholesterol pills with lemon juice.
Date: Sun, 6 Oct 2019 12:04:37 +0200 (METDST)

Riyadh, Oct 6, 2019 (AFP) - Saudi Arabia announced Sunday it would allow unmarried foreign couples to rent hotel rooms together as the ultraconservative kingdom begins offering up tourist visas for the first time.   The tourism authority said in a statement published on Twitter that Saudi women travelling alone would also be able to check into a hotel by presenting valid ID.

In the past, couples wanting to stay in a hotel had to prove they were married.    "This is no longer required for tourists," the statement said.   Saudi Arabia announced on September 27 it was opening its doors to holidaymakers with the goal of diversifying its oil-dependent economy.   The kingdom had previously only issued visas to Muslim pilgrims, foreign workers, and recently to spectators at sporting or cultural events.

Kickstarting tourism is one of the centrepieces of Crown Prince Mohammed bin Salman's Vision 2030 reform programme to prepare the biggest Arab economy for a post-oil era.   Citizens from 49 countries are now eligible for online e-visas or visas on arrival, including the United States, Australia and several European nations.   On September 28, Saudi authorities warned that tourists who violated "public decency", including with immodest clothing and public displays of affection, would be subject to fines.
Date: Sat, 5 Oct 2019 03:30:17 +0200 (METDST)
By Giovanna FLEITAS

Petorca, Chile, Oct 5, 2019 (AFP) - For Erick Hurtado, the worst thing about the drought that has devastated his family farm in Chile is the dead animals.   "Going out and seeing the animals dead on the ground is so horrible," Hurtado says as he gazes across the dusty paddocks of his farm in Petorca, near the coastal city of Valparaiso.

Farmers are counting the cost of one of the driest austral winters in six decades, which has destroyed crops and left tens of thousands of farm animals dead in the fields of central Chile.   Hurtado's farm, owned by his grandfather, has lost half its 60 head of cattle.   So far, 106,000 animals have died due to lack of water and fodder, mostly goats, cattle and sheep, according to the agriculture ministry.   President Sebastian Pinera, who last month announced a $5 billion plan to improve water distribution, this week set up a crisis group of government agencies to tackle the water crisis, which he said had become "more extensive and more intense."

In Colina, north of the capital Santiago, the drought has been hard on small farmers. Scrawny cattle pick at sprigs of strawy grass on pastures that have turned to dust. Cows, goats and horses roam hungry on hills have turned to a dry muddy brown.   "The drought has been disastrous for us," said Sandra Aguilar. Her family owned about a hundred head of cattle. Today, only half survive thanks to a trickle of water provided by a neighbor who still has some reserves.   "The situation is complicated," said Javier Maldonado, governor of the province of Chacabuco, where several agricultural areas have been hit particularly hard by the drought.    "We have to be realistic, climate change is here to stay," he said.

- Water shortages -
Dominga Mondaca points out the deep fissures that run through the garden behind her house in the village of La Ligua near Valparaiso. The garden used to be full of strawberries and citrus trees; now it's cracked earth.    "We have had many years with little water. But the last year, it didn't rain at all," said the 73-year-old, one of more than 600,000 people the government is supplying by tanker trucks as part of emergency measures.   She says she has had to give up raising chickens, in order to keep what little water she and her husband receive for their own consumption, washing and cleaning. Whatever is left, she uses to sprinkle on herbs in a small kitchen garden.   The agriculture ministry says 37,000 family farms need assistance in the central Chile.

- Thirsty avocados? -
In Petorca, some rivers have run dry, and the landscape has been left parched, but lush avocado and citrus plantations are nevertheless thriving.   Locals in Petorca say the real, long-term problem is the mismanagement of water resources.    "There is an excess of monoculture plantations that consume all the water," said Diego Soto of the Movement for the Defense of Access to Water, Land and Environmental Protection (MODATIMA) told AFP.   Avocados need a lot of water to grow, said Soto.   "An avocado tree needs 600 liters of water per week, whereas humans consume 50 liters a day, or 350 liters a week," he said.   Producers refute these figures and say the real problem is a lack of infrastructure to store water, both above and below ground.    "The avocado is not a crop that needs more water," insisted Francisco Contardo, chairman of the local producers' committee.   Avocados are a key export for Chile, mostly to the US and China, but drought has reduced exports by 25 percent.

- Less snow -
For many though, the changes being wrought by climate change are overwhelmingly obvious. Snow in the highlands of central Chile was relatively scarce this year.    Scientists predict an average decrease of between five and 10 percent snowfall every 10 years in almost the entire Andes mountains, one of the country's main sources of water.   "The central zone of Chile is highly dependent on the summer melt season, its snow and glaciers, which means that if the snow cover is reduced, there is also a reduction in the availability of water resources," said Paul Cordero, climate change expert at the University of Santiago.   Weak snowfall forced the country's main ski resorts to use artificial snow machines much earlier and more often this season than in previous years.    "Chile has been living as if it were a country with an abundance of water," said Pinera.   "Climate change and global warming have changed this situation probably forever."