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Andorra

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

Travel News Headlines WORLD NEWS

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

No Profile is available at present

Travel News Headlines WORLD NEWS

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Brazil

General

 Brazil is the largest country in South America and extends from the Atlantic Ocean to the Caribbean to the depths of the Amazon basin. The climate varies throughout the country but generally it experiences a humid

tropical climate.

Safety & Security

The level of crime in many of the main urban centres is certainly rising and tourists need to be aware of the risks involved in travelling particularly in the evening hours. It is wise to use an official taxi for any journeys after dark. It is sensible not to flaunt any personal wealth and to use the hotel safety boxes for any valuables and your travel documents. The amount of crime against tourists tends to be greater in areas surrounding hotels, discotheques, bars, nightclubs and other similar establishments that cater to visitors, especially at dusk and during the evening hours. There are frequent reports of theft on city buses and such transportation should be avoided. A number of the main cities have established specialised tourist police units to patrol areas frequented by tourists. Rio de Janeiro, Sao Paulo and Brasilia all continue to experience a high incidence of crime.

Road Safety

Throughout this huge country the state of the roads varies greatly. In many regions the roads are dirt tracks and assistance would be hard to obtain for those travelling off from the main tourists routes. Bag snatching from traffic lights occurs in the main cities. If considering hiring a car make certain that your travel insurance is sufficient.

Jet Lag

After your flight you will experience a degree of jet lag. Travelling from Europe this will be less than when you travel home but nevertheless it will still cause your body to complain for 24 to 48 hours. Try to have a more relaxing time for the first few days (and also after returning home if possible!). Be careful not to fall asleep by the pool and then awaken with sunburn which could ruin your time abroad.

Medical Facilities

In any country of this size the level of medical care will vary greatly. This is particular true out side the main tourist resorts. English speaking doctors should be available but the level of hospital care can be worrisome. Make certain you carry sufficient supplies of any medication you may require for your entire holiday. Essential drugs (asthma, diabetes, epilepsy etc) should be divided for security.

Sun Exposure and Dehydration

The hot humid tropical climate often leads to quite significant problems for the Irish traveller. Make sure you cover your head when out in the sunlight and drink plenty of fluids to replenish that lost through perspiration. Replace the salt you loose by eating crisps etc orby putting salt on your meal (providing there is no contraindication).

Visiting the Iguassu Falls

These huge waterfalls border Argentina, Brazil and Paraguay. There is only minimal risk of malaria and so malaria prophylaxis is not generally recommended. Also, Yellow fever is not transmitted in this area but mosquitoes can abound. Sensible insect bite precautions should be followed at all times.

Food & Water

Many tourists who visit Brazil stay in the main resorts along the southern coast. The food and water preparation in the hotels is normally excellent but eating food from street vendors is generally unwise. Shell fish (bivalve oysters, mussels, clams etc) are unwise even in a five star hotel. Check the water from the cold water tap in your room. If you can’t easily smell chlorine (swimming pool style) don’t use it even for brushing your teeth. If travelling around the country (Caribbean coast or into the Amazon regions) take significantly more care.

Rabies 

This viral disease occurs throughout Brazil and it is usually transmitted through the bite from an infected warm-blooded animal (eg dogs, cats & monkeys). Any contact should be avoided but if it occurs treat it very seriously and seek competent medical attention immediately after you wash out the area and apply an antiseptic.

Malaria

The risk of malaria is significant all year throughout the Amazon regions. There is insignificant risk for those staying along the coast up as far as Fortaleza and for those remaining in this region prophylaxis is not usually recommended. The risk in the region of Brasilia is also thought to be minimal though this is an area which has unusually experience an outbreak of Yellow Fever recently, and so the situation will require review.

Mosquito Borne Diseases  Apart from malaria the other two main diseases transmitted by mosquitoes which cause problems in Brazil are Dengue Fever (mainly along Caribbean Coast but has been reported much further south) and Yellow Fever (mainly in the Amazon Basin but thought to be spreading to other regions). Avoidance techniques are important at all times throughout the day. Swimming **************************************** Most of the main tourist swimming pools will be well maintained and the smell of chlorine will be evident. If sea swimming is on your agenda make sure you go where there are plenty of others and never swim alone. Look for warning signs and pay attention to local advice. Be very careful of local currents which can be dangerous. Vaccinations **************************************** The Brazilian Embassy is advising all travellers to Brazil to have vaccination cover against Yellow Fever. Also for your personal protection it is wise to consider some further vaccines. Generally we would recommend the following vaccination cover; * Yellow Fever (mosquito borne) * Tetanus (childhood booster) * Typhoid (food & water borne) * Hepatitis A (food & water borne) For those travelling more extensively or staying in the country for longer periods we would usually suggest that further vaccines are considered including Hepatitis B, Meningitis and Rabies. Summary **************************************** Many travellers to Brazil will remain perfectly healthy and well providing they follow some sensible precautions. Further information is available from either of our centres regarding any recent disease outbreaks.

Travel News Headlines WORLD NEWS

Date: Wed 9 Oct 2019
Source: OP9 [in Spanish, trans., abridged, edited]

In one week, Pernambuco recorded 14 new cases of measles. According to the latest epidemiological bulletin released on Wednesday [9 Oct 2019] by the State Department of Health (SES), the state has accumulated, in 2019, 37 confirmations of the disease. Since the beginning of the year [2019], 799 suspected viruses have been reported in Pernambuco cities. Among the investigated cases, 284 were discarded and 515 are still under evaluation. The state is one of 16 federation units with active disease outbreak in Brazil.

The municipalities with confirmed measles cases in Pernambuco are as follows: Northern Taquaritinga (14), Caruaru (6), Strands (5), Recife (3), Capibaribe Holy Cross (3), Toritama (3), Calves (1), Friar Miguelinho (1), Jaboatao of the Guararapes (1).

Despite the significant number of new confirmations, the state secretary of health, Andre Longo, considers that the new cases included in the newsletter are old. "These are people who fell ill between July and August [2019]. All measures to treat patients and investigate and block new cases are implemented soon after notification," he says.

According to the secretary, regardless of the positive result after laboratory tests, suspected cases are treated as if it were a confirmed case. The intention, according to the SES, is to prevent sequelae and deaths in patients and death and minimize the possibility of contagion. With the strengthening of vaccination, until 4 Oct [2019], 507 814 people were immunized with the triple virus in Pernambuco.

Among the number of vaccinated patients, 215 986 doses were administered to children between 6 months and 4 years. The figures also reveal that the state was able to achieve 98% coverage in the 1st dose of the triple virus in one-year-olds. In the 2nd dose, which should be done 3 months after the 1st dose, the coverage is lower: 74.5%.

According to the Ministry of Health, children are the most susceptible to complications and deaths from measles, since the incidence of cases in children under one year is 9 times higher than the general population. The 2nd-most-affected age group is 1-4 years.

Since the 2nd half of August [2019], immunization of infants between 6 months and 11 months with the triple virus has been instituted throughout Brazil. Until then, the vaccination schedule of the 3 diseases began only after the 1st year. After administration of the "zero dose," it will still be necessary to follow the basic vaccination schedule from 12 months, with one more dose and a booster at 15 months.

Little coverage of 2nd dose of vaccine in children is still worrying in Pernambuco Although Pernambuco has already reached the minimum target of vaccination of the 1st dose of the triple viral in children up to 12 months, the index was not reached in the set of municipalities of I and VIII Regional Health Management (Abreu e Lima, Aracoiaba, Cabo de St. Augustine, Camaragibe, Big Ch, Tea of Joy, Glory of Goita, Fernando de Noronha, Igarassu, Ipojuca, Itamaraca, Itapissuma, Jaboatao of the Guararapes, Moreno, Olinda, Paulista, Pigeons, Reef, Sao Lourenco da Mata Antao, Afranio, Cabrobo, Sleepers, Big Pond, Oroco, Petrolina, Santa Maria da Boa Vista).

"These are populated areas that have a large circulation of tourists all the time. That is why the importance of intensifying actions and actively searching to avoid pockets of unprotected children," points out the superintendent of immunization of the State Department of Health (SES-PE), Ana Catarina de Melo. According to her, regarding the 2nd dose of the vaccine, considered essential for the protection of children, only the Geres de Palmares and Salgueiro were able to reach the minimum target of 95%.

Children between 6 months and under one year old, residing in the following 9 municipalities, should [get vaccinated] take one dose of the triple viral: Recife, Paulista, Calves, Caruaru, Santa Cruz do Capibaribe, Taquaritinga do Norte, Vertentes, Friar Miguelinho, and Salgueiro. Importantly, these children will need to follow the normal immunization schedule from 12 months.

At the moment, vaccination is still indicated for children from 6 months to under one year who are going to move to municipalities with an active measles outbreak. Immunization must be done at least 15 days before travel.
Date: Thu, 3 Oct 2019 03:41:42 +0200 (METDST)
By Allison JACKSON

Rio de Janeiro, Oct 3, 2019 (AFP) - Dengue-resistant mosquitoes breed in a Rio de Janeiro laboratory, producing offspring infected with bacteria packing a punch in the fight against the deadly virus, which is exploding across Brazil this year.   Scientists are using Wolbachia, a bacteria common among insects except the dengue-transmitting Aedes aegypti mosquito, to dent the spread of the debilitating virus and other illnesses including Zika and chikungunya.

Since 2015, the Fiocruz institute in Rio has been producing mosquitoes infected with Wolbachia and releasing their dengue-hardened offspring into the densely populated city and neighboring Niteroi.   The hope is they will spread the bacteria by reproducing with wild mosquitoes.   Wolbachia works in two ways: it boosts a mosquito's immune system, making it less likely to contract dengue.   But if the mosquito does get dengue, Wolbachia makes it harder for the virus to grow inside the insect and be transmitted to humans.   So far, results are promising.    Scientists involved in the trial report a "significant reduction" in cases of dengue and chikungunya in targeted neighborhoods.   Tests show more than 90 percent of mosquitoes in areas where the first infected insects were released more than three years ago have the bacteria.

But Wolbachia is not the silver bullet for eliminating dengue, Luciano Moreira, head of the project in Brazil, tells AFP in a lab as workers walk around waving electrified mosquito racquets to zap insects that have escaped from test tubes.    "Where there are people, there are mosquitoes," Moreira explains, surrounded by hundreds of tubes holding thousands of Wolbachia-infected mosquitoes.    "We always say we are not the solution, it has to be an integrated process done together.   "People still have to destroy breeding sites at home. You want to have less mosquitos, but mosquitoes with Wolbachia.   "If there is a vaccine you can use it in conjunction with that ... it has to be a combination."

Brazil is one of several countries holding trials of the so-called Wolbachia method, which began in Australia in 2011, to tackle the virus that infects tens of millions around the world every year.    The self-sustaining process does not involve genetic modification (GM), which has been tested in Brazil and elsewhere.   In one GM trial, thousands of male mosquitoes carrying a "self-limiting gene" designed by British biotech company Oxitec were released in the eastern Brazilian state of Bahia between 2013 and 2015.   The number of viable offspring fell dramatically, suppressing the wild mosquito population by an average of 70 percent compared with before the release, Oxitec found.   But mosquito numbers rebounded after the project ended.    Moreira says previous attempts to wipe out mosquito populations have failed.   "There are too many (mosquitoes)," he says.

- Fresh blood is best -
Thousands of bacteria-carrying mosquitoes at Fiocruz institute are the descendants of insects originally infected with Wolbachia at Australia's Monash University.    Researchers there took the bacteria from fruit flies and injected it into mosquito eggs using a very fine needle.   The Brazilian insects are kept in small boxes in a temperature- and humidity-controlled room.   During their brief lives, which can be as long as 100 days in the lab, females have sex with their male counterparts multiple times.   After mating, the females dine on human blood supplied by a blood bank, and then deposit their eggs on the surface of water held in plastic containers.   The eggs, which inherit Wolbachia from the female, are harvested and transferred to large test tubes.

Only female mosquitoes consume blood, which they need to produce eggs, Catia Cabral, supervisor of the insectary, tells AFP during a recent visit.    Any blood type is ok, but fresh is always best.    "She is going to prefer 1,000 times more the blood from my arm, but she can't choose here so she has to eat this blood," says Cabral, showing AFP a bag of blood from a bank.   Within two weeks, the infected offspring have grown into adults and are ready for release.   Brazil's health ministry plans to expand the program to municipalities in other parts of the country to see if similar results can be produced in different environments.   But state and federal government budget cuts mean no more Wolbachia-carrying mosquitoes will be released in Rio or Niteroi after December, Moreira says.    He is lobbying authorities to keep the program going.   "Rio (state) has had quite large financial problems in recent years and for that reason cannot invest in this project," Moreira explains.

The decision comes as Brazil sees a spike in the number of cases of dengue, which causes fever, rash, nausea and -- in some cases -- death.   More than 1.4 million cases were registered in the first eight months of this year, health ministry figures show, up 600 percent on the same period in 2018.    Nearly 600 people have died so far.   Moreira blames this year's surge on the return of type two dengue, which has not been seen in Brazil for years, meaning many people have no resistance.   Unseasonal rain and high temperatures are also fueling the outbreak, the health ministry says.   A vaccination for the four types of dengue was in the "final stage of tests," Health Minister Luiz Henrique Mandetta announced last month.    Mandetta hopes it will be ready next year. In the meantime, he said, Brazilians should brace for a "very tough summer."
Date: Thu 29 Aug 2019
Source: Yahoo News [abridged, edited]

Brazil's Health Ministry said Thursday [29 Aug 2019] that a 42-year-old man died from measles in Sao Paulo. He was not vaccinated against the disease.

Nearly all the measles cases recorded this year [2019] in Brazil are in the state of Sao Paulo, where health authorities have confirmed 2457 cases.

Brazil received a measles eradication certificate from the Pan American Health Organization in 2016, but the disease returned in January 2018 from people immigrating from Venezuela.

Measles cases also have surged in Europe and parts of the United States. Health authorities blame that on people refusing vaccines.

The Pan American Health Organization says Brazil recorded more than 10 000 cases of measles with 12 deaths last year [2018].
Date: Fri 9 Aug 2019
Source: Folha de S. Paulo [trans. Kiratiana Freelon; abridged, edited]

A mutated measles virus is responsible for the recent outbreak of the virus that has led to 1000 cases in the the Sao Paulo area, according to Edison Luiz Durigon, a professor at USP's Institute of Biomedical Sciences and one of the country's most respected virologists.

The previous outbreak of the disease, which was considered eradicated in Brazil in the past decade, occurred in 1999. The current version of the virus, however, is another.

Still, the vaccine protects against this type of measles virus, the D-8. But the amount of antibodies in the body of an immunized person (made with the type A virus) drops after 15 years of application. Therefore, anyone who has never been immunized or injected for a long time should be vaccinated. WHO estimates that from 2000-2017, 21 million measles deaths were prevented by the vaccine.

With the amount of antibodies generated by someone who recently took the vaccine, the body can neutralize viruses of various types (8 in all, from A to H) and subtypes (24, distributed between types).

D-8 viruses circulated generally in Europe and began to pop up about a year ago in Venezuela and the northern part of the country. "Because there were a few cases, we thought the disease was spreading among unvaccinated people."  [Byline: Gabriel Alves]
Date: Thu 25 Jul 2019
Source: Teresina Prefecture [in Portuguese, trans. ProMED Mod.TY, edited]

PI [Piaui state] has been following with attention and care the developments regarding the 3rd confirmed case of West Nile fever in Piaui. Since 2013, all suspected cases admitted to the municipal public network have been subjected to an investigation protocol implemented by the FMS [Fundacao Municipal de Saude de Teresina; Teresina Municipal Health Foundation] that includes West Nile virus, among several others of important relevance.

The patient in question, a victim of encephalitis, coming from Piripiri in Piaui, received all possible assistance in the intensive care unit of the Teresina Emergency Hospital, but suffered several clinical complications that, due to her advanced age and the presence of comorbidities, led to her death.

The coast and the interior of the state of Piaui are located on migratory bird routes, identified as important links in the spread of the disease [virus], according to the National Center for Research for the Conservation of Wild Birds (CEMAVE / ICMBIO). The virus was also detected in the state of Espirito Santo in 2018 and in the state of Ceara in 2019.

From 2014 to 2019, the FMS investigated 399 suspected human cases of severe West Nile fever disease from various cities in Piaui and neighbouring states: 319 were discarded, 35 had "undetermined" results, and 42 remain under investigation. All hospitals in the municipality are trained to investigate and treat any new suspicious cases.  [Byline: Amariles de Souza Borba]
=======================
[West Nile virus transmission has been active in several spots in Brazil this year [2019]. There have been recent equine cases in Ceara and Espirito Santo states, so it is not surprising that a human case has occurred in Piaui state as well. As ProMED Mod.CRD noted in a previous ProMED-mail post (West Nile virus (19): Americas (Brazil) horse, OIE; archive no. http://promedmail.org/post/20190725.6586397), "West Nile fever is a mosquito-borne viral disease that can affect birds, humans, and horses causing inapparent infection, mild febrile illness, meningitis, encephalitis, or death. West Nile virus (WNV) is a member of the genus _Flavivirus_ in the family Flaviviridae. The arbovirus is maintained in nature by cycling through birds and mosquitoes; numerous avian and mosquito species support virus replication" (see  Source:<http://www.oie.int/fileadmin/Home/eng/Health_standards/tahm/3.01.24_WEST_NILE.pdf>).

Hosts are birds, some of which may succumb to fatal systemic illness. Among mammals, clinical disease is primarily exhibited in horses and humans, but they are dead-end hosts and cannot infect mosquitoes. There is a vaccine available for equine animals but not for humans. The best preventive measure is to avoid mosquito bites. - ProMED Mod.TY]

[HealthMap/ProMED-mail map:
More ...

Vanuatu

Vanuata US Consular Information Sheet
February 10, 2009
COUNTRY DESCRIPTION:
Vanuatu consists of more than 80 islands in a Y-shaped archipelago, 1300 miles northeast of Sydney, Australia.
It is an independent parliamentary democracy a
d a member of the British Commonwealth, with a primarily agricultural economy.
Tourist facilities are limited outside the capital, Port Vila, which is located on the Island of Efate.
The National Tourism Office of Vanuatu can be contacted at PO Box 209, Port Vila, Vanuatu, telephone (678) 22515, 22685, 22813, fax (678) 23889, e-mail: tourism@vanuatu.com.vu.
Read the Department of State Background Notes on Vanuatu for additional information.
ENTRY/EXIT REQUIREMENTS:
A valid passport and onward/return ticket and proof of sufficient funds are required.
Visas are not required for stays up to 30 days after which an extension of the stay of up to 120 days is possible.
For further information on entry requirements, particularly for those persons planning to enter by a sailing vessel, please contact the Permanent Mission of the Republic of Vanuatu to the United Nations,
800 Second Avenue, Suite 400B, New York, N.Y. 10017, Telephone: (212) 661-4303; fax: (212) 422-3427, (212) 661-5544, e-mail: vanunmis@aol.com
Travelers who plan to transit or visit Australia must enter that country with an Australian visa or, if eligible, through Electronic Travel Authority (ETA). The ETA replaces a visa and allows eligible travelers a stay of up to three months in Australia. An ETA may be obtained for a small service fee at http://www.eta.immi.gov.au/. Airlines and many travel agents in the United States are also able to issue ETA’s.
Travelers may obtain more information about the ETA and Australian entry requirements from the Australian Embassy at 1601 Massachusetts Ave. NW, Washington, DC
20036, tel. (202) 797-3000.
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:
Civil disorder is rare; however, U.S. citizens are advised to avoid public demonstrations and/or political rallies if they occur.
For the latest security information, Americans traveling abroad should regularly monitor the Department of State's, Bureau of Consular Affairs’ web site, where the current Travel Warnings and Travel Alerts, as well as the Worldwide Caution, can be found.
Up-to-date information on safety and security can also be obtained by calling 1-888-407-4747 toll-free in the U.S. and Canada, or for callers outside the U.S. and Canada, a regular toll-line at 1-202-501-4444.
These numbers are available from 8:00 a.m. to 8:00 p.m. Eastern Time, Monday through Friday (except U.S. federal holidays).
The Department of State urges American citizens to take responsibility for their own personal security while traveling overseas.
For general information about appropriate measures travelers can take to protect themselves in an overseas environment, see the Department of State’s A Safe Trip Abroad.
CRIME:
Although violent crime is rare in Vanuatu, the level of criminal activity has increased in the past year. Typical crimes in Vanuatu are theft, burglary and sexual harassment/assault. Tourists, therefore, should take reasonable precautions to avoid exposing themselves to undue risk especially in Luganville (Espiritu Santo island), Lakatoro (Malekula island), and Lenakel (Tanna island).
Women have sometimes been victims of sexual assault or harassment in Vanuatu; therefore, it is advisable that women travelers not travel alone.
INFORMATION FOR VICTIMS OF CRIME:
The loss or theft abroad of a U.S. passport should be reported immediately to the local police and the U.S. Embassy in Port Moresby.
If you are the victim of a crime while overseas, in addition to reporting to local police, please contact the U.S. Embassy in Port Moresby for assistance.
The Embassy staff can assist you to find appropriate medical care, to contact family members or friends, and explain how funds could be transferred.
Although the investigation and prosecution of the crime 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 Vanuatu is 112.
Please see our information on Victims of Crime, including possible victim compensation programs in the United States.
CRIMINAL PENALTIES:
While in a foreign country, a U.S. citizen is subject to that country's laws and regulations, which sometimes differ significantly from those in the United States and may not afford the protections available to the individual under U.S. law.
Penalties for breaking the law can be more severe than those in the United States for similar offenses.
Persons violating Vanuatu’s laws, even unknowingly, may be expelled, arrested, or imprisoned.
Penalties for possession or use of, or trafficking in illegal drugs in Vanuatu are severe, and convicted offenders can expect long jail sentences and heavy fines.
Engaging in sexual conduct with children or using or disseminating child pornography in a foreign country is a crime, prosecutable in the United States.
Please see our information on Criminal Penalties.
SPECIAL CIRCUMSTANCES:
Vanuatu and Australian customs authorities may enforce strict regulations concerning temporary importation into or export from Vanuatu of items such as firearms, certain prescription drugs, wooden artifacts, exotic animals, food, and sexually explicit material.
Other products may be subject to quarantine.
It is advisable to contact the Permanent Mission of the Republic of Vanuatu to the United Nations,
800 Second Avenue, Suite 400B, New York, N.Y. 10017, Telephone: (212) 661-4303; fax: (212) 422-3427, (212) 661-5544, e-mail: vanunmis@aol.com and the Australian Embassy for specific information regarding customs requirements.
Please see our Customs Information sheet.
U.S. citizens are encouraged to carry a copy of their U.S. passports with them at all times, so that, if questioned by local officials, proof of identity and proof of U.S. citizenship are readily available.

Natural Disasters:
=====================
Vanuatu is prone to sudden tidal movements, tropical storms, and cyclones. The Pacific cyclone season lasts from November through April.
Local media and hotels will convey cyclone alerts issued by local authorities, and detailed weather information is published by the Naval Pacific Meteorology and Oceanography Center, Météo-France in New Caledonia and the Fiji Meteorological Service.
Volcanoes/Earthquakes: Vanuatu is situated on in active seismic zone, and prone to volcanic eruptions and earthquakes, sometimes followed by tsunamis.
The risk level of Vanuatu’s many active volcanoes can change on a daily basis. Travelers to areas where there are volcanoes can contact the Department of Geology and Mines at 22423 to obtain information about the activity of a volcano.
Please contact the Vanuatu Tourism Office prior to traveling to areas where volcanic activity may occur.
Detailed information about earthquakes is available from the National Earthquake Information Center of the United States Geological Survey.
If a natural disaster occurs, follow the advice of local authorities.
General information about natural disaster preparedness is available from the U.S. Federal Emergency Management Agency
(FEMA) and from the Naval Pacific Meteorology and Oceanography Center.
MEDICAL FACILITIES AND HEALTH INFORMATION:
Medical facilities are limited.
The nearest reliable medical treatment is in Australia or New Zealand.
There are two hyperbaric recompression chambers in Vanuatu; one in Luganville, on Espiritu Santo Island, and the other in Port Vila, on Efate Island.
Please note, however, that diving-related injuries may require medical evacuation to Australia or New Zealand.
There is a paramedic service in Vanuatu called ProMedical, which is manned by Australian and New Zealand personnel. They also handle any medical evacuations.
Serious injuries requiring hospitalization and/or medical evacuation to the United States or elsewhere can cost thousands of dollars. Doctors and hospitals often expect immediate cash payment for their services.
Pharmacies in Vanuatu are found only in urban centers and at missionary clinics.
They are small and may be inadequately stocked.
Travelers should bring adequate supplies of their medications for their stay in Vanuatu.

Travelers who anticipate the possible need for medical treatment in Australia should obtain entry permission for Australia in advance.
Entry permission for Australian can be granted by the Australian High Commission in Port Vila, but it may be easier to obtain a visa or ETA prior to leaving the United States (See the section above on Entry/Exit Requirements).
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 web site.
For information about outbreaks of infectious diseases abroad consult the World Health Organization’s (WHO) web site. Malaria is prevalent in some areas.
Further health information for travelers is available from the WHO.
The Government of Vanuatu does not impose any entry restrictions for persons with the HIV/AIDS virus, as long as they include the information on the arrival form.
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 Vanuatu is provided for general reference only, and may not be totally accurate in a particular location or circumstance.
Vehicular traffic in Vanuatu moves on the right.
Travel on highways outside of major towns can be hazardous.
Drivers and passengers are advised to wear seatbelts.
There is no country-wide road network; roads are generally in poor repair.
Because Vanuatu is a chain of islands and atolls, most long-distance travel is by air or sea.
Only the capital city of Port Vila (on Efate Island) and the town of Luganville (on Espiritu Santo Island) have consistently paved roads, which have a maximum speed limit of 50 kilometers per hour.
These paved roads can be quite narrow in spots; drivers should take care, especially at night or along unfamiliar routes.
The roads in all other areas are mostly unpaved or dirt tracks.
Drivers on all roads should give way to traffic coming from the right, and to traffic coming from the left at a round-about.
Travelers must take care when driving off main roads to avoid trespassing on communal land.
Please refer to our Road Safety page for more information.
For specific information concerning Vanuatu driving permits, vehicle inspection, road tax and mandatory insurance, please contact the National Tourism Office of Vanuatu or the Vanuatu Mission to the United Nations at vmsnyc@attglobal.net
AVIATION SAFETY OVERSIGHT:
As there is no direct commercial air service to the United States by carriers registered in Vanuatu, the U.S. Federal Aviation Administration (FAA) has not assessed Vanuatu’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.
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:
The U.S. Embassy in Papua New Guinea
provides primary assistance for U.S. citizens in Vanuatu.
The Embassy is located on Douglas Street, adjacent to the Bank of Papua New Guinea, in Port Moresby.
Use that address for courier service deliveries.
The mailing address is PO Box 1492, Port Moresby, N.C.D. 121, Papua New Guinea; the telephone number is (675) 321-1455; after hours duty officer telephone number is (675) 683-7943; fax (675) 321-1593.
American citizens may submit consular inquiries via e-mail to ConsularPortMoresby@state.gov.

Americans living or traveling in Vanuatu are encouraged to register with the U.S. Embassy in Port Moresby through the State Department’s travel registration web site, https://travelregistration.state.gov, and to obtain updated information on travel and security within Vanuatu.
Americans without Internet access may register directly with the Embassy.
By registering, American citizens make it easier for the Embassy to contact them in case of emergency.
*

*

*
This replaces the Country Specific Information for Vanuatu dated July 18, 2008, to update sections on Crime, Special Circumstances and Medical Facilities.

Travel News Headlines WORLD NEWS

Date: Wed, 31 Jul 2019 17:52:50 +0200 (METDST)

Wellington, July 31, 2019 (AFP) - A strong 6.6-magnitude earthquake struck near the Pacific island nation of Vanuatu Thursday, the US Geological Survey said, but no tsunami warning was issued.   USGS said the quake hit about 178 kilometres (110 miles) northwest of the capital Port Vila at 2:02 am (1502 GMT Wednesday) at a depth of 179 kilometres.   The Pacific Tsunami Warning Center said there was no tsunami threat from the quake.   USGS said there was a low likelihood of casualties and damage.   Vanuatu is part of the "Ring of Fire," a zone of tectonic activity around the Pacific frequently subject to earthquakes and volcanic eruptions.
Date: Wed 19 Dec 2018
Source: BBC [edited]

A baby on a small Pacific island has become the 1st person given a vaccine delivered by a commercial drone. UNICEF arranged for the drone to be flown some 40 km (25 mi) across rugged mountains in Vanuatu that otherwise take hours to cross. About 20% of children in Vanuatu don't receive important vaccinations because the supply is too difficult. The UN children's organisation hopes that drone delivery will in the future be of vital importance in remote areas.

"Today's small flight by a drone is a big leap for global health," UNICEF executive director Henrietta Fore said. "With the world still struggling to immunize the hardest-to-reach children, drone technologies can be a game changer for bridging that last mile to reach every child."

While drones have been used before to deliver medicine, UNICEF says this was the 1st time globally that a country had contracted a commercial drone company to get vaccines to remote areas.

Two companies competed for the project on Vanuatu, and it was Australia's Swoop Aero that won the bid after successful trials earlier this month [December 2018]. Its drone carried the vaccines in a Styrofoam box with ice packs and a temperature logger to a remote village on the island of Erromango, from Dillon's Bay on the west of the island to Cook's Bay on the east. The medicine was then used by local nurse Miriam Nampil to vaccinate 13 children and 5 pregnant women.

Without the drone, Cook's Bay is only accessible on foot or by boat; both of those options take hours compared to the 25 minutes it took for the drone to reach the village. Medical supplies also have to be kept at a cold temperature.

"It's extremely hard to carry ice boxes to keep the vaccines cool while walking across rivers and mountains, through the rain, and across rocky ledges," Ms Nampil said. "As the journey is often long and difficult, I can only go there once a month to vaccinate children. But now, with these drones, we can hope to reach many more children in the remotest areas of the island."
Date: Tue, 18 Dec 2018 09:43:37 +0100

Sydney, Dec 18, 2018 (AFP) - A one-month-old on a remote island in the Pacific archipelago of Vanuatu became the first child to be immunised in a commercial trial of drone-delivered vaccines, the UN children's fund UNICEF said Tuesday.   Aid agencies hope the successful run in the country, where one in five children is not fully immunised, could eventually help governments and organisations reach others in far-flung places around the world.  "Today's small flight by drone is a big leap for global health," UNICEF executive director Henrietta Fore said in a statement.   "With the world still struggling to immunise the hardest to reach children, drone technologies can be a game changer for bridging that last mile to reach every child."

While this is not the first time that drones have been used to deliver vaccines, it is the first time such a method has been deployed in Vanuatu, which has 83 islands, most only accessible by boat.   It is also the first time a commercial contract is being used for routine immunisations, UNICEF said.   A key requirement for the deliveries is maintaining the temperatures at which the vaccines are carried.   In warmer places such as Vanuatu, transportation across limited roads has its challenges.   In the trial, the drone travelled across almost 40 kilometres (25 miles) of rough and mountainous terrain from the west of the southern island of Erromango to its east, arriving at the remote Cook's Bay.

The vaccines were kept in styrofoam boxes that carried ice-packs and a temperature sensor that would be triggered if it exceeded the required range. A total of 13 children and five pregnant women were vaccinated by a registered nurse, UNICEF added.   "As the journey is often long and difficult, I can only go there once a month to vaccinate children. But now, with these drones, we can hope to reach many more children in the remotest areas of the island," the nurse, Miriam Nampil, told UNICEF.   The agency said Vanuatu's government was considering incorporating drone deliveries of vaccines into their national immunisation programme, and with the supply of other health aids.
Date: Wed, 22 Aug 2018 01:34:08 +0200

Sydney, Aug 21, 2018 (AFP) - A 6.7-magnitude earthquake hit the Pacific island nation of Vanuatu on Wednesday morning, the US Geological Survey said, but no tsunami warning was issued.   The quake struck at a moderate depth of 30 kilometres (19 miles) with the epicentre just off the northern tip of Vanuatu's sparsely-populated Ambrym island.

The Pacific Tsunami Warning Center said there was no tsunami risk.    "Shaking would have been felt throughout the whole of Vanuatu," Geoscience Australia senior seismologist Eddie Leask told AFP.   "But it's hard to tell whether it will cause damage. It's reasonably shallow but it all depends on the buildings, soil type and so on."

On its website, Geoscience put the potential damage radius at 63 kilometres.   The nearest city, Lakatoro, is 78 kilometres away, with the capital Port Vila 187 kilometres north of the epicentre.   "We get a lot of five and six magnitude quakes coming through Vanuatu," added Leask.   "We'd expect to see smaller aftershocks, and even a bigger one."   The Vanuatu Disaster Management Office told AFP it was not aware of any immediate damage.

Vanuatu, with a population of about 280,000 spread over 65 inhabited islands, is regarded as one of the world's most disaster-prone countries.   It sits on the so-called "Pacific Ring of Fire," making it vulnerable to strong earthquakes and volcanic eruptions, while powerful cyclones also regularly lash the islands.   A 7.0-magnitude quake struck in 2017, but no damage was reported.
Date: Fri, 27 Jul 2018 05:34:13 +0200

Wellington, July 27, 2018 (AFP) - Vanuatu renewed a state of emergency on the volcano-hit island of Ambae Friday and ordered the compulsory evacuation of all residents.   A series of eruptions at the Manaro volcano that began last September intensified this week, sending a 12 kilometre (7.5 mile) column of ash spewing into the atmosphere.

The Vanuatu Meteorology and Geo-hazards department has described the volcano as a "danger to direct safety to life" and warned people to stay three kilometres from its vent.   "The local population from Ambae and from neighbouring islands will continue to hear rumbling, volcanic explosions (and) smell volcanic gases," it said.

The Red Cross reported that a thick cloud of ash had covered the Pacific island, choking crops and cutting visibility to two metres in some areas.   Foreign Minister Ralph Regenvanu said the government had decided to order the island's population to be evacuated.   "Cabinet has reimposed the state of emergency and ordered the compulsory evacuation of the entire population of Ambae," he tweeted.

The island has already undergone two evacuations since September. In the first one, just after the volcano started rumbling, authorities scrambled to temporarily remove all 11,000 residents using ferries and small private boats.   The second evacuation in May was better organised, with thousands of people shipped to camps set up on neighbouring islands.   However, it was not compulsory and many villagers indicated they wanted to stay.   It is unclear whether the government is planning to make the latest compulsory evacuation permanent.
More ...

Jordan

General Information:
***************************************
The Middle East is a favourite destination for many Irish holiday makers. The combination of a beautiful climate linked with such historical richness is hard to beat. Unfortunately the
security situation throughout the region has led to some significant concerns over the years. Nevertheless, in the vast majority of cases those visiting the region will not encounter any particular concerns in this regard. It is a wise precaution to ensure that your passport is valid for at least a further six months beyond the time of your holiday as otherwise you may be refused entry.
Security Situation:
***************************************
Security throughout the Middle East is generally tight. Carry some means of identification at all times in case you are requested to produce it by police or army personnel. In Jerusalem the city has been divided and it is sensible to remember which quarter you are in at all times.
Health Facilities:
***************************************
Generally the health facilities throughout the region are excellent. However, when visiting certain rural regions you may find it difficult to obtain hospital care similar to that at home. In Israel, travellers can find information in English about emergency medical facilities and after-hours pharmacies in the "Jerusalem Post" and English language "Ha'aretz" newspapers.
Food & Water Facilities:
***************************************
Again, this depends on your location and the facilities which are there at the time of the year you visit. Bottled water is easily available and food hygiene is usually excellent throughout all the main tourist destinations. However, it is generally wiser not to drink hotel tap water and only to use it for brushing your teeth if there is a clear smell of chlorine. When on organised trips tourists are sometimes offered local tea or other drinks. Generally this will be safe as the water is boiled but take care that the cup hygiene is acceptable.
Sun Exposure:
***************************************
The climatic conditions in the Middle East vary considerably throughout the year. Many tourists visit in late autumn or early spring. At these times the climate is much cooler and the evenings can be distinctly chilly. However, during the main tourist season (May to September) the temperatures rise high into the 80’s or 90’s and dehydration can easily occur. Increasing fluid and salt intake is important under these circumstances. It is essential that travellers are aware of the climatic conditions which should be present for their trip and that sensible clothing is used at all times.
Rabies:
***************************************
Tourists should avoid all animals as this viral disease is transmitted through the bite, lick or scratch of any infected warm blooded animal. In Israel the most common animals involved are foxes and jackals and in Jordan, dogs tend to be the main culprits.
Exploring the Region:
***************************************
Leaving the main tourist routes is unwise. There are a number of security risks which have to be considered and there are also significant health concerns which may be encountered. In July 2000 an 18 year old American tourist died of sunstroke when she became separated from her group in the Dead Sea region of Israel. Those exploring caves and parts of the desert areas also run the risk of diseases like Borreliosis and Rabies.
Walking & Trekking:
***************************************
For many going to these countries their trip will involve visiting some of the major ruins and archeological sites. This will involve a good deal of walking and trekking. Good supporting foot wear is essential and it would be wise to carry a crepe bandage in case of a sprained ankle. Having a suitable painkiller or anti-inflammatory medication would also be advantageous. Check your health will be up to the journey.
Swimming:
***************************************
Pools are usually very well maintained and the risk of disease is small. Those swimming in the sea should remember that the Mediterranean is home to many jelly fish. Swim with others and never alone and especially after alcohol or a heavy meal.
Anthrax:
***************************************
This bacterial disease is rare in the Middle east though travellers should be aware that it can be transmitted through unprepared leather goods usually bought in the local market places. Typically the disease may then present with a black ulcerated skin lesion.

Malaria:
***************************************
Fortunately this disease does not occur in Israel or Jordan. However other mosquito and sandfly diseases do occur and so protection against their bites should be used when necessary.
Hepatitis:
***************************************
There are many forms of this disease but the most common is Hepatitis A, often known as Infectious Jaundice. This disease can keep an infected individual off work for many weeks and it is wise to consider vaccination cover before exposure. In Israel approx 65% of the population will have been infected before 18 years of age.
Vaccinations:
***************************************
There are no essential vaccines for entry/exit however most Irish tourists are recommended to receive cover against; Poliomyelitis, Typhoid, Tetanus and Hepatitis A. Those living in these countries or planning an extended trip should also consider cover against Hepatitis B and Rabies.
Summary:
***************************************
Due to the unrest within Israel there are concerns regarding the safety of tourists at this time. If you are travelling to this region it is wise to ensure that your insurance policy is sufficient if your circumstances or travel plans change.

Travel News Headlines WORLD NEWS

Date: Mon 26 Apr 2019, 3:51 PM
Source: Roya News [edited]

The initial results of the laboratory specimens of the food poisoning cases in Raymon town, west of Jarash revealed that _E. coli_ bacteria was the cause of the poisoning. The reports indicated that the bacterium was found in samples taken from water tanks in a bakery and restaurant during inspections conducted by teams of the Ministry of Health, the Ministry of Environment and the Jordan Food and Drug Administration (JFDA).

The report said that 5 people were referred to hospital on [Sat 24 Aug 2019], where it was suspected that they have food poisoning. The Ministry of Health had then sent an investigation committee to take water samples, after it was thought that the poisoning was caused by water that people used from 2 water stations.

Water samples were also taken from houses of people who suffered poisoning, 2 restaurants and a bakery. However, the bacteria were found in one of the restaurants and the bakery.

So far, 49 cases were referred to the Comprehensive Health Center, while 22 were referred to Jarash Government Hospital, where 7 of which left the hospital.

Preliminary results of the water samples taken from the 2 stations showed that water is clear of any kind of bacteria. The restaurant and bakery were closed down.
=======================
[_E. coli_ contamination does not necessarily mean that the organism was the cause of the illnesses as the observation can just reflect human faecal contamination and other pathogens including viruses, parasites and other bacteria may be involved. - ProMED Mod.LL]

[HealthMap/ProMED map available at:
Date: Sat, 10 Nov 2018 16:22:28 +0100

Amman, Nov 10, 2018 (AFP) - Flash floods killed 12 people in Jordan and forced nearly 4,000 tourists to flee the famed ancient desert city of Petra, emergency services said on Saturday.   Search teams were scouring valleys near the historic hill town of Madaba for a young girl who was still missing after Friday's floods, civil defence spokesman Iyad Amru told state television.

Among those confirmed dead after torrential rains swept the south of the kingdom were six people found in the Madaba area southwest of the capital Amman.   To the east, three people were killed near Dabaa on the Desert Highway, one of Jordan's three main north-south arteries, while one was killed near Maan in the south.    It was not immediately clear where the other two died.   Amru said two girls had gone missing in the Madaba region, later announcing that one of their bodies had been found.

Government spokeswoman Jumana Ghneimat said authorities had found alive four Israeli tourists who had gone missing in the Wadi Rum desert in southern Jordan but were looking for two more.   "Our embassy in Tel Aviv contacted the Israeli foreign ministry for information on the identities of the missing Israelis," Ghneimat said in statements carried by the state news agency Petra.   Israel initially confirmed the report but in a later update a spokesman for the foreign ministry said that "all the Israelis in Jordan have contacted us. All of them were found".

- Tourists evacuated -
The Jordanian army deployed helicopters and all-terrain vehicles to help with search and rescue operations after floodwaters cut off the Desert Highway in both directions.   A rescuer was also among the dead, the civil defence spokesman said.   State television said the waters had reached as high as four metres (13 feet) in parts of the red-rock ravine city of Petra and the adjacent Wadi Musa desert.

It broadcast footage of tourists sheltering on high ground on both sides of the access road to Jordan's biggest attraction.   The government spokeswoman said 3,762 tourists were evacuated.   Designated a UNESCO World Heritage site in 1985, Petra draws hundreds of thousands of tourists a year to its rock-hewn treasury, temples and mausoleums.   Its buildings have been used as sets for several Hollywood blockbusters including "Indiana Jones and the Last Crusade".   Wadi Rum, also a UNESCO World Heritage site, has attracted generations of tourists with its spectacular sandstone and granite rock formations.   Its landscapes served as a backdrop in the filming of the Hollywood classic "Lawrence of Arabia".

The latest deaths come after October 25 flash floods in the Dead Sea region of the kingdom killed 21 people, most of them children on a school trip.   Jordan's education and tourism ministers both resigned last week over failings in the government's response to those floods.   The education ministry ordered schools closed nationwide on Saturday amid warnings of more heavy rains.   Jordan's minister of water and irrigation, Raed Abu al-Saoud, said on Saturday that the country's 14 main dams had filled up by some 26 percent of full capacity in the past 48 hours because of the torrential rains.   Jordan is a water-poor country that is 90 percent desert.
Date: Fri, 26 Oct 2018 11:36:00 +0200

Amman, Oct 26, 2018 (AFP) - At least 20 people, most of them school pupils, have been killed in flash floods in Jordan, the emergency services said Friday in an updated toll.   A further 35 people were injured following heavy rains on Thursday, including members of the security forces involved in rescue operations, said an official from the civil defence -- Jordan's fire service -- who asked not to be named.   He said rescuers were still searching for people missing in the area, a popular tourist attraction around 50 kilometres (30 miles) west of Amman.   "Most of the dead were schoolchildren aged 11 to 14 who were taking part in a school trip to the Dead Sea region" when their bus was swept away by floodwaters.   Also among the dead were passers-by who had been picnicking in the area, he said, adding that a nearby bridge had collapsed.   "Security force personnel who were taking part in the rescue operations were among the injured," he added.

The Dead Sea, the lowest point on earth, is surrounded by steep valleys and gullies that frequently see flash floods and landslides.   Education Minister Azmi Mahafzah promised a "full inquiry" into the schoolchildren's deaths.   He said the bus took a route not agreed upon by the ministry and the organiser of the trip bore full responsibility.   Roads leading to the area were closed on Friday morning "to allow the continuation of search and rescue operations", the Directorate of General Security said.   The Israeli military said on Thursday it was helping with the operation, sending helicopters and forces specialised in search and rescue.   Jordanian television reported that King Abdullah II had cancelled a planned visit to Bahrain to monitor developments.
Date: Tue 26 Sep 2017
Source: Jordan Times [edited]

Following a rise in hepatitis A cases among school students in Mafraq's Akeider area, the president of the Lower House's Health Committee, Ibrahim Bani Hani, has called for more governmental attention to the area, which "has suffered negligence for so long".

The Ministry of Health has recorded 32 cases of Hepatitis A in students from the Akeider area, in Mafraq Governorate, since [22 Aug 2017]. Hepatitis A is a liver disease caused by a virus transmitted through contaminated food or water, inadequate sanitation and poor personal hygiene, the Health Ministry's spokesperson, Hatem Azrui, told The Jordan Times.

Bani Hani visited Akeider 2 months ago, along with other officials and the Lower House's Environmental Committee, to examine the impacts of the landfill in Akeider on the environment and the health of its citizens. "There is no doubt that hepatitis A has spread in the area due to a lack of hygiene in health and public facilities," he stated.

Mafraq health director at the Ministry of Health, Hani Oleimat, said that the disease is not epidemic and that the rate of [past] infection in adults amounts to over 90 percent.

Azrui said that the ministry has conducted experiments on the water sources at schools and homes and noted that no signs of the virus were found. He said that the disease is spread through sharing personal items like towels at public health facilities.

For his part, Bani Hani stressed that the area is lacking a health centre, which the ministry had promised to build, but noted that "no real measures were taken". He also said that the area suffers from other issues such as the emission of phenol gas from Akeider landfill and the increased number of stray dogs, a potential source of rabies.

Oleimat noted that since the discovery of the cases, no schools have stopped working in the area and noted that the ministry urged the school staff to direct any suspected case to the health directorate, in order to provide the infected students with a 7- to 10-day sick leave. The sickness needs no medication other than rest, Oleimat highlighted, noting that the body of the infected person naturally generates immunity  against the virus.  [Byline: Sawsan Tabazah]
==================
[This is a completely preventable disease using the inactivated hepatitis A vaccine. In the developing world, it is seen primarily in children and by adulthood, almost all individuals are immune. Most infections in children are asymptomatic so a cluster of 32 cases, so far here, implies a great deal more total infections. - ProMED Mod.LL]

[A HealthMap/ProMED-mail map can be accessed at:
Date: Tue 26 Sep 2017
Source: GIDEON (Global Infectious Disease Epidemiology Network) [edited]

re: ProMED-mail Hepatitis A - Jordan: (MA)
-----------------------------------------------------------
The potential benefit for hepatitis A vaccination in Jordan is illustrated by the chart at

In 1999, Israel became the world's 1st country to institute routine hepatitis A immunization (blue arrow), and has since largely eradicated the disease [1].

Reference
---------
1. Chart generated by a Gideon multi-graph tool, see
--------------------------------------------
Communicated by:
Stephen Berger
Geographic Medicine
Tel Aviv Medical Center
Tel Aviv, Israel
=========================
[ProMED thanks Dr Berger for his continued contributions. - ProMED Mod.LL]

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

World Travel News Headlines

Date: Wed, 16 Oct 2019 18:45:39 +0200 (METDST)

Manila, Oct 16, 2019 (AFP) - A child was killed in a strong 6.4-magnitude quake that hit the southern Philippines on Wednesday, a local mayor said, as houses collapsed, power was knocked out and a shopping mall burst into flames.   Residents evacuated homes and buildings across the Mindanao region including a mall that caught fire in the city of General Santos shortly after the quake struck in the evening, officials said.   The child died in a house collapse in the town of Datu Paglas, while four residents of nearby Tulunan town were injured when at least two other houses fell down, Tulunan Mayor Reuel Limbungan told AFP.   "The child was crushed by a collapsed house wall" and pronounced dead in hospital, Limbungan said, adding that he had visited the medical facility and spoken to its director.

Rescue and local officials said there were no immediate reports of deaths elsewhere in Mindanao, and rescue official Anthony Allada told local television that 20 people were treated for injuries in the town of Magsaysay, near the epicentre.   Three other people were hurt in the town of M'lang, added its vice-mayor, Joselito Pinol.   The quake was 14 kilometres (8.7 miles) deep and was followed by at least two aftershocks, according to the United States Geological Survey (USGS).   "It was the most powerful earthquake I have ever experienced," Sara Duterte, mayor of the largest Mindanao city of Davao, and daughter of President Rodrigo Duterte, told local television.

- Falling debris -
The Philippines is part of the Pacific "Ring of Fire", an arc of intense seismic activity that stretches from Japan through Southeast Asia and across the Pacific basin.   An elderly man was treated for injuries after being struck by a falling object during the evacuation of a Davao mall, local TV reported.   Jerome Barranco, civil defence officer for the region, said several people were also injured in the city of Kidapawan "as a result of falling debris".   In General Santos, television footage showed firemen battling a blaze that engulfed the three-storey Gaisano shopping mall.   It was not known if there were still people inside the building, which was evacuated as the quake struck.   The blaze was still raging more than three hours later despite the efforts of nearly 100 firemen, fire officer Redentor Batulan told AFP.

Coastal residents of Davao fled their homes in fear of a tsunami, but rescue workers were trying to convince them to return as no warning was issued, city civil defence chief Rodrigo Bustillo told local television.   "Our volunteers are out to calm the people and tell them there is no tsunami," Bustillo added.   Chief Philippine government seismologist Renato Solidum said there was no risk of a tsunami because the quake occurred inland, but he advised residents to check their homes for possible damage.   "We ran out of the police station, and we also let the inmates at the municipal jail out," patrolwoman Celina Sarte told AFP by telephone from the town of Bansalan.   She said the 10 prisoners were put in handcuffs outside moments later.
Date: Tue, 15 Oct 2019 20:35:37 +0200 (METDST)

Addis Ababa, Oct 15, 2019 (AFP) - Rescue workers on Tuesday used excavators to dig out bodies after a landslide in southern Ethiopia washed away homes and killed more than 20 people, a local official said.    The landslide in the remote district of Konta occurred Sunday following 10 hours of heavy rains, said the official, Takele Tesfu.   "There are 22 people dead and we have only been able to dig up 17 using manpower and machine power," Takele told AFP.   "So far, we cannot get the others, so tomorrow we will continue to dig."     He said the victims included nine women and six children.

While the district -- located in Ethiopia's Southern Nations, Nationalities, and Peoples' Region -- sees landslides with some regularity, Takele said this was the deadliest he could remember.    "The area where this occurred is very mountainous, and this means the landslide was very dangerous," he said.    Ethiopia is nearing the end of its rainy season, but security forces are nonetheless relocating some families for fear that more rain in the coming days could lead to similar disasters, Takele said.
Date: Tue, 15 Oct 2019 10:00:23 +0200 (METDST)

New Delhi, Oct 15, 2019 (AFP) - New Delhi banned the use of diesel generators on Tuesday as pollution levels in the Indian capital exceeded safe limits by more than four times.   Every winter, New Delhi is enveloped in a noxious blanket of smog of car fumes, industrial emissions and smoke from stubble burning at farms outside the megacity of 20 million people.   The ban on generators is part of the Graded Response Action Plan (GRAP) that entered into force on Tuesday.   Other measures that will come into effect as smog levels rise, particularly following the Diwali festival in late October, include banning trucks and setting up a "war room".

From November 4-15, a road-rationing scheme will come into force, meaning cars with odd and even plates would be allowed on alternate days in that period.   "We will hand out anti-pollution masks to schoolchildren next week but the date is yet to be decided," the official told AFP.   Indian authorities have also sought to reduce the burning of stubble by farmers in areas surrounding Delhi.   According to government data, concentrations of particles measuring less than 2.5 microns across -- which can penetrate the lung barrier and enter the blood -- hit 108 icrograms per cubic metre on Tuesday.   This was more than four times the recommended World Health Organization safe daily maximum of 25. In previous years, the level has regularly exceeded 400.   Last year, a UN report found 14 of the world's 15 most polluted cities were in India, with one US study saying it kills a million people prematurely every year.
Date: Tue, 15 Oct 2019 09:50:21 +0200 (METDST)
By Kyoko HASEGAWA

Tokyo, Oct 15, 2019 (AFP) - Rescuers in Japan were working around the clock Tuesday in an increasingly desperate search for survivors of a powerful weekend typhoon that killed nearly 70 people and caused widespread destruction.   Hagibis slammed into Japan on Saturday night, unleashing fierce winds and unprecedented rain that triggered landslides and caused dozens of rivers to burst their banks.   By Tuesday afternoon, local media put the toll at nearly 70, with around a dozen people missing. The government's tally was lower, but it said it was still updating information.   Prime Minister Shinzo Abe said there was no plan to slow rescue operations, with around 110,000 police, coast guard, firefighters and military troops involved.   "Currently in damaged areas rescue work and searches for the missing are continuing around the clock," Abe told parliament.   "Where rivers flooded, work is ongoing to fix spots where banks broke, and water is being pumped out where floods occurred," he added.   The prime minister's office said more than 3,000 people have been rescued in the wake of the disaster, which affected 36 of the country's 47 prefectures.   The defence ministry has called up several hundred reserve troops in addition to active duty soldiers for the first time since the 2011 earthquake and tsunami.

- Rain prompts new warnings -
Government officials warned that more rain was expected throughout the day Tuesday in several parts of the country affected by the typhoon.   "We ask people not to drop their guard and to remain fully alert," chief cabinet secretary Yoshihide Suga. told reporters.   Hagibis crashed into land packing gusts up to 216 kilometres (134 miles) per hour, but it was the storm's heavy rain that caused the most damage.   At least 176 rivers burst their banks, including in central Nagano, where a levee breach sent water from the Chikuma river gushing into residential neighbourhoods and submerging bullet trains in a depot up to their windows.   Deaths were reported across many prefectures and included a man whose apartment was flooded, a municipal worker whose car was caught in rising waters and at least seven crew aboard a cargo ship that sank in Tokyo bay on Saturday night.   By Tuesday morning, some 34,000 households were still without power, and 133,000 homes had no water.   Tens of thousands of people spent Monday night in government shelters, with many unsure when they would be able to return home.   "My frightened daughter can't stop shaking. We want to go home quickly," Rie Nishioka, 39, told Kyodo News agency in Miyagi prefecture.

- Government pledges aid -
The government pledged financial support to affected regions without specifying how much aid it would set aside.   "Support for the victims of the disaster is an urgent task," Abe said.   "There are concerns that the impact on daily life and economic activities may be long-lasting."   Another area affected by the storm was Fukushima, where several bags containing soil and plants collected during nuclear decontamination efforts were washed away.   "Ten bags out of 2,667 were swept into a river during the typhoon, but six of them were recovered yesterday," environment ministry official Keisuke Takagi told AFP, adding that the remaining four bags had been found and would be collected soon.   "Residents must be worried about the environment, but there are no reports that the bags were broken, so there will be nothing to worry about once they have been recovered safely," he said.   Hagibis caused transport chaos over a holiday weekend in Japan, grounding flights and halting train services.   By Tuesday, things were largely back to normal, though some flights were cancelled and train services partially disrupted where tracks or train stock were damaged by the storm.   The typhoon also caused disruption to sporting events, delaying Japanese Grand Prix qualifiers and forcing Rugby World Cup organisers to cancel three matches.   A crunch fixture pitting the hosts against Scotland went ahead on Sunday night, with Japan winning its first-ever quarter final spot.
Date: Mon, 14 Oct 2019 17:55:47 +0200 (METDST)

Harare, Oct 14, 2019 (AFP) - Striking Zimbabwe doctors on Monday defied a court order to return to work, saying a pay rise offered by the government failed to meet everyday costs.   Doctors remained home for a 43rd consecutive day, striking for better pay after their salaries were eroded by the country's spiralling inflation.   Zimbabwe's labour court ruled the action "unlawful" on Friday and ordered the medics back to their wards within 48 hours.

The Zimbabwe Hospital Doctors Association (ZHDA) announced Sunday it would appeal to the Supreme Court.    "We noted the court order but unfortunately we don't have the means by which to comply," said ZHDA spokesman Masimba Ndoro on Monday.   "We remain incapacitated... There is nothing we can do when we don't have the means to go to work and to meet our basic needs," he told AFP.   The doctors say the value of their pay shrank 15-fold over the past year -- a legacy of hyperinflation caused by economic mismanagement under ex-president Robert Mugabe.   His successor Emmerson Mnangagwa has so far failed to redress the situation.    Fuel prices have increased by more than 400 percent since the start of the year, and the ZHDA said that doctors had to use their savings just to show up to hospital each morning.

Negotiations with the government have been deadlocked since the ZHDA rejected a 60-percent salary rise offer.   With pay slips worth less than the equivalent of $100 (91 euros) in some cases, they are demanding doctors' salaries be pegged to the US dollar and have appealed to international bodies to supplement their wages.   "While doctors would want nothing more than to return to work in service of their patients, they continue to be incapacitated and lack the resources to comply with the Labour Court judgement," the ZHDA said in a statement on Sunday.   Nurses joined in the action last week.   "We have reduced the number of days we are coming to work initially to three days a week now we are down to two days," Zimbabwe Nurses Association spokesman Enoch Dongo told AFP.   "If the issue of salaries is not urgently addressed we will soon have a situation where nurses will no longer be able to come to work," he said, adding that nurses were "taking turns" in coming to hospital.      Rural teachers also embarked on strike action on Monday with a stay-at-home protest "against underpayment".   "We urge the government to respect our right to engage in job actions and peacefully protest demanding a living wage," the Amalgamated Rural Teachers Union of Zimbabwe posted on Twitter.
Date: Mon, 14 Oct 2019 16:33:26 +0200 (METDST)
By Daniel BOSQUE

Barcelona, Oct 14, 2019 (AFP) - "I feel fury and a sense of powerlessness," said Joan Guich, a 19-year-old student protesting in Barcelona after Spain's Supreme Court jailed nine Catalan leaders jailed over a failed independence bid.   "They have been convicted for an ideology which I agree with."   Within minutes of the ruling demonstrators had poured onto the streets of the Catalan capital, waving flags and blocking traffic over the conviction of the separatist leaders who organised a 2017 referendum banned by Madrid.   "We have to mobilise and stick up for them ... in a way that has an impact, closing airports, stations, but always avoiding violence," Guich said. "Or at least, it won't be us that provokes it."

Workers rallied outside their offices, university students walked out of classes and regional lawmakers demonstrated inside Catalonia's parliament, where most of the defendants had held a senior role.   "Today is going to be historic, you can feel it in the atmosphere. Serious things are happening, we can't stay home," said Oscar Quiles, a 47-year-old real estate entrepreneur.   News of the verdict reached him as he arrived at the office and he immediately called his mother to join him at a protest in Plaza Cataluna in the centre of Barcelona.   By noon the square was packed with thousands of demonstrators, many waving yellow, red and blue Catalan separatist flags or banners reading "We would do it again" and "Freedom for political prisoners".   The protesters then set off walking towards Barcelona's airport, Spain's second busiest, in the hope of blocking it, just as pro-democracy activists have done recently in Hong Kong.

- 'Weeks of mobilisation' -
Tension gripped Barcelona on Monday morning ahead of the ruling, with a heavy police presence outside the courts, the airport and the city's main train station, as a helicopter flew overhead.    Democratic Tsunami, a group advocating more active forms of civil disobedience, had urged demonstrators to hit the streets as soon as the verdicts were announced.   "Tomorrow everyone ready! When the verdict is out, the response will be immediate," said the group in a message to its roughly 150,000 followers on mobile messaging service Telegram.   Juli Cuellar, a 44-year-old office worker, said he believed the verdict was politically motivated.    "Now all we have left is a life of civil and institutional disobedience," he told AFP, predicting "weeks of mobilisation".   The Catalan National Assembly (ANC) and Omnium Cultural, the region's two biggest grassroots pro-independence groups, have also called supporters to attend an evening rally. They have organised some of the largest separatist protests in recent years.   Several more protests are scheduled over the next few days across Catalonia, as well as a general strike on Friday.

- 'Felt like crying' -
Democratic Tsunami, the group that called the gathering in Plaza Cataluna, only emerged in recent weeks. It says it does not depend on Catalan separatist parties or civil associations for support.   Its leaders remain unknown, keeping in touch with each other through encrypted messaging apps such as Wire.   But supporters tend to be kept in the dark until the last minute.   "We don't know exactly what we have to do," said Arnau Font, a 22-year-old shop assistant who took the week off to protest.   "We have to get involved. Right now I feel really powerless in light of the verdicts," he told AFP.    "When I found out, I felt like crying."   The uncertainty was over a few minutes later when a Telegram message arrived urging everyone to "go to the airport", a 15-kilometre (nine-mile) walk from the city centre.    "The time has come to make our voice felt around the world. The goal: stop the activity of Barcelona's airport," it said.   Spain's airport operator Aena said no flights were disrupted, but many passengers got stuck in traffic jams leading to the airport.
Date: Mon, 14 Oct 2019 14:09:03 +0200 (METDST)

Frankfurt am Main, Oct 14, 2019 (AFP) - German cabin crew union UFO urged members Monday to walk off their jobs at airline giant Lufthansa on October 20, although the carrier contests its right to represent workers.   "We call on all cabin crew... not to show up to work" between six and eleven am (0400 to 0900 GMT) at Germany's two busiest hubs Frankfurt and Munich, Ufo chairman Daniel Flohr said in a video message to staff.   At least five of the Lufthansa group's airlines -- Lufthansa, Eurowings, Germanwings, Cityline and Sunexpress -- would be hit by strikes for higher pay in the coming weeks, Flohr added.

Lufthansa told AFP it would "maintain its entire timetable", calling UFO's call to strike "illegal".   Bosses at the airline group believe UFO may no longer have the legal right to speak for workers and have challenged its status in court.   Internal disputes at the union have cost it members and support among cabin crew, some of whom have now turned to other representative organisations.   Berlin daily Tagesspiegel on Monday called UFO a "half-dead" outfit.   "UFO is battling for its life," agreed business daily Handelsblatt.   "With its far-reaching call for strikes, it wants to show members it remains capable of acting and is representing cabin crew interests."   Lufthansa could also contest before a court whether UFO has the right to initiate a strike -- potentially leaving the worker representatives on the hook for any resulting costs.
Date: Mon, 14 Oct 2019 11:08:10 +0200 (METDST)

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

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

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

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

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

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

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

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

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

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

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

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

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