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Andorra

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

Travel News Headlines WORLD NEWS

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

No Profile is available at present

Travel News Headlines WORLD NEWS

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Tick-borne encephalitis and lyme disease are widespread throughout the country. Those intending to visit parks or forested areas in Lithuania are urged to speak with their health care practitioners about immunization. Rabies is also increasingly prevalent in rural areas.
The Lithuanian Government does not require HIV testing for U.S. citizens. However, sexually transmitted diseases are a growing public health problem.
Information on vaccinations and other health precautions, such as safe food and water precautions and insect bite protection, may be obtained from the Centers for Disease Control and Prevention’s hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747); or via the CDC’s web site at http://wwwn.cdc.gov/travel/default.aspx. For information about outbreaks of infectious diseases abroad consult the World Health Organization’s (WHO) web site at http://www.who.int/en. Further health information for travelers is available at http://www.who.int/ith.
MEDICAL INSURANCE: The Department of State strongly urges Americans to consult with their medical insurance company prior to traveling abroad to confirm whether their policy applies overseas and whether it will cover emergency expenses such as a medical evacuation. All foreigners of non-European Union countries seeking entry into Lithuania must carry proof of a medical insurance policy contracted for payment of all costs of hospitalization and medical treatment in Lithuania (please see entry/exit requirements above). Please see our information on medical insurance overseas.
TRAFFIC SAFETY AND ROAD CONDITIONS: While in a foreign country, U.S. citizens may encounter road conditions that differ significantly from those in the United States. The information below concerning Lithuania is provided for general reference only, and may not be totally accurate in a particular location or circumstance.
The Police allow Americans to drive in Lithuania with an American driver’s license for up to 90 days. Americans who reside in Lithuania for 185 days or more in one calendar year and who wish to continue driving in Lithuania must acquire a Lithuanian driver's license. The foreign license must be given to the Lithuanian Road Police to be processed by the Consular Department of the Lithuanian Ministry of Foreign Affairs, which in turn sends it to the U.S. Embassy’s Consular Section, where the owner is expected to claim it.
Roads in Lithuania range from well-maintained two- to four-lane highways connecting major cities to small dirt roads traversing the countryside. Violation of traffic rules is common. It is not unusual to be overtaken by other automobiles, traveling at high speed, even in crowded urban areas. Driving at night, especially in the countryside, can be particularly hazardous. In summer, older seasonal vehicles and inexperienced drivers are extra hazards. Driving with caution is urged at all times. Driving while intoxicated is a very serious offense and carries heavy penalties. The speed limit is 50 km/hr in town and 90 km/hr out of town unless otherwise indicated. The phone number for roadside assistance is 8-800-01414 from a regular phone and 1414 from a GSM mobile phone.
Seatbelts are mandatory for the driver and all passengers except children under the age of 12. During the winter, most major roads are cleared of snow. Winter or all-season tires are required from November 10th through April 1st. Studded tires are not allowed from April 10th through October 31st. Drivers must have at least their low beam lights on at all times while driving. Public transportation is generally safe.
Please refer to our Road Safety page for more information. Visit the website of the country’s national tourist office and national authority responsible for road safety at www.tourism.lt and at www.lra.lt/index_en.html.
AVIATION SAFETY OVERSIGHT: As there is no direct commercial air service to the United States by carriers registered in Lithuania, the U.S. Federal Aviation Administration (FAA) has not assessed Lithuania’s Civil Aviation Authority for compliance with International Civil Aviation Organization ICAO aviation safety standards. For more information, travelers may visit the FAA’s web site at www.faa.gov/safety/programs_initiatives/oversight/iasa.
SPECIAL CIRCUMSTANCES: Lithuanian customs authorities may enforce strict regulations concerning the temporary importation into or export from Lithuania of items such as firearms and antiquities. Please see our Customs Information.
Telephone connections are generally good. American 1-800 numbers can be accessed from Lithuania but not on a toll-free basis; the international long distance rate per minute will be charged. Local Internet cafes offer computer access. ATMs are widely available. Most hotels and other businesses accept major credit cards.
CRIMINAL PENALTIES: While in a foreign country, a U.S. citizen is subject to that country's laws and regulations, which sometimes differ significantly from those in the United States and may not afford the protections available to the individual under U.S. law. Penalties for breaking the law can be more severe than in the United States for similar offenses. Persons violating Lithuanian laws, even unknowingly, may be expelled, arrested or imprisoned. Penalties for possession, use, or trafficking in illegal drugs in Lithuania are severe, and convicted offenders can expect long jail sentences and heavy fines. Engaging in sexual conduct with children or possessing or disseminating child pornography in a foreign country is a crime prosecutable in the United States. For more information about arrest procedures in Lithuania, please visit the Embassy’s web site at http://vilnius.usembassy.gov/arrests.html. Please see our information on Criminal Penalties.
CHILDREN'S ISSUES: For information on international adoption of children and international parental child abduction, see the Office of Children’s Issues web page.
REGISTRATION / EMBASSY LOCATION: Americans living or traveling in Lithuania are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department’s travel registration web site, and to obtain updated information on travel and security within Lithuania. Americans without Internet access may register directly with the nearest U.S. Embassy or Consulate. By registering, American citizens make it easier for the Embassy or Consulate to contact them in case of emergency. The U.S. Embassy is located at Akmenu Gatve 6, tel. (370) (5) 266-5500 or 266-5600; fax (370) (5) 266-5590. Consular information can also be found on the Embassy Vilnius web site at http://vilnius.usembassy.gov/.
* * *
This replaces the Consular Information Sheet dated November 5, 2007 to update sections on Crime and Medical Facilities and Health Information.

Travel News Headlines WORLD NEWS

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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: Thu 20 Feb 2020
Source: G1 [in Portuguese, trans. ProMED Mod.TY, edited]

The Office of Epidemiological Surveillance (DIVE-SC) confirmed another human yellow fever case this year [2020] in the state. The patient, a resident of Pomerode in the Vale do Itajai, is 45 years old and has not been vaccinated. As of this Thursday (20 [Feb 2020]) he was interned in the intensive care unit of the Nereu Ramos Hospital in Florianopolis. He was in stable condition as of this afternoon. He was sent to the [state] capital the same day since the Nereu Ramos Hospital is the reference facility for infectious diseases.

The other confirmed human yellow fever cases are in Blumenau, also in Vale do Itajai, and 2 other cases are in the north of the state, in Jaragua do Sul and Sao Bento do Sul. In 2019, there were 2 cases, and both died.

Vaccination
Everyone from 9 months of age and above needs to receive a dose of the vaccine that protects for life against the disease. A dose of the vaccine is free of charge and is available in health units in the entire state.

Yellow fever
Yellow fever is a disease caused by a virus that can lead to death in a week if not treated rapidly. It is transmitted by the bite of mosquitoes. In the forest, the vectors are insects of the _Haemagogus_ and _Sabethe_ genera. In the city it is _Aedes aegypti_.

The symptoms of the disease are
- initially, a rapid rise in fever
- chills and fever
- intense headache
- back and body pain
- nausea and vomiting
- weakness and fatigue
- abdominal pain
- yellow skin

Monkeys
In addition to humans, monkeys in the state also have yellow fever. There were 2 cases in Blumenau, another 2 in Pomerode, and one each in the following municipalities: Timbo, Gaspar and Indaial in the Vale do Itajai, and Jaragua do Sul, according to the most recent DIVE-SC bulletin issued on Monday [17 Feb 2020]. All were found dead.

Monkeys do not transmit the disease [directly] to people but are indicators that yellow fever virus is circulating in the region.
=====================
[In 2019, 2 cases of yellow fever [YF] were the 1st since almost one year ago. There were several yellow fever epizootics confirmed in non-human primates in 2020. In other words, it is more than predictable that, without effective and timely preventive actions, cases of yellow fever in humans would reoccur: no surprise. As we have mentioned numerous times, for yellow fever, in the current epidemiological scenario of sylvan transmission, as (or more) important as prioritizing goals of high rates of vaccination coverage in the general population in the short term is vaccinating the right people in the right places at the right time, that is, susceptible individuals residing or visiting the areas at greatest risk. Not infrequently, this is only feasible with differentiated strategies, including active searches. The question: Have the 4 confirmed cases so far not been vaccinated due to refusal, misinformation, or difficult access? - ProMED Mod.RNA]

[The human cases this year (2020) are due to YF virus spill-over from the sylvan (forest) transmission cycle. The dead monkeys indicate that the virus has been circulating in the state for over a year. It is important that the human population YF vaccination coverage reach the 95% goal set by the Ministry of Health. Vaccination is the only way to avoid these sylvan cases, since elimination of the forest YF virus transmission cycle is not feasible. Without prevention of these human sylvan cases, there is the risk that YF virus could be introduced by them into the urban cycle of virus transmitted by _Aedes aegypti_ and spread quickly. - ProMED Mod.TY]

[HealthMap/ProMED-mail map:
Santa Catarina, Brazil: <http://healthmap.org/promed/p/2975>]
Date: Wed 12 Feb 2020
Source: Teresina Municipal Health Foundation [in Portuguese, machine trans., edited]

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

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

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

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

Date: Wed, 5 Feb 2020 22:30:14 +0100 (MET)

Rio de Janeiro, Feb 5, 2020 (AFP) - A tourist who was robbed while vacationing in Rio de Janeiro posted a disgusted message online... only to have Brazil's national tourism board post it to its official Instagram account by mistake.   "Rio is such a beautiful city," begins the message posted by Instagram user @withlai -- and that is perhaps as far as the Brazilian Tourist Board's social media department read before clicking "share."   But the message continues: "Beautiful is not enough."   During a three-day stay in Rio, @withlai wrote, "my family and I were robbed and my nine-year-old sister witnessed a violent robbery. I can't recommend a visit to a city where I felt afraid of even leaving the apartment."

Embratur, as the tourism board is known, shared the message on its own Instagram account Tuesday evening, leaving it up long enough for the gaffe to go viral before deleting the post.  "This message was shared by mistake," Embratur said in a red-faced statement, adding that it was in fact working to "publicize the drop in violent crime (in Brazil) in 2019."   Rio, the port of entry for many of the millions of tourists who visit Brazil each year, is known for the breath-taking beauty of its sun-soaked beaches and emerald mountains, but also its violent crime.   Rio de Janeiro state, of which the city is the capital, registered nearly 4,000 murders and 120,500 muggings last year -- though that was a drop of 19 percent and eight percent, respectively.
Date: Mon 3 Feb 2020
Source: NSC Total [in Portuguese, trans. ProMED Mod.TY, edited]

Santa Catarina has another confirmed case [the 2nd] of yellow fever [YF] in humans. The information was confirmed by the secretary of state for health (SES) this Mon 3 Feb 2020. The patient is admitted to the Nereu Ramos Hospital, in Florianopolis, a reference infectious disease unit in Santa Catarina.

The diagnosis of the disease [as yellow fever] was confirmed by the Central Laboratory of Public Health (LACEN/SC)on Sunday [2 Feb 2020]. The 40 year old man, resident of Jaragua do Sul, in Planalto Norte of Santa Catarina, was not registered for the [YF] vaccination in the Information System of the National Program of Immunizations (SIPNI).

This is the 2nd case of human infection in the state and the 4th since 2019, when there was the 1st diagnosis in the state. Last year [2019], SC registered 2 deaths on account of the disease.

The 1st case of 2020:
The patient whose diagnosis was confirmed on 24 Jan [2020] remains hospitalized at Nereu Ramos Hospital, in Florianopolis. He is 47 years old and is a resident of the municipality of Sao Bento do Sul, also in Planalto Norte, and with no vaccine registration in the system.

Transmission:
Yellow fever is a serious disease, transmitted by mosquitoes in wildland areas and close to forests. Vaccination is the best way to protect oneself from the disease. The dose is free. To date, the state's vaccination coverage is 84%, below what the Ministry of Health recommends, which is to vaccinate at least 95% of the target population.

Symptoms:
Yellow fever is a rapidly progressive disease. The infection results
in the following symptoms:
- fever of up to 6 days duration;
- intense headache;
- abdominal pain;
- haemorrhagic manifestations;
- jaundice.

Monkey deaths:
On Mon 3 Feb 2020, SES also confirmed 2 more monkeys dead of yellow fever. The howlers were located in Corupa on 26 Dec 2019 and in Blumenau on 7 Jan of this year [2020].

In total, 9 monkeys dead of yellow fever were counted in 2019 (in Garuva, Joinville, Indaial, Jaragua do Sul, Sao Bento do Sul, and Corupa) and the 2 animals diagnosed with the disease in 2020 (Blumenau e Pomerode).  [byline: Clarissa Battistella]
====================
[The 2 human cases this year (2020) are due to YF virus spill-over from the sylvan (forest) transmission cycle. The dead monkeys indicate that the virus has been circulating in the state for over a year. It is important that the human population YF vaccination coverage reach the 95% goal set by the Ministry of Health. Vaccination is the only way to avoid these sylvan cases, since elimination of the forest YF virus transmission cycle is not feasible. - ProMED Mod.TY]

[HealthMap/ProMED map available at:
Santa Catarina, Brazil: <http://healthmap.org/promed/p/2975>]
Date: Wed 29 Jan 2020
Source: Globo.com [in Portuguese, trans. ProMED Mod.PMB, edited]
<https://g1.globo.com/pr/parana/noticia/2020/01/29/mortes-de-macacos-por-febre-amarela-aumentam-para-46-no-parana-indica-boletim.ghtml> [edited]

Monkey deaths due to yellow fever (YF) in Parana state have increased to 46 from 40 the previous week. According to a report issued by the state secretary of health, no case has been confirmed in humans so far, although 16 suspected cases are being investigated. Five of the new confirmed monkey cases were from Lapa, in the metropolitan region of Curitiba. This municipality had no previous record of dead monkeys due to YF. Another monkey death due to YF was in Antonio Olinto, in Southern Parana state. That city already had reported a confirmed case in monkeys.

The previous list of localities with records of monkey deaths due to YF is as follows: Castro: 11 Ponta Grossa: 8 Lapa: 5 Candido de Abreu, Sapopema, Teixeira Soares, Antonio Olinto, Ipiranga and Piraí do Sul: 2 Balsa Nova, Mandirituba, Quatro Barros, Rio Negro, Palmeira, Sao Joao do Triunfo, Imbituva, Mallet, Prudentópolis and Sao Mateus do Sul: 1. "The weekly newsletter is useful to monitor the outbreaks and alert on the presence of the virus in these localities", said the secretary of health, Beto Preto. Citizens of Parana state are being summoned to local units of health to receive vaccination against YF.

The vaccine is indicated for adults of up to 59 years old, and children from 9 months of age, with a booster at the age of 4 years. Pregnant and breastfeeding women, children up to 9 months of age and adults over 60, people with severe egg allergy or immunocompromised people should be vaccinated only after medical assessment.
===================
[The current expansion of YF in South America raises concern for public health and also about potential conservation problems for susceptible non-human primate species in the continent. The virus is endemic in much of central and northern South America, and makes sporadic incursions to southern areas of the continent, like the states of Santa Catarina, Parano and Rio Grande do Sul in Brazil, Misiones in Argentina, or Paraguay.

The YF virus was introduced into the Americas about 400 years ago, yet the complex interactions that were established after its introduction are far from being elucidated. There is need for more research on the eco-epidemiology of the disease in the continent, specifically on the role of each non-human primate species, and especially in the presence of the persistent anthropogenic global environmental change. - ProMED Mod.PMB]

[HealthMap/ProMED map available at: Brazil:
<http://healthmap.org/promed/p/6>]
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 ...

Thailand



*****
Travel in Health in Thailand
*****
General Introduction:
Irish travellers are going to Thailand in great numbers. The relatively cheap cost and also the contrast in culture has captured many hearts. Some are travelli
g for a once off 2 week trip and for others the exploration of Thailand will take longer. It is truly a beautiful country and the people have a charm all of their own but nevertheless your journey can be so very easily ruined by taking health risks.
Water-Borne Disease:
In most of the major cities of Thailand the water supply is well chlorinated and so the risks associated with drinking mains tap water are limited. However many of the bedrooms will not be supplied with mains water so take care. Smell the water and if there is a distinct chlorine odour then it should be safe. Also remember that when you travel around the country, especially around the northern regions, the water supply may be grossly contaminated and so never drink the water or use it for brushing your teeth. Also no ice in your drinks under these circumstances.
Food-Borne Disease:
There is a good selection of food in Thailand and you should have no great difficulty in finding food to suit your taste. In the majority of the restaurants the food is well cooked and maintained in a healthy sterile fashion. These are the places to eat. As you walk around the cities you will see many street traders selling food stuffs from their carts. The level of hygiene is very low and frequently the food will be contaminated. Never indulge yourself by eating from street vendors.
Mosquito-Borne Disease:
Under this title most travellers will only consider the possibility of developing malaria. This is of course one of the most important illnesses transmitted via mosquitoes but by no means the only one in Thailand. For most travellers to Thailand there will be no need to take malarial prophylaxis as the cities are deemed to be free of malaria. This does not mean that you will not be bitten by mosquitoes and develop some of the other diseases such as Dengue Fever or perhaps Japanese Encephalitis. Many travellers also develop a very severe reaction to the mosquito bite and so for all these reasons it is prudent to avoid being bitten whenever possible.
Entertainment-Borne Disease:
It would be wrong not to emphasize the very high risk which travellers face if they are unwise enough to indulge in any form of sexual activity in Thailand. The percentage of street girls with the Aids virus is rising each year and is now thought to be over 80%. This figure may be an underestimate. Be especially careful if you have taken any alcohol. The cities of Bangkok and Pattaya are thought to be among the main centres of HIV transmission throughout the world and within the next few years the extent of the Aids problem in S.E. Asia will have exceeded Africa. There is limited availability of condoms.
Road-Borne Disease:
The traffic situation in Thailand is severe. The motorbikes have no insurance as they are too often involved in accidents. Use only regular taxi cabs and fix your price before you leave.
Vaccination Schedule:
There are no compulsory vaccines for entry into Thailand from Ireland. Nevertheless the usual recommended vaccines include Polio, Typhoid, Tetanus and Hepatitis A cover. For those trekking or staying for longer periods then cover against Hepatitis B and Rabies would be worth discussing.
Most travellers should start their vaccines about 4 to 5 weeks before they leave Ireland.
Note:
For the vast majority of Irish travellers a holiday in Thailand will be a time of great pleasure and, later, fond memories of the people, their customs and the countryside. Just remember that illness can occur so follow some good common sense rules and so you can enjoy yourself
and Travel in Health.

Thailand

Travel News Headlines WORLD NEWS

Date: Mon, 10 Feb 2020 10:59:15 +0100 (MET)

Bangkok, Feb 10, 2020 (AFP) - Russian siblings aged 12 and six-years-old died Monday in a speed boat accident off the tourist island of Phuket, an official said, as two vessels collided near a pier.   The accident took place 100 metres off a privately-run pier in Phuket, after the speed boat carrying Russian tourists to an nearby island crashed into an incoming vessel.   "The cause of accident was speeding by both the drivers," a Phuket government official said, requesting anonymity.

The brother and sister died in the crash, while "21 other Russians were injured, two critically" he added.    Thailand's tourist industry has been hard hit by a combination of the sharp slump in Chinese visitors since the coronavirus outbreak and the strong Thai baht.   Accidents at popular resorts -- mainly car, motorbike and boat crashes -- are common in a kingdom with lax enforcement of safety rules.
Date: Fri 7 Feb 2020
From: Davidson Hamer <dhamer@bu.edu> [edited]

Case report: Japanese encephalitis, Belgian ex Thailand following a short tourist trip
------------------------------------------
We would like to report a case of Japanese encephalitis in a 14 year old Belgian girl who had travelled with her family (total 8 persons) to Khao Lak, Phang Nga province, Thailand, on 20 Dec 2019 for a short holiday. During the following 10 days, she undertook day trips to Krabi, Similan Islands, Phi Phi Islands, Krasom, and Amphoe Kapong.

On 30 Dec 2019, 11 days after arrival in Thailand, symptoms began with fever, headache, fatigue, and difficulty in swallowing. On 31 Dec [2019] whilst on the return flight home, she experienced progressive difficulty in walking due to a right-sided hemiparesis and became confused and lethargic.

On 1 Jan 2020, upon initial evaluation at a hospital in Frankfurt, Germany, she had marked confusion and irritability. An initial MRI scan was inconclusive, and results of a lumbar puncture revealed CSF mononuclear pleiocytosis (182 WBC), and serum PCR was negative for JEV. Sedation and mechanical ventilation were initiated, and the patient was transferred to University Hospital Antwerp, Belgium, on 4 Jan 2020. Between 3-6 Jan 2020, serum JEV IgM and IgG became positive (IIFT Flavivirus 2, Euroimmun, Lubeck, Germany); JEV plaque reduction neutralization testing (PRNT) returned greater. than 50% day 7 and greater than 90% day 21 (ATCC CCL-81); on 6 Jan [2020], CSF JEV IgM and IgG were also positive. EEG showed symmetric sedation-like curves without a clear gradient with predominant alpha rhythm superposed on delta (with isolated frontal slow waves).

Fortunately, her 7 other travel companions (including her monozygotic twin sister and her father) all tested negative for JEV IgM seroconversion.

Within a week after the start of mechanical ventilation, attempts to extubate her failed twice, as a result of hypersalivation, swallowing dysfunction, and muscle weakness (hypercapnic respiratory failure). On 10 Jan 2020, sedative medication was discontinued, and the patient could respond to questions appropriately. The strength in her legs and arms returned to normal, but muscle tone and strength in the neck remained weak, and there is residual respiratory muscle weakness and dysphagia, with gastroparesis and vomiting. She had limited enteral intake and, in part, continues to receive parenteral nutrition. On 17 Jan 2020, tracheal cannulation and G-tube placement were performed to assist with breathing and provision of nutritional support.

By 29 Jan 2020, she was breathing independently, slowly recovering, and was able to be transferred from the PICU to a ward. She will be transferred to a long-term rehabilitation hospital in the coming days.

This sad case report highlights the potentially devastating impact of Japanese encephalitis in travelers and how this may arise even after relatively short-term exposure (in this case less than 2 weeks) in major touristic areas. Although major debates persist about the role of vaccination, given the rarity of the disease, the duration of potential exposure in deciding whether to vaccinate, and the cost of the vaccine, travel-medicine providers should continue to describe the potential risk of infection (low) and complications and mortality if infection occurs (high) to travelers to south and south east Asia.
-----------------------------------
communicated by:
Dr Ralph Huits
GeoSentinel co-site director
Department of Clinical Sciences at the Institute of Tropical Medicine
Antwerp, Belgium
and
Vanessa Field
GeoSentinel tracking and communication working group chair
====================
[Thailand is endemic for Japanese encephalitis (JE) virus, and Phang Nga province, located in the southern part of the country, can susta inyear-round JE virus transmission. The girl was very unfortunate to have become infected despite a short visit there. Her situation raises the question about the advisability of vaccination of visitors to areas endemic for JE. The USA CDC Advisory Committee of Vaccination Practices states, "JE vaccine is recommended for persons moving to a JE-endemic country to take up residence, longer-term (for example, greater than or equal to one month) travelers to JE-endemic areas, and frequent travelers to JE-endemic areas. JE vaccine also should be considered for shorter-term (for example, less than one month) travelers with an increased risk for JE on the basis of planned travel duration, season, location, activities, and accommodations and for travelers to JE-endemic areas who are uncertain about their specific travel duration, destinations, or activities. JE vaccine is not recommended for travelers with very low-risk itineraries, such as shorter-term travel limited to urban areas or outside of a well-defined JE virus transmission season." The girl and her family would normally not be considered at significant risk for such a short stay in Thailand. About one in 4 people with JE clinical encephalitis die, and about 50% of survivors have permanent neurological sequelae. One hopes that the girl will be one of the remaining 50% that recover completely. - ProMED Mod.TY]

[HealthMap/ProMED-mail maps:
Phang Nga, Phang Nga province, Thailand:
Date: Fri, 7 Feb 2020 09:21:31 +0100 (MET)

Bangkok, Feb 7, 2020 (AFP) - Thailand's health minister lashed out at "Western" tourists on Friday for not wearing face masks and suggested they be expelled from the country for putting others at risk during the coronavirus outbreak.

The outburst came as the kingdom faced steep losses over a drop in visitors from China, where the virus has killed more than 600 people and prompted sweeping travel restrictions.   Tourism accounts for 18 percent of the country's gross domestic product and Chinese holidaymakers make up a quarter of total arrivals.   Thailand has detected 25 coronavirus cases and nine of those patients have recovered, while streets, public transport and shopping centres have filled with people wearing face masks.

Health Minister Anutin Charnvirakul was distributing masks at a busy Bangkok skytrain entrance when he complained that "farang" tourists didn't take them and acted as if they "don't care".   Farang is a commonly used Thai word to describe Westerners and is sometimes used dismissively.   "These kinds of people, we should kick them out of Thailand," he told reporters, waving a handful of masks in the air.

Anutin did not respond to additional requests for comment but posted an apology on his Facebook page for "losing it" after "some foreigners from Europe" were uncooperative in the mask campaign.   More than 10 million Chinese tourists visited Thailand last year but the industry projects about two million fewer arrivals in 2020 because of the coronavirus, making US, European and other markets more vital.   Debates over the efficacy of masks have bounced around the internet since the contagion first emerged in the Chinese city of Wuhan last month.

Since then it has spread to more than two dozen countries and infected tens of thousands, mostly within mainland China.   Health experts generally agree masks are useful if you have respiratory symptoms or are caring for patients.   But the World Health Organization's own Thailand office tweeted a graphic on February 4 stating masks are "not needed for general public who do not have respiratory symptoms".   The WHO has advised people to wash their hands regularly and avoid touching their face.
Date: Fri 31 Jan 2020
From: Claudia Wallrauch <Claudia.Wallrauch@lrz.uni-muenchen.de>
[edited]

A male German tourist visited Little Koh Chang Island (Andaman Sea, Thailand) from 25 Dec 2019 to 20 Jan 2020.

Starting 21 Jan 2020 onwards he complained about intermittent fever and headache. On 24 Jan 2020, he presented at the Division for Tropical Medicine and Infectious Diseases in Munich, Germany. At presentation, the patient was afebrile, and the commercial malaria rapid test was negative.

However, malaria was diagnosed using thin smear microscopy. Parasitaemia was below 0.1%; a species diagnoses could not be made by microscopy. A differential malaria PCR revealed _Plasmodium knowlesi_ infection. The further clinical course was uncomplicated; the patient was treated successfully with atovaquone and proguanil.

We have seen and reported a similar case of _P. knowlesi_ malaria acquired on that same island before (see reference below), an island that is currently defined as a low-risk area.

We'd like to emphasize this specific part of Thailand as an area of potential _P. knowlesi_ infections and want to stress the importance of smear microscopy and differential PCR in diagnosing this type of malaria, as rapid tests are negative in _P. knowlesi_ infection.

Reference:
Froeschl G, Beissner M, Huber K, et al. _Plasmodium knowlesi_ infection in a returning German traveller from Thailand: a case report on an emerging malaria pathogen in a popular low-risk travel destination. BMC Infect Dis 2018;18:148.  <https://doi.org/10.1186/s12879-018-3059-z>
---------------------------------------------
Claudia Wallrauch
Division for Tropical Medicine and infectious Diseases
Munich, Germany
==========================
[ProMED-mail thanks Dr. Claudia Wallrauch for reporting this case. Infection with _Plasmodium knowlesi_ is a problem in southeast Asia. The infection evolves rapidly with the parasite having a 24-h asexual life-cycle in the human host.

As pointed out by Dr. Wallrauch, the rapid test was negative, and it is important to know that the rapid tests are validated only for _P. falciparum_ and _P. vivax_ infections. Most rapid tests also include a test for a "pan-malaria antigen" supposed to catch _P. ovale_, _P. malariae_ and _P. knowlesi_, but the tests are not validated for these infections; thus, the detection level, i.e., the parasite counts where the tests become positive, are not known. - ProMED Mod.EP]

[HealthMap/ProMED-mail map:
Rayong Province, Thailand: <http://healthmap.org/promed/p/10728>]
Date: Mon, 13 Jan 2020 16:12:29 +0100 (MET)
By Nina LARSON

Geneva, Jan 13, 2020 (AFP) - A new virus from the same family as the deadly SARS disease has spread beyond China's borders for the first time with a case emerging in Thailand, UN and Thai officials said on Monday.   Thai doctors diagnosed a Chinese traveller with mild pneumonia on January 8 later confirmed to have been caused by the so-called novel coronavirus -- which has already given rise to 41 pneumonia-like cases and one death in China.   The outbreak has caused alarm because of the link with SARS (Sudden Acute Respiratory Syndrome), which killed 349 people in mainland China and another 299 in Hong Kong in 2002-2003.

The UN health agency (WHO) confirmed that the outbreak in the city of Wuhan was caused by a previously unknown type of corona virus, a broad family ranging from the common cold to more serious illnesses like SARS.   "Laboratory testing subsequently confirmed that the novel coronavirus was the cause," WHO spokesman Tarik Jasarevic told AFP in an email, referring to the case in Thailand.   WHO said it might soon host an emergency meeting on the spread of the new virus.   Thai Health Minister Anutin Charnvirakul stressed to reporters in Bangkok Monday that a 61-year-old Chinese woman who had travelled from Wuhan "was infected with the virus from outside Thailand".   Thai health officials said on Monday she was recovering.   Authorities in Wuhan said a seafood market in the city was the centre of the outbreak. It was closed on January 1.   There is so far no indication of human-to-human transmission of the virus.

- 'Not unexpected' -
Scientists in Hong Kong's Department of Health said on Saturday that genetic sequencing of the virus from a Wuhan patient, published online by a Chinese expert, indicated it was 80 percent similar to SARS found in bats.   WHO said on Monday it was not surprising that the virus had spread beyond China.   "The possibility of cases being identified in other countries was not unexpected, and reinforces why WHO calls for ongoing active monitoring and preparedness in other countries," it said in a statement.   Thai authorities have been on high alert, with airport officials checking all passengers coming from Wuhan to the kingdom's major airports.   An official from the Public Health Emergency Operation Center told AFP the infected woman travelling from Wuhan had been intercepted on arrival in Thailand, after airport officials determined she had a fever.

WHO said it had issued guidance on how to detect and treat people with the new virus and stressed that China's decision to rapidly share the genetic sequencing of the virus made it possible to quickly diagnose patients.   WHO has not recommended any specific measures for travellers or restrictions on trade with China, but stressed on Monday it was taking the situation seriously.   "Given developments, WHO Director-General Dr Tedros Adhanom Ghebreyesus will consult with Emergency Committee members and could call for a meeting of the committee on short notice," it said in a statement.   During such meetings, experts determine whether the UN health agency should declare an international health emergency -- a designation used only for the gravest epidemics.
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Cambodia

Cambodia US Consular Information Sheet
June 05, 2008
COUNTRY DESCRIPTION:
Cambodia is a developing country with a constitutional monarchy and an elected government. King Norodom Sihamoni is the constitutional monarch and head of state. Ele
tions for Members of the National Assembly were last held in July 2003, and are scheduled to take place again in July 2008. Two political parties, the CPP and FUNCINPEC, have formed a coalition government, which the CPP dominates. The country has a market economy with approximately 80 percent of the population of 13.6 million engaged in subsistence farming. The government has good relations with its neighbors despite strains over residual border disputes and other historic antagonisms. The quality of tourist facilities varies widely in Cambodia with the highest standard found in Phnom Penh, Siem Reap, and Sihanoukville. Read the Department of State Background Notes on Cambodia for additional information.

ENTRY/EXIT REQUIREMENTS:
A valid passport and a Cambodian visa are required.
Cambodia offers on-line visa processing at http://evisa.mfaic.gov.kh.
Tourist and business visas are valid for one month beginning with the date of entry into Cambodia. You may also apply in person at the Cambodian Embassy located at 4530 16th Street NW, Washington, DC
20011, tel. 202-726-7742, fax 202-726-8381. Tourists and business travelers may also obtain a Cambodian visa at the airports in Phnom Penh, Siem Reap, and at all major border crossings.
Both methods of obtaining a Cambodian visa require a passport-sized photograph and a passport that is valid for a minimum of six months beyond the date of entry into Cambodia. A departure tax is charged on all domestic and international flights. This tax must be paid in U.S. dollars.
Overseas inquiries may be made at the nearest embassy or consulate of Cambodia. Travelers should note that Cambodia regularly imposes fines of USD 5.00 per day on charges of overstay on an expired visas. Visit the Embassy of the Kingdom of Cambodia web site http://www.embassyofcambodia.org/ for the most current visa information.

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

SAFETY AND SECURITY:
The State Department is concerned that individuals and groups may be planning terrorist actions against United States citizens and interests, as well as sites frequented by Westerners, in Southeast Asia, including in Cambodia.
Extremist groups present in Southeast Asia have transnational capabilities to carry out attacks against locations where Westerners congregate.
American citizens traveling to Cambodia should therefore exercise caution in clubs, discos, bars, restaurants, hotels, places of worship, schools, outdoor recreation venues, tourist areas, beach resorts, and other places frequented by foreigners.
They should remain vigilant with regard to their personal security and avoid crowds and demonstrations.
From time to time, the U.S. Embassy places local establishments off limits to Embassy personnel due to safety and security incidents.
You can contact the Embassy for notification on the current restrictions in place for Embassy personnel.
Local commune elections in April 2007 were peaceful.
National elections are scheduled for July 27, 2008. Political tensions have eased, and the current situation is relatively stable; however, Cambodian political activities have turned violent in the past, and the possibility for politically motivated violence remains.

In November 2006, police arrested six people for allegedly plotting to conduct bomb attacks in Phnom Penh during the November Water Festival.
On July 29, 2007, three improvised explosive devices (IEDs) were planted at the Vietnam-Cambodia Friendship Monument in Phnom Penh. One of the IEDs partially exploded, but the others failed to detonate and were recovered by Cambodian authorities. No one was injured, primarily because the explosion occurred during the early morning hours. Police subsequently arrested several individuals suspected of constructing the devices and planning the bombings. While there is no indication this attack was directed at U.S. or other Western interests, the possibility remains that further attacks could be carried out, harming innocent bystanders.
The U.S. Embassy advises U.S. citizens to avoid large public gatherings and crowded public areas.
Land mines and unexploded ordnance are found in rural areas throughout Cambodia, and especially in Battambang, Banteay Meanchey, Pursat, Siem Reap, and Kampong Thom provinces. Travelers should never walk in forested areas or even in dry rice paddies without a local guide. Areas around small bridges on secondary roads are particularly dangerous.
Travelers should not touch anything that resembles a mine or unexploded ordnance; they should notify the Cambodia Mine Action Center at 023-368-841/981-083 or 084.

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

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

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

CRIME:
Cambodia has a high crime rate, including street crime. Military weapons and explosives are readily available to criminals despite authorities’ efforts to collect and destroy such weapons. Armed robberies occur frequently in Phnom Penh. Foreign residents and visitors are among the victims.
Victims of armed robberies are reminded not to resist their attackers and to surrender their valuables, since any perceived resistance may be met with physical violence, including lethal force. Local police rarely investigate reports of crime against tourists, and travelers should not expect to recover stolen items.
The U.S. Embassy advises its personnel who travel to the provinces to exercise extreme caution outside the provincial towns at all times. Many rural parts of the country remain without effective policing. Individuals should avoid walking alone after dusk anywhere in Sihanoukville, especially along the waterfront. Some of the beaches are secluded, and post has received reports that women have been attacked along the Sihanoukville waterfront during the evening hours. Take security precautions when visiting the Siem Reap (Angkor Wat) area. Travelers should be particularly vigilant during annual festivals and at tourist sites in Phnom Penh, Siem Reap and Sihanoukville, where there have been marked increases in motorcycle “snatch and grab” thefts of bags and purses. A group of young men sexually assaulted a foreigner in Phnom Penh in November 2006 while she was taking a moto-taxi from a nightclub.
Pickpockets, including some who are beggars, are present in the markets and at the tourist sites. Persons visiting Cambodia should practice sound personal security awareness by varying their routes and routines, maintaining a low profile, not carrying or displaying large amounts of cash, not wearing flashy or expensive jewelry, and not walking the streets alone after dark. In addition, we recommend that Americans travel by automobile and not use local moto-taxis or cyclos (passenger-carrying bicycles) for transportation. These vehicles are more vulnerable to armed robberies and offer no protection against injury when involved in traffic accidents.
To avoid the risk of theft or confiscation of original documents, the U.S. Embassy advises its personnel to carry photocopies of their U.S. passport, driver's license or other important documents.

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 assist you to find appropriate medical care, to contact family members or friends and explain how funds can be transferred.
Although the investigation and prosecution of the crime is solely the responsibility of local authorities, consular officers can help you to understand the local criminal justice process and to find an attorney if needed.

See our information on Victims of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION:
Medical facilities and services in Cambodia do not meet international standards.
Both Phnom Penh and Siem Reap have a limited number of international-run clinics and hospitals that can provide basic medical care and stabilization. Medical care outside these two cities is almost non-existent. Local pharmacies provide a limited supply of prescription and over-the-counter medications, but because the quality of locally obtained medications can vary greatly, travelers should bring adequate supplies of their medications for the duration of their stay in Cambodia.

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

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

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

Driving at night in Cambodia is strongly discouraged. Road maintenance is sporadic in both urban and rural areas. Roads between major areas are adequate; however, roads leading to areas that are more rural are poor. During the rainy season, both urban and rural road conditions deteriorate considerably. Roadside assistance is non-existent. The safety of road travel outside urban areas varies greatly. Cambodian drivers routinely ignore traffic laws, and vehicles are poorly maintained. Intoxicated drivers are commonplace, particularly during the evening hours, and penalties for DWI offenses vary greatly. Banditry occurs even on heavily traveled roads, so all travel should be done in daylight between the hours of 7:00 a.m. and 5.00 p.m.
Serious flooding occurs in both Phnom Penh and the rest of Cambodia starting at the end of July, early August. Heavy flooding continues into November. The unimproved highways to Prey Veng, Battambang, Pailin, Stung Treng and Poipet become more difficult and dangerous during this time of the year, and travel on unpaved or dirt roads is virtually impossible. The National Route highways are the only roads that can be traveled, with caution, this time of the year.
The U.S. Embassy advises Embassy personnel not to travel by train because of low safety standards and the high risk of banditry. Travel by boat should be avoided because boats are often overcrowded and lack adequate safety equipment.
Boat owners accept no liability for accidents.
Travelers also should exercise caution when using intercity buses, including those to popular tourist destinations such as Siem Reap and Sihanoukville.
Moto-taxis and cyclos are widely available; however, the Embassy does not recommend using them due to safety concerns and because personal belongings can be easily stolen. Organized emergency services for victims of traffic accidents are non-existent outside of major urban areas, and those available in major urban areas are inadequate. Please refer to our Road Safety page for more information.

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

The U.S. Embassy strongly discourages its employees from using domestic air carriers due to safety incidents that have occurred in recent years.
A PMT Air flight from Siem Reap to Sihanoukville crashed in bad weather in a coastal mountain range on June 25, 2007.
There were no survivors.
Incidents at the Ratanakiri airport since 2005 have included collapsed landing gear and hard landings.
Embassy employees are permitted to use international carriers Siem Reap Airways and Bangkok Airways between Phnom Penh and Siem Reap.
SPECIAL CIRCUMSTANCES:
Cambodian customs authorities may enforce strict regulations concerning temporary importation into or export from Cambodia of items such as drugs, firearms, antiquities, or ivory. It is advisable to contact the Embassy of Cambodia in Washington for specific information regarding customs requirements. Please see our information on Customs Regulations.

Dual Nationality:
Dual nationality is not prohibited under Cambodia's 1996 nationality law. In addition to being subject to all Cambodian laws affecting U.S. citizens, individuals who possess Cambodian nationality may also be subject to laws that impose special obligations on Cambodian citizens.
Business Transactions: Some U.S. citizens have reported threats of personal injury, extortion, detention or kidnapping related to personal business disputes, in particular those involving real estate.
The Embassy urges any American citizen planning to engage in real estate deals or other significant financial transactions to proceed with caution.
U.S. citizens who do not have confidence in the ability of the local police to protect them may wish to depart the country expeditiously.

Financial Transactions:
The U.S. dollar is widely used, especially for larger transactions, and most prices are quoted in dollars. Ripped or torn U.S. bills are not accepted. The Cambodian riel can also be used, but is less favored and is mostly given to tourists as change for dollar purchases. The riel is commonly used in smaller towns and rural areas.
Credit cards are increasingly accepted within Cambodia, and a number of banks in Phnom Penh accept Visa cards for cash advances. Credit cards are often subject to a service charge. Banks and major hotels accept travelers' checks, but usually charge a service fee.
Several international banks operate ATM machines that allow travelers to obtain U.S. dollar currency in Phnom Penh, Siem Reap and other urban centers.
Personal checks are not generally accepted. Several banks serve as Western Union agents in Phnom Penh, Siem Reap, Sihanoukville and other provincial cities to which funds can be wired. Information on Western Union can be found at http://www.westernunion.com.
Photography: Taking photographs of anything that could be perceived as being of military or security interest — including government buildings, military installations, airfields, bridges — may result in problems with the authorities and confiscation of the camera.
Please see our Customs Information.
CRIMINAL PENALTIES:
While in a foreign country, a U.S. citizen is subject to that country's laws and regulations, which sometimes differ significantly from those in the United States and may not afford the protections available to the individual under U.S. law.
Penalties for breaking the law can be more severe than in the United States for similar offenses.
Persons violating Cambodian laws, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession of, use of, or trafficking in illegal drugs in Cambodia are severe, and convicted offenders can expect long jail sentences and heavy fines.
Engaging in sexual conduct with children or using or disseminating child pornography in a foreign country is a crime, prosecutable in the United States.
Please see our information on Criminal Penalties.

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

REGISTRATION / EMBASSY LOCATION:
Americans living or traveling in Cambodia 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 Cambodia. 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 No. 1, Street 96 (near Wat Phnom), Phnom Penh, Cambodia. The telephone number is (855-23) 728-000; fax (855-23) 728-600. Additional information about American Citizen Services can be found at the U.S. Embassy in Phnom Penh at http://cambodia.usembassy.gov/
* * *
This replaces the Country Specific Information for Cambodia dated September 14, 2007, to update sections on Safety and Security, Medical Facilities and Health Information, Traffic Safety and Road Conditions, Aviation Safety Oversight and Special Circumstances.

Travel News Headlines WORLD NEWS

Date: Thu, 13 Feb 2020 13:58:41 +0100 (MET)
By Suy SE

Sihanoukville, Cambodia, Feb 13, 2020 (AFP) - A US cruise ship blocked from several Asian ports over concerns that a passenger could have been infected with the new coronavirus docked at a Cambodian pier Thursday, as frustrated holidaymakers expressed hope their ordeal may soon be over.   The Westerdam was supposed to be taking its 1,455 passengers on a dream 14-day cruise around east Asia, beginning in Hong Kong on February 1 and disembarking on Saturday in Yokohama, Japan.   But the ship was turned away from Japan, Guam, the Philippines, Taiwan and Thailand over fears of the novel coronavirus epidemic that has killed more than 1,300 people in China.

Cruise operator Holland America has insisted there are no cases of the SARS-like virus on board and Cambodia announced Wednesday that the boat would be able to dock in Sihanoukville, on its southern coast.   By evening, the ship moved into the beach town's port, moving past the small fishing vessels that usually ply the waters.   As it slowly approached the pier, people onshore snapped selfies of themselves with the massive vessel.   The mood was equally buoyant on the boat.   "Thank you Cambodia! You believed in us when no one would!" tweeted passenger Lydia Miller around 7 pm (1200 GMT). "We promise to spend lots of money in your country."

Fellow cruiser Christina Kerby -- who has been posting light-hearted updates from the Westerdam -- tweeted she was "feeling rebellious tonight so I'm wearing sneakers in the dining room".   But all passengers would have to remain onboard until flights have been arranged, said provincial governor Kuoch Chamroeun.    "The arrangement of the planes to take them from (Sihanoukville) airport to Phnom Penh airport is underway," he said, explaining that three flights were scheduled Friday morning.    Buses were lined up by the pier ready to transfer passengers to Sihanoukville's airport. Holland America has said they would foot the bill to return all guests.

- 'Disease of fear' -
Before the ship docked, doctors conducted health checks for the passengers.    The samples of 20 on board who were sick were sent to the Pasteur Institute in Phnom Penh to test for the virus, said transport minister Sun Chanthol.    Cambodian premier Hun Sen is a staunch Chinese ally and has been vocal in his support of Beijing's handling of the epidemic, even going so far as to visit China last week in a show of solidarity.   "The permission to dock is to stop the disease of fear that is happenin
around the world," he told state-affiliated media website Fresh News on Wednesday.    "We must help them when they asked us for help," he added.   Neighbouring Thailand, which blocked the Westerdam from docking in its eastern seaboard port, on Thursday received two cruise liners in holiday resort town Phuket. 

Both Seabourne Ovation and Quantum of the Seas were allowed to dock, and passengers to alight for roughly 10 hours as part of the scheduled stop.    "They were all checked by their doctors on the ship, and we also examined them when they disembarked," Phuket governor Pakapong Tawipat told AFP.    He added that the passengers and the crew members "were not Chinese", and that Phuket was part of their regular routes, unlike the Westerdam.    Japan's premier Shinzo Abe expressed worries last week over a possible infection on the Westerdam, and said measures will be taken to "reject entries" for foreigners into the country.    Cambodia, which has one confirmed case of the virus, is the recipient of billions of dollars in soft loans, infrastructure, and investment from China.
Date: Fri, 15 Nov 2019 09:41:09 +0100 (MET)

Phnom Penh, Nov 15, 2019 (AFP) - Cambodia will ban all elephant rides at the country's famed Angkor temple park by early next year, an official said Friday, a rare win for conservationists who have long decried the popular practice as cruel.   The Angkor archaeological complex in northern Siem Reap attracts the bulk of the kingdom's foreign tourists -- which topped six million in 2018 -- and many opt for elephants rides around the ancient temples.

But these rides "will end by the start of 2020", said Long Kosal, a spokesman with the Apsara Authority, which manages the park.   "Using elephants for business is not appropriate anymore," he told AFP, adding that some of the animals were "already old".   So far, five of the 14 working elephants have been transferred to a community forest about 40 kilometres (25 miles) away from the temples.   "They will live out their natural lives there," Kosal said.   The company that owns the elephants will continue to look after them, he added. 

Cambodia has long come under fire from animal rights groups for ubiquitous elephant rides on offer for tourists, also seen in neighbouring Thailand, Vietnam and Laos.    The elephants are broken in during training and rights groups have accused handlers of overworking them.   In 2016, a female elephant died by the roadside after carrying tourists around the Angkor Wat temple complex in severely hot weather.   The animal had been working for around 45 minutes before she collapsed.
Date: Mon, 28 Oct 2019 08:10:36 +0100 (MET)

Phnom Penh, Oct 28, 2019 (AFP) - Cambodia deployed soldiers, police and divers to scour an island popular with backpackers after a British tourist went missing there four days ago, an official told AFP on Monday.

Nearly 200 members of the army, navy and police have fanned out across Koh Rong in southern Cambodia in an attempt to find Amelia Bambridge, who was last seen at a beach party around 3:30 am on October 24.   "Divers are searching in the sea around Koh Rong while the others are scanning the jungle," said Kheang Phearun, a spokesman for the Preah Sihanouk provincial administration.   "We have not yet found the missing British woman."

British media reports said the 21-year-old had befriended other tourists, but the alarm was raised after she failed to check out of her hostel.   The mystery deepened after authorities said they found her bag and phone where she was last seen, a late-night hangout called Police Beach.   Bambridge's family have arrived in Cambodia and headed to the closest city, Sihanoukville, on Sunday night, Phearun added.

Located in the Gulf of Thailand, Koh Rong is a two-hour boat ride from the coast and draws budget travellers with its cheap guesthouses, beachside bars and idyllic beaches.   But it has also undergone development in recent years in keeping with a construction and casino boom in nearby Sihanoukville.   Cambodia has long been a stop for tourists travelling around Southeast Asia.   Though generally safe, crimes involving foreigners have grabbed headlines in the past.

Last week a Cambodian court charged three men with gang-raping a French tourist in the coastal province of Kampot after offering her a ride in their car.   In 2013, Kampot town was rocked by the discovery of a mutilated body of a 25-year-old Frenchwoman floating in a river.    A Belgian was charged with the alleged rape and murder of the woman, but released on bail due to a lack of evidence.
31 Jul 2019

The north eastern province of Si Sa Ket, on the Cambodian border, has declared that the prevention and control of dengue fever required urgent attention throughout its area. Local health officials say they are now especially concerned about what will happen during the last 3 months of the annual wet season. At a Provincial Hall meeting it was announced that 7 people had died from dengue so far in 2019 and that 1664 people were now suffering from the mosquitoborne disease, making Si Sa Ket the country's 12th worst-hit province. They agreed the situation had worsened drastically, saying the monthly figures for those hospitalised had exploded from 81 cases in January to 618 in June and 457 in July [2019].

HealthMap/ProMED-mail map of Cambodia:
Date: Thu, 15 Aug 2019 06:14:20 +0200 (METDST)

Battambang, Cambodia, Aug 15, 2019 (AFP) - As he tears off a leg of a charcoal-grilled rat at a roadside stall in western Cambodia, Yit Sarin hails the simple joy of rodent and rice washed down with beer.   "It's delicious," he says of the snack.   Barbecued field rats are not everybody's idea of a tasty treat, but in Cambodia's rural Battambang province they are popular as a quick -- and cheap -- snack, with small skewered ones going for $0.25 each while larger rodents can cost $1.25.

Rats were commonly eaten in the 1970s, under the ultra-Maoist Khmer Rouge, when frogs, tarantulas and other small creatures were considered fair game as a means to survive.   Now they are simply an inexpensive lunch for workers and farmers -- though there is disagreement over what its meat tastes like.    Sarin tells AFP that rat is like "chicken or beef", whereas others say it's more like pork.

He is one of many customers and Cambodian tourists stopping at a stall outside of Battambang town, where rows of grilled field rats are displayed over burning coals and served with dipping sauces made from lime juice, black peppers or chillies.    Vendor Ma Lis says the snack has grown in popularity since she launched her stall more than a decade ago and sold just a few kilograms a day.   Today, she can net daily sales of around 20 kilograms, making brisk business from van-loads of travelling Cambodians and the occasional curious foreigner. 

The holiday season also spells bad news for the field rodents -- Ma Lis can sell up to 180 large rats a day on the Cambodian New Year or water festival.   Dismissing any health concerns one might have about eating her unconventional treat, Ma Lis says her rodents are caught from rice fields and are good for you.    "These rats are healthier than pork and chicken... they eat lotus roots and rice grains," she says, as she flips the barbecued bodies on the grill.    Despite the snack's enduring appeal, many people remain squeamish.     "They feel it is disgusting," she says, smiling.
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Uzbekistan

Uzbekistan - US Consular Information Sheet
May 07, 2007
COUNTRY DESCRIPTION:
Uzbekistan gained independence from the Soviet Union in 1991.
While the country has undergone significant change since then, its progress towards democratic
nd economic reform has been halting and uneven.
Corruption is endemic at all levels of society.
Much of the country, particularly areas outside of Tashkent and the major tourist destinations of Samarkand, Bukhara, and Khiva, are remote and difficult to access.
Tourist facilities, when they exist at all, are typically below Western standards, and many goods and services remain difficult to find on a regular basis.
Read the Department of State Background Notes on Uzbekistan for additional information.

ENTRY/EXIT REQUIREMENTS:
A passport and visa are required.
Although official invitation letters are not required for American citizens applying for tourist visas, they are required for those planning to visit an individual who resides in Uzbekistan.
Tourist visas cannot be extended in Uzbekistan.
Visas are issued by Uzbek embassies and consulates abroad.
Visitors coming from countries where Uzbekistan does not have diplomatic or consular representation should obtain visas in a third country.
Visas are not available upon arrival at Uzbek airports.
The Embassy has received a number of reports from American citizens who have had problems obtaining Uzbek visas or who received Uzbek visas valid for a very limited period, usually for fewer than three months.
Americans seeking visas are encouraged to apply for their visas well in advance of their travel.

It is important to note that Uzbek visas indicate not only the validity of the visa, but also the period of time a person is allowed to stay in Uzbekistan on a given trip.
A visitor will have to leave the country after the number of days indicated as the duration of stay on the visa.
Therefore, it is important to indicate your intended period of stay when applying for your Uzbek visa.
American citizens who are affiliated with a non-governmental organization (NGO), which has been closed in Uzbekistan, may be prevented from entering the country, even with a valid visa.
All travelers, even those simply transiting Uzbekistan for fewer than 72 hours, must obtain an Uzbek visa before traveling to Uzbekistan.

The Uzbek Government maintains travel restrictions on large parts of the Surkhandarya province bordering Afghanistan, including the border city of Termez. The border crossing point at Hayraton between Afghanistan and Uzbekistan, while open, is tightly controlled.
Foreign citizens intending to travel to this region must obtain a special permission card from the Ministry of Foreign Affairs, the Ministry of Internal Affairs or Uzbek embassies and consulates abroad.
Even with such permission, however, some American citizens transiting to Afghanistan via Termez have been briefly detained and/or fined for not registering in Uzbekistan.

Travel within Uzbekistan by rail or land sometimes requires brief exit into neighboring countries.
Travelers should have multiple-entry Uzbek visas and a proper visa for the neighboring country in order to avoid delays in travel.

Registration after entry:
All travelers present in Uzbekistan for more than three business days must register with the Office of Entry, Exit, and Citizenship, commonly known as “OVIR.”
Hotel guests are registered automatically, but all other travelers are responsible for registering themselves.
Registration fees vary depending on length of stay.
See http://uzbekistan.usembassy.gov/consular for more information.
Visitors without proper registration are subject to fines, imprisonment, and deportation.
The fines range from $500 to $4,000.
Uzbek law mandates that visitors carry a medical certificate attesting that they are not infected with HIV, but this requirement is sporadically enforced.
For more information, see the Department of State's Human Immunodeficiency Virus (HIV) Testing Requirements for Entry into Foreign Countries brochure.

Further visa information is available from the Consular Section of the Embassy of the Republic of Uzbekistan, 1746 Massachusetts Ave., NW, Washington, D.C. 20036; telephone: (202) 530-7291; fax: (202) 293-9633; website: http://www.uzbekistan.org ; or from the Consulate General of Uzbekistan in New York City, 866 United Nations Plaza, Suite 327A, New York, NY 10017; telephone:
(212) 754-7403; fax: (212) 838-9812; website: http://www.uzbekconsulny.org .

See our Foreign Entry Requirements brochure for more information on Uzbekistan and other countries.
Visit the Embassy of Uzbekistan web site at http://www.uzbekistan.org for the most current visa information.

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

SAFETY AND SECURITY:
A Travel Warning remains in effect for Uzbekistan.
The Department of State reminds U.S. citizens of the potential for terrorist attacks or civil disturbance in Uzbekistan, although there have been no violent incidents there since May 2005, and continues to urge Americans in Uzbekistan to exercise caution.
The U.S. Government continues to receive information that indicates terrorist groups may be planning attacks, possibly against U.S. interests, in Uzbekistan.
Supporters of terrorist groups such as the Islamic Movement of Uzbekistan, Al-Qaida, the Islamic Jihad Union, and the Eastern Turkistan Islamic Movement are active in the region.
Members of these groups have expressed anti-U.S. sentiments and have attacked U.S. Government interests in the past, including the U.S. Embassy in Tashkent, and may attempt to target U.S. Government or private American interests in Uzbekistan.
In the past, these groups have conducted kidnappings, assassinations, and suicide bombings.

Increased security at official U.S. facilities over the past year may lead terrorists and their sympathizers to seek softer targets.
These may include facilities where Americans and other foreigners congregate or visit, such as residential areas, clubs, restaurants, places of worship, schools, hotels, outdoor recreation events, and resorts.
The U.S. Embassy in Tashkent continues to employ heightened security precautions.
U.S. citizens should report any unusual activity to local authorities and then inform the Embassy.

Uzbekistan experienced a wave of terrorist violence in 2004.
In July 2004 there were three suicide bombings in Tashkent, including one outside the U.S. Embassy.
The Islamic Jihad Union (IJU) claimed responsibility for the attacks.
The IJU also used suicide bombers in multiple attacks focused on police and Uzbek private and commercial facilities in Tashkent and Bukhara in late March and early April 2004.
In May 2005, armed militants stormed a prison in Andijon, released its prisoners, and then took control of the regional administration and other government buildings in Andijon Province.
Fighting broke out between government forces and the militants, and reports indicated that several hundred civilians died in the ensuing violence.
While there were no reports of U.S. citizens affected by these events, U.S. citizens and other foreigners in Uzbekistan frequently have experienced harassment from authorities and local residents since the 2005 violence.

Depending upon security conditions, travelers can expect restricted personal movement, including the closing of roads to traffic, and frequent document, vehicle, and personal identification checks should be anticipated.
The Uzbek Government has intermittently restricted travel to certain parts of the country in response to security concerns.

For the latest security information, Americans traveling abroad should regularly monitor the Department’s Internet website, where the current Travel Warnings and Public Announcements , including the Travel Warning for Uzbekistan , Worldwide Caution Public Announcement , and the Public Announcement for Central Asia, can be found.

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

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

CRIME:
Uzbekistan’s rate of violent crime, including against foreigners, has increased in recent years.
In urban areas, travelers are urged to take the same precautions against crime that they would take in a large American city.
If you are traveling at night, please travel in groups, maintain a low profile, and do not display large amounts of cash.

Although using private cars as taxicabs is a common practice in Uzbekistan, Americans, especially women, should not consider this a safe practice.
Americans are encouraged to use clearly marked taxicabs, such as those at hotels.
Also, Americans should avoid riding in taxis alone.

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 this serious problem 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 the crime to local police, please contact the nearest U.S. Embassy or Consulate for assistance.
The Embassy/Consulate staff can, for example, assist you to find appropriate medical care, contact family members or friends and explain how funds could be transferred.
Although the investigation and prosecution of the crime is solely the responsibility of local authorities, consular officers can help you to understand the local criminal justice process and to find an attorney if needed.

See our information on Victims of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION:
Medical care in Uzbekistan is below Western standards, with severe shortages of basic medical supplies, including disposable needles, anesthetics, and antibiotics.
Elderly travelers and those with pre-existing health problems may be at particular risk due to inadequate medical facilities.
Most resident Americans travel to North America or Western Europe for their medical needs.

Travelers are advised to drink only boiled water, peel all fruits and vegetables, and avoid undercooked meat.
Due to inadequate sanitation conditions, travelers should avoid eating unpasteurized dairy products and most food sold in the streets.

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

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

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

Uzbekistan has a developed but deteriorating traffic infrastructure.
Although main roads in central Tashkent are relatively well maintained, many secondary roads inside and outside Tashkent, and particularly those in the Tien Shan and Fan Mountains, are in poor condition and may be passable only by four-wheel-drive vehicles.
Driving at night can be quite dangerous because only the main roads in Tashkent and a few other major cities have streetlights; rural roads and highways generally are not lit.
Visitors are strongly urged to avoid driving at night outside Tashkent.
The gasoline supply can be sporadic; therefore, travelers should expect occasional difficulty finding gasoline, particularly outside of Tashkent.

Livestock, as well as farm equipment and carts drawn by animals that lack lights or reflectors, are found on both urban and rural roads at any hour.
Local drivers are not familiar with safe driving techniques.
Pedestrians in cities and rural areas cross streets unexpectedly and often without looking for oncoming traffic.
Uzbekistan has a large road police force, which frequently stops drivers for minor infractions or simple document checks.
There have been reports of harassment of foreign drivers by the road police, with reported minor police corruption in the form of solicitation of bribes.

Please refer to our Road Safety page for more information.

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

SPECIAL CIRCUMSTANCES: Travelers to Uzbekistan are subject to frequent document inspections.
Therefore, U.S. citizens are strongly encouraged to carry a certified copy of their U.S. passport and their Uzbek visa with them at all times so that, if questioned by local officials, proof of identity and U.S. citizenship are readily available.
In accordance with the Vienna Convention on Consular Relations and certain bilateral agreements, local authorities must grant a United States Consular Officer access to any U.S. citizen who is arrested.
U.S. citizens who are arrested or detained should ask to contact the U.S. Embassy immediately.

Uzbek customs authorities may enforce strict regulations concerning temporary import to or export from Uzbekistan of items such as armaments and ammunition, space technology, encryption devices, X-ray and isotope equipment, nuclear materials, poisons, drugs, precious and semi-precious metals, nullified securities, pieces of art, and antiques of historical value.
Contact the Embassy of Uzbekistan in Washington, D.C. or the Consulate of Uzbekistan in New York for specific information regarding customs requirements.

Most transactions are conducted on a cash-only, local currency (soum) basis.
Credit cards are accepted only at the main hotels and a few shops and restaurants; travelers’ checks can be cashed into dollars at the National Bank of Uzbekistan.
The commission fee is two percent.
Importation of currency exceeding $10,000 (US) is subject to a one- percent duty.
Foreigners must complete a customs declaration upon entering Uzbekistan and may face fines upon departure if unable to produce certificates verifying legal conversion of foreign currency.
Old U.S. dollar bills (prior to 1990) and/or those in poor condition (with tears, writing or stamps) are not acceptable forms of currency in Uzbekistan.
Although payment in U.S. dollars is required for certain hotel charges, airline tickets, and visa fees, other dollar transactions, as well as black market currency exchanges, are prohibited.
Please see our Customs Information.

Uzbekistan is an earthquake-prone country.
General information about natural disaster preparedness is available via the Internet from the U.S. Federal Emergency Management Agency (FEMA) at http://www.fema.gov/ .

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

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

REGISTRATION / EMBASSY LOCATION: Americans living or traveling in Uzbekistan are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department’s travel registration website and to obtain updated information on travel and security within Uzbekistan.
Americans without Internet access may register directly with the U.S. Embassy in Tashkent.
By registering, American citizens make it easier for the Embassy to contact them in case of emergency.
The U.S. Embassy is located at # 3, Moyqorghon Street, 5th Block, Yunusobod District, Tashkent -700093, Uzbekistan.
The main Embassy telephone number, which can also be reached after hours, is (998 71) 120-5450, fax:
(998 71) 120-6335; Consular fax: (998 71) 120-54-48; e-mail address: ConsularTashkent@state.gov; web site: http://uzbekistan.usembassy.gov.
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This replaces the Consular Information Sheet dated October 13, 2006, to update the sections on Country Description, Entry/Exit Requirements, Safety and Security, Crime, and Traffic Safety and Road Conditions.

Travel News Headlines WORLD NEWS

Date: Fri, 1 Feb 2019 09:29:10 +0100

Tashkent, Feb 1, 2019 (AFP) - Uzbekistan on Friday granted visa-free entry to citizens of 45 countries to boost tourism, which the government views as vital for economic growth.  The countries benefiting from a 30-day visa waiver that went into force on Friday include the majority of European countries including Britain as well as Australia, Canada, Argentina and Chile. The United States is a notable exception.

The impoverished ex-Soviet country has made tourism a priority to reduce its dependence on commodity exports.   The government is keen to show off the lavish Silk Road heritage of ancient cities such as Bukhara, Khiva and Samarkand.    Earlier this year, Uzbekistan granted a 30-day visa waiver to Germany while France became the first European Union country to benefit from the measure last year.

Uzbekistan's tourism committee said last month that annual visitor numbers for 2018 were 5.3 million, double the figure for 2017.   President Shavkat Mirziyoyev has reversed a number of policies that hampered tourism under his late predecessor Islam Karimov.    Among the restrictions he scrapped was a ban on photography in the capital Tashkent's ornate metro that had led to police detentions of unsuspecting tourists.    Mirziyoyev's bid to boost tourism in the immediate aftermath of Karimov's death in 2016 suffered a false start.

In December that year, he issued an order easing or cancelling visa requirements for visitors from 27 developed countries but this was swiftly reversed before coming into force.   Observers attributed the reversal to resistance within the powerful security apparatus.      Uzbekistan already offers visa-free entry to visitors from Turkey, Israel, Indonesia, South Korea, Malaysia, Singapore and Japan, in addition to long-standing reciprocal visa-free entry for citizens of most former Soviet countries.
Date: Fri, 4 Jan 2019 13:59:14 +0100

Tashkent, Jan 4, 2019 (AFP) - Uzbekistan said Friday it will allow German citizens to visit for up to 30 days visa-free to boost tourism as the ex-Soviet country emerges from long-term isolation.   Germany will be the second European Union country after France to gain visa-free travel to Uzbekistan, which has opened up somewhat since the death of its long-reigning hardline leader Islam Karimov in 2016.    Germans will be able to enter the central Asian nation visa-free from January 15, the Uzbek tourism committee said Friday, three months after authorities granted French citizens the same 30-day visa waiver.

The impoverished country is highly dependent on commodity exports and has made developing tourism a priority.   In particular the government is keen to show off the lavish Silk Road heritage of cities such as Bukhara, Khiva and Samarkand.    According to the Uzbek tourism committee, 18,094 Germans visited Uzbekistan in 2018, almost five times as many as in 2016.   Reform-touting Uzbek president Shavkat Mirziyoyev is set to visit Germany this month after meeting US President Donald Trump and French leader Emmanuel Macron last year.    These high-profile visits are seen as rewards for his steps towards greater openness following the death of  Karimov, under whom Mirziyoyev served as prime minister for 13 years.   The current president has reversed a number of policies that hampered the tourism sector in recent years.

Among the restrictions he scrapped was a ban on photography in the capital Tashkent's ornate metro that had led to police detentions of unsuspecting tourists.    Mirziyoyev's bid to boost tourism in the immediate aftermath of Karimov's death suffered a false start, however.    In December 2016, he issued an order easing or cancelling visa requirements for visitors from 27 developed countries but this was reversed a month later before actually coming into force.   The reversal was attributed to resistance within the powerful security apparatus.      Uzbekistan offers visa-free entry to citizens of Turkey, Israel, Indonesia, South Korea, Malaysia, Singapore, and Japan, in addition to long-standing reciprocal visa-free entry for citizens of most former Soviet countries.
Date: Thu 27 Dec 2018
Source: Vanguard NGR News [edited]

The World Health Organization (WHO) has certified Uzbekistan as malaria-free, confirming the end of the country's half-century-long battle for malaria elimination within its borders. Uzbekistan has become the 2nd country in 2018 to be certified malaria-free -- Paraguay was certified in June -- marking another milestone on the road to ending the disease for good.

"Malaria No More commends the government of Uzbekistan for its resilience and determination to eliminate malaria once and for all. Uzbekistan's decade-long commitment demonstrates the government's recognition that malaria stood in the way of development, and that ridding the country of the disease was critical to improving [the country's] economic outlook and protecting the health of its people," said Martin Edlund, CEO of Malaria No More.

Uzbekistan 1st eliminated malaria in 1961 but struggled to maintain elimination as malaria cases continued to flow in from neighbouring countries. In 2000, recognising the barriers that having malaria within its borders had on the country's economy and overall health of its citizens, the government of Uzbekistan stepped up its investment and implemented a holistic multisectoral approach that went beyond health, with support from other ministries -- agriculture, education and transportation.

Highlighting the critical factors needed to get the job done, the WHO certification committee cited Uzbekistan's decision to maintain its support of the nation's primary health care system -- the backbone of the malaria response -- even during the economic crisis that gripped the country during the 1990s; its use of data to better target malaria interventions where they're need most; and its approach toward early detection, diagnosis and efficacious treatment of malaria patients -- free of charge and irrespective of nationality.

Another critical factor was support from non-governmental organizations and partners, particularly the Global Fund to Fight AIDS, TB and Malaria, which played a vital role in Uzbekistan's achievement by providing financial support to ensure the national malaria program had the full amount of insecticide-treated bed nets, indoor residual spraying equipment, medicines and other tools needed to protect its citizens from malaria.  [Byline: Sola Ogundipe]
========================
[ProMED congratulates Uzbekistan with this important achievement. It is important to note that the achievement included mobilization beyond the health sector alone, applying a "holistic multisectoral approach that went beyond health," and the importance of the "primary health care system -- the backbone of the malaria response."

It is also noted that the malaria-free status would probably not have been achieved without the support of "non-governmental organizations and partners, particularly the Global Fund to Fight AIDS, TB and Malaria." - ProMED Mod.EP]

[HealthMap/ProMED-mail map:
Date: Sun, 29 Apr 2018 12:05:35 +0200
By Christopher RICKLETON

Samarkand, Uzbekistan, April 29, 2018 (AFP) - Coiffed, cheerful and multilingual, identical twins Fatima and Zukhra Rakhmatova do not immediately resemble agents of ex-Soviet Uzbekistan's long-feared security apparatus.   But the photogenic 30-year-old pair are frontline members of a newly formed, user-friendly Tourist Police deployed in the famed Silk Road city of Samarkand and other hotspots as a visitor boom sweeps the Central Asian country.

The force, established in January, is viewed as part of a broader opening initiated by Uzbekistan's authoritarian government following a long period of self-enforced isolation.    More than 2.5 million tourists visited Uzbekistan last year, a 24 percent increase on the previous year, according to the UzDaily news site.   "In the past I worked as a teacher and then as a wedding stylist. I even won a national prize as a stylist," recalls Zukhra Rakhmatova, one half of a sister act proficient in English, Russian, Farsi, Turkish and Japanese.   "But our grandfather served in the force and our uncle too," Rakhmatova told AFP. "It was always our dream to serve."

- Change and continuity -
Samarkand -- a former power centre positioned at the epicentre of millennia-old trade routes linking China and Europe -- hosts symbols of authoritarian continuity as well as tentative reform.    A short walk from the ceramic and marble dazzle of the three madrasahs towering over the city's old square is the statue of Islam Karimov, who ruled the country from before independence in 1991 until his death in 2016.    Laid to rest in a grand mausoleum in Samarkand's historic centre, Karimov is criticised by rights groups as the architect of one of the world's most repressive and closed-off police states.

Far from being disavowed, his monument is now yet another photo opportunity for visitors and wedding parties in the city, where he was born in 1938 and remains widely revered.    "Everyone makes mistakes but Islam Karimov is a hero. He worked day and night to protect the Uzbek people," said a 22-year-old bridesmaid posing for pictures by the monument.    The young woman, who did not give her name but said she had travelled to Samarkand from the capital Tashkent, refused to say what "mistakes" she thought Karimov had made.

- Power struggle -
Whether out of political pragmatism or genuine deference to a man he served for 13 years as prime minister, Karimov's successor, 60-year-old Shavkat Mirziyoyev has also continued to honour his mentor in public.   In the aftermath of the former leader's death, new strongman Mirziyoyev likened him to a "father", even as he toned down some of the totalitarian excesses that defined Karimov's 27-year rule. 

Foreign tourism, which grew by around a quarter during Mirziyoyev's first year in office emerged as a key battleground in a power struggle that pitted the new reform-touting president against regime hardliners.   In February for instance, Mirziyoyev ordered the introduction of a 30-day visa-free regime for citizens of seven countries -- Israel, Indonesia, South Korea, Malaysia, Singapore, Turkey and Japan -- and relaxation of registration rules for citizens of 39 others.

In cities like Samarkand, the changes were cheered by a population that endured long stretches of economic stagnation under Karimov.   "(We need to) open up of course!" said Malika Shakhimardonova, a chef at a mutton-grilling teahouse in the shadows of the Bibi-Khanym Mosque, completed on the orders of medieval conqueror Tamerlane in the 15th century.   "Let the tourists arrive to us like brothers and sisters!" said Shakhimardonova, whose kitchen is expanding.

- 'Take photos and share them!' -
Many saw significance in the fact that Mirziyoyev's relaxation of visa restrictions came days after Rustam Inoyatov, 73, who led the notorious national security service for over two decades, was dismissed.   Inoyatov was widely reported to have blocked a previous effort by Mirziyoyev to revamp tourism and to have insisted on retaining long-standing security measures, including a blanket ban on photography in the capital's metro.    Such bans, which occasionally saw visitors detained by police, were "rudiments of the Soviet Union" now consigned to the past, said the country's new 44-year-old tourism chief Aziz Abdukhakimov.

"We want tourists to take as many photos as possible. Put them on Instagram! It is the best advert for the country," he told AFP.     The Rakhmatova sisters, who scoot around Samarkand on two-wheeled, motorised "Segways" and are trained to administer first aid, certainly seem far removed from the grimmer elements of a former communist police state.   But Fatima jokes their dual presence on the tourism beat might sometimes give visitors a different impression.    "Some tourists will see one of us close to one attraction then move on to another and find the other sister standing there," she explained.    "They smile but sometimes give us a strange look. Probably because we are identical they think the police are following them around," she laughed.
Date: Wed, 7 Feb 2018 13:23:32 +0100

Tashkent, Feb 7, 2018 (AFP) - Uzbek authorities are to ease strict rules that bar visitors from taking photos or videos in parts of the country's picturesque capital, in a new bid to encourage tourism.   Uzbek President Shavkat Mirziyoyev has made boosting the tourism sector a priority as his country seeks to emerge from a long period of economic stagnation under late ruler Islam Karimov, who died of a reported stroke in 2016.

But tourists have long been forbidden from capturing on camera the Uzbek capital Tashkent's elaborate metro stations and some government buildings.    Late on Tuesday state media published a presidential decree saying tourists would now be able to take photos of and film public places "without any sort of restrictions" as long as there is no specific legal act to prevent them from doing so.

It was not stated in the February 3 decree whether or not tourists would now be able to take photos of the metro stations.    Two travel agencies told AFP they had not yet received a list of spots that could not be photographed.   The decree also said tourists would be permitted to use drones to take photos and video, which was previously not allowed in the capital Tashkent.     Mirziyoyev, who served as prime minister for 13 years before taking over, has made moves to distance himself from Karimov's authoritarian excesses while also honouring his memory.

The new decree also allows for some foreign nationals to obtain a 72-hour transit visa on arrival in Tashkent airport, providing they can show proof of onward travel.    It was not immediately clear which passport holders this rule would apply to.     Uzbekistan is expected to grant citizens of Israel, Indonesia, South Korea, Malaysia, Singapore, Turkey and Japan visa-free entry into the country starting from Saturday.

In December 2016, the government moved to lift visa restrictions for a longer list of countries but the order was unexpectedly deferred until 2021 weeks later.    Analysts attributed the nixing of the law to the intervention of the country's powerful national security chief, Rustam Inoyatov, whose dismissal after 23 years in power last month was widely seen as paving the way for further reforms.
More ...

World Travel News Headlines

Date: Tue, 25 Feb 2020
13:15:00 +0100 (MET)
By Ella IDE and Jastinder KHERA

Rome, Feb 25, 2020 (AFP) - Italy's new coronavirus spread south on Tuesday to Tuscany and Sicily, as the civil protection agency reported a surge in the number of infected people and Rome convened emergency talks.    Prime Minister Giuseppe Conte has blamed poor management in a hospital in the country's north for the outbreak, which has caused seven deaths in Italy so far and infected the largest number of people in Europe.    Tuscany reported its first two cases, including one in the tourist destination of Florence, while Sicily marked one: a tourist from the worst-hit Lombardy region, where 212 people have tested positive. The female tourist in Sicily, who had been staying in a hotel in Palermo, tested positive on the first swab but was awaiting the definitive result from Italy's institute of infectious diseases, civil protection agency chief Angelo Borrelli said.

Health ministers from neighbouring countries were to meet in Rome as the 
number of confirmed infections jumped to 283, with over 50 new cases reported since Monday.    The EU's health commissioner and other international health officials were also expected in the Italian capital Tuesday.    Hundreds of people were confined to their rooms at a Tenerife hotel after an Italian tourist was hospitalised with a suspected case of coronavirus, health officials in the Canary Islands said.  While no neighbouring country has closed its borders with Italy, several governments have announced additional measures for travellers arriving from Italy, in particular from the two northern regions of Lombardy and Veneto.  They range from medical screening to recommendations to self-isolate.

- 'Mission Impossible' -
Several upcoming matches in Italian Serie A and the Europa League will be played behind closed doors to combat the spread of the disease.    Production of the latest "Mission: Impossible" film starring Tom Cruise in Venice has been stopped following the outbreak.    The main centre of infection in Italy has been the town of Codogno, a town of some 15,000 people around 60 kilometres (35 miles) to the south of Milan. Codogno and several others in northern Italy have been put under isolation in an attempt to stem the spread of the virus.

The 38-year-old man dubbed "Patient One" by Italian media was admitted to 
hospital last Wednesday in Codogno, and it is thought a large number of the cases in the worst-hit region of Lombardy can be traced back to him.    His heavily pregnant wife, several doctors, staff and patients at the hospital are thought to have caught the virus from him.    As well as the towns placed under quarantine, further wide-ranging measures have affected tens of millions of inhabitants in the north of Italy, with schools closed and cultural and sporting events cancelled.    Elsewhere in the country officials have also been recommending precautionary measures.  In Calabria in the south, bishops have asked their worshippers not to make the sign of peace during mass, media reported.    All seven of those who have died so far in Italy were either elderly or had pre-existing medical conditions.
Date: Tue, 25 Feb 2020 11:48:12 +0100 (MET)

Madrid, Feb 25, 2020 (AFP) - Hundreds of people were confined to their rooms at a Tenerife hotel Tuesday after an Italian tourist was hospitalised with a suspected case of coronavirus, health officials in the Canary Islands said.   "Hundreds of hotel clients are being monitored for health reasons and the degree of supervision will be assessed during the day, but so far, we're not talking about quarantine," health authority spokeswoman Veronica Martin told AFP, confirming that the Italian tourist "was staying at this hotel while on holiday in Tenerife".
Date: Tue, 25 Feb 2020 11:40:20 +0100 (MET)
By Laurent Thomet with Dario Thuburn in Geneva

Beijing, Feb 25, 2020 (AFP) - Fresh deaths and a surge in new coronavirus cases in Iran, Japan and South Korea on Tuesday fuelled fears of a pandemic, as the disease took root in some of the world's poorest -- and worst-equipped -- countries.  The rapid spread abroad came as the World Health Organization announced that the epidemic had peaked at its epicentre in China, where it has killed more than 2,600 people and infected over 77,000 others.

But the situation has worsened elsewhere with nearly 2,700 other cases and more than 40 deaths globally, prompting restrictions on travellers from infected nations, the cancellation of football matches and national efforts to isolate suspected patients.    South Korea, Italy and Iran have each logged sharp increases in infections and deaths, while several Middle Eastern countries also reported their first confirmed COVID-19 cases.

WHO chief Tedros Adhanom Ghebreyesus insisted the virus could still be contained, praising China's drastic quarantine measures in several cities for helping to prevent an even bigger spread.   "For the moment we are not witnessing the uncontained global spread of this virus and we are not witnessing large-scale deaths," Tedros told reporters in Geneva on Monday.   He added, however, that countries should do everything they can to "prepare for a potential pandemic" -- a term is used to describe an illness that spreads across numerous communities.   The White House plans to spend $2.5 billion to combat the epidemic, according to US media. There are 53 cases in the United States so far.

- Iran hotspot -
Iran has emerged as a major hotspot with the death toll rising to 15 on Tuesday as three more people succumbed to the disease.   The country has been scrambling to contain the epidemic since last week when it announced its first two deaths in Qom, a centre for Islamic studies and pilgrims that attracts scholars from abroad.

Iran has confirmed 61 cases so far, making its mortality rate exponentially higher than anywhere else in the world and raising suspicion that many more people have contracted the disease there.   A WHO team was due in Iran on Tuesday.   Several neighbours have enacted measures to block arrivals from Iran but the virus has already spread to Afghanistan and elsewhere in the Middle East.   The WHO has warned that poorer countries with weak health care systems are the most at risk.

- Games off -
South Korean President Moon Jae-in warned that the outbreak was "very grave" as the country's death toll rose to 10 and the number of confirmed infections approached 1,000 -- the largest total outside China.   Scores of events have been cancelled or postponed as the outbreak has spread in the world's 12th-largest economy, from K-pop concerts to the World Team Table Tennis championship.   Parliament closed for cleaning Tuesday after confirmation a person with the coronavirus had attended a meeting last week.   More than 80 percent of the infections have been in and around Daegu, South Korea's fourth-largest city.

Streets there have been largely deserted for days, apart from long queues at the few shops with masks for sale.   Most of the country's infections are linked to the Shincheonji Church of Jesus, an entity often accused of being a cult.   The US Centers for Disease Control warned Americans against "all nonessential travel to South Korea".   In Japan, a fourth former passenger of the coronavirus-stricken Diamond Princess cruise ship died, according to local media. The man was in his 80s.   Nearly 700 people from the quarantined ship have tested positive for the illness so far.

Infections have also spiked inside Japan, with at least 160 cases including one death.   The government has expanded the number of hospitals that can receive suspected patients and asked people with moderate symptoms to stay home.   Businesses were asked to "let people stay away from offices, to avoid rush hour commuting hours, and to encourage telecommuting," Health Minister Katsunobu Kato said.   Italy -- which has reported seven deaths and over 200 cases -- has locked down 11 towns, while upcoming football matches in its Serie A and the Europa League will be played behind closed doors.    Prime Minister Giuseppe Conte has said that residents could face weeks of lockdown.

- China cases slow -
In China, 508 new cases were reported, with all but nine at the outbreak's epicentre in central Hubei province.   The death toll nationwide reached 2,663 on Tuesday after 71 more people died, the lowest rise in almost three weeks.   Reassured by the official numbers, the country is gingerly returning to business.   Beijing is seeing more cars on the street, factories are resuming work, Apple is reopening several stores, and some regions are relaxing traffic restrictions.   But schools remain closed, the capital has a mandatory 14-day quarantine for returning residents, and authorities are keeping some 56 million people in Hubei under lockdown.
Date: Sun 23 Feb 2020
Source: ZBC News [edited]

Mbire, Mashonaland Central Province has been affected by an outbreak of anthrax prompting the Veterinary Services Department to place an embargo on the movement of cattle from the province.

The acting provincial coordinator, Richard Chipfuwa, said 34 beasts had so far succumbed to the disease in the remote district, which sits on the border with Mozambique and Zambia. "These (the 34) are the reported cases, but we suspect there could be many more that were not reported. We have since mobilized vaccines to the district's 5 dip tanks: Nyatsengwa, Masomo, Tengu, Bonga and Sapa, so that farmers can have the remaining herd saved," he said.

But a poor road network in the district is making it difficult for veterinary officials to access some of the dip tanks, a situation made worse by the ongoing rains. The officials, in addition to treating infected animals, are also educating communities against consuming meat from dead animals, because this could pose health risks to people.

The anthrax outbreak in Mbire, an arid district rich in an assortment of wildlife, is suspected to have been passed on to livestock by infected wild animals such buffaloes, which are typical carriers of the disease. Last year [2019], the province lost nearly 1300 cattle due to anthrax and other livestock diseases.
=====================
[For a description of Mashonaland, go to: <https://en.wikipedia.org/wiki/Mashonaland>. It is in northern Zimbabwe and is made up of 3 provinces, East, West, and Central. For a map showing the location of Mashonaland Central Province go to: <https://en.wikipedia.org/wiki/Mashonaland_Central_Province>.

In these hard to reach areas, it is a constant concern knowing what is happening where. And this goes a long way as to why some 34 animals are reported affected and probably more. And why it is so important to get the necessary volumes of vaccine out to these communities as soon as possible. We wish the provincial veterinary service well and all the luck that they enjoy. - ProMED Mod.MHJ]

[HealthMap/ProMED map available at:
Mashonaland Central Province, Zimbabwe:
Date: Mon, 24 Feb 2020 16:22:59 +0100 (MET)

Dubai, Feb 24, 2020 (AFP) - The new coronavirus hit four more Middle Eastern states on Monday, with Bahrain, Iraq, Kuwait and Oman reporting new cases and the UAE calling on its citizens not to travel to Iran and Thailand.   Oman also halted flights to and from Iran  -- which is battling the deadliest outbreak outside China --with immediate effect.   The move came shortly after two Omani women who had returned from Iran were diagnosed with the disease.

The three cases in Kuwait and the one in Bahrain were also in individuals who had returned from Iran, where the virus has claimed the lives of 12 people.   Bahrain also shut three schools after a man who had transported children to the institutions tested positive after returning from Iran on February 21 via Dubai airport, the health ministry said.

In Kuwait, a 53-year-old Kuwaiti, a 61-year-old Saudi national and a 21-year-old stateless Arab who tested positive had all returned from Iran's holy city of Mashhad, the Kuwaiti health ministry said.   In Iraq, the virus was confirmed in an Iranian national studying in the southern shrine city of Najaf, health officials said.   All seven bourses in the oil-rich Gulf states were down on Monday as fears of a pandemic hit crude prices. The Saudi stock exchange led the slide, shedding 2.95 percent.

- Travel bans -
Iran's confirmed death toll rose to 12 on Monday, with the government vowing to be transparent and dismissing a lawmaker's claim the toll could be as high as 50.   The outbreak has prompted travel bans from nearby countries.

Last week, Kuwait banned entry of all ships from the Islamic republic and suspended flights to and from the country.   Kuwait also banned non-citizens coming from Iran from entering the Gulf state and operated chartered flights to bring back hundreds of Kuwaiti Shiite pilgrims from the Islamic republic.

Around a third of Kuwait's 1.4 million citizens are Shiite Muslims, who travel regularly to Iran to visit religious shrines. Kuwait also hosts roughly 50,000 Iranian workers.   Over half of Bahrain's population of under one million are Shiites, who also travel frequently to Iran.   The United Arab Emirates has already announced 13 cases of the novel coronavirus, all of them foreigners. The latest were a 70-year-old Iranian man, whose condition is unstable, and his 64-year-old wife.

On Monday, Abu Dhabi authorities called on all UAE citizens "to not travel to Iran and Thailand at present and up until further notice" as part of its efforts to monitor and contain the spread of the disease.   UAE airlines have suspended most flights to China -- where the virus first emerged in December -- except to the capital Beijing, but have not yet taken any measures to restrict travel to and from Iran. Around half a million Iranians live and work in the UAE.

Two Gulf states -- Saudi Arabia and Qatar -- remain free of the virus, but all have suspended flights to China.   Qatar Airways said on Monday that people arriving from Iran and South Korea would be asked to stay in home isolation or a quarantine facility for 14 days.   China's death toll from COVID-19 rose to nearly 2,600 on Monday, while the virus has now spread to more than 30 countries.
Date: Mon, 24 Feb 2020 17:49:00 +0100 (MET)

Kolkata, Feb 24, 2020 (AFP) - Rangers have suspended safari rides in a popular nature reserve in eastern India after five one-horned female rhinoceroses died from a suspected infectious disease, officials said Monday.  The animals were found dead over four days last week in Jaldapara National Park, nearly 700 kilometres (434 miles) north of West Bengal state's capital Kolkata.

India is home to two-thirds of the world's remaining one-horned rhinos, a vulnerable species on the IUCN red list   "Blood smears from carcasses have been sent to a laboratory in Kolkata," the reserve's chief conservator Ujjal Ghosh told AFP.   "All the five dead rhinos were adult females. We have put our staff on alert."

The park -- spread over 200 square kilometres (77 square miles) in the foothills of the eastern Himalayas -- is home to 204 rhinos according to the last official count in 2015.  More than 70 captive elephants used for safaris and patrolling also live in the reserve. The safari rides are carried out on elephants.   Activists said the animals may have died from anthrax, a communicable disease that attacks herbivores.

Humans can contract anthrax directly or indirectly from animals or animal products.  "We suspect that the animals died from a communicable disease like anthrax. Jaldapara forest has the odd case of anthrax which killed animals earlier," wildlife activist Animesh Bose told AFP.   Rangers were riding on elephants to reach the rhinos and vaccinate them using dart guns, the Hindustan Times reported.   Drones would try to find out if other animals have died or fallen ill, the newspaper said.
Date: Tue, 25 Feb 2020 04:50:33 +0100 (MET)

Jakarta, Feb 25, 2020 (AFP) - Dozens of Jakarta neighbourhoods were flooded Tuesday after torrential rains pounded Indonesia's capital, less than two months after nearly 70 people were killed in some of the megacity's worst flooding in years.   There were no immediate reports of casualties after the latest deluge, but parts of the city ground to a halt as whole neighbourhoods were swamped in muddy water, while power outages hit some districts.   At least 81 neighbourhoods were inundated with a dozen toll roads closed and some commuter train lines shuttered, according to an announcement by Indonesia's Disaster Mitigation Agency.

More torrential rains were expected later in the day.    "So the flooding will likely spread," agency spokesperson Agus Wibowo said on Twitter.   Floodwaters in some districts were as high as 127 centimetres (4 feet).   The low-lying city is prone to flooding during the wet season which starts around November.   Torrential rain in January triggered flooding and landslides that killed nearly 70 people in and around Jakarta while thousands more were forced to evacuate to shelters.
Date: Mon 24 Feb 2020
Source: Dhaka Tribune [edited]

In Baliadanga upazila of Thakurgaon district, 2 members of a family have died and 3 other members fell sick of an unknown disease. The deceased are MB 35, wife of HI, and her sister in law PB, wife of H from Songaon village of the upazila.

Quoting family members, local schoolteacher SPL said: "MB fell sick and died on Friday [21 Feb 2020] and on Saturday [22 Feb 2020], PB fell sick. "She came back home after undergoing primary treatment at Baliadanga Health Complex; however, she died early Sunday [23 Feb 2020]."

Soon afterwards, 3 other members of the family -- TA, HK and AA -- fell sick and were taken to Adhunik Sadar Hospital, she added.

Thakurgaon Civil Surgeon Dr MD Mahfuzar Rahman Sarker said a representative team of the health department has visited the village to investigate the cause of deaths.

The reasons of the deaths are yet to be known; however, the ones who fell sick are in better condition now, he added.

In 2019, 4 members of a family died due to Nipah virus in the same upazila. Locals are assuming the current deaths are occurring for the same reason.
===================
[With these cases described only as fatal or ill without mention of symptoms, it is not possible to speculate on what the etiology of thisdisease might be. The above report does mention that 4 fatal Nipah virus infections occurred in the same locality last year (2019). Nipah virus must surely be on the list of rule-outs in these current cases. This is the season when Nipah virus is circulating in Bangladesh in giant fruit bats (_Pteropus_ species) with spill-over of the virus by the bats' contamination of fruit or of palm sap juice in collecting pots on the palms. Person-to-person transmission of the virus can also occur. The transmission season is usually January to April.

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

An image of a Pteropus fruit bat can be found at

HealthMap/ProMED map available at:
A map showing the location of the area where the cases occurred can be accessed at the above URL. - ProMED Mod.TY]

24-02-2020 -- Italy has reported a rapid increase in cases of laboratory-confirmed coronavirus (COVID-19) since 21 February 2020. An initial investigation by Italian authorities has found several clusters of cases in different regions of northern Italy, with evidence of local transmission of COVID-19.

A WHO-led team of experts from WHO and the European Centre for Disease Prevention and Control (ECDC) arrived in Italy on Monday 24 February to support Italian authorities in understanding the situation. WHO experts are providing support in the areas of clinical management, infection prevention and control, surveillance and risk communication. At this stage the focus is on limiting further human-to-human transmission.

While limited local person-to-person transmission of COVID-19 in countries outside of China was expected, the rapid increase in reported cases in Italy over the past two days is of concern. However, it should also be noted that based on current data, in the majority of cases (4 out of every 5) people experience mild or no symptoms.

“COVID-19 is a new virus that we need to take very seriously. This mission to Italy is one of the ways in which WHO/Europe is supporting countries across the Region. We are working hard with our Member States to ensure that they are ready for COVID-19, preparing for the arrival of cases and possible localized spread. It is vital that we treat patients with dignity and compassion, put measures in place to prevent onward transmission, and protect health workers,” commented Dr Hans Kluge, WHO Regional Director for Europe.

Health authorities in Italy are implementing measures to prevent onward transmission, including closing of schools and bars and cancelling of sports events and other mass gatherings in the areas affected. This aligns with the containment strategy currently being implemented globally in an effort to stop the spread of COVID-19. “WHO stands by the Government of Italy in its efforts and commitment to mitigate this outbreak and manage the cases effectively. Now is the time for solidarity and cooperation, to work together to protect everyone’s health,” added Dr Kluge.

Countries across the European Region continue to prepare for and respond to cases of COVID-19. This includes establishing how to promptly detect sick people, testing samples from suspect cases, ensuring appropriate infection control and case management to minimize the risk of the virus spreading, and maintaining communication with the public.

Best Regards,
WHO Media Team

Date: Mon, 24 Feb 2020 12:29:01 +0100 (MET)
By David Vujanovic

Tehran, Feb 24, 2020 (AFP) - Iran's government vowed Monday to be transparent after being accused of covering up the deadliest coronavirus outbreak outside China, dismissing claims the toll could be as high as 50.

The authorities in the Islamic republic have come under mounting public pressure since it took days for them to admit to "accidentally" shooting down a Ukrainian airliner last month, killing 176 people.   The government said on Monday that Iran's coronavirus death toll had jumped by four to 12 -- by far the highest outside China -- as its neighbours closed their borders and imposed strict quarantine measures.

But Ahmad Amirabadi Farahani, a lawmaker from the holy city of Qom, south of Tehran, alleged the government was "lying" about the full extent of the outbreak.   The ILNA news agency, which is close to reformists, said the lawmaker spoke of "50 deaths" in Qom alone.   "The rest of the media have not published this figure, but we prefer not to censor what concerns the coronavirus because people's lives are in danger," ILNA editor Fatemeh Mahdiani told AFP.

Farahani was wearing a face mask during the closed session of parliament but left after speaking, as he felt unwell, state news agency IRNA reported, adding sanitary workers then cleaned his seat.   Iran's government rejected his claim that the virus had killed 50 in Qom.   "I categorically deny this information," Deputy Health Minister Iraj Harirchi said in a news conference aired live on state television.   "This is not the time for political confrontations. The coronavirus is a national problem," he added.

- Transparency pledge -
The government pledged transparency over the outbreak.   "We will announce any figures (we have) on the number of deaths throughout the country. We pledge to be transparent about the reporting of figures," its spokesman Ali Rabiei said.   Iran has been scrambling to contain the COVID-19 outbreak since it announced the first two deaths in the holy city of Qom on Wednesday last week.   Authorities have since ordered the closure of schools, universities and other educational centres across the country as a "preventive measure".

A spokesman for Iran's parliament, Assadollah Abbassi, announced the latest four deaths among more than 60 infections after Monday's closed-door gathering of lawmakers.   Citing Health Minister Said Namaki, he said that "the cause of coronavirus infections in Iran are people who have entered the country illegally from Pakistan, Afghanistan and China".   Iran has yet to give a breakdown of where the other deaths occurred.   The worst-hit province for infections is Qom, with 34 cases, according to health ministry figures.

The others are in Tehran with 13 infections, Gilan with six, Markazi with four, Isfahan with two and one each for Hamedan and Mazandaran.   But the health minister said that one person who died of coronavirus in Qom, south of Tehran, was a businessman who had made several trips to China.   Namaki had unsuccessfully pleaded in January for Iran's government to order the suspension of all commercial flights between Iran and China.   In his remarks to state television on Sunday, the minister said direct flights between Iran and China were now suspended, but the Qom businessman had travelled there "on a connecting flight".

- Border closures -
Since it emerged in December, the new coronavirus has killed more than 2,500 people in China.   Iran now accounts for nearly half of the deaths elsewhere in the world, which currently stand at 30.   Many of Iran's neighbours have reported cases of coronavirus in people who had travelled to the Islamic republic.   Afghanistan on Monday reported its first case in a person who had travelled to Qom.   Baghdad also reported its first case on Monday -- an elderly Iranian citizen living in the southern Iraqi city of Najaf.

Iraq has shut its border with the Islamic republic and imposed a travel ban.   Similar preventive measures were imposed by Afghanistan, Armenia, Pakistan and Turkey.    Qom is a centre for Islamic studies and pilgrims, attracting scholars from Iran and beyond.   Kuwait and Bahrain also confirmed their first novel coronavirus cases, all of whom had come from Iran.