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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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South Africa

General Introduction: The Republic of South Africa lies at the Southern tip of the African continent, flanked between the Indian and Atlantic oceans. Although it lies close to the tropic of Capricorn, the inland areas are tempered by the relatively high a
titudes. Summers and winters are opposite to that found in Ireland. In South Africa the summer extents from October to March. Although South Africa is basically a developed country, much of its population, particularly in rural parts, live in poverty. However facilities for tourists in urban areas and game parks are generally excellent. Despite all the well documented reports overall violence against tourists is usually low but obviously care should always be taken. Travelling late at night is usually unwise and take particular care if visiting nightclubs etc.
Climate: There is generally a moderate climate with sunny days and cool nights. The Cape Town region has a mean yearly temperature of 170C while Johannesburg has an annual mean temperature of 160C. This is mainly because Johannesburg is at 5,700 feet altitude. Throughout South Africa, summer extends between October and March and winter is between June and September. In Johannesburg the winter months tend to be dry and cool while the rainy season tends to occur during the warmer summer months.
Health Facilities: In the larger cities of Johannesburg, Cape Town, Durban & Pretoria and many others there will be no difficulty in receiving excellent medical attention. However when travelling throughout the more isolated rural regions the same situation does not occur. Travellers should always ensure that they are up-to-date in their routine travel vaccinations. World Travel Medicine Consultants (WTMC) in South Africa offer excellent medical facilities in many of the main centres. Contact by email their head office at for further information.
Jet Lag: Even though the hour changes from Ireland are not great after flying for approximately 13 hours you will arrive tired. On the plane journey take some exercise by walking around and occasionally stretching your calf muscles to lessen any risk of blood clots. If you are on the contraceptive pill (women only!) this will increase your risk on a long haul flight and you should talk this through with the doctor looking after your health care advice and vaccines. On arrival, try and rest for the first 24 hours to allow your body to catch up with itself. If lying by the pool remember not to fall asleep and wake some hours later with significant sunburn!
Mosquito-Borne Disease: Mosquitoes are most often associated with Malaria, however it is not the only disease which the insect may carry. Insect repellents which contain more than 30% DEET are effective for keeping mosquitoes away but remember to cover your arms and legs when they are biting. This is mainly in the hours between dusk and dawn. The risk of malaria can be reduced by taking malarial prophylaxis on a regular basis if you are planning to visit the risk areas. Anti malaria tablets are advised for those visiting low altitude areas especially areas around the Kruger National Park, north, east and western Transvaal, and the costal lowlands of Natal. Large towns and cities and high altitudes are more likely to be free of mosquitoes.
Effects of Heat: Extreme climate conditions can also lead to gastrointestinal difficulties but don't forget that when you perspire you will loose both water and salt. Replacing the lost water is easy but many travellers forget to replace the salt in their diet. This can lead to muscular cramps, tiredness and lethargy, a dull headache and generally feeling cross and out of sorts. Replacing depleted salt is most easily achieved by sprinkling it on your meals. Salt tablets can be dangerous and are best avoided except in expert hands. If you have any blood pressure difficulties then it will be important to talk this whole issue through with your doctor before leaving Ireland.
Waterborne diseases: Water sources in well developed urban areas of South Africa are generally safe. Outside the main cities caution must always be exercised with regard to drinking water. Safe water should be well chlorinated and so will have a distinct chlorine odour. Sealed bottled water is more preferable especially in less developed areas. Avoid ice in your drinks as its source may be unknown and don't brush your teeth in water you wouldn't want to drink. If unsure be careful and use sealed bottled water from one of the hotels.
Food-Borne Disease: Again, in the larger cities and tourist resorts, the food and its preparation is generally of an excellent standard and you should experience no problems. It is advised however to avoid eating shellfish and cold/rare meats. In particular, Capetown is famous for its various shellfish meals. Personally I would strongly encourage travellers to avoid them even in the best hotels and restaurants. It is just not worth the risk. As in any hot climate it is also wise to choose only the type of fruit you can peel yourself. Above all avoid buying or consuming food from roadside stalls or street vendors.
Rabies in South Africa: Travellers need to be aware that this potentially fatal viral condition occurs throughout Africa. The risk to any tourist or business traveller is very small but common sense needs to be maintained at all times. The disease is mainly transmitted through the bite of an infected warm blooded animal. Usually dogs and cats are involved but also be very careful of monkeys. If bitten by any potentially at risk animal wash out the wound immediately, apply a strong antiseptic and seek medical attention urgently
Yellow Fever: A yellow fever vaccination certificate is only required for travellers coming from endemic zones in Africa and the Americas. Travellers on scheduled airlines whose flights have originated outside the areas regarded as infected (or who are only in transit through these areas) are NOT required to possess a certificate.
If the flight originated from within a Yellow fever endemic area a certificate is then required.

Vaccination Schedule: Apart from Yellow Fever vaccine in certain circumstances, as mentioned above, there are no other vaccinations required for entry into South Africa from Ireland. Nevertheless there are a number of recommended vaccines for most travellers which need to be discussed. For trekking holidays or extended visits Rabies and Hepatitis B may need to be considered. Most travellers should start their vaccines at least 4 to 6 weeks before departure.
Further Information: South Africa is a beautiful destination with much to offer. Further general health information on staying healthy while travelling abroad may be obtained from the Tropical Medical Bureau. www.tmb.ie

Travel News Headlines WORLD NEWS

Date: Tue, 23 Apr 2019 10:08:27 +0200

Johannesburg, April 23, 2019 (AFP) - At least five people died early Tuesday in South Africa's coastal city of Durban after torrential rains triggered mudslides that crushed homes, emergency services said.   Among those killed were a six-month-old baby, a child of about 10 and two adults.   "Torrential rains damaged peoples houses (and) there were mudslides," Garrith Jamieson, spokesman for Rescue Care, told AFP.

"I can confirm five (deaths) but there are many more casualties," he said, adding there were unconfirmed reports of "multiple" deaths in other parts of the KwaZulu-Natal province.   Victims were either crushed to death by the mudslides or drowned in flood waters.   It was not immediately clear how many people were missing, but search and rescue operations continued on Tuesday.

Downpours have caused flooding in the southern and eastern parts of the country.   The military has been dispatched to help in rescue and evacuation efforts in some of the affected areas.   The South African Weather Services warned that more heavy rain was expected until Wednesday which could lead to more flooding and pose a threat to low-lying bridges and roads.
Date: Thu 28 Mar 2019
Source: IOL [edited]

A well-known Kimberley man [ME] is being treated for Congo fever in the isolation unit at the Robert Mangaliso Sobukwe Hospital. He is the 2nd patient to be diagnosed with Congo fever in South Africa this year [2019]. The other case is in the Free State.

According to [ME]'s wife, [SE], the 58-year-old started feeling ill on Sunday [24 Mar 2019]. "We went away for the weekend and when we came home my husband, who enjoys generally good health, began to complain of joint pain, a headache and feeling nauseous."

[SE] said her husband went to work at the Kareevlei Mine in the Koopmansfontein area on Monday [25 Mar 2019], still feeling unwell. "He had to attend a meeting but felt too ill and he knew he had to see a doctor. He then drove through to Kimberley and saw a doctor at the Mediclinic Gariep hospital.

"He was referred to a specialist as it was suspected that he could have contracted Congo fever as he had been bitten the week before by ticks." The specialist transferred him to the isolation unit at Robert Mangaliso Sobukwe (RMS) Hospital. This is also where [ME] had blood tests done to confirm that he had Congo fever, as these tests cannot be done in the private sector.

The diagnosis of Crimean-Congo haemorrhagic fever was confirmed yesterday morning [27 Mar 2019]. [SE] said her husband had a bite mark on his shoulder and he found a tick in his groin area last week. "It is suspected that the ticks came from the veld as there is a lot of veld around the mine where he works."

[SE] added that her husband was receiving the normal treatment for Congo fever. "We are very fortunate that there are no signs of haemorrhaging at this stage and we are hopeful that he recovers without any complications. He is fine at this stage, although he is being kept in isolation. I can wave at him through the glass window and we keep in contact on the phone."

As Congo fever is contagious and is transmitted from one infected human to another by contact with infected blood or body fluids, [SE] will have to monitor herself for the next few days. "I was instructed by the doctor to take my temperature twice a day for 2 weeks as well as to watch out for any bleeding, flu-like symptoms and joint pain. I have also just been told to leave work."

There is no danger, however, of other contacts at this stage. Mediclinic Gariep spokesperson Denise Coetzee confirmed yesterday [27 Mar 2019] that a 58-year-old male patient, with possible Congo fever, was referred to the RMS hospital on the evening of 25 Mar 2019. "The patient had a history of being bitten by a tick and presented with fever and swollen glands."

The Northern Cape Department of Health also confirmed yesterday [27 Mar 2019] that a 58-year-old male was admitted to the isolation unit at RMS Hospital. Department spokesperson Lulu Mxekezo said that the man works near Koopmansfontein and was bitten by a tick sometime last week.  "A laboratory test result on Tuesday [26 Mar 2019] confirmed he is suffering from Crimean-Congo haemorrhagic fever (CCHF). He is currently in a stable condition, still in the isolation unit," Mxekezo said.

The length of the incubation period for Congo fever depends on the mode of acquisition of the virus. According to the World Health Organisation, following infection by a tick bite the incubation period is usually 1 to 3 days, with a maximum of 9 days. The incubation period following contact with infected blood or tissues is usually 5 to 6 days, with a documented maximum of 13 days.

Onset of symptoms is sudden, with fever, myalgia (muscle ache), dizziness, neck pain and stiffness, backache, headache, sore eyes and photophobia (sensitivity to light). There may be nausea, vomiting, diarrhoea, abdominal pain and a sore throat early on, followed by sharp mood swings and confusion. After 2 to 4 days, the agitation may be replaced by sleepiness, depression and lassitude, and the abdominal pain may localise to the upper right quadrant, with detectable hepatomegaly (liver enlargement).

Other clinical signs include tachycardia (fast heart rate), lymphadenopathy (enlarged lymph nodes) and a petechial rash (a rash caused by bleeding into the skin) on internal mucosal surfaces, such as in the mouth and throat and on the skin. The petechiae may give way to larger rashes called ecchymoses, and other haemorrhagic phenomena. There is usually evidence of hepatitis, and severely ill patients may experience rapid kidney deterioration, sudden liver failure or pulmonary failure after the 5th day of illness.

The mortality rate from CCHF is approximately 30%, with death occurring in the 2nd week of illness. In patients who recover, improvement generally begins on the 9th or 10th day after the onset of illness.  [Byline: Michelle Cahill]
========================
[CCHF was 1st reported in South Africa in 1981 [1]. CCHF is being reported with increasing frequency from South Africa. In 1985, an outbreak was reported from a Cape Town hospital due to nosocomial spread of virus [2]. Nosocomial infections with CCHF have occurred in other countries, including Iraq, the former Soviet Union, and Pakistan [3,4]. Contact with bloody secretions appeared to be the means of transmission in those outbreaks, although airborne transmission has been neither proven nor disproven [4].

CCHF is caused by a bunyavirus of the arbovirus group. Widespread occurrence of the antibodies in wild and domestic animals in South Africa has been documented [5]. Transmission to humans is thought to be primarily via the _Hyalomma_ genus of tick or contact with the blood of infected animals [5].

CCHF, as well as other viral hemorrhagic fevers, such as Ebola virus disease, Marburg virus disease, and Lassa fever, have the potential to spread in a hospital setting. Patients are often hospitalized with a severe illness, but the nonspecific nature of their signs and symptoms may not suggest a viral hemorrhagic fever.

Even simple isolation procedures, such as barrier nursing on open wards, can effectively halt transmission of these viruses. Therefore, it is imperative that a diagnosis of a viral hemorrhagic fever be considered in any patient with an unknown febrile disease who either resides in or traveled to an endemic area within 3 weeks of the onset of symptoms. If other more common causes of the fever, such as malaria or sepsis, can be reasonably excluded, measures for isolation of the patient should be taken immediately. - ProMED Mod.UBA]

[References
1. Gear JHS, Thomson PD, Hopp M, et al. Congo-Crimean haemorrhagic fever in South Africa. Report of a fatal case in the Travsvaal. S Afr Med J 1982;62:576-80.
2. CDC. International Notes Crimean-Congo Hemorrhagic Fever -- Republic of South Africa. MMWR Weekly 1985;34:94,99-101 <https://www.cdc.gov/mmwr/preview/mmwrhtml/00000489.htm>.
3. Burney MI, Ghafoor A, Saleen M, et al. Nosocomial outbreak of viral hemorrhagic fever caused by a Crimean hemorrhagic fever-Congo virus in Pakistan, January 1976. Am J Trop Med Hyg 1980;29:941-7.
4. Hoogstraal H. The epidemiology of tick-borne Crimean-Congo hemorrhagic fever in Asia, Europe, and Africa. J Med Entomol 1979;15:307-417.
5. Swanepoel R, Struthers JK, Shepherd AJ, et al. Crimean-Congo hemorrhagic fever in South Africa. Am J Trop Med Hyg 1983;32:1407-15.

[HealthMap/ProMED-mail maps:
Northern Cape Region, South Africa:
Date: Tue 22 Jan 2019
Source: Review Online [abridged, edited]

The Limpopo Department of Health is alerting people, particularly those who regularly work or handle livestock and animals, to be cautious following confirmation of a case of brucellosis in the Giyani area, where a livestock farmer died after having been diagnosed with the disease.

Brucellosis is an infectious disease caused by a type of bacteria called _Brucella_. The bacterium can spread from animals to humans. The infection is acquired through ingestion or direct contact such as touching, splashes onto mucous membranes, and inhalation (breathing in) of contaminated animal products. The infection with _Brucella_ species is not spread from person to person.

Spokesperson for the department, Neil Shikwambana, says the farmer contracted the disease after he was reported to have drank unpasteurized (unboiled) milk from his cattle.

Brucellosis can be contracted through eating undercooked/uncooked meat or consuming unpasteurized/raw dairy products (milk, cheese, ice cream), or coming into contact with an infected animal. Bacteria can also enter wounds in the skin/mucous membranes through contact with infected animals. This includes people who have close contact with animals or animal excretions (new-born animals, foetuses, and excretions that may result from birth) such as slaughterhouse workers, meat-packing plant employees, veterinarians, farmers and hunters (inhaling the bacteria while dressing their game).

People most at risk include infants and young children, older adults, pregnant women, and people with weakened immune systems, such as people with cancer, an organ transplant, or HIV.
=======================
[The species generally associated with cattle is _Brucella abortus_. Brucellosis is one of the classical zoonoses linked to ingestion of unpasteurized milk and dairy products. - ProMED Mod.LL]

[HealthMap/ProMED-mail maps:
Limpopo Province, South Africa: <http://healthmap.org/promed/p/2947>]
Date: Tue 11 Dec 2018
Source: National Institute for Communicable Diseases, Johannesburg:

Malaria cases in South Africa are increasing as expected during the summer months. As at the end of October 2018, more than 16,000 cases with 110 deaths have been reported. This is fewer than during the large upsurge in malaria seen in the 2017-2018 season, but still more than the average over the 10-year period 2007-2016, which was around 7600 cases per year.

During the holiday season, many people will be exposed because of their travel to higher transmission areas, both internally and outside the country borders, particularly in Mozambique.

There has been some recent expansion of low or very low malaria transmission to some districts previously regarded as non-malaria areas in South Africa, such as parts of the Waterberg district. People who are planning to travel are urged to take adequate measures to protect themselves from malaria.

All people in malaria risk areas should reduce contact with mosquitoes by limiting outdoor activity after dark, covering up bare skin (not forgetting feet and ankles), using mosquito repellents, ensuring mosquito screens on windows are closed, and using bed nets, fans, or air-conditioning, if available. Consider antimalarial prophylaxis in higher risk areas -- doxycycline and atovaquone-proguanil are available without prescription from pharmacies. Public sector travel clinics will also supply prophylaxis to travellers. It is important to understand that while these precautions will substantially reduce the chance of acquiring malaria, the risk is never completely abolished.

All travellers returning from malaria transmission areas, including very low risk ones, should get medical advice about 'flu-like' illness (headache, fever, chills, muscle and joint pain) that occurs up to 4 to 6 weeks after 1st possible exposure, in case it is malaria. Please [go to <http://www.nicd.ac.za/wp-content/uploads/2017/03/Malaria-FAQ-NICD-Nov-2018.pdf> for further information on malaria prevention.
=====================
[The South Africa National Institute for Communicable Diseases risk map updated December 2018 can be found at
Malaria prophylaxis is recommended in high risk areas (see map). - ProMED Mod.EP]

[HealthMap/ProMED-mail map of South Africa:
Date: Tue 23 Oct 2018
Source: News24 (South Africa) [edited]

Early this month [October 2018], a crossbreed puppy of approximately 12 weeks old was brought into the Kloof and Highway SPCA reception by a kind member of the public who had found it in her garden in Wyebank. The puppy was brought in a box, and the reception staff immediately noticed that there was something wrong with the puppy. When examined, it was observed to have neurological issues and was extremely vocal.  The decision was immediately made to humanly euthanise the puppy, and it was sent to the state vet for rabies testing. Once the test was conducted, a positive rabies result was confirmed. This is the 13th positive rabies result this year at the Kloof and Highway SPCA.

This puppy was suffering and could have infected other animals and people with the rabies virus; we are so grateful to the lady and her son who rushed the puppy to our SPCA and saved it from further suffering.  When the staff received the positive rabies result, the woman was immediately contacted and informed of the seriousness of the situation. She also confirmed that 5 people had been in contact with the puppy before it was brought into the Kloof and Highway SPCA.

The Kloof and Highway SPCA are urging members of the public to make sure their pets are vaccinated against rabies as well as exercise caution when approaching stray animals.  "If you find a stray animal you are not familiar with, approach it only if it is safe to do so and absolutely necessary. In the event of being bitten or scratched, immediately wash the area very well, flush under running water, and immediately seek medical attention. "If you are bitten or scratched by an animal with no proof of vaccination, you will be required to go for a costly course of rabies vaccinations treatment.  "Rabies is fatal, and the threat of it should not be taken lightly. We strongly advise against keeping any stray animals with the rising threat of rabies," said Brigitte Ferguson of the SPCA.
=========================
[The serious hazard of rabies in puppies has been repeatedly addressed in ProMED-mail's rabies postings. Collecting stray puppies may pose a life-endangering threat, in particular for children who commonly deal with them. Do keep in mind that the clinical signs in puppies may be easily missed. - ProMED Mod.AS]
More ...

World Travel News Headlines

Date: Tue, 23 Apr 2019 13:01:09 +0200
By Ron LOPEZ

Porac, Philippines, April 23, 2019 (AFP) - Philippine rescuers raced Tuesday to reach some two dozen people still feared buried under a building near Manila that collapsed a day earlier in a deadly earthquake, as a powerful second tremor hit the nation.   The US Geological Survey put the second quake -- on the central island of Samar -- at 6.4 magnitude, stronger than the one that wrought significant damage Monday near the capital in the north.

The latest quake sent terrified locals fleeing into the streets, with images on social media showing cracked roads, crumbling church walls and shattered glass.   "No one started crying, but of course some panicked because it was really strong," said Rey Estrobo, a supervisor at a hotel in Borongan town, near the epicentre.   At the same time, the toll in Monday's quake rose to 16, with most of the fatalities in the worst-hit northern province of Pampanga, national disaster officials said.   More than 100 others were injured by falling rubble on Monday, including in Manila, according to police.

However, initial reports indicated relatively minor destruction in Samar given the strength of Tuesday's quake, which could be down to differences in ground composition.   "The damage is more pronounced if the houses and buildings are built on a foundation of soft soil," seismologist Myla Advincula told AFP, referring to Pampanga's soft sediment. "It enhances the shaking effect."

Scores of rescuers in the northern town of Porac spent Tuesday using cranes and jackhammers to peel back the pancaked concrete structure of a four-storey market building where the Red Cross said 24 people were unaccounted for.   "Every minute, every second is critical in this rescue," Cris Palcis, a volunteer rescue dog handler, told AFP. "Time is short for the people under the rubble so we have to be quick."

Pampanga Governor Lilia Pineda told journalists that rescuers could still hear at least one person trapped beneath the rubble, but the digging was proceeding delicately to avoid accidentally crushing the survivor.   Rogelio Pacelo was shopping with his wife and child when the market building collapsed around them, but they incredibly made it out almost without a scratch.   "I thought this only happens in movies. I thought that was the end of the world, it's our end," he told journalists. "I looked for a way out."   The quake also damaged several centuries-old churches which were crowded with worshippers in recent days as the majority-Catholic Philippines marked the Easter holiday.

- 'Ring of Fire' -
Father Roland Moraleja, who is based in Porac, said the 18th-century belfry of the Saint Catherine of Alexandria church collapsed in the quake.   "It was the only part left from the old church," he told AFP. "The historical value is now gone, but we are hopeful that it will rise again."   High-rise buildings in the capital swayed after the tremor struck Monday evening, leaving some with large cracks in their walls.

Thousands of travellers were stranded after aviation authorities shut down the secondary Clark Airport, which is located on the site of the former US military installation that lies about an hour's drive north of the capital.   It was still closed on Tuesday as officials assessed the heavy damage to the terminal building and some cracking on the air traffic control tower.

The quake was centred on the town of Castillejos, about 100 kilometres (62 miles) northwest of Manila, local geologists said.   Seismologists put Monday's tremor at 6.3 initially, but subsequently downgraded it to a 6.1 magnitude.   The Philippines is in the Pacific "Ring of Fire", an arc of intense seismic activity that stretches from quake-prone Japan through Southeast Asia and across the Pacific basin.
Date: Tue, 23 Apr 2019 10:08:27 +0200

Johannesburg, April 23, 2019 (AFP) - At least five people died early Tuesday in South Africa's coastal city of Durban after torrential rains triggered mudslides that crushed homes, emergency services said.   Among those killed were a six-month-old baby, a child of about 10 and two adults.   "Torrential rains damaged peoples houses (and) there were mudslides," Garrith Jamieson, spokesman for Rescue Care, told AFP.

"I can confirm five (deaths) but there are many more casualties," he said, adding there were unconfirmed reports of "multiple" deaths in other parts of the KwaZulu-Natal province.   Victims were either crushed to death by the mudslides or drowned in flood waters.   It was not immediately clear how many people were missing, but search and rescue operations continued on Tuesday.

Downpours have caused flooding in the southern and eastern parts of the country.   The military has been dispatched to help in rescue and evacuation efforts in some of the affected areas.   The South African Weather Services warned that more heavy rain was expected until Wednesday which could lead to more flooding and pose a threat to low-lying bridges and roads.
Date: Tue, 23 Apr 2019 06:03:52 +0200

Colombo, April 23, 2019 (AFP) - The toll from a string of deadly suicide bomb attacks in Sri Lanka has risen to 310, with several people dying of their injuries overnight, a police spokesman said Tuesday.   Around 500 people were wounded in the blasts, Ruwan Gunasekera said in a statement.   He added that 40 people were now under arrest in connection with the attacks, which Sri Lanka's government has blamed on a previously little-known local Islamist group, National Thowheeth Jama'ath.
Date: Mon, 22 Apr 2019 06:22:23 +0200

Melbourne, April 22, 2019 (AFP) - A father and son lifesaving team drowned while trying to save a tourist swept out to sea near one of Australia's most famous sights off the south coast, officials said Monday.   Ross Powell, 71, and his son Andrew, 32, died on Sunday after their lifesaving boat overturned in the surf during the rescue of a 30-year-old man near the Twelve Apostles, a set of 12 limestone stacks off the Victoria state coast.

The tourist, whose nationality or name has not been released, had been wading at the mouth of a river when he got into trouble.   He was winched from the water alongside a third lifesaver from the boat, who was seriously injured, by a rescue helicopter and taken to hospital, Victoria Police said. The bodies of the Campbells were found in the water shortly after.   The tragedy has rocked the small tourist town of Port Campbell where the two men came from, with Prime Minister Scott Morrison leading the tributes.   "Surf lifesavers are selfless & brave. We thank them all for their service & extend our deepest sympathies to Ross & Andrew's family & friends," Morrison tweeted Monday.

Surf Lifesaving Victoria president Paul James hailed the pair as heroes, and said the conditions had been rough and "not the place to be swimming".   "It's just terrible, it's heart-breaking," he told reporters in an emotional press conference of the death of the dairy farmers and experienced volunteer lifesavers.   "I understand the boat was operating in a two-metre (6.5 feet) swell, so a very high swell, and we know that it is very treacherous down there... These brave people, these heroes, have gone out to try and help."   Amber Griffiths, the partner of Andrew Campbell and who local media reported was pregnant with their second child, wrote about her heartbreak on Facebook.   "Today we lost two of the most beautiful people to ever exist -- always putting others first," she wrote.   "The love of my life, light of my life, father of my baby girl. My heart is broken. I miss you Andrew Powell."

Australia's beaches are among the island continent's biggest tourist drawcards, but can have strong rips and tides. Swimmers are advised to keep between areas bounded by flags and patrolled by lifesavers.   The area where the tourist was rescued is near high cliffs and said to have wild and treacherous seas.   The Twelve Apostles are giant rock stacks of varying heights in the Southern Ocean which began forming 20 million years ago when erosion gradually began whittling away the limestone cliffs of Port Campbell.
Date: Mon, 22 Apr 2019 01:55:28 +0200

Montreal, April 21, 2019 (AFP) - Flooding in eastern Canada forced the evacuation of more than 1,500 people while over 600 troops have been deployed in response, authorities said Sunday.   Warming weather over the Easter weekend has brought spring floods due to heavy rains and snowmelt from Ontario to southern Quebec and New Brunswick.

Authorities, who initially feared a repeat of catastrophic 2017 floods in Quebec, the worst in half a century, appeared more confident about the situation on Sunday.   "We are optimistic about the coming days," civil security spokesman Eric Houde told AFP.   "There will be significant floods but overall not at the level of 2017, except in certain areas like Lake St Pierre," a widening of the St Lawrence River in Quebec, he added.   "The big difference from 2017 is the level of preparation of municipalities and citizens."

Over the past several days, towns have mobilized volunteers and distributed hundreds of thousands of sandbags to erect barriers or protect houses in threatened areas.   The areas most affected were around Ottawa, and Beauce, a region south of Quebec City where nearly 800 people were evacuated. More than 1,200 homes had been affected by the flooding in Quebec by late Sunday.

The provincial governments of Quebec and New Brunswick asked for reinforcements from the military.    About 200 soldiers had deployed in Quebec by late Saturday, and 400 others near Ottawa, in Laval north of Montreal and in Trois-Rivieres between Montreal and Quebec City.   About 120 additional soldiers stood at the ready to be mobilized in New Brunswick.   On Saturday, the flooding claimed its first victim in the municipality of Pontiac, west of Ottawa: a man in his seventies who did not see that a bridge had been washed away, and plunged his car into the stream below.
Date: Mon, 22 Apr 2019 01:08:11 +0200

Montreal, April 21, 2019 (AFP) - The bodies of three world-renowned professional mountaineers -- two Austrians and an American -- were found Sunday after they went missing during an avalanche on a western Canadian summit, the national parks agency said.   American Jess Roskelley, 36, and Hansjorg Auer, 35, and David Lama, 28, of Austria went missing late Tuesday at Banff National Park. Authorities launched an aerial search the next day.   The three men were attempting to climb the east face of Howse Pass, an isolated and highly difficult route.

They were part of a team of experienced athletes sponsored by American outdoor equipment firm The North Face.   "Parks Canada extends our sincere condolences to their families, friends and loved ones," the agency said in a statement.   "We would also like to acknowledge the impact that this has had on the tight-knit, local and international climbing communities. Our thoughts are with families, friends and all those who have been affected by this tragic incident."

Roskelley was the son of John Roskelley, who was also considered one of the best mountaineers of his own generation.   Father and son had climbed Mount Everest together in 2003. At the time, the younger Roskelley was only 20 years old, and became the youngest mountaineer to climb the planet's highest mountain above sea level.   Auer and Lama, from Tyrol in Austria, were also considered among the best mountaineers of the times.
Date: Sun, 21 Apr 2019 23:36:53 +0200

Kano, Nigeria, April 21, 2019 (AFP) - Two people including a British aid worker have been shot dead and four tourists abducted in an attack by armed gunmen on a holiday resort in north-western Nigeria, police said on Sunday.   Police and aid agency Mercy Corps named the dead woman as Faye Mooney.   "Faye was a dedicated and passionate communications and learning specialist", Chief executive Neal Keny-Guyer said in a statement posted on social media, adding that colleagues were "utterly heartbroken".   Mooney had "worked with Mercy Corps for almost two years, devoting her time to making a difference in Nigeria", Keny-Guyer added.

Gunmen stormed the Kajuru Castle resort, 60 kilometres (40 miles) southeast of Kaduna City at 11.40 pm (2240 GMT) on Friday, Kaduna state police spokesman Yakubu Sabo told reporters.   The Briton "was gunned down from the hill by the kidnappers who tried to gain entrance into the castle but failed", Sabo said.   "They took away about five other locals but one person escaped," he said.   A Nigerian man believed by local residents in Kajuru to be Mooney's partner was also killed in the attack on the resort where a group of 13 tourists had arrived from Lagos, southwest Nigeria the police spokesman said.   In Kaduna and the wider northwest region, kidnapping for ransom has become an increasingly rampant, particularly on the road to the capital, Abuja, where armed attacks have thrived.

Kidnapping in Nigeria's oil-rich south, has long been a security challenge, where wealthy locals and expatriate workers are often abducted.   Yet the problem has escalated in northern areas too, like Kaduna where criminal gangs made up of former cattle rustlers have been pushed into kidnapping after military crackdowns on cattle theft.   Kajuru is also flash point in the deadly conflict over increasingly limited land resources in Africa's most populous country, between herders and farmers, predominantly across central and northern Nigeria.    The conflict has increasingly taken on ethnic and religious dimensions in the region, with the Fulani Muslim herders in conflict with Christian Adara farmers in Kajuru.

Tourists are rarely affected by the herder-farmer violence and Kajuru Castle resort has attracted many foreign and local visitors.   Yet police have struggled to thwart kidnappers in the region. The latest attack comes in a resort in northern Nigeria, particularly popular amongst foreign and well-to-do local tourists.   In January four western tourists -- two Americans and two Canadians -- were also abducted in Kaduna by gunmen in an ambush in which two of their police escorts were killed.   Earlier in April, recently re-elected President Muhammadu Buhari, ordered his most senior security chiefs to curb kidnapping in the region.
Date: Sun, 21 Apr 2019 09:55:31 +0200

Lilongwe, Malawi, April 21, 2019 (AFP) - Three people died after a landslide hit a village in the Rumphi district in northern Malawi, with at least five still missing Sunday and many others injured and hospitalised.   Rumphi police spokesperson Tupeliwe Kabwilo told AFP that incessant rains in the area led to the landslide early Saturday which washed away an entire village nestled between Mphompha Hills and Lake Malawi.   Among the dead are two boys aged 12 and 15 and a 35-year-old woman, according to police.   The missing persons, who are feared dead, include a one-year-old boy, two other boys aged six and 10 as well as two women aged 35 and 46.

A Rumphi district council official who was at the scene of the disaster told AFP that the affected area was inaccessible by road and it would be impossible to mount a rescue operation.   "Huge boulders rolled from the mountain and these are the ones that cause the biggest damage and if the missing victims are buried under these rocks, then we will need an excavator to move them." said council official Wakisa Mtete.    "But there is no access by road to the area so this is an impossible task. The boulders are so big that moving them by hand is not possible," Mtete said.    He added that it was also possible for some of the missing bodies to have been washed into the lake, in which case the bodies would resurface within the next two days.

Disaster management officer Alufeyo Mhango told AFP that government ministries were preparing to step in to transport heavy duty excavation equipment over the lake as soon as the weather cleared.   "We have been informed by government ministries that we should get ready to transport the equipment. But this will depend on whether we get a large boat for that and on whether the hailstorm stops because there could be a recurrence of the landslide," he said.   According to Mhango, Police officers, soldiers and emergency personnel are on site attending to the disaster.
Date: Sat, 20 Apr 2019 15:21:54 +0200

Butembo, DR Congo, April 20, 2019 (AFP) - The DR Congo army fought off an attack on a hospital by a rebel group, killing one militiaman, police said Saturday, in the latest assault on medical staff trying to rein in an Ebola outbreak in the east of the country.   Armed rebels from the Mai-Mai militia attacked Katwa hospital near the city of Butembo at around 3.40 am (0140 GMT), officers told AFP.   "We have resisted and repelled the attack even though these 'Mai-Mai' had a PKM machine gun," said Butembo police chief Colonel Paul Ngoma.   He said one rebel was killed and four captured.   The attack came a day after a WHO doctor, Richard Valery Mouzoko Kiboung, was shot dead in an assault by armed militiamen on Butembo University Hospital, according to the World Health Organization.   The WHO said the epidemiologist had been deployed to help combat Ebola in the region.

The attacks are the latest in a string of assaults on teams grappling with a near nine-month-old Ebola outbreak that has claimed almost 850 lives.   UN Secretary General Antonio Guterres on Friday condemned the Butembo University Hospital attack and called on Congolese authorities to bring the perpetrators to justice.   DR Congo declared its tenth outbreak of Ebola last August, in north-eastern North Kivu province, before the virus spread into the neighbouring Ituri region.   Local organisations have said the number of Ebola deaths is rising.    An updated toll by the health ministry, issued on Wednesday, said there had been 843 deaths since August.

WHO data from April 9 put the number of confirmed or probable cases at 1,186, of which 751 had been fatal.   The outbreak is the second deadliest on record, after the epidemic that struck West Africa in 2014-16, which killed more than 11,300 people.    Efforts to roll back the highly contagious haemorrhagic fever in DRC have been hampered by fighting but also by resistance within communities to preventative measures, care facilities and safe burials.    On March 9, an attack on a treatment centre at Butembo left a policeman dead and a health worker wounded. It was the third attack on that centre.   On February 24, a treatment centre in Katwa was set ablaze.
Date: Fri, 19 Apr 2019 16:36:32 +0200

Khokha, Yemen, April 19, 2019 (AFP) - Oxfam has warned that war-torn Yemen risks a "massive resurgence" of cholera, with around 195,000 suspected cases of the disease recorded so far this year.   "Fears that the world's worst cholera outbreak could be set for a massive resurgence are growing," the relief organisation said Thursday.   It said aid agencies were struggling to reach suspected cases.

In a statement, Oxfam pointed to "fighting and restraints on access, including checkpoints and permit requirements imposed by the warring parties", and warned the coming rainy season was likely to accelerate the spread of the disease.   The water-borne bacterial infection has claimed more than 3,000 lives in Yemen since the outbreak began in 2016, according to Oxfam.

At a medical centre for the displaced in the government-held western town of Khokha, Qassem Suleiman had brought his son Alaa for tests after a serious case of diarrhoea.   Doctor Wadah al-Tiri told AFP that several patients had been transferred to Aden while others had been treated at the Khokha centre.   He said a tent was to be set up for suspected cases.

The doctor said Yemen badly needed international aid to combat the epidemic.   The UN's humanitarian coordination office OCHA said last month that children under the age of five make up nearly a third of this year's cases.   The spike, which comes two years after Yemen suffered its worst cholera outbreak, was concentrated in six governorates including in the Red Sea port of Hodeida and Sanaa province, both combat zones, it said.

Yemen's conflict, which pits Iran-linked rebels against a regional pro-government alliance led by Saudi Arabia, has left some 10,000 people dead since 2015 and pushed millions to the brink of famine.   Aid groups say the actual death toll could be five times as high.    The war has created the perfect environment for cholera to thrive, as civilians across the country lack access to clean water and health care.