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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: Tue, 24 Sep 2019 07:27:34 +0200 (METDST)

Miami, Sept 24, 2019 (AFP) - A strong 6.0 magnitude struck off the northwest coast of Puerto Rico late Monday, the United States Geological Survey said, although no casualties or damage were reported.   The quake struck 62km northwest of San Antonio at 11:23 pm local time (03:20 GMT) at a depth of 10km, the agency said.  San Antonio is home to Rafael Hernandez Airport, a key air link to the mainland US.    In 2010 nearby Haiti was struck by a devastating 7.0 magnitude earthquake that killed more than 250,000 people and crippled the nation's infrastructure.
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:
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Samoa

General:
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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:
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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:
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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:
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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:
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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:
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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:
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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:
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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:
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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:
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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:
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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]
More ...

Nepal

General:
*******************************
Nepal is regarded as a developing nation which has a great variability of facilities for the tourist depending on the location throughout the country. It is a mountainous country and many travellers to th
s region undertake long arduous treks. It is wise to ensure that your general health will be sufficient for the trip you plan under normal circumstances. Talking your itinerary through with other experienced travellers to this region will be important before you finally book your holiday. The climate varies throughout the year with their monsoon season typically stretching from May to October. During this time significant flooding can occur and the high humidity leads to increased numbers of mosquitoes. Travel to the Terai plains during this period leads to the greatest risk of mosquito borne disease.
Safety & Security:
*******************************
The security situation throughout Nepal has caused quite a degree of concern throughout the past few years. There has been a general increased level of robberies and this has involved tourists on a number of occasions. Those trekking in Nepal are strongly advised to travel with reputable organised groups who will have checked the local situation out carefully before departure. It is very inadvisable to trek alone in Nepal. This is particularly true in the Rasuwa District of the Langtang Area. Airport security in Katmandu has been improved since the hijacking of Indian Airlines flight IC814 in December 1999 but take care of your belongings at all times and never carry anything for strangers no matter how plausible their reason may be.
Health Facilities:
*******************************
The level of Western health facilities in Katmandu and Pokhara are excellent but expensive. Outside of the main city the level of healthcare can be very limited. It is essential that all tourists ensure that they have adequate travel insurance which will cover accidents and evacuation by helicopter. Cover for cancelled flights and loss of belongings is also extremely important. The CIWEC Medical Clinic in Katmandu provides an excellent medical service for travellers and their web page gives extensive advice on travelling throughout Nepal.Telephone numbers Katmandu 228531, or 241732. Web site: www.ciwec-clinic.com
Food & Water Facilities:
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Katmandu is a large city with a large population and much squalor. The main tourist hotels provide a good degree of hygiene for travellers but those undertaking trekking holidays will leave this relative health security and head to regions of the country where food and water hygiene are very poor. It is essential that all food consumed is freshly prepared and well cooked. Cold vegetables or salads should be avoided as the risk of diseases like amoebiasis and giardiasis is very high. All water should be checked for a smell of chlorine and if this is not present then it should not be used for either drinking or brushing your teeth. Even bottled water from any source outside of the main hotels should be treated with suspicion as in many cases it will be plain untreated tap water.
Rabies risks in Nepal:
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This viral disease is usually transmitted by the bite (lick or scratch) from any infected warm blooded animal. Usually humans are infected by dogs but cats and monkeys are also frequently implicated. In many of the temples of Nepal there will be a multitude of monkeys and it may be difficult to avoid contact. If you are exposed then urgent medical attention will be required and this will often mean a rapid return to Katmandu. Never treat this disease lightly and always ensure that any contact is followed up as soon as possible.
Altitude Problems:
*******************************
Arriving into Katmandu at 4,500ft usually presents no major difficulty for travellers. However, depending on the actual trek which is proposed you may put yourself at risk of exhaustion, dehydration and altitude sickness. The better tour companies will tailor the actual trek to the abilities of those taking part but try not to allow yourself become attached to a group which will push your health to extremes. Many treks will take travellers to heights reaching 18,000ft.
Malaria risk in Nepal:
*******************************
The main risk of malaria in Nepal will be for those visiting the Terai region. Even here, the significant risk occurs during the monsoon season and for a period afterwards. However, malaria transmission is reported from other regions of the country and this will need to be talked through in depth before you leave home.
Mosquito Borne diseases:
*******************************
Apart from malaria there are two other significant mosquito borne diseases which occur in regions of Nepal. Dengue Fever and Japanese B Encephalitis are both frequently implicated in outbreaks and both diseases can cause severe illness even death. Avoiding mosquito and sandfly bites at all times is essential.
Road & Climbing Safety:
*******************************
The road conditions throughout rural Nepal are poor and care will be required at all times. Many mountainous passes are impassible during the monsoon season and can even be very hazardous at other times throughout the year. In Katmandu the roads are congested, pollution is a significant problem and walkways may be non existent in many places. If undertaking a trek it is important to make sure your general health is sufficient and that you have adequate clothing and shoes to suit both the expected and unexpected.
Local Laws & Customs:
*******************************
The Nepalese customs are very strict regarding importation and exportation of many goods including valuable metals, articles of archeological or religious importance, drugs, arms and communication equipment. Imprisonment can quickly follow any infringement of their rules. Women are advised to dress modestly and generally it is wiser to avoid inappropriate clothing in public such as shorts, sleeveless tops etc.
Vaccination for Nepal:
*******************************
Unless you are entering Katmandu from tropical Africa there are no essential vaccines for entry or exit. We used to receive reports of buses being stopped coming overland from India and for all on board to have evidence of Cholera vaccination. However, this does not appear to be a current problem. Nevertheless, for your own personal health it is recommended that travellers are covered against the following diseases;
*
Poliomyelitis (childhood booster)
*
Tetanus (childhood booster)
*
Typhoid (food and water borne disease)
*
Hepatitis A (food and water borne disease)
For those undertaking a longer more rural trip other vaccines may need to be considered including Hepatitis B, Rabies, Japanese B and Meningitis.
Summary:
*******************************
Tourists will need to ensure the highest level of personal care while visiting Nepal at all times. Many of the conditions and situations mentioned above occur frequently in those who forget the basic commonsense rules about travelling healthy.

Travel News Headlines WORLD NEWS

Kathmandu. 6 Sep 2019

If laboratory tests carried out at Sukraraj Tropical and Infectious Disease Hospital today [6 Sep 2019] are anything to go by, roughly 50% of those who visit the hospital with fever and muscle pain are dengue-infected. According to the hospital, of the 372 blood tests done today [6 Sep 2019], 175 tested positive for dengue. "There has been a significant rise in the number of dengue-infected patients at the hospital. Unless people are aware and start working on their own, it is difficult to prevent the infection," said Anup Bastola, spokesperson and consultant tropical medicine physician at Sukraraj Tropical and Infectious Disease Hospital.

- Kathmandu. 19 Sep 2019.The cases of dengue fever are on the rise in Bhaktapur, indicating that it is gradually taking an epidemic turn. In the past 2 weeks, 197 people have been diagnosed with dengue in the district.
12th September 2019
Communication from a medical colleague based in Kathmandu
=======================
Dear friends,  I would like to alert you to a dengue outbreak in Nepal including in Kathmandu. It started in May 2019 in eastern Nepal but has come to Kathmandu in a big way in the past 2 weeks or so. Government figures (http://www.edcd.com.np/) indicates total of 5095 cases in Nepal including 1170 cases from Kathmandu. The government figures underestimate the problem due to underreporting issues. Kathmandu hospitals seem stretched to capacity due to dengue visits and admissions.

This problem is new to Kathmandu as we have had only sporadic cases of dengue in previous years. The public in Kathmandu has never taken mosquito bites seriously since we have not had major vector borne diseases in the past. We hope that the current dengue outbreak has peaked and will slow down once we get cooler nights from end September - early October.

If you have travellers coming this way, please alert them to this and send them with insect repellents and information on mosquito protection measures. DEET is not readily available and other repellent supplies have been depleted. 

Thank you. 
Prativa
======================
Dr. Prativa Pandey
Medical Director
CIWEC Hospital I Travel Medicine Center
prativapandey@ciwec-clinic.com
+977
98510-36742 I
http://www.ciwec-clinic.com/
Date: Sat, 13 Jul 2019 09:52:36 +0200

Kathmandu, July 13, 2019 (AFP) - Floods and landslides triggered by torrential monsoon rains have killed at least 40 people across South Asia in the last two days, officials said Saturday.   The monsoon, which lasts from June to September, causes widespread death and destruction across South Asia each year.   In Nepal, 27 people have died in floods and landslides after heavy rains hit the country's eastern region and the southern plains.

Bishwaraj Pokharel, spokesperson for Nepal Police, added that another 11 people were injured and 15 others reported missing.    Three of the victims were killed when a wall collapsed in the capital Kathmandu.   "Our first priority is life saving rescue and all our resources have been deployed," Home Ministry official Umakanta Adhikari told AFP.

Police used boats to bring people to safety as rivers swelled, inundating their settlements, while parents were seen wading across chest-high waters carrying children on their shoulders.    Nepal's weather department issued a high alert for the southern Sapta Koshi river on Saturday and sent SMS warnings to people in the area.

In neighbouring India 11 deaths have been recorded in the north-eastern states of Assam and Arunachal Pradesh, officials said Friday.  Monsoon floods have inundated 21 districts in Assam, affecting thousands, officials said Friday.

In Bangladesh aid groups were providing rations to Rohingya refugees in the southeast of the country with the UN World Food Programme saying Friday that two people including a child had died.   Last year, more than 1,200 people were been killed across South Asia in monsoon storms with India's Kerala suffering its worst floods in nearly 100 years.
Date: Mon, 27 May 2019 13:48:42 +0200

Kathmandu, May 27, 2019 (AFP) - Nepalese police arrested suspected Maoist activists after three deadly bomb blasts in Kathmandu as a general strike disrupted daily life in much of the South Asian nation on Monday, police said.   Amid a high alert after Sunday's attacks, which were blamed on an outlawed Maoist group, police blew up several suspicious packages.   The group broke away from the country's main communist party, which is now in power, and called the general strike to protest against the death of one of its leaders in police custody.

Police said at least 13 officials from the Maoist group had been arrested on Sunday night and early Monday in different parts of the country.   "Security agencies dealt with suspicious objects found in different areas, mostly outside the capital," said police spokesman Bishwa Raj Pokharel.   While some schools and offices remained closed in Kathmandu, "the effect of the general strike is nominal in the Kathmandu valley but very few vehicles are working outside the capital," the spokesman added.    Four men were killed and seven people injured in three explosions in Kathmandu on Sunday.

A blast inside a shop killed three people, one died in an explosion at a nearby house, whilst two men carrying explosives on a motorbike were among those injured.   There was no immediate claim of responsibility but police said they suspected the Maoist group whose pamphlets were found in a house where one of the explosions took place.

Nepal has enjoyed relative calm since the end of a decade-long civil war in 2006. But some former guerrillas have formed a new group accusing their former leaders of betraying their revolutionary cause.   The group was banned after it was implicated in an explosion that killed one person outside a telecom company office in February.
Date: Sun, 26 May 2019 19:09:29 +0200

Kathmandu, May 26, 2019 (AFP) - Four men died and seven were injured Sunday in three separate explosions in Kathmandu, Nepali police said.   There was no immediate claim of responsibility but police said they suspect involvement of a Maoist splinter group whose pamphlets were found in a house where one of the explosions took place.   A powerful blast inside a shop killed three people and injured four, while the explosion at a home about four kilometres away left one dead and another injured.

Two more were injured when an explosive they were carrying on a motorcycle in the outskirts of Kathmandu exploded.   Security personnel also defused explosives in other areas.    "We are investigating all incidents and have stepped up the security," police spokesman Bishwa Raj Pokharel told AFP.   Pokharel said that seven people have been arrested so far.    The incidents come on the eve of a nationwide strike called the same Maoist splinter group, protesting death of their cadre in a police encounter over a week ago.

Nepal has enjoyed a relatively peaceful environment since the end of a decade-long civil war which concluded with a peace deal struck in 2006.   But some former guerrillas, have broken away, accusing its leaders of betraying their original revolutionary ideals.   In February, the group was implicated in an explosion that killed one person outside the office of a telecom company Ncell, part of Malaysia-based Axiata Group Berhad.    The government outlawed the group following the incident, banning their activities.
More ...

World Travel News Headlines

Date: Wed, 16 Oct 2019 18:45:39 +0200 (METDST)

Manila, Oct 16, 2019 (AFP) - A child was killed in a strong 6.4-magnitude quake that hit the southern Philippines on Wednesday, a local mayor said, as houses collapsed, power was knocked out and a shopping mall burst into flames.   Residents evacuated homes and buildings across the Mindanao region including a mall that caught fire in the city of General Santos shortly after the quake struck in the evening, officials said.   The child died in a house collapse in the town of Datu Paglas, while four residents of nearby Tulunan town were injured when at least two other houses fell down, Tulunan Mayor Reuel Limbungan told AFP.   "The child was crushed by a collapsed house wall" and pronounced dead in hospital, Limbungan said, adding that he had visited the medical facility and spoken to its director.

Rescue and local officials said there were no immediate reports of deaths elsewhere in Mindanao, and rescue official Anthony Allada told local television that 20 people were treated for injuries in the town of Magsaysay, near the epicentre.   Three other people were hurt in the town of M'lang, added its vice-mayor, Joselito Pinol.   The quake was 14 kilometres (8.7 miles) deep and was followed by at least two aftershocks, according to the United States Geological Survey (USGS).   "It was the most powerful earthquake I have ever experienced," Sara Duterte, mayor of the largest Mindanao city of Davao, and daughter of President Rodrigo Duterte, told local television.

- Falling debris -
The Philippines is part of the Pacific "Ring of Fire", an arc of intense seismic activity that stretches from Japan through Southeast Asia and across the Pacific basin.   An elderly man was treated for injuries after being struck by a falling object during the evacuation of a Davao mall, local TV reported.   Jerome Barranco, civil defence officer for the region, said several people were also injured in the city of Kidapawan "as a result of falling debris".   In General Santos, television footage showed firemen battling a blaze that engulfed the three-storey Gaisano shopping mall.   It was not known if there were still people inside the building, which was evacuated as the quake struck.   The blaze was still raging more than three hours later despite the efforts of nearly 100 firemen, fire officer Redentor Batulan told AFP.

Coastal residents of Davao fled their homes in fear of a tsunami, but rescue workers were trying to convince them to return as no warning was issued, city civil defence chief Rodrigo Bustillo told local television.   "Our volunteers are out to calm the people and tell them there is no tsunami," Bustillo added.   Chief Philippine government seismologist Renato Solidum said there was no risk of a tsunami because the quake occurred inland, but he advised residents to check their homes for possible damage.   "We ran out of the police station, and we also let the inmates at the municipal jail out," patrolwoman Celina Sarte told AFP by telephone from the town of Bansalan.   She said the 10 prisoners were put in handcuffs outside moments later.
Date: Tue, 15 Oct 2019 20:35:37 +0200 (METDST)

Addis Ababa, Oct 15, 2019 (AFP) - Rescue workers on Tuesday used excavators to dig out bodies after a landslide in southern Ethiopia washed away homes and killed more than 20 people, a local official said.    The landslide in the remote district of Konta occurred Sunday following 10 hours of heavy rains, said the official, Takele Tesfu.   "There are 22 people dead and we have only been able to dig up 17 using manpower and machine power," Takele told AFP.   "So far, we cannot get the others, so tomorrow we will continue to dig."     He said the victims included nine women and six children.

While the district -- located in Ethiopia's Southern Nations, Nationalities, and Peoples' Region -- sees landslides with some regularity, Takele said this was the deadliest he could remember.    "The area where this occurred is very mountainous, and this means the landslide was very dangerous," he said.    Ethiopia is nearing the end of its rainy season, but security forces are nonetheless relocating some families for fear that more rain in the coming days could lead to similar disasters, Takele said.
Date: Tue, 15 Oct 2019 10:00:23 +0200 (METDST)

New Delhi, Oct 15, 2019 (AFP) - New Delhi banned the use of diesel generators on Tuesday as pollution levels in the Indian capital exceeded safe limits by more than four times.   Every winter, New Delhi is enveloped in a noxious blanket of smog of car fumes, industrial emissions and smoke from stubble burning at farms outside the megacity of 20 million people.   The ban on generators is part of the Graded Response Action Plan (GRAP) that entered into force on Tuesday.   Other measures that will come into effect as smog levels rise, particularly following the Diwali festival in late October, include banning trucks and setting up a "war room".

From November 4-15, a road-rationing scheme will come into force, meaning cars with odd and even plates would be allowed on alternate days in that period.   "We will hand out anti-pollution masks to schoolchildren next week but the date is yet to be decided," the official told AFP.   Indian authorities have also sought to reduce the burning of stubble by farmers in areas surrounding Delhi.   According to government data, concentrations of particles measuring less than 2.5 microns across -- which can penetrate the lung barrier and enter the blood -- hit 108 icrograms per cubic metre on Tuesday.   This was more than four times the recommended World Health Organization safe daily maximum of 25. In previous years, the level has regularly exceeded 400.   Last year, a UN report found 14 of the world's 15 most polluted cities were in India, with one US study saying it kills a million people prematurely every year.
Date: Tue, 15 Oct 2019 09:50:21 +0200 (METDST)
By Kyoko HASEGAWA

Tokyo, Oct 15, 2019 (AFP) - Rescuers in Japan were working around the clock Tuesday in an increasingly desperate search for survivors of a powerful weekend typhoon that killed nearly 70 people and caused widespread destruction.   Hagibis slammed into Japan on Saturday night, unleashing fierce winds and unprecedented rain that triggered landslides and caused dozens of rivers to burst their banks.   By Tuesday afternoon, local media put the toll at nearly 70, with around a dozen people missing. The government's tally was lower, but it said it was still updating information.   Prime Minister Shinzo Abe said there was no plan to slow rescue operations, with around 110,000 police, coast guard, firefighters and military troops involved.   "Currently in damaged areas rescue work and searches for the missing are continuing around the clock," Abe told parliament.   "Where rivers flooded, work is ongoing to fix spots where banks broke, and water is being pumped out where floods occurred," he added.   The prime minister's office said more than 3,000 people have been rescued in the wake of the disaster, which affected 36 of the country's 47 prefectures.   The defence ministry has called up several hundred reserve troops in addition to active duty soldiers for the first time since the 2011 earthquake and tsunami.

- Rain prompts new warnings -
Government officials warned that more rain was expected throughout the day Tuesday in several parts of the country affected by the typhoon.   "We ask people not to drop their guard and to remain fully alert," chief cabinet secretary Yoshihide Suga. told reporters.   Hagibis crashed into land packing gusts up to 216 kilometres (134 miles) per hour, but it was the storm's heavy rain that caused the most damage.   At least 176 rivers burst their banks, including in central Nagano, where a levee breach sent water from the Chikuma river gushing into residential neighbourhoods and submerging bullet trains in a depot up to their windows.   Deaths were reported across many prefectures and included a man whose apartment was flooded, a municipal worker whose car was caught in rising waters and at least seven crew aboard a cargo ship that sank in Tokyo bay on Saturday night.   By Tuesday morning, some 34,000 households were still without power, and 133,000 homes had no water.   Tens of thousands of people spent Monday night in government shelters, with many unsure when they would be able to return home.   "My frightened daughter can't stop shaking. We want to go home quickly," Rie Nishioka, 39, told Kyodo News agency in Miyagi prefecture.

- Government pledges aid -
The government pledged financial support to affected regions without specifying how much aid it would set aside.   "Support for the victims of the disaster is an urgent task," Abe said.   "There are concerns that the impact on daily life and economic activities may be long-lasting."   Another area affected by the storm was Fukushima, where several bags containing soil and plants collected during nuclear decontamination efforts were washed away.   "Ten bags out of 2,667 were swept into a river during the typhoon, but six of them were recovered yesterday," environment ministry official Keisuke Takagi told AFP, adding that the remaining four bags had been found and would be collected soon.   "Residents must be worried about the environment, but there are no reports that the bags were broken, so there will be nothing to worry about once they have been recovered safely," he said.   Hagibis caused transport chaos over a holiday weekend in Japan, grounding flights and halting train services.   By Tuesday, things were largely back to normal, though some flights were cancelled and train services partially disrupted where tracks or train stock were damaged by the storm.   The typhoon also caused disruption to sporting events, delaying Japanese Grand Prix qualifiers and forcing Rugby World Cup organisers to cancel three matches.   A crunch fixture pitting the hosts against Scotland went ahead on Sunday night, with Japan winning its first-ever quarter final spot.
Date: Mon, 14 Oct 2019 17:55:47 +0200 (METDST)

Harare, Oct 14, 2019 (AFP) - Striking Zimbabwe doctors on Monday defied a court order to return to work, saying a pay rise offered by the government failed to meet everyday costs.   Doctors remained home for a 43rd consecutive day, striking for better pay after their salaries were eroded by the country's spiralling inflation.   Zimbabwe's labour court ruled the action "unlawful" on Friday and ordered the medics back to their wards within 48 hours.

The Zimbabwe Hospital Doctors Association (ZHDA) announced Sunday it would appeal to the Supreme Court.    "We noted the court order but unfortunately we don't have the means by which to comply," said ZHDA spokesman Masimba Ndoro on Monday.   "We remain incapacitated... There is nothing we can do when we don't have the means to go to work and to meet our basic needs," he told AFP.   The doctors say the value of their pay shrank 15-fold over the past year -- a legacy of hyperinflation caused by economic mismanagement under ex-president Robert Mugabe.   His successor Emmerson Mnangagwa has so far failed to redress the situation.    Fuel prices have increased by more than 400 percent since the start of the year, and the ZHDA said that doctors had to use their savings just to show up to hospital each morning.

Negotiations with the government have been deadlocked since the ZHDA rejected a 60-percent salary rise offer.   With pay slips worth less than the equivalent of $100 (91 euros) in some cases, they are demanding doctors' salaries be pegged to the US dollar and have appealed to international bodies to supplement their wages.   "While doctors would want nothing more than to return to work in service of their patients, they continue to be incapacitated and lack the resources to comply with the Labour Court judgement," the ZHDA said in a statement on Sunday.   Nurses joined in the action last week.   "We have reduced the number of days we are coming to work initially to three days a week now we are down to two days," Zimbabwe Nurses Association spokesman Enoch Dongo told AFP.   "If the issue of salaries is not urgently addressed we will soon have a situation where nurses will no longer be able to come to work," he said, adding that nurses were "taking turns" in coming to hospital.      Rural teachers also embarked on strike action on Monday with a stay-at-home protest "against underpayment".   "We urge the government to respect our right to engage in job actions and peacefully protest demanding a living wage," the Amalgamated Rural Teachers Union of Zimbabwe posted on Twitter.
Date: Mon, 14 Oct 2019 16:33:26 +0200 (METDST)
By Daniel BOSQUE

Barcelona, Oct 14, 2019 (AFP) - "I feel fury and a sense of powerlessness," said Joan Guich, a 19-year-old student protesting in Barcelona after Spain's Supreme Court jailed nine Catalan leaders jailed over a failed independence bid.   "They have been convicted for an ideology which I agree with."   Within minutes of the ruling demonstrators had poured onto the streets of the Catalan capital, waving flags and blocking traffic over the conviction of the separatist leaders who organised a 2017 referendum banned by Madrid.   "We have to mobilise and stick up for them ... in a way that has an impact, closing airports, stations, but always avoiding violence," Guich said. "Or at least, it won't be us that provokes it."

Workers rallied outside their offices, university students walked out of classes and regional lawmakers demonstrated inside Catalonia's parliament, where most of the defendants had held a senior role.   "Today is going to be historic, you can feel it in the atmosphere. Serious things are happening, we can't stay home," said Oscar Quiles, a 47-year-old real estate entrepreneur.   News of the verdict reached him as he arrived at the office and he immediately called his mother to join him at a protest in Plaza Cataluna in the centre of Barcelona.   By noon the square was packed with thousands of demonstrators, many waving yellow, red and blue Catalan separatist flags or banners reading "We would do it again" and "Freedom for political prisoners".   The protesters then set off walking towards Barcelona's airport, Spain's second busiest, in the hope of blocking it, just as pro-democracy activists have done recently in Hong Kong.

- 'Weeks of mobilisation' -
Tension gripped Barcelona on Monday morning ahead of the ruling, with a heavy police presence outside the courts, the airport and the city's main train station, as a helicopter flew overhead.    Democratic Tsunami, a group advocating more active forms of civil disobedience, had urged demonstrators to hit the streets as soon as the verdicts were announced.   "Tomorrow everyone ready! When the verdict is out, the response will be immediate," said the group in a message to its roughly 150,000 followers on mobile messaging service Telegram.   Juli Cuellar, a 44-year-old office worker, said he believed the verdict was politically motivated.    "Now all we have left is a life of civil and institutional disobedience," he told AFP, predicting "weeks of mobilisation".   The Catalan National Assembly (ANC) and Omnium Cultural, the region's two biggest grassroots pro-independence groups, have also called supporters to attend an evening rally. They have organised some of the largest separatist protests in recent years.   Several more protests are scheduled over the next few days across Catalonia, as well as a general strike on Friday.

- 'Felt like crying' -
Democratic Tsunami, the group that called the gathering in Plaza Cataluna, only emerged in recent weeks. It says it does not depend on Catalan separatist parties or civil associations for support.   Its leaders remain unknown, keeping in touch with each other through encrypted messaging apps such as Wire.   But supporters tend to be kept in the dark until the last minute.   "We don't know exactly what we have to do," said Arnau Font, a 22-year-old shop assistant who took the week off to protest.   "We have to get involved. Right now I feel really powerless in light of the verdicts," he told AFP.    "When I found out, I felt like crying."   The uncertainty was over a few minutes later when a Telegram message arrived urging everyone to "go to the airport", a 15-kilometre (nine-mile) walk from the city centre.    "The time has come to make our voice felt around the world. The goal: stop the activity of Barcelona's airport," it said.   Spain's airport operator Aena said no flights were disrupted, but many passengers got stuck in traffic jams leading to the airport.
Date: Mon, 14 Oct 2019 14:09:03 +0200 (METDST)

Frankfurt am Main, Oct 14, 2019 (AFP) - German cabin crew union UFO urged members Monday to walk off their jobs at airline giant Lufthansa on October 20, although the carrier contests its right to represent workers.   "We call on all cabin crew... not to show up to work" between six and eleven am (0400 to 0900 GMT) at Germany's two busiest hubs Frankfurt and Munich, Ufo chairman Daniel Flohr said in a video message to staff.   At least five of the Lufthansa group's airlines -- Lufthansa, Eurowings, Germanwings, Cityline and Sunexpress -- would be hit by strikes for higher pay in the coming weeks, Flohr added.

Lufthansa told AFP it would "maintain its entire timetable", calling UFO's call to strike "illegal".   Bosses at the airline group believe UFO may no longer have the legal right to speak for workers and have challenged its status in court.   Internal disputes at the union have cost it members and support among cabin crew, some of whom have now turned to other representative organisations.   Berlin daily Tagesspiegel on Monday called UFO a "half-dead" outfit.   "UFO is battling for its life," agreed business daily Handelsblatt.   "With its far-reaching call for strikes, it wants to show members it remains capable of acting and is representing cabin crew interests."   Lufthansa could also contest before a court whether UFO has the right to initiate a strike -- potentially leaving the worker representatives on the hook for any resulting costs.
Date: Mon, 14 Oct 2019 11:08:10 +0200 (METDST)

Manila, Oct 14, 2019 (AFP) - Parents lined up from sunrise holding sleeping infants as the Philippines launched a campaign on Monday to vaccinate millions of children against polio, which has re-emerged nearly two decades after the nation's last cases.   Years of falling vaccination rates, made worse by the botched rollout of a dengue vaccine, culminated in an outbreak of the preventable disease in September.   "This is for the welfare of my child," Ruth Miranda told AFP after the vaccine was squirted into her child's mouth at the Manila slum they call home.

Miranda's child is among scores who are unprotected in the capital of about 13 million people, where vaccination rates of young children plunged from 77 percent in 2016 to a mere 24 percent in June.   The atmosphere at the event in Manila was festive -- with ice cream vendors and music -- but the stakes for the campaign are high.

Polio, which can cause paralysis and can be fatal in rare cases, has no cure and can only be prevented with several doses of oral and injectable vaccines.   Two cases were detected in September, the first polio infections in the Philippines since 2001, adding to the woes of a country already hit by deadly measles and dengue epidemic.   The risk of the disease spreading within the Philippines is high, according to World Health Organization, due to low immunisation coverage partly blamed to a dengue vaccine scandal.

The Philippines was the first nation to use Dengvaxia in a mass programme in 2016, but a botched rollout led to claims that children had died after being vaccinated.   A dramatic drop in vaccine confidence followed, with trust plunging from 93 percent in 2015 to 32 percent in 2018, according to a study led by the London School of Hygiene and Tropical Medicine.   The Philippines polio outbreak has been traced back to the weakened form of the virus used in vaccines, which is excreted by people for a time after they receive it.   According to the WHO, that form can mutate and spread in the surrounding community when immunisation rates get too low.
Date: Mon, 14 Oct 2019 10:25:38 +0200 (METDST)
By Shingo ITO, Sara HUSSEIN

Tokyo, Oct 14, 2019 (AFP) - Tens of thousands of rescue workers in Japan battled on Monday to find survivors of a powerful typhoon that killed at least 43 people, as fresh rain threatened to hamper efforts.   Typhoon Hagibis crashed into the country on Saturday night, unleashing high winds and torrential rain across 36 of the country's 47 prefectures, and triggering landslides and catastrophic flooding.   "Even now, many people are still unaccounted for in the disaster-hit area," Prime Minister Shinzo Abe told an emergency disaster meeting on Monday.   "Units are trying their best to search for and rescue them, working day and night," Abe said.

But even as rescuers, including troops, combed through debris, the country's weather agency forecast rain in central and eastern Japan that it warned could cause further flooding and new landslides.   "I would like to ask people to stay fully vigilant and continue watching for landslides and river flooding," Chief Cabinet Secretary Yoshihide Suga told a news conference.   In Nagano, one of the worst-hit regions, rain was already falling and was expect to intensify.   "We are concerned about the impact of the latest rain on rescue and recovery efforts," local official Hiroki Yamaguchi told AFP.   "We will continue operations while watching out for secondary disasters due to the current rain."

- 43 dead, 16 missing: NHK -
By late Monday afternoon, national broadcaster NHK said the toll had risen to 43 dead, with 16 others missing and over 200 people injured. The government gave lower figures but was continuing to update its information.   The dead included a municipal worker whose car was overcome by floodwaters and at least seven crew from a cargo ship that sank in Tokyo Bay on Saturday night, a coast guard spokesman said.   Four others, from China, Myanmar and Vietnam, were rescued when the boat sank and the coast guard was still searching for a last crew member.   While Hagibis, one of the most powerful storms to hit the Tokyo area in decades, packed wind gusts of up to 216 kilometres (134 miles) per hour, it was the heavy rains that caused most damage.

A total of 142 rivers flooded, mainly in eastern and northern Japan, with river banks collapsing in two dozen places, local media said.   In central Nagano, a levee breach sent water from the Chikuma river gushing into residential neighbourhoods, flooding homes up to the second floor.   As water slowly receded Monday, television footage showed patients being transferred by ambulance from a Nagano hospital where some 200 people had been cut off by flooding.   Elsewhere, rescuers used helicopters to winch survivors from roofs and balconies, or steered boats through muddy waters to reach those trapped.

- Japan dedicates rugby win to victims -
By Monday afternoon, some 75,900 households remained without power, with 120,000 experiencing water outages.   The disaster left tens of thousands of people in shelters, with many unsure when they would be able to return home.   "Everything from my house was washed away before my eyes, I wasn't sure if it was a dream or real," a woman in Nagano told NHK.   "I feel lucky I'm still alive."   The storm brought travel chaos over the holiday weekend, grounding flights and halting commuter and bullet train services.

By Monday, most subway trains had resumed service, along with many bullet train lines, and flights had also restarted.   The storm also brought havoc to the sporting world, forcing the delay of Japanese Grand Prix qualifiers and the cancellation of three Rugby World Cup matches.   But a crucial decider pitting Japan against Scotland went ahead, with the hosts dedicating their stunning 28-21 win to the victims of the disaster.   "To everyone that's suffering from the typhoon, this game was for you guys," said Japan captain Michael Leitch.
Date: Sun, 13 Oct 2019 23:31:57 +0200 (METDST)

Kinshasa, Oct 13, 2019 (AFP) - Doctors will use a second Ebola vaccine from November in three eastern provinces in the Democratic Republic of Congo to fight the deadly virus, medical officials said Sunday.   "It's time to use the new Ad26-ZEBOV-GP vaccine, manufactured by Johnson & Johnson's Belgian subsidiary," said Dr. Jean-Jacques Muyembe, who leads the national anti-Ebola operation in the DRC.    It will arrive in the eastern city of Goma, in North Kivu province, on October 18 and be used from the beginning of next month, he added.   DRC's latest Ebola epidemic, which began in August 2018, has killed 2,144 people, making it the second deadliest outbreak of the virus, after the West Africa pandemic of 2014-2016.

Muyembe said the communes of Majingo and Kahembe had been selected to receive the vaccine as they were considered the epicentres of the epidemic.   "We will extend this vaccination to our small traders who often go to Rwanda to protect our neighbours," he added.   "If it works well, we will expand vaccination in South Kivu and Ituri."   DR Congo's eastern provinces of Ituri, North Kivu and South Kivu sit on the borders with Uganda, Rwanda and Burundi.   The Belgian laboratory will send a batch of 200,000 doses to neighbouring Rwanda and 500,000 doses in the DRC, Muyembe said.   More than 237,000 people living in active Ebola transmission zones have received a vaccination produced by the pharma company Merck Sharpe and Dohme since August 8, 2018. 

The J&J vaccine had been rejected by DRC's former health minister Oly Ilunga, who cited the risks of introducing a new product in communities where mistrust of Ebola responders is already high.   But Ilunga's resignation in July appears to have paved the way for approval of the second vaccine. He currently faces charges that he embezzled funds intended for the fight against Ebola.   In his letter of resignation Ilunga said "actors who have demonstrated a lack of ethics" want to introduce a second vaccine, but did not elaborate.    Muyembe, who took over the Ebola fight in the DRC in July, said "The Johnson & Johnson vaccine has the most science-based data."