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Andorra

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

Travel News Headlines WORLD NEWS

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

No Profile is available at present

Travel News Headlines WORLD NEWS

Date: Thu, 16 Jan 2020 02:45:27 +0100 (MET)
By Ivelisse RIVERA, con Leila MACOR en Miami

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

An alert issued by the Tsunami Warning Center immediately following the earthquake was later cancelled.   Tuesday's quake was the strongest of a series of tremors that have shaken the island since December 28, topping Monday's 5.8 quake.   That earthquake toppled houses and caused power outages, but there were no reports of casualties.
Date: Mon, 6 Jan 2020 18:04:21 +0100 (MET)

Miami, Jan 6, 2020 (AFP) - A 5.8-magnitude earthquake shook Puerto Rico Monday, toppling houses and causing power outages and small landslides but there were no reports of casualties, the US Geological Survey said.   The quake, just off the US territory's southern Caribbean coastline, was felt throughout much of the island, including the capital San Juan.

Some 250,000 customers were hit by electric power outages after the quake, which struck at 6:32 am local time (1032GMT).   Images posted on social media showed houses tumbled from their supporting pillars, cracks in walls, cars crushed under collapsed houses and small scale landslides.   The quake was the strongest of a series that have rippled through the island since December 28, and it was followed by at least eight aftershocks, officials said.   No tsunami alerts were issued.
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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 ...

Bangladesh

Bangladesh - US Consular Information Sheet
June 17, 2008

COUNTRY DESCRIPTION:
Bangladesh is a democratic republic with a parliamentary form of government.
On January 11, 2007, President Iajuddin Ahmed declared a state of emergenc
.
On May 12, 2008, the Chief Adviser announced that national parliamentary elections would be held in the third week of December, 2008.
Bangladesh remains a developing country with poor infrastructure.
Tourist facilities outside major cities and tourist areas are minimal.
Read the Department of State Background Notes on Bangladesh for additional information.

ENTRY/EXIT REQUIREMENTS:
A passport, visa and onward/return ticket are required.
All travelers to Bangladesh, including American citizens, must have a valid visa in their valid passport prior to arrival.
Although airport visas (landing permits) are available upon arrival by air, the U.S. Embassy in Dhaka does not recommend this option for most categories of travelers as working hours may not coincide with flight arrival times and precise formalities can vary.
Additionally, if issued, landing permit validity is usually limited to a maximum of fifteen days.
A valid visa in an expired or cancelled U.S. passport is not acceptable to the Bangladeshi authorities; if you are issued a new U.S. passport, you will need a new visa.

If you intend to use Dhaka as a hub from which to visit other countries in the region, ensure that you obtain a multiple-entry visa before arrival.
If you intend to work for a non-governmental organization (NGO) in Bangladesh, you should ensure that your sponsor has provided you with up-to-date advice on the kind of visa you must obtain before arrival.
It is difficult and time-consuming to change your immigration status once you have arrived in Bangladesh.

Visas to Bangladesh which are expiring may be extended at the Directorate of Immigration and Passport, located at Sher-e-Bangla Nagar, Agargaon, Dhaka.
The phone numbers are (880-2) 913-1891 and 913-4011.

New visa rules, introduced in October 2006, require foreign nationals who come to Bangladesh to work or for long-term visits to have the appropriate work permits and clearances on arrival.
There are increased financial penalties for overstaying visas.
Additionally, those who overstay for more than 90 days face the possibility of being charged with violating the Foreigners Act of 1946.
For further information on these rules, please check with the nearest Bangladeshi Embassy or Consulate (U.S. addresses listed below) before traveling, or visit the Bangadeshi Immigration Police web site at www.immi.gov.bd, which provides further details on rules relating to foreigner registrations.

There are two exit requirements:
A.
When traveling by air, there is a departure tax on all foreigners except children under the age of two.
This tax is often included when air tickets are purchased.
Otherwise, it is collected at the airport at the time of departure.
The amount of the departure tax varies, depending on the destination (e.g., the departure tax for the U.S. is the most expensive, at USD $43).
There is no travel tax for transit passengers transiting Bangladesh without a visa and in country for 72 hours or fewer.
These requirements may be subject to change, and travelers are advised to check with the Embassy of Bangladesh before traveling.

B.
Departing foreign nationals are also required to comply with the income tax ordinance of 1984 and submit an income tax clearance certificate/income tax exemption certificate to local airline offices upon departure from Bangladesh.
More information can be obtained from the Bangladesh Board of Revenue web site at http://www.nbr-bd.org/.

For further information on entry requirements and possible exceptions to the exit requirements, please contact the Embassy of the People's Republic of Bangladesh, 3510 International Drive NW, Washington, DC
20008, telephone 202-244-0183, fax 202-244-5366, web site http://www.bangladoot.org, or the Bangladeshi Consulates in New York at 211 E. 43rd Street, Suite 502, New York, NY 10017, telephone 212-599-6767 or Los Angeles at 10850 Wilshire Boulevard, Suite 1250, Los Angeles, CA 90024, telephone 310-441-9399. Visit the Embassy of Bangladesh web site at http://www.bangladoot.org for the most current visa information.

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

SAFETY AND SECURITY:
Bangladesh is currently under a state of emergency.
As of May, 2008, national parliamentary elections have been scheduled for the third week of December, 2008.
The security situation in Bangladesh is fluid, and Americans are urged to check with the U.S. Embassy for the latest information.
Spontaneous demonstrations take place in Bangladesh from time to time.
American citizens are reminded that even demonstrations intended to be peaceful can turn confrontational and escalate into violence quickly and unexpectedly.
American citizens are therefore urged to avoid the areas of demonstrations if possible, and to exercise caution if within the vicinity of any demonstrations.
American citizens should stay up-to-date with media coverage of local events and be aware of their surroundings at all times.
Information regarding demonstrations in Bangladesh can be found on the U.S. Embassy Dhaka’s web site at http://dhaka.usembassy.gov/.

A terrorist bombing campaign in the second half of 2005, political violence throughout the country at the end of 2006, and threats to U.S. and Western interests led to increased security around U.S. Government facilities.
On August 17, 2005, a banned Islamist terrorist group, Jamaatul Mujahideen Bangladesh (JMB), claimed responsibility for nearly 500 coordinated small bomb blasts in virtually every part of Bangladesh that killed two persons and injured several dozen.
The most recent JMB bombing occurred on December 8, 2005, and the Bangladeshi government subsequently apprehended the known senior leadership of JMB.
Six JMB leaders convicted of complicity in JMB attacks were executed on March 29, 2007.
JMB and other extremist groups are small in number but remain active and may resume violent activities.

Demonstrations, political activity, and hartals (nationwide strikes) were initially banned during the state of emergency, but the rules restricting political activity have been slightly relaxed as part of the process leading up to the planned elections in the third week of December 2008.
Prior to the state of emergency, rallies, marches, demonstrations and hartals took place frequently.
In August 2007, violent protests involving thousands of demonstrators occurred in several cities in Bangladesh, including Dhaka.
Authorities imposed a curfew to restore calm.
Protests involving workers from the large garment-manufacturing industry are not uncommon.
Visitors to Bangladesh should check with the Consular Section of the U.S. Embassy in Dhaka for updated information on the current political situation.

U.S. citizens are advised against traveling to the Khagrachari, Rangamati and Bandarban Hill Tracts districts (collectively known as the Chittagong Hill Tracts) due to kidnappings and other security incidents, including those involving foreign nationals.
Foreigners traveling in the Chittagong Hill Tracts are required to register with local authorities.
Additionally, the U.S. Embassy has in the past received reports of incidents of kidnapping, arms and narcotics smuggling and clashes between local Bangladeshis and Rohingyan refugees in areas near Rohingyan refugee camps in the Teknaf, Kutupalong, Ukhia, and Ramu areas of the Cox’s Bazar district.
The U.S. Embassy also recommends against travel to these areas.
Individuals who choose to visit these districts are urged to exercise extreme caution.

For the latest security information, Americans traveling abroad should regularly monitor the Department of State, Bureau of Consular Affairs web site at http://travel.state.gov where the current Travel Warnings and Travel Alerts, including the Worldwide Caution, can be found.
Americans traveling to or living in Bangladesh who are registered at the U.S. Embassy will receive updated security information about Bangladesh via e-mail.
All Demonstration Notices and Warden Messages are posted on the Embassy’s web site at http://dhaka.usembassy.gov/.
Up-to-date information on safety and security can also be obtained by calling 1-888-407-4747 toll free in the U.S. and Canada, or for callers outside the U.S. and Canada, a regular toll-line at 1-202-501-4444.
These numbers are available from 8:00 a.m. to 8:00 p.m. Eastern Time, Monday through Friday (except U.S. federal holidays).

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

CRIME:
Urban crime can be organized or opportunistic, conducted by individuals or groups, and commonly encompasses fraud, theft (larceny, pick-pocketing, snatch-and-grab), robbery (armed and unarmed), carjacking, rape, assault, and burglary (home and auto).
Incidents of crime and levels of violence are higher in low-income residential and congested commercial areas, but are on the rise in wealthier areas as well.
Visitors should avoid walking alone after dark, carrying large sums of money, or wearing expensive jewelry.
Valuables should be stored in hotel safety deposit boxes and should not be left unattended in hotel rooms.
Police are generally responsive to reports of crimes against Americans.
Crimes, however, often go unsolved.

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

The local equivalent to the “911” emergency line in Bangladesh is 999.
This connects you to the Dhaka Metro Police Exchange.
There is no guarantee that English will be spoken or understood at the Dhaka Metro Police Exchange.
The Police Exchange can only transfer calls to the appropriate police station within the Dhaka metropolitan area, and then the caller will have to speak with that police station in order to actually have any police services performed.
There is similarly no guarantee that English will be spoken or understood at the local police station.

Outside of Dhaka, the caller will need to add the city code for Dhaka, so dial 02-999.
The caller will again be connected to the Dhaka Metro Police Exchange, which should be able to provide the number of the appropriate police station within Bangladesh, but the Dhaka Metro Police Exchange is unlikely to be able to transfer the call to a police station outside Dhaka.
The caller would have to hang up and dial the number provided by the Dhaka Metro Police Exchange.
The ability to speak and/or understand English is even more unlikely at local police stations outside of Dhaka.

See our information on Victims of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION:
Medical facilities in Bangladesh do not approach U.S. standards, even in tourist areas.
There is limited ambulance service in Bangladesh.
Several hospitals in Dhaka (e.g., Apollo Hospital and Square Hospital) have emergency rooms that are equipped at the level of a community hospital.
Hospitals in the provinces are less well equipped and supplied.
There have been reports of counterfeit medications within the country, but medication from major pharmacies and hospitals is generally reliable.
Medical evacuations to Bangkok or Singapore are often necessary for serious conditions or invasive procedures.

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

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

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

The Bangladeshi road network is in poor condition and poorly maintained.
The streets of Dhaka are extremely congested; bicycle rickshaws compete with three-wheeled mini-taxis (CNGs), cars, overloaded buses, and trucks on limited road space.
Also, driving on the left-hand side of the road may be confusing to American visitors.
Inter-city roads are narrow.
Driving at night is especially dangerous.
Streetlights are rare even in cities.
Road accidents are common in Bangladesh.
Fatal head-on collisions on inter-city roads are common.
When vehicle accidents occur, a crowd quickly gathers and violence can occur when the crowd becomes unruly.
Travelers are strongly urged not to use public transportation, including buses, rickshaws, and three-wheeled baby taxis due to their high accident rate and crime issues.
An alternative to consider is a rental car and driver.

Please refer to our Road Safety page for more information.
Visit the website of Bangladesh’s National Tourism Organization at http://www.parjatan.org, e-mail bpcho@bangla.net.

SPECIAL CIRCUMSTANCES:
Bangladesh is a country crisscrossed with rivers, and thus uses a wide network of water-based public transportation.
Ferries and other boats compete with the railroads as a major means of public transport.
Typically overloaded and top-heavy, ferries do capsize, particularly during the monsoon season from May to October or during unexpected thunderstorms or windstorms.
Every year there are dozens of fatalities resulting from ferry accidents.

Bangladeshi customs authorities may enforce strict regulations concerning temporary importation into or export from Bangladesh of items such as currency, household appliances, alcohol, cigarettes and weapons.
There is no restriction as to the amount of U.S. currency visitors may bring into Bangladesh; however, they must declare to customs authorities if they are carrying more than USD $5,000 at the time of arrival.
It is advisable to contact the Bangladeshi Embassy or Consulates for specific information regarding customs requirements.

Please see our Customs Information.

Land disputes are extremely common in Bangladesh and are extremely difficult to resolve through legal channels.
Court cases can last for months, and sometimes years, without there ever being a final and accurate determination of which party has legitimate claim to the title.

The U.S. Embassy currently has on file nearly twenty cases of American citizens who claim to be victimized in land-grabbing disputes.
Rarely are these simple cases of a legitimate property owner and an opportunistic land-grabber.
More often, it is a case of disagreement between an owner who believes he has historical ownership of the property and a new owner who has just purchased the same property.
One of them has been swindled, both of them have deeds, and it is next to impossible to determine whose deed is valid.

The dangers in becoming involved in a property dispute range from being threatened by bullies to being involved in a lengthy court dispute.
Those involved in a court dispute run the risk of having cases filed against them, and may be arrested and jailed, sometimes for months.

American Citizens wishing to purchase property in Bangladesh should be thoroughly aware of the risks they take and should only purchase property from a seller whose ownership is beyond doubt.
Additionally, they should recognize the risks associated if they are not physically present to oversee their property.
American Citizens should bear in mind that the U.S. Embassy cannot protect personal property in the absence of owners and cannot take sides in a legal dispute.

A marriage must be entered into with the full and free consent of both individuals.
The parties involved should feel that they have a choice.
If an American citizen is being forced into a marriage against his/her will, help and advice are available.
For more information, please and the U.S. Embassy in Dhaka information on forced marriage at http://dhaka.usembassy.gov/forced_marriage_home.html, or contact the American Citizens Services unit directly at DhakaACS@state.gov, or 011-88-02-885-5500 from the United States, 02-885-5500 from inside Bangladesh, or 885-5500 from anywhere in the city of Dhaka.
All travelers to Bangladesh should retain their passports and their return plane tickets to ensure independence to travel.

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

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 Bangladeshi laws, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession or use of, or trafficking in illegal drugs in Bangladesh are severe, and convicted offenders can expect long jail sentences and heavy fines.
Engaging in sexual conduct with children or using or disseminating child pornography in a foreign country is a crime, prosecutable in the United States.
Please see our information on Criminal Penalties.

CHILDREN'S ISSUES:
For information see our Office of Children’s Issues web pages on intercountry adoption, international parental child abduction and the U.S. Embassy in Dhaka information on forced marriage at http://dhaka.usembassy.gov/forced_marriage_home.html.

REGISTRATION / EMBASSY LOCATION:
Americans living or traveling in Bangladesh are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department’s travel registration web site so that they can obtain updated information on travel and security within Bangladesh.
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 approximately four miles south of Zia International Airport, and five miles north of downtown in the Diplomatic Enclave, Madani Avenue, Baridhara, Dhaka, telephone (88-02) 885-5500, fax number (88-02) 882-3744.
The workweek is Sunday through Thursday.
The Consular Section is open for American Citizens Services Sunday through Thursday from 1:00 p.m. to 4:00 p.m.
For emergency services and general information during business hours, please call (88-02) 882-3805.
For emergency services after hours, please call (88-02) 885-5500 and ask for the duty officer.
The Embassy's Internet home page is http://dhaka.usembassy.gov/
* * *
This replaces the Country Specific Information for Bangladesh dated November 23, 2007 to update sections on Country Description, Entry/Exit Requirements, Safety and Security, Crime, Information for Victims of Crime, Traffic Safety and Road Conditions, Special Circumstances, and Children’s Issues.

Travel News Headlines WORLD NEWS

Date: Thu 30 Jan 2020
Source: Outbreak News Today [edited]

In a follow-up on recent stories on Nipah virus infections in Bangladesh, the Institute of Epidemiology, Disease Control and Research (IEDCR) has reported on their website, 6 Nipah virus infections, including 4 deaths in 2020.

According to the World Health Organization (WHO), in the Bangladesh and India outbreaks, consumption of fruits or fruit products (such as raw date palm juice) contaminated with urine or saliva from infected fruit bats was the most likely source of infection. Fruit bats of the family Pteropodidae -- particularly species belonging to the _Pteropus_ genus -- are the natural hosts for Nipah virus. There is no apparent disease in fruit bats.

In more recent outbreaks of the disease, person-to-person transmission has been seen in Bangladesh and India. The disease in humans can range from asymptomatic infection to fatal encephalitis. Encephalitis and seizures occur in severe cases, progressing to coma within 24 to 48 hours. The case fatality rate is estimated at 40% to 75%; however, this rate can vary by outbreak depending on local capabilities for surveillance investigations, according to WHO.

Most of those who survive acute encephalitis make a full recovery, but around 20% are left with residual neurological consequences such as persistent convulsions and personality changes.

Table. Yearly distribution of Nipah cases in Bangladesh 2001-2020
Year / No. cases / No. deaths / Case fatality %
2001 / 13 / 9 / 69
2002 / 0 / 8 / 0
2003 / 12 / 0 / 0
2004 / 67 / 50 / 75
2005 / 13 / 11 / 85
2006 / 0 / 0 / 0
2007 / 18 / 9 / 50
2008 / 11 / 9 / 82
2009 / 4 / 0 / 0
2010 / 18 / 16 / 69
2011 / 42 / 36 / 86
2012 / 18 / 13 / 72
2013 / 26 / 22 / 85
2014 / 38 / 15 / 39
2015 / 18 / 11 / 61
2016 / 0 / 0 / 0
2017 / 3 / 2 / 67
2018 / 4 / 3 / 75
2019 / 8 / 7 / 88
2020 / 6 / 4 / 67
Totals / 319 / 225 / 71
=======================
[The total number of cases so far this year (2020) has reached 6. This is still early in the Nipah season, so more cases can be expected. Nipah virus infections occur sporadically in Bangladesh as documented in the 2001-2020 case numbers in the above table. Cases occur in a geographic area termed the Nipah belt and during certain seasons of the year when the reservoir fruit bat is abundant. As noted in the previous comment (ProMED-mail archive no. http://promedmail.org/post/20150204.3143251) and noted in the above report, giant fruit bats or flying foxes (_Pteropus_ of several species) are reservoirs of Nipah virus, and they contaminate date palm sap or fruit. This is the season for cases of Nipah virus infection to occur. The transmission season is usually January to April.

As noted earlier, it is unfortunate that the public awareness efforts have not prevented these cases from occurring. Perhaps because cases are sporadic and geographically scattered there is little public perception of risk of infection and serious disease. Until effective public education to prevent infection by avoiding eating contaminated fruit or date palm sap is implemented, sporadic cases will continue to occur.

Interestingly, a simple skirt constructed out of locally available materials can prevent access of the bats to the palm sap collecting pots, but apparently they are not commonly used. Boiling the palm sap would inactivate the virus, but local consumers indicated that it alters the flavor of the sap.

An image of a pteropus fruit bat can be found at

[HealthMap/ProMED map available at:
Date: Fri 17 Jan 2020
Source: Outbreak News Today [edited]

Media sources in Bangladesh are reporting a Nipah virus infection in the city of Khulna. The reported case is a 20-year-old female who has been hospitalized since last Saturday [11 Jan 2020] at the Khulna Medical College Hospital (KMCH).

"A medical board has confirmed her infection by Nipah virus. As her infection is a risk to other patients, she is being treated separately at the hospital's Medicine unit 1," said SM Kamal Hossain, chief of KMCH Medicine Department.

According to the World Health Organization (WHO), in the Bangladesh and India outbreaks, consumption of fruits or fruit products (e.g. raw date palm juice) contaminated with urine or saliva from infected fruit bats was the most likely source of infection. Fruit bats of the family Pteropodidae -- particularly species belonging to the _Pteropus_ genus -- are the natural hosts for Nipah virus. There is no apparent disease in fruit bats.

In more recent outbreaks of the disease, person-to-person transmission has been seen in Bangladesh and India.

The disease in humans can range from asymptomatic infection to fatal encephalitis. Encephalitis and seizures occur in severe cases, progressing to coma within 24 to 48 hours.

The case fatality rate is estimated at 40% to 75%; however, this rate can vary by outbreak depending on local capabilities for surveillance investigations, according to the WHO.

Those who survive acute encephalitis make a full recovery, but around 20% are left with residual neurological consequences, such as persistent convulsions and personality changes.

There is no treatment or vaccine available for either people or animals.
======================
[Nipah virus infections occur sporadically in Bangladesh in a geographic area termed the Nipah belt and during certain seasons of the year when the reservoir fruit bat is abundant. As noted in the previous comment (ProMED-mail archive no. http://promedmail.org/post/20150204.3143251), giant fruit bats or flying foxes (_Pteropus_ of several species) are reservoirs of Nipah virus, and they contaminate date palm sap or fruit. This is the season for cases of Nipah virus infection to occur. The transmission season is usually January to April.

As noted earlier, it is unfortunate that the public awareness efforts have not prevented these cases from occurring. Perhaps because cases are sporadic and geographically scattered there is little public perception of risk of infection and serious disease. Until effective public education to prevent infection by avoiding eating contaminated fruit or date palm sap is implemented, sporadic cases will continue to occur.

Interestingly, a simple skirt constructed out of locally available materials can prevent access of the bats to the palm sap collecting pots, but apparently they are not commonly used. Boiling the palm sap would inactivate the virus, but local consumers indicated that it alters the flavour of the sap.

An image of a _Pteropus_ fruit bat can be found at

[HealthMap/ProMED map available at:
Khulna, Khulna, Bangladesh: <http://healthmap.org/promed/p/14886>]
Date: Sat 4 Jan 2020
Source: bdnews24 [edited]

The death of Fazilatun Nasa Bappy has triggered fresh fears over swine flu [influenza A/H1N1] in Bangladesh, but experts have urged the people to follow health safety rules instead of panicking.  Bappy, a former Awami League MP [Member of Parliament] from the seats reserved for women, died at the Bangabandhu Sheikh Mujib Medical University [BSMMU] on [Thu 2 Jan 2020], 4 days after the doctors put her on life support. The 49-year-old was admitted to the hospital on [28 Dec 2019] with a combination of pneumonia and other respiratory diseases.

Tests found she was H1N1 positive, according to Professor AKM Akhtaruzzaman, the chairman of the BSMMU's Intensive Care Unit. "She contracted swine flu virus," the doctor told bdnews24.com on [Fri 3 Jan 2020].

The hospital authorities have urged all not to panic, saying that there are vaccines for the disease. Prof. ABM Abdullah, a former dean of the BSMMU's medicine department, told bdnews24.com patients suffering from the disease recover "most of the times."

Patients with problems in the respiratory system or lungs, those who have diabetes, pregnant women, children aged between 6 months and 5 years, and people older than 65 years are more vulnerable to swine flu, he said. "There is nothing to panic over swine flu. But there is also no room to take it lightly," he added.

The H1N1 influenza virus was 1st reported in April 2009 in Mexico before spreading across the globe. The World Health Organization [WHO] declared a global H1N1 flu pandemic on [11 Jun 2009].

Bangladesh's 1st case was detected on [18 Jun 2009] amid a global outbreak, which created panic. When the virus was detected in Bangladesh again in 2013, doctors said swine flu became a "seasonal influenza" (H1N1) in Bangladesh like the other 2 viruses -- influenza B and [influenza A/H3N2].

A combined vaccine against these 3 viruses is available, meaning a single shot can help high-risk groups like pregnant women, [people with] uncontrolled [diabetes], and cancer patients. Fever, runny nose, sore throat, and cough followed by breathing difficulty are some of the symptoms of swine flu.

Maintaining personal hygiene, especially washing hands and the crook of one's elbow with soap, [is] advised to prevent any flu.

Respiratory transmission occurs mainly by droplets disseminated by unprotected coughs and sneezes, according to the WHO. Short-distance airborne transmission of influenza viruses may occur, particularly in crowded enclosed spaces.

Hand contamination and direct inoculation of virus is another possible source of transmission, which is why experts advise caution while taking care of swine flu patients.

Meerjady Sabrina Flora, a director at the government's disease control agency IEDCR [Institute of Epidemiology, Disease Control and Research], said swine flu affects people regularly in Bangladesh now as it transmits from person to person, a way in which Bappy "might have contracted the virus."

She also said those returning from Europe or China or Korea should consult doctors if any symptom of swine flu is found in them, as it is the swine flu season there. "We can do the tests as well and give advice for free. Tests and treatment are also available outside," she added.  [Byline: Obaidur Masum]
9 December 2019
https://www.who.int/bangladesh/news/detail/09-12-2019-cholera-vaccination-campaign-launched-to-protect-635-000-people-in-cox-s-bazar

Cox’s Bazar, Bangladesh

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


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

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

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

Earlier rounds of cholera vaccination, which have taken place since the beginning of the emergency response in 2017, have helped prevent outbreaks of the disease. To this date, over 1 million people were vaccinated against cholera.
Date: Sat, 9 Nov 2019 18:59:25 +0100 (MET)

MOUSOUNI ISLAND, India, Nov 9, 2019 (AFP) - Cyclone Bulbul hit India and southern Bangladesh on Saturday, leaving two dead as authorities in the countries ordered more than two million people to get out of the path of the storm.   The cyclone, packing winds of up to 120 kilometres (75 miles) per hour, has "weakened" and "started crossing" India's West Bengal and Bangladesh's Khulna coast at about 9:00 pm (1500 GMT), Dhaka's Meteorological Department said in a special bulletin.   "It is likely to move in a northeasterly direction" and "weaken gradually, and may complete crossing West Bengal-Khulna coast by midnight tonight," the department said.     Airports and ports were shut down and the deaths were reported before the full force of the cyclone had hit.   One person was killed by an uprooted tree in Kolkata and another by a wall that collapsed under the force of the winds in Odisha state, authorities said.

More than 60,000 people were moved away from the coast on the Indian side of the border.   Bangladesh disaster management secretary Shah Kamal told AFP that "2.028 million" have been evacuated and moved to more than 5,500 cyclone shelters.   He said there was no reports of casualties and rejected reports in local media that dozens of local fishermen were missing on the southern coast.    Bangladeshi troops were sent to some villages, while about 55,000 volunteers went door-to-door and making loudspeaker announcements in the streets to get people away from the danger zone in villages, many of which were below sea level.

- Ports closed, flights halted -
A storm surge up to two metres (seven feet) was predicted along the coast, Bangladesh's Meteorological Department said.   About 1,500 tourists were stranded on the southern island of Saint Martin after boat services were suspended due to bad weather.   Bangladesh's two biggest ports, Mongla and Chittagong, were closed because of the storm, and flights into Chittagong airport were halted.   In India, flights in and out of Kolkata airport were suspended for 12 hours because of the storm.   On the West Bengal island of Mousouni, which lies in the path of the storm, frightened residents took shelter in schools and government buildings because they had not been able to escape.   Military planes and ships have been put on standby to help in emergencies, Indian authorities said.

Bulbul hit the coast at the Sundarbans, the world's largest mangrove forest, which straddles Bangladesh and part of eastern India, and is home to endangered species including the Bengal tiger and the Irrawaddy dolphins.   Bangladesh's low-lying coast, home to 30 million people, is regularly battered by cyclones that leave a trail of destruction.   Hundreds of thousands of people have been killed in cyclones in recent decades.   While the frequency and intensity have increased, partly due to climate change, the death tolls have come down because of faster evacuations and the building of 4,000 cyclone shelters along the coast.   In November 2007, Cyclone Sidr killed more than 3,000 people. In May this year, Fani became the most powerful storm to hit the country in five years, but the death toll was about 12.
More ...

Christmas Island

No Profile is available at present

Travel News Headlines WORLD NEWS

Date: Tue, 19 Sep 2006 17:41:31 +0200 (METDST) SYDNEY, Sept 19, 2006 (AFP) - A large earthquake with an estimated magnitude of 6.1 struck Tuesday near the Australian territory of Christmas Island, the US Geological Survey said. The quake struck at 20:58 local time (1358 GMT) and its epicentre was located 191 kilometres (119 miles) east-northeast of Christmas Island, the USGS report said. The reading was based on the open-ended Moment Magnitude scale, now used by US seismologists, which measures the area of the fault that ruptured and the total energy released.
27 Aug 2001 A NORWEGIAN ship carrying 438 sick and starving refugees was moored in limbo off Christmas Island last night, with John Howard refusing to allow them to disembark and Indonesia reluctant to let them berth anywhere in its territory. http://email.ni.com.au/Click?q=96-pjPWQtdfI9qzkLcbUQgkSoeR
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Guadeloupe

French West Indies US Consular Information Sheet
April 02, 2008
COUNTRY DESCRIPTION:
The French West Indies consists of the islands of Martinique, Guadeloupe, St. Martin (the French side) and St. Barthélemy. These islands are well develop
d. In St. Martin and St. Barthélemy, English is widely spoken, and U.S. currency is accepted. Read the Department of State Background Notes on France for additional information.

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

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

Visas are generally not required for visitors planning to remain for up to 90 days. For further information, travelers can contact the Embassy of France at 4101 Reservoir Road NW, Washington, DC 20007; telephone 1 202 944-6000; or the nearest French consulate in Atlanta, Boston, Chicago, Houston, Los Angeles, Miami, New York, New Orleans or San Francisco. Visit the web site for the Embassy of France at http://www.info-france-usa.org for the most current visa information.

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

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

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

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

CRIME:
Petty street crime, including purse snatching, occurs throughout the French West Indies. Visitors should take care whenever traveling to safeguard valuables and always lock hotel rooms and car doors.

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

See our information on Victims of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION:
Good medical care is available throughout the French West Indies. Not all doctors speak or understand English. Hyperbaric chambers are available in Guadeloupe at the Centre Hospitalier Universitaire in Abymes, http://www.chu-guadeloupe.fr/fr/fw_index.asp, and, in Martinique at the Centre Hospitalier Universitaire in Fort de France, http://www.chu-fortdefrance.fr/pages/sommaire.html.
Cases of dengue fever have been reported in Martinique and Guadeloupe.

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

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

TRAFFIC SAFETY AND ROAD CONDITIONS:
While in a foreign country, U.S. citizens may encounter road conditions that differ significantly from those in the United States.
The information below concerning the French West Indies is provided for general reference only, and may not be totally accurate in a particular location or circumstance.
Driving in the French West Indies is on the right side of the road. Children under 12 are not legally allowed in the front seat. Seatbelt laws are strictly enforced.

The roads in the French West Indies are the best in the Eastern Caribbean. Roads are well paved and well maintained. Main roads are well marked; secondary roads and tourist sites are adequately marked. Excellent maps are available and local residents are helpful, especially if greeted in a friendly manner. Both Martinique and Guadeloupe have expressways. Traffic safety is enforced by the police. Night driving can be dangerous, especially in the mountains and on winding rural roads. Public transportation in the form of taxis, vans, and buses is relatively safe. For specific information concerning French West Indies driver's permits, vehicle inspection, road tax and mandatory insurance, contact the French National Tourist Organization offices at: http://www.franceguide.com/.

Please refer to our Road Safety page for more information.
Visit the web site of the country’s national tourist office and national authority responsible for road safety at http://www.securite-routiere.gouv.fr/index.html.

AVIATION SAFETY OVERSIGHT:
Civil aviation operations in the French West Indies fall under the jurisdiction of French authorities.
The U.S. Federal Aviation Administration (FAA) has assessed the Government of France’s Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for oversight of France’s air carrier operations.
For more information, travelers may visit the FAA’s web site at http://www.faa.gov/safety/programs_initiatives/oversight/iasa.

SPECIAL CIRCUMSTANCES: In addition to being subject to all French laws affecting U.S. citizens, dual nationals may also be subject to other laws that impose special obligations on French citizens. Although France recognizes dual nationality, dual nationals are considered French citizens and are subject to French laws without regard to the other nationality. For additional information, please see our Dual Nationality flyer.

French customs authorities may enforce strict regulations concerning temporary importation into or export from the French West Indies of items such as firearms, medications, animals, etc. For questions, travelers may wish to contact the Embassy of France or a French Consulate for specific information regarding customs requirements. Please see our information on customs regulations.

The French West Indies can be affected by hurricanes. The hurricane season normally runs from June to the end of November, but there have been hurricanes in December in recent years. General information about natural disaster preparedness is available via the Internet from the U.S. Federal Emergency Management Agency (FEMA) at: http://www.fema.gov/.
Please see Customs Information.

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

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

REGISTRATION / EMBASSY LOCATION:
Americans living or traveling in the French West Indies are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department's travel registration web site, and to obtain updated information on travel and security within the French West Indies. Americans without Internet access may register directly with the U.S. Embassy in Barbados, which has jurisdiction over the French West Indies. 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 in Wildey Business Park in St. Michael, Barbados; web site: http://barbados.usembassy.gov/.

The Consular Section is open for American Citizens Services from 8:30am to 4:00pm, Monday-Friday, except Barbados and U.S. holidays. For after-hours service, American citizens may contact the U.S. Embassy in Bridgetown, Barbados, telephone 1-246-436-4950. The U.S. Consular Agent in Martinique, Henry Ritchie, is located at the Hotel Valmeniere #615, Avenue des Arawaks, 97200 Fort de France, telephone (011) (596) (596) 75-6754, fax (011) (596) (596) 70-8501, mobile (011) (596) (696) 93-8406, email: hritchie@sbcglobal.net. Consular Agent Henry Ritchie is available Monday through Friday from 9:00am to 12:00pm, except French and U.S. holidays.
* * *
This replaces the Country Specific Information for French West Indies dated June 7, 2007, to update sections on Entry/Exit Requirements, Safety and Security, Traffic Safety and Road Conditions, Medical Facilities and Health Information, and Registration/Embassy Location.

Travel News Headlines WORLD NEWS

Date: Thu, 24 May 2018 11:39:42 +0200

Paris, May 24, 2018 (AFP) - The French government is preparing a plan to deal with a new invasion of stinky seaweed that is covering the beaches of some its islands in the Caribbean, causing health problems for residents and threatening key fishing and tourism industries.

The brown sargassum algae "is one more disaster for the West Indies, one which we here probably haven't fully taken into account," Environment Minister Nicolas Hulot told lawmakers in Paris late Wednesday.   Tons of the seaweed began arriving on the islands of Martinique and Guadeloupe several weeks ago, where it has piled up knee deep in some areas over large stretches of shoreline.

It soon begins decaying, producing huge amounts of hydrogen sulphide and other noxious gases which reek of ammonia or rotten eggs and can severely irritate the eyes, nose and throat.   The fumes also damage nearby houses and other property by eating away at metal, while also killing fish and fauna, hurting the local fishing industry.   Officials have closed schools near infested zones, while some islands have been cut off since supply boats and ferries cannot get past the thick banks of seaweed.

The French government has already unlocked three million euros ($3.5 million) of credits for supplying tractors, gas masks and other equipment to remove the seaweed -- though it often returns in a matter of weeks.   "Beyond the urgent response, a new national plan for combatting sargassum will be finalised by mid-June," Hulot said in parliament.   Although researchers are not sure why the seaweed suddenly begins proliferating in the region, "climate change is probably aggravating the problem," Hulot said.

Similar outbreaks have occurred in the Caribbean in recent years, often requiring officials to deploy the army to gather up the seaweed.   But officials then need to figure out what to do with it, since the fumes are so toxic that the algae cannot be used for producing biomass fuel, nor can it be turned into fertiliser.

Currently the only option is to spread it out across acres of isolated land until it fully decays and dries out.   This latest invasion comes as Guadeloupe, Martinique and other French islands are still rebuilding from devastating hurricanes that struck the Caribbean last September, causing millions of euros in damages.
Date: Tue, 19 Sep 2017 19:05:52 +0200

Pointe-à-Pitre, Sept 19, 2017 (AFP) - At least one person was killed as Hurricane Maria battered Guadeloupe, officials said Tuesday, in the first confirmed casualty from the huge storm sweeping the eastern Caribbean.     The person was killed by a falling tree, the local administration said, while two more were reported missing after their ship sank off Desirade, the easternmost island in the French territory's archipelago.   The dead person "did not respect orders to stay inside", authorities said in a statement, adding that "several floods have been signalled" around Pointe-a-Pitre, Guadeloupe's largest city.

Coastal areas around the capital Basse-Terre have also been "submerged".   "All of the archipelago's road networks have been affected by falling trees or branches," it said.   Little damage to buildings had been reported so far, though "some roofs have been ripped off".   Authorities said 40 percent of households in the territory of some 400,000 had no electricity, and 25 percent of landlines had been cut.   The US National Hurricane Center described Maria as "potentially catastrophic" as it pushed northwest towards the Virgin Islands and Puerto Rico.
Date: Wed 7 Jun 2017
From: Aubert Lyderic <lyderic.aubert@santepubliquefrance.fr> [edited]

Since May 2015, the French Caribbean territories experience an outbreak of viral conjunctivitis.

According to the general practitioners (GP) sentinel network, the number of medical consultations due to conjunctivitis during the last 2 weeks (W2017-20 and W2017-21) was estimated between 500 and 600 cases per week in Guadeloupe and 150 and 250 cases per week in Martinique.

The beginning of the outbreak in week 2017-20 [week 14 to 20 May 2017] was confirmed by the GP's network on the 2 territories. Their reports showed that the outbreak had spread in Guadeloupe Archipelago from Marie-Galante island and in Martinique, the center and the south of the island are currently the most affected areas. As of today [Wed 7 Jun 2017], around 35 percent of municipalities of the 2 territories do not report any case. The peak does not seem to have been reached.

In order to determine the etiology of this outbreak, biological samples were performed on conjunctiva and naso-pharynx from cases of conjunctivitis who consulted in emergency departments of the main public hospitals of both territories. The 1st analyses confirmed presence of enteroviruses with significant viral loads. Results from biological investigation of adenovirus are not yet known. Among the conjunctivitis specimens testing positive for enteroviruses, samples were sent to the National Reference Centre for Enteroviruses (Lyon, France) for further characterization.

Outbreaks of viral conjunctivitis occur mainly in tropical countries with high population density, hot and humid climate. They are mostly attributed to adenoviruses and enteroviruses (EV). Enteroviruses are ubiquitous pathogens responsible for a large range of infections. There is no specific antiviral treatment.

In the Caribbean and in the American region, several outbreaks of conjunctivitis have also been reported (Haiti, Dominican Republic, Mexico, French Guiana and Surinam) but the pathogen has not yet been identified.

The source of the week epidemiological bulletin (will be update soon at this link):
-----------------------------------
Aubert Lyderic
National Public Health Agency
Regional Office of French Caribbean Territories
lyderic.aubert@santepubliquefrance.fr
====================
[Conjunctivitis, also known as pinkeye, is an inflammation of the conjunctiva. The conjunctiva is the thin clear tissue that lies over the white part of the eye and lines the inside of the eyelid.

There are a number of different causes, including infectious agents such as Viruses (Adenoviruses, Enteroviruses), Bacteria (gonorrhea or chlamydia), or Allergies to dust, pollen, contact lenses.

Both viral and bacterial conjunctivitis are highly contagious. Each of these types of germs can spread from person to person in different ways. They are usually spread from an infected person to others through:
- close personal contact, such as touching or shaking hands
- the air by coughing and sneezing
- touching an object or surface with germs on it, then touching your eyes before washing your hands. <https://www.cdc.gov/conjunctivitis/about/transmission.html>.

Infectious conjunctivitis caused by some bacteria and viruses can spread easily from person to person, but is not a serious health risk if diagnosed promptly.

As confirmed by laboratory diagnosis in the above report, the causative agent for most of the tested cases was enteroviruses.

Most cases of viral conjunctivitis are mild. The infection will usually clear up in 7 to 14 days without treatment and without any long-term consequences. But in some cases, viral conjunctivitis can take 2 to 3 weeks or more to clear up. An antiviral medication can be prescribed to treat more serious forms of conjunctivitis for which there is a specific treatment, such as those caused by herpes simplex virus or varicella-zoster virus. Antibiotics will not improve viral conjunctivitis. - ProMED Mod.UBA]

[The HealthMap/ProMED maps can be found at:
Guadeloupe, Guadeloupe: <http://healthmap.org/promed/p/57615> and,
Martinique: <http://healthmap.org/promed/p/43638>. - ProMED Mod.MPP]
Date: Sat 8 Mar 2014
Source: European Centre for Disease Prevention and Control (ECDC), [edited]

Communicable Disease Threats Report (CDTR), week 10 (2-8 Mar 2014)
------------------------------------------------------------------
On 6 Dec 2013, France reported 2 laboratory-confirmed autochthonous cases of chikungunya in the French part of the Caribbean island of St Martin. Since then, local transmission has been confirmed in the Dutch part of Saint Martin [St Maarten], on Martinique, St Barthelemy, Guadeloupe, British Virgin Islands, Dominica, Anguilla, and French Guiana. Aruba only reported imported cases. This is the 1st documented outbreak of chikungunya with autochthonous transmission in the Americas. As of 6 Mar 2014, there have been close to 8000 suspected cases in the region. There have been 3 fatalities reported.

Update of the week
------------------
During the past week the number of new cases reported increased in some of the affected areas. No new affected areas or islands were reported. The islands affected are St Martin/St Maarten, Martinique, St Barthelemy, Guadeloupe, Virgin Islands (UK), Anguilla, Dominica, Aruba, Saint Kitts and Nevis, and French Guiana in mainland South America.
===================
[It is good to learn that there are no new localities reporting chikungunya virus infections, either locally acquired or imported. However, with new cases being reported in localities with previously reported cases, the risk of spread to other islands or mainland countries remains real. There is no further information concerning the suspected cases in Merida, Yucatan, Mexico reported in last week's update (see ProMED-mail archive no 20140302.2309812). It is important to know if these cases were confirmed or discarded.

Maps showing the location of the islands mentioned can be accessed at
Date: 3-9 Feb 2014
Source: Pointe Epidemiologique No. 6. French Caribbean Antilles [in French, trans. ProMed Mod.TY, summarized, edited]

Cases since November 2013:
  • St. Martin (susp.) 1450 cases, (probable and conf.) 653 cases.
  • St. Barthelemy (susp.) 270 cases, (probable and conf.) 104 cases
  • Martinique (susp.) 2040 cases, (probable and conf.) 844 cases; increasing
  • Guadeloupe (susp.) 1120 cases, (probable and conf.) 253 cases.

[Weekly graphs and maps for these case locations are provided in the above URL. ProMed Mod.TY]

Other Caribbean localities:
  • British Virgin Islands 6 locally acquired cases
  • St. Maarten 65 locally acquired cases
  • Anguilla 5 locally acquired cases, 1 imported case
  • Dominica 3 locally acquire cases, 1 imported case
  • Aruba 1 imported case from St. Maarten.
More ...

Benin

Benin - US Consular Information Sheet
April 28, 2008

COUNTRY DESCRIPTION:
Benin is a developing country in West Africa. Its political capital is Porto Novo. However, its administrative capital, Cotonou, is Benin's largest city and the
site of most government, commercial, and tourist activity. Read the Department of State Background Notes on Benin for additional information.

ENTRY/EXIT REQUIREMENTS: A passport and visa are required. Visas are not routinely available at the airport. Visitors to Benin should also carry the WHO Yellow Card (“Carte Jaune”) indicating that they have been vaccinated for yellow fever. Contact the Embassy of Benin for the most current visa information. The Embassy is located at: 2124 Kalorama Road NW, Washington, DC 20008; tel: 202-232-6656.

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

SAFETY AND SECURITY:
U.S. citizens should avoid crowds, political rallies, and street demonstrations and maintain security awareness at all times.
U.S. citizens should not walk on the beach alone at any time of day. It is also highly recommended not to carry a passport or valuables when walking in any part of the city. Travelers should carry a notarized photocopy of the photo page of their passport (see Crime section). They should not walk around the city after dark, and should take particular care to avoid the beach and isolated areas near the beach after dark.
The ocean currents along the coast are extremely strong and treacherous with rough surf and a strong undertow, and several people drown each year.

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

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

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

CRIME: Street robbery is a significant problem in Cotonou. Robbery and mugging occur along the Boulevard de France (the beach road by the Marina and Novotel Hotels) and on the beaches near hotels frequented by international visitors. Most of the reported incidents involve the use of force, often by armed persons, with occasional minor injury to the victim. Travelers should avoid isolated and poorly lit areas and should not walk around the city or the beaches between dusk and dawn. Even in daylight hours, foreigners on the beach near Cotonou are frequent victims of robberies. When visiting the beach, travelers should not bring valuables and should carry only a photocopy of their passport. If you are a victim of crime, you should contact the U.S. Embassy immediately. There has been a continued increase in the number of robberies and carjacking incidents after dark, both within metropolitan Cotonou and on highways and rural roads outside of major metropolitan areas. Motorists are urged to be wary of the risk of carjacking. Keep the windows of your vehicle rolled up and the doors locked. Stay alert for signs of suspicious behavior by other motorists or pedestrians that may lead to carjacking, such as attempts to stop a moving vehicle for no obvious reason. Travelers should avoid driving outside the city of Cotonou after dark and should exercise extreme caution when driving in Cotonou after dark (see Traffic Safety and Road Conditions below). Overland travel to Nigeria is dangerous near the Benin/Nigeria border due to unofficial checkpoints and highway banditry.
Travelers should avoid the use of credit cards and automated teller machines (ATMs) in Benin due to a high rate of fraud. Perpetrators of business and other kinds of fraud often target foreigners, including Americans. While such fraud schemes in the past have been largely associated with Nigeria, they are now prevalent throughout West Africa, including Benin, and are more frequently perpetrated by Beninese criminals. Business scams are not always easy to recognize, and any unsolicited business proposal should be carefully scrutinized. There are, nevertheless, some indicators that are warnings of a probable scam. Look out for:

Any offer of a substantial percentage of a very large sum of money to be transferred into your account, in return for your "discretion" or "confidentiality";

Any deal that seems too good to be true;
Requests for signed and stamped, blank letterhead or invoices, or for bank account or credit card information;
Requests for urgent air shipment, accompanied by an instrument of payment whose genuineness cannot immediately be established;
Solicitations claiming the soliciting party has personal ties to high government officials;
Requests for payment, in advance, of transfer taxes or incorporation fees;
Statements that your name was provided to the soliciting party either by someone you do not know or by "a reliable contact";
Promises of advance payment for services to the Beninese government; and
Any offer of a charitable donation.
These scams, which may appear to be legitimate business deals requiring advance payments on contracts, pose a danger of both financial loss and physical harm. Recently more American citizens have been targeted. The perpetrators of such scams sometimes pose as attorneys. One common ploy is to request fees for “registration” with fictitious government offices or regulatory authorities. The best way to avoid becoming a victim of advance-fee fraud is common sense – if it looks too good to be true, it probably is. Travelers should carefully check out any unsolicited business proposal originating in Benin before committing any funds, providing any goods or services, or undertaking any travel. For additional information, please see the Department of State’s Bureau of Consular Affairs brochure, International Financial Scams.

Scams may also involve persons posing as singles on Internet dating sites or as online acquaintances who then get into trouble and require money to be "rescued." If you are asked to send money by someone you meet online please contact the U.S. Embassy before doing so.

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

See our information on Victims of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION: Medical facilities in Benin are limited and not all medicines are available. Travelers should bring their own supplies of prescription drugs and preventive medicines. Not all medicines and prescription drugs available in Benin are USFDA-approved. Malaria is a serious risk to travelers to Benin. For information on malaria, its prevention, protection from insect bites, and anti-malarial drugs, please visit the CDC Travelers' Health web site at http://www.cdc.gov/malaria/.

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

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

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

With the exception of the road linking Cotonou in the south to Malanville on the border with Niger in the north, and from Parakou in central Benin to Natitingou in the northwestern part of the country, roads in Benin are generally in poor condition and are often impassable during the rainy season. Benin's unpaved roads vary widely in quality; deep sand and potholes are common. During the rainy season from mid-June to mid-September, dirt roads often become impassable. Four-wheel drive vehicles with full spare tires and emergency equipment are recommended.
Most of the main streets in Cotonou are paved, but side streets are often dirt with deep potholes. Traffic moves on the right, as in the United States. Cotonou has no public transportation system; many Beninese people rely on bicycles, mopeds, motorbikes, and zemidjans (moped taxis). All official Americans are required to wear safety helmets when on a motorcycle and are strongly discouraged from using zemidjans. Travelers using zemidjans, particularly at night, are much more vulnerable to being mugged, assaulted or robbed. Buses and bush taxis offer service in the interior.
Gasoline smuggled from Nigeria is widely available in glass bottles and jugs at informal roadside stands throughout Cotonou and much of the country. This gasoline is of unreliable quality, often containing water or other contaminants that can damage or disable your vehicle. Drivers should purchase fuel only from official service stations. There are periodic gas shortages, which can be particularly acute in the north of the country where there are few service stations.
U.S. citizens traveling by road should exercise extreme caution. Poorly maintained and overloaded transport and cargo vehicles frequently break down and cause accidents. Drivers often place branches or leaves in the road to indicate a broken down vehicle is in the roadway. Undisciplined drivers move unpredictably through traffic. Construction work is often poorly indicated. Speed bumps, commonly used on paved roads in and near villages, are seldom indicated. Drivers must be on guard against people and livestock wandering into or across the roads. Nighttime driving is particularly hazardous as vehicles frequently lack headlights and/or taillights, and brake lights are often burned out.
With few exceptions, Cotonou and other cities lack any street lighting, and lighting on roads between population centers is non-existent. The U.S. Embassy in Cotonou prohibits non-essential travel outside of metropolitan areas after dusk by official Americans and strongly urges all U.S. citizens to avoid night driving as well. There have been numerous carjackings and robberies on roads in Benin after dark, several of which resulted in murder when the driver refused to comply with the assailants' demands. The National Police periodically conduct vehicle checks at provisional roadblocks in an effort to improve road safety and reduce the increasing number of carjackings. When stopped at such a roadblock, you must have all of the vehicle's documentation available to present to the authorities.
Please refer to our Road Safety page for more information. Visit the website of the country’s national tourist office at http://www.benintourisme.com.

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

SPECIAL CIRCUMSTANCES:
U.S. citizens are advised to keep a notarized photocopy of the photo page of their passport with them at all times when traveling in Benin.
The Embassy has had a few reports of officials requesting a "gift" to facilitate official administrative matters (e.g., customs entry). Such requests should be politely but firmly declined.
It is prohibited to photograph government buildings and other official sites, such as military installations, without the formal consent of the Government of Benin. In general, it is always best to be courteous and ask permission before taking pictures of people. Beninese citizens may react angrily if photographed without their prior approval.
Obtaining customs clearance at the port of Cotonou for donated items shipped to Benin from the United States may be a lengthy process. In addition, to obtain a waiver of customs duties on donated items, the donating organization must secure prior written approval from the Government of Benin. Please contact the U.S. Embassy in Cotonou for more detailed information.Please see our Customs Information.

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

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

REGISTRATION / EMBASSY LOCATION:
Americans living or traveling in Benin are encouraged to register with the U.S. Embassy through the State Department’s travel registration web site so that they can obtain updated information on travel and security within Benin. Americans withoutInternet access may register directly with the U.S. Embassy. 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 Rue Caporal Anani Bernard in Cotonou. The Embassy's mailing address is B.P. 2012, Cotonou, Benin. The 24-hour telephone numbers are (229) 21-30-06-50, 21-30-05-13, and 21-30-17-92. The Embassy’s general fax number is (229) 21-30-06-70; the Consular Section’s fax number is (229) 21-30-66-82; http://cotonou.usembassy.gov/.
* * *
This replaces the Country Specific Information for Benin dated August 17th, 2007 to update sections on Safety and Security and Traffic Safety and Road Conditions.

Travel News Headlines WORLD NEWS

Date: Fri, 10 May 2019 19:38:30 +0200
By Hazel WARD and Daphne BENOIT

Paris, May 10, 2019 (AFP) - French special forces have freed two French hostages, an American and a South Korean in northern Burkina Faso in an overnight raid in which two soldiers died, authorities announced Friday.   The operation was launched to free two French tourists who had disappeared while on holiday in the remote Pendjari National Park in neighbouring Benin on May 1.

But during the raid, the French troops were surprised to discover two women also in captivity, with top officials saying they had been held for 28 days.    The French tourists were identified as Patrick Picque, 51, and Laurent Lassimouillas, 46, but the women's identities were not immediately clear.     "No one was aware of (the women's) presence," French Defence Minister Florence Parly told reporters, while French armed forces chief Francois Lecointre said.   "We know little about these other two hostages," Parly told reporters, saying that even Seoul and Washington did not appear to be aware the pair were in increasingly unstable Burkina Faso.    The raid was approved by French President Emmanuel Macron in what was seen as the last opportunity to stop the hostages being transferred to lawless territory in Mali to the north.

Parly said it was "too early to say" who had snatched the two French nationals from Benin, which has long been an island of stability in a region where Islamist militants are increasingly active.   "The message to terrorists and criminal gangs is clear: those who attack France and its nationals know that we will not spare any effort to track them down, find them and neutralise them," she said.   Four of the six kidnappers were killed in the raid.    French forces, helped by intelligence provided by the United States, had been tracking the kidnappers for several days as they travelled across the semi-desert terrain of eastern Burkina Faso from Benin to Mali.   They seized the opportunity to prevent "the transfer of the hostages to another terrorist organisation in Mali," Lecointre said, referring to the Macina Liberation Front (FLM).   The FLM is a jihadist group formed in 2015 and headed by a radical Malian preacher, Amadou Koufa. It is aligned with Al-Qaeda in the region.

- US intelligence support -
In a statement, Macron congratulated the special forces on the operation, in which he also expressed sorrow over the death of the two soldiers "who gave their lives to save those of our citizens".   And Parly thanked authorities in Benin and Burkina Faso for their help with the "complex operation", as well as the United States which provided intelligence and support.

The operation was also made possible by the presence of France's Operation Barkhane, which counts some 4,500 troops deployed in Mali, Burkina Faso, Niger and Chad to help local forces battle jihadist groups.   American special forces and drones are also known to operate in the violence-wracked Sahel region, which France fears could become further destabilised as jihadist groups are pushed out of north Africa, Iraq and Syria.   Burkina Faso has suffered from increasingly frequent and deadly attacks attributed to a number of jihadist groups, including the Ansarul Islam group, the Group to Support Islam and Muslims (GSIM) and Islamic State in the Greater Sahara.

- Relief and sadness -
The French tourists -- Patrick Picque who works in a Paris jewellery shop, and Laurent Lassimouillas a piano teacher, -- went missing with their guide on the last leg of their holiday in usually peaceful Benin.   The Pendjari wildlife reserve, which is famed for its elephants and lions, lies close to the porous border with Burkina Faso.   The badly disfigured body of their guide was found shortly after they disappeared, as well as their abandoned four-wheel Toyota truck.   The two freed men will be flown back to France on Saturday, alongside the South Korean woman, where they will be met on arrival by Macron and other top French officials.   Washington thanked the French forces for freeing the American hostage, with France saying she would likely be "repatriated independently" from the other three. 

The two dead French soldiers were named as Cedric de Pierrepont and Alain Bertoncello, decorated naval special forces members born in 1986 and 1991 respectively.   They were part of the prestigious Hubert commando unit of the French naval special forces which was deployed to the Sahel at the end of March.   A total of 24 French soldiers have died in the region since 2013 when France intervened to drive back jihadist groups who had taken control of northern Mali. The last death was on April 2.
Date: Tue 15 Jan 2019
Source: Punch [edited]

The Kwara state government has confirmed 2 cases of Lassa fever infecting a husband and wife in the state.

Speaking with newsmen on Tuesday [15 Jan 2019] at a news briefing, the Kwara commissioner for health, Alhaji Usman Rifun-Kolo, said the outbreak of Lassa fever was identified in a farm settlement in Taberu, Baruten local government area.

He explained that the 2 cases of the disease affected a husband and wife, natives of Benin republic, which shares a border with the state. He added that the husband and wife are farming in Baruten. "These cases of Lassa fever originated from Benin republic, whose citizen have interrelations with people in the Baruten area," he said.

According to him, the husband and wife were diagnosed in a health facility, and the state government had already deployed a disease-surveillance team to identify those who have been in contact with the patients.

Rifun-Kolo further explained that the surveillance team identified 4 people with a history of fever in the area. He said that the 4 cases raised suspicion of Lassa fever, which prompted them to take samples from the individuals for further investigation. He noted that the 4 individuals have commenced treatment in Taberu, Baruten LGA.
=====================
[The above report states that the couple was infected in Benin, although the timeline when that may have occurred is not given. The report also mentions 4 individuals in the Kwara state who had a history of Lassa fever, implying that the virus is present in that state in Nigeria as well. In December [2018], there were Lassa fever cases in Benin that were imported from Nigeria as well as infections that were locally acquired in Benin, so the Lassa fever cases cross the border in both directions. The source of the infecting virus for any of these cases is not mentioned. - ProMED Mod.TY

[HealthMap/ProMED-mail maps:
Kwara state, Nigeria: <http://healthmap.org/promed/p/19690>]
Date: Wed 26 Dec 2018
Source: Quotidein Le Matinal [in French, trans. ProMED Corr.SB, edited]

Minister of health Benjamin Hounkpatin confirmed on Wednesday [26 Dec 2018] 4 new cases of Lassa haemorrhagic fever in Benin, including one in Cotonou. This occurred in the period from 15-26 Dec 2018.

In the case of Cotonou, a 28-year-old (has been infected). His case was detected on 24 Dec [2018], but his illness commenced the previous week. He had a fever, a cough, a cold, and fatigue. Due to the persistence of the cough and cold, and with the appearance of traces of blood in nasal discharge on 24 Dec 2018, the alert was given.

The patient was placed in isolation on [Tue 25 Dec 2018], and on the morning of Wed 26 Dec 2018, his result from the laboratory came back positive [for Lassa fever]. Subsequently, the patient was isolated and put on treatment.

According to the details provided by Hounkpatin, there is no indication of travel [by the patient] to an epidemic locality of Lassa fever. According to the patient's statements, there is no known contact with rodents.

Taking advantage of this opportunity, the minister reassured the public that public health measures are underway. He also reminded people of the behaviours that will help avoid becoming infected. This involves washing hands regularly with soap and water; avoiding contact with stool, sperm, urine, saliva, vomit, and contaminated objects from a person suspected to be ill or dead from Lassa; and protecting food and keeping it in a safe place, out of reach of rodents.

It should be recalled that 7 cases have been recorded since the beginning of the epidemic to date, including 5 positive cases.
=======================
[One case is located in Cotonou on the Benin coast and apparently was locally acquired, perhaps from contact with the rodent host or its excrement. The location of the other 3 cases is not mentioned, but a 13 Dec 2018 report indicated that there were 3 cases in the municipality of Parakou in Borgou Department, in the northern part of Benin. Perhaps these 3 cases, which came from the village Taberou (in Nigeria), located 5 km [3.1 mi] from Tandou in the commune of Tchaourou, are the ones mentioned in this report.

The previous Lassa fever cases in Benin this year [2018] occurred in January and also involved case importation from Nigeria. A previous WHO report stated that Lassa fever is endemic in bordering Nigeria, and, given the frequent population movements between Nigeria and Benin, the occurrence of additional cases is not unexpected. Strengthening of cross-border collaboration and information exchange between the 2 countries is, therefore, needed. - ProMED Mod.TY]

[Images of the rodent reservoirs of Lassa fever virus can be seen as follows:
For _Mastomys natalensis_, see
For _M. erythroleucus_ and _Hylomycus pamfi_, see

HealthMap/ProMED-mail maps:
Date: Fri, 29 Jun 2018 13:37:32 +0200

Cotonou, June 29, 2018 (AFP) - Benin's Constitutional Court has banned the right to strike by workers in the country's defence, security, justice and health sectors, sparking concern among union officials and legal observers.   The ruling, issued late on Thursday, came after months of wrangling between the government and the court, which had previously said the measure was unconstitutional.

"Civil servants, public security forces and equivalents should fulfil their duties in all circumstances and not exercise their right to strike," the court said in its new ruling.   "There should be no disruption to the duties of public sector defence, security, justice and health workers."   The decision was taken "in the public interest" and for "the protection of citizens", it said.

Speaking on Friday, one senior union leader, who asked to remain anonymous, described the ruling as shocking and a "hammer blow".   And Benin legal affairs expert Albert Medagbe told AFP the decision was a "worrying sudden legal U-turn".   Earlier this month, a close ally of President Patrice Talon, Joseph Djogbenou, was elected to lead the Constitutional Court during a vote held behind closed doors.   Djogbenou is Talon's former personal lawyer and was previously  Benin's attorney general.

Until his arrival, the court had strained relations with Talon, and had criticised the government for misunderstanding and failing to respect the constitution.   The small West African nation was last year hit by a wave of public sector strikes, which brought the education, health and justice system to a near halt.   The industrial action was sparked by Talon's attempts to introduce free-market reforms.
Date: Wed, 21 Feb 2018 17:31:52 +0100

Cotonou, Feb 21, 2018 (AFP) - Nine people appeared in a Benin court Wednesday on charges of selling fake drugs at the start of a landmark trial in a regional campaign against illicit medicines.   The suspects, who include executives from major pharmaceutical companies operating in the West African nation, were remanded in custody until March 6 on technical grounds.   They are accused of "the sale of falsified medicines, (and) display, possession with a view to selling, commercialisation or sale of falsified medical substances."   A tenth defendant, the head of the Directorate for Pharmacies, Medications and Diagnostic Evaluation (DPMED) under the control of the ministry of health, was not in court on the trial's opening day.   He is accused of failing to prevent the offences.

Benin launched the crackdown last year after mounting alarm about the scale of the trafficking of expired and counterfeit drugs in West Africa.   Fake medicines are drugs that are bogus or below regulatory standards but often are outwardly indistinguishable from the genuine product.   Taking them may do nothing to tackle an illness or -- in the case of antibiotics -- worsen the problem of microbial resistance.   According to an investigation by the Paris-based International Institute of Research Against Counterfeit Medicines (IRACM), West African markets are awash with fake drugs made in China and India.

In 2015, the American Society of Tropical Medicine and Hygiene estimated that 122,000 children under five died due to taking poor-quality antimalarial drugs in sub-Saharan Africa.   A 15-nation regional body, the Economic Community of West African States (ECOWAS), last April announced an investigation into the fake drugs business.   A lawyer for the civilian plaintiffs told AFP that the trial in Benin was adjourned until March 6 at their request "in order to incorporate another case, of illegal pharmaceutical practice".
More ...

Gambia

General
*******************************
The Gambia is situated on the coast of West Africa and is a common tourist destination. It enjoys a tropical climate with a rainy season between May to October each year. Harmattan winds can be experienced
during the dry season.
Stability throughout the country has been in question since a coup in 1994 but generally tourists remain unaware of any particular difficulty in this regard. Civilian rule has been in place since 1996. There is a successful tourist industry and the majority of travellers will remain in the resort regions along the coast.
Safety & Security
*******************************
It is uncommon to hear of attacks against tourists but it is considered unwise to flaunt personal wealth. Thus wearing valuable jewellery or watches should be avoided. Use the hotel safety deposit boxes for storing items of value and keep an eye on personal belongings while on the beach, on ferries or walking through market places. Many of the main tourist beaches have police or hotel security but there would be a risk if visiting some of the more isolated areas along the coast.

Road Transport
*******************************
In the main tourist regions road transport is perfectly reasonable but travelling throughout the country, particularly during the rainy season, is much more difficult. Paved roads exist in the capital, Banjul, but pedestrians still need to take care while out walking. If leaving the main tourists resorts it is essential to travel with a recognised guide. If driving, take care to stop at all check points and never reverse to avoid a road checkpoint. It is safer to use a taxi where possible (green ones for tourists). Avoid travelling to the Casamance region in Senegal (close to Gambia border), as this area is quite unstable at present. The region around Ziguinchor has also unexploded mines and armed bandits and so it would be wise to avoid.
Ferry Risks
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Taking the Banjul to Barra ferry may involve safety risks as the boat is frequently overcrowded and does not carry enough life belts etc for the number of passengers. All the engines for the ferry do not always work and it may be wiser to consider travelling 150km upriver and use the Yelitenda to Bambatenda ferry.
Health Facilities
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The level of medical facilities varies greatly throughout the country. The Medical Research Council facility in Banjul offers excellent healthcare but travellers are advised to carry sufficient supplies of any personal medication they may require while abroad.
Food & Water Facilities
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The main tourist resorts offer a good standard of food for tourists. However, it is wise to ensure that all food is fresh and well cooked. Avoiding bivalve shell fish (oysters, mussels, clams etc) is essential as these foods are frequently associated with illness among those who partake. The tap water supply may not always be regularly maintained and so it is safer to use sealed mineral water for both drinking and brushing your teeth while in The Gambia. Ice in drinks will be made from tap water and so best avoided. Food and fluids should not be purchased from street vendors except in the case of fruit, which you will then peel yourself. Tinned drinks may be safe but be careful to clean the lip before drinking straight from the can.
Malaria & Mosquitoes
*******************************
The risk of malaria in The Gambia is generally between June to December each year. Tourists have seldom been at significant risk up until recently when there has been a significant increase in the numbers of cases returning to Europe with the disease. Malaria prophylaxis should be used throughout the year. Mosquitoes mainly bite between dusk and dawn but other species can bite at any time of the day.
Rabies Risk
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There is an ever-present risk of Rabies in Africa and The Gambia is no exception. The disease is mainly transmitted to humans through the bite of an infected dog but other animals also pose a risk including cats and monkeys. The disease can also be transmitted through licks and scratches’ so avoiding all contact with animals is a wise precaution.
Sun Exposure & Dehydration
************************************
The heat and radiation from sunlight in The Gambia can be very significant especially for fair skinned Irish travellers. Make sure you use a wide brimmed hat and keep covered from the suns rays. Dehydration and salt depletion are also common and you will need to increase the amount of fluid (and salt, unless there is a contraindication) while in this climate.
Local Laws & Customs
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The Gambian authorities take strong action against those involved in any drug trade and so take care not to carry any item for another person at any time. It is a predominantly Muslim country and so care should be taken to respect their customs for example by dressing modestly particularly when away from the main tourist regions. Never take photographs or videos of any police or military installations.
Vaccinations
*******************************
If travelling to The Gambia you are advised to consider vaccination cover against the following;
*
Yellow Fever (mosquito borne viral disease)
*
Poliomyelitis (childhood booster)
*
Tetanus (childhood booster)
*
Typhoid (food & water borne disease)
*
Hepatitis A (food & water borne disease)
Occasionally travellers are advised to also consider protection against diseases like Hepatitis B, Rabies and Meningitis.
Malaria prophylaxis is essential at all times of the year for your personal protection.
Summary
*******************************
Tourist holidays to The Gambia are increasing after a lull following the unrest of the mid 90’s. However, the recent increase in malaria during December 2000 among European tourists shows how travel to tropical Africa must be treated with the respect it deserves. The majority of travellers who follow sensible guidelines will travel healthy and well.

Travel News Headlines WORLD NEWS

Date: Thu 22 Nov 2018
From: Vanessa Field vanessa.field@nhs.net

Dr. Bram Goorhuis and Dr Martin Grobusch of the GeoSentinel Surveillance Network site, Center for Tropical & Travel Medicine, AMC, Amsterdam, have reported a patient with confirmed yellow fever (YF) after travel to the Gambia and Senegal. The patient is a 26-year-old male, with no significant medical history, and previously unvaccinated against YF, who had travelled, together with his girlfriend, to the Gambian coastal region, Mansa Konko (14 days) and the Niokolo Park game reserve, Senegal (3 days). He had exposure to insect bites, but not tick bites, and did not have contact with fresh water or animals. He did not take malaria chemoprophylaxis.

On 17 Nov [2018], whilst on his flight home to Amsterdam, Netherlands, he developed a fever, chills, photophobia, and some transient gastrointestinal complaints (frequent liquid stools and abdominal discomfort). On 20 Nov [2018], he was transferred to the Center for Tropical and Travel Medicine, Amsterdam, from a peripheral hospital, with fulminant hepatitis (AST 22,000 U/L; ALT 12,500 U/L) and signs of liver failure. He tested negative for malaria and dengue; yellow fever PCR showed a very high viral load of 3.82 x 109/L. Due to an evolving encephalopathy, and a potential need for liver transplantation, the patient has now been transferred to the Erasmus Medical Center, a GeoSentinel site (Dr. Jan Nouwen and Dr. Perry van Genderen), Rotterdam, Netherlands. More follow-up is pending.

The last reported case of yellow fever in a traveller from the Gambia was in 2001 in a 47-year-old unvaccinated Belgian woman, who acquired yellow fever during a one-week vacation and subsequently died. Ref. Colebunders R et al.: A Belgian Traveler Who Acquired Yellow Fever in the Gambia. Clinical Infectious Diseases. 2002. 35(10): e113-e116. doi: <https://doi.org/10.1086/344180>.

The Ministry of Health in Senegal last notified the WHO in 2001 of 3 cases of yellow fever in K'dougou and Saraya Health districts, near the border with Mali and Guinea Conakry. A mass vaccination campaign followed. There have been no official reports to the WHO from the Gambia.

Ref: WHO Disease Outbreak News

In 2017, there were major yellow fever (YF) outbreaks in Brazil and Nigeria. These outbreaks were not marked by the rapid urban spread seen in 2016 in Angola and the Democratic Republic of the Congo (DRC), yet they illustrate the increased risk of YF and urban outbreaks with international spread. The "Eliminate Yellow Fever Epidemics" (EYE1) strategy was developed with the goal to reduce the risk of YF through a continuum ranging from outbreak detection and response to prevention. The YF surveillance network also identified suspected cases in several other high-risk countries including Congo, DRC, and Liberia.
Ref: World Health Organization (WHO) Weekly epidemiological record, 10 Aug 2018, No. 32, 2018, 93, 409-416; Yellow fever in Africa and the Americas, 2017.
<http://apps.who.int/iris/bitstream/handle/10665/273782/WER9332.pdf?ua=1>.

World Health Organization (WHO) data suggest that the rate of yellow fever transmission is increasing, especially in sub-Saharan Africa. The WHO estimates that, after adjustment for underreporting, about 200 000 cases of yellow fever occur each year. In most of west Africa, with the exception of the Gambia, yellow fever vaccination coverage is low, and there are regular epidemics of yellow fever that fluctuate according to the sylvatic cycle. Since the mid-1990s, epidemics have been reported from Ghana, Gabon, Liberia, Senegal, Benin, and Ivory Coast.

Yellow fever remains endemic in west Africa. Even urban yellow fever has recently been detected in Abidjan, Ivory Coast. Many countries in areas of endemicity in Africa (such as the Gambia) and South America (such as Venezuela) do not require travelers to undergo yellow fever vaccination. International guidelines for travellers recommend vaccination against yellow fever for persons traveling to these countries, but vaccination is not required by the countries themselves.
-----------------------------------------
Communicated by:
Davidson Hamer, MD (GeoSentinel PI)
Professor of Global Health and Medicine
Boston University School of Public Health and School of Medicine
Boston, MA USA
and
Vanessa Field, MD
Chair, GeoSentinel Tracking and Communication Working Group
International Society of Travel Medicine
=======================
[Drs. Hamer and Field are thanked for this report of the Netherlands case and the overview of the YF situation in endemic countries. The Netherlands case is another example of failure of travellers to receive YF vaccination at least 10 days prior to arrival in an endemic country. Although the Netherlands case presents no risk of initiation of ongoing YF virus transmission, it does illustrate the fact that viremic individuals can travel long distances and, should their destination be an area that could support transmission, such as Central America or south/southeast Asia, can initiate an outbreak in a population that is overwhelmingly unvaccinated. - ProMED Mod.TY]

[Map of the Netherlands:

Maps of Senegal and the Gambia:
Date: Wed, 18 Jan 2017 17:50:39 +0100

Banjul, Gambia, Jan 18, 2017 (AFP) - Gambian President Yahya Jammeh looked determined to cling to power on Wednesday as his mandate came to an end, prompting neighbouring Senegal asking the UN to back regional actions against him.   Jammeh has announced a state of emergency which he said was necessary due to interference of foreign powers in the West African country's December 1 election, which the president of 22 years lost to opponent Adama Barrow.

Barrow, who is currently sheltering in Senegal, maintains his inauguration will go ahead on Thursday on Gambian soil, putting the country on a collision course.   Senegal on Wednesday presented a draft resolution to the UN Security Council seeking support for west African efforts to press Jammeh to step down, diplomats said in New York.   But the text does not explicitly seek council authorisation to deploy troops to The Gambia, they added.   Jammeh's declaration immediately triggered travel advisory warnings by Britain and the Netherlands, with around 1,000 British tourists expected to leave on special flights on Wednesday alone.   The 15-nation Economic Community Of West African States (ECOWAS) has repeatedly urged Jammeh to respect the outcome of the vote and step aside, a call backed unanimously by the international community.

The exact location of the inauguration was "in the hands of ECOWAS," said James Gomez, the inauguration's head organiser who said he had spoken with Barrow twice on Tuesday.   Gomez said that plans for the transfer of power in a huge stadium outside the capital Banjul were now cancelled, but added "there will be a big celebration" despite the state of emergency.   A source at Nigeria's military HQ told AFP a deployment to Senegal, whose territory surrounds The Gambia, would happen "very soon", ramping up expectations of a possible military intervention.   Under the Gambian constitution a state of emergency lasts up to 90 days if the national assembly confirms it -- which the legislature did late Tuesday.   The country's vice-president Isatou Njie-Saidy resigned Wednesday, family sources said, along with environment minister Pa Ousman Jarju, the latest in a mass string of cabinet members deserting Jammeh's government.

- Tourist disappointment -
Tourists were streaming out of the country, leaving the small airport near Banjul struggling to handle extra flights.   Brian and Yvonne Souch, a couple from Witney in southern England, told AFP they were unaware of the potential risk of flying to the country 10 days ago and felt tour company Thomas Cook should have kept them better informed.   "We didn't know anything until we came down for breakfast,"  Brian Souch said, sitting in shorts and sleeveless T-shirt in the lobby of a hotel in the Kololi tourist strip as he awaited a bus to the airport.

Thomas Cook said in a statement Wednesday a programme of additional flights into Banjul airport would bring home the 1,000 package holidaymakers it has in The Gambia, followed by up 2,500 more at the "earliest possible flight availability".   Holidaymakers were told that Thomas Cook flights would stop completely in a few days time, leaving them at risk of being stranded.   The Dutch travel firm TUI Nederland told AFP Tuesday it would repatriate "about 800" clients.   Some tourists were unfazed by the news as the state of emergency, however, as their countries have not issued travel alerts.   "We have over two weeks left and we are staying," said Mariann Lundvall, who flew into Banjul to escape Finland's freezing winter.   "If the Finnish government decides we go, then we go," she added, but with a pained face added "the climate in Helsinki... it is so cold now!"   The panic caused by the state of emergency could prove devastating for the country's economy, which experts say relies on tourism for up to 20 percent of the economy.

- Stockpiling -
Gambians were taking precautions and stocking up on food and supplies in the few shops that remained open in districts near the capital, with roads quiet and street hawkers notably absent.   A source told AFP that patients at Banjul's Edward Francis Small Teaching Hospital, which sits opposite Jammeh's seat of power, were removed for security reasons. Only those in intensive care remained.   Fatou Sarr, a resident of the fishing community of Old Jeshwang, said: "Only a few shops had bread this morning and they ran out of stock very early. If this stalemate drags on for a week or two, the country will run out."   Citizens continue to pack their bags and stream out of Gambia -- a small, narrow enclave of Senegal except for its coast -- by road and ferry heading for Senegal, Guinea-Bissau and Guinea, taking as many possessions as they could carry.   "My two children and I are staying with my aunt. We don't know what will happen tomorrow," said a 50-year-old woman who recently took shelter in Senegal, adding that she hoped to return home soon.
Date: Wed, 18 Jan 2017 04:45:54 +0100

Banjul, Gambia, Jan 18, 2017 (AFP) - Gambia's Yahya Jammeh declared a state of emergency just days before he was due to step down, with British and Dutch travel agencies scrambling to evacuate thousands of tourists Wednesday.   Jammeh, who has ruled The Gambia with an iron fist for 22 years, initially acknowledged opponent Adama Barrow as the victor in December elections, but later rejected the ballot count as flawed and lodged a complaint with the country's Supreme Court.   He declared a state of emergency on Tuesday due to the "unprecedented and extraordinary amount of foreign interference in the December 1 presidential elections and also in the internal affairs of The Gambia," Jammeh announced on state TV.

Citizens were henceforth "banned from any acts of disobedience to the laws of The Gambia, incitement to violence and acts intended to disturb public order and peace," Jammeh said, asking security forces to maintain law and order.   Under the Gambian constitution a state of emergency lasts up to 90 days if the national assembly confirms it -- which the legislature did late Tuesday, a parliamentary source told AFP.   In Washington, the US State Department urged Jammeh to "peacefully hand over power" to Barrow -- who is in Senegal, where he plans to remain until his planned inauguration Thursday.   "Doing so would allow him to leave office with his head held high and to protect the Gambian people from potential chaos," spokesman John Kirby said. "Failure to do so will put his legacy, and more importantly The Gambia, in peril."

The 15-nation Economic Community Of West African States (ECOWAS) has also repeatedly urged Jammeh to respect the outcome of the vote and step aside, a call backed by the UN Security Council, African Union and others.   Jammeh has rebuffed two high-level delegations by west African leaders pleading with him to go.   "The potential for military intervention and civil disturbance is high," the British foreign ministry said on its website, a warning echoed on social media by its Dutch counterpart, who both urged citizens to avoid all but essential travel.   British travel agency Thomas Cook said it had "implemented our contingency plans to bring all our UK customers home," and was trying to arrange evacuation of up to 3,500 tourists from Banjul airport as soon as possible.    "We will operate a programme of additional flights into Banjul airport over the next 48 hours," the company said in a statement, adding this included four extra flights on Wednesday.   The Dutch travel firm TUI Nederland told AFP it would repatriate "about 800" clients.

- String of resignations -
Four more cabinet ministers in Jammeh's government defected, a source close to the regime told AFP on Tuesday.   Foreign minister Neneh Macdouall-Gaye, finance minister Abdou Kolley, trade minister Abdou Jobe and tourism minister Benjamin Roberts all resigned, the source said, requesting anonymity for safety reasons.   They follow the high-profile defection last week of information minister Sheriff Bojang, who is now in neighbouring Senegal.   Citizens continued to pack their bags and stream out of Gambia -- a small, narrow enclave of Senegal except for its coast -- by road and ferry heading for Senegal, Guinea-Bissau and Guinea, taking as many possessions as they could carry.   One traveller told AFP that those arriving at 10:00 am would have to wait until the following day to board a ferry at Banjul port to cross the river headed for Senegal, unless they bribed officials, due to huge numbers exiting the city.

- Military deployment? -
Military intervention in The Gambia seems closer than ever, following declarations by the UN and African Union that boots on the ground could get the green light without a rapid resolution to the crisis.   In Nigeria -- the regional power of west Africa -- a source at the country's military HQ said, "We are deploying to Dakar, Senegal, very soon."   "We are deploying platforms, a few personnel, pilots, technicians and the maintenance crew," said the source, speaking on condition of anonymity.   "You already know that this deployment is in connection with the unfolding development in The Gambia."   In Rabat, it was reported that Morocco had offered Jammeh asylum for accepting the election defeat and stepping down "in return for a golden retirement", but Banjul sources were reluctant to confirm the claim.   Seven journalists -- from Sweden and Senegal, plus four from Kenya and South Africa who were working for a Chinese TV channel -- were expelled late Monday soon after they arrived at Banjul airport to cover the ongoing crisis.
Date: Tue, 13 Dec 2016 05:39:37 +0100
By Jennifer O'MAHONY

Banjul, Gambia, Dec 13, 2016 (AFP) - The cocktails keep flowing by the pool on the tourist strip, but in The Gambia's markets many African migrant traders are packing up their businesses and heading home.   The international community is piling pressure on President Yahya Jammeh to leave power after 22 years and hand over to opposition leader Adama Barrow, who won an election two weeks ago only for Jammeh to later reverse his original concession of defeat.

Of the economy's two main sources of investment from abroad, tourism appears to be weathering the country's political storm far better than the thousands of petty traders who move to The Gambia from the rest of west Africa.   President-elect Barrow told AFP on Monday claims that tourist numbers could be hit were "exaggerated", and with hotels and restaurants full, for the moment he appears to be right.   Flights from Brussels and London are still arriving like clockwork for the peak winter sun season, with many holidaymakers telling AFP they return to the country year after year -- and aren't changing their minds.

"I did think there were more checkpoints," said Elly Preston, a returning retired schoolteacher spending three and a half months in Kololi, the Gambian heartland of full English breakfasts and karaoke bars stuffed with crooning pensioners.   Preston had seen alarming posts on the Tripadvisor tourism website, but with hotel prices as low as £40 a night (48 euros) she stuck with her instinct and left behind the cold and rain of Cleckheaton in northern England.   "I feel safe here. I know everybody and we come together," she said from her sunlounger, waving at a friend she met while on holiday here a few years ago.

Reading a thriller while taking in some rays in the late afternoon, Joseph Fowlis from Liverpool is well aware that Jammeh has refused to stand down, and supports Barrow's fight for change.   "Taxi drivers told me they want a democracy," he told AFP. "And why shouldn't they have one?"   But that hasn't affected his budget break. Apart from a higher than usual level of political conversation in the back of cabs, he said, little had changed from the previous years he has been here.   "If you didn't know about it you wouldn't think anything of it," he said.   Hotel owners are slightly more nervous, but as long as the tour operators keep the flights up, business will boom, they told AFP.

- Trader panic -
The tiny west African state relies on largely British and Scandinavian tourists for 20 percent of its GDP.   Meanwhile Guineans, Mauritanians and Senegalese are well known for importing goods and selling them to the local population.   In a recent speech, Jammeh said 100,000 foreigners were working in The Gambia's markets, but did not specify a source for that figure.   Fifteen minutes down the road from Kololi, the hawkers and fruit sellers of Serekunda market have a very different interpretation of the events unfolding.

Amadou Wurri Jallow, a Guinean shopkeeper, spoke of his fear of soldiers being stationed on the streets of his neighbourhood.   "I do not understand why soldiers armed with machine guns would be deployed every night in built-up areas of Serekunda," Jallow said.   "This is really frightening and disturbing. I am leaving for my country until this political stalemate is resolved peacefully."   Fallou Diop, a Senegalese hawker who has lived and worked in The Gambia for the past few years, told AFP shortly before his departure to the city of Touba in central Senegal that the uncertainty was too much.   "Since no one can tell how this problem would come to an end, I am going back to Touba until the dust settles," he said.
Date: Fri 14 Nov 2014
Source: StarAfrica, APA (Agence Africaine de Presse) report [edited]

The head of disease control in the Gambia, Sanna Sambou, has confirmed the reopening of the country's border to countries affected by the deadly Ebola virus, APA reported on Friday [14 Nov 2014]. Mr Sambou noted that border closure was not the best solution to contain the virus, hence the need to reopen borders to allow in and out movement of people between the Gambia and countries affected by Ebola. According to media reports, the issue of border closure, as a result of the outbreak of the disease, was deemed discriminatory and unworthy by the World Health Organisation (WHO), adding that it should be considered a global pandemic.

Despite the restoration of the border crossing, however, Sambou said the health authorities are poised to continue on the thorough screening of people moving into the country from Ebola hit nations. It could be recalled the Gambia in September [2014] announced that it would no longer be granting entrance to Guineans, Liberians, Nigerians or Sierra Leoneans, due to fear of the disease getting into the country.
More ...

World Travel News Headlines

Date: Mon, 17 Feb 2020 11:56:28 +0100 (MET)

Tokyo, Feb 17, 2020 (AFP) - Organisers said Monday they are cancelling the amateur portion of the Tokyo marathon, affecting around 38,000 runners, on fears about the spread of the new coronavirus in Japan.   "We reached the conclusion that unfortunately it is difficult to organise the event... after several cases (of the virus) were confirmed in Tokyo," the Tokyo Marathon Foundation said in a statement.
Date: Mon, 17 Feb 2020 10:59:27 +0100 (MET)

Cairo, Feb 17, 2020 (AFP) - Egypt's Sharm el-Sheikh has welcomed the first British charter flights since 2015, when the Islamic State group's bombing of a Russian airliner dealt a devastating blow to the Red Sea resort.   Britain halted flights to Sharm el-Sheikh following the attack, which killed all 224 people on board the plane that took off from the resort, long popular with British tourists.

After multiple airport inspections and visits by aviation security experts, Britain announced in October that it was lifting the flight restrictions.   "Sharm el-Sheikh airport received the first two direct charter flights... from London's Gatwick airport carrying 184 passengers and Manchester airport carrying 190 passengers," Egypt's civil aviation ministry said in a statement late Sunday.    The flights were operated by Britain's biggest travel agency, TUI.

The company has scheduled three flights a week between London's Gatwick Airport and Sharm el-Sheikh until late March, the statement said.   British budget airline easyJet said in January it would restart flights to the resort town in June.   On Sunday, flag carrier EgyptAir said it would start operating a weekly flight between London and Sharm el-Sheikh later this month.   British tourists have long been vital to the tourism industry in Sharm el-Sheikh, which was left reeling after the airliner bombing.

Egypt has since sought to lure tourists back, boosting airport security and allowing international inspections of security procedures there.   Russia, another major source of tourists to Egypt, initially suspended all direct flights to the North African country following the attack.   It resumed direct flights to Cairo in 2018 but has yet to restart them to popular Red Sea resorts.   Egypt's tourism industry has shown signs of recovery in recent years with arrivals reaching 11.3 million in 2018, compared with 5.3 million in 2016.
Date: Mon, 17 Feb 2020 10:43:58 +0100 (MET)

Hong Kong, Feb 17, 2020 (AFP) - A gang of knife-wielding men jumped a delivery driver in Hong Kong and stole hundreds of toilet rolls, police said Monday, in a city wracked by shortages caused by coronavirus panic-buying.   Toilet rolls have become hot property in the densely packed business hub, despite government assurances that supplies remain unaffected by the virus outbreak.   Supermarkets have found themselves unable to restock quickly enough, leading to sometimes lengthy queues and shelves wiped clean within moments of opening.

There has also been a run on staples such as rice and pasta, as well as hand sanitiser and other cleaning items.     Police said a truck driver was held up early Monday by three men outside a supermarket in Mong Kok, a working-class district with a history of "triad" organised crime gangs.   "A delivery man was threatened by three knife-wielding men who took toilet paper worth more than HK$1,000 ($130)," a police spokesman told AFP.   A police source told AFP the missing rolls were later recovered and two suspects were arrested on scene although it was not clear if they were directly involved in the armed robbery.

Footage from Now TV showed police investigators standing around multiple crates of toilet roll outside a Wellcome supermarket. One of the crates was only half stacked.   Hong Kongers reacted with a mixture of bafflement and merriment to the heist.   One woman passing by the scene of the crime who was interviewed by local TV station iCable quipped: "I'd steal face masks, but not toilet roll."   The city, which has 58 confirmed coronavirus cases, is currently experiencing a genuine shortage of face masks.    The hysteria that has swept through Hong Kong since the coronavirus outbreak exploded on mainland China is partly fuelled by the city's tragic recent history of confronting a deadly disease.

In 2003, some 299 Hong Kongers died of Severe Acute Respiratory Syndrome (SARS), an outbreak that began on the mainland but was initially covered up by Beijing -- action that left a lasting legacy of distrust towards the authorities on public health issues.   The new coronavirus outbreak also comes at a time when the city's pro-Beijing leadership has historic low approval ratings after refusing to bow to months of angry pro-democracy protests last year.   Authorities have blamed online rumours for the panic-buying and say supplies of food and household goods remain stable.   But the panic-buying has itself created shortages in one of the world's most densely populated cities where supermarkets and pharmacies have limited
floor space.

Photos posted online have shown some people proudly stuffing their cramped city apartments with packets of hoarded toilet rolls.    On Sunday, the head of the city's Consumer Council warned people not to stockpile toilet rolls in their flats as they were prone to mould in the notoriously humid climate.   She also reiterated that there were ample stocks of paper.    Supermarket chain Wellcome called Monday's robbery a "senseless act", and called on people not to bulk buy or hoard toilet roll.    "We want to emphasize that we have sufficient toilet roll supply to meet demand," it said in a statement. "The temporary shortage was caused by the sudden and unusual surge in demand."
Date: Mon, 17 Feb 2020 10:11:30 +0100 (MET)

Tokyo, Feb 17, 2020 (AFP) - An additional 99 people have tested positive for coronavirus on a cruise ship off the Japan coast, Japanese media said Monday, citing new figures from the health ministry.   That would take the total number of positive cases on the Diamond Princess to 454. The health ministry declined to confirm the reports immediately.   It was also not clear whether the figures included 14 US citizens who tested positive for the virus but were allowed to board evacuation flights home.

The Diamond Princess vessel moored in Yokohama near Tokyo has become the second-largest cluster of coronavirus cases outside the epicentre in China.    Passengers have been largely confined to quarters since February 5 with only brief and occasional breaks to take air on deck -- with face masks.   The quarantine period is over on Wednesday but many countries have decided to repatriate their citizens after an alarming climb in cases on board.

The US was the first country to evacuate its citizens from the ship but Australia, Canada, Italy and Hong Kong have indicated they will follow suit.   On land, cases in Japan have risen to 65, with authorities warning that the outbreak is entering a "new phase" and advising people to avoid large gatherings.    A public celebration of the new emperor's birthday on Sunday has been scrapped and organisers of the Tokyo Marathon scheduled on March 1 are reportedly considering cancelling the amateur part of the race.
Date: Sat, 15 Feb 2020 15:25:00 +0100 (MET)
By Benoît Pavan à Moûtiers avec Thomas Rossi dans les Pyrénées

Moûtiers, France, Feb 15, 2020 (AFP) - French protests at planned labour reforms hit ski resorts on Saturday, with chairlift operators and other seasonal staff downing tools over fears their livelihoods could be on a slippery slope.   Hundreds of staff at a clutch of resorts in the Alps and Pyrenees walked out in response to calls for action by the CGT and FO unions, forcing some runs to be closed or partially closed.   They are concerned that reforms extending the required period of employment before people are eligible for benefits, set to take effect from April 1, could stop thousands of seasonal workers from claiming.

Some voiced their protest in song at the bottom of pistes at Serre-Chevalier close to the Italian border, chanting: "We're going down the mountain to get rid of Macron," referring to French President Emmanuel Macron.   The French leader's attempts to overhaul pensions and welfare have led to months of bitter protests and strikes.    "Our situation will become even more precarious with these reforms," explained Christophe Dupuis, who works as a ski patroller at La Plagne, one of the world's most popular ski areas.   "We will need six months instead of four before we can apply for unemployment benefit," added Dupuis, who works as a lifeguard during the summer.   "We don't have six-month seasons, not least as the winter seasons are tending to get shorter rather than longer," said Maud Goret, a seasonal worker and CGT member at Font-Romeu in the Pyrenees -- where half the workforce had downed tools.

Many relatively low altitude resorts are suffering from a lack of snow owing to climate change, compounding fears over what the future holds.   As the workers voiced their grievances, further signs of the shortage of snow increasingly hitting resorts came as local authorities at Luchon-Superbagneres in the French southwest told AFP they had decided to have extra snow helicoptered in to three areas running short.

A union official said some 50 tons were being brought in for between 5,000 and 6,000 euros ($5,500-6,500) "in the knowledge that in terms of return on the investment you need to multiply that at least by ten," for an operation lasting around two-and-a-half hours.   He added that it might not be a "particularly ecological" solution but "we had no choice" at the height of the season when many children in French are on half-term holiday.
Date: Wed 12 Feb 2020
Source: Teresina Municipal Health Foundation [in Portuguese, machine trans., edited]

Health Surveillance Directorate - Epidemiology Management
---------------------------------------------------------
Given the laboratory confirmation of 5 human cases of melioidosis (ICD-10 A24.4) that occurred in the state of Piaui in 2019 (including one death), the FMS Health Surveillance Directorate recommends Hospital Infection Control Commissions, to the Hospital Surveillance Centers, public and private microbiology laboratories, infectious disease specialists, pulmonologists, microbiologists, biochemists and physicians in general who are attentive, immediately report any case with a result of a culture of biological material (blood culture, urine culture, wound culture, tracheal secretion, cerebrospinal fluid, bronchial lavage, ascitic fluid, abscess, tissues, etc.) positive for the bacterium _Burkholderia pseudomallei_ (or _Burkholderia_ sp.). The notification must be made through the individual notification form of SINAN (available at <http://portalsinan.saude.gov.br/images/documentos/Agravos/NINDIV/Notificacao_Individual_v5.pdf>) and sent to the FMS, with the code appended ICD10: A24.4.

The positive bacterial isolate should be sent to the Central Public Health Laboratory, Dr. Costa Alvarenga (LACEN - PI) for confirmatory examination (Nested - PCR), upon registration in the GAL system (research: _Burkholderia pseudomallei_ sample: swab), in swab with Stuart's medium, at room temperature, along with a copy of the notification form.
======================
[This 2016 article (Limmathurotsakul D, Golding N, Dance DA, et al., Predicted global distribution of _Burkholderia pseudomallei_ and burden of melioidosis. Nat Microbiol. 2016;1:15008. <https://doi.org/10.1038/nmicrobiol.2015.8>; article available at <http://www.nature.com/articles/nmicrobiol20158.pdf>) for 2015 estimates the burden of melioidosis for the areas of major and some risk as follows:

Area / Population at risk in millions / Melioidosis cases in thousands / Melioidosis deaths in thousands
South Asia / 1525 / 73 / 42
East Asia and Pacific / 858 / 65 / 31
Sub-Saharan Africa / 602 / 24 / 15
Latin America and Caribbean / 246 / 2 / 1
Middle East and North Africa / 49 / less than 1 / less than 1

Although a classical infection in eastern Asia and northern Australia, cases have been acquired in Africa, the Caribbean basin, Central America, and, as in this case, South America. - ProMED Mod.LL]

Date: Tue 11 Feb 2020
Source: SABC News [edited]

A 56-year-old was admitted at the Klerksdorp Tshepong Hospital on Saturday [8 Feb 2020] with a history of tick bite followed by flulike symptoms including headaches and fatigue.

The North West Health Department says while no active bleeding was noted, treatment was started immediately.

Crimean-Congo fever, also known as Congo fever/haemorrhagic fever, is a disease caused by a tick-borne virus with a case fatality rate of 10% to 40%.

Transmission to humans occurs through contact with infected animal blood or ticks. It can be transmitted from one infected human to another by contact with infectious blood or body fluids.

Symptoms include high fever, vomiting and abdominal pain, but as the illness progresses, large areas of severe bruising and severe nosebleeds are also common.

Clinical Manager at the Klerksdorp Hospital Dr. David Leburu says: "Crimean-Congo fever can make a person bleed. It can make people bleed just like Ebola but not as aggressive as Ebola."
===================
[Occupational groups such as herders, farmers, abattoir workers, veterinarians/animal health workers, hunters and persons informally slaughtering domestic/wild animals are at higher risk of infection. These persons often have exposure to ticks on the animals and in the animal environment, and also often have exposure to animal blood/tissues (e.g., during castration of calves, vaccination, notching/tagging of ears, slaughtering).

Humans can become infected in the following ways:
- Being bitten by infected ticks;
- Squashing infected ticks (if fluid from the ticks enters into cuts/grazes on the skin, or splashes onto mucous membranes, including the eyes, nose and mouth);
- If blood/tissue from infected animals (during the short period that the animals have virus in circulation) comes into contact with cuts/grazes on the skin, or splashes onto mucous membranes, including the eyes, nose and mouth;
- Needle-stick/sharps injuries in healthcare workers from infected patients.

The patient in the above report had a history of tick bite, but no other epidemiological information is available.

Human CCHF cases have been reported annually from South Africa since 1981, when it was first recognized in the country; between 0 and 20 cases of CCHF are reported each year. Through nearly 30 years of passive surveillance, more than 180 cases have been laboratory-confirmed. Although cases have been reported from all 9 provinces in the past 30 years, more than half of the cases originate from the semi-arid areas of Northern Cape Province (31.5% of cases) and Free State Province (23% of cases) (<http://www.nicd.ac.za/assets/files/CCHF_FAQ-General_Public.pdf>). - ProMED Mod.UBA]

[HealthMap/ProMED-mail maps:
North West Province, South Africa:
Date: Wed 12 Feb 2020 05:23 PM EST
Source: ABC27/WHTM [edited]

Two Newberry Township [York County] men are getting treatments for rabies after a coyote that attacked them tested positive for the deadly virus.

One man was with his dog when the coyote attacked [Mon 10 Feb 2020] on Red Bank Road. The 2nd man was working nearby in his garage when the coyote entered and bit him.

A neighbour shot and killed the coyote the following day and gave the carcass to the Pennsylvania Game Commission. A test confirmed the animal was rabid.
=====================
[[HealthMap/ProMED-mail map of Pennsylvania, United States:
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Rabies is a serious disease, and is always fatal in animals. In humans there is post exposure prophylaxis (PEP), which must be given within a prescribed amount of time. Individuals bitten by a rabid animal who do not seek treatment within the narrow window for PEP in all likelihood will die if they develop rabies. Heroic measures have succeeded in preserving the lives of only a handful of individual, and yet their live is never a complete return to normal.

Rabies is a serious disease and should be taken seriously by all individuals, whether you are a pet owner or not. Animal owners, regardless of whether your animal is a horse, or dog, or cow, or cat, or goat, or other animal, vaccinate the animal against this fatal disease. Protect your investment in your farm animals, and protect yourself by vaccinating farm animals and pets.

Rabies can be in wildlife, as these stories note. However, we seldom get one involving an otter. While otters are cute and playful on the nature programs, they are susceptible to rabies, as is any mammal, so it is imperative we be alert to the animals around us, no matter where we are or what animal is involved. - ProMED Mod.TG]
Date: Sat 8 Feb 2020 05:16 PM EST
Source: Fox 8 [edited]

A Florida mom says she had to tackle an otter to protect her daughter and dog, WFLA reports. We don't often hear about aggressive river otters. But by fighting its way inside a home in Florida, experts say the otter was definitely not acting normal.  "My husband's like 'you just alligator wrangled an otter in the living room!'" [CE] said. The otter learned to not mess with a mother's instincts. "I think life is full of surprises, and you should just be ready for whatever," [she] said.

The story starts after 17-year old [GE] let their dog Scooter out before dawn Tuesday morning [4 Feb 2020]. Scooter had found an enemy.  "I sprinted to the backdoor, and I was like 'Scooter!' All I saw was like a big black ball just all over the place. So he stumbled in the door, and I tried to shut it as fast as possible, but then the otter got stuck," [GE] said.

By this time, the whole house is awake and her mother bursts in.  "I snatched it by the tail," [CE] said. "And then I held it up like a prize. And the otter's going crazy. It was like clawing at me and grabbing on to the backs of the furniture in my house." [CE] tossed the otter outside and discovered it had bit her daughter in the leg.

Several rabies shots later, [GE] and Scooter are on the mend. Now Florida Fish and Wildlife is trying to find the otter. It is unknown whether the otter has rabies because it has not been caught. His behaviour was definitely abnormal.  "Any time an otter's onshore going for a human, there's something not right. Usually, they see you, they're gone," said Dustin Hooper, an animal trapper, and owner of All Creatures Wildlife Control.
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Date: Tue 4 Feb 2020
Source: Robesonian [edited]

A 9-year-old boy is undergoing treatment after being bitten by a rabid fox, according to the [Robeson] County Department of Public Health.

The boy was riding his bicycle Sunday evening [2 Feb 2020] on Barnhill Road in Lumberton when he was attacked by a fox, according to the Health Department. The fox was killed at the scene and its head was submitted for testing on [Mon 3 Feb 2020]. The results came back positive for rabies on [Tue 4 Feb 2020].

The boy will undergo a series of shots to prevent the onset of rabies, according to the Health Department. Area residents have been alerted and advised to monitor their children's and pets' activities.

According to the Health Department release, Sunday's bite case was properly reported "and as such, the system responded correctly. After-hour calls go to communications who contact the Animal Control officer on call."

Sunday's attack by a rabid wild animal is the 1st confirmed case of rabies in Robeson County this year [2020], said Bill Smith, Health Department director.

"I believe we had 3 this past year," he said. Those cases were animal-on-animal attacks, Smith said. "I think they were all pets last year," he said.

County residents need to be aware there are many more rabid animals in the area, he said. But the rate of confirmed contact between rabid animals and humans or pets is low because Robeson County is a rural county with large tracts of forests.

In rural areas the most likely scenario is an animal attacking a pet or human and then running into the woods, where it will die without anyone knowing if it had rabies or not, Smith said. In urban areas, there is more contact between humans and pets and animals known to be rabid because the attacking animal has no woods into which to run and hide. Therefore, the animal is easier to catch and test.

If someone is bitten by an animal that runs into the woods and is not caught and tested then precautions have to be taken, he said.

"We would treat that as a rabid animal," Smith said.

Sunday's incident prompted the county Health Department to issue the following advisories:
- all dogs, cats, and ferrets 4 months and older are required to be vaccinated against rabies and wear a current rabies vaccination tag per North Carolina law;
- if an animal is destroyed, try not to damage the head because it jeopardizes the testing of the brain;
- avoid feeding wild animals. Foxes and raccoons are the main sources of rabies in the Robeson County area and feeding them increases the likelihood of interaction between the wildlife and dogs, cats and humans.
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