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Andorra

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

Travel News Headlines WORLD NEWS

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

No Profile is available at present

Travel News Headlines WORLD NEWS

Date: Mon, 12 Feb 2018 05:54:19 +0100

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

[A HealthMap/ProMED-mail map can be accessed at:
Date: Thu, 19 Oct 2017 16:37:27 +0200
By Ricardo ARDUENGO, con Nelson DEL CASTILLO en San Juan y Leila MACOR en Miami

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

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

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

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

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

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

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

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

Making things worse, people are leaving the island for the mainland US. Forecasts are that the population now at 3.4 million will go down to 3.1 million or even less by 2026, said Villamil.   The government of Florida estimates that since October 3 -- the day a state of emergency to deal with an influx of Puerto Ricans was declared -- more than 36,000 people from the island have poured in.
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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: 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.
Date: Tue, 29 Aug 2017 11:52:52 +0200
By Marielle VITUREAU

Vilnius, Aug 29, 2017 (AFP) - Behind a heavy wooden door next to a Vilnius church, a couple of dozen Lithuanian men are talking about their dependence on alcohol. The moderator is Kestutis Dvareckas, a priest and a decade sober.   The World Health Organization ranks Lithuanians as the world's heaviest drinkers.   WHO estimates published in May pegged average annual consumption at 18.2 litres (4.8 gallons) of pure alcohol per person in 2016, putting the small EU Baltic state ahead of Belarus, Moldova and Russia.   "Drinking on the job had been tolerated on various occasions since the Soviet era. Today, you still see alcohol at baptisms and burials," Father Dvareckas, 37, told AFP.

Rather than being social, drinking on these occasions is often excessive to the point of passing out.   Poor mental health and coping skills play a role, especially among Lithuanian men. WHO statistics from 2014 show that 16.7 percent of them abused alcohol or were dependent on it.    Largely at fault is "Lithuanian pessimism", according to Visvaldas Legkauskas, a psychologist at Vytautas Magnus University in the central city of Kaunas.   "Life isn't too bad here, but we have this character trait and we drown our sorrows in alcohol or we commit suicide," he told AFP.

- Curbing consumption -
Dvareckas says he managed to quit drinking and get his life back thanks to a 12-step programme similar to the one used by Alcoholics Anonymous and the support of friends and family.    Wanting to pass on what he learnt, he created the free programme As Esu ("I am" in Lithuanian) in 2009, whose combination of group meetings, prayer, therapy and work opportunities help alcoholics get back on their feet.    An association created this year forged a network allowing 20 such communities to share resources. Other initiatives such as Alcoholics Anonymous are also afoot.

Burdened by the high social costs of heavy drinking, the government is taking action to curb consumption, including tax hikes and a blanket ban on alcohol advertising.   Fighting alcoholism was among the key campaign promises that gave the Lithuanian Peasants and Greens Union (LPGU) a surprise victory in 2016 elections. Its leader has been organising a booze-free cultural festival in his village for a decade.     Although parliament raised the tax on alcohol in March, consumption did not fall in the eurozone state of nearly three million residents.    Lawmakers then voted by a large margin in June to raise the legal drinking age to 20 from 18 and introduce a blanket ban on alcohol ads next year.    Whether these measures will work is another matter.   "Already back in 1998, Lithuania had adopted a strategy to curb consumption by 25 percent. But the reality is that it went up by 130 percent instead," Health Minister Aurelijus Veryga told AFP.

- Medical care -
For Father Dvareckas, the new legislation is not enough: "Why do I still have to pass the alcohol shelf at stores before reaching the one with dairy products?"   At a local store in the village of Semeliskes, located 20 kilometres (12 miles) from Vilnius, a saleswoman named Ona is sceptical.    "Prices may have gone up, but no one really cares. People will continue to buy as long as they have money, and they'll buy five bottles instead of one to make sure they're stocked," she told AFP.    Many believe that to really be effective, the restrictions affecting sales must be coupled with other forms of help.    Medical treatment of alcoholics is still spotty in Lithuania, where the necessary medication is not paid for by the state, according to the national health insurance fund.    There are only five state-run alcohol rehab centres across Lithuania.    For Veryga, the health minister, it is critical "to ensure equal access to everyone concerned in the various regions".
Date: Thu, 1 Jun 2017 20:28:08 +0200

Vilnius, June 1, 2017 (AFP) - Lithuania on Thursday banned alcohol advertising and raised the legal drinking age to 20 from 18 as part of efforts to curb consumption in one of the world's hardest-drinking nations.    The measures, which also include a ban on alcohol sales between 8pm to 10am, were approved by 101 lawmakers in the 141-seat parliament. Ten MPs were opposed, and another ten abstained.

The blanket ban on alcohol ads, which includes billboards, TV, radio, the printed press and the internet, will come into force on January 1, 2018.    Fighting alcoholism was among the key campaign promises that gave the Lithuanian Peasants and Greens Union (LPGU) a surprise victory in elections last October.   LPGU party chairman Ramunas Karbauskis said the EU nation of some 2.8 million people was taking its cue from several Nordic countries that have strict rules on alcohol sales.   "We need changes so that fewer people become dependent on alcohol and kids are not affected by this industry," Karbauskis said Thursday.

The average Lithuanian over the age of 15 consumed the equivalent of 13.2 litres of pure alcohol last year, the country's statistics agency reported this week, down by nearly a litre per person compared with a year ago.   But Gauden Galea, a senior World Health Organization official, last month pegged average annual consumption at 16 litres per person, making Lithuanians the world's "top" drinkers, according to the Baltic News Service.   Critics said the measures were unlikely to be effective.   "We're preventing adults from buying alcohol and we think that this will solve all social ills. This is a short-sighted approach," said liberal lawmaker Ausrine Armonaite.
Date: Sun 12 Mar 2017
Source: The Baltic Times [edited]
<http://m.baltictimes.com/article/jcms/id/138566/>

An emergency has been declared in Vilnius [Lithuania] after _Legionella_ bacteria were found in the water systems of several apartment buildings in the Lithuanian capital. The Emergency Commission at the Vilnius local authority stated on [Fri 10 Mar 2017] that the situation met the criteria for an emergency, Arvydas Darulis, acting director of the city's administration, told BNS [Baltic News Service].

"We have 2 deaths and a 3rd incident is still under investigation. This affects over 500 people because there are 3 buildings and it takes more than 24 hours to eliminate (the emergency situation). Based on these criteria, an emergency situation has been declared," he said. According to the official, the commission has activated an emergency operations centre to handle the emergency.

The National Public Health Service said that samples from 2 apartment blocks in the Zirmunai neighborhood, at Tuskulenu 5, and Ladygos 3, had tested positive for the bacteria that cause legionnaires' disease and samples from an apartment block in the Lazdynai neighborhood were still being tested. To date, 2 residents of these buildings have died of legionnaires' disease and a 3rd is being treated. [Byline: Donata Motuzaite]
==================
[ProMED-mail thanks Denis Green for his continued contributions. Genotyping clinical and environmental _Legionella_ isolates will help establish transmission pathways: a common source would be presumed for cases that have matching of _Legionella_ genotypes; and a source for these cases with matching genotypes would be confirmed if the clinical genotype matches an environmental genotype.

Vilnius is the capital of Lithuania and its largest city, with a population of 542,664 residents as of 2015
(<https://en.wikipedia.org/wiki/Vilnius>).

Zirmunai, where 2 apartment blocks tested positive for _Legionella_, is Vilnius's most populous administrative division, located north of central Vilnius
(<https://en.wikipedia.org/wiki/ŽirmÅ«nai>).

Lazdynai, where buildings are still being tested, is another neighbourhood located southwest of central Vilnius
(<https://www.google.com/maps/place/Lazdynai,+Vilnius,+Lithuania>). - ProMED Mod.ML]

[A HealthMap/ProMED-mail map can be accessed at: <http://healthmap.org/promed/p/57955>.]
More ...

Djibouti

Djibouti - US Consular Information Sheet
May 30, 2006

COUNTRY DESCRIPTION: Djibouti is a developing African country located on the Gulf of Aden. It is a multi-party democracy with a legal system based on French civil law (Djibouti was a Fr
nch colony until 1977), though modified by traditional practices and Islamic (Sharia) law. Although exact statistics are unavailable, unemployment is estimated in excess of 50% of the working-age population. About two-thirds of the country's 650,000 residents live in the capital, also called Djibouti. Modern tourist facilities and communications links are limited in the city of Djibouti and are virtually non-existent outside the capital. Read the Department of State Background Notes on Djibouti for additional information.

ENTRY/EXIT REQUIREMENTS: A passport, visa, and evidence of yellow fever vaccination are required. Travelers may obtain the latest information on entry requirements from the Embassy of the Republic of Djibouti, 1156 15th Street, N.W., Washington, D.C. 20005, telephone (202) 331-0270, or at the Djibouti Mission to the United Nations, 866 United Nations Plaza, Suite 4011, New York, N.Y. 10017, telephone (212) 753-3163. Overseas, inquiries may be made at the nearest Djiboutian embassy or consulate. In countries where there is no Djiboutian diplomatic representation, travelers may sometimes obtain visas at the French Embassy. See our Foreign Entry Requirements brochure for more information on Djibouti and other countries. Visit the Embassy of Djibouti web site at www.embassy.org/embassies/dj.html for the most current visa information.
American journalists or any American connected with the media must contact the U.S. Embassy's Public Affairs section prior to travel to facilitate entry into Djibouti. If you are unclear whether this applies to you, please contact the U.S. Embassy for more 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: Djibouti enjoys a stable political climate. However, its international borders are porous and lightly patrolled. In particular, Somalia, Djibouti's neighbor to the south, is considered by many to be a haven for terrorists and other insurgent elements. In addition, tensions exist between neighboring Ethiopia and Eritrea due to the unsettled nature of their long-running border dispute. Civil unrest or armed conflict in neighboring countries could disrupt air travel to and from Djibouti or otherwise negatively affect its security situation.
Terrorism continues to pose a threat in East Africa. U.S. citizens should be aware of the potential for indiscriminate attacks on civilian targets in public places, including tourist sites and other sites where Westerners are known to congregate.
Travelers should exercise caution when traveling to any remote area of the country, including the borders with Eritrea, Ethiopia, and Somalia. Djiboutian security forces do not have a widespread presence in those regions. In recent years, acts of sabotage have occurred along the Djibouti-Ethiopia railway. Although Americans were not specifically targeted in any of these attacks, U.S. citizens should exercise caution.
Demonstrations have become more frequent due to the recent increase in energy prices. Americans are advised to avoid all demonstrations as they may become violent.
Americans considering seaborne travel around Djibouti's coastal waters should exercise extreme caution, as there have been several recent incidents of armed attacks and robberies at sea by unknown groups. These groups are considered armed and dangerous. When transiting in and around the Horn of Africa and/or the Red Sea near Yemen, it is strongly recommended that vessels convoy in groups and maintain good communications contact at all times. Marine channels 13 and 16 VHF-FM are international call-up and emergency channels and are commonly monitored by ships at sea. 2182 Mhz is the HF international call-up and emergency channel. In the Gulf of Aden, transit routes farther offshore reduce, but do not eliminate, the risk of contact with suspected assailants. Wherever possible, travel in trafficked sea-lanes. Avoid loitering in or transiting isolated or remote areas. In the event of an attack, consider activating the Emergency Position Indicating Radio Beacons. Due to distances involved, there may be a considerable delay before assistance arrives. Vessels may also contact the Yemeni Coast Guard 24-hour Operations Center at 967 1 562-402. Operations Center staff members speak English.
U.S. citizens are encouraged to carry a copy of their U.S. passports with them at all times for readily available proof of identity and U.S. citizenship if questioned by local officials. Police occasionally stop travelers on the main roads leading out of the capital to check identity documents.

For the latest security information, Americans traveling abroad should regularly monitor the Department's Internet web site where the current Worldwide Caution Public Announcement , Travel Warnings and Public Announcements 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: Accurate crime statistics are not available, but crime appears to be on the rise. Petty thefts and pickpockets are common, and a few home invasions have been reported. Major crimes involving foreigners are rare, but are increasing in frequency. In the past year the number of murders has increased in Djibouti, involving mainly Djiboutian and third country nationals (TCNs). This increase in crime is possibly linked to declining economic conditions and a deepening resentment toward the increasing number of TCN workers brought in to assist with major construction projects in Djibouti.

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

See our information on Victims of Crime .
MEDICAL FACILITIES AND HEALTH INFORMATION: Adequate medical facilities in the capital of Djibouti are limited and medicines are often unavailable. Medicines that are available are extremely expensive. Medical services in some outlying areas may be completely nonexistent. Motorists especially should be aware that in case of an accident outside the capital, emergency medical treatment would depend almost exclusively on passersby. In addition, cell phone coverage in outlying areas is often unavailable, making it impossible to summon help.
Malaria and dengue fever are prevalent in Djibouti. Travelers who become ill with a fever or flu-like illness while traveling in a malaria-risk area and up to one year after returning home should seek prompt medical attention and tell the physician their travel history and what anti-malarial drugs they have been taking.

In 2005, polio was found in all of Djibouti's neighbors (Somalia, Ethiopia, Eritrea and Yemen) and health professionals strongly suspect it is present in Djibouti. The Advisory Committee on Immunization Practices (ACIP) recommends that all infants and children in the United States should receive four doses of inactivated poliovirus vaccine (IPV) at 2, 4, and 6-18 months and 4-6 years of age. Adults who are traveling to polio-endemic and epidemic areas and who have received a primary series with either IPV or oral polio vaccine should receive another dose of IPV. For adults, available data does not indicate the need for more than a single lifetime booster dose with IPV.

In May 2006, avian influenza was confirmed in three chickens and one human in Djibouti. For more information about this illness, see the Department of State's Avian Flu Fact Sheet .

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 . For information about outbreaks of infectious diseases abroad consult the World Health Organization's (WHO) website at . Further health information for travelers is available at .

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

The Djiboutian Ministry of Defense and the national police force share responsibility for road safety in Djibouti. While Djibouti has been declared a "mine-safe" country, this indicates landmines have been identified and marked, not that they have been removed. Landmines are known to be present in the northern districts of Tadjoureh and Obock. In addition, there may be mines in the Ali Sabieh district in the south. Travelers should stay on paved roads and should check with local authorities before using unpaved roads.
The two main international routes to the capital city via Dire Dawa, Ethiopia, and Yoboki, Djibouti, are both in poor condition due to heavy truck traffic, whose presence demands that drivers remain vigilant. Major roads outside the capital are paved but lack guardrails. Railroad crossings are often not clearly marked.
Roads are often narrow, poorly maintained, and poorly lit. Drivers and pedestrians should exercise extreme caution. Excessive speed, unpredictable local driving habits, pedestrians and livestock in the roadway, and the lack of basic safety equipment on many vehicles are daily hazards. Speed limits are posted occasionally but are not enforced. The leafy narcotic khat is widely used, particularly in the afternoons, creating another traffic hazard. Travelers should be aware that police set up wire coils as roadblocks on some of the major roads, and these may be difficult to see at night.
The only means of public inter-city travel is by bus. Buses are poorly maintained and their operators often drive erratically with little regard for passenger safety.
Please refer to our Road Safety page for more information. Visit the web site of Djibouti's national tourist office and national authority responsible for road safety at .

AVIATION SAFETY OVERSIGHT: As there is no direct commercial air service between the United States and Djibouti, the U.S. Federal Aviation Administration (FAA) has not assessed Djibouti's Civil Aviation Authority for compliance with ICAO international aviation safety standards. For more information, travelers may visit the FAA's Internet website at .

SPECIAL CIRCUMSTANCES: Although the narcotic khat is legal and widely chewed in Djibouti, it is considered an illegal substance in many countries, including the United States.
Djiboutians are generally conservative in dress and manner, especially in rural areas.
Photography of public infrastructure (including, but not limited to, public buildings, seaports, the airport, bridges, military facilities or personnel) is not allowed in Djibouti. Use extreme caution when photographing anyone or anything near prohibited areas. Photographic equipment will be confiscated, and the photographer may be arrested.
Djibouti is a cash-based economy and credit cards are not widely accepted. Reliable automated teller machines (ATMs) are not available. Changing money on the street is legal, but be aware of possible scams as well as personal safety considerations if people observe you carrying large amounts of cash. The exchange rate on the street will be similar to that at a bank or hotel. It is important that the U.S. banknotes that you carry have a date of 2003 or newer because some currency exchanges will not accept U.S. paper money older than 2003.

Djiboutian customs authorities may enforce strict regulations concerning temporary importation into or export from Djibouti of firearms. It is advisable to contact the Embassy of Djibouti in Washington, D.C., for specific information regarding customs requirements.

Please see our information on 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 Djiboutian law, even unknowingly, may be expelled, arrested or imprisoned. Penalties for possession, use, or trafficking in illegal drugs in Djibouti 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 Djibouti 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 Djibouti. Americans withoutInternet 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 Plateau du Serpent, Boulevard Marechal Joffre, Djibouti City. The mailing address is Ambassade Americaine, B.P. 185, Djibouti, Republique de Djibouti. The telephone number is (253) 35-39-95. The fax number is (253) 35-39-40. Normal working hours are Sunday through Thursday, 7:30 a.m. to 4:00 p.m.
* * *
This replaces the Consular Information Sheet dated November 2, 2005, to update sections on Safety and Security, Crime, Medical Facilities and Health Information, Special Circumstances, and Registration/Embassy Location.

Travel News Headlines WORLD NEWS

Date: Mon, 26 Feb 2018 08:27:14 +0100

Djibouti, Feb 26, 2018 (AFP) - President Ismael Omar Guelleh's ruling party claimed a resounding victory in Friday's parliamentary elections in Djibouti, taking nearly 90 percent of seats after the opposition largely boycotted the poll.   Mohamed Abdallah Mahyoub, a senior member of Guelleh's UMP party and campaign spokesman, told AFP late Sunday the party had won 58 out of 65 parliamentary seats, an increase of three since the last vote in 2013.   There was no immediate figure for turnout among the tiny Horn of Africa nation's 194,000 registered voters.   Guelleh has ruled Djibouti since 1999 and was last re-elected in 2016 with 87 percent of the vote.

The UMP's victory has helped by the badly-divided opposition with two parties -- MRD and RADDE and a faction of a third party, ARD -- refusing to put forward any candidates, saying the elections would neither be fair nor transparent while others accused the election commission of bias.   The UMP claimed every seat outside of the capital and all but seven seats in Djibouti city with the remainder going to the UDJ party.   The law stipulates that 25 percent of seats must go to women, an increase from just 10 percent in the outgoing parliament. According to Mahyoub, this threshold was nearly met as 15 women won parliamentary seats, 14 of them from the UMP.
Date: Thu, 12 Jun 2014 16:56:37 +0200 (METDST)

GENEVA, June 12, 2014 (AFP) - Nearly a quarter of the population in drought-hit Djibouti is in desperate need of aid, with malnutrition and a dramatic lack of water causing a mass exodus from rural areas, the UN said on Thursday.   "Persistent and recurring droughts have resulted in a general lack of water for both people and livestock," said the UN's Djibouti coordinator Robert Watkins.   The crisis, which has dragged on since 2010, has left a full 190,000 of the country's 850,000 residents in need of humanitarian assistance.   They include 27,500 refugees, mainly from neighbouring Somalia, Watkins told reporters in Geneva.

Yet the crisis in Djibouti has received little international attention, with a UN appeal for aid last year reaching only a third of its target -- the lowest level of funding for any such appeal worldwide.   The appeal comes amid warnings from Britain on Thursday that Somalia's Al-Qaeda-linked Shebab insurgents were planning further attacks in the tiny and traditionally tranquil Horn of Africa country.   Shebab suicide bombers hit a crowded restaurant in Djibouti last month, killing at least one, in an attack apparently linked to the country's participation in the African Union force in Somalia.   Djibouti's port also serves as a key base for international anti-piracy operations off the Somali coast.

Watkins also said on Thursday that some 60,000 migrants -- most of them Ethiopians trying to reach the Gulf for work -- were also in need of aid inside Djibouti.   Last year alone, 100,000 passed through the country, he said. Most migrants come on foot, staggering alongside the roads in the extreme heat.   "Many die from dehydration," he said.   Foreigners are not the only ones on the move in the country, where most people still live off livestock which have been hard-hit by the drought.   "There has been a huge exodus of people living in rural areas," Watkins said, adding that the population in the capital Djibouti City had more than doubled since 2010, now home to 85 percent of the population.

Nationwide, a full 18 percent of the population is considered acutely malnourished, rising to 26 percent in some areas -- well above the 15-percent emergency threshold, Watkins said.   Sixty percent of the country's population was also suffering from diarrhoeal diseases, he said.   Watkins said he hoped the lack of interest from funders would change, pointing out that a new appeal last month for $74 million (55 million euros) was already 13 percent funded, with contributions from the United States, the EU and Japan among others.
Date: Mon, 26 Nov 2012 18:20:54 +0100 (MET)

RIYADH, Nov 26, 2012 (AFP) - The United Nations said on Monday that the number of people in Arab countries infected with HIV more than doubled to 470,000 in the eight years to 2009. "The number of adults and children living with HIV has more than doubled between 2001 and 2009 from 180,000 to 470,000," according to data from UNAIDS, the UN programme on HIV and AIDS. New HIV infections increased from 43,000 in 2001 to 59,000 in 2009, it said at a meeting in Riyadh on combatting AIDS, organised by the Arab League and the Saudi government. The number of deaths from AIDS also surged from about 8,000 in 2001 to 24,000 in 2009.

In Djibouti and Somalia, the percentage of infected people represents 2.5 percent and 0.7 percent of the countries' respective populations. "These figures are very worrying and need an immediate response," it said in an Arabic-language statement. The figures appear in contrast with the global trend. UNAIDS said last week that 25 low- and middle-income countries had managed to at least halve their rate of new HIV infections since 2001, representing a reduction of 700,000 new HIV infections. Globally, new HIV infections fell to 2.5 million last year from 2.6 million in 2010 and represented a 20-percent drop from 2001, it said.
Date: Wed 23 Nov 2011
Source: IC Publications [edited]

Authorities in Djibouti have reported a serious outbreak of a potentially fatal diarrhea infection in the capital [Djibouti], with 2 deaths since October 2011 and 127 new cases this month [November 2011], the WHO said on Tuesday [22 Nov 2011]. WHO said 5000 cases of acute watery diarrhea (AWD) have already been reported this year [2011] compared to 2000 in the Red Sea port in 2010.

Poor hygiene and sanitation along with recent rainfall in some areas had led to the contamination of already limited and unsafe water supplies, according to the UN health agency, which said the drought in the Horn of Africa had exacerbated the situation.

"The effects of the recurring drought on several parts of Djibouti and neighbouring countries have resulted in a malnourished, poorer and more vulnerable population," a WHO statement said. [WHO] is working with the Djibouti ministry of health to train health workers and set up treatment centres.
Date: Tue, 22 Nov 2011 12:16:01 +0100 (MET)

GENEVA, Nov 22, 2011 (AFP) - Authorities in Djibouti have reported a serious outbreak of a potentially fatal diarrhoea infection in the capital, with two deaths since October and 127 new cases this month, the WHO said on Tuesday. The World Health Organization said 5,000 cases of Acute Watery Diarrhoea (AWD) have already been reported this year compared to 2,000 in the Red Sea port in 2010.

Poor hygiene and sanitation along with recent rainfall in some areas had led to the contamination of already limited and unsafe water supplies, according to the UN health agency, which said the drought in the Horn of Africa had exacerbated the situation. "The effects of the recurring drought on several parts of Djibouti and neighbouring countries have resulted in a malnourished, poorer and more vulnerable population," a WHO statement said. The body is working with the Djibouti ministry of health to train health workers and set up treatment centres.

Last week the UN rights agency reported an outbreak of cholera among Somali refugees in Kenya's huge Dadaab refugee camp, with one death. The WHO said on Tuesday that all five camps were affected by AWD but no cases had been reported in Kenya outside the camps. AWD is rife in south central Somalia where more than 53,000 cases were reported this year, resulting in 795 deaths, the agency said.
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Date: Tue, 21 May 2019 12:37:30 +0200

Khartoum, May 21, 2019 (AFP) - Sudanese protest leaders called on their supporters Tuesday to prepare for a general strike after talks with the country's military rulers stalled on who will lead an agreed three-year transition.   Protest leaders had reached agreement with the ruling military council on the other main aspects of the transition.   But early on Tuesday, the generals who overthrew veteran president Omar al-Bashir last month baulked at protesters' demands for a civilian head and a civilian majority for an agreed new sovereign council to lead the transition.

"In order to achieve a full victory, we are calling for a huge participation in a general political strike," said the Sudanese Professionals Association, which took the lead in organising the four months of nationwide protests that led to Bashir's ouster.   "The strike is our revolutionary duty and the participation in the sit-in ... is a crucial guarantee to achieve the goals of the revolution."

Protest leader Madani Abbas Madani told AFP the preparations for a "general political strike and civil disobedience" were already under way.   "Whenever we will decide on applying these plans, we will make an announcement," said Madani, a prominent leader of protest umbrella group the Alliance for Freedom and Change.   The two sides launched what had been billed as a final round of talks on the transition late on Sunday.

The military council has faced pressure from Western government and the African Union to agree to a civilian-led transition -- the central demand of the thousands of demonstrators who have spent weeks camped outside army headquarters in Khartoum.   When talks broke up early on Tuesday, neither side said when they would resume.

Protest leader Siddiq Yousef told reporters they had been suspended.   "The main point of dispute that remains is concerning the share of representatives of the military and the civilians in the council and who will be the head of the new body," the two sides said in a joint statement.   The military council has been pushing for its chairman General Abdel Fattah al-Burhan to head the new sovereign council but protest leaders want a civilian.
Date: Tue, 21 May 2019 05:22:30 +0200
By John WESSELS with Samir TOUNSI in Kinshasa

Butembo, DR Congo, May 21, 2019 (AFP) - People in Ebola-hit eastern DR Congo are struggling to come to terms with high-security burials that are part of a hard-pressed strategy to roll back the disease.   Anyone who dies of the highly infectious haemorrhagic fever has to be buried in carefully-controlled conditions designed to minimise the risk of infection from body fluids.   But that means ceremonies are carried out in sanitised conditions, with relatives and friends kept at a distance -- for many, a traumatic break with traditions that demand the body of a loved-one be seen or touched.   "We're astonished she's being buried like this," said Denise Kahambu as she watched the specially-prepared burial in Butembo of her 50-year-old cousin, Marie-Rose.   "They said she died of Ebola," she said sceptically.   First declared last August, the epidemic has now claimed nearly 1,200 lives -- 200 of them in May alone.    The outbreak is the second deadliest on record, after an epidemic that killed more than 11,300 people in West Africa in 2014-16.

The burial in Butembo followed strict precautions. A pick-up truck delivered the coffin to the burial site, where a grave had been prepared, as the family stood by at a distance.   Gloved Red Cross workers handled the burial, which took place in silence and without a religious ceremony.   A family member or loved one was allowed only to place a cross on the tomb, once they too had donned protective gloves.   Half a dozen police officers escorted the convoy and remained on guard throughout.    On Friday, two burial teams from the treatment centres were attacked by stone-throwing crowds at Butembo and Bunia, a little further north in Ituri province, according to the health ministry. One burial worker was injured.

- Culture shock -
"The custom is that the body of the deceased first returns to the home. And once people have mourned, they have the chance to touch the body for the last time," said Seros Muyisa Kamathe, a guide and interpreter in Beni and Butembo.   "Before going to the cemetery, you open the coffin so people can take one last look at the deceased."

And normally it would be the family and neighbours who would take responsibility for digging the grave -- and deciding where if should be.   Ebola experts say denial and resistance were familiar obstacles in the 2014-16 epidemic in the West African states of Guinea, Liberia and Sierra Leone.   The World Health Organization (WHO) has a 12-step protocol for dealing with burials so that handling of the remains is kept to a minimum, but it also emphasises the importance of respect and mourning.   "The burial process is very sensitive for the family and the community and can be the source of trouble or even open conflict," it acknowledges.    No burial should begin until family agreement has been obtained, and workers should engage with the community "for prayers to dissipate tensions
and provide respectful time," it says.

- Armed escorts -
The burial process is part of the notoriously time-consuming and labour-intensive task of combatting Ebola.   And in this troubled region, the challenge has been further complicated by bloody deadly attacks on Ebola treatment centres by local militias.   Suspicion, political infighting in the capital Kinshasa and militia violence provide a fertile breeding ground for the virus.   Sometimes local people cover the graves overnight as a sign of their opposition, the ministry said.   In Butembo, health workers need an armed escort when they go looking for cases of Ebola in some neighbourhoods, an AFP photographer noted during one outing Saturday evening.

WHO Director-General Tedros Adhanom Ghebreyesus, at the opening of the organisation's annual assembly on Monday, described the outbreak as "one of the most complex health emergencies any of us have ever faced."   "Unless we unite to end this outbreak we run the risk it will become more widespread and more expansive and more aggressive," he said.   "We are not just fighting a virus," Tedros insisted. "We're fighting insecurity. We're fighting violence. We're fighting misinformation... and we're fighting the politicisation of an outbreak."   On the plus side, health officials are keen to emphasise some important gains. More than 118,000 have been vaccinated against the virus, and no cases have been recorded in neighbouring Rwanda and Uganda.
Date: Mon, 20 May 2019 15:09:54 +0200

Milan, May 20, 2019 (AFP) - Alitalia has scrapped around half its flights scheduled for Tuesday after a call to strike by Italian pilots, cabin crew and ground staff.   The industrial action by employees of Alitalia, Blue Air and Blue Panorama was confirmed Monday over the future of the sector and specifically that of the troubled national carrier.   Alitalia has cancelled around half its flights on Tuesday, as well as some late Monday and early Wednesday. The company said it hoped to get 60 percent of passengers to their destination.

Unions lamented "on the one hand, a rising number of passengers and flights, and on the other a proliferation of bankruptcies", a statement said.   They are worried about Alitalia's future and want their jobs protected.   The Italian government earlier this month extended to June 15 a deadline for the state railway to submit a concrete takeover offer, following a request from Alitalia's administrators for more time.   Italy's state railway Ferrovie dello Stato (FS) floated a bid to buy Alitalia at the end of October, but it does not want to hold more than 30 percent in the airline.   The railway has been discussing a potential partnership with Atlanta-based Delta airlines, which is interested in a 15-percent stake.
Date: Sun, 19 May 2019 21:55:33 +0200

Giza, Egypt, May 19, 2019 (AFP) - A bomb blast hit a tourist bus near Egypt's famed Giza pyramids on Sunday, wounding some of them, including South Africans, in the latest blow to the country's tourism industry.   The roadside bomb went off as the bus was being driven in Giza, also causing injuries to Egyptians in a nearby car, medical and security sources said.   Security and medical sources in Egypt said 17 people were injured, without giving a breakdown of their nationalities. No deaths were reported.   South Africa said in a statement that the "bus explosion" injured three of its 28 citizens who were part of the tourist group.   They would remain in hospital while the rest would return home on Monday, said the statement from the department of international relations.   "A device exploded and smashed the windows of a bus carrying 25 people from South Africa and a private car carrying four Egyptians," the security source said.

Video footage captured by AFP showed the bus and car with broken windows on the side of the road.   According to the security source, the wounded were being treated for scratches caused by the broken glass.   Sunday's incident comes after three Vietnamese holidaymakers and their Egyptian guide were killed when a roadside bomb hit their bus as it travelled near the Giza pyramids outside Cairo in December.   It also comes just little more than a month before the African Cup of Nations hosted by Egypt is to kick off.   Egypt has been battling an insurgency that surged especially in the turbulent North Sinai region following the 2013 military ouster of Islamist president Mohamed Morsi, who was replaced by former army general Abdel Fattah al-Sisi.   In February 2018, the army launched a nationwide operation against militants, focusing mainly on the North Sinai region.

- Tourism recovery -
Some 650 militants and around 45 soldiers have been killed since the start of the offensive, according to separate statements by the armed forces.   Since first being elected in 2014, Sisi has presented himself as a bulwark against terrorism, promising stability and increased security.   Recently, the country's vital tourism industry has started to slowly rebound after suffering strong blows due to deadly attacks targeting tourists following the turmoil of the 2011 uprising that toppled longtime ruler Hosni Mubarak.   Figures by the official statistics agency showed that tourist arrivals reached 8.3 million in 2017, compared with 5.3 million the previous year.    Authorities have gone at great lengths to lure tourists back, touting a series of archaeological finds and a new museum next to the pyramids, as well as enhanced security at airports and around ancient sites.    But that figure was still far short of the record influx of 2010 when more than 14 million visitors flocked to see the country's sites.
Date: Sun, 19 May 2019 05:17:37 +0200

Tegucigalpa, May 19, 2019 (AFP) - Four Canadians and an American pilot died Saturday when their small plane plunged into the sea off the Honduran island of Roatan where they were vacationing, firefighters said.   The plane crashed near the town of Dixon Cove, a few minutes after taking off from the island's airport, rescuers said.   The dead were identified as Bradley Post, Bailey Sony, Tomy Dubler and pilot Patrick Forseth.

The other Canadian pilot, Anthony Dubler, briefly survived the crash but died at the Roatan hospital of his injuries.   The causes of the crash and the registration information for the aircraft were not immediately available.   It occurred as the tourists were headed toward the city of Trujillo, about 77 kilometres (48 miles) from Roatan.
Date: Fri, 17 May 2019 16:32:13 +0200

London, May 17, 2019 (AFP) - London warned British-Iranian dual nationals against all travel to Iran on Friday due to Tehran's "continued arbitrary detention and mistreatment" of such citizens.   The move comes as Britain continues to try to secure the release from jail of dual national Nazanin Zaghari-Ratcliffe.   Tehran has also recently sentenced an Iranian British Council employee, Aras Amiri, to 10 years in prison on charges of spying.   In a statement, the Foreign Office said British-Iranian dual nationals faced an "unacceptably higher risk of arbitrary detention and mistreatment" than nationals of other countries.   "The security forces may be suspicious of people with British connections, including those with links to institutions based in the UK, or which receive public funds from, or have perceived links to, the British government," the statement said.   British-Iranian mother Zaghari-Ratcliffe was arrested by Iranian authorities in 2016 as she was leaving Tehran.

Zaghari-Ratcliffe, who worked for the Thomson Reuters Foundation, was put on trial and is now serving a five-year jail sentence for allegedly trying to topple the Iranian government.   "Dual nationals face an intolerable risk of mistreatment if they visit Iran," Foreign Secretary Jeremy Hunt said.   "Despite the UK providing repeated opportunities to resolve this issue, the Iranian regime's conduct has worsened.   "Having exhausted all other options, I must now advise all British-Iranian dual nationals against travelling to Iran.   "The dangers they face include arbitrary detention and lack of access to basic legal rights, as we have seen in the case of Nazanin Zaghari-Ratcliffe, who has been separated from her family since 2016."   The Iranian government does not recognise dual nationality, meaning the Foreign Office's ability to provide consular support is limited.   Hunt added: "Regrettably, I must also offer a message of caution to Iranian nationals resident in the UK -- but who return to visit family and friends -- especially where the Iranian government may perceive them to have personal links to UK institutions or the British government."
Date: Fri, 17 May 2019 11:42:01 +0200

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

Food and medical services have been extended to those stranded, she added.   Farming land in the district known for its rice production has also been inundated, destroying crops and raising fears of food shortages in coming months.   In April 2018 at least 14 people were killed in torrential rains and flooding in Dar es Salaam, Tanzania's economic capital.
Date: Thu, 16 May 2019 23:41:35 +0200

Washington, May 16, 2019 (AFP) - The Church of Scientology said Thursday all the passengers from a cruise ship that was quarantined over a measles case had been cleared to leave.    "All passengers and crew (100%) of the Freewinds have been fully cleared of any possible risk of being infected by the measles or infecting others," the organization said in a statement.   "All passengers and crew are free to come and go as they wish," a spokesman added to AFP.

The infected individual was a member of the crew who, according to the Church, had fully recovered and was given a clean bill of health a week ago. She had been earlier confined on the ship.   The ship, which is based in Willemstad on the island of Curacao in the Dutch West Indies, was quarantined after its arrival in Saint Lucia on April 30.   It remained there for two days before returning to Willemstad on May 4 where local authorities ordered a fresh quarantine to give them time to confirm the passengers were either immunized or had no risk of contracting the virus.
Date: Thu, 16 May 2019 18:37:39 +0200

Bamako, May 16, 2019 (AFP) - Heavy floods claimed 15 lives Thursday in the Malian capital Bamako along with serious property damage, authorities said.   A statement said the flooding claimed a "provisional toll" of 15 dead and two injured.   "Teams are in place to rescue the distressed people," the government said, calling on residents to be "prudent" in the face of the disaster.   Flooding is common in Mali, located in the semi-desert Sahel region.
Date: Thu, 16 May 2019 04:40:13 +0200
By Ashraf KHAN

Rato Dero, Pakistan, May 16, 2019 (AFP) - Parents nervously watch as their children wait to be tested for HIV in a village in southern Pakistan, where hundreds of people have been allegedly infected by a doctor using a contaminated syringe.   Dispatched to keep order, police scan the anxious crowd as families hustle into one of five different screening rooms set up in the last month in the village of Wasayo, on the outskirts of Larkana in Sindh province.

Health officials say more than 400 people, many of them children, have tested HIV positive in recent weeks as experts warn of a surge in infection rates across Pakistan, due to the use of unsanitary equipment and rampant malpractice -- often at the hands of quack doctors.   Anger and fear continue to swell in the desperately poor village hit hard by the epidemic, which authorities say could be linked to either gross negligence or malicious intent by a local paediatrician.   "They are coming by the dozens," says a doctor at the makeshift clinic, beset by a lack of equipment and personnel to treat the surging number of patients.

Mukhtar Pervez waits anxiously to have her daughter tested, worrying a recent fever may be linked to the outbreak. For others, their worst fears have already become a reality.   Nisar Ahmed arrived at the clinic in a furious search for medicine after his one-year-old daughter tested positive three days earlier.   "I curse [the doctor] who has caused all these children to be infected," he says angrily.   Nearby Imam Zadi accompanies five of her children to be examined after her grandson tested positive.   "The entire family is so upset," she tells AFP.   Others worry their children's futures have been irreparably harmed after contracting HIV, especially in a country whose masses of rural poor have little understanding of the disease or access to treatment.   "Who is she going to play with? And when she's grown up, who would want to marry her?" asks a tearful mother from a nearby village, who asked not to named, of her four-year-old daughter who just tested positive.  

- 'Helpless'-
Pakistan was long considered a low prevalence country for HIV, but the disease is expanding at an alarming rate, particularly among intravenous drug users and sex workers.    With about 20,000 new HIV infections reported in 2017 alone, Pakistan currently has the second fastest growing HIV rates across Asia, according to the UN.   Pakistan's surging population also suffers the additional burden of having insufficient access to quality healthcare following decades of under-investment by the state, leaving impoverished, rural communities especially vulnerable to unqualified medical practitioners.    "According to some government reports, around 600,000 quack doctors are operating across the country and around 270,000 are practicing in the province of Sindh," said UNAIDS in a statement.

Provincial health officials have also noted that patients are at particular risk of contracting diseases or viruses at these clinics, where injections are often pushed as a primary treatment option.   "For the sake of saving money, these quacks will inject multiple patients with a single syringe. This could be the main cause of the spread of HIV cases," said Sikandar Memon, provincial programme manager of the Sindh Aids Control Programme.

The large number of unqualified doctors along with the "reuse of syringes, unsafe blood transfusions, and other unsafe medical practices" have all led to the spike in HIV cases in recent years, explains Bushra Jamil, an expert on infectious diseases at the Aga Khan University in Karachi.   "Rampant medical malpractices without any effective checks and balances are causing repeated outbreaks in Pakistan," said Jamil.   Authorities investigating the outbreak in Sindh say the accused doctor has also tested positive for HIV.

From a ramshackle jail cell in the nearby city of Ratodero, he denied the charges and accusations he knowingly injected his patients with the virus, while complaining of being incarcerated with common criminals.   But for the parents of the newly diagnosed, the ongoing investigation means little if they are unable to secure access to better information and the necessary drugs that can help stave off the deadly AIDS virus.   "We are helpless. I have other children and I am afraid they might catch the disease," says another mother whose daughter recently tested positive for HIV.   "[Please] send some medicine for our children so that they can be cured. If not, all of our children will die, right?"