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Andorra

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

Travel News Headlines WORLD NEWS

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

No Profile is available at present

Travel News Headlines WORLD NEWS

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Making things worse, people are leaving the island for the mainland US. Forecasts are that the population now at 3.4 million will go down to 3.1 million or even less by 2026, said Villamil.   The government of Florida estimates that since October 3 -- the day a state of emergency to deal with an influx of Puerto Ricans was declared -- more than 36,000 people from the island have poured in.
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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: 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."
Date: Tue, 2 May 2017 16:29:01 +0200
By Cyril BELAUD

Kigali, May 2, 2017 (AFP) - Around 20 of Africa's endangered Eastern black rhinos are returning in an "extraordinary homecoming" to Rwanda after the species disappeared there 10 years ago, the African Parks organisation said Tuesday.   The rhinos are being moved from South Africa to the Akagera national park in eastern Rwanda, according to the non-profit group that manages protected areas for African governments.   "This extraordinary homecoming will take place over the first two weeks of May," it said in a statement.   The Eastern black rhino, one of the sub-species of the rhinoceros, is in critical danger of extinction, according to the International Union for Conservation of Nature (IUCN).   Back in the 1970s, more than 50 black rhinos thrived in the savannah habitat of the Akagera park, but their numbers declined due to wide-scale poaching and the last confirmed sighting was in 2007.

- 'Great symbol of Africa' -
"Rhinos are one of the great symbols of Africa yet they are severely threatened and are on the decline in many places across the continent due to the extremely lucrative and illegal rhino horn trade," said African Parks CEO Peter Fearnhead.    According to the conservationists, there are fewer than 5,000 black rhino in the wild worldwide, with only about 1,000 of the Eastern sub-species.

Since 2010 African Parks has boosted security at  Akagera and has prepared to accept the rhinos with financial help from the Howard Buffett Foundation, headed by the son of US billionaire Warren Buffett.   The measures taken include deploying a helicopter for air surveillance and an expert rhino tracking and protection team as well as a canine anti-poaching unit.   "We are fully prepared to welcome them (rhinos) and ensure their safety for the benefit of our tourism industry and the community at large," said Clare Akamanzi, chief executive of the Rwanda Development Board.

In July 2015, Rwanda had reintroduced lions in the Akagera park, 15 years after they had disappeared. The lions were decimated in the years after Rwanda's genocide in 1994 as Rwandans who had fled the slaughter returned and occupied the park killing the lions to protect their livestock.   The park, which takes its name from the nearby Kagera river, is located near the border with Tanzania.   With the reintroduction of the rhinos, Akagera, which welcomed more than 36,000 visitors last year, will now boast being home to Africa's "big five" -- rhino, lion, elephant, leopard and buffalo.
More ...

Samoa

General:
**********************************
Cuba is an independent island country situated in the Caribbean. It is the largest of the islands and covers 42,000sq miles. The climate is sub tropical throughout the year with most of the rainfall in
the northern parts of the country. Temperatures of between 20C to 35C are fairly standard throughout the year. Generally the winter effects of the American continent only last for short periods.
Safety & Security:
**********************************
The majority of tourists visiting Cuba will have no difficulty but bag snatching and other street crime appears to be increasing. The old Havana area and other major tourist resorts may be particular areas of concern in this regard. On arrival be careful to only use your recognised tour operator. If you are taking a taxi at any stage make sure it is a registered one and not a private vehicle. It is unwise to carry large quantities of money or jewellery away from your hotel and try not to flaunt wealth with your belongings. Pickpockets are too common an occurrence on buses and trains and at train stations so be careful with your essential documents and credit cards. Valuables should not be stored in suitcases when arriving in or departing from Havana as there have been a number of thefts from cases during the time the cases are coming through baggage handling. There is an airport shrink-wrap facility for those departing Havana which reduces the risk of tampering. Remember to carry a photocopy of your main documents (passport, flight tickets etc).
Road Safety:
**********************************
Following a number of serious road accidents involving tourists, you are advised not to use mopeds for travelling around Cuba or in Havana. Also, if you are involved in any accident a police investigation will be required to clear you and this may significantly delay your travel plans. On unlit roads at night there have been a number of accidents associated with roaming cattle (sounds like Ireland!). The traffic moves on the right side of the roads. There is a main highway running the length of the country but many of the country roads are in poor repair.
Local Laws & Customs:
**********************************
When arriving into Cuba make sure you are not carrying any items which could be considered offensive. Any illicit drug offense is treated very seriously and Cuban law allows for the death penalty to be used under these circumstances. If you require personal medication for your health, make sure it is in original packing and carry a letter from your doctor describing the medication. Never agree to carry any item for another individual and always secure your cases once they are packed. Taking photographs of military or police installations or around harbours, rail and airport facilities is strictly forbidden.

Currency:
**********************************
Since 1993 it is now possible to use US dollars for all transactions within Cuba. Remember, there is a 20$ airport departure tax. Certain travellers cheques and credit cards may not be acceptable within Cuba. This is particularly true of American Express cheques and cards but check your situation with the travel operator before departure.
Health Facilities:
**********************************
Generally healthcare facilities outside of Havana are limited and many standard medications may not be available. It is important to carry sufficient quantities of any medications which may be required for the duration of your time in Cuba.
Food & Water:
**********************************
The level of food and water hygiene varies throughout the country and between resorts. On arrival check the hotel cold water supply for the smell of chlorine. If it is not present then use sealed bottled water for both drinking and brushing your teeth throughout your stay. Cans and bottles of drinks are safe but take care to avoid pre-cut fruit. Peel it yourself to make sure it is not contaminated. Food from street vendors should be avoided in most cases. Bivalve shellfish are also a high risk food in many countries and Cuba is no exception in this regard. (Eg Mussels, Oysters, Clams etc)
Malaria & Mosquito Borne Diseases:
***********************************************
Malaria transmission does not occur within Cuba and so prophylaxis is not required. However, a different mosquito borne disease called Dengue has begun to reoccur in the country over the past few years. This viral disease can be very sickening and even progress to death. It is rare for tourists to become infected but avoiding mosquito bites is a wise precaution.
Swimming, Sun & Dehydration:
************************************
The extent of the Cuban sun (particular during the summer months (April to October) can be very excessive so make sure your head and shoulders are covered at all times when exposed. Watch children carefully as they will be a significant risk. Drink plenty of fluids to replace what will be lost through perspiration and, unless there is a reason not to,
take extra salt either on your food or in crisps, peanuts etc. Take care if swimming in the Caribbean to stay with others and to listen to local advice. Never swim after a heavy meal or alcohol.
Rabies Risk in Cuba:
**********************************
This viral disease does occur throughout Cuba and it is essential that you avoid any contact with all warm blooded animals. Dogs, cats and monkeys are the most commonly involved in spreading the disease to humans. Don't pick up a monkey for a photograph! If bitten, wash out the wound, apply an antiseptic and seek urgent medical attention.
Vaccinations for Cuba:
**********************************
There are no essential vaccines for entry / exit if coming from Ireland. However, for your own personal protection travellers are advised to have cover against the following;
*
Tetanus (childhood booster)
*
Typhoid (food & water borne disease)
*
Hepatitis A (food & water borne disease)
For those planning a longer or more rural trip vaccine cover against conditions like Hepatitis B and Rabies may also need to be considered.
Summary:
**********************************
Cuba is becoming a popular destination for tourists and generally most will stay very healthy. However commonsense care against food and water borne disease is essential at all times. Also take care with regard to sun exposure, dehydration and mosquito bites.

Travel News Headlines WORLD NEWS

Date: Tue 10 Jul 2018
Source: MSN [edited]

Samoa has issued an immediate recall of the vaccine for mumps, measles and rubella (MMR) following the deaths of 2 infants who reportedly passed away just hours after receiving their shots. The 2 children, a boy and a girl, were both aged about 12 months. They were not related, came from different communities and were vaccinated on [Fri 6 Jul 2018] using the same batch of the MMR vaccine.

Australian forensic experts will fly into the country tonight to help investigate the incident, which happened at the Safotu District Hospital on the island of Savai'i.

In a statement, Samoan Prime Minister Tuilaepa Sailele expressed condolences to the children's families and called for a full inquiry."There are already processes that will determine if negligence is a factor," Mr. Tuilaepa said. "And if so, rest assured those processes will be implemented to the letter to ensure that such a tragedy will not be repeated and those responsible will be made to answer."

Health officials said testing was underway to see if the vaccine was responsible, and it has been recalled nationwide as a precautionary measure. The Government has called on the World Health Organisation (WHO) for assistance. Rasul Baghirov, the WHO's Samoa Representative, told the ABC's Pacific Beat program the situation was serious, but it was too early to determine exactly what caused the deaths.

"These deaths are a tragedy and the Government is committed to understanding exactly what happened, for the families of those children, but also to ensure the ongoing safety of the immunisation program," Dr Baghirov said.

He said the investigation would examine the vaccine itself, the injecting equipment and the storage arrangements for the vaccine. The training and conduct of staff would also be looked at, as well as the medical history of the infants' families. An autopsy team from the Victorian Institute of Forensic Medicine in Melbourne will arrive in Samoa tonight to assist the investigation.

Severe vaccine reaction 'very, very rare'. Dr Baghirov said there have been no other reported cases of children dying after being vaccinated using the batch supplied to Samoa.

The vaccines were from India, were safety checked by the WHO and supplied by the United Nations Children's Fund (UNICEF).

"The MMR immunisation is the best way to reduce a child's risk of getting these highly infectious diseases," Dr Baghirov said. "It has been used around the world for many years, providing more than 2 billion children with protection against these diseases. The severe reaction following the administration of MMR vaccine is very, very rare -- that's why we want to really investigate and find out what caused the deaths here in Samoa."

UNICEF's Pacific Representative Sheldon Yett said it was important for people concerned by the case to remember that vaccines are safe.  "Stopping immunisation would be a disaster for children in the South Pacific and around the world," he said. "It does make sense to pause, and do a complete investigation to know what specifically happened here. "But stopping immunisation of course would be a very wrong approach to pursue here."  [Byline: Catherine Graue & Michael Walsh]
======================
[The very unfortunate death of these 2 infants should be investigated immediately, but it is a mistake to completely stop vaccination, which would result in more morbidity and possibly mortality. All vaccines carry a minimal risk, which generally is mild and only very rarely severe. It is not clear whether there were underlying conditions such as a weakened immune system or allergies in these 2 infants that led to complications from the MMR vaccine, or even whether the vaccine was truly the cause of death. The enquiry will look into the vaccine itself, equipment, storage of the vaccine and its administration. It is important to monitor the safety of this very commonly used vaccine, as appears to have been done by WHO in this case. Only a strong monitoring program will reassure the public.

According to CNN report (<https://www.cnn.com/2018/07/10/health/samoa-mmr-baby-deaths-intl/index.html>), "Vaccines prevent almost 6 million deaths worldwide every year, according to the World Health Organization. In countries that widely use vaccines, diseases such as measles have been nearly eradicated, with a 99 percent reduction in cases."

Typically given in 2 doses in early childhood, the MMR vaccine protects against 3 diseases: measles, mumps, and rubella.

One dose is about 93 percent effective at preventing measles if the person is exposed to the virus, while 2 doses are about 97 percent effective, according to the US Centers for Disease Control and Prevention (CDC).

Dr. Sanjay Gupta: Benefits of vaccines are a matter of fact.

"Most children in the world receive this vaccine or similar vaccines to this," Helen Petousis-Harris, a vaccinologist at the University of Auckland, told CNN. "We have safety data on the vaccine, we understand the effects really well. This type of case is exceedingly rare."

Furthermore, she said, child mortality has gone down in many countries that use these vaccines.

"Every country has a vaccine program that has been demonstrated to be very safe," she added. "At the moment we need to understand what's happened so we can work out strategies to ensure it doesn't happen again. There's a lot we don't know about (the deaths)." - ProMED Mod.LK]

[HealthMap/ProMED map available at:
Date: Thu, 12 Jul 2018 03:45:09 +0200

Wellington, July 12, 2018 (AFP) - International health experts launched an investigation Thursday into why two Samoan infants died shortly after receiving childhood vaccination injections in a tragedy that has rocked the close-knit Pacific nation.

The tiny country has suspended its vaccination programme and seized all doses for testing after the deaths at the Safotu District Hospital last Friday.   The health department said two one-year-old babies, a boy and a girl, died soon after being administered a vaccine for measles, mumps and rubella (MMR).   A World Health Organisation expert has arrived to investigate and a specialist from UNICEF was also en route, along with a forensic pathologist to carry out autopsies, it added.

"We will investigate the cause and will take the appropriate actions to ensure that the lives of Samoan children will not be compromised in the future," the director-general of health Take Naseri said.   Samoa Prime Minister Tuilaepa Sailele Malielegaoi expressed his condolences at the deaths, which have rattled the nation of 195,000 people.   Malielegaoi, who almost lost his grandson several years ago under similar circumstances, said an inquiry would look at whether negligence was a factor.

Medical experts say the cause of the deaths remains unknown and have warned the tragedy should not be exploited by anti-vaccination activists.   "The message is -- please understand vaccination is very safe, it's very appropriate and everyone should still continue with their appointments as currently planned," Australian Medical Association president Tony Bartone told Sky News.

University of Auckland vaccinologist Helen Petousis-Harris said almost every child in the world received an MMR vaccine or a similar jab and deaths were extremely rare.   "There are two main reasons why something like this might happen," she said.   "Medical error, where the vaccine is prepared for injection incorrectly and the wrong substance is injected, (or) contamination of the vaccine due to leaving it at room temperature for a long period of time."

WHO data shows measles kills about 134,000 children a year and rubella causes some 100,000 children to be born with birth defects such as deafness.   Concerns about the MMR vaccine surfaced in 1998 when a British study, since discredited, linked it with autism.   While the study was found to be a fraud and the autism link debunked, vaccination rates have dropped in some countries as parents prevent children receiving their shots.
Monday 16th April 2018

- Samoa. 9 Apr 2018. Serotype 2 Outbreak in Samoa, 2017/2018. The cumulative total as of 18 Mar 2018 is 3255, with a national attack rate of 16.6 per 1000 population. Dengue fever continues to spread geographically, mostly in the Apia Urban and North West Upolu regions. A majority of those affected are 5-9-year-old children, which make up 31 percent of the total cases. There have not been any dengue related deaths reported, hence the total dengue-related mortality remains at 5.
Date: Mon 15 Dec 2014
Source: Radio New Zealand [edited]

The number of people infected with chikungunya in Samoa has reached more than 3000.

Ministry of Health figures up until the last week of November [2014] show 3135 cases of the mosquitoborne virus. The ministry says 333 people reported to hospitals that week, the most number of people showing symptoms of the disease in one week since the initial outbreak in July [2014].

The latest numbers mean that 1.7 per cent of Samoa's population has contracted "chik", whose symptoms include fever, sore joints, and a rash. The ministry says the largest clusters of chikungunya are within the Faleata and Vaimauga districts and more women than men have been affected.

There have been no deaths from chikungunya in Samoa. In French Polynesia, 5 people have died and more than 35 000 people have been affected by the disease.
=================
[The chikungunya outbreak continues to grow in Samoa, from 269 cases reported on 25 Aug 2014, to 626 cases on 20 Sep 2014, to an estimated 2500 on 24 Nov 2014, and now to 3135 cases, with cases reported throughout Samoa. Vigilance alone will not halt the outbreak. The Ministry of Health and the public will need to cooperate in the elimination of the breeding sites of the vector mosquitoes.

A map showing the location of Samoa in the Pacific Ocean can be accessed at
a HealthMap/ProMED-mail map can be accessed at
Date: Wed 10 Dec 2014
Source: Outbreak News Today [edited]

The chikungunya outbreak in the Pacific Islands continue to balloon, particularly in French Polynesia, where health authorities report seeing an estimated 9000 new cases during the past week.

According to numbers released by the Auckland Regional Public Health Service in New Zealand, as of [1 Dec 2014], the following island countries are battling an on-going chikungunya outbreak: French Polynesia: 18,352 cases, American Samoa: 1148 cases, Samoa: more than 2500 suspected cases and Tokelau: 159 suspected cases.

Radio New Zealand reported more up-to-date numbers today [10 Dec 2014] showing the French Polynesia outbreak is actually up to 27,000 cases and 5 deaths.

Chikungunya is a viral disease transmitted by the bite of infected mosquitoes such as _Aedes aegypti_ and _Aedes albopictus_, the same mosquito vector that transmits dengue fever. It can cause high fever, joint and muscle pain, and headache.

Chikungunya does not often result in death, but the joint pain may last for months or years and may become a cause of chronic pain and disability. There is no specific treatment for chikungunya infection, nor any vaccine to prevent it.  [Byline: Robert Herriman]
======================
[Pending the development of a new vaccine, the only effective means of prevention is to protect individuals against mosquito bites.

The chikungunya outbreak in the Pacific islands, especially in French Polynesia, continues with increasing numbers of cases. So far, attempts to halt transmission through mosquito vector control have not prevented the increase in case numbers. There is a dengue outbreak in French Polynesia as well, and those viruses are transmitted by the same mosquito vector. In the absence of available vaccines, mosquito vector control and avoidance of mosquitoes bites are the only preventive measures available. These measures would require active public collaboration through education.

A HealthMap/ProMED-mail map showing the location of the islands in French Polynesia can be accessed at <http://healthmap.org/promed/p/31048>; maps showing the location of American Samoa and Samoa can be accessed at <http://www.worldatlas.com/webimage/countrys/oceania/wsnewz.gif> and <http://healthmap.org/promed/p/2>; maps of Tokelau, a New Zealand territory, can be accessed at <http://www.worldatlas.com/webimage/countrys/oceania/tk.htm> and <http://healthmap.org/promed/p/6767>. - ProMED Mod.TY]
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Senegal

Senegal - US Consular Information Sheet
July 08, 2008
COUNTRY DESCRIPTION: The Republic of Senegal is a developing West African country.
The capital is Dakar.
Facilities for tourists are widely available but vary in quality.
Read
the Department of State Background Notes on Senegal for additional information.
ENTRY/EXIT REQUIREMENTS:
A passport is required.
For U.S. passport holders, a visa is not required for stays of less than 90 days.
Current yellow fever vaccination is mandatory to enter Senegal and meningitis vaccination is highly recommended if the traveler is arriving from or has recently traveled to an endemic area.
Travelers unable to provide proof of vaccinations may be required to pay for and receive vaccinations at the Dakar airport.
Travelers should obtain the latest information on entry requirements from the Embassy of Senegal, 2112 Wyoming Avenue NW, Washington, DC 20008, telephone (202) 234-0540, and at the Senegal Tourism Authority's official web site, http://www.senegal-tourism.com.
Overseas inquiries should be made at the nearest Senegalese 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:
Public demonstrations, political gatherings, and student protests are relatively common in Senegal, both in Dakar and in outlying regions, particularly on Friday afternoons. In the past, these events have sometimes turned violent.
Due to the potential for violence, U.S. citizens should avoid political gatherings and street demonstrations, and maintain security awareness at all times.
For guidelines on dealing safely with public demonstrations, please see the American Citizen Services page of the U.S. Embassy Dakar web site at http://dakar.usembassy.gov/service.html.
Lac Rose (Pink Lake) is a popular tourist destination in Senegal.
The Lac Rose area has a large number of tourists and isolated beach areas, but lacks multiple exit and entry points.
The U.S. Embassy recommends that all visitors to Lac Rose and its surrounding beaches be particularly vigilant and not travel alone.
Banditry occurs with some regularity on the main highways after dark, particularly in the central and eastern area of Senegal, including around Tambacounda and Matam. Bandits often target RN2 (National Road) between Ndioum and Kidira and occasionally target RN1 between Kidira and Tambacounda.
The U.S. Embassy recommends that U.S. citizens avoid non-essential travel to the Casamance region west of the city of Kolda, except direct air travel to the Cap Skirring resort area or to the city of Ziguinchor.
If travel is deemed essential, the U.S. Embassy recommends that U.S. citizens carefully monitor the security situation before traveling.
There are currently instances of fighting in the Casamance region (composed of the Ziguinchor and Kolda regions) involving factions of the Casamance separatist MFDC (Mouvement des Forces Démocratiques de la Casamance) in southern Senegal and the Senegalese military. Some military and political leaders in the Casamance region have been killed.
In May 2008, rebels kidnapped 16 local residents 5 kilometers from Ziguinchor and then cut off their left ears before releasing them.
That same month two soldiers and a peasant were killed in other clashes near the same area.
Reports of banditry in the area remain high.
In addition, vehicles have been attacked by armed bandits even during daylight hours on well-traveled roads.
On February 14, 2007, four people were killed when their bus was attacked after being stopped at a roadblock.
Landmine explosions continue to plague inhabitants of the Casamance, with fatalities and serious injury continuing into 2008.
One man was killed in Tounkara, approximately 70 kilometers north of Ziquinchor.
A Senegalese soldier was injured by a landmine near Boutoupa-Camaracounda, on the border with Guinea Bissau.
Since 1990, more than 1,000 people have been killed by land mines in the Casamance. The U.S. Embassy strongly recommends that U.S. citizens remain on well-traveled routes at all times.
For the latest security information, Americans traveling abroad should regularly monitor the Department of State, Bureau of Consular Affair’s Internet site at http://travel.state.gov, where the current Travel Warnings and Public Announcements, including the Worldwide Caution, can be found.

Up-to-date information on safety and security can also be obtained by calling 1-888-407-4747 toll free in the U.S. 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:
Minor street crime is very common in Senegal, particularly in cities.
Most reported incidents involve pickpockets and purse-snatchers, who are especially active in large crowds and around tourists. Aggressive vendors, panhandlers and street children may attempt to divert the victim’s attention while an accomplice carries out the crime.
To avoid theft, U.S. citizens should avoid walking alone in isolated areas or on beaches, particularly at night, lock their doors and close their windows when driving, and avoid public transportation.
Americans should not walk on dark streets at night, even in groups.
To minimize inconvenience in the event of theft, U.S. citizens should carry copies, rather than originals, of their passports and other identification documents.
U.S. citizens should carry a credit card only if it will be used soon, rather than carrying it as a routine practice.
There is traditionally an increase in crime before major religious holidays.
U.S. citizens are encouraged to use common sense and situational awareness to ensure personal safety and to reduce the risk of becoming a crime victim.
Always be aware of the surroundings, especially in large cities and crowded places such as markets and taxi parks.
Keep a low profile, remain vigilant, and avoid potential conflict situations.
Do not wear flashy clothing or jewelry, and be cautious about displaying any amount of currency in public.
Use common sense when faced with something out of the ordinary or if someone is following you.
While violent crime is not common in Senegal, it does occur.
There have been incidents in the past year of Americans in groups of two or three being robbed at knife-point.
If confronted by criminals, remember that cash and valuables can be replaced, but life and health cannot.
U.S. citizens are encouraged to walk away from a criminal confrontation no matter the material cost.
Break-ins at residential houses occur frequently as in major cities everywhere.
Persons who plan to reside in Senegal on a long-term basis should take measures to protect their dwellings.
Long-term residents should consider installation of window grilles, solid core doors with well-functioning locks, and an alarm system.
In the past year, a number of American citizen residences have experienced burglaries.
No violence or personal injuries have been reported in these cases, in which the burglars appear to have been exclusively seeking financial gain.
Fraud is prevalent in Senegal and U.S. citizens are often the target of scams that may cause both financial loss and physical harm.
Typically, business scam operations begin with an unsolicited communication (usually by e-mail) from an unknown individual who describes a situation that promises quick financial gain, often by the transfer of a large sum of money or valuables out of West Africa.
The perpetrators of these scams often claim to be victims of various western African conflicts (notably refugees from Sierra Leone) or relatives of present or former political leaders.
There are many variations of these business scams.
In some cases, a series of “advance fees” must be paid in order to conclude the transaction, such as fees to open a bank account, or to pay certain taxes.
In fact, the final payoff does not exist since the purpose of the scam is simply to collect the advance fees.
Another common variation consists of a request for the U.S. citizen's bank account information, purportedly to transfer money into the account.
Once the perpetrator obtains this information, however, he or she then simply transfers all money out of the victim's account.
Other variations include apparently legitimate business deals requiring advance payments on contracts and offers to sell gold at a very low price.
In the last case, the seller may present real gold to be verified then substitute fake gold and disappear with the payment.
The best way to avoid becoming a victim of advance-fee fraud or business scam is to use common sense:
If an offer seems too good to be true, it is probably a scam.
You should carefully research any unsolicited business proposal originating in Senegal before you commit funds, provide goods or services, or undertake travel.

Visa scams take advantage of people who wish to travel to the U.S.
Generally, these scams "guarantee" a U.S. visa for participants who pay a large sum of money to register for a conference or attend an event in the United States.
In fact, only consular officers of the U.S. State Department may issue visas, so any offer that guarantees a U.S. visa is a scam.
Please refer to the State Department web site at http://travel.state.gov or the web site of the U.S. Embassy in Dakar at http://dakar.usembassy.gov/visas.html for authoritative information about the visa process and the costs involved.
In addition to business and visa scams, personal and dating scams are also prevalent. U.S. citizens should be wary of persons claiming to live in Senegal who profess friendship or romantic interest over the Internet.
A chat or e-mail exchange which quickly moves to discussion of intimate matters is often an indication of a scam.
Beware of any request or appeal for money.
In a typical personal scam, the scammer typically asks the U.S. citizen to send money for essential purposes: living or travel expenses, medical treatment, visa costs or bribes to free unjustly imprisoned family members.
Scammers often claim emergency circumstances, hoping that the intended victim will send money quickly and without careful consideration.
Many variations of these scams exist, all with the principal goal of soliciting money from the victim.
Several U.S. citizens in West Africa have reported losing thousands of dollars through such scams.
The anonymity of the Internet means that the U.S. citizen cannot be sure of the real name, age, marital status, nationality or even gender of the correspondent.
In some cases, the correspondent is a fictitious persona created only to lure the U.S. citizen into sending money.
U.S. citizens may prepay for a plane ticket directly with an airline rather than wiring money for transportation to the traveler.
U.S. citizens may also research the legitimate immigration process with the United States Citizenship and Immigration Services (USCIS) web site at http://www.uscis.gov.
U.S. citizens who are victims or witnesses of a crime are encouraged to report crimes to the police by telephoning 800-00-20-20; 800-00-17-00, Senegal's police hotline numbers. Another 24 hour phone number for the police in Senegal is 33-821-2431.
The Government of Senegal has also created a tourist police unit, which may be reached at (+221)33 860-3810.

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 Senegal is 800-00-20-20 and 800-00-17-00. See our information on Victims of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION:
Several hospitals and clinics in the capital, Dakar, can treat major and minor injuries and illnesses.
There is inadequate inpatient psychiatric care and limited office-based psychiatric treatment.
Public hospitals do not meet U.S. standards.
Medical facilities outside Dakar are limited.
French medications are far more readily available than American pharmaceuticals, and drugs in stock are often listed under the French trade name.
Medications may be obtained at pharmacies throughout Dakar and in other areas frequented by tourists, and are usually less expensive than in the U.S. Travelers should carry a supply of any needed prescription medicines, along with copies of the prescriptions, including the generic name for the drugs, and a supply of preferred over-the-counter medications.
Malaria is a serious risk to travelers in Senegal.
Travelers should consult their physician to discuss the benefits and risks of taking anti-malarial medication.
Travelers who become ill with a fever or flu-like illness while traveling in a malaria-risk area and up to one year after returning home should seek prompt medical attention and tell the physician their travel history and what anti-malarial medications they have been taking.
For additional information on malaria, protection from insect bites, and anti-malarial drugs, visit the CDC Travelers' Health web site at http://www.cdc.gov/malaria/faq.htm.
Water supplies in Senegal are not consistently free of disease-causing microorganisms.
For this reason, the Embassy recommends drinking filtered or boiled water, particularly for babies under one year of age.
Raw vegetables and fruits should be washed in a bleach solution before eating.
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 Senegal is provided for general reference only, and may not be totally accurate in a particular location or circumstance.
Driving in Senegal is very different from driving in the United States.
Many U.S. citizens find the traffic in Senegal chaotic, particularly in Dakar.
Drivers tend to exceed speed limits, follow other vehicles closely, ignore lane markings and attempt to pass even when facing oncoming traffic.
Many vehicles are not well-maintained; headlights may be either extremely dim or not used at all. Roadways are poorly lit and poorly marked and many sections have deteriorated surfaces.
Some roads have sidewalks or sufficient space for pedestrian traffic; others do not, and pedestrians are forced to walk along the roadway.
Due to limited street lighting, pedestrians are difficult to see at night.
Drivers in both rural and urban areas may expect to frequently encounter and share the road with motorcycles, bicyclists, pedestrians, livestock and animal carts.
Caution and defensive driving techniques are strongly recommended.
While most main roads in Senegal are in relatively good condition for daytime driving, smaller roads are poor by American standards.
During the rainy season, many roads are passable only with four-wheel drive vehicles.
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.
Due to poor road conditions and the risk of crime, driving outside major cities at night is not recommended.
Due to language barriers (outside Dakar, relatively few Senegalese speak French) and the lack of roadside assistance, receiving help may be difficult in the event of distress.
For safety reasons, the Embassy recommends against the use of motorbikes, van taxis ("cars rapides"), and public transportation.
They can be dangerous due to overloading, careless driving, inadequate maintenance, and the lack of basic safety equipment such as seat belts.
Regulated orange-striped sedan auto taxis are safer, but make sure to agree on a fare before beginning the trip.
In Senegal, one drives on the right-hand side.
Vehicles give priority to traffic coming from the right, except at traffic circles, where vehicles already in the circle have the right of way.
Before January 2005, however, cars entering traffic circles had the right of way.
This change is not well known, so drivers should exercise extreme caution at traffic circles.
All drivers are expected to carry the following documents in their vehicles and present them at any time at the request of the police:
(1) valid driver's license; (2) valid insurance papers; (3) vehicle registration/immatriculation card ("carte grise"); (4) "vignette" tax disc for the current year; and (5) valid identification.
If Americans carry a copy of their U.S. passport, the copy must be clear enough to identify the driver of the vehicle.
Third-party insurance is required and will cover any damages if you are involved in an accident resulting in injuries, and found not to have been at fault.
If you are found to have caused an accident, the penalty ranges from five months to two years in prison, with a possible fine.
If you cause an accident which results in a death, the penalty can be as high as five years in prison.
For guidance on what to do if you are in an automobile accident in Senegal, please see the American Citizen Services page of the U.S. Embassy Dakar web site at http://dakar.usembassy.gov/service/living-in-senegal-and-guinea-bissau/driving-in-senegal.html.
Senegalese law prohibits the use of cell phones while driving, unless the driver is using “hands-free” equipment.
Protective helmets are mandatory for all bicycle, moped, scooter and motorcycle drivers/riders and passengers.
When police officers stop a vehicle for a traffic violation, the police officer will generally confiscate the driver’s license or ID card until the fine is paid.
We encourage you to comply with the request. Sometimes, police officers try to solicit bribes instead of or in addition to the fine.
The U.S. Embassy does not encourage paying bribes. Please refer to our Road Safety page for more information.

AVIATION SAFETY OVERSIGHT:
As there is no direct commercial air service to the United States by carriers registered in Senegal, the U.S. Federal Aviation Administration (FAA) has not assessed Senegal’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:
Senegalese law requires that all persons carry personal identification at all times, and all Senegalese law enforcement officials have the authority to challenge suspicious activity and to request personal identification.
Be aware that they may request personal identification even without cause, which is generally not the case in the U.S.
If a U.S. citizen does not cooperate and provide identification, s/he may be detained for up to 48 hours without the filing of formal charges.
The U.S. Embassy does not always receive timely notification by Senegalese authorities of the arrest of U.S. citizens. 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. If arrested, U.S. citizens should always ask to be allowed to contact the U.S. Embassy.
You may not bring several types of items into Senegal without clearance by Senegalese customs officials: these include computers and computer parts, video cameras and players, stereo equipment, tape players, auto parts, and various tools and spare parts.
Airport customs officials may hold such items if brought in as baggage or carry-on luggage.
Travelers should check with the Embassy of Senegal in Washington, DC, regarding these restrictions. (See Entry Requirements Section above for contact information.)
Senegalese customs authorities encourage the use of an ATA (Admission Temporaire/Temporary Admission) Carnet for the temporary admission of professional equipment, commercial samples, and/or goods for exhibitions and fair purposes.
ATA Carnet Headquarters, located at the U.S. Council for International Business, 1212 Avenue of the Americas, New York, NY 10036, issues and guarantees the ATA Carnet in the United States.
For additional information, call (212) 354-4480, send an email to atacarnet@uscib.org or visit http://www.uscib.org for details.
Travelers can obtain cash from some ATMs in Senegal.
Travelers can get cash and/or traveler's checks through international credit cards, such as Master Card, Visa, and American Express, by presenting their credit card at a local financial institution sponsoring their card. 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 Senegalese laws, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in Senegal 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 Senegal 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 Senegal.
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 Avenue Jean XXIII, Dakar; the mailing address is B.P. 49, Dakar, Senegal.
The telephone number is (221) 33 829-2100; after hours (221) 33 829 2209.
The U.S. Embassy web site is http://dakar.usembassy.gov/.
*

*

*
This replaces the Country Specific Information Sheet for Senegal dated November 08, 2007 to update sections on Country Description, Entry/Exit Requirements, Crime, Safety and Security, Information for Victims of Crime, Medical Facilities and Health Information, and Registration and Embassy Location.

Travel News Headlines WORLD NEWS

- National. 12 Nov 2018

Suspected cases totalling 2123 with 216 confirmed have been reported across 6 regions, with one death confirmed, as of 3 Nov 2018. The CDC has issued a travel warning. The 6 regions currently reporting confirmed cases are Diourbel (169), Fatick (34), St. Louis (6), Dakar (3), Louga (3) and Thies (1).

- National. 9 Nov 2018. The US Centers for Disease Control and Prevention (CDC) has issued a Level 1, Practice Usual Precautions, for the African country of Senegal, on 7 Nov 2018. Senegal, which is located on the north-west coast of central Africa, is an important partner of the US in promoting peace and security. Because dengue is a viral disease and spread by mosquito bites, all travellers to Senegal should prevent mosquito bites by using insect repellent and wearing protective clothing when outdoors, and sleeping in an air-conditioned or well-screened room or under an insecticide-treated bed net, said the CDC. Moreover, half of the world's population living in 128 countries is at risk of dengue.

[HealthMap/ProMED-mail map of Senegal:
Date: Sun, 21 Oct 2018 16:38:21 +0000
A ProMED-mail post

- National. 19 Oct 2018. In the capital of Sine, there are currently 31 cases. In the capital of Mouridism, there are 8 cases; 6 cases were counted in Rosso, Senegal.

- National. 15 Oct 2018. Dengue fever worries the population in several localities of Senegal. Fatick area has 3 cases. Currently, at least 23 dengue cases have been confirmed in the same region of Fatick (center), following tests on 487 suspected cases, revealed the chief of the commune, Mamadou Sarr at the beginning of October 2018.

In Senegal, dengue fever is concentrated this year [2018] in the Fatick region. In September 2018, 3 cases had been counted; the number rose to 23 cases in October 2018. According to the chief medical officer of the local area relayed by the Senegalese press agency: "Following tests on 487 suspected cases, at least 23 dengue cases were confirmed, and the average age of people affected by the disease varies between 20 and 40 years old. Most are women.

This is the 4th dengue epidemic in Senegal. On 19 Oct 2017, the disease was revealed to the public in the Louga region. The Institut Pasteur in Dakar confirmed the diagnosis of 9 cases of dengue fever out of a total of 24 samples received on 6 and 12 Oct 2017, respectively, which had been carried out at the Santhiaba health post in Louga commune, in northwest Senegal. On 27 and 28 Oct 2018, 2 other confirmed cases were recorded in the commune of Dahra, next to that of Louga. On 6 Nov 2017, the Senegalese health authorities recorded 79 confirmed cases out of 510 samples tested: 70 in Louga, 6 in Dahra, 2 in Coki, 1 in Keur Moma Sarr. "No serious case is noted so far. All the patients have been treated as outpatients," said the Ministry of Health and Social Action.

This is not the 1st time that an outbreak of dengue fever has been reported in the country. There were outbreaks also in 1981, 1984 and 2009, said Dr. Abdoulaye Bousso of the Center for Emergency Health Operations (COUS), an entity under the supervision of the Ministry of Health and Social Action in 2017. As of 30 Oct 2017, a total of 232 suspected patients, out of 36 positive cases (34 in Louga and 2 in Dahra), had been enumerated by the Senegalese health authorities. "No complication was noted in these patients; all patients diagnosed positive are doing well and have resumed their daily activities," said the Ministry of Health. For this year [2018], the number increased to 32 confirmed cases.
Date: Thu, 3 May 2018 17:48:15 +0200

Ziguinchor, Senegal, May 3, 2018 (AFP) - Armed men tried to blow up a key bridge in a touristy part of Senegal's restive Casamance region, killing a fisherman, a military source said on Thursday.   The overnight attack on the Niambalang bridge near the Casamance capital Zinguinchor was the first on the bridge since 1998.   "Armed men tried to blow up the bridge with explosives" but failed, a military source told AFP.

They torched the huts of eight fishermen living underneath the bridge, killing one, the source said. A relative of the fisherman confirmed this.   The bridge links Zinguinchor to the beach resort of Cap Skirring, which is popular with Western tourists.   Tensions have mounted in Casamance following the massacre of 14 young men in execution-style killings in a protected forest on January 6.   The bloodbath caused some to blame a group that has led a 35-year armed campaign for the region's independence.
Date: Fri 19 Jan 2018
Source: WHO [edited]

On [3 Jan 2018], the Ministry of Health of Senegal notified WHO of a case of Rift Valley fever (RVF) reported from a hospital in Dakar. On [29 Dec 2017], a blood sample taken from a 52-year-old Korean man, resident in the Gambia, done at the Institute Pasteur Dakar, was positive for RVF on IgM testing. Previous PCR testing had been negative for RVF and other arboviruses.

The case patient worked for a fishing company in the Gambia and had no known history of handling raw meat. On [5 Dec 2017], the case patient travelled with his brother and 2 colleagues from Banjul, the Gambia, to Ziguinchor, Senegal. On [8 Dec 2017], the case patient continued travelling with his brother, a colleague, and a driver, from Ziguinchor to Bissau, Guinea-Bissau, and continued to Buba the following day. On [10 Dec 2017], the case patient returned from Buba to Bissau, and presented with a dry cough, fever, headache, and joint pain. His brother and the driver also developed a dry cough on [10 Dec 2017], which improved the following day. The group returned to the Gambia (via Ziguinchor) on [12 Dec 2017].

The case patient, however, continued to suffer a persistent cough during this time. On his return to Banjul, he additionally developed fever, headache, and vertigo. He was hospitalized on [20 Dec 2017] and diagnosed with severe malaria. On [23 Dec 2017], he became delirious and developed psychomotor agitation, profuse mucousy diarrhoea, bile-stained vomiting, and haemorrhage. On [25 Dec 2017], he became comatose and was evacuated by ambulance to Dakar. His symptoms improved, and blood samples were taken on 26, 28, and 30 Dec 2017. However, he experienced a recurrence of haemorrhagic symptoms on 31 Dec 2017 and died the same day.

Public health actions
A case investigation was conducted by a multidisciplinary team from the Centre of Health Emergency Operations of the Ministry of Health of Senegal. As part of this investigation, blood samples were collected from the brother of the case and the colleague and driver who accompanied him to Guinea-Bissau. These samples were all negative for RVFV by PCR. The results of the investigation and recommendations for action from the Ministry of Health of Senegal are pending. A case investigation was conducted by a multidisciplinary team from the Epidemic and Disease Control Unit of the Ministry Health of the Gambia. Enhanced RVF surveillance in the animal population and community RVF sensitization have been implemented in the country.

Situation interpretation
Outbreaks of RVF are uncommon in the Gambia and its neighbouring countries. The last documented human case of RVF in the Gambia was reported in 2002. There is currently no indication of risk of a major RVF outbreak in the Gambia, Senegal, or Guinea-Bissau. Heavy rainfall, causing flooding and mass emergence RVF vectors, _Aedes_ and _Culex spp._ mosquitoes, is closely associated with RVF outbreaks. Uncontrolled movement of livestock can increase the risk of spread of the disease to new areas. RVF can cause trade reductions and important economic losses due to high mortality and abortion rates among infected livestock. Integrated control measures that address both human and animal health are therefore necessary (e.g. preventive animal vaccination, vector control, control of animal movements, educational campaigns for populations at risk).
====================
[The case, who travelled in 3 different countries (The Gambia, Senegal, and Bissau) was diagnosed as being affected by malaria. Later, this person and people accompanying him exhibited symptoms that can be attributed to RVF. However, all of the other 3 tested negative, while the case was diagnosed RVF positive on IgM testing and negative on PCR. The situation needs some clarification, especially since it is not the flooding season in the region, which favors the multiplication of disease vector insects and thereby precipitates the appearance of RVF in animals with possible contamination of humans. - ProMED Mod.AB]

[Rift Valley fever (RVF) virus can persist for a long time in some areas, maintained in _Aedes_ vector mosquitoes that deposit eggs in seasonally-flooded areas, where those eggs are transovarially infected with the virus. Adult female mosquitoes coming from infected eggs can transmit the virus during their 1st blood meals. Eradicating the virus from these areas is not possible with current technology.

Although ProMED-mail has not previously posted cases of RVF in the Gambia, there is a report from neighboring Senegal. - ProMED Mod.TY]

[Mauritania, a country in close proximity (neighboring with Senegal to its north) has also experience recurrent outbreaks of RVF (see prior ProMED-mail posts). - ProMED Mod.MPP]

[HealthMap/ProMED-mail map:
Date: Fri, 15 Dec 2017 17:03:27 +0100

Dakar, Dec 15, 2017 (AFP) - Flights to and from Dakar's brand-new airport were cancelled on Friday after air traffic controllers went on strike just eight days after it opened.   Controllers announced they would strike for 24 hours from 0001 GMT Friday, Blaise Diagne International Airport's operators, LAS, said in a statement.   The company "deplores the consequences of this movement, which strongly impacts the image of Senegal, as well as the service provided to passengers and airlines", it said.

The air traffic controllers' association, Asecna, did not immediately respond to a request for comment.   President Macky Sall had inaugurated the airport on December 7 in the presence of fellow heads of state from Gabon, Guinea-Bissau and The Gambia. He was due to return to the country on Friday evening after a trip abroad.

The Senegalese press say air traffic controllers are aggrieved over working conditions, especially the problem of getting to the airport which is much farther from the capital than the previous one.   The airport is located in Diass, 47 kilometres (29 miles) southeast of Dakar. Its predecessor,  Leopold Sedar Senghor international airport, now a military airport, is in Dakar's suburbs.
More ...

World Travel News Headlines

31st May 2019

A volcano on the Indonesian island of Bali erupted Friday, spewing a plume of ash and smoke more than 2,000 metres (6,500 feet) into the sky. Mount Agung, about 70 kilometres from the tourist hub of Kuta, has been erupting periodically since it rumbled back to life in 2017, sometimes grounding flights and forcing residents to flee their homes.
Mount Agung is about 70 kilometres from the tourist hub of Kuta

The latest shortly before noon on Friday shot a cloud of volcanic ash high into the sky, but caused no disruption to flights, Indonesia's geological agency said.  Agung remained at the second highest danger warning level, and there is a four-kilometre no-go zone around the crater.

Last summer, dozens of flights were cancelled after Agung erupted, while tens of thousands of locals fled to evacuation centres after an eruption in 2017.

The last major eruption of Agung in 1963 killed around 1,600 people.

Indonesia is situated on the Pacific "Ring of Fire", a vast zone of geological instability where the collision of tectonic plates causes frequent quakes and major volcanic activity.

31st May 2019

Heatwaves across India have exacted heavy casualties this year, including dozens of deaths by sunstroke and other heat-related causes. The deaths have been mainly reported from states like Maharashtra (particularly Vidarbha), Andhra Pradesh (mainly Rayalseema) and Telangana, due to the temperature extremes in these regions. What's worrying is, a study suggests that the heatwave conditions are likely to increase from next year and continue till 2064 because of El Niño Modoki and depletion in soil moisture. Here's how the heatwave is taking a toll in the above states.

Maharashtra

Parts of Maharashtra have been reeling under high temperatures accompanied by severe heatwave condition during this summer. According to a report in The Times Of India, a 50-year old man in Beed succumbed to death because of heatstroke recently, taking the overall number to 8. Reports show a total of 456 cases of heat-related illnesses in Maharashtra this summer. Last year, the number of cases reported was 568. However, the death toll this year is more than last year's figure of 2 victims.

Regions like Nagpur and Akola show the most number of deaths and illnesses in the Vidarbha region. About 163 cases of heat-related illness were reported in Nagpur and 76 ailments were reported in Latur region. Recently, Chandrapur in Maharashtra (which lies 150km south of Nagpur) registered a day temperature of 48°C, the highest recorded in India this summer.

Andhra Pradesh

Parts of Andhra Pradesh have been experiencing temperatures of 45°C and more since the last few days. These conditions have persisted in the state after the heavy rains caused by Cyclone Fani.

Two women going on a two-wheeler and covered themselves with scarfs to protect themselves from the heat wave, in Vijayawada
(Mahesh G, TOI, BCCL, Vijayawada.)

Three people have died in Andhra Pradesh due to heat-related causes this year. Also, 433 people have been diagnosed with heatstroke. Earlier this month, electrical transformers had blown up in many parts of Krishna and Guntur districts, disrupting power supply for more than five hours and intensifying the effects of heatwave conditions and the severe temperatures.

In 2015, Andhra Pradesh experienced the most number of heat deaths in the country: 1,369 people died that year from heat-related illnesses.

Telangana

Seventeen people have succumbed in Telangana over the last 22 days. However, the number of unconfirmed deaths is expected to be higher. The region saw 541 heat-related deaths in 2015, and 27 in 2018. The farmers and those who work in the sun are usually the ones to be affected the most by high temperatures and heatwave conditions.

As heat blankets the country, make sure you stay protected. Follow official guidelines and do not step out in the Sun, especially in the afternoon hours, unless absolutely necessary.

(With inputs from The Times Of India.)

11th June 2019
https://afro.who.int/news/confirmation-case-ebola-virus-disease-uganda

Kampala, 11 June 2019 - The Ministry of Health and the World Health Organization (WHO) have confirmed a case of Ebola Virus Disease in Uganda. Although there have been numerous previous alerts, this is the first confirmed case in Uganda during the Ebola outbreak on-going in neighbouring Democratic Republic of the Congo.

The confirmed case is a 5-year-old child from the Democratic Republic of the Congo who travelled with his family on 9th June 2019. The child and his family entered the country through Bwera Border post and sought medical care at Kagando hospital where health workers identified Ebola as a possible cause of illness. The child was transferred to Bwera Ebola Treatment Unit for management. The confirmation was made today by the Uganda Virus Institute (UVRI). The child is under care and receiving supportive treatment at Bwera ETU, and contacts are being monitored.

The Ministry of Health and WHO have dispatched a Rapid Response Team to Kasese to identify other people who may be at risk, and ensure they are monitored and provided with care if they also become ill. Uganda has previous experience managing Ebola outbreaks. In preparation for a possible imported case during the current outbreak in DRC, Uganda has vaccinated nearly 4700 health workers in 165 health facilities (including in the facility where the child is being cared for); disease monitoring has been intensified; and health workers trained on recognizing symptoms of the disease. Ebola Treatment Units are in place.

In response to this case, the Ministry is intensifying community education, psychosocial support and will undertake vaccination for those who have come into contact with the patient and at-risk health workers who were not previously vaccinated.  

Ebola virus disease is a severe illness that is spread through contact with the body fluids of a person sick with the disease (fluids such as vomit, faeces or blood). First symptoms are similar to other diseases and thus require vigilant health and community workers, especially in areas where there is Ebola transmission, to help make diagnosis. Symptoms can be sudden and include:
  • Fever
  • Fatigue
  • Muscle pain
  • Headache
  • Sore throat
People who have been in contact with someone with the disease are offered vaccine and asked to monitor their health for 21 days to ensure they do not become ill as well.

The investigational vaccine being used in DRC and by health and frontline workers in Uganda has so far been effective in protecting people from developing the disease, and has helped those who do develop the disease to have a better chance of survival. The Ministry strongly urges those who are identified as contacts to take this protective measure.

Investigational therapeutics and advanced supportive care, along with patients seeking care early once they have symptoms, increase chances of survival.

The Ministry of Health has taken the following actions to contain spread of the disease in the country:
  • The District administration and local councils in the affected area have been directed to ensure that any person with Ebola signs and symptoms in the community is reported to the health workers immediately and provided with advice and testing.
  • The Ministry of Health is setting up units in the affected district and at referral hospitals to handle cases if they occur.
  • •Social mobilization activities are being intensified and education materials are being disseminated.

There are no confirmed cases in any other parts of the country.

The Ministry is working with international partners coordinated by the World Health Organization.

The Ministry of Health appeals to the general public and health workers to work together closely, to be vigilant and support each other in helping anyone with symptoms to receive care quickly. The Ministry will continue to update the general public on progress and new developments.
Date: Mon, 10 Jun 2019 14:24:43 +0200

Lima, June 10, 2019 (AFP) - Peru has declared a health emergency in five regions, including Lima, after the deaths of at least four people linked to Guillain-Barre syndrome, an autoimmune disorder that attacks the nervous system.   Health Minister Zulema Tomas said Sunday that in addition to the deaths there were currently 206 cases of the disease.   "We have an outbreak, there has been a brusque increase" since June 5, Tomas said on state-run TV Peru, adding that health authorities were taking steps to control and contain the disease.

While the syndrome is not contagious, a 90-day health emergency was declared because the current cases "have unusual and atypical characteristics that require rapid or immediate initial treatment," Peru's Institute of Neurological Sciences said.   The precise cause of the disorder is unknown, but most cases develop after a person has been sick with diarrhoea or a respiratory infection.

The Centers for Disease Control and Prevention in the US says its research suggests that the syndrome is "strongly associated" with the Zika virus, a mosquito-borne illness.   The regions affected by GBS include three on the country's northern coast -- Piura, Lambayeque, La Libertad -- tourist destinations known for their archaeological sites and beaches.   Also included was the central region of Junin and Lima, which has nine million inhabitants.   Two deaths were reported in Piura, one in La Libertad and another in Junin.
Date: Mon, 10 Jun 2019 16:39:03 +0200

Madrid, June 10, 2019 (AFP) - Three tourists have fallen from their hotel balconies in Spain's Balearic Islands in recent days, one of them dying on impact, police said Monday as the summer season in the party archipelago begins.   The incidents came as Britain's foreign office warned holidaymakers heading to Spain against "balcony falls" and asked them not to "take unnecessary risks... particularly if you're under the influence of drink or drugs."   On Friday in Magaluf, a party resort notorious for its booze-fuelled tourism, a 19-year-old British man fell to his death from the second floor of his hotel, Spain's Civil Guard police force said.

A spokesman said police were looking at two theories -- either "he threw himself off voluntarily, or he fell by accident."   He did not know whether the victim had consumed drugs or alcohol.   On Thursday, a 35-year-old German man fell from the second floor of his hotel too, this time in Palma de Majorca, and was seriously injured, police said.   A source close to the probe, who declined to be named, said the man had drunk, dozed off, woken up and subsequently fallen from the balcony, possibly disorientated.   And on Monday, an Australian man in his early thirties fell from the second floor of his hotel in Ibiza and was seriously hurt, police said, without giving further details.

Balcony falls happen every year in the Balearic Islands and other party resorts in Spain, most of them due to excessive drinking or drug-taking/   Some are accidental slips, while others happen when tourists miss while trying to jump into pools or onto another balcony -- a practice known as "balconing."   The British foreign office's online travel advice for Spain has an entire section warning against "balcony falls".   "There have been a number of very serious accidents (some fatal) as a result of falls from balconies," says the website.    "Many of these incidents have involved British nationals and have had a devastating impact on those involved and their loved ones."
Date: Mon, 10 Jun 2019 06:44:54 +0200

Sydney, June 10, 2019 (AFP) - Australian police said Monday they were scouring bushland for a Belgian teenage tourist missing in a popular surf town for more than a week.   Theo Hayez, an 18-year-old backpacker, was last seen on May 31 at a hotel in the coastal tourist town of Byron Bay -- some 750 kilometres (470 miles) north of Sydney -- New South Wales state police said.   "We have a large amount of resources searching... in bushland that is towards the east and northeast of the town," police Chief Inspector Matthew Kehoe said in a statement.   "We are advised that this disappearance is completely out of character for him."   Police said they were alerted to his disappearance on Thursday after he failed to return to a hostel he was staying in.   Hayez's passport and personal belongings were all left at the hostel, and police believe he had not made any financial transactions since his disappearance or used his mobile phone.
Date: Sat 8 Jun 2019
Source: New Jersey 101.5 [edited]

The potentially deadly Powassan tick-borne virus has been confirmed in 2 Sussex county residents, one of whom died last month [May 2019], state health officials confirmed [Sat 8 Jun 2019].

The Powassan virus is spread by the deer tick [_Ixodes scapularis_]. The illness is rarer than Lyme disease, which is also spread by the tick, but 10% of people who contract the [Powassan virus] illness die from it.

A Department of Health official on [Sat 8 Jun 2019] said that the department had not determined the cause of death for the patient who died last month [May 2019] but said that lab results this week [week of 3 Jun 2019] confirmed that he had the virus.

A 2nd victim continues to recover at home.

Symptoms of the virus include brain swelling, meningitis, fever, headache, vomiting, weakness, confusion, loss of coordination, trouble speaking, and memory loss. Symptoms can appear a week to a month after a tick bite, although some people show no symptoms and do not require treatment.

There is no vaccine or cure for the disease. Treatment includes hospitalization, support for breathing, and intravenous fluids.

Prevention involves the same precautions that should be taken to avoid Lyme disease: avoid wooded areas with tall grasses, use insect repellent while outdoors, and check for ticks after being outdoors.

Powassan [virus] -- first discovered in Powassan, Ontario, in 1958 -- has been confirmed in recent years in New Jersey, with one case each in 2013, 2014, and 2015, and 4 cases in 2017, the most recent year for which data is available. The cases were reported in Sussex, Warren, Morris, and Essex counties.

Between 2008 and 2017, there were 125 confirmed cases in the entire country and 9 deaths.

A person who said they were close to the man who died last month [May 2019] posted on Facebook that the man was bitten in the arm by a tick while gardening and fell ill about 2 weeks later. The Facebook post said that there was no bull's-eye mark around the bite -- a known tell-tale sign for Lyme infection. About a day before he was hospitalized, the man reported feeling like he was coming down with a cold and had a high fever.

State health department's tip sheet for preventing Powassan [virus infection]:
- avoid contact with ticks by avoiding wooded areas with high grass;
- when hiking, stay on the center of the trail;
- picnic in areas away from wooded and bushy areas;
- keep children on playground equipment and away from tall grass and shrubs;
- when outdoors, apply insect repellents;
- wear light-colored clothes so it is easy to see and remove ticks;
- wear long-sleeve shirts and pants;
- tuck long pants into socks so ticks cannot crawl under pants;
- do tick checks every couple hours while outdoors and before coming indoors;
- if you see a tick during tick checks, remove it right away;
- keep grass mowed short;
- keep children's toys, playground equipment, pools, and lawn furniture at least 15 feet [4.6 m] from wooded areas;
- create a woodchip or mulch border between your yard and wooded areas;
- keep areas under bird feeders and pet dishes clean, so they do not attract animals that may carry ticks;
- keep trash in closed containers or areas so it does not attract animals that may carry ticks.  [Byline: Sergio Bichao]
=======================
[Powassan virus is endemic in New Jersey, and cases occur there sporadically. The tick vector is the deer tick, _Ixodes scapularis_. Humans become infected with POWV during spillover transmission from the natural transmission cycles. In humans, POWV can be a causative agent of a severe neuroinvasive illness, with 50% of survivors displaying long-term neurological sequelae. Individuals living or visiting areas where the deer tick occurs, should follow the above recommendations to avoid tick bites. If a tick is found feeding, it should be removed with forceps or tweezers grasping the tick at skin level and then gentle, constant force applied. The tick should never be removed by grasping it with thumb and forefinger, as squeezing the tick may cause inoculation of contents containing the pathogenic agent into the feeding site.

POWV was recognized as a human pathogen in 1958, when a young boy died of severe encephalitis in Powassan, Ontario, Canada. In that case, POWV was isolated from the brain autopsy. There are 2 distinct genetic lineages now recognized: POWV (lineage I) and deer tick virus (lineage II). Since the index case in 1958, over 100 human cases of POWV have been reported, with an apparent rise in disease incidence in the past 16 years. This recent increase in cases may represent a true emergence of POWV in regions where the tick vector species are prevalent, or it could represent an increase in POWV surveillance and diagnosis. - ProMED Mod.TY]

[HealthMap/ProMED-mail map of New Jersey, United States:
New Jersey county map:
Date: 6 Jun 2019
Source: Washington Post [edited]

Dominican government officials released more-detailed autopsy results on Thursday [6 Jun 2019] for 3 American tourists who died at adjacent beach resorts owned by the same hotel company during the last week of May 2019.

All 3 victims experienced eerily similar symptoms and internal trauma before their deaths, according to a news release from Dominican authorities. Pathologists said autopsies showed the 3 had internal haemorrhaging, pulmonary oedema, and enlarged hearts.

Toxicology reports are pending [These are likely to be the most interesting. - ProMED Mod.TG].

A U.S. State Department official said authorities have not yet established a connection between the 30 May 2019 deaths of 49-year-old CAD, and 63-year-old NEH, both of Prince George's County, MD, and the death on 25 May 2019 of 41-year-old MSW of Pennsylvania.

The FBI is providing Dominican law enforcement with "technical assistance with the toxicology reports," the State Department official said.

MSW had just checked into the Luxury Bahia Principe Bouganville, in the town of San Pedro de Macoris, and was taking pictures from her room balcony when she started to feel ill.

Less than 2 hours later, she was dead, local authorities said.

The bodies of CAD and HEH were found inside their room at the Grand Bahia Principe La Romana after relatives grew concerned because they had not checked out of the resort.

The hotels are located next to each other on the island's southern coast, about 60 miles from the tourist-heavy Punta Cana area.

Dominican authorities initially did not run toxicology tests for MSW because there were no signs of violence, said Ramon Brito, a spokesman for the National Police's special tourism unit. After the Maryland couple was found, investigators ordered a set of tests to determine whether anything the 3 Americans consumed may have led to their deaths, Brito said.  [Byline: Arelis R. Hernandez]
Date: 31 May 2019
Source: 4 News [edited]

The Alachua County Health Department is warning residents that there are 12 confirmed cases of mumps, primarily from college students at the University of Florida.  "This is a little more than usual," says Steve Orlando, University of Florida spokesman.

Alachua County normally receives around 2 reported cases a year, and UF believes more students could be infected.  "So, it's curious because these are individuals who are vaccinated, and that's what we are seeing nationwide," says Paul Myers, Alachua County Health Department administrator.

Officials say it is still unclear why there has been an uptick with the virus. So far, the CDC shows 736 people have contracted mumps nationwide in 2019.

"The sharing of the utensils, sharing of the cups, sharing of the water bottles, you know it is a very common thing for students to share those things, and that's exactly the kind of thing that could lead to transmission," says Orlando.
Date: Sat 8 Jun 2019
Source: Business Standard [edited]

As many as 14 children have died due to acute encephalitis syndrome (AES) in the district, while over a dozen are admitted in hospitals with high fever and other symptoms of the infection.

Sunil Shahi, Superintendent of Shri Krishna Medical College and Hospital (SKMCH), told ANI, "We have received 38 patients so far; most of them have a deficiency of glucose in their blood. Of these, 2 have also tested JE [Japanese encephalitis] positive; the overall casualty till now is 14."

Dr Gopal Sahni, head of Critical Care Unit, said, "When heat and humidity rise, the body's sweat cannot evaporate. The humidity level is over 50 per cent in the last few days. We have about 15 such children admitted in the hospital currently, and 89 such cases come regularly."

Encephalitis is a viral infection, which causes mild flu-like symptoms such as a fever or a headache.
=======================
[Again, this year (2019), cases of AES and JE are appearing in north-western India. Of the 14 AES cases, 2 tested positive for JE. The aetiology of the remaining cases is not stated, but the majority are reported as hypoglycaemic. As noted previously, frequently, in reports of JE cases in India, acute encephalitis syndrome (AES) of undefined aetiology is often mentioned with JE cases that are a minority of those hospitalized.

The determination of the aetiology or aetiologies of AES has been confusing and elusive. Various etiological agents have been proposed in recent years as responsible for AES cases. AES has continued to be attributed to a variety of aetiologies, including Reye syndrome-like disease, possible enterovirus infection from polluted water, heatstroke, lychee fruit consumption, and scrub typhus (_Orientia tsutsugamushi_). Recently, scrub typhus has been implicated in many AES cases. A recent publication (reference below) states that dengue virus is one of the 3 most common agents identified in acute encephalitis syndrome (AES). Unfortunately, existing surveillance for AES does not include routine testing for dengue. Dengue accounts for 5% of AES cases in India, especially in the absence of laboratory evidence for other pathogens tested. Dengue should be added to the list of possible AES etiological agents.

Reference:
Vasanthapuram Ravi, Shafeeq Keeran Shahul Hameed, Anita Desai, Reeta Subramaniam Mani, Vijayalakshmi Reddy, et al.: Dengue virus is an under-recognised causative agent of acute encephalitis syndrome (AES): Results from a 4-year AES surveillance study of Japanese encephalitis in selected states of India. International Journal of Infectious Diseases. 2019. doi: <https://doi.org/10.1016/j.ijid.2019.01.008>.

Maps of India:

[HealthMap/ProMED map available at: