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Andorra

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

Travel News Headlines WORLD NEWS

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

No Profile is available at present

Travel News Headlines WORLD NEWS

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Travel News Headlines WORLD NEWS

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Libya

Libya - US Consular Information Sheet
August 13, 2008
COUNTRY DESCRIPTION:
Officially known as the Great Socialist People's Libyan Arab Jamahiriya, Libya has a developing economy. Islamic ideals and beliefs provide the conservative foundat
on of the country's customs, laws, and practices. Tourist facilities are not widely available. Read the Department of State Background Notes on Libya for more information.

ENTRY/EXIT REQUIREMENTS:
Passports and visas are required. The restrictions on the use of U.S. passports for travel to, in, or through Libya were lifted in February 2004. Please see the section below on Special Circumstances.
Without prior notice, the Libyan government on November 11, 2007 “reinstated” a requirement that all foreign travelers must have an Arabic translation of their personal biographic data added to their passport in order to apply for a Libyan visa, or to enter Libya. This requirement includes foreigners who already received visas before the requirement was put into place, including those foreigners currently resident in Libya. Since that date, foreign travelers whose passports do not have Arabic translations have been denied entry into Libya or refused boarding by airlines on flights into Libya.
The U.S. passport is a U.S. travel document that meets all generally recognized international standards. While the Libyan government has the right to impose its own requirements for travelers in connection with obtaining a Libyan visa, it also has the responsibility to give travelers information on where and how to meet these requirements. Travelers should be aware that in some cases, Libyan officials may ask that U.S. citizens obtain translations from U.S. Government-approved translation services. However, U.S. consular officers have no authority to designate or certify private translations; nor do they have authority to place a consular authentication stamp over a privately-obtained translation.

American citizens who hold Libyan visas or who intend to apply for a visa are advised to contact the nearest Libyan embassy or consulate for information on how to obtain an acceptable translation. Information from Libyan embassies and consulates may differ from country to country. American citizens may also contact the Consular Section at the U.S. embassy or consulate for additional information.
The Government of Libya does not allow persons with passports bearing an Israeli visa or entry/exit stamps to enter the country. At this time, neither Libya nor the U.S. provides visa services to the general public in each other’s countries; U.S. visitors to Libya should therefore plan to obtain a visa via a third country. Libyan visas require an invitation or sponsor, can take up to several months to process, and should be obtained prior to travel. All visas are vetted and approved by immigration departments in Tripoli and only issued by the appropriate Libyan Embassy upon receipt of that approval. There may be another wait for actual visa issuance once approval has been received. For tourists, the visa application procedure in most cases requires a letter of invitation from an accredited tour company in Libya; for business travelers, a letter of invitation is needed from the Libyan business entity. Americans who apply for Libyan visas are experiencing significant delays, often waiting several weeks or months if their applications are approved at all. Inconsistent Libyan visa practice is subject to change without notice and visa service to American citizens is often blocked without warning. With few exceptions, Libya has stopped issuing tourist visas to Americans. It is recommended that Americans always obtain individual Libyan visas prior to travel, rather than group visas. Americans who expected to enter on group tour visas or individual airport visas arranged by Libyan sponsors have routinely been denied entry at the air and sea ports and have been forced to turn back at the airport or remain onboard ship at the port while other nationals disembark. The U.S. Embassy in Tripoli cannot provide assistance to American citizens seeking Libyan visas.
Inquiries about obtaining a Libyan visa may be made through the Libyan Embassy in Washington, D.C. The Embassy is located at 2600 Virginia Avenue NW – Suite 705, Washington, DC 20037, phone number 202-944-9601, fax number 202-944-9606, website www.libyanbureau-dc.org. Neither the Libyan Mission to the UN in New York nor the Libyan Embassy in Washington, DC accepts visa applications from the general public. The closest Libyan visa-issuing office to the continental United States is the Libyan People’s Bureau in Ottawa, Canada; however, that office frequently declines to accept visa applications from American citizens. The land borders with Egypt and Tunisia are subject to periodic closures even to travelers with valid Libyan visas. Short-term closures of other land borders may occur with little notice. Within three days of arrival, visitors must register at the police station closest to where they are residing or they may encounter problems during their stay or upon departure.
Women and children in Libya are often subject to strict family controls.
This can be a particular problem for young single women of marriageable age. Although a woman does not need her father’s or husband's explicit consent every time she wishes to leave Libya, a Libyan husband may take legal action to prevent his wife from leaving the country, regardless of her nationality. While not illegal, it is unusual for women and children to travel alone. Children under 18 whose fathers are Libyan must have the father's permission to depart Libya, even if the mother has been granted full custody by a Libyan court.
The Libyan Government requires all its citizens, including dual nationals of Libyan descent, to enter and depart Libya on Libyan documents. In some cases American citizens of Libyan descent have entered Libya on old or expired Libyan identity document and then discovered that they cannot depart Libya without obtaining a valid Libyan passport, which can be a cumbersome process.
Information about dual nationality or the prevention of international child abduction can be found on our web site.
For further information about customs regulations, please read our Customs Information sheet.

SAFETY AND SECURITY: As Libya has taken steps to cooperate in the global war on terrorism, the Libyan Government’s designation as a state sponsor of terrorism was rescinded on June 30, 2006. Recent worldwide terrorist alerts have stated that extremist groups continue to plan terrorist attacks against U.S. interests in the region. Therefore, any American citizen who decides to travel to Libya should maintain a strong security posture by being aware of surroundings, avoiding crowds and demonstrations, keeping a low profile, and varying times and routes for all required travel.
Security personnel may at times place foreign visitors under observation. Hotel rooms, telephones, and fax machines may be monitored, and personal possessions in hotel rooms may be inspected. Taking photographs of anything that could be perceived as being of military or security interest may result in problems with the authorities.
For the latest security information, Americans traveling abroad should regularly monitor the Department of State, Bureau of Consular Affairs’ website at http://travel.state.gov, where the current Travel Warnings and Travel Alerts, as well as the Worldwide Caution, can be found.

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

The Department of State urges American citizens to take responsibility for their own personal security while traveling overseas.
For general information about appropriate measures travelers can take to protect themselves in an overseas environment, see the Department of State’s pamphlet A Safe Trip Abroad.
CRIME: Crime against foreigners is a growing problem in Libya. The most common types of crime are property crimes of opportunity, to include vehicle burglaries. Pick-pocketing and residential burglaries are also on the increase. Women routinely face verbal harassment. While physical violence is not common, there have been instances of assault against women. These assaults can range from sexual groping or assault/battery, to attempted rape.

In many countries around the world, counterfeit and pirated goods are widely available. Transactions involving such products may be illegal under local law. In addition, bringing them back to the United States may result in forfeitures and/or fines. More information on this serious problem is available at http://www.cybercrime.gov/18usc2320.htm
INFORMATION FOR VICTIMS OF CRIME:
The loss or theft abroad of a U.S. passport should be reported immediately to the local police and the nearest U.S. Embassy or Consulate.
If you are the victim of a crime while overseas, in addition to reporting to local police, please contact the nearest U.S. Embassy or Consulate for assistance.
The Embassy/Consulate staff can, for example, assist you to find appropriate medical care, contact family members or friends and explain how funds could be transferred.
Although the investigation and prosecution of the crime is solely the responsibility of local authorities, consular officers can help you to understand the local criminal justice process and to find an attorney if needed.

The local equivalent to the “911” emergency line in Libya is: 193.
This number is generally monitored only in Arabic.
See our information on Victims of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION:
While some health care providers have been trained in the United States or Europe, basic modern medical care and/or medicines may not be available in Libya. Many Libyan citizens prefer to be treated outside of Libya for ailments such as heart disease and diabetes. A representative list of healthcare providers is available at the U.S. Embassy Tripoli’s web site at http://libya.usembassy.gov/medical_information.html.

Information on vaccinations and other health precautions, such as safe food and water precautions and insect bite protection, may be obtained from the Centers for Disease Control and Prevention’s hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747) or via the CDC’s website at http://wwwn.cdc.gov/travel/default.aspx.
For information about outbreaks of infectious diseases abroad consult the World Health Organization’s (WHO) website at http://www.who.int/en.
Further health information for travelers is available at http://www.who.int/ith/en.
Some HIV/AIDS entry restrictions exist for visitors to and foreign residents of Libya.
All positive HIV/AIDS tests made in country must be reported to the government.

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

Paved roads in rural areas are satisfactory; however, many rural roads are unpaved (i.e. dirt roads). Also, major highways along the seacoast and leading south merge into single-lane highways once they are outside the cities. These roads are heavily trafficked and precarious to navigate, especially at night and during the winter rainy season. The presence of sand deposits, and domestic and wild animals that frequently cross these highways and rural roads, makes them even more hazardous.

Availability of roadside assistance is extremely limited and offered only in Arabic. In urban areas and near the outskirts of major cities there is a greater possibility of assistance by police and emergency ambulance services, although they are usually ill equipped to deal with serious injuries or accidents.

Driving in Libya may be hazardous, and there is a high accident rate. Police enforcement of traffic signs and laws is rare. As a result, it is often difficult to anticipate the actions of other drivers on Libyan streets and highways. Wind-blown sand can reduce visibility without warning. Road conditions are poor, and public transportation, which is limited to occasional bus service, is poor. Taxis are available, but many taxi drivers are reckless and untrained, and English-speaking drivers are extremely rare.
The sidewalks in urban areas are often in bad condition and cluttered, but pedestrians are able to use them.

Please refer to our Road Safety page for more information.

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

SPECIAL CIRCUMSTANCES: Libya's economy operates on a “cash-only" basis for most transactions, even though U.S. law now permits the use in Libya of credit cards and checks drawn on U.S. banks. Some hotels, restaurants, and major airlines are the only businesses known to accept credit cards (Visa more often than MasterCard). It is recommended that travelers consult their credit card entity prior to travel to ensure that transactions from Libya can be accepted by that entity. A very limited number of ATM machines are being put into service at a few large hotels, major office complexes, the airport, and one or two markets. Service is sporadic and sometimes unreliable. Foreign visitors should be aware that the penalties for use of unauthorized currency dealers are severe. Foreign visitors should also be aware that their passports might be confiscated in business disputes and/or they may not be permitted to depart Libya until the dispute has been settled. The workweek is Sunday-Thursday. Most U.S. economic sanctions against Libya were terminated effective September 21, 2004. For further information, please contact the Office of Foreign Assets Control at http://www.treas.gov/offices/enforcement/ofac/.
On June 30, 2006, the U.S. Department of State officially rescinded Libya’s designation as a State Sponsor of Terrorism. On August 31, 2006, the U.S. Commerce Department’s Bureau of Industry and Security (BIS) published an amendment to the Export Administration Regulations (EAR) in the Federal Register. This amendment updated BIS’ license requirements for Libya under the EAR due to its removal from the State Sponsors’ List. For further information specific to Libya, contact BIS’ Office of Nonproliferation and Treaty Compliance/Foreign Policy Controls Division at (202) 482-4252. Libya-related information is also found on the BIS web site: http://www.bis.doc.gov/PoliciesAndRegulations/regionalconsiderations.htm.
Libyan customs authorities enforce strict regulations concerning the introduction into Libya or removal from Libya of firearms, religious materials, antiquities, medications, and currency. Importation of pornographic materials is illegal. The importation and consumption of alcohol and pork products are illegal in Libya. At times, passengers arriving in Libya have been required to bring varying amounts of convertible currency into Libya.
This requirement is subject to a border check, and the passenger faces possible deportation if this requirement is not met. It is advisable to contact any Libyan Embassy abroad for specific information regarding customs requirements. Please see our Customs Information.
In addition to being subject to all Libyan laws, U.S. citizens of Libyan origin may also be subject to other laws that impose special obligations on Libyan citizens.
The Government of Libya considers all children born to Libyan fathers to be Libyan citizens even if they were not issued a Libyan birth certificate or a passport. Dual Libyan-American nationals may not enter and leave Libya on their U.S. passports, and must obtain a Libyan travel document before traveling to Libya.
Persons with dual nationality who travel to Libya on their Libyan passports are normally treated as Libyan citizens by the local government.
The ability to provide U.S. consular assistance to those traveling on Libyan passports is extremely limited.
For additional information, please see our dual nationality flyer.

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

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

REGISTRATION / EMBASSY LOCATION:
Americans living or traveling in Libya are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department’s travel registration website so that they can obtain updated information on travel and security within Libya.
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 Consular Section of U.S. Embassy is located in the Seraj District of Tripoli.
Their phone number is (+218) 91-220-0125.
This number may also be used for emergencies after-hours by American citizens. General information, including forms, is available on the U.S. Embassy’s web site at http://libya.usembassy.gov/.
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This replaces the Country Specific Information for Libya dated January 16, 2008, to update the sections on Entry/Exit Requirements, Crime, Medical Facilities and Health Information, Traffic Safety and Road Conditions, and Special Circumstances.

Travel News Headlines WORLD NEWS

Date: Thu, 26 Dec 2019 20:35:51 +0100 (MET)

Tripoli, Dec 26, 2019 (AFP) - An air strike Thursday on a shopping area during rush hour near Libya's capital killed at least two civilians and wounded 20 others, a local official said.   The air strike on the town of Zawiya, 45 kilometres (30 miles) west of Tripoli, hit a pharmacy, a bakery and cars parked on the street, the mayor of the town, Jamal Baher, told AFP.   "Two people were killed and 20 others were wounded," he said.   The air strike took place as the area was busy with shoppers ahead of the weekend, which starts Friday in the North African country.   It comes amid fighting between the Tripoli-based, UN-recognised Government of National Accord (GNA) and rival forces answering to strongman Khalifa Haftar, who is based in the country's east.

Tensions have further spiked in recent weeks as Turkey said it could deploy troops in Libya to support the GNA.   Earlier on Thursday, GNA Interior Minister, Fathi Bashaga, said his government may officially seek Turkish military support to counter an offensive on Tripoli launched by Haftar in April.   Haftar has "provided foreign forces with military bases in Libya," Bashagha told journalists in the Tunisian capital Tunis.   "If this position continues, we have the right to defend Tripoli and we will officially ask the Turkish government for its military support," he added.   Turkish President Recep Tayyip Erdogan, who is in Tunisia to discuss the conflict in Libya, said his country's parliament will vote in January on a motion to send troops to Libya to support the GNA.   "God willing, we will pass it in parliament on January 8-9 and thus respond to an invitation" from the GNA, said Erdogan.

His comments come after the Turkish parliament on Saturday ratified a security and military cooperation deal with the GNA.   Libya was plunged into chaos with the toppling and killing of longtime dictator Moamer Kadhafi in a 2011 NATO-backed uprising.    It has since become divided between two main camps: the GNA and a rival administration in the country's east, backed by Haftar.   The GNA on Thursday accused Haftar's forces of carrying out the deadly air strike on Zawiya.   There was no immediate comment from Haftar's self-styled Libyan National Army.   At least 284 civilians have been killed and 363 wounded since Haftar launched his offensive to seize Tripoli, according to UN figures. Tens of thousands have been displaced from their homes.
Date: Sun 13 Oct 2019
Source: Libya Observer [edited]

150 persons with leishmaniasis disease arrived in Tawergha hospital on Friday [11 Oct 2019], and the number of affected people is increasing, the hospital said.

On Facebook, the hospital called on all medical staffers from all across Libya to provide assistance to the hospital in Tawergha to treat the patients with leishmaniasis.

Member of Tawergha local council Abdelnabi Abu Araba said Saturday [12 Oct 2019] that 500 leishmaniasis cases have been registered in the city since last July [2019]. He told reporters that the leishmaniasis cases started after the people of Tawergha returned to their city in July 2018, saying 410 cases were registered since last year [2018] and 500 from July to October 2019, adding that sewage water across the city is behind the disease.

Abu Araba called on the residents not to take heed of media reports that urge them to leave the city, saying fighting this disease needs the people to remain in their locations to get treatment.

He indicated that public service companies are removing garbage to terminate the rodents that cause leishmaniasis, calling on the Health Ministry to speed up repairing the hospitals in Tawergha so people can receive medical care.

Last Sunday, the Anti-Disease National Center said it had started distributing medical treatment for leishmaniasis across Libya.  [Byline: Abdulkader Assad]
==================
[We assume that these are cases of cutaneous leishmaniasis [CL].  CL is caused by the protozoan leishmania parasite, which is transmitted by sandflies. Outbreaks occur when vector and reservoir control activities break down, as is the case in Tawergha (see sections below).

Zoonotic CL is endemic in Libya, with sporadic outbreaks. In 2006, over 7000 cases were recorded in 8 districts, with an outbreak of 3961 cases in Misratah, and the disease spread to non-endemic areas (el-Buni AA et al. (2000). "Cutaneous leishmaniasis in the Libyan Arab Jamahiriya: a study of the Yafran area. East Mediterr Health J 2000;6:884-7).

In 2009, the prevalence of CL was 7.1 per 10,000 population. There is a vector control program that involves insecticide spraying, and regular rodent control is performed (Alvar J. et al. Leishmaniasis Worldwide and Global Estimates of Its Incidence. PLoS One. 2012; 7(5): e35671, supporting file S54).

From other reports about the Tawergha displaced populations, it appears that the residents have been returning only sporadically to Tawergha since 2018 due to a blockade and intimidation by Misratah militias and that the local infrastructure has been destroyed (<https://www.hrw.org/news/2019/01/24/libya-displaced-population-cant-go-home>).

Tawargha is, as of August 2011, a ghost town in Libya that is under administrative jurisdiction of the city of Misratah, which is 38 km away. It was the site of intense fighting during the Libyan Civil War before its capture and ethnic cleansing by anti-Gaddafi forces in August 2011. By the end of the war in October 2011, the town was largely cleared of its population by NTC militias (<https://en.wikipedia.org/wiki/Tawergha>). - ProMED Mod.EP]

[HealthMap/ProMED map available at:
Misratah District, Libya: <http://healthmap.org/promed/p/5116>]
Date: Thu, 15 Aug 2019 15:36:40 +0200 (METDST)

Tripoli, Aug 15, 2019 (AFP) - Flights at the Libyan capital's sole functioning airport were suspended Thursday after deadly overnight rocket fire, a spokesman for the country's unity government said.   Wednesday night's rocket fire "killed a guard and wounded several security agents tasked with protecting the airport," said Moustafa al-Mejii, spokesman for the Tripoli-based Government of National Accord (GNA).   He blamed the attack on "the militias of (Khalifa) Haftar" whose forces launched an offensive on the Libyan capital in April.   Arrivals and departures at Mitiga airport were suspended as a result, Mejii said.   Located east of Tripoli, Mitiga is a former military airbase that has been used by civilian traffic since Tripoli international airport suffered severe damage during fighting in 2014.

Mitiga is in a zone under the control of forces loyal to the GNA and has often been targeted, leading to repeated suspensions of flights.   United Nations envoy Ghassan Salame, in a report to the UN Security Council last month, urged "authorities in Tripoli to cease using the (Mitiga) airport for military purposes and for the attacking forces to halt immediately their targeting of it."   The GNA protested at what it said were "untruths" in the envoy's report.   Haftar's self-styled Libyan National Army (LNA) has encountered fierce resistance from pro-government forces in the battle for Tripoli.   A stalemate on the ground in the capital's southern outskirts has led to a greater reliance on air strikes by both sides.

The fighting since April has killed 1,093 people and wounded 5,752 others, according to the World Health Organization.   More than 120,000 people have been displaced.   The LNA said Thursday its air force carried out a strike against an airfield in Zuwara, a town west of Tripoli, and destroyed two hangars allegedly used to house Turkish drones.   "The runway and terminals were spared" at the airfield, which is not open to commercial flights, LNA spokesman General Ahmed al-Mesmari wrote on Facebook.   The GNA, however, posted pictures of a huge crater and debris on the tarmac.   Libya has been mired in chaos since a NATO-backed uprising that toppled and killed dictator Moamer Kadhafi in 2011.
Date: Wed, 3 Jul 2019 21:54:46 +0200

Tripoli, July 3, 2019 (AFP) - The Libyan capital's only functioning airport suspended flights on Wednesday after an air raid claimed by strongman Khalifa Haftar's forces, airport authorities said in a statement.   The attack did not cause casualties or damage, a security source at Mitiga airport said.   But Ahmad al-Mesmari, a spokesman for Haftar's self-styled Libyan National Army, said that a "command centre for drones at Mitiga" was destroyed in the raid.

Haftar launched an offensive in early April to take the capital Tripoli, seat of the rival Government of National Accord.   The GNA is recognised by the international community.   Over the past three months his self-styled Libyan National Army (LNA) has repeatedly targeted Mitiga airport.   It says it is targeting "Turkish drones" which it claims take off from Mitiga to carry out strikes on LNA forces south of Tripoli.

On Sunday the LNA said it had destroyed a Turkish drone in a strike on Mitiga, which prompted aviation authorities to temporarily suspend flights there.   Haftar's forces, which hold much of eastern and southern Libya, last month lost a key town to forces loyal to the unity government in an operation the strongman has accused Ankara of backing.   Afterwards Haftar ordered his forces to target Turkish companies, ban flights and arrest Turkish nationals in Libya, his spokesman said Friday.
WorldHealthOrganizationNews@who.int
Thu 09/05/2019 12:26
http://www.emro.who.int/lby/libya-news/who-denounces-attack-on-health-workers-and-ambulance-in-libyan-capital.html

Tripoli, 9 May – The World Health Organization today condemned in the strongest terms an attack on an ambulance in Tripoli, Libya, on Wednesday 8 May, that left 3 health workers injured, one severely.

“This attack on an ambulance with visible logos is a shocking and intolerable violation of international humanitarian law,” said Dr Syed Jaffar Hussain, WHO Representative in Libya. “Not only did this attack injure key personnel, but the ambulance itself was taken away, thereby depriving patients of future care.”

Since the conflict in Libya escalated in early April, 11 additional ambulances have been impacted or suffered collateral damage. In April, 3 health workers were killed in Tripoli, and numerous first-line responders have struggled to reach the wounded without being injured themselves. As the conflict continues into its second month, more than 400 people have died and over 2000 have been wounded.

WHO has been supporting field hospitals and field ambulance teams in Libya since the beginning of the conflict. The Organization has also deployed emergency medical teams to key referral hospitals to perform surgeries in hospitals in and around Tripoli. WHO is also providing health facilities with medical supplies, including trauma kits with medicines for war injuries.

“This flagrant breach of the basic rules of warfare could jeopardize the operations of field hospitals and ambulance teams, and deter dedicated health staff from performing their life-saving duties,” said Dr Ahmed Al-Mandhari, WHO’s Regional Director for the Eastern Mediterranean. “WHO cannot accept any actions that put health workers in harm’s way. Health staff in Libya are working to save lives and must be allowed to work without additional risk to their safety or well-being.”
More ...

Martinique

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

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

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

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

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

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

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

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

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

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

See our information on Victims of Crime.

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

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

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

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

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

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

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

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

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

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

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

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

REGISTRATION / EMBASSY LOCATION:
Americans living or traveling in the French West Indies are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department's travel registration web site, and to obtain updated information on travel and security within the French West Indies. Americans without Internet access may register directly with the U.S. Embassy in Barbados, which has jurisdiction over the French West Indies. By registering, American citizens make it easier for the Embassy or Consulate to contact them in case of emergency. The U.S. Embassy is located in Wildey Business Park in St. Michael, Barbados; web site: http://barbados.usembassy.gov/.

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

Travel News Headlines WORLD NEWS

Date: Tue, 19 Sep 2017 00:01:29 +0200
By Amandine ASCENSIO with Jean-Philippe LUDON in Fort-de-France

Pointe-à-Pitre, Sept 18, 2017 (AFP) - Islands in the Caribbean still reeling from megastorm Irma braced Monday for a fresh battering as Hurricane Maria approached, wielding potentially lethal force.   In just a few hours, the US National Hurricane Center (NHC) hiked Maria from a Category Two to a Category Four hurricane, packing winds of 130 miles (209 kilometres) per hour that it forecast would strengthen further over the next day or so.

"Potentially life-threatening" storm surges, destructive waves, flash floods and mudslides threatened the Leeward Islands -- the island group that includes Martinique, Puerto Rico and the US and British Vigin islands -- the NHC said.   "The eye and the intense inner core is expected to pass near Dominica in the next few hours," the center warned in its 2100 GMT bulletin, describing Maria as "an extremely dangerous major hurricane".   The French Caribbean island of Guadeloupe -- the bridgehead for aid for Irma-hit French territories -- ordered all at-risk zones to be evacuated.

The order, effective from 4pm local time, bars specific areas considered to be at risk of "flooding, submersion and landslips," according to the statement, issued by the island's prefect.   Islanders on Martinique, which is also part of France, were ordered to stay indoors under a maximum-level "violet" alert.   As heavy rain beat down, energy supplier EDF said power had been cut off from 16,000 homes on Martinique, which has a population of some 400,000.   Dominica, St Kitts and Nevis, St Lucia and the British island of Montserrat are also on alert.

In Pointe-a-Pitre, Elodie Corte, the boss of a metalworking company, said there had been frantic preparations to limit the damage from the storm.   "We spent the morning strapping down the aluminium to stop it from flying away if the winds are strong," she said.   But she worried that the torrential rains forecast could flood her home.   "We'll seal everything as tightly as we can and then we'll certainly go and stay with friends for the night," she said.

- 'Worst-case scenario' -
Criticised for the pace of relief efforts in their overseas territories devastated by Irma, Britain, France and the Netherlands said they were boosting resources for the Caribbean as Maria approaches.   "We are planning for the unexpected, we are planning for the worst," said Chris Austin, head of a UK military task force set up to deal with Irma, as the British Virgin Islands readied for the storm.

On the island of St Martin, which is split between France and the Netherlands, authorities announced a red alert ahead of Maria's arrival.    "We're watching its trajectory very closely, and we're preparing for the worst-case scenario," said local official Anne Laubies.   The Dutch navy tweeted that troops were heading to the two tiny neighbouring islands of Saba and St Eustatius to ensure security following widespread complaints of looting and lawlessness on St Martin after the first hurricane.

French Interior Minister Gerard Collomb said 110 more soldiers would be deployed to the region to reinforce about 3,000 people already there shoring up security, rebuilding infrastructure and distributing aid.   But he warned of "major difficulties" if Guadeloupe is hard hit, noting the territory was "the logistical centre from where we could supply St Martin and organise all the airlifts".   Maria is due to sweep over the south of Sint Maarten -- as the Dutch side of St Martin is called -- on Tuesday. The island was among the worst hit by Irma, with 14 killed.   Air France, Air Caraibes and Corsair have cancelled flights in and out of Martinique and Guadeloupe.

- Hurricane series -
Irma, a Category 5 hurricane, left around 40 people dead in the Caribbean before churning west and pounding Florida, where at least 20 people died.   Irma broke weather records when it whipped up winds of 295 kilometres per hour for more than 33 hours straight.   Another hurricane, Jose, is also active in the Atlantic and has triggered tropical storm warnings for the northeastern United States.   Many scientists are convinced that megastorms such as Irma, and Harvey before it, are intensified by the greater energy they can draw from oceans that are warming as a result of climate change.
Date: Fri 14 Jul 2017
Source: WIC News[edited]

Grenada on alert over spread of 'red eye' outbreak, the number of medical consultations due to conjunctivitis during recent weeks was estimated at between 500 and 600 cases per week in Guadeloupe, and 150 to 250 cases per week in Martinique.

Outbreaks of viral conjunctivitis occur mainly in tropical countries with high population density and a hot, humid climate. Since the chikungunya outbreak a few years ago, Grenada has had an active surveillance and monitoring system that has proven to be effective in subsequent outbreaks, like that of the Zika virus.

The island's health ministry is encouraging people to take all necessary and preventative measures to avoid becoming infected. Red eye is very contagious -- it can easily be spread from person to person -- but it can be effectively treated at home.

The germs are passed on to others through hand-to-hand contact when hands are not washed after contact with discharge from an infected eye. Symptoms include redness or swelling of the white of the eye or inside the eyelid, watering eye and excess tears, increased sensitivity to light, and pus or discharge from the eyelids which result in eyelids being stuck together.  [Byline: Joyce Loan]
===================
[Viral conjunctivitis, commonly known as pinkeye, is a common, self-limiting condition that is typically caused by adenovirus. Other viruses that can be responsible for conjunctival infection include herpes simplex virus (HSV), varicella-zoster virus (VZV), picornavirus (enterovirus 70, Coxsackie A24), poxvirus (molluscum contagiosum, vaccinia), and human immunodeficiency virus (HIV). Viral conjunctivitis is highly contagious, usually for 10-12 days from onset as long as the eyes are red. Patients should avoid touching their eyes, shaking hands, and sharing towels, napkins, pillow cases, and other fomites, among other activities. Transmission may occur through accidental inoculation of viral particles from the patient's hands or by contact with infected upper respiratory droplets, fomites, or contaminated swimming pools. The infection usually resolves spontaneously within 2-4 weeks (extracted from  <http://emedicine.medscape.com/article/1191370-overview>).

Treatment of adenoviral conjunctivitis is supportive. No evidence exists that demonstrates the efficacy of specific antiviral agents other than topical ganciclovir. A combination topical agent that contains betadine and low-dose dexamethasone is currently in confirmatory phase III clinical trials as a broad-spectrum agent for the treatment of adenovirus, HSV, VZV, and other forms of infectious conjunctivitis.

HealthMap/ProMED-mail maps can be found at:
Martinique: <http://healthmap.org/promed/p/528> - ProMED Mod.UBA]
Date: Fri, 20 May 2016 21:03:32 +0200

Fort-de-France, May 20, 2016 (AFP) - The French Caribbean island of Martinique has suffered its first Zika virus-related death, the regional health agency said Friday.   "The patient, aged 84, had been hospitalised for 10 days in intensive care with Guillain Barre Syndrome (GBS)," the agency said, adding that the Zika link came to light late last week.   Some experts believe there is a link between Zika and GBS -- in which the immune system attacks the nervous system.

Doctors tests found that "the death is directly linked to Zika with Guillain-Barre Syndrome associated with Zika as the initial cause," regional health authority ARS said.   "This death is the only one registered in Martinique since the start of the epidemic,"  the agency added.   Before the death, the French Caribbean overseas department had listed 19 patients as confirmed suffering from GBS, which has been linked with Zika, as has paralysis-causing myelitis.   Several cases of the virus have emerged from assumed GBS cases in Martinique's French Caribbean neighbour Guadeloupe as well as French Guyana.

Zika has been linked to birth defects and deaths in new-borns amid surging cases of neurological disorders and birth defects, notably in Brazil.   According to a World Health Organisation report earlier this year, more than 40 countries or territories have reported transmission of Zika within their borders since last year, and eight have reported an increase in Guillain-Barre cases.    Experts agree that Zika is behind a surge in cases of the birth defect microcephaly -- babies born with abnormally small heads and brains -- after their mothers were infected with the virus.

But it is not clear just to what extent the disease, for which there is no vaccine or treatment for Zika, is linked with GBS.   The ARS said that 1,770 people had contacted doctors between May 9 and 15 to ascertain if they might have the virus.   The first Zika-related death was in Brazil last November and two other deaths have followed.   Last week, Puerto Rican health authorities announced the first case of Zika-related microcephaly in a foetus, as the US territory grapples with the spread of the mosquito-borne virus.
Date: Tue, 22 Mar 2016 09:42:21 +0100

Paris, March 22, 2016 (AFP) - French authorities said Tuesday there was "a very strong suspicion" that the first case of microcephaly linked to the Zika virus had been detected on the Caribbean island of Martinique.    The case would be the first on French territory of microcephaly, a birth defect thought to be caused by Zika, the mosquito-borne virus that has spread rapidly through South America.

French Health Minister Marisol Touraine said a total of 130 pregnant women had been diagnosed with the Zika virus in the Antilles islands, which include Martinique, as well as French Guiana on the South American mainland.    "For one of them, we have elements that lead us to believe her baby has contracted microcephaly and that this microcephaly is directly linked to her infection with the Zika virus," said Touraine.
Date: Fri 28 Mar 2014
Source: The Global Dispatch [edited]

The number of confirmed and suspected chikungunya cases in the Caribbean continues to increase; in fact, some new cities on the islands of Martinique and Guadeloupe have reported cases for the 1st time, according to a European Centre for Disease Prevention and Control (ECDC) update today [28 Mar 2014].

To date, there have been 3211 confirmed/probable chikungunya cases reported in the region, including 5 deaths and 15 282 suspected cases.

In addition, a suspected outbreak is being reported in the Dominican Republic according to a Spanish language news source. According to Health Minister Freddy Hidalgo, more than 1000 patients since February 2014 have come to the medical centre with chikungunya-like symptoms. Samples have been sent to the US Centers for Disease Control and Prevention for confirmation. The report does note that there are no confirmed cases of chikungunya to date.
======================
[The presence of chikungunya virus transmission in these Caribbean islands is of economic significance because they are important tourist destinations, and loss of tourism could have serious adverse effects on the economy. If the Dominican Republic cases are confirmed as chikungunya virus infections, that could be especially adverse, because that country has the highest number of tourist stop-overs, with 3 840 761 in 2013. Cruise ship arrivals were highest in St. Maarten. Caribbean tourist stops can be seen at this same source (<http://www.onecaribbean.org/wp-content/uploads/DEC12Lattab13.pdf>).

Maps showing the location of the islands mentioned can be accessed at
(with case numbers as of 17 Mar 2014) and
<http://healthmap.org/r/9NLv>. - ProMed Mod.TY]
More ...

Guinea

Guinea US Consular Information Sheet
August 15, 2008
COUNTRY DESCRIPTION:
Guinea is a developing country in western Africa, with minimal facilities for tourism.
Travelers who plan to stay in Conakry, the capital, should make reservati
ns well in advance. French is the official language; Pular, Malinké, and Soussou are also widely spoken.
Read the Department of State Background Notes on Guinea for additional information.

ENTRY/EXIT REQUIREMENTS:
A passport, visa, international vaccination record (WHO card), and current yellow fever vaccination are required.
Travelers should obtain the latest information and details from the Embassy of the Republic of Guinea, 2112 Leroy Street, NW, Washington, DC
20008, tel. (202) 986-4300, fax (202) 478-3010.
The Guinean embassy does not maintain a current website. Overseas, inquiries should be made to the nearest Guinean embassy or consulate.
Overseas, inquiries should be made at the nearest Guinean embassy or consulate.

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

SAFETY AND SECURITY:
Since early 2008, there has been a constant threat of violent strikes and demonstrations in Guinea.
The price of gasoline increased by more than 60 percent in April 2008, squeezing already economically hard-pressed Guineans and increasing tension in the country.
Parliamentary elections scheduled for late 2008 could result in violence.

While U.S. citizens have not been targeted in past outbreaks of violence, being in the wrong place at the wrong time can be very dangerous.
During periods of civil unrest, public services such as transportation and medical care, as well as availability of goods and services, can be affected.
During many demonstrations, crowds of people gather and burn tires, create roadblocks, and damage vehicles by throwing rocks and bricks. The military has also been known to demonstrate and incite unrest due to their grievances with the government.
Because of the potential for violence, U.S. citizens should avoid large crowds, political rallies, and street demonstrations. They should also avoid sensitive government installations, including the Presidential Palace, official government buildings, and military bases.

U.S. citizens should maintain security awareness at all times. There are no known terrorist groups officially operating in the country.

Most border crossings are controlled jointly by Guinean armed forces, gendarmes, police and immigration officials.
A long land frontier and the military’s lack of physical and monetary resources, however, mean that borders are lightly patrolled. U.S. citizens considering travel to the border regions with Liberia, Sierra Leone or Côte d’Ivoire should consult the latest Travel Warnings and Country Specific Information for those countries (available at the Bureau of Consular Affairs' Web site at http://travel.state.gov) and contact the U.S. Embassy in Conakry for the latest travel and security information.
Crossing land borders requires visas and complete paperwork, and can be difficult.

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

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

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

CRIME:
In Conakry, as in many large cities, crime is a fact of daily life.
Residential and street crime is very common.
Sentiments toward Americans in Guinea are generally positive, but criminals regularly target foreigners, including Americans, because they are perceived as lucrative targets.
Nonviolent and violent crimes are a problem.
The majority of nonviolent crime involves acts of pick pocketing and purse snatching, while armed robbery, muggings, and assaults are the most common violent crimes.
In spite of good intentions, the police have been unable to prevent the rapid escalation of crime.
There have also been cases of direct and indirect requests for bribes from the police and military officials. Criminals particularly target visitors at the airport, in the traditional markets, and near hotels and restaurants frequented by foreigners.
Visitors should avoid unsolicited offers of assistance at the airport and hotels because such offers often mask an intention to steal luggage, purses, or wallets. Travelers should arrange for hotel personnel, family members, or business contacts to meet them at the airport to reduce their vulnerability to these crimes of opportunity.

Commercial scams and disputes with local business partners can create legal difficulties for U.S. citizens because corruption is widespread in Guinea.
Business routinely turns on bribes rather than the law, and enforcement of the law is irregular and inefficient.
The U.S. Embassy has extremely limited recourse in assisting Americans who are victims of illegal business deals.

Business fraud is rampant and the targets are usually foreigners, including Americans.
Schemes previously associated exclusively with Nigeria are now prevalent throughout West Africa, including Guinea, and pose a danger of severe financial loss.
Typically these scams begin with the receipt of an unsolicited communication (usually e-mails) from strangers who promise quick financial gain, often by transferring large sums of money or valuables out of the country, but then require a series of "advance fees" to be paid -- such as fees for legal documents or taxes -- to finalize the release of the transferred funds.
The final payoff does not exist; the purpose of the scam is simply to collect the advance fees. A common variation is the scammer’s claim to be a refugee or émigré of a prominent West African family, or a relative of a present or former political leader who needs assistance in transferring large sums of cash.
Still other variations appear to be legitimate business deals that require advance payments on contracts.
Sometimes victims are convinced to provide bank account and credit card information and financial authorization that drains their accounts, incurs large debts against their credit, and takes their life savings.

The best way to avoid becoming a victim of advance-fee fraud is common sense -- if a proposition looks too good to be true, it probably is.
You should carefully check and research any unsolicited business proposal before committing any funds, providing any goods or services, and undertaking any travel.
A good clue to a scam is the phone number given to the victim; legitimate businesses and offices provide fixed line numbers, while scams typically use only cell phones.
It is virtually impossible to recover money lost through these scams.

There is no “911” type of emergency assistance in Guinea.
For additional information on these types of scams, see the Department of State's publication, International Financial Scams.
INFORMATION FOR VICTIMS OF CRIME:
The loss or theft abroad of a U.S. passport should be reported immediately to the local police and the nearest U.S. Embassy or Consulate. If you are the victim of a crime while overseas, in addition to reporting to local police, please contact the nearest U.S. Embassy or Consulate for assistance. The Embassy/Consulate staff can, for example, assist you to find appropriate medical care, contact family members or friends, and explain how funds could be transferred. Although the investigation and prosecution of the crime is solely the responsibility of local authorities, consular officers can help you to understand the local criminal justice process and to find an attorney if needed.

See our information on Victims of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION:
Medical facilities are poorly equipped and extremely limited both in the capital city and throughout Guinea. Medicines are in short supply, sterility of equipment should not be assumed, and treatment is frequently unreliable. Some private medical facilities provide a better range of treatment options than public facilities but are still well below global standards. There are no ambulance or emergency rescue services in Guinea and trauma care is extremely limited. Water in Guinea is presumed contaminated, so you should use only bottled or distilled water for drinking. Malaria is a serious risk to travelers in Guinea. For additional information on malaria, including protective measures, see the CDC travelers’ health web site at http://wwwn.cdc.gov/travel/contentDiseases.aspx#malaria.

The U.S. Department of State is unaware of any HIV/AIDS entry restrictions for visitors to or foreign residents of Guinea.

Information on vaccinations and other health precautions, such as safe food and water precautions and insect bite protection, may be obtained from the Centers for Disease Control and Prevention’s hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747) or via the CDC’s website at http://wwwn.cdc.gov/travel/default.aspx.
For information about outbreaks of infectious diseases abroad consult the World Health Organization’s (WHO) website at http://www.who.int/en.
Further health information for travelers is available at http://www.who.int/ith/en
MEDICAL INSURANCE:
The Department of State strongly urges Americans to consult with their medical insurance company prior to traveling abroad to confirm whether their policy applies overseas and whether it will cover emergency expenses such as a medical evacuation.
Please see our information on medical insurance overseas.

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

Drivers in Guinea tend to be poorly trained and routinely ignore road safety rules.
Guinea's road network, paved and unpaved, is underdeveloped and unsafe.
Roads and vehicles are poorly maintained, road signs are insufficient, and roads and vehicles are frequently unlit.
Livestock and pedestrians create constant road hazards and make nighttime travel inadvisable.
Guinea has many roadblocks set up by the police or the military, making inter- and intra-city travel difficult from 10:00 p.m. to 6:00 a.m.
During the rainy season (July through September), flash floods make some roads temporarily impassable.
There is also a significant increase in banditry along the roadways between towns and upcountry during the hours of darkness.
Americans and other foreigners are strongly discouraged from traveling after dark outside of populated areas.
Roadside assistance is not available in Guinea.

Guinea has no public transportation. Taxis, including small cars and larger vans, are often poorly maintained and overcrowded.
Taxis frequently stop and start without regard to other vehicles, making driving hazardous.
Rental vehicles, with drivers, are available from agencies at major hotels in Conakry.

Please refer to our Road Safety page for more information.

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

SPECIAL CIRCUMSTANCES:
Guinean customs authorities may enforce strict regulations concerning the temporary import or export of items such as firearms, antiquities, medications, business equipment, and ivory.
You should contact the Embassy of Guinea in Washington (see contact information above in the Entry Requirements section) for specific information regarding customs requirements.

The local currency is the Guinean franc (FG).
Travelers may not have more than 100,000 FG (currently about $23.00 nor more than $5,000 when they depart Guinea.
Guinea has a cash economy.
ATMs are not available, and traveler’s checks are accepted only at some banks and hotels.
Credit cards are accepted at some larger hotels in Conakry, but should be used only at reputable hotels and banks.
Cash advances on Visa credit cards are available at various branches of BICIGUI, a local bank.
Inter-bank fund transfers are possible at BICIGUI branches but can be difficult and expensive.
Money transfers from the U.S. have worked successfully in the past.
Western Union has several offices in Conakry, and Moneygram has an office downtown.

Visitors should restrict photography to private gatherings and should obtain explicit permission from the Guinean government before photographing military and transportation facilities, government buildings, or public works.
Photographing without permission in any public area may provoke a response from security personnel or a dangerous confrontation with people who find being photographed offensive.

Please see our Customs Information.

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

Please see our information on Criminal Penalties.

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

REGISTRATION / EMBASSY LOCATION:
Americans living or traveling in Guinea 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 Guinea. 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 on the Transversale No. 2, Centre Administratif de Koloma opposite the New Radio Station in Ratoma, Conakry, Guinea; telephone +224-30-42-08-61 through 68 or fax +224-30-42-08-71; web site: http://conakry.usembassy.gov/.
*

*

*
This replaces the Country Specific Information for Guinea dated August 28, 2007, to update sections on Safety and Security and Medical Facilities and Health Information.

Travel News Headlines WORLD NEWS

Date: Thu, 1 Aug 2019 17:40:25 +0200 (METDST)

Conakry, Aug 1, 2019 (AFP) - Six children aged between four and 10 died after they were struck by lightning while making tea under a mango tree in north-eastern Guinea on Wednesday, a witness said.   The storm began shortly before 7:00 pm (1900 GMT) in the town of Siguiri, close to the border with Mali, witness Mamadi Doumbouya, a local resident, told AFP.   He said eight children in total, accompanied by two of their mothers, were under a mango tree at the back of his house.   "I invited everyone to take shelter in my living room. The ladies rushed under my roof but the children stayed behind to make the last cups of tea," he added.

Lightning then struck the mango tree and when Doumbouya rushed out, all of the children were on the ground and unconscious, he said in a telephone call.   Six of the children -- five girls and a four-year-old boy -- died while being taken to hospital, he added.    A doctor from Siguiri Hospital said the six dead children were brought there in the early evening and two others were placed under observation for the coming days.   West Africa is currently undergoing its rainy season.   On Saturday a landslide hit a gold mine in the same area as Wednesday's storm, killing four people including a two-year-old girl and her mother.   "The victims were working in a former gold mine where mining was banned because of the risk of landslides" in the heavy rains, "but people were hiding to go to the tunnels", a Red Cross official said.
Date: Thu, 7 Feb 2019 18:17:54 +0100

Conakry, Feb 7, 2019 (AFP) - Medical services in Guinea are on alert after a man died from Lassa fever, health officials said on Thursday, with some 80 people being monitored for the deadly disease.   Lassa fever is caused by a haemorrhagic virus which belongs to the same family as Marburg and Ebola.   The virus was found in a 35-year-old man from the southwestern town of Kissidougou. He died on January 29 in Mamou, some 400 kilometres (250 miles) away, according to officials.   Kissidougou is where an outbreak of Ebola began in December 2013, leading to thousands of deaths in Guinea, Liberia and Sierra Leone.   "(We) have set to work to see if there are any hidden cases and to trace all the contacts" of the deceased man, said Sakoba Keita from the National Health Security Agency (ANSS).   Keita said it was not yet clear whether this was "an isolated case or an epidemic". 

Around 80 people -- 30 in Kissidougou and 50 in Mamou -- are being monitored but none have so far shown any symptoms of the disease, Keita said.   Lassa takes its name from the town of that name in northern Nigeria where it was first identified in 1969.   The virus is spread through contact with food or household items contaminated with rats' urine or faeces, or after coming into direct contact with the bodily fluids of an infected person.   It can be prevented by enhanced hygiene and avoidance of all contact with rats.   Nearly four in five peple who become infected with the virus do not have symptoms of the disease, the World Health Organization (WHO) says on its website.   A Lassa outbreak in Nigeria last year left 171 dead, and a resurgence of the disease there last month killed 16, according to official figures.
Date: Mon, 4 Feb 2019 21:26:07 +0100

Conakry, Feb 4, 2019 (AFP) - At least 17 people have been killed in a landslide at a gold mine in northeastern Guinea, local police said Monday.   A local elected official confirmed the death toll, saying he had "seen at least 17 dead" after the accident which took place late Sunday in Norassoba, some 35 kilometres (20 miles) from the town of Siguiri.   "This death toll is clearly provisional as the villagers say there are still many people missing," police lieutenant Marcus Bangoura said.

One local inhabitant said "the landslide apparently took everyone by surprise, there was no sign of danger in this mine where we have been working for several years."  There are many such accidents in mines in mineral-rich Guinea where thousands risk their lives working in illegal pits.   The work becomes even more dangerous in the rainy season.

Guinea has gold, diamonds, bauxite and huge reserves of iron ore but the west African country's population struggle to make ends meet.    The miners include locals and those from nearby countries such as Burkina Faso, Liberia and Ivory Coast.   Authorities say there are more than 20,000 such miners in the Siguiri region.
Date: Sun 3 Feb 2019 9:02 AM GMT+1
Source: Bloomberg [edited]

Guinea's government has reported one case of a 35-year-old man with Lassa fever in the central town of Mamou, some 260-kilometers [162 mi] from the country's capital of Conakry.

An investigative mission will be deployed to the region to support health authorities, the government said on [Sat 2 Feb 2019] in statement posted on the website of the National Health Security Agency. No other Lassa fever cases were reported.

Lassa fever is an acute viral haemorrhagic illness, transmitted to humans through contact with food or household items contaminated by infected rodents.  [Byline: Ougna Camara]
========================
[Although rarely reported in Guinea, this may not be the 1st Lassa fever case that has occurred there. As noted when an earlier case was first posted on Thu 8 Feb 2018, it was the 1st Lassa fever case that ProMED-mail had posted for Guinea (see Lassa fever - West Africa (09): Liberia ex Guinea http://promedmail.org/post/20180210.5620420). That report indicated that the affected individual actually died in Liberia but indicated that the infection was acquired in Guinea. West Africa, including Guinea and Liberia, is endemic for Lassa fever virus.

The situation where the person reported above acquired Lassa fever virus is not indicated in this case. Virus transmission to humans occurs when people are in contact with the reservoir rodent host, the multimammate mouse (in the genus _Mastomys_) or its excreta, as was likely the situation in this case. Rodent control has to be undertaken at the village level with individual households. This requires an extensive and continuous public education effort. Transmission also occurs in health facilities when personal protective equipment is not employed and barrier-nursing practices are not adequate to protect staff from blood and secretions of infected patients.

Images of the _Mastomys_ mouse, the rodent reservoir of Lassa fever virus, can be seen at
<https://www.inaturalist.org/taxa/45326-Mastomys-natalensis>. - ProMED Mod.TY]

[HealthMap/ProMED-mail map of Guinea:
Date: Mon, 29 Oct 2018 14:38:26 +0100

Conakry, Oct 29, 2018 (AFP) - A "dead city" strike call by the opposition in Guinea largely emptied the streets of the capital Conakry on Monday, with no solution in sight to a pay dispute in the education sector.   Streets were deserted in some parts of the West African city, while traffic was jammed in other areas where all drivers were being diverted, an AFP correspondent saw.   Troops and police were placed on alert but few were deployed on the streets. Instead they were gathered in strength in central police stations and gendarmerie barracks, the correspondent said.   Youths burned tyres early in the day along a main Conakry thoroughfare, Le Prince street, but rain soon put out the fires and dampened the ardour of would-be demonstrators.

The political opposition called for the strike in protest against what it considers a violation by the authorities of an agreement reached in August over the appointment of local government officials elected in a hotly disputed vote on February 4.   Rivals of President Alpha Conde have also called for a march and rally in Conakry on Tuesday, a week after a banned demonstration during which opposition leader Cellou Dalein Diallo alleged that police tried to assassinate him.   Also last Tuesday, an 18-year-old was killed in street clashes and his family blamed police, who denied both shooting allegations.

On Monday morning, hundreds of schoolchildren in Siguiri, a town in the far north of the country, took to the streets to call for the return of their teachers, who began "an unlimited strike" on October 3 to press demands for a raise in minimum pay, according to local media.   The teachers decided to take tougher action after the government announced that it would not pay October wages for the strikers, said Aboubabar Soumah, general secretary of the powerful Free Union of Teachers and Researchers of Guinea (SLECG).   "From now on, it's not the worker who gets paid, but the work," Conde warned on state media.   "Teachers will stay at home until the end of the head of state's second mandate in 2020," the SLECG said in response.
More ...

World Travel News Headlines

Date: Fri 17 Jan 2019
Source: Front Page Africa [edited]

The Surveillance Officer of Grand Bassa County Health team has confirmed to FrontPage Africa that there is a Lassa fever outbreak in District 4, Grand Bassa County leading to 3 deaths and 20 others confirmed infected with the virus.

Gabriel B. Kassay said over 60 specimens were taken to Monrovia for testing as a result of the outbreak.  "Out of the 60 plus, over 20 specimens were confirmed affected with Lassa fever," he said, adding that 3 persons have died from the disease at the Liberia Agricultural Company (LAC) concession area in Wee Statutory District.

Kassay said there were several incidents of Lassa fever in the LAC plantation area in 2019.  "According to the Liberia health law, one confirmed case of Lassa fever is considered an outbreak, and so since August 2019, there have been lots of people affected in the LAC area," he said while expressing concern that "the lack of awareness is a major factor" for the frequent cases of the virus in the county.  "The Grand Bassa Health Team has been very instrumental in helping to curtail the spread of the disease in the affected area, but there is a need for awareness in the entire county."

Kassay said the spread of Lassa fever might increase if the citizens are not trained to know the cause and effects of Lassa fever.
=====================
[The number of cases has increased from 9 on 2 Dec 2019 (See Lassa fever - West Africa (43): Liberia http://promedmail.org/post/20191207.6828798) to 20 confirmed cases now. The reported number of deaths remains at 3. The previous ProMED-mail post (see Lassa fever - West Africa (31): Liberia http://promedmail.org/post/20190902.6653653) reported that according to MoH data, a total of 92 suspected cases between 1 Jan-25 Aug 2019, including 21 deaths, have been reported. Of these, 25 cases have been confirmed by RT-PCR (Nimba (9), Bong (10), Grand Bassa (5), and Grand Kru (1)), while 9 remain suspected cases, the release recorded. The case-fatality rate among confirmed cases in that report was stated as 36% (9 deaths out of 25 confirmed cases). Males are mostly affected by the disease (56%) of confirmed cases as compared to females.

Occurrence of Lassa fever cases in areas outside the usual "Lassa fever belt" is of concern, and the Ministry of Health is wise to increase public information and advize citizens about measures that should be taken to avoid infection with the virus. Occurrence of Lassa fever in Liberia is not new, and cases have occurred there sporadically for several years. Between 1 Jan and 27 Jun 2018, 20 cases were laboratory confirmed (see archive no. http://promedmail.org/post/20180711.5898495). Apparently, all those Lassa fever virus infections were acquired by contact with infected rodents or their excretions. Lassa fever virus can be acquired from infected rodents or patients in the hospital. Transmission can occur in health facilities when personal protective equipment is not employed or barrier-nursing practices or biocontainment facilities in the laboratory are not adequate to protect staff from blood and secretions of infected patients.

As mentioned in previous posts, Lassa fever virus transmission to humans occurs when people are in contact with the reservoir rodent host, the multimammate mouse (_Mastomys natalensis_ and _M. erythroleucus_) and the African wood mouse (_Hylomycus pamfi_) or their excreta, as was likely the situation in many of these cases. Rodent control has to be undertaken at the village level with individual households employing the preventive measures listed above. This requires an extensive and continuous public education effort.

Images of the _Mastomys natalensis_ mouse, the rodent reservoir of Lassa fever virus, can be seen at
_M. erythroleucus_ and _Hylomycus pamfi_ at

Date: Sun 19 Jan 2019
Source: Outbreak News Today [edited]

With the arrival of summer when the occurrence of diseases transmitted by mosquitoes, such as yellow fever, increases, the Brazilian Ministry of Health is alerting the population to get vaccinated against the disease.  The alert is mainly focused on the population that lives in the South and Southeast regions of the country due to the confirmation of 38 monkey deaths in the states of Parana (34), Sao Paulo (3), and Santa Catarina (1). In total, 1087 reports of suspected monkey deaths were recorded in the country.

The alert is given because the regions have a large population and a low number of people vaccinated, which directly contributes to the cases of the disease.

The target public for vaccination is people from 9 months of age and 59 years of age who do not have proof of vaccination.

Regarding human cases, 327 suspected yellow fever cases were reported in the same period, of which 50 remain under investigation and one has been confirmed.

The yellow fever vaccine is offered in the National Vaccination Calendar and distributed monthly to the states. In 2019, more than 16 million doses of the yellow fever vaccine were distributed throughout the country. Despite this availability, there is a low demand from the population for vaccination. For 2020, the portfolio acquired 71 million doses of the vaccine, enough to serve the country for more than 3 years.

In 2020, the Ministry of Health will gradually expand yellow fever vaccination to 1101 municipalities in the Northeast states that were not yet part of the vaccination recommendation area. Thus, the whole country now has a vaccine against yellow fever in the routine of services.

Another change in the calendar was that the children started to have a booster vaccine at the age of 4. The decision came because recent scientific studies have shown a decrease in the child's immune response, which is vaccinated very early, at 9 months, as predicted in the child's National Vaccination Calendar. Since 2017, the Ministry of Health has followed the guidelines of the World Health Organization (WHO) to offer only one dose of the yellow fever vaccine in a lifetime.
=========================
[The current expansion of yellow fever in South America raises concern for public health and also about potential conservation problems for susceptible non-human primate species in the continent. Yellow fever virus was introduced into the Americas approximately 400 years ago, yet the complex interactions that were established after its introduction are far from being elucidated. There is a need for more research on the eco-epidemiology of the disease in the continent, especially in the presence of the persistent anthropogenic global environmental change. - ProMED Mod.PMB]

[HealthMap/ProMED-mail map of Brazil:
Date: Sat 18 Jan 2020 03:15 WAT
Source: Actualita [in French, machine trans., edited]
<https://actualite.cd/2020/01/18/rdc-une-maladie-inconnue-fauche-des-vies-kiri-5-morts>

An unknown disease has already killed 5 people at Kiri General Hospital, in the province of Mai-Ndombe, in the west of the Democratic Republic of the Congo (DRC), according to the authorities. The provincial minister of public health has said that all measures are underway to detect [diagnose?] the mysterious disease. "Admittedly, this was an abnormal situation; however, the situation is manageable because we have just gone into this health facility and we have tried to carry out investigations. My collaborators and I took some samples which have quickly been sent to the National Institute for Biomedical Research (INRB) in Kinshasa for the appropriate medical tests which can give us accurate [diagnosis] on this abnormal situation," declared the minister Jean Claude Bola. First, added the same official, "it is not an Ebola epidemic, contrary to the rumour circulating in the Kiri territory and in the social networks."

In an exclusive interview with actualita.cd, the provincial authority also confirmed the deaths. "However, I warn all those who broadcast through the various media and social networks that there is Ebola in Mai-Ndombe that they have neither qualification nor competence to do so, because the only authority having jurisdiction in the provinces to declare an epidemic is the provincial governor," declared Paul Mputu Boleilanga. "Severe and disciplinary sanctions will be reserved against usurpers of power," he threatened. According to provincial authorities, a team from the National Institute of Biomedical Research (INRB), a team is expected in the Kiri territory for "rapid" management of all patients and to determine the disease underlying deaths in this region.
=============================
[Other than the number of deaths and the geographical location of the cases there is no additional information to permit reasonable speculation as to the aetiology or dates of illnesses. ProMED Mod.MPP noted that Ebola denial leads one to suspect this is a viral haemorrhagic fever.

Laboratory tests should confirm or rule out diseases such as yellow fever or Lassa fever. However, there is no indication that these cases are due to a virus or other infectious agent. Toxicants should also be ruled out. Additional information about these or new cases would be appreciated. - ProMED Mod.TY]

[Maps of DR Congo: <http://goo.gl/DM2AT8> and
<http://healthmap.org/promed/p/194> and
<http://healthmap.org/promed/p/65284>]
Date: Fri, 17 Jan 2020 17:48:09 +0100 (MET)

Barcelona, Jan 17, 2020 (AFP) - Spain's Balearic Islands passed a bill Friday aimed at clamping down on alcohol-fuelled holidays in the Mediterranean archipelago which bans happy hours when drinks are offered a discount and open bars.   "This is the first law adopted in Europe which restricts the sale and promotion of alcohol in certain touristic areas," the regional government of the Balearic Islands which have long been a magnet for young German and British tourists, who often drink heavily and enjoy rowdy late-night clubbing.

The restrictions will apply to three areas with a reputation for excess: San Antoni on the island of Ibiza and El Arenal and Magaluf -- which has been nicknamed "Shagaluf" because of its reputation for drunken casual sex -- on Mallorca, the largest of the Balearic's four islands.   The law, which was drawn up in consultation with the tourism industry also bans pub crawls and two-for-one drink offers, prohibits the sale of alcohol in shops between 9:30 pm and 8 am and forbids advertising party boats in the designated areas.   Establishments that break the new rules risk fines of up to 600,000 euros ($669,000) and the threat of being closed down for three years.

The new law also takes aim at the so-called "balconing" craze, the term given to holidaymakers who decide to jump into a swimming pool from a hotel or apartment balcony, a stunt which claims several lives every year.   It bans "balconing" across the entire archipelago and requires hotels to evict anyone who does it. Those caught jumping from balconies face fines of up to 60,000 euros ($67,000).   Up until now only some resorts on the Balearics imposed fines for "balconing".

The regional government of the Balearics said the law, which stiffens measures already introduced in 2015, will "fight excesses in certain tourist zones" and "force a real change in the tourism model of those destinations".   Magaluf made global headlines in 2014 after a video showing a young woman performing oral sex on several men on the dance floor of a nightclub went viral.   Local shops sell souvenir T-shirts with the catchphrase "On it 'till we vomit".

The four islands which make up the Balearics -- Palma de Mallorca, Ibiza, Menorca and Formentera, received nearly fourteen million tourists in 2018, drawn by their crystal clear waters, and in many cases by all-inconclusive package holidays.   The archipelago is Spain's second most visited region. Spain is the world's second most visited country after France.
Date: Fri, 17 Jan 2020 12:55:16 +0100 (MET)

Rennes, France, Jan 17, 2020 (AFP) - Several oyster farmers along France's Atlantic and Mediterranean coasts have been forced to halt sales since December after their sites were contaminated by the highly contagious norovirus, which they blame on overflowing sewage treatment plants.   Authorities ordered the suspensions at 23 of the country's 375 designated fields, and recalls of affected oysters as well as mussels and clams, after tests revealed the virus, which can cause severe vomiting and diarrhoea.

The move came just before the year-end holidays, when oysters are a traditional delicacy on millions of French tables.   "The oysters are not sick. They're carrying the virus because it's in the water they are constantly filtering," Philippe Le Gal, president of France's national shellfish council (CNC), told AFP this week.   "They were in the wrong place at the wrong time," he said, adding the ban had prompted many people to stop eating oysters altogether.   Local officials say oyster farmers are paying the price of insufficient spending on wastewater treatment, with facilities strained to the limit even as development of coastal areas has surged in recent years.

Heavy rains before Christmas prompted treatment basins to overflow, they say, spilling tainted water into rivers.   "This was predictable -- they've kept issuing building permits even though treatment sites are already at full capacity," said Joel Labbe, a senator for the Morbihan region in Brittany.   Oyster farmers are demanding compensation, and a delegation met with agriculture ministry officials in Paris last week warning that more than 400 businesses had been impacted by the sales ban.

This week, angry growers dumped trash bins full of oysters and mussels in front of the offices of the regional ARS health authority in Montpellier over the decision to halt sales from a nearby basin on the Mediterranean coast.   "We're the victims, and we shouldn't have to suffer any financial damages," Le Gal said.
Date: Fri, 17 Jan 2020 04:44:41 +0100 (MET)

Suva, Fiji, Jan 17, 2020 (AFP) - Fiji opened evacuation centres and warned of "destructive force winds" Friday as a cyclone bore down on the Pacific island nation for the second time in three weeks.   Two people were missing after attempting to swim across a swollen river late Thursday when heavy rain fell ahead of the advancing Cyclone Tino, police said.   On the outer islands, locals prepared to go to emergency shelters while many tourists fled beach resorts and made their way to the capital Suva before regional flights and inter-island ferry services were suspended.

The Fiji Meteorological Service said Tino was strengthening as it headed for Fiji's second-largest island, Vanua Levu, warning of wind gusts of up to 130 kilometres per hour (80 mph), heavy rain, coastal flooding and flash flooding in low lying areas.    "I'm preparing to go to an evacuation centre soon with my family and wait for the cyclone to pass," Nischal Prasad, who lost his home in northern Vanua Legu when Cyclone Sarai struck just after Christmas, told AFP.   "Sarai destroyed my house and almost left my family homeless. My daughters had to hide under their bed from the strong winds. It was a scary experience," he said.

Russian tourist Inna Kostromina, 35, said she sought safety in Suva after being told her island resort was in the path of the cyclone.   "We didn't want to get stuck in there and with the authorities warning of coastal flooding, anything can happen. So we decided to move to Suva for now. I think we will be much safer here."    Police said a man and his daughter, believed to be aged nine or 10, were attempting to swim across a flooded river when they were caught in the strong currents.    The incident happened on Thursday before the storm developed into a tropical cyclone, but a police spokesman linked the tragedy to "heavy rain brought about by the current weather system (which) raised the river level".   Although the Pacific islands are popular tourist destinations in summer it is also the cyclone season, and Fiji is being targeted for the second time in three weeks.

In late December, Tropical Cyclone Sarai left two people dead and more than 2,500 needing emergency shelter as it damaged houses, crops and trees and cut electricity supplies.    On its present track, Tino would hit Tongatapu, the main island of neighbouring Tonga, on the weekend.    Two years ago, Tongatapu was hit by Cyclone Gina, with two people killed and nearly 200 houses destroyed.
Date: Thu, 16 Jan 2020 16:38:39 +0100 (MET)
By Hiroshi HIYAMA

Tokyo, Jan 16, 2020 (AFP) - Japan has confirmed a case of a mystery virus that first emerged in China and is from the same family as the deadly SARS pathogen, authorities said Thursday.   It appears to be only the second time the novel coronavirus has been detected outside China, after the World Health Organization (WHO) confirmed a case in Thailand.   Japan's health ministry said a man who had visited the central Chinese city of Wuhan, the apparent epicentre of the outbreak, was hospitalised on January 10, four days after his return to Japan. He reported a persistent fever.

Tests on the patient, who was released from hospital on Wednesday, confirmed he was infected with the new virus.   "This is the first domestic discovery of a pneumonia case related to the new coronavirus," the ministry said in a statement.   "We will continue active epidemiological research while also coordinating efforts with the World Health Organization and related agencies to conduct a risk assessment."   The outbreak has killed one person so far, with 41 patients reported in Wuhan.

The outbreak has caused alarm because the new virus is from the same family as the pathogen that causes SARS (Severe Acute Respiratory Syndrome), which killed 349 people in mainland China and 299 in Hong Kong in 2002 and 2003.   Authorities in Wuhan said a seafood market was the centre of the outbreak. It was closed on January 1.   Japanese authorities said the man had not visited the market and that it was possible he had been in contact with a person infected with the virus while in Wuhan.

- Outbreak in Japan 'unlikely' -
Health ministry official Eiji Hinoshita told reporters that the risk of the disease spreading from the patient was considered low, with careful checks done on those who had been in close contact with him.   "At this point, we feel it is unlikely this will lead to a dramatic outbreak," he said, adding that the patient was no longer suffering a fever and was recuperating at home.

Officials declined to give further information on the man, including his nationality, citing privacy concerns.   Local media said the patient was a Chinese national in his 30s living in Kanagawa, just southwest of Tokyo.   Public broadcaster NHK said he had already recovered and was resting at home, as quarantine officials at Tokyo's Narita airport boosted health checks on all travellers.

The health ministry urged people who develop a cough or fever after visiting Wuhan to wear a surgical mask and "swiftly visit a medical institution".   Hinoshita said Japan would need to be on guard ahead of the Lunar New Year, a popular travel period in China.   "It is expected that Japan will see many visitors from China," he said.   It is not yet clear whether the mystery virus can be transmitted between humans, but on Wednesday authorities said it was possible it had spread inside a family.

The woman diagnosed in Thailand, who is in a stable condition, also said she had not visited the Wuhan seafood market.   And WHO doctor Maria Van Kerkhove on Tuesday said she "wouldn't be surprised if there was some limited human-to-human transmission, especially among families who have close contact with one another".   Hong Kong authorities on Tuesday said several dozen people had been hospitalised with fever or respiratory symptoms after travelling to Wuhan, but no cases of the new virus have so far been confirmed.
Date: 20 Jan 2020
Source: News Joins [In Korean, machine trans. edited]
----------------------------
An unexplained pneumonia in China caused the Korean quarantine authorities to strengthen the quarantine, and a fever-sensing camera is installed to monitor the body temperature of Chinese tourists who entered Korea at Incheon Port 1 International Passenger Terminal. 

Pneumonia confirmed by the new coronavirus, which is prevalent in Wuhan, China, was confirmed for the first time on [20 Jan 2020]. According to health officials, a Chinese woman, A, who arrived at Incheon International Airport on a plane from Wuhan last weekend, was confirmed with pneumonia. The patient showed signs of pneumonia, including high fever and cough. The health authorities entered the airport at the same time, confirmed the symptoms of high fever, suspected pneumonia, and went into quarantine and testing. The Centers for Disease Control immediately quarantined A and entered treatment with a nationally designated quarantine bed. The Centers for Disease Control will hold an emergency press conference at 1:30 pm on [20 Jan 2020] and release the reporter A.
 
Meanwhile, Beijing's Daxing District Health and Welfare Committee said 2 fever patients who had been to Wuhan were confirmed as a new pneumonia patient on [19 Jan 2020]. They are currently being treated at a designated hospital and said they are stable. Daxing District is where Beijing New Airport opened last year [2019]. The Guangdong Provincial Health and Welfare Committee said on [19 Jan 2020] that a 66-year-old man who had visited a relative's home in Wuhan showed fever and lethargy and was diagnosed with Wuhan pneumonia. Confirmation patients have also emerged in Shenzhen, a neighbouring Hong Kong province in southern China, raising concerns that the new pneumonia has already spread throughout China.
 
The Chinese government has said that "there is no basis for human-to-human propagation," but domestic experts pointed out that "the nature of coronavirus is less likely to prevent human-to-human propagation."   [Byline: Esther Toile]
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[This is now the 4th international identification of the 2019-nCoV (novel coronavirus) associated illness reported outside of China.  To date, all 4 cases have reported being in Wuhan China in the 14 days preceding onset of illness.  Illness in each involved a history of fever and dry cough.  Cases were reported by Thailand (2 cases) and Japan, and now South Korea.  An update following a Ministry of Health Korea press conference mentioned that there were 5 individuals accompanying this woman, none of whom were currently showing symptoms. (<http://news1.kr/articles/?3821049>).

As mentioned in an earlier post (see Novel coronavirus (10): China (HU, GD, BJ) http://promedmail.org/post/20200119.6898567), there have also been cases confirmed in China outside of Wuhan City, with cases reported in Beijing, Guangdong and possibly Shanghai. It is becoming more difficult to conclude that there has been limited person-to-person transmission as the case numbers are climbing both inside of Wuhan City, elsewhere in China, and in individuals travelling from Wuhan China to other countries (Japan, Thailand and South Korea).

A map of South Korea can be found at:
Date: 15 Jan 2020
Source: Fox News [edited]

CDC is facing criticism over its response to a polio-like illness. The Centers for Disease Control and Prevention has confirmed 10 additional cases of acute flaccid myelitis.  An Ohio teen is determined to walk again despite doctors' warnings that she may not after she contracted a rare polio-like illness that's left her paralyzed from the waist down.  IK, a catcher on her middle school's softball team, said it started with what felt like a cramp in her leg on Christmas. "I just thought, 'Oh gosh, it's just growing pains or a Charley horse,'" NK, the 13-year-old's mother, told News 5 Cleveland.  But the next day, IK couldn't stand on her own, and her worried parents rushed her to Akron Children's Hospital, where she was diagnosed with acute flaccid myelitis (AFM). It's a rare but serious condition that affects the nervous system, specifically the grey matter of the spinal cord, which weakens the body's muscles and reflexes.

Health officials have noticed an increase of cases in children occurring every 2 years since 2014, according to the Centers for Disease Control and Prevention (CDC). And while it often is referred to as a "polio-like" illness, tests so far have tested negative for poliovirus.  Symptoms typically begin with sudden onset of arm or leg weakness and loss of muscle tone and reflexes, but can also include facial droop or weakness, difficulty moving eyes, drooping eyelids, difficulty swallowing,  slurred speech, and pain in the arms and legs.  Severe symptoms may include respiratory failure, or serious neurological complications, according to the CDC. Parents are encouraged to seek medical care right away if a child is suspected of developing any symptoms

Since her diagnosis, IK has been working in physical therapy and has received steroid treatments as well as multiple plasma exchange, according to the news outlet. Her mother said it's been like "a bad dream" for the family as they watch her struggle to gain strength.  "It's a lot, but I just try to go with the flow, just to push through," IK, who has received support from her teammates, classmates and members of the community, told News 5 Cleveland.  [Byline: Alexandria Hein]
======================
[Acute flaccid myelitis (AFM) is a rare but serious condition. It affects the nervous system, specifically the area of the spinal cord called gray matter, which causes the muscles and reflexes in the body to become weak.

In 2019, there were 33 total confirmed cases in 16 US states
[<https://www.cdc.gov/acute-flaccid-myelitis/cases-in-us.html>].

The case definition for AFM is based on clinical and lab criteria

Clinical Criteria: An illness with onset of acute flaccid limb weakness.
Laboratory Criteria:
Confirmatory Laboratory Evidence: a magnetic resonance image (MRI) showing spinal cord lesion largely restricted to grey matter and spanning one or more vertebral segments. Supportive Laboratory Evidence: cerebrospinal fluid (CSF) with pleocytosis (white blood cell count over 5 cells/mm3) Case Classification:
- Confirmed: Clinically compatible case AND Confirmatory laboratory evidence: MRI showing spinal cord lesion largely restricted to grey matter and spanning one or more spinal segments.
- Probable: Clinically compatible case AND Supportive laboratory evidence: CSF showing pleocytosis (white blood cell count over 5 cells/mm3)

With the high number of cases reported in 2018 and 2019, CDC enhanced AFM surveillance through collection of data at the national level by encouraging healthcare providers to recognize and report to their health departments all patients whom they suspect may have AFM; health departments are being asked to send this information to CDC to help us understand AFM activity nationwide. - ProMED Mod.UBA]

[HealthMap/ProMED map available at:
Date: Sat 18 Jan 2020
From: Guido Calleri <guidocalleri@aslcittaditorino.it> [edited]

90 persons presented to the Infectious Diseases Hospital Amedeo di Savoia, Torino, North-West Italy between 24 Dec 2019 and 10 Jan 2020 after consuming raw sausages from a wild boar hunted in the area of Susa Valley, 50 km [31.1 mi] away from Torino, in late November 2019.

All of them either were symptomatic (fever, muscle and/or abdominal pain, nausea) or had peripheral blood eosinophilia over 500/cmm, or both. IgG serology for trichinella was performed by immunoblot (Trichinella E/S IgG kit, EFFEGIEMME, Milan, Italy) and resulted positive in 48/90 (53.3%), allowing a diagnosis of confirmed trichinella infection.

Otherwise, a diagnosis of suspected trichinella infection was made with a negative serology, probably due to performing the test too early, before the development of antibodies or possibly a false negative result. In a few cases (under 10 cases) an alternative diagnosis was considered.

All patients were treated with oral albendazole 400 mg twice daily for 10 days and prednisone 50 mg/day.

Most likely, all patients were infected after eating meat from a single animal, given the low prevalence of the infection in this area: no human case has ever been detected in Torino province, and only one wild boar has been found positive for trichinella at microscopy in Susa valley in the last 10 years.
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Guido Calleri, Filippo Lipani, Giovanna Paltrinieri, Silvia Faraoni,
Valeria Ghisetti
ASL Citta di Torino, Infectious Diseases Unit and Microbiology Lab,
and ASL TO3,
Department of Prevention
Torino, Piedmonte, Italy
======================
[ProMED thanks Guido Calleri, Filippo Lipani, Giovanna Paltrinieri, Silvia Faraoni, and Valeria Ghisetti for sending us this information. The report underlines that _Trichinella_ are found in wild boars in Europe and should be assessed by a certified laboratory for _Trichinella_ before used for human consumption. Sausages made of smoked meat are especially dangerous, because the temperatures seldom reach what is needed to kill the trichinella larvae. - ProMED Mod.EP]

[HealthMap/ProMED map available at: