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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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Rwanda

Rwanda US Consular Information Sheet
May 19, 2008
COUNTRY DESCRIPTION:
Rwanda is a landlocked developing country in central Africa which has made considerable progress in rebuilding its infrastructure and establishing security since the 19
4 civil war and genocide in which at least 800,000 people were killed. Economic activity and tourism are on the rise in Rwanda. Hotels and guesthouses are adequate in Kigali, the capital, and in major towns, but are limited in remote areas. Read the Department of State Background Notes on Rwanda for additional information.

ENTRY/EXIT REQUIREMENTS: A passport and evidence of yellow fever immunization are required. Visas are not required for American citizens entering Rwanda for less than 90 days. U.S. citizens planning on working in Rwanda should apply for a work permit at the Directorate of Immigration as soon as possible after arrival in Rwanda. Detailed entry information may be obtained from Rwanda’s Directorate of Immigration at: http://www.migration.gov.rw/ or from the Embassy of the Republic of Rwanda, 1714 New Hampshire Avenue NW, Washington DC 20009, telephone 202-232-2882, fax 202-232-4544, web site http://www.rwandaembassy.org. Overseas, inquiries may be made at the nearest Rwandan 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:
There are currently no travel restrictions in place within Rwanda, but travelers should use caution when traveling near or crossing the border into Burundi, eastern Democratic Republic of the Congo (DRC), and Uganda.

In March 2005, the Congo-based Democratic Forces for the Liberation of Rwanda (FDLR), comprising ex-Rwandese Armed Forces, Interahamwe, and other extremists, announced it would end its armed struggle against the Government of Rwanda, but thousands of combatants are estimated to remain in eastern Congo. The combatants currently are not well-organized or funded, nor do they pose a serious threat to Rwandan security. However, in early March 2007, in Gisenyi Province (near the Volcanoes National Park in northwestern Rwanda) they launched a mortar round and rocket into Rwandan territory. There were no casualties, and it appears to have been an isolated incident. While visitors may travel freely to Volcanoes National Park, they are not permitted to visit the park without permission from Rwanda's Office of Tourism and National Parks (ORTPN). ORTPN stipulates that the park can only be used for gorilla tours and nature walks. Since December 2006, all restrictions have been lifted in the Nyungwe Forest near the Burundian border in southwestern Rwanda. In the past, the FDLR infiltrated Rwanda from Burundi through the Nyungwe Forest, but the last reported incident in the park was in November 2003. However, FDLR rebel factions are known to operate in northeastern DRC, Burundi, Tanzania, and Uganda, including near the popular tourist area of Bwindi Impenetrable Forest National Park. For information on travel to those and other countries, and for the latest security information, American citizens traveling abroad should regularly monitor the Department of State, Bureau of Consular Affairs web site at http://travel.state.gov, where the current Travel Warnings and Travel Alerts, as well as the Worldwide Caution, can be found.
From time to time, travel by U.S. Embassy personnel may be restricted based on changing security conditions. Visitors are encouraged to contact the appropriate U.S. Embassy Regional Security Office or Consular Section for the latest security information, including developments in eastern Congo, Uganda and Burundi. (See Registration/Embassy Location section below.)

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: Pick-pocketing in crowded public places is common, as is petty theft from cars and hotel rooms. Although violent crimes such as carjacking, robbery, and home invasion occur in Kigali, they are rarely committed against foreigners. Americans are advised to remain alert, exercise caution, and follow appropriate personal security measures. Although many parts of Kigali are safe at night, walking alone after dark is not recommended since foreigners, including Americans, have occasionally been the targets of robbery.

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. The U.S. Embassy provides some information on its web site about criminal justice in Rwanda at http://rwanda.usembassy.gov/criminal_justice_in_rwanda.html.

MEDICAL FACILITIES AND HEALTH INFORMATION: Medical and dental facilities are limited, and some medicines are in short supply or unavailable. Travelers should bring their own supplies of prescription drugs and preventive medicines. In Kigali, Americans may go to King Faisal Hospital, a private facility that offers limited services and dental facilities. There is also a missionary dental clinic and a few private dentists. American-operated charitable hospitals with some surgical facilities can be found in Kibagora, in southwestern Rwanda, in Ruhengeri, near the gorilla trekking area, and in Rwinkavu, near the entrance to Akagera National Park. The U.S. Embassy maintains on its website a current list of healthcare providers and facilities in Rwanda at http://rwanda.usembassy.gov/medical_information.html; this list is also included in the Consular Section’s welcome packets for American citizens. There are periodic outbreaks of meningitis in Rwanda. Yellow fever can cause serious medical problems, but the vaccine, required for entry, is very effective in preventing the disease. Malaria is endemic to Rwanda. All visitors are strongly encouraged to take prophylactic medications to prevent malaria. These should be initiated prior to entry into the endemic area. Because of possible counterfeit of antimalarial medications, these should be obtained from a reliable pharmaceutical source. Multiple outbreaks of ebola have been reported in neighboring Democratic Republic of Congo and Uganda in the past year, but none within Rwanda.
Information on vaccinations and other health precautions, such as safe food and water precautions and insect bite protection, may be obtained from the Centers for Disease Control and Prevention’s hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747) or via the CDC’s website at http://wwwn.cdc.gov/travel/default.aspx. For information about outbreaks of infectious diseases abroad consult the World Health Organization’s (WHO) web site at http://www.who.int/en. Further health information for travelers is available at http://www.who.int/ith/en.

MEDICAL INSURANCE: The Department of State strongly urges Americans to consult with their medical insurance company prior to traveling abroad to confirm whether their policy applies overseas and whether it will cover emergency expenses such as a medical evacuation. Please see our information on medical insurance overseas.
TRAFFIC SAFETY AND ROAD CONDITIONS: While in a foreign country, U.S. citizens may encounter road conditions that differ significantly from those in the United States. The information below concerning Rwanda is provided for general reference only, and may not be totally accurate in a particular location or circumstance.
Due to safety concerns, the use of motorbikes or van taxis for transportation is not recommended. Regulated orange-striped (along the base of the vehicle) sedan auto taxis are safer, but be sure to agree on a fare before beginning the trip. Public transportation can be dangerous due to overloading, inadequate maintenance, and careless drivers.
While the main roads in Rwanda are in relatively good condition, during the rainy season many side roads are passable only with four-wheel drive vehicles. Nighttime driving, particularly outside major cities, is hazardous and is discouraged. Often, roadways are not marked and lack streetlights and shoulders. Many sections have deteriorated surfaces. Due to possible language barriers and lack of roadside assistance, receiving help may be difficult. Travelers may be stopped at police roadblocks throughout the country, where their vehicles and luggage may be searched. Service stations are available along main roads.
In Rwanda, as in the U.S., traffic moves on the right-hand side of the road. Cars already in a traffic circle have the right of way. Until 2004, cars entering traffic circles had the right-of-way. Drivers should exercise caution at traffic circles, since some drivers might forget this change. Excessive speed, careless driving, and the lack of basic safety equipment on many vehicles are hazards on Rwanda's roads. Many vehicles are not well maintained, and headlights are either extremely dim or not used. Drivers also tend to speed and pass other cars with little discretion. Some streets in Kigali have sidewalks or sufficient space for pedestrian traffic; others do not, and pedestrians are forced to walk along the roadway. With the limited street lighting, drivers often have difficulty seeing pedestrians. Drivers frequently have unexpected encounters with cyclists, pedestrians and livestock.
Third-party insurance is required and will cover any damages from involvement in an accident resulting in injuries, if one is found not to have been at fault. The driver’s license of individuals determined to have caused an accident may be confiscated for three months. Causing a fatal accident could result in three to six months' imprisonment. Drunk drivers are jailed for 24 hours and fined Rwandan Francs 20,000 (approximately $35). In the city of Kigali, contact the following numbers for police assistance in the event of an accident: Kigali Center, 08311112; Nyamirambo, 08311113; Kacyiru, 08311114; Kicukiro, 08311115; Remera, 08311116. Ambulance assistance is very limited. Wear seat belts and drive with care and patience at all times. In case of an emergency, American citizens can contact the Embassy duty officer at 0830-0345.
For specific information concerning Rwandan driving permits, vehicle inspection, road tax, and mandatory insurance, please contact the Rwandan Office of Tourism and National Parks, B.P. 905, Kigali, Rwanda, telephone 250-76514, fax 250-76512.
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.gov.rw/.
AVIATION SAFETY OVERSIGHT: As there is no direct commercial air service to the United States by carriers registered in Rwanda, the U.S. Federal Aviation Administration (FAA) has not assessed Rwanda’s Civil Aviation Authority for compliance with International Civil Aviation Organization (ICAO) aviation safety standards. For more information, travelers may visit the FAA’s web site at http://www.faa.gov/safety/programs_initiatives/oversight/iasa.

In recent months, Rwandair, which charters aircraft to fly its routes, has had difficulties maintaining its schedule, resulting in delayed and cancelled flights which have left passengers stranded for extended periods.

SPECIAL CIRCUMSTANCES:
Telephone communication to and from Rwanda is generally reliable. Cellular telephones and Internet connections are available in Kigali and large towns.
Non-biodegradable plastic bags have been banned in Rwanda, and travelers carrying them upon arrival at the Kayibanda International airport may have them confiscated and have to pay approximately $4 for a reusable cloth replacement.
International ATMs are not available in Rwanda. The Rwandan franc is freely exchangeable for hard currencies in banks and the Bureaux de Change. Several Kigali banks can handle wire transfers from U.S. banks, including Western Union. Credit cards are accepted at only a few hotels in Kigali and only to settle hotel bills. Hotels currently accepting credit cards for payment include the Kigali Serena (formerly Intercontinental) Hotel, the Hotel des Mille Collines, the Novotel Umubano, Stipp Hotel and the Kivu Sun Hotel. Note that there may be an added fee for using a credit card. Travelers should expect to handle most expenses, including air tickets, in cash.

Traveler's checks can be cashed only at commercial banks. Because some travelers have had difficulty using U.S. currency printed before the year 2000, the Embassy recommends traveling with newer U.S. currency notes.
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 Rwandan laws, even unknowingly, may be expelled, arrested or imprisoned. Penalties for possession, use, or trafficking in illegal drugs in Rwanda 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.
The U.S. Embassy provides some information on its website about criminal justice in Rwanda.

CHILDREN'S ISSUES: For information see our Office of Children’s Issues web pages on intercountry adoption and international parental child abduction. Both foreigners and Rwandans taking Rwandan children to live outside Rwanda, e.g., after adoption, must obtain an exit permission letter from the Ministry of Family and Gender located within the Primature complex at P.O. Box 969, Kigali, Rwanda; Tel: 011-250-587-128; Fax: 011-250-587-127.

REGISTRATION / EMBASSY LOCATION:
Americans living or traveling in Rwanda 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 Rwanda. 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 2657 Avenue de la Gendarmerie; the mailing address is B.P. 28, Kigali, Rwanda; tel. (250) 596-400,; fax: (250) 596-591. The Consular Section’s email address is consularkigali@state.gov. The Embassy's web site is http://rwanda.usembassy.gov/. American Citizen Services hours are Tuesdays from 9:00 -17:00 and Fridays from 9:00 - 12:00 except on U.S. and Rwandan holidays.
* * *
This replaces the Country Specific Information for Rwanda dated October 4, 2007, to update sections on Country Description, Entry/Exit Requirements, Safety and Security, Information for Victims of Crime, Medical Facilities and Health Information, Traffic Safety and Road Conditions, Aviation Safety Oversight, Criminal Penalties, Children’s Issues, and Registration/Embassy Location.

Travel News Headlines WORLD NEWS

Date: Sun, 8 Dec 2019 17:30:45 +0100 (MET)

Kigali, Dec 8, 2019 (AFP) - Rwanda on Sunday started a voluntary Ebola vaccination programme at its border with the Democratic Republic of Congo in a bid to prevent the spread of the deadly virus from its neighbour.   All countries in high-risk areas, even if not hit by Ebola, had been advised by the WHO to use a new vaccine developed by US group Johnson & Johnson, the country's health minister, Diane Gashumba, told journalists.   The idea was "to protect those with high chances of getting in contact with people living in areas where Ebola has been reported to be active", she said.

The vaccine, Ad26-ZEBOV-GP, is an experimental drug produced by US pharmaceuticals giant, Johnson & Johnson. It was used for the first time in mid-November in Goma in DR Congo, on the other side of the border.    So far, there have no confirmed cases of Ebola in Rwanda.   The epicentre of the outbreak in DR Congo, which has killed more than 2,200 people since August 2018, is located 350 kilometres (217 miles) north of Goma, in the Beni-Butembo region.   That region sits on the DR Congo border with Uganda.   More than 250,000 people in DR Congo have already been vaccinated using another product, rVSV-ZEBOV, made by US drug company, Merck Shape and Dohme.

- Ebola in Goma -
People working in the health sector, at border crossings, police officers, and business executives who frequently travel between the two countries are being given priority in the vaccination campaign.   But all residents in the border districts can ask to be vaccinated if they wish.    The first volunteers expressed relief at the measure.    "We lived in a life of worry because of what was going on in DR Congo," Joel Ntwari Murihe, one of the first Rwandans to be vaccinated, told AFP.   "It caused a lot of border disruptions as we were restricted to buying or selling with DR Congo residents who live in Goma.    "The vaccine is an assurance to the safety for our lives and our children's lives."

The head of DR Congo's anti-Ebola efforts, Jean-Jacques Muyembe, and the WHO's representative in Rwanda, Kasonde Mwinga, were present at the campaign launch.    In August, Rwanda briefly closed its border with DR Congo and ordered its citizens not to visit the country when the first Ebola cases were recorded in Goma.   The city, which is the regional capital of the Congolese province of North Kivu, sits on the border with Rwanda.    The border has since been reopened, but strict medical checks are being enforced.
Date: Tue 6 Aug 2018
Source: New Times (Kigali, Rwanda) [summ., edited]
<https://www.newtimes.co.rw/news/livestock-vaccinations>

Livestock farmers have appealed to the government to ensure that cows get timely vaccination in order to effectively control deadly epidemics in cattle. The appeal comes after an outbreak of Rift Valley Fever [RVF] -- a deadly and infectious viral disease -- killed 154 cows countrywide since May [2018], according to figures from Rwanda Agricultural Board (RAB). Gahiga Gashumba, the chairman of Rwanda National Dairy Farmers' Federation, told The New Times that in their performance contracts, districts set themselves targets to inoculate cows, which leaves a gap in achieving effective vaccination.

Efforts to contain the recent outbreak of RVF included vaccinating 257 902 cows countrywide of which 119 520 were from Ngoma, Kirehe, and Kayonza -- the hardest hit by the disease. "All cows should be vaccinated at least in areas prone to given diseases," Gashumba said adding, "We need a clear vaccination calendar detailing the cows that should be immunised in a given period of time. When there are heavy rains, we should be prepared of [immunising cows against] East Coast fever."

Also known as theileriosis, East Coast fever is a deadly tickborne disease in cattle. Ngoma district vice mayor for Finance and Economic Development, Jean Marie Vianney Rwiririza, said that this year [2018], they want many cows to get vaccines against different diseases, including RVF and foot and mouth disease [FMD]. "With using funds from the district's budget alone, we cannot manage to give vaccines to all cows.

We request farmers' cooperatives and the farmers themselves to partake in the activity so that all the cows can be inoculated," he told The New Times. In Kirehe district, there are over 52 000 cows and over 30 000 of them were vaccinated against different diseases, including Rift Valley fever in the 2017/2018 financial year, according to Jean Damascane Nsengiyumva, Kirehe district vice mayor for Finance and Economic Development. "We have increased funding for the vaccination activity so that we inject all cows which we should vaccinate because we do not want the recurrence of such a problem," he said referring to RVF.

Rwanda Agriculture Board (RAB) said that they do not vaccinate all the cows because it can be wastage of resources or poor management when vaccination is done in areas where a disease has not been reported while it can be contained by vaccinating livestock in the risk zone. Instead of spending money on vaccinating all cows, currently estimated at over a million countrywide, appropriate strategies are devised to control the spread of outbreaks, said RAB director general Dr Patrick Karangwa. "We give more attention to diseases that spread faster than others. We do impact assessment based on spread pattern of a disease.

If a disease can be transmitted through air, measures taken to prevent its spreading should be different from the disease that cows or people catch through contact," Karangwa said. He cited FMD which often affects cattle on areas bordering Tanzania, such as Gatsibo, Kayonza, and Nyagatare, observing that when the disease has been checked in those areas, it dose spread elsewhere, pointing out that if all cows in the country are vaccinated, all the funds used [for the development of the livestock] sector might be consumed by such a single activity. Some vaccines are given free of charge, while others have to be paid for by farmers with government subsidy. [byline: Emmanuel Ntirenganya]
=======================
[RVF has become, according to local media, active in Rwanda in April 2018, as reported from the districts of Ngoma, Kirehe, and Kayonza, in the south west of the Eastern province. It was expressed mainly by cattle death and abortions. Later, Kamonyi, a southern province was added. The Rwandan Ministry of Agriculture and Animal Resources announced on [Mon 30 Jul 2018] the lifting of the ban imposed since mid-June [2018] on the movement of cattle in several parts of Eastern province. According to the ministry, 99 of the 147 604 cows in the affected districts died, and 452 aborted. This differs from other statistics from various sources, including the 154 deaths in cattle, as mentioned in the above media report, quoting the Rwanda Agricultural Board.

Official statistics are expected to be included in Rwanda's RVF report to the OIE, which all member countries are obliged to submit. In the absence of data on the number of susceptible animals on the affected holdings, the mortality rate in cattle is not known. Based on accumulated field observations and experimental RVF infection trials, the mortality in adult cattle would, generally, not exceed 10 per cent. No human cases have been reported in Rwanda during the recent event. Vaccination of livestock against RVF can be applied either with a live attenuated (Smithburn) vaccine (relatively cheap, several years immunity rendered, but may cause foetal abnormalities or abortion in pregnant animals).

Alternatively, particularly in pregnant animals, an inactivated (formalin-killed) RVF vaccine can be selected (more costly, safer in all breeds/ages/reproductive stages of cattle, sheep, and goats, but requires a booster 3-6 months after the initial vaccination, then followed by yearly boosters). For the considerations related to vaccine policies, vaccines to be selected, and other tools for the prevention and control of RVF under various epidemiological situations, please refer to references 1-3.

References
------------------------------
1. Consultative Group for RVF Decision Support. Decision-support tool for prevention and control of Rift Valley fever epizootics in the Greater Horn of Africa. Am J Trop Med Hyg. 2010. 83(2 Suppl): 75-85. DOI: 10.4269/ajtmh.2010.83s2a03; <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2913494/>.

2. Anonymous. Risk-based decision-support framework for prevention and control of Rift Valley fever epidemics in eastern Africa. EU Collaborative Project, Seventh Framework Programme. 2015. (Grant Agreement no. 266327); <http://www.healthyfutures.eu/images/healthy/deliverables/d5.4%20risk-based%20decision-support%20framework.pdf>.

3. Mariner J. Rift Valley fever surveillance. FAO animal production and health manual no. 21. Rome: FAO. 80 pages; <http://www.fao.org/3/i8475en/I8475EN.pdf>. - ProMED Mod.AS]

[Maps of Rwanda: <http://www.geographicguide.com/pictures/map-rwanda.jpg>
and <http://healthmap.org/promed/p/173>.]
Date: Mon 30 Jul 2018
Source: Journalducameroun.com, APA News report [summ., edited]
<https://www.journalducameroun.com/en/rift-valley-fever-rwanda-lifts-quarantine-on-cattle-movement/>

The Rwandan Ministry of Agriculture and Animal Resources, on [Mon 30 Jul 2018] announced it was lifting the quarantine on the movement of cattle that was imposed to control the deadly Rift Valley fever [RVF] in several parts of Eastern province. A quarantine on cattle in the country's 4 affected eastern districts has been imposed since mid-June [2018] after about 100 heads of cattle were killed by the virus. In a notice issued [Mon 30 Jul 2018], the minister Ministry of Agriculture and Animal Resources, Gérardine Mukeshimana, said the quarantine is no longer serving the purpose of slowing the spread of the deadly Rift Valley fever.

Reports indicate that the outbreak was first detected on 18 May 2018 in 4 districts in Eastern Rwanda including Ngoma, Kirehe, Rwamagana, and Kayonza. Of the 147 604 cows in the affected districts, the ministry says 99 died while 452 aborted. The ministry says it has treated 1638 cows, with 36 930 sheep and 245 goats vaccinated against the disease. To combat further deaths among animals, the ministry says it has dispatched veterinary doctors across the affected districts. Official reports indicate that no human case has been reported so far in Rwanda, yet the number of affected livestock is thought to be much higher.

According to the Director General of Rwanda Agriculture Board (RAB), Dr Patrick Karangwa, the cause of the outbreak is unusually heavy rains, which have created ponds and lakes where mosquitoes can breed, in this region which is normally dry. "Most human infections result from contact with the blood or organs of infected animals", Dr Karangwa said.
========================
[RVF, expressed mainly by cattle death and abortions, became active in Rwanda in April 2018, in the districts of Ngoma, Kirehe and Kayonza, in the southwest of the Eastern Province. Later, Kamonyi, a southern province was added.

An administrative map of Rwanda and detailed districts maps are available at
<https://en.wikipedia.org/wiki/Districts_of_Rwanda#Eastern_Province>.

In the absence of data on the number of susceptible animals on the affected holdings, the mortality rate in cattle is not known. Based on accumulated field observations and experimental RVF infection trials, the mortality in adult cattle would, generally, not exceed 10 percent. No human cases have been reported in Rwanda during the recent event. The tests upon which RVF, an OIE-listed disease, has been confirmed and statistics pertaining to the number, locations, morbidity, and mortality rates in Rwanda's animal population, are expected to be included in an official report to the OIE, as anticipated from all OIE member countries. - ProMED Mod.AS]

[HealthMap/ProMED-mail map of Eastern Province, Rwanda:
<http://healthmap.org/promed/p/15277>]
Date: Sun, 11 Mar 2018 11:43:19 +0100

Kigali, March 11, 2018 (AFP) - At least 16 people were killed and dozens more injured after lightning struck a Seventh-Day Adventist church in Rwanda, a local official said Sunday.   Fourteen victims were killed on the spot as lightning hit the church in the Nyaruguru district in the Southern Province on Saturday, local mayor Habitegeko Francois told AFP over the phone.

Two others died later from their injuries, he said.   He added that 140 people involved in the incident had been rushed to hospital and district health centres, but that many had already been discharged.   "Doctors say that only three of them are in critical condition but they are getting better," he said.   According to the mayor, a similar accident took place on Friday when lightning struck a group of 18 students, killing one of them.
Date: Wed, 26 Jul 2017 11:31:06 +0200
By Fran BLANDY

Volcanoes National Park, Rwanda, July 26, 2017 (AFP) - Nicaraguan singer Hernaldo Zuniga brought his entire family to trek through the lush forests and mist-shrouded volcanoes of northwestern Rwanda in search of mountain gorillas.   He described their encounter with the critically endangered primates as "an almost spiritual" experience, and said it was the only reason they made Rwanda a stop on a trip taking in a safari in Kenya, and a tour of South Africa.

But Rwanda is no longer content with being a whirlwind stop on a tourist's itinerary, and is working hard to broaden its appeal beyond its world-famous mountain gorillas while narrowing its niche market to the wealthiest of visitors.   Zuniga counts himself lucky that his family of five scored their permits to see the gorillas before Rwanda's eyebrow-raising move to double the cost to $1,500 (1,300 euros) per person in May.   "I think that is going to be a drawback for many people. It is just going to be an elite group of people who can pay that," said Zuniga, a well-known star in Latin America.

For Rwanda however, the price hike is part of a careful strategy to boost conservation efforts while positioning itself as a luxury tourist destination.   "The idea behind (the increase) is that it is an exclusive experience which also needs to be limited in numbers. Our tourism is very much based on natural resources and we are very serious about conservation," said Clare Akamanzi, the chief executive of the Rwanda Development Board.   It is a high-value, low-impact strategy that has worked well for countries such as Botswana and Bhutan.

- Safe and clean -
The remote, mountainous border area straddling Rwanda, the Democratic Republic of Congo and Uganda is the only place in the world where one can see the gorillas, whose numbers have slowly increased to nearly 900 due to conservation efforts.   Permits in the DRC ($400) and Uganda ($600) are far cheaper, but Rwandan officials are not concerned that they will lose tourists to their neighbours, arguing the country offers an experience that is rare in the region.   Ever since the devastating 1994 genocide in which 800,000 mainly Tutsis were killed, the country has been praised for a swift economic turnaround.   "When you come to Rwanda it is a clean, organised, safe country with zero tolerance for corruption. We have concentrated on creating a good experience," said Akamanzi, also highlighting a quick visa process.

The challenge is getting tourists to make Rwanda their main destination, and spend more than the usual four days it takes to visit the gorillas and maybe the genocide museum before heading elsewhere.   "We want to keep it high-end as an anchor for tourism but provide other offerings," said Akamanzi. She said tourism is already the country's top foreign exchange earner, but believes they "have only scratched the surface".   So the country, known as the Land of a Thousand Hills is looking into sports tourism such as cycling, cultural tourism and becoming a Big Five safari destination in its own right.   In the past two years Rwanda has re-introduced both lions and rhino to its Akagera National Park -- which had gone extinct due to poor conservation -- and visitor numbers to the reserve have doubled, said Akamanzi.

- 'There will be an impact' -
However gorillas remain the main lure, and industry players are concerned about the impact the price increase could have on the whole tourism chain.   "We risk losing substantial revenue for the industry and government as a whole. Currently a number of gorilla permits are already not sold in the low season," the Rwanda Tours and Travel Association (RTTA) said in a statement after the decision was announced.   Mid-range hotels around the Volcanoes National Park say it is too soon to tell what the fallout will be, but several managers expressed concerns they would lose their main clientele.   "Either way there will be an impact," said Fulgence Nkwenprana, who runs the La Palme hotel.

Aloys Kamanzi, a guide with Individual Tours, acknowledged there has been an initial slowdown in reservations, but is convinced people will keep coming, adding his clients are mostly "retired tourists who have saved their whole lives", some of whom come three or four times.   The singer Zuniga said coming to Rwanda was a hard decision, as he had not heard much about what the country was like today from Mexico, where he lives with his family.   "Rwanda has a lot of sensitive echoes in my generation, the genocide ... we had to cross over all these personal obstacles to make the decision to come here," he said.   "They have to do better in promoting their tourism. Once you are here it is amazing, the people are unique, the country is beautiful. I would like to stay longer."
More ...

Costa Rica

Costa Rica - US Consular Information Sheet
June 05, 2008
COUNTRY DESCRIPTION:
Costa Rica is a middle-income, developing country with a strong democratic tradition.
Tourist facilities are extensive and generally adequate.
The capi
al is San Jose.
English is a second language for many Costa Ricans.
Read the Department of State Background Notes on Costa Rica for additional information.

ENTRY/EXIT REQUIREMENTS:
For entry into Costa Rica, U.S. citizens must present valid passports that will not expire for at least thirty days after arrival, and a roundtrip/outbound ticket.
Some U.S. airlines may not permit passengers to board flights to Costa Rica without such a ticket.
Passports should be in good condition; Costa Rican immigration will deny entry if the passport is damaged in any way.
Costa Rican authorities generally permit U.S. citizens to stay up to ninety days; to stay beyond the period granted, travelers must submit an application for an extension to the Office of Temporary Permits in the Costa Rican Department of Immigration.
Tourist visas are usually not extended except under special circumstances, and extension requests are evaluated on a case-by-case basis.
There is a departure tax for short-term visitors.
Tourists who stay over ninety days may experience a delay at the airport when departing.
Persons who overstayed previously may be denied entry to Costa Rica.
Persons traveling to Costa Rica from some countries in South America and Sub-Saharan Africa must provide evidence of a valid yellow fever vaccination prior to entry.
The South American countries include Bolivia, Brazil, Colombia, Ecuador and Venezuela.
See “SPECIAL CIRCUMSTANCES” for information on requirements to carry documentation within Costa Rica and on travel by dual national minors.


The most authoritative and up-to-date information on Costa Rican entry and exit requirements may be obtained from the Consular Section of the Embassy of Costa Rica at 2114 “S” Street NW, Washington, DC 20008, telephone (202) 234-2945/46 , fax (202) 265-4795 , e-mail consulate@costarica-embassy.org, web site http://www.costarica-embassy.org, or from the Costa Rican consulates in Atlanta, Chicago, Houston, Los Angeles, Miami, New Orleans, New York, San Juan (Puerto Rico), San Francisco, and Tampa.
The Costa Rican immigration agency web site is http://www.migracion.go.cr.
It is advisable to contact the Embassy of Costa Rica in Washington or one of Costa Rica's consulates in the United States for specific information regarding customs requirements before shipping any items.
Visit the Embassy of Costa Rica web site at http://www.costarica-embassy.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:
There have been no recent acts of terrorism in Costa Rica.
Visitors to Costa Rica may experience the effects of civil disturbances such as work stoppages and strikes.
Although infrequent, these acts can create inconveniences for visitors.
On both the Caribbean and Pacific coasts, currents are swift and dangerous, and there are few lifeguards or signs warning of dangerous beaches.
Every year eight to twelve American citizens drown in Costa Rica due to riptides or sudden drop-offs while in shallow water.
Extreme caution is advised.

Adventure tourism is popular in Costa Rica, and many companies offer white-water rafting, bungee jumping, jungle canopy tours, deep sea diving, and other outdoor attractions.
Americans are urged to use caution in selecting adventure tourism companies.
The government of Costa Rica regulates and monitors the safety of adventure tourism companies; enforcement of safety laws is overseen by the Ministry of Health.
Registered tourism companies with operating permits must meet safety standards and have insurance coverage.
The safety regulations enforced in Costa Rica are not the same as safety regulations enforced in the United States.

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

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

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

CRIME:
Over one and a half million foreign tourists, the majority American, visit Costa Rica annually.
All are potential targets for criminals, primarily thieves looking for cash, jewelry, credit cards, electronic items and passports.
U.S. citizens are encouraged to exercise the same level of caution they would in major cities or tourist areas throughout the world.
Local law enforcement agencies have limited capabilities and do not act according to U.S. standards.
Travelers should minimize driving at night, especially outside urban areas.

Americans should avoid areas with high concentrations of bars and nightclubs, especially at night, and steer clear of deserted properties or undeveloped land.
For safety reasons, the Embassy does not place its official visitors in hotels in the San Jose city center, but instead puts them at the larger hotels in the outlying suburbs.
Americans should walk or exercise with a companion, bearing in mind that crowded tourist attractions and resort areas popular with foreign tourists are common venues for criminal activities.
Travelers should ignore any verbal harassment, and avoid carrying passports, large amounts of cash, jewelry or expensive photographic equipment.
Tourists are encouraged to carry photocopies of the passport data page and Costa Rican entry stamp on their persons, and leave the original passport in a hotel safe or other secure place.
Costa Rican immigration authorities conduct routine immigration checks at locations, such as bars in downtown San Jose and beach communities, frequented by illegal immigrants.
American citizens detained during one of these checks who have only a copy of the passport will be required to provide the original passport with appropriate stamps.



Travelers should purchase an adequate level of locally valid theft insurance when renting vehicles, park in secured lots whenever possible, and never leave valuables in the vehicle.
The U.S. Embassy receives several reports daily of valuables, identity documents, and other items stolen from locked vehicles, primarily rental cars.
Thefts from parked cars occur in downtown San Jose, at beaches, in the airport and bus station parking lots, and at national parks and other tourist attractions.
Travelers should use licensed taxis, which are red with medallions (yellow triangles containing numbers) painted on the side.
Licensed taxis at the airport are painted orange.
All licensed taxis should have working door handles, locks, seatbelts and meters (called "marias"); passengers are required to use seatbelts.
When traveling by bus, avoid putting bags or other personal belongings in the storage bins.
At all times have your belongings in your line of sight or in your possession.

Thieves usually work in groups of two to four.
A common scam has one person drop change in a crowded area, such as on a bus, and when the victim tries to assist, a wallet or other item is taken.
The most prevalent
scam involves the surreptitious puncturing of tires of rental cars, often near restaurants, tourist attractions, airports, or close to the car rental agencies themselves.
When the travelers pull over, "good Samaritans" quickly appear to change the tire - and just as quickly remove valuables from the car, sometimes brandishing weapons.
Drivers with flat tires are advised to drive, if at all possible, to the nearest service station or other public area, and change the tire themselves, watching valuables at all times.
In late 2006, the government of Costa Rica established a Tourist Police force, and units were established in popular tourist areas throughout the country.
The Tourist Police can assist with the reporting of a crime, which can be difficult for victims due to language barriers and the requirement that only investigative police can accept crime reports.

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 care in San Jose is adequate, but is limited in areas outside of San Jose.
Most prescription and over-the-counter medications are available throughout Costa Rica.
Doctors and hospitals often expect immediate cash payment for health services, and U.S. medical insurance is not always valid outside the United States.
A list of local doctors and medical facilities can be found at the website of the U.S. Embassy in San Jose, at http://sanjose.usembassy.gov.
An ambulance may be summoned by calling 911.
Most ambulances provide transportation but little or no medical assistance.
The best-equipped ambulances are called “unidad avanzada.”
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 Costa Rica is provided for general reference only, and may not be totally accurate in a particular location or circumstance.

Costa Rica has one of the highest vehicle accident rates in the world.
The fatality rate for pedestrians and those riding bicycles and motorcycles is disproportionately high.
Traffic laws and speed limits are often ignored, turns across one or two lanes of traffic are common, turn signals are rarely used, passing on dangerous stretches of highway is common, and pedestrians are not given the right of way.
Roads are often in poor condition, and large potholes with the potential to cause significant damage to vehicles are common.
Pedestrians, cyclists, and farm animals may use the main roads.
Traffic signs, even on major highways, are inadequate and few roads are lined.
Shoulders are narrow or consist of drainage ditches.
All of the above, in addition to poor visibility due to heavy fog or rain, makes driving at night especially treacherous.
Landslides are common in the rainy season.
All types of motor vehicles are appropriate for the main highways and principal roads in the major cities.
However, some roads to beaches and other rural locations are not paved, and many destinations are accessible only with high clearance, rugged suspension four-wheel drive vehicles.
Travelers are advised to call ahead to their hotels to ask about the current status of access roads.
Costa Rica has a 911 system for reporting emergencies.
In the event of a traffic accident, vehicles must/must be left where they are.
Both the Transito (Traffic Police) and the Insurance Investigator must make accident reports before the vehicles are moved.

Please refer to our Road Safety page for more information.
Visit the website of Costa Rica’s national tourist office and national authority responsible for road safety at http://www.mopt.go.cr and www.visitecostarica.com.

AVIATION SAFETY OVERSIGHT:
The U.S. Federal Aviation Administration (FAA) has assessed the Government of Costa Rica’s Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for oversight of Costa Rica’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:
Land Ownership and Shoreline Property: U.S. citizens are urged to use caution when making real estate purchases, and consult reputable legal counsel and investigate thoroughly all aspects before entering into a contract.
Coastal land within fifty meters of the high tide line is open to the public and therefore closed to development, and construction on the next one hundred fifty meters inland is possible only with the approval of the local municipality.

Squatters: Organized squatter groups have invaded properties in various parts of the country.
These squatter groups, often supported by politically active persons and non-governmental organizations, take advantage of legal provisions that allow people without land to gain title to unused agricultural property.
Local courts may show considerable sympathy for the squatters.
Victims of squatters have reported threats, harassment, and violence.
Documentation Requirements: Visitors are required to carry appropriate documentation at all times.
However, due to the high incidence of passport theft, tourists are permitted and encouraged to carry photocopies of the datapage and entry stamp from the passport, leaving the passport in a hotel safe or other secure place.
However, as noted under CRIME, Costa Rican immigration authorities conduct routine checks for illegal immigrants, especially in bars located in downtown San Jose and in beach communities.
An American citizen detained during one of these checks and carrying only the copy of the passport will be required to produce the original passport.
Tourists should consider carrying their passports when traveling overnight or a considerable distance from their hotel.
Tourists who carry passports are urged to place them securely in an inside pocket.

Exit Procedures for Costa Rican Citizens: Costa Rican children may only depart the country upon presentation of an exit permit issued by immigration authorities.
This policy, designed to prevent international child abduction, applies to dual national U.S./Costa Rican citizens.
Parents of minors who obtained Costa Rican citizenship through a parent or through birth in Costa Rica are advised to consult with appropriate Costa Rican authorities prior to travel to Costa Rica, especially if one (or both) parent(s) is not accompanying the child.



Disaster Preparedness: Costa Rica is located in an earthquake and volcanic zone.
Serious flooding occurs annually on the Caribbean side near the port city of Limon, but flooding occurs in other parts of Costa Rica as well, depending on the time of year and rainfall.
General information about natural disaster preparedness is available via the Internet from the U.S. Federal Emergency Management Agency (FEMA) at http://www.fema.gov/.

CRIMINAL PENALTIES:
While in a foreign country, a U.S. citizen is subject to that country's laws and regulations, which sometimes differ significantly from those in the United States and may not afford the protections available to the individual under U.S. law.
Penalties for breaking the law can be more severe than in the United States for similar offenses.
Persons violating Costa Rica’s laws, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in Costa Rica 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 Costa Rica are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department’s travel registration web site so that they can obtain updated information on travel and security within Costa Rica.
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 in Pavas, San Jose, and may be reached at (506) 2519-2000; the extension for the Consular Section is 2453.
The Embassy is open Monday through Friday, and is closed on Costa Rican and U.S. holidays.
Those seeking information are strongly encouraged to utilize the embassy web site http://sanjose.usembassy.gov/, and can email consularsanjose@state.gov with any questions/concerns.
For emergencies arising outside normal business hours, U.S. citizens may call (506) 2220-3127 and ask for the duty officer.
*

*

*
This replaces the Country Specific Information for Costa Rica dated August 15, 2007, to update sections on Registration/Embassy Location and Special Circumstances.

Travel News Headlines WORLD NEWS

Date: Tue 21 Jan 2020
Source: Ahora Noticias, Costa Rica [in Spanish, machine trans., edited]
<https://www.ahoranoticiascr.com/2020/01/21/autoridades-cerraron-pizzeria-debido-a-casos-de-hepatitis-a-en-san-ramon/>

As many as 22 people suffered from hepatitis A infection in San Ramon de Alajuela, and consequently the Health authorities closed a pizzeria in the area. A source close to this media confirmed the existence of the cases which were detected since 13 Jan 2020.

The cases were thought to be related to food consumption in that establishment 4 of patients were employees of the pizzeria. In statements to the media La Nación, Azalea Espinoza of the Directorate of Surveillance of the Ministry of Health, said they intervened in the business, issued a closing health order, and proceeded to cleaning and disinfecting it. [Byline: Carlos Miranda]
========================
[Although the eating establishment was identified as a pizzeria, pizza itself is not likely to be the vehicle of transmission as it is cooked before serving unless ingredients are added after the cooking process. It is unclear if the pizzeria employees were the source of, or just part of, the outbreak.

With an incubation period averaging 28 but up to 45 days, more cases may occur. The cases are not broken down in regard to age. In children, most cases of HAV infection are subclinical so it is likely that the cases reported were in adults. In the developing world, HAV is not reported much in adults as most children have been infected, and therefore immune to subsequent infection, by the age of 10. That outbreaks are occurring in the area suggests improvement in potable water so fewer children are infected and therefore still susceptible to HAV as adults. - ProMED Mod.LL]

[HealthMap/ProMED map available at: Costa Rica:
<http://healthmap.org/promed/p/17>]
Date: Wed, 8 Jan 2020 02:28:38 +0100 (MET)

San José, Jan 8, 2020 (AFP) - Costa Rica on Tuesday vehemently objected to the US government's decision to raise the alert level for tourists visiting the Central American country due to the risk of crime.   "We express energetic protest on the part of the Costa Rican government for the decision to change the recommendation level for American tourists," said foreign minister Manuel Ventura.

Ventura's statement came shortly after the US government issued a new travel advisory for visitors to Costa Rica.   According to the alert, "petty crime is the predominant threat for tourists in Costa Rica."   But the advisory warns that "armed robbery, homicide and sexual assault" could also occur.   Costa Rica also rose from Level 1, the lowest level, to Level 2 on he US State Department's travel alert scale. The highest is Level 4, which recommends no visiting.

The Central American country, known for its natural resources and beaches, attracts 1.2 million US tourists each year, according to official figures. In 2019, a total of more than 3 million foreign tourists visited.   "The change is surprising, because it puts Costa Rica -- which ended 2019 with a rate of 11 homicides per 100,000 inhabitants -- on par with countries on the continent that are among the most violent in the world," the Costa Rican foreign ministry said in a statement.

Data from the Ministry of Public Service indicates that there were 688 cases of theft of mobile phones, passports and money from tourists in 2019 -- only 0.02 percent of visitors to Costa Rica.   Tourism in Costa Rica has been shaken in recent years by several murders of female tourists, as well as sexual violence, including a Venezuelan-American woman who was killed near her hotel outside of the capital San Jose.
Date: Thu 8 Jan 2020
Source: Outbreak News Today [edited]

The Costa Rica Ministry of Health reported [Tue 7 Jan 2019] (computer translated) on the 2nd ever _Naegleria fowleri_, or "brain-eating amoeba" infection in their history.

The case is a 15-year-old who is presenting with a clinical picture of primary amebic meningoencephalitis (PAM) remains in a serious state at the Liberia Hospital. The investigation into the case shows the young man acquired the amoeba by inhaling water in the thermal springs of Guayabo de Bagaces.

The 1st case of primary amebic meningoencephalitis in the history of Costa Rica was recorded in 2014 in an American child who later died.

_Naegleria fowleri_ is a microscopic amoeba which is a single-celled living organism. It can cause a rare and devastating infection of the brain called primary amebic meningoencephalitis (PAM). The amoeba is commonly found in warm freshwater such as lakes, rivers, ponds and canals.

Infections can happen when contaminated water enters the body through the nose. Once the amoeba enters the nose, it travels to the brain where it causes PAM (which destroys brain tissue) and is usually fatal. Infections usually occur when it is hot for prolonged periods of time, which results in higher water temperatures and lower water levels.  _Naegleria fowleri_ infections are rare. Most infections occur from exposure to contaminated recreational water. Cases due to the use of neti pots and the practice of ablution have been documented.

[Byline: Robert Herriman]
=======================
[Amoebic meningoencephalitis is rare but is found worldwide and the reservoir is fresh water sources like lakes and rivers. It has been discussed if it is found in household water supplies, but so far cases have not been linked to tap water although it is possible in theory. - ProMED Mod.EP]

[HealthMap/ProMED map available at:
Date: Fri 25 Oct 2019
From: Donald J. Brightsmith <dbrightsmith@cvm.tamu.edu> [edited]

There have been 37 cases of autochthonous transmission of malaria in 2019 as reported by the Costa Rican Ministry of Health (<https://www.ministeriodesalud.go.cr/index.php/vigilancia-de-la-salud/analisis-de-situacion-de-salud>). The ministry also reports 39 cases of malaria in country that were likely contracted in foreign countries, mostly in Nicaragua.

The autochthonous cases came mostly from the northern part of the country in the district of Crucitas, but cases were also reported from other areas of the country.
---------------------------------------------------
Donald J. Brightsmith
University College of Veterinary Medicine & Biomedical Sciences
Texas A&M University
College Station, TX
=============================
[ProMed thanks Dr. Donald J. Brightsmith for communicating this to us.

This is a comment from the WHO website, "Costa Rica: 'Ripe' for malaria elimination?"

"Costa Rica is one of 21 countries identified by WHO as having the potential to eliminate malaria by 2020. Its success in bringing down cases of indigenous malaria -- that is, transmission of the malaria parasite within a country's own borders -- has been commendable, so much so that it has received an award from the Pan American Health Organization in recognition of the strides made. Notably, no one has died from malaria since 2009.

"However, after recording 3 consecutive years of zero indigenous cases between 2013 and 2015, local transmission of the disease has slowly been creeping upwards: 4 cases in 2016 and 12 in 2017. Of equal concern is imported malaria: To date, 21 such cases have been detected in 2018, up from 5 for all of 2017.

"In June 2018, the Costa Rican Ministry of Health issued a public health alert following the reporting of 10 imported malaria cases in just one week in the country's northern region bordering malaria-endemic Nicaragua. The Ministry is working to quickly identify and treat imported cases to prevent onward transmission to local communities in high-risk zones of the country. The areas of concern are mainly agricultural sites, like banana plantations.

"One such area is the canton of Matina, home to some of Costa Rica's largest plantations that grow the yellow fruit. Situated next to a major port on the Caribbean Sea, the canton's agricultural produce is shipped to markets worldwide, making Matina an important economic hub.

"Although Matina is far from the area of the recent alert, and no cases of malaria have been reported this year, all 4 indigenous cases reported in 2016 originated from the canton, as well as 2 of the 12 indigenous cases in 2017. Health authorities are not taking any chances and are working with the canton's fincas bananeras (banana plantations) to step up malaria surveillance activities, particularly among plantation workers and nearby communities." - ProMED Mod.EP]

[HealthMap/ProMED-mail map:
Date: Sun, 21 Jul 2019 00:04:32 +0200

San José, July 20, 2019 (AFP) - Alcohol tainted with potentially toxic levels of methanol has killed 19 people in Costa Rica, where authorities issued an alert against drinking some half-dozen brands.   The Ministry of Health issued the national warning Friday while also updating the death toll.   Of 34 people who have been poisoned, 14 men and five women, age 32 to 72, have died since the first week of June, the ministry said.   Authorities warned that it was not known how much alcohol had been adulterated, but have confiscated some 30,000 bottles and are carrying out a countrywide investigation.

The doctored alcohol contained between 30 to 50 percent methanol, according to Donald Corella, head of emergency services at Calderon Guardia Hospital in San Jose, who was quoted in the daily La Nacion.   He said six people who were treated at his hospital had died, while four others survived but suffered "very serious after-effects" ranging from irreversible total blindness to brain lesions that cause tremors similar to Parkinson's disease.   If ingested in large quantities, methanol can cause blindness, liver damage and death.   According to authorities, the majority of the 19 deaths occurred among homeless and alcoholic individuals.
More ...

Zambia

Zambia US Consular Information Sheet
June 02, 2008
COUNTRY DESCRIPTION:
Zambia is a developing country in southern Africa. Tourist facilities outside of the capital, Lusaka, Livingstone (Victoria Falls), and well-known game parks are not f
lly developed. Read the Department of State Background Notes on Zambia for additional information.
ENTRY/EXIT REQUIREMENTS: A passport and visa are required. A visa may be obtained in advance at a Zambian Embassy or Consulate or at the port of entry. Zambia raised the visa fee for American passport holders to $135 as of January 26, 2008. American citizens should bring exact change, whenever practical. Visas are valid for 3 years, and for multiple entries. At the time of entry, the immigration officer will stamp your passport with the permitted length of stay. This is normally 30 days and can ordinarily be extended twice (for a total time of 90 days) by visiting the immigration home office in Lusaka. All Americans, except resident diplomats, must pay an airport departure tax which is collected in U.S. dollars. Airlines include this tax in the cost of the ticket. However, passengers will need to verify that this tax has been paid at the airport. The passenger will receive a “no-fee” receipt reflecting this payment.

Travelers transiting through South Africa should ensure that they have at least two blank (unstamped) visa pages in their passports. South African immigration authorities routinely turn away visitors who do not have enough blank visa pages in their passports. Zambian Immigration officials insist visitors carry the original or a certified copy of their passport and their immigration permit at all times. Certified copies must be obtained from the immigration office that issued the permit. American citizens should closely follow immigration guidelines, including visa requirements for travel to Zambia.
NOTE: Some tour operators were previously able to obtain visas at reduced rates using a special tourism waiver. Zambia announced that they were ending this waiver program as of January 26, 2008 and that all American tourists would be required to pay the new $135 fee. Travelers with outstanding reservations with tour operators should be prepared to pay the difference upon arrival in Zambia.
Additional information on entry requirements may be obtained from the Embassy of the Republic of Zambia, 2419 Massachusetts Avenue NW, Washington, DC 20008, telephone (202) 265-9717 or 19 or online at http://www.zambiaembassy.org. Information about dual nationality or the prevention of international child abduction can be found on our web site. For further information about customs regulations, please read our Customs Information sheet.

SAFETY AND SECURITY:
U.S. citizens are advised to exercise caution when traveling in northern Luapula Province and in areas of the Northern Province adjacent to the Democratic Republic of Congo (DRC). Although a cease-fire is currently in effect, the DRC is not yet stable and uncontrolled militias operate in the eastern DRC. In the past, armed gunmen have occasionally attacked vehicles near the DRC-Zambian border. Land mines and unexploded ordnance along the western, southern, and eastern borders make off-road travel to those areas potentially hazardous. For these reasons, the U.S. Embassy discourages travelers from driving off-road or on remote little-used tracks near the borders with DRC and Angola. American citizens who must drive in these areas are encouraged to drive in convoy and to carry satellite telephones.

U.S. citizens should avoid political rallies and street demonstrations and maintain security awareness at all times. For the latest security information, Americans traveling abroad should regularly monitor the Department of State, Bureau of Consular Affairs’ web site at http://travel.state.gov, where the current Travel Warnings and Travel Alerts, as well as the Worldwide Caution, can be found.

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

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

CRIME: Travel in many sections of Lusaka, Livingstone and most other major cities as well as in the major game parks, is generally safe during daylight hours. Travelers using public transportation or visiting high pedestrian traffic areas are advised to be vigilant against robbery and pick-pocketing.

Vehicle thefts, burglaries, and armed robbery occur throughout the country. Carjacking remains an ongoing problem, especially in Lusaka and other major cities. Carjackers generally employ a strategy of blocking the back of one’s car when the car is waiting to pass through a security gate into a residence or other facility. It is recommended to drive with doors locked and windows closed at all times and remain vigilant when entering or exiting one’s residence.
Foreign tourists have frequently been the target of small-scale financial scams involving bogus “fees” to be paid to various Zambian officials and groups. The embassy cautions travelers to make sure that they receive an official, Government of Zambia receipt for any fines and duties paid. Often, travelers will be told that the official does not have a receipt book or that this type of fine is not receipted. Polite, but firm insistence on a Zambian Government receipt will often result in these fines disappearing.
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: Government hospitals and clinics are often understaffed and lack supplies. Private medical clinics in major cities can provide reasonable care in many cases, but major medical emergencies usually require medical evacuation to South Africa, Europe, or the United States. Basic medical care outside of major cities is extremely limited. Doctors and hospitals often expect immediate cash payment for health services. Travelers should carry their prescription drugs and medications in original labeled containers, as well as the written prescription from their physician. (See “Criminal Penalties” section.)
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 Zambia is provided for general reference only, and may not be totally accurate in a particular location or circumstance.
Traffic circulates on the left side of the road, and there are many British-style roundabouts rather than intersections with traffic lights. There is no left turn on red. Seat belts are mandatory, as are helmets for motorcyclists. A child's seat is not mandatory by law, but is essential for safeguarding children. The speed limit is 50 km/30 mph in Lusaka and 100 km/60 mph outside of city limits. However, speed limits are rarely respected, and most cars drive 80 km/50 mph in the city and 120 km/75 mph outside town. Most vehicles operate at even faster speeds on the road from Lusaka to Livingstone. Drivers under the influence of alcohol who are involved in accidents are tested at Lusaka's University Teaching Hospital (UTH) and then taken to court.

Driving on Zambian roads can be hazardous. Most roads do not have shoulders or sidewalks; pedestrians and livestock use the roadways both day and night. While the main roads in Lusaka as well as the principal highways linking Lusaka with the major provincial capital are generally maintained, many secondary roads are in poor repair. During the rainy season (end of October to mid-March), travelers who do not have a four-wheel drive vehicle will encounter problems driving on rural roads. Even in daylight, passing another vehicle can be particularly dangerous given the general condition of roads. Driving at night can be hazardous and is discouraged. When breakdowns occur, local drivers place a few branches behind the car to indicate trouble, but this is hardly visible at night. As a result, many drivers use their high beams at night to detect stopped vehicles and pedestrians.
Since 2000, Americans have been involved in a number of series car accidents. There are no emergency services for injured or stranded drivers. Car accident victims are vulnerable to theft by those who pretend to be “helpful.” It is advisable to have a cell phone when undertaking a trip outside of town, although many parts of the country do not yet have cell phone service.

City traffic is comprised mostly of cars and minibuses; motorcycles are rare. Minibuses serve as the primary means of inter-city travel in Zambia. They are often overcrowded and seldom punctual. Drivers often use pass using road shoulders or opposing traffic lanes. Often they will stop with little or no warning, in order to pick up or drop off passengers. Some luxury buses do ply the routes between Lusaka and Livingstone and the Copperbelt. 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.zambiatourism.com/.
AVIATION SAFETY OVERSIGHT:As there is no direct commercial air service to the United States by carriers registered in Zambia, the U.S. Federal Aviation Administration (FAA) has not assessed Zambia’s Civil Aviation Authority for compliance with International Civil Aviation Organization (ICAO) aviation safety standards. For more information, travelers may visit the FAA’s web site at http://www.faa.gov/safety/programs_initiatives/oversight/iasa.

SPECIAL CIRCUMSTANCES:
Perpetrators of business fraud often target foreigners, including Americans. While such fraud schemes in the past have been largely associated with Nigeria, they are now prevalent throughout Africa, including Zambia. For additional information, please consult The Department of State's publication "International Financial Scams." In addition, Americans are advised to exercise caution when approached with unsolicited offers to purchase gemstones or precious metals for export as the Embassy has received multiple recent complaints from Americans who have been victimized as a result of their involvement in these deals.
U.S. citizens are encouraged to carry a copy of their U.S. passports with them at all times, so that, if questioned by local officials, proof of identity and U.S. citizenship is readily available. Zambian police do not provide the U.S. Embassy with timely notification of the arrest of American citizens. If you are detained, you should insist on your right to contact a U.S. consular officer.
MasterCard and Visa cards are accepted in major supermarkets, restaurants, stores, and hotels in Lusaka and Livingstone (Victoria Falls). Credit card fraud is increasing in Zambia and there have been several cases involving fraudulent charges, including some at major hotels catering primarily to foreign visitors. Many businesses use carbonized paper documents to process payment. These documents are not secure and can pose a threat to cardholders. The Embassy urges caution when using debit or credit cards at any point of purchase, especially if the transaction is not processed electronically. Normally, American travelers can withdraw money (in local currency) from ATMs in major cities in Zambia using their ATM cards or credit cards from the United States. However, from time to time, the banks lose their connections with the credit card exchanges, thus making withdrawals impossible. Zambian banks and bureaux de change will not accept dollar-denominated notes issued before 1990.
Travel to military areas and photographing military facilities, airports, bridges, and other facilities deemed to be of security relevance, are prohibited. Often these sites are not clearly marked and the first notification that a tourist would receive is a police officer demanding their film and/or camera. Authorities may also challenge photography of areas other than tourist attractions. Service providers in Zambia, including the tourism sector, are not subject to the same standards of safety oversight that exist in the United States; visitors should evaluate risks carefully.

Travelers are cautioned to observe local or park regulations and heed all instruction given by tour guides. Even in the most serene settings, wild animals can pose a threat to life and safety.

Large numbers of travelers visit tourist destinations, including South Luangwa National Park and Livingstone (Victoria Falls), without incident. However, American citizens are advised to avoid rafting and other whitewater boating activities on the Zambezi River below Victoria Falls during the high-water season, February through June. During periods of high water, the Batoka Gorge section of the river becomes unpredictable and several tourists have been involved in fatal accidents.
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 Zambian laws, even unknowingly, may be expelled, arrested or imprisoned. Penalties for possession, use, or trafficking in illegal drugs in Zambia 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.

It is against both Zambian and U.S. law to buy, possess or transport animals or animal products, such as tortoise shell, rhino horn, elephant ivory, tusks of any animal or any items made out of these materials. In Zambia, penalties range from large fines to mandatory 5-year prison sentences. The Zambian Wildlife Authority has screeners at international ports of entry/exit and WILL prosecute offenders to the fullest extent of the law.

While many of these items are sold in open markets particularly aimed at foreign tourists, it remains the responsibility of the customer to ensure that he/she is not purchasing a prohibited item.

Further instructions on the importation of items to the U.S. may be found on the U.S. Customs and Border Protection web site at
http://www.customs.gov/xp/cgov/travel/vacation/kbyg/prohibited_restricted.xml.

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 Zambia are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department’s travel registration web site so that they can obtain updated information on travel and security within Zambia. 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 the corner of Independence and United Nations Avenues. The mailing address is P.O. Box 31617, Lusaka, Zambia. Telephone exchanges have recently changed within Zambia. When calling from the United States, please contact the American Embassy during regular work hours, Monday through Thursday from 7:30 a.m. to 5:00 p.m., and on Friday from 7:30 a.m. to 12:30 p.m. by dialing 011-260-21-125-0955. For after-hours emergencies involving American citizens, please dial 011-260-21-125-0955 extension 1. The fax number is 260-21-125-2225. The web site is http://zambia.usembassy.gov.
* * *
This replaces the Country Specific Information for Zambia dated February 14, 2008, to update sections on Entry/Exit Requirements and Crime.

Travel News Headlines WORLD NEWS

Date: Wed, 18 Dec 2019 18:01:59 +0100 (MET)

Lusaka, Dec 18, 2019 (AFP) - Zambia's 19-hour rolling blackouts have sent homes plunging into darkness, crippling daily life and business operations with the worst power outages the nation has seen.   Recurring drought across southern Africa has cut the water reserves of the hydroelectric dam of Kariba, the main source of energy of the country.   "Water levels in the dam continued receding, dropping to 476.93 metres above sea level as at 10 December 2019," the country's Energy minister Matthew Nkhuwa told parliament last week.   Currently, the water level in the dam is at 1.48 metres above the minimum operating level which translates to 10 percent usable water for power generation.    "At a similar period in 2018 the water level in the dam... was at 55 percent," Nkhuwa said.   Residents are subjected to 19 hours of power outages daily but in some instances others stay without power for longer, fuelling popular anger.

Some residents of the slums of Lusaka's Chaisa and Chilenje areas have staged protests against prolonged blackouts, stoning power installations as well as offices of the power utility firm, ZESCO.   "These long hours of staying without power have really made us suffer," local barber shop owner John Likumbi said.   In November, state utility power operator ZESCO started importing power from ESKOM of South Africa to cushion the impact of the power deficit on the country's economy.   But the imported power has only reduced outages by two hours.   ESCO board chairperson Mbita Chitala admitted that despite importing power from ESKOM, the utility firm still faced challenges in "importing the full 300 megawatt from time to time."

Eskom faces its own woes, with its old and poorly maintained coal-fired power stations struggling to keep up with the electricity demands of Africa's most industrialised economy.    Opposition leader Chishimba Kambwili blamed the rolling blackouts on the "total failure by this government."   The energy minister has said he feared that if the rainfall for Zambia did not improve, the situation might worsen.   For some, solar energy is the only sure way to survive the power outages.    "I am making savings ... in future I plan to buy a solar panel," barber Likumbi told AFP, adding that the blackouts made it difficult to even take children to school.
Date: Mon, 16 Dec 2019 19:30:12 +0100 (MET)

Lusaka, Dec 16, 2019 (AFP) - Zambia on Monday decided to allow the cultivation of cannabis for export for medicinal purposes, a government spokesperson said.   Up to now, the cultivation or possession of cannabis for whatever reasons was prohibited in Zambia and subject to a jail sentence.   " I wish to confirm that the cabinet... gave its approval, in principle, ...  for the cultivation, processing and exportation of cannabis for economic and medicinal purposes," said spokesperson Dora Siliya in a statement.

Siliya added that the health ministry would provide overall leadership as well as coordinate the issuance of licenses.   Cannabis for medicinal purposes has been authorised in around 30 countries.   The small kingdom of Lesotho was the first African nation to allow medicinal cannabis in 2017.   South Africa followed suit a year later but went further and approved the consumption of marijuana for personal use by adults.
Date: Tue, 29 Oct 2019 20:07:03 +0100 (MET)

Lusaka, Oct 29, 2019 (AFP) - More than two million Zambians are facing "severe" food insecurity after drought and flooding reduced harvests, the Red Cross said Tuesday.   Southern Africa is grappling with one of the worst droughts in decades after months of erratic rainfall and record-high temperatures.   Zambia Red Cross warned the drought had left an estimated 2.3 million people facing "severe food insecurity", up from 1.7 million a month ago.   "The successive mixture of drought and flooding has been catastrophic for many communities," said Zambia Red Cross head Kaitano Chungu in a statement.

While rainfall hit a record low in southern and western Zambia, flash floods and  waterlogging occurred in the north and east of the country.   The Red Cross said that combination resulted in "poor harvests", with families in the worst-affected areas surviving on wild fruit and roots -- posing a serious risk to their health.   "In most of the affected areas there isn't enough drinking water, which means that people and animals-both livestock and wildlife-are having to use the same water points," said Chungu.    "This is unacceptable as it exposes people to diseases and creates a heightened risk of animal attacks," he added.

Zambia's regional neighbours have also felt the impact.   More than five million rural Zimbabweans -- nearly a third of the population -- could face food shortages before the next harvest in 2020, according to the United Nations.   And wildlife has been affected as well.   At least 55 elephants died in Zimbabwe and 100 in Botswana over the past two months due to lack of food and water.
Date: 21 Oct 2019
Source: Outbreak News Today [edited]
<http://outbreaknewstoday.com/polio-cases-reported-in-zambia-chad-and-togo-73820/>

Circulating vaccine-derived polio virus (cVDPV) type cases have been confirmed in 10 African countries through [16 Oct 2019] this year [2019]. Now, the World Health Organization (WHO) is reporting 3 additional countries from the continent that more recently reported circulating vaccine-derived polio virus type 2 (cVDPV2) cases: Zambia, Chad and Togo.

Zambia
The Ministry of Health of Zambia reported last week on a confirmed case of circulating vaccine-derived polio virus type 2 (cVDPV2) in a 2-year-old child in Chienge district, Luapula province on the border with Democratic Republic of the Congo. This is the 1st case of cVDPV2 reported from Zambia in 2019. [Date of onset of paralysis reported to be 16 Jul 2019 according to another media report <https://www.lusakatimes.com/2019/10/21/polio-case-has-been-recorded-in-zambias-luapula-province/>.

In addition to the initial case-patient, 34 stool samples were collected from healthy contacts, and 2 samples tested positive for VDPV2, which were genetically linked to the case-patient. No established links have so far been found with the ongoing outbreak of cVDPV2 in Democratic Republic of the Congo, where 37 cases have been reported in 2019. The last recorded case of indigenous polio in Zambia was in 1995, while between 2001 and 2002, 5 cases of wild polio virus were identified among Angolan refugees in the Western province of the country.

Chad
Last week, WHO was informed about cVDPV2 in Chad. A cVDPV2 was isolated from a 13-month-old case of acute flaccid paralysis (AFP), with onset of paralysis on [9 Sep 2019] in Chari Baguirmi province, bordering Cameroon. The isolated virus has 32 nucleotide changes from Sabin 2, and is genetically linked to a cVDPV2 detected in Borno, Nigeria and is part of the Jigawa emergence. The last indigenous wild poliovirus cases were reported in 2000 in Chad.

Togo
In addition, last week WHO was informed about cVDPV2 in Togo. A cVDPV2 was isolated from a 30-month-old case of AFP with onset of paralysis on [13 Sep 2019] in Plateaux province, bordering Benin and Ghana. The isolated virus has 32 nucleotide changes from Sabin 2 and is genetically linked to a cVDPV2 detected in Irewole state, Nigeria and is part of the Jigawa emergence as well. The last indigenous wild poliovirus case was reported in 1999 in Togo.
======================
[Three more countries are joining the list of cVDPV outbreak countries, all with cVDPV2 isolates. Two of the 3 countries (Togo and Chad) have viruses related to the Jigawa, Nigeria cVDPV2 outbreak. The case in Zambia is suspected to be associated with the ongoing cVDPV2 transmission in the Democratic Republic of the Congo (DR Congo), but genetic testing is presumably still pending or has been negative. See my comments below after the following section, as they are relevant to what is ongoing globally with respect to cVDPVs.

Below are the HealthMap/ProMED map links to countries where cVDPV cases/outbreaks have occurred in the past 12 months, a total of 20 countries.

Angola: <http://healthmap.org/promed/p/165>
Benin: <http://healthmap.org/promed/p/59>
Cameroon: <http://healthmap.org/promed/p/65>
Central African Republic: <http://healthmap.org/promed/p/66>
Chad: <http://healthmap.org/promed/p/57>
China: <http://healthmap.org/promed/p/155>
Democratic Republic of the Congo: <http://healthmap.org/promed/p/194>
Ethiopia: <http://healthmap.org/promed/p/95>
Ghana: <http://healthmap.org/promed/p/53>
Indonesia: <http://healthmap.org/promed/p/184>
Kenya: <http://healthmap.org/promed/p/174>
Mozambique: <http://healthmap.org/promed/p/177>
Myanmar: <http://healthmap.org/promed/p/148>
Niger: <http://healthmap.org/promed/p/58>
Nigeria: <http://healthmap.org/promed/p/62>
Papua New Guinea: <http://healthmap.org/promed/p/188>
Philippines: <http://healthmap.org/promed/p/158>
Somalia: <http://healthmap.org/promed/p/125>
Togo: <http://healthmap.org/promed/p/64>
Zambia: <http://healthmap.org/promed/p/170> - ProMED Mod.MPP]
Date: Fri, 23 Aug 2019 15:08:04 +0200 (METDST)
By Obert SIMWANZA

Lusaka, Aug 23, 2019 (AFP) - Children living in a central Zambian mining town are still exposed to high levels of toxic lead 25 years after the mine closed, Human Rights Watch said Friday, as lawyers announced plans to take legal action.   Decades of lead mining have left Kabwe, around 150 kilometres (95 miles) north of Lusaka, severely polluted, with serious health implications for residents.   The mine, which operated from the early 1900s until its closure in 1994, was at one time the world's largest lead mine. It was run by the Zambian government from the early 1970s when the mining industry was nationalised.     In a report published Friday, HRW said the town in the Copperbelt area still has extreme levels of contamination and children continue to be exposed to high levels of toxic lead in soil and dust around their homes, schools and play areas.

HRW's children's rights fellow and report author Joanna Naples-Mitchell described the situation in Kabwe as "a public health emergency" and said the government was "not responding with the sense of urgency that is warranted".    "The Zambian government is aware that Kabwe has been severely contaminated... since the 1990s and efforts to clean up have been inadequate," she told AFP.   A class action suit is being prepared to demand compensation for poisoning from Anglo American South Africa, a former investor in the mine, London-based law firm Leigh Day announced Friday. The law firm deals in human rights issues.   The case will be brought in courts in South Africa, where the mining firm is based, said the lawyers, who are acting on behalf of some 200 children who have been treated for lead poisoning.   Anglo American on Friday said in a statement it did not believe it was "in any way responsible for the current situation" in Kabwe.    "We were concerned to learn of the situation at Kabwe as reported by the press," it said, adding "the nationalisation more than 40 years ago effectively placed these issues under the control of the Zambian Government".

- 'Severely contaminated' -
The HRW report said that although lead and zinc mining have stopped in the town, various medical studies conducted over the past seven years show children there still had elevated levels of lead in their blood.   Between 2003 and 2011, the World Bank funded a government project to decontaminate Kabwe's affected townships, and to test and treat children. But some 76,000 people, or a third of the town's population, still live in contaminated areas.   One recent study published last year and cited by HRW estimated that more than 95 percent of children in the townships surrounding the lead mine have elevated blood lead levels and that about half of them require medical intervention.   "This is the worst environmental disaster I have seen in 30 years of practice," said lawyer Richard Meeran of Leigh Day.    Johannesburg-based collaborating lawyer Zanele Mbuyisa said they will argue that "the environmental damage created has potentially contaminated almost three generations of men, women and children".

- Insufficient resources -
Three years ago, the government launched another five-year World Bank-funded project to get rid of the lead and carry out new rounds of testing and treatment.   The project targets around 10,000 people including children, pregnant women and mothers.   "We think this a very important opportunity for the Zambian government to find a lasting solution to this problem," said Naples-Mitchell.   She urged Zambia to find new and effective methods to clean up the lead, adding that their 2018 study indicated that pollution levels were "as high they had been in the 1970s".    In a letter last month, the government indicated to HRW that it does not have enough resources to address the full scale of the contamination.   The government did not immediately comment on the report.   Children are more vulnerable to lead poisoning since they absorb four to five times as much as an adult and this can retard their growth and IQ, while in worst cases it can result in brain damage or even death.
More ...

Uganda

Uganda - US Consular Information Sheet
March 02, 2009
COUNTRY DESCRIPTION:
Uganda is a landlocked, developing country in central eastern Africa. Infrastructure is adequate in Kampala, the capital, but is limited in other areas.
Read t
e Department of State Background Notes on Uganda for additional information.
ENTRY/EXIT REQUIREMENTS:
A passport valid for three months beyond the date of entry, visa and evidence of yellow fever vaccination are required.
Visas are available at Entebbe Airport upon arrival or may be obtained from the Embassy of the Republic of Uganda.
The current fee for a three month tourist visa obtained upon arrival at Entebbe Airport is $50.00.
Travelers should be aware that a visa does not determine how long a person may remain in Uganda.
The Ugandan immigration officer at the port of entry will determine the length of authorized stay, which is generally from one to three months as a tourist.
Extensions of duration of stay may be requested at Ugandan immigration headquarters on Jinja Road in Kampala.
Airline companies may also require travelers to have a visa before boarding.
Travelers should obtain the latest information and details from the Embassy of the Republic of Uganda at 5911 16th Street, NW, Washington, DC
20011; telephone (202) 726-7100.
The Ugandan Embassy may also be contacted by email.
Travelers may also contact the Ugandan Permanent Mission to the United Nations, telephone (212) 949-0110. Overseas, inquiries may be made at the nearest Ugandan 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:
U.S. citizens residing in or planning to visit Uganda should be aware of threats to their safety posed by insurgent groups operating in the Democratic Republic of the Congo and southern Sudan, and the potential of cross border attacks carried out by these armed groups.
In addition, U.S. citizens traveling to the area commonly known as Karamoja in northeastern Uganda should also be aware of ongoing conflict and armed banditry in this region.

Northern Uganda:
After years of conflict, relative stability has returned to northern Uganda with the departure of the Lord’s Resistance Army (LRA) insurgent group in 2006.
Recent LRA activity has been restricted to the remote region of Garamba National Park in the Democratic Republic of the Congo (DRC), where LRA insurgents have continued to attack and terrorize civilian populations.
LRA attacks have also occurred in the neighboring Central African Republic and southern Sudan.
The Governments of Uganda, the DRC, and southern Sudan initiated joint military operations against LRA bases in Garamba National Park on December 14, 2008, after LRA leader Joseph Kony refused to sign a peace agreement following two years of negotiations.
These military operations continue and in order to deter an LRA return to Uganda, the Uganda Peoples Defense Force (UPDF) maintains a significant presence in the northern districts.
Given the continued threat to regional security posed by the LRA, American citizens should exercise caution when traveling in those districts of northwestern Uganda that border the DRC and southern Sudan and which could potentially be subject to LRA incursions.
The Ugandan Government also continues to expand and improve the capacity of the civilian police force in northern Uganda by deploying additional personnel and concentrating resources to further recovery and re-development activities throughout the north.

American citizens traveling to northern Uganda are advised to ensure that they have made appropriate travel, lodging, and communication arrangements with their sponsoring organization before visiting the region.
Local officials in northern Uganda have expressed concern for the safety and security of foreigners visiting the area to assist with relief efforts, but without any specific arrangements with a sponsoring organization.
Foreign citizens who travel to the region without a sponsoring organization may not find secure lodging or safe transport, and may become more susceptible to crime.
They may also find that local officials are unable to provide assistance in the event of an emergency.
There is a general lack of infrastructure throughout northern Uganda, and services such as emergency medical care are nonexistent.
Given crime and other security concerns in northern Uganda, American citizens are advised to restrict travel to primary roads and during daylight hours only.

Cattle rustling, armed banditry, and attacks on vehicles are very common in the Karamoja region of northeastern Uganda, and the UPDF continues to implement a program to disarm Karamojong warriors.
Past incidents have included ambushes of UPDF troops, and attacks on vehicles, residences, and towns that resulted in multiple deaths.
Most of the violence occurred in the districts of Kaabong, Kotido, and Abim, although some violent incidents also occurred in Moroto and Nakapiripirit Districts.
American citizens are advised to avoid travel to the Karamoja region given the frequent insecurity.
Any travel to Karamoja (excluding charter flights to Kidepo National Park) by U.S. Embassy personnel must first be authorized by the Chief of Mission.

Southwestern Uganda:
American citizens traveling in southwestern Uganda should also exercise caution given the ongoing conflict in the districts of North and South Kivu in the DRC, and the close proximity of fighting to the Ugandan border.
During spikes in the conflict, refugee flows across the border number in the thousands and there is also a risk of incursions by armed combatants.
American citizens should review the Travel Warning for the Democratic Republic of the Congo for the most up-to-date information regarding the conflict in the DRC.

On August 8, 2007, a group of armed assailants entered Uganda from the DRC and raided Butogota, a town in Kanungu District, southwestern Uganda.
Three Ugandans were killed and many others assaulted during the raid.
Ugandan officials believe that the perpetrators of the attack were members of one of the various militia groups operating in the southeastern region of the DRC or possibly remnants of the "Interahamwe," a group that participated in the 1994 genocide in Rwanda and was also responsible for the 1999 attack on Bwindi Impenetrable National Park.
The 1999 Bwindi attack killed four Ugandans and eight foreign tourists.
The 2007 raid on Butogota is in an area transited by tourists traveling to Bwindi, a popular gorilla-trekking destination.
Within Bwindi Impenetrable National Park, armed security personnel accompany tourists on the daily gorilla hikes and the UPDF maintains a military presence.
At Ishasha Camp, another popular tourist destination located in the southern sector of Queen Elizabeth National Park, the UPDF also maintains a small military base near the park headquarters for security purposes.

Eastern Uganda:
In February 2008, an isolated incident occurred in Mount Elgon National Park in eastern Uganda that resulted in the death of a foreign tourist.
A Belgian tourist climbing Mt. Elgon in the company of park rangers was shot and killed.
The attack occurred while the group was camped for the night and assailants fired into the campsite.
The tourist was reportedly struck by gunfire when exiting her tent in the darkness.
Ugandan security and park officials suspected that the attack was perpetrated by smugglers engaged in cattle rustling or other illicit activities that are common in the border area.

Demonstrations:
Demonstrations take place in Kampala and other Ugandan cities from time to time in response to world events or local developments.
In most cases, these demonstrations occur with no warning and demonstrations intended to be peaceful can turn confrontational and possibly violent.
American citizens are therefore urged to avoid the areas of demonstrations if possible, and to exercise caution if they find themselves in the vicinity of any demonstration.
American citizens should stay current with media coverage of local events and be aware of their surroundings at all times.
Because many demonstrations are spontaneous events, the U.S. Embassy may not always be able to alert American citizens that a demonstration is taking place and to avoid a specific area.
If employed with an institution or other large organization, American citizens may find it helpful to request that local employees notify expatriates when they learn of a demonstration from local radio reports or other sources.
Recent protests have occurred over land disputes involving Kampala market areas, university closures and strikes, opposition political party demonstrations, and protests by taxi drivers over the enforcement of traffic regulations.

For the latest security information, Americans traveling abroad should regularly monitor the Department of State's, Bureau of Consular Affairs’ web site, where the current Travel Warnings and Travel Alerts, as well as the Worldwide Caution, can be found.

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

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

CRIME:
Crimes such as pick pocketing, purse snatching, and thefts from hotels and parked vehicles or vehicles stalled in traffic jams are common.
The Embassy receives frequent reports of theft of items from locked vehicles, even when the stolen items were secured out of sight and the vehicle was parked in an area patrolled by uniformed security personnel.
Pick pocketing and the theft of purses and bags is also very common on public transportation.
Armed robberies of pedestrians also occur, sometimes during daylight hours and in public places.
Although infrequent, the Embassy also receives reports of armed carjackings and highway robbery.
In May 2007, two American citizens reported an attempted robbery when they were traveling near the town of Bugiri in eastern Uganda.
The Americans reported that a second vehicle with at least one armed assailant tried to stop their vehicle by forcing it off the road.
This incident occurred during daylight hours.
On June 27, 2007, two American citizens were robbed and held at gunpoint when the vehicle transporting them to Entebbe Airport was stopped by a group of armed men.
This incident occurred during the early morning hours on Entebbe Road.
Although some of these attacks are violent, victims are generally injured only if they resist.
U.S. Embassy employees are advised against using roads at night, especially in areas outside the limits of cities and large towns. Home burglaries also do occur and sometimes turn violent.
In April 2008, the Ugandan police reported an increase in armed robberies in the Kampala neighborhoods of Bukoto, Kisaasi, Kiwatule, Naalya, Najera, and Ntinda.
Several of these robberies occurred as the victims were arriving at their residences after nightfall and the assailants struck as they were entering their residential compounds.

Women traveling alone are particularly susceptible to crime.
In early 2008, there was an increase in reports of sexual assaults against expatriate females.
In some instances, the victims were walking alone, or were single passengers on one of the common modes of public transport which include "boda boda" motorcycle taxis.
If the victim of a sexual assault, medical assistance should be sought immediately and counseling provided regarding prophylactic treatment to help prevent the transmission of HIV and other sexually transmitted diseases. The U.S. Embassy provides a list of local medical providers for those with medical needs.

American citizens visiting Uganda are advised not to accept food or drink offered from a stranger, even a child, because such food may contain narcotics used to incapacitate a victim and facilitate a robbery or sexual assault.
In addition, patrons of bars, casinos, nightclubs, and other entertainment centers should never leave their drink or food unattended.
When visiting such establishments, it is advisable to remain with a group of friends as single individuals are more likely to be targeted.
Victims have included female patrons who reported they were drugged, and taken to another location and sexually assaulted.
Robberies have been facilitated on public transportation under similar circumstances.
In 2006, an American citizen traveling by bus from Kenya to Uganda was incapacitated and robbed on the bus when the passenger accepted a sealed beverage from a fellow traveler.
Expatriates traveling by bus to the popular tourist destination of Bwindi Impenetrable National Forest in southwest Uganda were also incapacitated and robbed when they accepted snacks from fellow bus passengers.

There has been a recent, marked increase in financial crime, including fraud involving wire transfers, credit cards, checks, and advance fee fraud perpetrated via email.
The U.S. Embassy recommends using money orders for all fund transfers and protecting all bank account and personally identifiable information such as social security numbers and other types of information.

An increasing number of U.S. exporters (primarily vendors of expensive consumer goods such as computers, stereo equipment, and electronics) have been targeted by a sophisticated check fraud scheme.
A fictitious company in Uganda locates a vendor on the Internet, makes e-mail contact to order goods, and pays with a third-party check.
The checks, written on U.S. accounts and made out to entities in Uganda for small amounts, are intercepted, chemically "washed" and presented for payment of the goods with the U.S. vendor as payee and an altered amount.
If the goods are shipped before the check clears, the U.S. shipper will have little recourse, as the goods are picked up at the airport and the company cannot be traced.
American companies receiving orders from Uganda are encouraged to check with the Political - Economic Section of the Embassy to verify the legitimacy of the company.
The Embassy strongly cautions U.S. vendors against accepting third-party checks as payment for any goods to be shipped to Uganda.

Additional information about the most common types of financial fraud can also be found in the State Department Financial Scams brochure.

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 Uganda is: 999.
Please see our information on Victims of Crime, including possible victim compensation programs in the United States.

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

SPECIAL CIRCUMSTANCES:
Please note that U.S. currency notes in $20 and $50 denominations are exchanged at a lower rate than $100 currency notes.
In addition, travelers often find that they cannot exchange or use U.S. currency printed earlier than the year 2000.
Travelers who find they cannot pay for accommodation or expenses often must request that friends or family wire money to them in Uganda.
There are offices that facilitate Western Union, MoneyGram, and other types of money transfers in Kampala and other cities throughout the country.
ATMs are available in Uganda, particularly in downtown Kampala, but usually only customers who have an account with a specific Ugandan bank may use them.
A few machines function with overseas accounts.

The U.S. Embassy frequently receives requests from American citizens to verify the bona fides of nongovernmental (NGO) and charity organizations operating in Uganda.
The Embassy is unable to provide information regarding the bona fides of these organizations and American citizens traveling to Uganda to work for an organization are encouraged to request that the charity provide references of past volunteers whom they may contact.
American citizens have also reported intimidation and harassment by directors of organizations, when the Americans questioned the organization's activities or use of donated funds.
While the vast majority of NGOs operating in Uganda are legitimate organizations aiding development efforts, there have been reports from concerned Americans regarding the suspected diversion of charity funds for personal gain, etc.

Ugandan Customs authorities may enforce strict regulations concerning the importation of pets.
A Ugandan import permit is required, along with an up-to-date rabies vaccination certificate and a veterinary certificate of health issued by a USDA-approved veterinarian no more than thirty days before arrival.
Travelers are advised to contact the Ugandan Embassy in the United States for specific information regarding customs requirements.
Please see our Customs Information sheet.

Photography in tourist locations is permitted.
However, taking pictures of military/police installations or personnel is prohibited.
Military and police officers have detained tourists for taking photographs of Entebbe Airport and of the area around Owen Falls Dam, near Jinja, although the prohibition on taking photographs is not publicly displayed on signs.

The U.S. Embassy receives frequent inquiries from American citizens wishing to register a nongovernmental organization (NGO) in Uganda.
Information about registering an NGO can be obtained from the Ugandan NGO Board which has offices within the Ministry of Internal Affairs.
The NGO Board can be reached on phone number: 256 414 341 556.
One of the requirements for registering an NGO is that a foreign national employee or volunteer must provide a Certificate of Good Conduct/Criminal Background Check.
The U.S. Embassy Kampala cannot provide a Certificate of Good Conduct or Criminal Background Check, so American citizens intending to travel to Uganda as an employee an NGO or who plan to register an NGO should obtain a Certificate of Good Conduct from their local police or the Federal Bureau of Investigation (FBI) before departing the United States.
More information on how to obtain a Criminal Background Check can be found on the FBI web page about Identification Record Requests.
MEDICAL FACILITIES AND HEALTH INFORMATION:
Medical facilities in Uganda, including Kampala, are limited and not equipped to handle most emergencies, especially those requiring surgery. Outside Kampala, hospitals are scarce and offer only basic services.
Recently, American citizens involved in automobile accidents required immediate evacuation from Uganda as surgery could not be performed due to insufficient blood supplies at the hospital where they sought treatment.
Equipment and medicines are also often in short supply or unavailable.
Travelers should carry their own supplies of prescription drugs and preventive medicines.
A list of medical providers is available at the U.S. Embassy.

Tuberculosis is an increasingly serious health concern in Uganda.
For further information, please consult the CDC's Travel Notice on TB.

Malaria is prevalent in Uganda.
Travelers who become ill with a fever or flu-like illness while traveling in a malaria-risk area and up to one year after returning home should seek prompt medical attention and tell the physician their travel history and what antimalarials they have been taking.
For additional information on malaria, including protective measures, see the CDC’s information on malaria.

In January, 2009, the CDC’s Special Pathogens Branch retrospectively diagnosed a case of Marburg hemorrhagic fever in a U.S. traveler, who had returned from Uganda in January, 2008. The patient developed illness four days after returning to the United States.
The Amcit had visited the “python cave” in Queen Elizabeth Park, western Uganda, which is a popular destination among tourists to see the bat-infested cave.
For additional information on Marburg hemorrhagic fever, including protective measures, visit the CDC web site.

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.
For information about outbreaks of infectious diseases abroad, consult the World Health Organization’s (WHO) web site.
Further health information for travelers is available from the WHO. Uganda has experienced recent outbreaks of Marburg Hemorrhagic Fever, Ebola Hemorrhagic Fever, Pneumonic Plague, Meningitis, and other types of infectious diseases.

The U.S. Department of State is unaware of any HIV/AIDS entry restrictions for visitors to or foreign residents of Uganda.
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.
American citizens who are seriously injured in vehicle or other types of accidents in Uganda generally seek medical evacuation to Kenya or other destinations for more advanced emergency medical treatment.
These medical evacuations can be very expensive, and in the event the American citizen does not have sufficient insurance coverage, the evacuation is carried out at their personal expense.
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 Uganda is provided for general reference only, and may not be totally accurate in a particular location or circumstance.

Most inter-city transportation in Uganda is by small van or large bus.
Many drivers of these vehicles have little training and some are reckless.
Small vans and large buses are often poorly maintained, travel at high speeds, and are the principal vehicles involved in the many deadly single and multi-vehicle accidents along Ugandan roads.
Accident victims have included American citizens traveling in small vans and personal cars, passengers on motorcycle taxis locally known as "boda bodas," and pedestrians.
Large trucks on the highways are often over-loaded, with inadequately secured cargo and poor braking systems.
Alcohol frequently is a contributing factor in road accidents, particularly at night.
Drivers are advised to take extra care when driving.
Nighttime driving and road transportation should be avoided whenever possible.
Pedestrians often walk in the roads and may not be visible to motorists.
Large branches or rocks in the road sometimes indicate an upcoming obstruction or other hazard.
Highway travel at night is particularly dangerous, including the road between Entebbe Airport and Kampala.
The Embassy recommends caution on this road and use of a reliable taxi service to and from the airport.

Traffic accidents draw crowds.
Ugandan law requires that the drivers stop and exchange information and assist any injured persons.
In some cases where serious injury has occurred, there is the possibility of mob anger.
In these instances, Ugandans often do not get out of their cars, but drive to the nearest police station to report the accident.

Please refer to our Road Safety page for more information.
For specific information concerning Ugandan driving permits, vehicle inspection, road tax and mandatory insurance, please contact Tourism Uganda, IPS building, 14, Parliament Avenue, Kampala, Uganda; telephone 256-414-342 196. You may also wish to consult the Tourism Uganda web site or, for information on government agencies, see the My Uganda web site.

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

International airlines offer several weekly flights to Europe and the United Arab Emirates, and Kenya Airways has daily flights between Entebbe Airport and Nairobi.
Other regional airlines operate weekly flights to other destinations in Africa, such as Dar es Salaam, Addis Ababa, Cairo, and Johannesburg.

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 Uganda are encouraged to register with the U.S. Embassy in Kampala through the State Department’s travel registration web site to obtain updated information on travel and security within Uganda.
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 1577 Ggaba Road, Kampala; telephone 256-414-259-791 or 256 414 306 001; fax 256-414-258-451.
You may contact the Embassy via e-mail.
* * *
This replaces the Country Specific Information dated May 6, 2008, to update sections on Entry/Exit Requirements, Safety and Security, Crime, Information for Victims of Crime, Medical Facilities and Health Information, Medical Insurance, Traffic Safety and Road Conditions, Special Circumstances, Aviation Safety Oversight, Special Circumstances, and Registration/Embassy Location.

Travel News Headlines WORLD NEWS

Date: Wed 22 Jan 2020 1:04 PM EAT
Source: Uganda Red Cross Twitter [edited]

One confirmed case of Crimean-Congo haemorrhagic fever, 4 others suspected, in Kagadi [western Uganda]

A district Task Force has been formed to manage and coordinate the cases across the district @MinofHealthUG @robert_kwesiga @inakasiita1
========================
[Crimean-Congo haemorrhagic fever (CCHF) can cause serious disease in humans, with a case fatality rate of 10-40%. It can be responsible for severe outbreaks in humans, but it is not pathogenic for ruminants, their amplifying hosts. WHO states that the onset of symptoms in humans is sudden, with fever, myalgia, (muscle ache), dizziness, neck pain and stiffness, backache, headache, sore eyes and photophobia (sensitivity to light). There may be nausea, vomiting, diarrhoea, abdominal pain, and sore throat early on, followed by sharp mood swings and confusion. After 2-4 days, the agitation may be replaced by sleepiness, depression, and lassitude, and the abdominal pain may localize to the upper right quadrant, with detectable hepatomegaly (liver enlargement). Other clinical signs include tachycardia (fast heart rate), lymphadenopathy (enlarged lymph nodes), and a petechial rash (a rash caused by bleeding into the skin) on internal mucosal surfaces, such as in the mouth and throat, and on the skin.

Public education, especially among individuals in contact with livestock or their products, is needed to prevent cases of CCHF infection. A One Health approach is needed for effective surveillance, with effective communication between animal health and human health professionals.

The information in the tweet above indicates that there is one confirmed and at least 4 suspected cases of CCHF in Kagadi district, in the western region of Uganda.  Any updates on the epidemiology of these cases, occupational exposure, and public health response measures to control the transmission will be highly appreciated. - ProMED Mod.UBA]

[Maps of Uganda:
Date: Tue 31 Dec 2019
Source: Outbreak News Today [edited]

A 2nd fatal human Rift Valley fever (RVF) case in recent weeks was reported in Uganda. According to the World Health Organization (WHO), the 2nd confirmed case of RVF was reported from Ntoroko district, Uganda.

The individual was a 25-year-old male from the Democratic Republic of Congo who was living and working in Kimara Village, Butungama sub-county, in Ntoroko district, Uganda. The patient developed haemorrhagic symptoms on 5 Dec [2019] and despite treatment, the patient died the next day [6 Dec 2019]. A safe and dignified burial occurred later in the month [December 2019].

The 1st RVF case/death was reported from Obongi district (see Rift Valley fever - Eastern Africa (06): Uganda ex South Sudan http://promedmail.org/post/20191209.6829994).

According to WHO, RVF is caused by a virus transmitted by mosquitoes and blood-feeding flies that usually affects animals (commonly cattle and sheep) but can also involve humans. In humans, the disease ranges from a mild flu-like illness to severe haemorrhagic fever that can be lethal. When livestock are infected, the disease can cause significant economic losses due to a high mortality rate in young animals and waves of abortions in pregnant females.
========================
[The WHO report cited above leads one to conclude that although the man was from the DR Congo, he was living and working in Uganda and contracted the Rift Valley fever [RVF] there. There is no indication that RVF cases were occurring in livestock in Uganda at the time this case occurred, nor how the man became infected. There were RVF livestock cases in 2018. There were 3 reported RVF outbreaks located in 3 separate southwestern districts of Uganda (Mbarara, Isingiro, Lyantonde) (see Rift Valley fever - Eastern Africa (31): Uganda, bovine, OIE http://promedmail.org/post/20180907.6014484).

At that time, there also were 2 confirmed human cases (see Rift Valley fever - Eastern Africa (13): Uganda, WHO http://promedmail.org/post/20180711.5898523). However, in 2019, no livestock cases were reported. The occurrence of human cases in the absence of reported animal cases prompted Mod.AS to comment: "Unfortunately, during the recent South Sudan RVF event, as in most -- if not all -- previous RVF events in other African countries, humans served as sentinels. Improved surveillance in animals is desperately needed in Africa to allow timely measures applied, predominantly preventive vaccination, before the development of a full-blown epizootic involving secondary infection in humans."

It is likely that RVF virus has persisted in this Uganda and other countries in East Africa in transovarially infected eggs of _Aedes_ mosquito vectors. These eggs can remain viable for long periods of time and hatch when flooded during future rain events, with the subsequent emergence of infected females ready to transmit the virus. This risk provides justification for keeping livestock of the area well vaccinated into the future. This may have accounted for the reappearance of RVF in South Sudan in 2018, after nearly 2 years without additional reported cases in humans or livestock, and again with this human case in 2019. - Mod.TY]

[HealthMap/ProMED-mail map:
Ntoroko district, Uganda: <http://healthmap.org/promed/p/24929>]
Date: Tue 3 Dec 2019
Source: Outbreak News Today [edited]

In late November [2019], Uganda health authorities notified the World Health Organization of a fatal Rift Valley fever (RVF) case from Obongi district.  The case was a 35-year-old man from South Sudan who was living in the Palorinya Refugee camp in Obongi district, Uganda. The case had travel history to South Sudan between 12 and 19 Nov 2019 to harvest cassava. While in his home country, he developed fever and other symptoms and was treated for malaria; however, his condition got worse.  He later returned to the refugee camp in Uganda and his symptoms progressed and he was hospitalized. Viral hemorrhagic fever was suspected. Samples were collected and sent to the Uganda Virus Research Institute; however, the patient died. A safe and dignified burial was performed on 22 Nov 2019. As of 24 Nov 2019, a total of 19 contacts were recorded during the active case search including 10 healthcare workers.
===================
[The circumstances and specific location under which the man became infected with Rift Valley fever (RVF) virus in South Sudan is not mentioned. It is worth noting that there was an RVF outbreak in the Eastern Lakes region of South Sudan during the 1st 3 months of last year (2018). At the end of that outbreak, the OIE's follow-up report no. 3 reported: "The event cannot be considered resolved, but the situation is sufficiently stable. No more follow-up reports will be sent. Information about this disease will be included in the next 6-monthly reports."

There were more human cases than animal ones in that outbreak, prompting Mod.AS to comment: "Unfortunately, during the recent South Sudan RVF event, as in most -- if not all -- previous RVF events in other African countries, humans served as sentinels. Improved surveillance in animals is desperately needed in Africa, to allow timely measures applied, predominantly preventive vaccination, before the development of a full-blown epizootic involving secondary infection in humans." Intensified surveillance is needed in South Sudan in those localities where the affected man had been prior to his return to Uganda.

It is likely that RVF virus has persisted in this area in transovarially infected eggs of _Aedes_ mosquito vectors. These eggs can remain viable for long periods of time and hatch when flooded during future rain events, with the subsequent emergence of infected females ready to transmit the virus. This risk provides justification for maintaining livestock of the area well vaccinated into the future. This may have accounted for the reappearance of RVF in South Sudan in 2018, after nearly 2 years without additional reported cases in humans or livestock and again with this human case in 2019. - ProMED Mod.TY]

Obongi district, Uganda is located approximately 50 km (30 mi) from the South Sudan border.
HealthMap/ProMED-mail maps:

According to OIE's data, a total of 2 outbreaks of RVF affecting animals have been reported from Sudan during the event. The 1st outbreak started in the Arabaata dam area, Red Sea state, on 25 Sep 2019, affecting goats. The 2nd (and, so far, last) outbreak started 10 Oct 2019 in the River Nile state, affecting sheep and goats. Both outbreaks have been declared as 'resolved' on 14 Nov 2019.

Outbreak summary:
Total outbreaks = 2 (Submitted)
Species / Susceptible / Cases / Deaths / Killed and disposed of / Slaughtered
Goats / 1700 / 37 / 7 / 0 / 0
Sheep / 1550 / 37 / 5 / 0 / 0

According to the recent (5 Dec 2019) OCHA (UN Office for the Coordination of Humanitarian Affairs) update, the (human) RVF situation in Sudan, as of 26 Oct 2019, was the following: "a total of 345 suspected RVF cases -- including 11 related deaths -- reported in the states of Red Sea (128), River Nile (212), Khartoum (1), White Nile (1), Kassala (2), and Gedaref (1). The most affected age group is 15 to 45 years, which accounts for 83% of the total suspected cases. The male to female ratio is 2.6, with a high proportion of the cases being farmers (37.5 per cent). RVF is endemic in Sudan and 3 outbreaks affecting people have been documented in 1973, 1976, and 2008. During the outbreak in 2008, a total of 747 laboratory-confirmed cases were reported, including 230 deaths."

Egypt suffered its 1st RVF outbreak in 1977/78 with serious human disease and death as well as severe losses in livestock; several additional events have been recorded since. A recent historical review paper [1] concluded: "due to the availability and abundance of the potential vectors, the suitability of environmental conditions, continuous importation of livestock's from Sudan, and the close association of susceptible domestic animals with humans, the RVF virus could possibly occur and circulate in Egypt."   (https://tinyurl.com/whz3pz5)

Reference
---------
1. Kenawy MA, Abdel-Hamid YM, Beier JC. Rift Valley fever in Egypt and other African countries: Historical review, recent outbreaks, and possibility of disease occurrence in Egypt. Acta Trop. 2018; 181: 40-49; <https://doi.org/10.1016/j.actatropica.2018.01.015>  - ProMED Mods.AS/TY]
Date: Sat, 7 Dec 2019 15:58:56 +0100 (MET)

Kampala, Dec 7, 2019 (AFP) - Twelve people have been swept to their deaths by floods in western Uganda, the Red Cross said on Saturday, as the East African country is battered by torrential rain.   "We have recovered 12 bodies from the water and one person has been rushed to hospital with serious injuries," said Diana Tumuhimbise, Red Cross branch manager in the Bundibugyo district.   "The rain started last night and continued until 9:00 am (0600 GMT)," she told AFP on Saturday.   "Several houses have been swept away, roads have been blocked and some washed away completely."

The Red Cross has launched a search and rescue operation with the police, military and community members in 12 affected areas but it is not yet clear how many people are missing.    Rain is hampering communication in the remote location, on the border with DR Congo and separated from the rest of Uganda by the Rwenzori mountains.   At least 20 people have been killed as a result of floods and mudslides in the last week in Uganda.

The extreme weather has been blamed on the Indian Ocean Dipole -- a climate system defined by the difference in sea surface temperature between western and eastern areas of the ocean.   At the moment, the ocean around East Africa is far warmer than usual, resulting in higher evaporation and moist air flowing inwards over the continent as rain: the hallmarks of a "positive" dipole.   Scientists warn that as ocean temperatures rise because of climate change, Indian Ocean dipoles will become more frequent and severe.
Date: Wed, 20 Nov 2019 12:59:15 +0100 (MET)

Kampala, Nov 20, 2019 (AFP) - Global health charity Marie Stopes said Wednesday it had recalled hundreds of thousands of faulty condoms on sale in Uganda, where HIV rates are among the highest in the world.   The recall followed a warning from Uganda's National Drug Authority (NDA) that the Life Guard brand condoms had failed manufacturing "quality tests" because they contained holes and may burst.   The affected condoms were manufactured by India-based MHL Healthcare in April 2019 and have an expiry date of April 2024, the government regulator said.   Marie Stopes Uganda spokesman David Kamu told AFP on Wednesday that the two affected batches each contained "around 400,000" condoms.

Earlier reports had suggested millions of condoms could have been involved but NDA spokesman Fred Ssekyana told AFP the figure was below one million.   Marie Stopes Uganda said more than half of the condoms of concern had been recalled.   "While the LifeGuard brand follows strict quality controls, unfortunately two recent batches have fallen short of the quality we demand," the charity's country director, Carole Sekimpi, said in a statement Tuesday.   Marie Stopes is the largest and most specialised sexual reproductive health organisation in Uganda, the charity says on its website.   According to UNAIDS, 1.4 million Ugandans are living with HIV.   Last year 53,000 people were newly infected with the disease in the East African country, the UN agency said.
More ...

World Travel News Headlines

Date: Fri, 24 Jan 2020 12:26:57 +0100 (MET)

Beijing, Jan 24, 2020 (AFP) - China has quarantined cities and shut major tourist attractions from Disneyland to the Forbidden City and a section of the Great Wall as it scrambles to stop a deadly SARS-like virus from spreading further.   The drastic moves come as hundreds of millions of people criss-crossed the country in recent days to celebrate the Lunar New Year holiday, which officially started Friday and is typically a joyous time of gatherings and public celebration.   Here is a rundown of the measures taken so far in an unprecedented quarantine effort:

- Cities under lockdown -
Public transport has been stopped in 13 cities in central Hubei province, with train stations shut, events cancelled and theatres, libraries and karaoke bars closed in some locations.   The epicentre of the outbreak is provincial capital Wuhan, the biggest city on lockdown, where the government has halted all travel out of the Yangtze River metropolis of 11 million.   Wuhan residents have been told to stay home and authorities are limiting the number of taxis allowed on roads. There are few flights available to the city, deepening the isolation.   Similar quarantine measures are being taken in the other, smaller cities. These include strict controls on weddings and funerals, temperature screening of people as they arrive and the suspension of online taxi services.   More than 41 million people in total are affected by the city shutdowns.

- Festivities cancelled -
Wuhan and Beijing have cancelled public events that usually attract hundreds of thousands of people to temples during the New Year holiday.   Gao Fu, head of the Chinese Center for Disease Control and Prevention, has asked China's 1.4 billion citizens to forego New Year gatherings and confine themselves at home until all is clear.   To discourage nationwide travel, the government also said all tickets for rail, air, road, or water transport could be refunded.

- Attractions closed -
The historic Forbidden City, a sprawling imperial palace in Beijing that is one of the country's most revered cultural sites, will temporarily close from Saturday.   Other famous landmarks including a section of the Great Wall, the Ming Tombs and Yinshan Pagoda are also not open to visitors.   Shanghai Disneyland said it would shut for an indefinite period "to ensure the health and safety of our guests and cast".   Women's Olympics football qualifiers scheduled for February 3-9 in Wuhan have been moved to the eastern city of Nanjing.

- Temperature checks -
Staff in full body protective suits were seen checking the temperatures of people entering a subway station in Beijing on Friday.   The country has ordered sterilisation and ventilation at airports and bus stations, as well as inside planes and trains, while travellers are being screened for fever.   Health authorities are urging people to wash their hands regularly, avoid crowded places, get plenty of fresh air and wear a mask if they have a cough.   In Wuhan, city authorities have made it mandatory to wear a mask in public places.   In response to skyrocketing demand for masks -- starting to sell out at pharmacies and on some popular websites -- China's industry and information technology ministry said it would "spare no effort in increasing supply".

- A new hospital -
In Wuhan, authorities are rushing to build a new hospital in a staggering 10 days as a rising number of patients are infected by the new coronavirus.   The facility is expected to be in use by February 3 and will have a capacity of 1,000 beds spread over 25,000 square metres, according to state media.   Dozens of excavators and trucks were filmed working on the site by state broadcaster CCTV.   Its construction began after reports surfaced of bed shortages in hospitals designated as dealing with the outbreak, which has now infected 830 people across China.
Date: Fri, 24 Jan 2020 11:22:00 +0100 (MET)

Beijing, Jan 24, 2020 (AFP) - China announced Friday it will close a section of the Great Wall and other famous Beijing landmarks to control the spread of a deadly virus that has infected hundreds of people across the country.   A range of Lunar New Year festivities have been cancelled to try to contain the virus, and Beijing's Forbidden City and Shanghai's Disneyland have also been closed temporarily.

The Ming Tombs and Yinshan Pagoda will also be closed from Saturday, the authority that oversees the sites said, while the Bird's Nest stadium -- the site of the 2008 Olympic Games -- was shuttered from Friday.   The Great Wall attracts around 10 million tourists a year and is a popular destination for visitors during the New Year holiday.   The Juyongguan section will close, while the Great Wall temple fair was cancelled at the Simatai section of the famous landmark.

Tourists at the Gubei water town by the Simatai section will have their temperature tested, the authority said in a statement on the WeChat social media app.   The Bird's Nest will be closed until January 30 in order to "prevent and control" the spread of the virus, authorities said. An ice and snow show taking place on the pitch will be closed.   The measures in the capital are the latest to try and control the outbreak of the new coronavirus, after authorities rapidly expanded a mammoth
quarantine effort that affected 41 million people in central Hubei province.

The previously unknown virus has caused alarm because of its similarity to SARS (Severe Acute Respiratory Syndrome), which killed hundreds across mainland China and Hong Kong in 2002-2003.   Although there have only been 29 confirmed cases in Beijing, city authorities have cancelled large-scaled Lunar New Year events this week.   The city government said it would call off events including two popular temple fairs, which have attracted massive crowds of tourists in past years.   Beijing's Forbidden City -- which saw 19 million visitors last year -- is usually packed with tourists during the Lunar New Year festival, when hundreds of millions of people travel across China.
Date: Fri, 24 Jan 2020 10:40:12 +0100 (MET)
By Sébastien RICCI

Wuhan, China, Jan 24, 2020 (AFP) - Chinese authorities rapidly expanded a mammoth quarantine effort aimed at containing a deadly contagion on Friday to 13 cities and a staggering 41 million people, as nervous residents were checked for fevers and the death toll climbed to 26.

While the World Health Organization (WHO) held off on declaring a global emergency despite confirmed cases in half a dozen other countries, China expanded its lockdown to cover an area with a total population greater than Canada's.   A range of Lunar New Year festivities have been cancelled, while temporary closures of Beijing's Forbidden City, Shanghai's Disneyland and a section of the Great Wall were announced to prevent the disease from spreading further.   The previously unknown virus habeis caused alarm because of its similarity to SARS (Severe Acute Respiratory Syndrome), which killed hundreds across mainland China and Hong Kong in 2002-2003.

The WHO said China faced a national emergency but stopped short of making a declaration that would have prompted greater global cooperation, including possible trade and travel restrictions.   The outbreak emerged in late December in Wuhan, an industrial and transport hub of 11 million people in China's centre, spreading to several other countries including the United States.   China is in the midst of its Lunar New Year holiday, a typically joyous time of family gatherings and public festivities.   But on Friday Wuhan was a ghost town, its streets deserted and stores shuttered.

- Worried patients -
Hospitals visited by AFP journalists bustled with worried patients being screened by staff wearing full-body protective suits.   At a temperature-check station, a medical staffer in bodysuit, face mask and goggles took a thermometer from a middle-aged woman, pausing to examine the reading before quickly turning back to the patient.   "Have you registered? Then go and see the doctor," the staffer said.   One 35-year-old man surnamed Li voiced the fears of many.   "I have a fever and cough, so I'm worried that I'm infected," he said.   "I don't know the results yet."

With hundreds of millions of people on the move across China for the holiday, the government has halted all travel out of Wuhan, shut down its public transport and told residents to stay home. Deepening the isolation, there were few flights available to the city.   "This year we have a very scary Chinese New Year. People are not going outside because of the virus," said a taxi driver in the city, who asked not to be named.   But said a prolonged shutdown should not pose food-shortage problems because many Chinese had stocked up for the holiday.

Besides Wuhan, 12 other smaller cities nearby have battened down the hatches, with most of them going public on Friday with various measures ranging from closing public venues and restricting large gatherings to halting public transportation and asking citizens not to leave their cities.   Several of the cities have populations numbering several million, led by Huanggang, which has 7.5 million.    The pathogen -- 2019 Novel Coronavirus (2019-nCoV) -- has caused many outlets in Shanghai, Beijing and other cities to sell out their stocks of face masks.   As reports surfaced of bed shortages in Wuhan hospitals, state media said authorities were rushing to build a new facility devoted to the outbreak in a mind-blowing 10 days.

The Wuhan hospital is targeted to be ready by February 3. Dozens of excavators and trucks were filmed working on the site by state television.   To discourage nationwide travel, the government has said all tickets for rail, air, road, or water transport could be exchanged for a refund.   On Friday, staff in full body protective suits were seen checking the temperatures of people entering a subway station in Beijing.   Thermal cameras scanned passengers arriving at Beijing's West Railway Station.

- 'Work as one' -
Chinese authorities said the number of cases leapt overnight to more than 800, with 177 in serious condition. There were another 1,072 suspected cases.   Officials also said that a virus patient died in Heilongjiang province in China's far northeast, the second death outside the Wuhan epicentre.   Beijing has been praised for its response in contrast to SARS, when it took months to report the disease and initially denied WHO experts any access.

Gao Fu, head of the Chinese Center for Disease Control and Prevention, asked China's people to forego New Year gatherings this year and confine themselves at home until the all-clear.    "If we all work as one, we can contain the virus in Wuhan and add no more cases exported from Wuhan, so as to stem the virus nationwide," Gao told state TV.   Beijing has cancelled popular New Year public events at temples in the capital, the historic Forbidden City will close from Saturday, and Shanghai Disneyland said it also will shut down for an indefinite period from Saturday to protect visitors and staff.
Date: Fri, 24 Jan 2020 07:46:42 +0100 (MET)

Shanghai, Jan 24, 2020 (AFP) - Shanghai Disneyland will close until further notice this weekend due to a deadly virus outbreak that has infected hundreds of people in China, the amusement park said Friday.   The closure comes as China entered its nearly week-long Lunar New Year holiday, and the home of Mickey Mouse had prepared special "Year of the Mouse" celebrations for its guests.

But the park and resort said on its website it would temporarily close from Saturday "in response to the prevention and control of the disease outbreak and in order to ensure the health and safety" of its guests and staff.   "We will continue to carefully monitor the situation and be in close contact with the local government, and we will announce the reopening date upon confirmation," it said, adding that guests who had purchased tickets or booked a resort hotel would be reimbursed.   The entertainment conglomerate opened its $5.5 billion theme park in Shanghai in June 2016, Disney's sixth amusement park and third in Asia.
Date: Fri, 24 Jan 2020 03:33:13 +0100 (MET)
By Rusmir SMAJILHODZIC with Emmy VARLEY in Belgrade

Sarajevo, Jan 24, 2020 (AFP) - As winter grips the Balkans, the poor are caught in a cruel bind, being forced to light fires at home for heating while fuelling a pollution crisis smothering the region.   In recent weeks, Balkan capitals from Belgrade and Sarajevo to Skopje and Pristina have been ranked among the world's top 10 most polluted major cities, according to the monitoring application AirVisual.

While these are small cities compared to leading Asian polluters like New Delhi and Dhaka, a combination of coal-fired power plants, old cars and fires to heat homes are pumping the air with toxins.   "I know it is polluting. I am not an idiot but my only other choice would be to heat this home with electricity and that is damn expensive," said Trajan Nestorovski, who like many in his working-class Skopje neighbourhood burns wood to stay warm in winter.   His wife Vera added: "There are a couple of factories near our neighbourhood that are burning God knows what in the evenings".

Thanks to the rise of mobile phone apps that measure air quality, like the local Moj Vozduh (My Air) created by a Macedonian developer, citizens are finally grasping the full extent of the crisis.    "Serbia is suffocating, has anyone seen the minister of the environment?", said a recent headline in Belgrade's local Blic newspaper, speaking of the fog and dirty air enveloping the city.   Protests have been erupting around the region in recent days.

In Skopje, the capital of North Macedonia, young people have taken inspiration from Swedish activist Greta Thunberg by holding a spate of protests on Fridays.    "Greta inspired all of us," said 17-year-old Iskra Ilieska.   "In winter, half of my school class is absent because of lung problems. That is not normal," she said.

In neighbouring Bosnia, several hundred people wearing face masks gathered in the city of Tuzla to demand a plan from authorities to tackle pollution and phase out coal-fired plants in the next five years.   "The only recommended measures are that we stay shut up at home... when you go out on the streets, in the playgrounds, you won't see children anywhere," said Alisa Kasumovic, a mother in her forties.

- Silent killer -
According to a recent UN environment report, air pollution causes nearly 20 percent of premature deaths in 19 Western Balkan cities.   The main sources of the dust, soot and smoke are low-grade coal plants and household heating, the report said.    More than 60 percent of people in the region rely on coal and firewood to heat their homes, the report said. Only 12 percent of buildings are connected to district heating systems.

Governments need to make "clean energy more accessible", ban old polluting vehicles and tighten regulations on industry emissions and power plants, the UN urged.    Many people cannot afford cleaner heating options at home in countries where average wages are around 500 euros or less.   Sali Ademi, a 78-year-old in Kosovo's capital Pristina, uses coal.     "There's no worse thing, but what can you do?" he said in a city whose air is already poisoned by two nearby coal-fired power plants running on outdated technology.

- Cable car escape -
Those who warm their homes with fires also bear the brunt of health risks, according to experts.   "Some of the emissions from these stoves stay in the house and poison them," warned Anes Podic, president of an environmental group in Bosnia who has called on the government to replace inefficient wood stoves in the country.

In cities like Sarajevo and Skopje, a circle of mountains helps trap the hazardous air in the valleys where residents live.   Sakiba Sahman, 60, is a Sarajevan taking advantage of a recent reduction on ticket prices for a cable car that rides to the top of the 1,160-metre-high (3,800-foot-high) Mount Trebevic, which peaks above the smog over the Bosnian capital.   "We've come to spend a few hours to ventilate the lungs," she told AFP.   Down below, "the pollution is enormous, there are a lot of cars, everything is dirty, grey and depressing."
Date: Fri, 24 Jan 2020 00:46:15 +0100 (MET)

Lima, Jan 23, 2020 (AFP) - Peru's government promised on Thursday to protect the Machu Picchu sanctuary and other Inca ruins when building a new airport to serve the ancient civilization's capital of Cusco.   Machu Picchu and the Inca road system are UNESCO World Heritage sites, and the UN agency has previously expressed concerns over the proposed airport at Chinchero, less than 60 kilometers from the Inca sanctuary that was built in the 15th century.   "We have made a commitment that before work begins on constructing the Chinchero airport, in June of this year, we will present the heritage impact study that UNESCO demands," Transport Minister Edmer Trujillo, who is responsible for the project, told journalists.

UNESCO has told Peru that even though the airport will be built outside of the archeological areas, it is necessary to study how a potential increase in tourists would affect them.   The new airport will be able to receive six million passengers per year -- 60 percent more than the current Cusco airport, which has a capacity for 3,000 passengers a day but receives 5,000.

The existing airport cannot grow because it is inside Cusco, a major Andean city in southeast Peru.   Machu Picchu -- the most iconic site from the Inca empire that ruled a large swathe of western South America for 100 years before the Spanish conquest in the 16th century -- is Peru's most popular tourist attraction, located about 100 kilometers (60 miles) from Cusco.   Trujillo said construction of the new airport would be constantly monitored
by culture ministry experts in case archeological ruins are found.

The airport will be built at 3,780 meters above sea level in the old Inca Sacred Valley.   Many have criticized the impact it could have not only on the country's national treasures but on rural communities.   "Building an airport in the Sacred Valley will have irreparable effects in terms of noise, increase in traffic and uncontrolled urbanization," historian Natalia Majluf said in August.   But local Cusco authorities say it will bring in vital tourism revenue, which the region depends on.
Date: Tue 21 Jan 2020
Source: Channels TV [edited]

In Ondo state, 16 people have been confirmed killed as a result of a Lassa fever outbreak. The state chief epidemiologist, Dr Steven Fagbemi, disclosed this on Tuesday [21 Jan 2020] at the governor's office in the Government House in Akure, the state capital.

Dr Fagbemi made the disclosure while briefing Governor Oluwarotimi Akeredolu as well as the local government chairmen from Ondo North and Central senatorial districts of the state. He also revealed that 84 cases have been reported so far in the state since 1 Jan 2020.

According to the epidemiologist, 16 of the patients have passed on, as their cases had reached the advanced stage before they were taken to the hospital. He added that 47 patients on admission were responding to treatment, while 21 others had already been treated and discharged.

The outbreak is said to have affected Owo, Akoko South-West, Akure South, and Ondo West LGAs of the state.

Also confirming the outbreak, the commissioner for health, Dr Wahab Adegbenro, noted that the disease has been occurring in the state for some years, especially during the dry season. He therefore advised Nigerians to visit hospitals when they noticed symptoms of fever.

Earlier, Governor Akeredolu advised the local government chairmen in the state to deploy cleaners to markets and public places to prevent the outbreak of diseases. He also called on residents to maintain a high level of hygiene to curtail further spread of the Lassa virus in the state.
====================
[The 81 new confirmed and 159 suspected cases in week 3 of 2020 indicate that Lassa fever (LF) virus transmission is continuing to accelerate. The 1st report above confirms that Ondo state has the majority of cases, tied with Edo state. Nigeria is now entering the period of the year when fewer cases usually occur, as illustrated in the graph in Figure 6 (at the source URL above). There has been a peak in case numbers between weeks 1 and 11 (January-March) over the past 3 years and probably will be the case again this year (2020).

Transmission of LF virus occurs when individuals are in contact with rodent reservoir host excreta or are within healthcare facilities. It would be interesting to know whether the prevalence of Lassa fever virus has been increasing in populations of rodent hosts in areas where human cases are occurring.

Images of the rodent reservoirs of Lassa fever virus:
_Mastomys natalensis_: <https://www.inaturalist.org/taxa/45326-Mastomys-natalensis>
_Mastomys erythroleucus_ and _Hylomyscus pamfi_: <http://punchng.com/nigerias-large-rat-population-threatens-lassa-fever-war/>

The pygmy mouse (_Mus baoulei_) has recently been implicated as a reservoir species in West Africa but not in Nigeria.

There is no specific mention in the plans above of public education for avoidance of contact with these rodents and their excreta. - ProMED Mod.TY]

[Maps of Nigeria:
Date: Tue 21 Jan 2020
Source: Ahora Noticias, Costa Rica [in Spanish, machine trans., edited]
<https://www.ahoranoticiascr.com/2020/01/21/autoridades-cerraron-pizzeria-debido-a-casos-de-hepatitis-a-en-san-ramon/>

As many as 22 people suffered from hepatitis A infection in San Ramon de Alajuela, and consequently the Health authorities closed a pizzeria in the area. A source close to this media confirmed the existence of the cases which were detected since 13 Jan 2020.

The cases were thought to be related to food consumption in that establishment 4 of patients were employees of the pizzeria. In statements to the media La Nación, Azalea Espinoza of the Directorate of Surveillance of the Ministry of Health, said they intervened in the business, issued a closing health order, and proceeded to cleaning and disinfecting it. [Byline: Carlos Miranda]
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[Although the eating establishment was identified as a pizzeria, pizza itself is not likely to be the vehicle of transmission as it is cooked before serving unless ingredients are added after the cooking process. It is unclear if the pizzeria employees were the source of, or just part of, the outbreak.

With an incubation period averaging 28 but up to 45 days, more cases may occur. The cases are not broken down in regard to age. In children, most cases of HAV infection are subclinical so it is likely that the cases reported were in adults. In the developing world, HAV is not reported much in adults as most children have been infected, and therefore immune to subsequent infection, by the age of 10. That outbreaks are occurring in the area suggests improvement in potable water so fewer children are infected and therefore still susceptible to HAV as adults. - ProMED Mod.LL]

[HealthMap/ProMED map available at: Costa Rica:
<http://healthmap.org/promed/p/17>]
Date: Thu, 23 Jan 2020 17:57:34 +0100 (MET)
By Eva XIAO

Beijing, Jan 23, 2020 (AFP) - The first fatality of China's new virus would come to represent a common set of traits for those who died to the disease: he was over the age of 60 and in poor health.   Since China reported the emergence of a new coronavirus at the end of December, the SARS-like virus has infected more than 500 and killed 17.   So far, the majority of the victims were elderly individuals with pre-existing health conditions, such as diabetes and liver cirrhosis.   All hailed from central Hubei province, where a local seafood market in the capital city of Wuhan is believed to be the epicentre of the epidemic.   But while older individuals have died from the Wuhan virus, some younger patients -- including a 10-year-old boy -- have since been released from the hospital.   Here's what we know so far about the deaths:

Most victims were over 60
According to details released by China's National Health Commission (NHC) on Thursday, the 17 victims of the virus were between 48 and 89 years old.   Only two were under the age of 60, while the average age of the victims was 73.   Most of them died this week, according to the NHC.   Among those who have been discharged from the hospital were younger patients, including a 35-year-old man from Shenzhen, a bustling tech hub in southern Guangdong province.   He was released from the hospital on Thursday, according to the local health commission, as well as the 10-year-old boy who had visited relatives in Wuhan before falling ill.

Many had pre-existing health conditions
Many of those who died from the virus also had pre-existing health issues before contracting the Wuhan disease, such as diabetes and hypertension.   One man, an 86-year-old who was hospitalised on January 9, had surgery for colon cancer four years prior, on top of suffering from high blood pressure and diabetes.   Another, an 80-year-old woman surnamed Hu, had Parkinson's Disease and more than 20 years of high blood pressure and diabetes in her medical history.

Some were hospitalised for weeks before dying
Several of the 17 victims were hospitalised for weeks before dying -- raising questions on the preparedness of hospitals that may have to treat patients for long periods of time.   The youngest victim of the Wuhan virus, a woman surnamed Yin, was hospitalised for more than a month before succumbing to the virus.   On December 10, the 48-year-old woman reported a fever, coughing, body soreness, and fatigue, and underwent anti-infection treatment for two weeks, according to the NHC.   Later in the end of the month, Yin suffered shortness of breath and chest tightness, and she passed away on January 20.

Not all of them had a fever
Currently, Wuhan authorities are screening passengers for fever at the airport, railway stations, and bus terminals.   At four airports in Thailand, authorities introduced mandatory thermal scans of passengers arriving from high-risk areas of China.   But not all those who died after being infected reported a fever before being hospitalised, according to the NHC.   A 66-year-old man surnamed Luo reported a "mainly dry cough" but no fever on December 22 before suffering from shortness of breath more than a week later.

By mid-January, Luo required a ventilator to help him breathe.   "A major concern is the range of severity of symptoms this virus is causing," said Dr Jeremy Farrar, Director of the Wellcome Trust.   "It is clear some people are being affected and are infectious while experiencing only very mild symptoms or possibly without experiencing symptoms at all," he said in an emailed statement.   "This may be masking the true numbers infected and the extent of person to person transmission," he added.
Date: Thu, 23 Jan 2020 16:05:30 +0100 (MET)

Singapore, Jan 23, 2020 (AFP) - Singapore Thursday confirmed its first case of the new SARS-like virus which has killed 17 people in China and spread to multiple countries including the United States.   The Ministry of Health (MOH) said the patient was a 66-year-old man from Wuhan who arrived in Singapore with his family on Monday.    He was immediately isolated after arriving at a hospital with a fever and cough, and test results later confirmed he was infected with the coronavirus.   One of his travelling companions, a 37-year-old man from Wuhan, has also been admitted to hospital as a suspect case.

Prior to admission, they had stayed at a hotel on the resort island of Sentosa, the ministry said.   It added that Singapore was expecting more cases and alarms "given the high volume of international travel".   Singapore's Changi Airport started screening flights from Wuhan at the beginning of the month, and on Wednesday extended the checks to all flights from China.   The travel hub receives over 430 flights from China every week.   The virus has caused alarm in China and abroad because of its genetic similarities to Severe Acute Respiratory Syndrome (SARS), which killed nearly 650 people across mainland China and Hong Kong in 2002-2003.

Singapore was among the hardest hit by SARS with 33 deaths.   Prime Minister Lee Hsien Loong, who is in Davos for the World Economic Forum, said there was "no need to panic".   Speaking to reporters travelling with him, Lee said Singapore has beefed up its hospital facilities and laid out response measures since the SARS epidemic.   "I think we are much better prepared now," he said in remarks carried by the Straits Times newspaper.