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United Arab Emirates

United Arab Emirates US Consular Information Sheet
28th February 2008
COUNTRY DESCRIPTION: The United Arab Emirates (UAE) is a federation of seven independent emirates, each with its own ruler.
The federal government is a constitutional re
ublic, headed by a president and council of ministers.
Islamic ideals and beliefs provide the conservative foundation of the country's customs, laws and practices. The UAE is a modern, developed country, and tourist facilities are widely available. Read the Department of State Background Notes on the United Arab Emirates for additional information.

ENTRY/EXIT REQUIREMENTS: A passport is required. For stays of less than 60 days, U.S. citizens holding valid passports may obtain visitor visas at the port of entry for no fee. For a longer stay, a traveler must obtain a visa before arrival in the UAE. In addition, an AIDS test is required for work or residence permits; testing must be performed after arrival. A U.S. AIDS test is not accepted. For further information, travelers can contact the Embassy of the United Arab Emirates, 3522 International Court NW, Washington, DC 20037, telephone (202) 243-2400.
Visit the web site of the UAE's Ministry of Information regarding tourism, business, and residence in the UAE at http://www.uaeinteract.org.

Unlike other countries in the region that accept U.S. military ID cards as valid travel documents, the UAE requires U.S. military personnel to present a valid passport for entry/exit.

UAE authorities will confiscate any weapons, weapon parts, ammunition, body armor, handcuffs, and/or other military/police equipment transported to or through a civilian airport.
Americans have been arrested and jailed for transporting such weapons and equipment without the express written authorization of the UAE government, even though airline and U.S. authorities allowed shipment on a US-originating flight.

U.S. citizens and citizens of other countries that are not members of the Gulf Cooperation Council (GCC), who depart the UAE via land are required to pay a departure fee. This fee is 20 UAE dirhams and is payable only in the local UAE dirham currency.

Visit the Embassy of the United Arab Emirates web site at http://uae-embassy.org for the most current visa information.

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

SAFETY AND SECURITY: Americans in the United Arab Emirates should exercise a high level of security awareness. The Department of State remains concerned about the possibility of terrorist attacks against U.S. citizens and interests throughout the world. Americans should maintain a low profile, vary routes and times for all required travel, and treat mail and packages from unfamiliar sources with caution. In addition, U.S. citizens are urged to avoid contact with any suspicious, unfamiliar objects, and to report the presence of the objects to local authorities.
U.S. Government personnel overseas have been advised to take the same precautions. In addition, U.S. Government facilities may temporarily close or suspend public services from time to time as necessary to review their security posture and ensure its adequacy.

Taking photographs of potentially-sensitive UAE military and civilian sites, or foreign diplomatic missions, including the U.S. Embassy, may result in arrest, detention and/or prosecution by local authorities.
In addition, engaging in mapping activities, especially mapping which includes the use of GPS equipment, without coordination with UAE authorities, may have the same consequences.

On several occasions in the past three years, small groups of expatriate recreational boaters were detained by the Iranian Coast Guard for alleged violation of Iranian territorial waters while fishing near the island of Abu Musa, approximately 20 miles from Dubai.
The UAE and Iran have had a long-standing dispute concerning jurisdiction of Abu Musa.
Fishing or sailing in these waters may result in seizure of vessels and detention of passengers and crew in Iran.
Obtaining consular assistance in Iran is difficult and can only be done through the Swiss Embassy in Tehran, which acts as a Protecting Power, providing limited U.S. consular services.

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

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

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

CRIME: Crime generally is not a problem for travelers in the UAE. However, the U.S. Embassy advises U.S. citizens to take normal precautions against theft, such as not leaving a wallet, purse, or credit card unattended. Although vehicle break-ins in the UAE are rare, U.S. citizens are encouraged to ensure that unattended vehicles are locked and that valuables are not left out in plain sight.

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

See our information on Victims of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION: Basic modern medical care and medicines are available in the principal cities of the UAE, but not necessarily in outlying areas.

Information on vaccinations and other health precautions, such as safe food and water precautions and insect bite protection, may be obtained from the Centers for Disease Control and Prevention's hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747); fax 1-888-CDC-FAXX (1-888-232-3299), or via the CDC's web site at http://wwwn.cdc.gov/travel/default.aspx. For information about outbreaks of infectious diseases abroad consult the World Health Organization's (WHO) web site at http://www.who.int/en. Further health information for travelers is available at http://www.who.int/ith.

MEDICAL INSURANCE:
The Department of State strongly urges Americans to consult with their medical insurance company prior to traveling abroad to confirm whether their policy applies overseas and whether it will cover emergency expenses such as a medical evacuation.
Please see our information on medical insurance overseas.
TRAFFIC SAFETY AND ROAD CONDITIONS: While in a foreign country, U.S. citizens may encounter road conditions that differ significantly from those in the United States. The information below concerning the United Arab Emirates is provided for general reference only, and may not be totally accurate in a particular location or circumstance.

The police emergency number and ambulance number is 999. Mobile phones are widely used throughout the UAE, so passers-by usually request emergency police and medical services quickly. Response time by emergency services is adequate. However, medical personnel emphasize transport of the injured to the hospital rather than treatment on site. Traffic accidents are a leading cause of death in the UAE because drivers often drive at high speeds. Unsafe driving practices are common, especially on inter-city highways. On highways, unmarked speed bumps and drifting sand create additional hazards.

Country-wide traffic laws impose stringent penalties for certain violations, particularly driving under the influence of alcohol.
In the UAE, there is zero tolerance for driving after consumption of alcohol.
Penalties may include hefty jail sentences and fines over $6,000 and, for Muslims (even those holding U.S. citizenship), lashings. Persons involved in an accident in which another party is injured automatically go to jail, until the injured person is released from the hospital. Should a person die in a traffic accident, the driver of the other vehicle is liable for payment of compensation for the death (known as "dhiyya"), usually the equivalent of 55,000 U.S. dollars. Even relatively minor accidents may result in lengthy proceedings, during which both drivers may be prohibited from leaving the country.

In order to drive, UAE residents must obtain a UAE driver's license. Foreign driver's licenses are not recognized. However, a non-resident visitor to the UAE can drive if he/she obtains a valid international driver's license issued by the motor vehicle authority of the country whose passport the traveler holds. The UAE recognizes driver's licenses issued by other Gulf Cooperation Council (GCC) states only if the bearer is driving a vehicle registered to the same GCC state. Under no circumstances should anyone drive without a valid license.

Please refer to our Road Safety page for more information.
You may also visit the web site of the UAE’s national tourist office and national authority responsible for road safety at http://www.uaeinteract.org.

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

SPECIAL CIRCUMSTANCES: The UAE government does not recognize dual nationality.
Children of UAE fathers automatically acquire UAE citizenship at birth and must enter the UAE on UAE passports. UAE authorities have confiscated U.S. passports of UAE/U.S. dual nationals in the past. This act does not constitute loss of U.S. citizenship, but should be reported to the U.S. Embassy in Abu Dhabi or the U.S. Consulate General in Dubai. In addition to being subject to all UAE laws, U.S. citizens who also hold UAE citizenship may also be subject to other laws that impose special obligations on citizens of the UAE.
For additional information, please refer to our Dual Nationality flyer.

U.S. citizens have at times become involved in disputes of a commercial nature that have prompted local firms or courts to take possession of the U.S. citizen's passport. Travel bans may also be enforced against U.S. citizens involved in financial disputes with a local sponsor or firm. Such travel bans, which are rigidly enforced, effectively prevent the individual from leaving the UAE for any reason until the dispute is resolved. Although it is customary for a local sponsor to hold an employee's passport, it is illegal to do so under UAE law. Most contractual/labor disputes can be avoided by clearly establishing all terms and conditions of employment or sponsorship in the labor contract at the beginning of any employment. Should a dispute arise, the UAE Ministry of Labor has established a special department to review and arbitrate labor claims. A list of local attorneys capable of representing Americans in such matters is available from the Consular and Commercial sections of the U.S. Embassy in Abu Dhabi and the U.S. Consulate General in Dubai.

Codes of behavior and dress in the UAE reflect the country's Islamic traditions and are more conservative than those of the United States. Visitors to the UAE should be respectful of this conservative heritage, especially in the Emirate of Sharjah where rules of decency and public conduct are strictly enforced. Female travelers should keep in mind the cultural differences among the many people who coexist in the UAE and should be cognizant that unwitting actions may invite unwanted attention to them. Isolated incidents of verbal and physical harassment of Western women have occurred. Victims of harassment are encouraged to report such incidents to the U.S. Embassy in Abu Dhabi or the Consulate General in Dubai.

American citizens intending to reside and work in the UAE may have to present personal documents authenticated by the Department of State's Office of Authentications in Washington, D.C. before traveling to the UAE. This can be a complex process involving local, state and federal offices and requiring several weeks to complete.
For procedural information, the Office of Authentications may be contacted by telephone from within the United States at 800-688-9889 or 202-647-5002, by fax at 202-663-3636, or by e-mail at aoprgsmauth@state.gov.
In order to meet UAE government requirements for school registrations and residency sponsorship for family members, Americans intending to bring their families to reside with them in the UAE will need to have their marriage certificate and children's birth certificates, or custody/adoption decrees, if appropriate, authenticated by the Department of State in Washington, DC.
The U.S. Embassy and Consulate General cannot authenticate U.S. local- and state-issued personal, academic or professional documents; they will only be able to authenticate the final authentication document from the Department of State.
Additional information on authentication of documents can be found at http://www.state.gov/m/a/auth/.
In terms of employment, a recent change to UAE labor law requires local sponsors to have employees' diplomas, academic and/or occupational/professional certificates validated through a “Degree Verification” process established in the UAE.
Prospective employees will be required to submit photocopies of such documents for verification to a firm under contract to the Ministry of Labor.

In addition, persons in the education and health professions reportedly have to meet two requirements for validation of their educational credentials at this time – the formal “chain” authentication of academic/professional credentials in the U.S. and the “Degree Verification” process in the UAE.
Different UAE Ministries have different requirements in this regard.
Determining these requirements with one’s prospective employer is strongly recommended before arrival in the UAE.

Please see our Customs Information.

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

Legislation enacted in January 1996 imposes the death sentence for convicted drug traffickers. Since January 2006, possession of even trace amounts of illegal drugs has resulted in sentences of four years imprisonment for foreign citizens transiting the UAE. American citizens transiting and entering the UAE’s airports and in possession of illegal drugs have been discovered, arrested and prosecuted by UAE authorities.
As mentioned, in such cases the minimum penalty is four years imprisonment.

Some drugs normally taken under a doctor's supervision in the United States, and even some over-the-counter U.S. drugs and medications, are classified as narcotics in the UAE and are illegal to possess.
A doctor's prescription should be carried along with any medication that is brought into the country.
A person may be subject to arrest and prosecution if possession of prescribed medicines (especially those containing codeine and similar narcotic-like ingredients) comes to the attention of local authorities.
The U.S. Embassy’s web site includes an unofficial list of such medicines, obtained from the UAE Ministry of Health.
Most medications available in the U.S. are also available by doctors’ prescription through hospitals and pharmacies in the UAE.

In addition, the UAE's tough anti-narcotics program also includes poppy seeds, widely used in other cultures, including the U.S., for culinary purposes, on its list of controlled substances. The importation and possession of poppy seeds in any and all forms is strictly prohibited. Persons found to possess even very small quantities of controlled substances listed by the UAE are subject to prosecution by the authorities and may be given lengthy prison terms of up to 15 years. Travelers with questions regarding the items on the list of controlled substances should contact the U.S. Embassy in Abu Dhabi or the U.S. Consulate General in Dubai. If suspected of being under the influence of drugs or alcohol, individuals may be required to submit to blood and/or urine tests and may be subject to prosecution.

Crimes of fraud, including passing bad checks and non-payment of bills (including hotel bills), are regarded seriously in the UAE and can result in imprisonment and/or fines. Bail generally is not available to non-residents of the UAE who are arrested for crimes involving fraud.

Drinking or possession of alcohol without a Ministry of Interior liquor permit is illegal and could result in arrest and/or fines and imprisonment. Alcohol is served at bars in most major hotels but is intended for guests of the hotel. Persons who are not guests of the hotel, and who consume alcohol in the restaurants and bars, technically are required to have their own personal liquor licenses. Liquor licenses are issued only to non-Muslim persons who possess UAE residency permits. Drinking and driving is considered a serious offense. Penalties generally are assessed according to religious law.

While individuals are free to worship as they choose, and facilities are available for that purpose, religious proselytizing is not permitted in the UAE.
Persons violating this law, even unknowingly, may be imprisoned or deported.

If arrested, U.S. citizens should contact the U.S. Embassy or Consulate General for assistance. The U.S. Consul will provide information on the local judicial system and a list of local attorneys. In Dubai, the U.S. Consul can also arrange for U.S. citizen detainees to meet with an ombudsman from the Human Rights Department of the Dubai police headquarters, if the detainee believes he or she is not being treated fairly.

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

REGISTRATION/EMBASSY AND CONSULATE LOCATION:
Americans living or traveling in the United Arab Emirates are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department’s travel registration web site and to obtain updated information on travel and security within the United Arab Emirates. Americans without Internet access may register directly with the nearest U.S. Embassy or Consulate. By registering, American citizens make it easier for the Embassy or Consulate to contact them in case of emergency.

The U.S. Embassy in Abu Dhabi is located at Embassies District, Plot 38, Sector W59-02, Street No. 4, P.O. Box 4009. The telephone number is (971) (2) 414-2200, and the Consular Section fax number is (971) (2) 414-2241. The email address for American Citizens Services inquiries, including passport questions, is abudhabiacs@state.gov. The after-hours telephone number is (971) (2) 414-2500. The Embassy Internet web site is http://uae.usembassy.gov.

The U.S. Consulate General in Dubai is located on the 21st floor of the Dubai World Trade Center, P.O. Box 9343. The telephone number is (971) (4) 311-6000 (for after-hours emergencies, contact the Embassy at (971)(2) 414-2200 for the Dubai Duty Officer, and the Consular Section fax number is (971) (4) 311-6213. The email address for American Citizens Services inquiries, including passport questions, is dubaiwarden@state.gov. The web site for the U.S. Consulate General in Dubai is http://dubai.usconsulate.gov.

The workweek for both the Embassy in Abu Dhabi and the Consulate General in Dubai is Sunday through Thursday.
* * *
This replaces the Country Specific Information for the UAE dated July 06, 2007, to update the sections on Traffic Safety and Road Conditions and Criminal Penalties.

Travel News Headlines WORLD NEWS

Date: Mon, 6 Jan 2020 17:38:26 +0100 (MET)

Dubai, Jan 6, 2020 (AFP) - The United Arab Emirates on Monday introduced a multiple-entry visa scheme valid for five years for all nationalities, with the aim of turning the Gulf state into a tourism hub.   "#UAE Cabinet chaired by @HHShkMohd, approves new amendment for tourist visas in #UAE," the government of Dubai Media Office tweeted, referring to Sheikh Mohammed bin Rashid Al Maktoum, the UAE prime minister and ruler of Dubai.   "The new tourist visa will be valid for 5 years and can be used for multiple entries and is open for all nationalities," the Dubai Media Office wrote.

Sheikh Maktoum said on Twitter that the UAE currently attracts 21 million tourists a year.   Travellers from Africa, some South American countries, Arab states outside the Gulf, and European states from outside the European Union and former Soviet Union previously needed visas.   In October, Dubai is to host Expo 2020, a big-budget global trade fair.
Date: Thu 26 Sep 2019
Source: Gulf Business [edited]

Dubai Municipality has shut down a restaurant in Jumeirah after 15 people fell ill following an outbreak of _Salmonella_ infection, local media reported. An initial investigation revealed that the outbreak was likely caused by raw eggs served in a hollandaise sauce.

Officials received a report that several people, including a child, fell sick with symptoms such as diarrhoea, fever, and vomiting after eating at the restaurant. They collected samples and conducted tests, following which they found that the chef had used raw eggs in violation of the food safety rules.

The chef and person-in-charge (PIC) of food safety have been held, the municipality said. The food safety department has also downgraded the rating of the outlet and revoked its PIC certificate, Gulf News reported. The unnamed American outlet will be under "strict monitoring" for the next 6 months once it is allowed to reopen.

The municipality banned the use of raw eggs in ready-to-eat products in 2012 after authorities found them to be a cause for _Salmonella_ infections. Following the recent incident, the department has issued a fresh alert to restaurants reminding them about the ban.
=======================
[Salmonellosis is often thought to be associated with cracked eggs or eggs dirty with fecal matter, a problem controlled by cleaning procedures implemented in the egg industry. It is clearly the case, however, that most of the salmonellosis outbreaks linked to eggs were associated with uncracked, disinfected grade A eggs, or foods containing such eggs. The undamaged eggs become contaminated during ovulation, and thus were contaminated with the bacteria before the eggshell was formed. To avoid this, uncooked eggs should only be used as an ingredient if pasteurized. - ProMED Mod.LL]

[HealthMap/ProMED-mail map:
Dubai, United Arab Emirates: <http://healthmap.org/promed/p/3442>]
Date: Sat 24 Aug 2019 3:39:38 PM PKT
Source: Mena FN[edited]

A resident of Swabi district has succumbed to Congo fever in Sharjah hospital and was laid to rest there on [Sat 24 Aug 2019].

According to details, the man was cutting meat on Eid day, when he accidentally cut one of his fingers. He didn't take it seriously, but after few days, he felt unwell and was taken to the hospital in Sharjah where he was told that he is suffering from a lethal infection known as Crimean-Congo haemorrhagic fever.

Doctors have told him that while he was cutting meat, the deadly Congo virus entered into his body. He was unaware of it while the virus was gradually spreading in his veins, killing him a slow death.

And finally, the virus shattered his body to an extent that he was unable to recover. He was admitted to a hospital in Sharjah in an isolated ward and was kept away from his relatives so that they may not contract the virus. His dead body was laid to rest in Sharjah and was not allowed to be taken to his home town in Swabi due to the fear of virus spread. The man was a resident of Cham village in Daghai, in District Swabi and was living with his family in Sharjah.
=======================
[The report above does not signify how the case was confirmed, and whether any contact follow up was done post confirmation, since there is an incubation period between possible exposure and appearance of symptoms.

CCHF virus has the greatest geographic range of any tick-borne virus and there are reports of viral isolation and/or disease from more than 30 countries in Africa, Asia, Eastern and Southern Europe, and the Middle East. Numerous domestic and wild animals, such as cattle, goats, and sheep, and small mammals, such as hares and rodents, serve as asymptomatic hosts for amplification of the virus, which is transmitted through _Ixodid_ ticks, especially _Hyalomma_ spp that act as both reservoirs and vectors  (<https://www.biorxiv.org/content/biorxiv/early/2018/12/20/502641.full.pdf>).

CCHF was first reported in the United Arab Emirates (UAE; Sharjah is one Emirate) in 1979, when 6 cases were reported among the staff of a hospital in Dubai. An outbreak of CCHF occurred during 1994-1995 with 35 human infections. In 1994, 35 clinical CCHF cases were reported in 1994,and between January 1998 and October 2013, 5 more cases and 2 deaths were reported from the UAE (Ince Y, Yasa C, Metin M, et al. Crimean-Congo hemorrhagic fever infections reported by ProMED. Int J Infect Dis 2014; 26: 44-6;  <https://www.ijidonline.com/article/S1201-9712(14)01499-4/fulltext>).

As the vector is widely distributed and impending climatic changes are likely to widen this spectrum, there is need for the development and implementation of a strategic framework for the prevention and control of CCHF through a coordinated 'One Health' approach. - ProMED Mod.UBA]

[Maps of United Arab Emirates:
Date: Fri, 8 Mar 2019 11:58:53 +0100
By Shatha Yaish

Hatta, United Arab Emirates, March 8, 2019 (AFP) - Just over 100 kilometres (62 miles) from Dubai's skyscrapers, Mohammed al-Kaabi strolls through the tranquil desert with his friends as the sun sets.   Kaabi, 27, hails from a long line of Emiratis, a people with a centuries-old bedouin history tied inextricably to the local desert.    Today, he is among a fast-growing group drawn to a new wave of a tradition of desert camping but with all the trappings of comfort, style and modernity.   With "glamping", short for "glamorous camping", Dubai aims to expand on its renown for luxurious city living and its tradition of camping.

Betting on tourism at a time of low oil prices, Dubai is now offering stays in chic desert trailers, in plush mountainside lodgings and beach camps, as it seeks to put its own mark on the glamping trend that has swept world tourism destinations.   "This place is far from the cities and the high-rises," said Kaabi, sporting the traditional full-length white Emirati robe worn by men.   "Camping is very popular in the UAE, but when you want to bring the family it becomes more complicated," he added, at a campsite in Hatta, near the Omani border.   "But here, safety and comfort are provided for."

- A room with... a bed -
Camping is still a beloved way of life for many Emiratis, who take their equipment and head for the desert from the fall months onwards, when the scorching summer heat has faded.    Tourists and expat residents also increasingly opt to escape the hustle and bustle of the city.

Dubai welcomed a record 15.9 million visitors in 2018, many of whom were drawn to its mega malls, luxurious hotels and pristine beaches.   It hopes to push the figure up to 20 million visitors annually by next year, when it hosts the six-month global trade fair, Expo 2020.    The mountainous eastern Hatta desert has lots to offer "glampers" with a taste for adventure but also for their home comforts.   Near the Hatta dam, campers have a choice between a trailer, caravan or five-star lodge fully equipped with TVs and power points for charging a smartphone.

Seated outside a trailer, Jamil Fahmy, a Dubai resident from Saudi Arabia, said glamping was the perfect way to escape the city without compromising on hygiene.    "It's fun, with the fire and hanging with friends and all that, but I personally prefer to sleep in a room with a bed and a private bathroom, and that's what we get here," he told AFP.    "It's great to be an adventurer and explore and cook fireside, and that's what we did.   "But when the time came, we retreated into the beautiful room and slept on a bed."

- 'Five-star camping' -
Rooms with modern amenities, including bathrooms and beds, start from 400 dirhams (about $110, 100 euros) per night at the Hatta site, which opened in October.    The Hatta camping project, part of Dubai's plan to use tourism to diversify revenues, is also home to a 350-metre zip wire.   Last year, Dubai faced a downturn in the real-estate market due to a supply glut, while oil prices also dropped, affecting the UAE as a whole.    Several glamping sites, some on the beach, have popped up across the UAE in recent years, with options to participate in yoga classes, star gazing or kayaking.

For Jay, a 37-year-old Briton, glamping offers a new experience after a decade in the UAE.    "We're fairly outdoorsy, we came here kayaking before, we did the big zip line," he told AFP, referring to the Hatta zip wire.    But, he added with a laugh that with the usual no-frills style of camping "you haven't got a shower or all the facilities" so glamping is a welcome step-up.   "You get the outdoors and all of that, and nature, and you can barbeque -- but you can also have a shower and get clean!   "It's not five-star hoteling, but five-star camping."
Date: 30 Jan 2019
From: Taiichiro Kobayashi <tkobayashi@cick.jp> [edited]

Two women who returned to Japan from the United Arab Emirates (UAE) were diagnosed with dengue fever (DF). They could be the 1st reported cases of DF infected in the UAE. They live in Japan and travelled together to the UAE from 29 Dec 2018 to 4 Jan 2019. During their stay in the UAE, they mostly stayed in Dubai and were bitten by mosquitoes several times.

They came to Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital on 16 Jan 2019. A 32-year-old woman and a 29-year-old woman complained of high fever for 6 and 4 days, respectively. One revealed an erythematous rash on her trunk, face and extremities, and their tourniquet test results were positive. Their blood examinations revealed leukocytopenia, thrombocytopenia and mild liver dysfunction.

Although the UAE is not known as an endemic country of DF, we suspected the women of having DF because of their history, physical examination and laboratory test results. We performed a rapid diagnostic test of DF (SD BIOLINE Dengue DUO), and their results of non-structural protein 1 (NS1) antigen were positive. Furthermore, dengue virus serotype 3 (DENV-3) genotype III genome was detected from both of their sera with real-time RT-PCR and following viral genome sequence analysis at the Laboratory of Arboviruses, National Institute of Infectious Diseases (NIID), Japan.

These 2 cases may be a signal of the emergence of DF in the UAE, where urbanization progresses and many travellers and immigrants from DF-endemic countries are being accepted.
===============================
Taiichiro Kobayashi
Department of Infectious Diseases
Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome
Hospital
Tokyo, Japan
<tkobayashi@cick.jp>

Yuya Atsuta, Masaru Tanaka, Kazuaki Fukushima, Keishiro Yajima and Akifumi Imamura
Department of Infectious Diseases
Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital Tokyo, Japan

Takahiro Maeki, Shigeru Tajima, Satoshi Taniguchi, Masayuki Saijo and Chang-Kweng Lim
Department of Virology I, National Institute of Infectious Diseases Tokyo, Japan

[ProMED thanks the colleagues from Japan for sharing this important update on imported dengue fever cases, which were serotyped as DENV-3, from the UAE into Japan.

The worldwide distribution of dengue is expanding, in part due to globalized traffic and trade. _Aedes albopictus_ is a competent vector for dengue viruses (DENV) and is now established in numerous regions of the world. Travellers with viraemia arriving in any country from dengue-affected areas of the world can become proponents of local outbreaks. The above report also highlights the importance of considering dengue in differential diagnosis of fever with suggestive blood picture even in cases presenting in nonendemic areas. - ProMED Mod.UBA]

[HealthMap/ProMED-mail maps:
United Arab Emirates: <http://healthmap.org/promed/p/132]
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Paraguay

Paraguay - US Consular Information Sheet
September 15, 2008
COUNTRY DESCRIPTION:
Paraguay is a constitutional democracy with a developing economy.
Tourist facilities are adequate in the capital city of Asuncion, but they vary greatly
n quality and prices.
Travelers outside Asuncion should consider seeking travel agency assistance, as satisfactory or adequate tourist facilities are very limited in other major cities and almost nonexistent in remote areas.
Read the Department of State Background Notes on Paraguay for additional information.
ENTRY/EXIT REQUIREMENTS:
A passport and visa are required.
U.S. citizens traveling to Paraguay must submit completed visa applications in person or by secure messenger to the Paraguayan Embassy or one of the consulates and pay a fee.
Paraguay issues visas for one-entry or multiple entries up to the validity of the U.S. passport.
Applicants under 18 years of age traveling alone must appear with both of their parents or a legal guardian.
In case of a guardian, an original and one copy of proof of legal guardianship are required.
A document of authorization from parents/guardian will be accepted only if it is notarized and certified by the county clerk.
Travelers entering or departing Paraguay with regular U.S. passports will be fingerprinted.
Some airlines include the Paraguayan airport departure tax in the price of the airline ticket.
It is recommended that you check with the airline in order to determine whether or not the departure tax has been included.
If the tax is not included in the airline ticket then payment would be required upon departure in either U.S. or local currency (no credit cards or checks accepted). Visit the Embassy of Paraguay web site at http://www.embaparusa.gov.py for the most current visa information.

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

SAFETY AND SECURITY:
As stated in the Department of State's latest Worldwide Caution, U.S. citizens overseas may be targeted by extremist groups and should maintain a high level of vigilance.
The U.S. Embassy is not aware of any specific terrorist threat to Americans in Paraguay.
Individuals and organizations providing financial support to extremist groups operate in Ciudad del Este and along the tri-border area between Paraguay, Brazil and Argentina.
Small armed groups have also been reported to be operating in the San Pedro and Concepcion Departments.
Drug trafficking remains a serious concern in the Department of Amambay.
Because of concerns about the lack of security in border areas, the U.S. Embassy in Asuncion requires U.S. Government personnel and their family members to provide advance notice and a travel itinerary when traveling to Ciudad del Este or Pedro Juan Caballero.
As a general precaution, the Embassy also counsels its employees traveling outside the capital to provide an itinerary including dates, contact names, and telephone numbers where the employee may be reached.

Since January 2007, there have been numerous kidnapping incidents mainly in the Alto Parana department.
Targets have been members of the Paraguayan business community or their family members.
It is believed that the individuals responsible for the kidnappings are financially motivated and have pre-selected their targets based on the victims’ wealth.

U.S. citizens should avoid large gatherings or any other event where crowds have congregated to demonstrate or protest.
Such activities have resulted in intermittent road closures including major routes traveled by tourists and residents.
While generally nonviolent, demonstrations and/or roadblocks have turned violent in the past.
Areas where such closures and barricades exist should be avoided.
U.S. citizens who encounter demonstrations and/or roadblocks should not attempt to continue the planned travel or to confront those at the roadblock.
Instead, they should avoid areas where individuals are demonstrating and in case of roadblock, wait for the road to reopen or return to the origin of their trip.
Uniformed police often conduct roving checks of vehicles and passengers.

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

Up-to-date information on safety and security can also be obtained by calling 1-888-407-4747 toll free in the United States and Canada, or for callers outside the United States and Canada, a regular toll-line at 1-202-501-4444.
These numbers are available from 8:00 a.m. to 8:00 p.m. Eastern Time, Monday through Friday (except U.S. federal holidays).
The Department of State urges American citizens to take responsibility for their own personal security while traveling overseas.
For general information about appropriate measures travelers can take to protect themselves in an overseas environment, see the Department of State’s pamphlet A Safe Trip Abroad.

CRIME:
Crime has increased in recent years with criminals often targeting those thought to be wealthy.
Although most crime is nonviolent, there has been an increase in the use of weapons and there have been incidents where extreme violence has been used.
U.S. citizens have on occasion been the victims of assaults, kidnappings, robberies, and rapes.
Local authorities frequently lack the training and resources to solve these cases.
Under these circumstances, U.S. citizens traveling to or residing in Paraguay should be aware of their surroundings and security at all times.
They should take common sense precautions including refraining from displaying expensive-looking cameras and jewelry, large amounts of money, or other valuable items.
Resistance to armed assailants has often aggravated the situation and therefore is not advised.

Armed robbery, carjackings, car theft, and home invasions are a problem in both urban and rural areas.
Street crime, including pick pocketing and mugging, is prevalent in cities.
The number of pick pocketing incidents and armed assaults is also increasing on public buses and in the downtown area of Asunción.
As many incidents on public buses involve individuals snatching valuables, passengers should not wear expensive-looking jewelry or display other flashy items.
There have been incidents of pilferage from checked baggage at both airports and bus terminals.
Travelers have found it prudent to hide valuables on their person or in carry-on luggage.
Unauthorized ticket vendors also reportedly operate at the Asuncion bus terminal, badgering travelers into buying tickets for substandard or non-existent services.

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

Below are the local equivalent phone numbers to the “911” emergency line in Paraguay.
In Asuncion, the following phone numbers exist for roadside/ambulance assistance:
Emergency Services, including police and ambulances:
911.
Fire Department, including rescue of accident victims: 131, 132.
See our information on Victims of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION:
Adequate medical facilities, prescription and over-the-counter medicine, supplies, and services are available only in Asuncion.
Elsewhere, these are limited and may not exist.

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

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

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

U.S. citizens have been injured and killed in traffic accidents.
Only minimal standards must be met to obtain a Paraguayan driver's license, and driver education prior to licensing is not common.
Drivers throughout Paraguay routinely ignore traffic regulations.
No vehicle insurance is required, and many Paraguayans drive without any insurance coverage.
Persons who drive in Paraguay should be prepared to drive defensively and with their own insurance in both urban and rural areas.

Public transportation is readily available for urban and inter-city travel.
Buses vary in maintenance conditions and may not meet U.S. safety standards.
Armed robberies and pick pocketing occur on buses in cities and rural areas, sometimes with the apparent collusion of the bus driver.
Taxis are available and may be called using telephone numbers listed in the newspapers.
No passenger train service exists.
Bicycle travel may not be safe due to traffic and other road hazards.
Most urban streets consist of cobblestones over dirt.
Some roads in Asuncion and other large cities are paved.
However, these roads frequently develop potholes that often remain unrepaired.
Nearly all rural roads are unpaved, and during rainy periods and the rainy season (November-March/April), they may be impassable.
Road signs indicating hazards, such as sharp curves or major intersections, are lacking in many areas.

Driving or traveling at night is not advisable outside Asuncion because pedestrians, animals, or vehicles without proper lights are often on the roads.
In addition, assaults and other crimes against motorists traveling at night have occurred.
Extra precautions should be exercised along infrequently traveled portions of the rural roads.

Intercity highway maintenance is not equal to U.S. standards.
The privately maintained toll road between Caaguazu and Ciudad del Este and the routes between Asuncion and Encarnacion and Asuncion and Pedro Juan Caballero are in good condition.
Most other intercity routes are in good to fair condition, with brief stretches in poor condition.
The Trans-Chaco route is in fair condition except for the portion between Mariscal Estigarribia and the Bolivian border, which is unpaved and at times impassable.

The Touring and Automobile Club provides some roadside assistance to its members.
The Club may be contacted in Asuncion by visiting its offices at 25 de Mayo near Brazil, First Floor, or telephoning 210-550, 210-551, 210-552, 210-553, Monday through Friday from 8:00 a.m. to 5:00 p.m., or Saturday from 8:00 a.m. to noon, except for Paraguayan holidays.
The Touring Club also has offices in Ciudad del Este (tel. 061-512-340), Coronel Oviedo (tel. 0521-203-350), Encarnación (tel. 071-202-203), San Ignacio Misiones (tel. 082-232-080), Caaguazu Campo 9 ( tel. 0528-222-211), Santani (tel. 043-20-314), Pozo Colorado (cell phone. 0981-939-611, Villa Florida (tel. 083-240-205) and Ybyyau (tel. 039-210-206).
Towing services are scarce outside urban areas.
Twenty-four-hour tow truck services from Asuncion may be contacted by telephoning (021) 224-366, (021) 208-400, (cellular service provider) Tigo by dialing *822 or 0971-951-930.
For an extra fee, these companies may provide service outside Asuncion, but they typically demand immediate payment and may not accept credit cards.

Please refer to our Road Safety page for more information.
Visit the website of Paraguay’s national tourist office and national authority responsible for road safety at http://www.senatur.gov.py and http://www.mopc.gov.py/
AVIATION SAFETY OVERSIGHT: The U.S. Federal Aviation Administration (FAA) has assessed the Government of Paraguay’s Civil Aviation Authority as not being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for the oversight of Paraguay’s air carrier operations.
For more information, travelers may visit the FAA’s web site at http://www.faa.gov/safety/programs%5Finitiatives/oversight/iasa/
SPECIAL CIRCUMSTANCES: Paraguay’s customs authority may enforce strict regulations concerning temporary importation into or export from Paraguay of items such as firearms, medications, toys resembling weapons, or protected species.
It is advisable to contact the Paraguayan Embassy in Washington, D.C., or one of Paraguay's consulates in the United States for specific information regarding customs requirements.

Paraguay does not recognize dual Paraguayan nationality for American citizens.
Under Article 150 of the Paraguayan Constitution, naturalized Paraguayans lose their nationality by virtue of a court ruling based on unjustified absence from the Republic for more than three years, or by voluntary adoption of another nationality.
Please see our Customs Information.

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

Please see our information on Criminal Penalties.

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

REGISTRATION / EMBASSY LOCATION: Americans residing or traveling in Paraguay are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department’s travel registration web site so that they can obtain updated information on travel and security within Paraguay.
Americans without Internet access may register directly with the nearest U.S. Embassy or Consulate.
By registering, American citizens make it easier for the Embassy or Consulate to contact them in case of emergency.
The U.S. Embassy is located at 1776 Mariscal Lopez Avenue, Asuncion; telephone (011-595-21) 213-715, fax (011-595-21) 213-728; Internet: http://paraguay.usembassy.gov, email: paraguayconsular@state.gov.
The Consular Section is open for U.S. citizen services, including registration, Monday through Thursday from 1:00 p.m. to 4:30 p.m. and Fridays from 7:30 a.m. to 10:30 a.m., except for U.S. and Paraguayan holidays; telephone (011-595-21) 213-715, fax (011-595-21) 228-603.

Travel News Headlines WORLD NEWS

Date: Tue, 28 May 2019 03:40:13 +0200
By Hugo OLAZAR

Nanawa, Paraguay, May 28, 2019 (AFP) - Like 70,000 people living close to the broken banks of the Paraguay River, where the water level has risen seven meters (23 feet) in some places, Graciela Acosta has had to pack up her belongings and evacuate.   Piled up on a canoe are the 39-year-old housewife's bed, wardrobe, bedside table and her dog Pirulin.

Acosta is getting ready to cross the border into Argentina with her daughter to seek refuge in a reception center in the neighboring town of Clorinda.   "I've had enough! It's the third time that I've had to move everything because of the floods," said Acosta.   "I pray to God that it ends. Every time. it costs a lot of money."   However, there's no chance of Acosta leaving her home in Nanawa, a town of just 6,000 people that borders Argentina to the west and faces the capital Asuncion to the east across the Paraguay River, for good.   "As soon as the water level drops, I'll go home," she said.

- 'Greater impact' -
In Nanawa, only around 500 people were able to avoid evacuation, due to living in homes with upper floors above the flood levels.   They're used to this as the Paraguay River, one of the largest in the Americas, breaks its banks and causes havoc in the poorest Nanawa neighborhoods built on the flood plain.   The river's brown waters rise almost to the height of street signs: in some areas, there is up to one or two meters of water covering roads.

Paraguayans have seen worse, though, back in 1983, according to the assistant director of the country's meteorology and hydrology service, Nelson Perez.   "It's not the Paraguay River's worst flood, but the impact is greater because more people live close to the river," said Perez.   "These are the worst floods I've seen," said Ruben Acosta, 55, who peddles his moving services by canoe.   It's a far cry from January and February, when the river's level was so low that navigating it became difficult.   "It rained a lot in March, three times more than usual, and it also rained a lot in April and May," said Perez, who pointed to deforestation as an added problem.

- 'It's like being in Venice' -
Wading through water up to his chest, Rigoberto Nunez leaves a cemetery carrying a chandelier, a vase, some crucifixes and family portraits, all plucked from the family vault.   "I prefer to take them away to be safe," says the 47-year-old traveling salesman.    The town is without electricity or police and inhabitants are afraid of looters.   Nunez is heading to a reception center provided by Argentine authorities in a Clorinda slum where he's already stashed his furniture.   Enrique Cardozo's workshop has already been ravaged by the floods.   "I've lost my sofa, the cupboard, I had nowhere to put them," said the 51-year-old father of four.

The family has moved into the first floor of their house, which is just 15 meters from the river.   "It rained non-stop for a week. One day, the water rose one meter. It was impressive, we couldn't save everything," said Cardozo.   "There's nowhere you can put your feet on the ground. It's like being in Venice, we move about by Gondola!"

On the other side of the river, Asuncion has not been spared as several areas have also had to be evacuated.   In the Sajonia residential zone, inhabitants and shopkeepers have seen their sidewalks lined with sandbags, to keep back the floodwaters.   According to Perez, though, the problems -- and waters -- will soon subside.   The water level rose only slightly on Monday, and will continue to do so for a few more days before it drains away during the first half of June, he said.
Date: Mon, 27 May 2019 12:07:58 +0200

Asuncion, May 27, 2019 (AFP) - Heavy flooding in Paraguay has displaced 70,000 families and is threatening to further inundate the capital Asuncion in the coming weeks, the country's weather bureau said.   Water levels on the Paraguay River are rising at a rate of 4-5 centimetres (1.5-2 inches) every day and is only 46 cm (18 in) below a "disaster" level, according to official data from the Department of Meteorology and Hydrology (DMH).

Crossing that threshold would "have a very strong impact" because of the number of Asuncion residents who have moved into the city's floodplain, said DMH deputy director Nelson Perez on Sunday.   The city's water service infrastructure was clogged with garbage which was exacerbating the floods, Perez added. 

Unusually heavy downpours over May, including two days which together exceeded Asuncion's average monthly rainfall, have exacerbated the flooding, said DMH meteorologist Eduardo Mingo.    Some 40,000 people in Asuncion have already been affected by the floods, official data reported.   A further 10,000 people have been displaced in the southern town of Pilar on the Argentinian border.   The government has mobilized armed forces to help displaced residents relocate to shelters, but hundreds of families have opted to stay behind in their inundated homes.
Date: Thu, 4 Apr 2019 03:06:45 +0200

Asuncion, April 4, 2019 (AFP) - More than 20,000 families across Paraguay have been affected by severe flooding from two weeks of heavy rain that caused the country's main river to burst its banks, a senior official said Wednesday as an emergency was declared in the capital.   National Emergency Minister Joaquin Roa made the announcement as forecasters said the precipitation would continue for the rest of the week.   The Paraguay River, which runs some 1,000 kilometres north to south and splits the country in two, is expected to continue overflowing.

A 90-day emergency was declared in Asuncion on Wednesday due to the flooding. Hardest-hit are some 5,000 families living in the Banado Sur working-class neighbourhood on the city outskirts.   The people affected by flooding "need sheet metal roofing, wood, and all types of help," a municipal official told AFP.   The Paraguay River flows past Asuncion and eventually merges into the Parana River in Argentina.   "We did not expect it to swell so quickly," said Pablo Ramirez, a resident of Banado Sur, a neighbourhood in the capital, dismayed after returning to his home after he left it one month ago due to flooding.

Ramirez, who relies on crutches to get around following a car accident, said that he will not leave home this time. The flooding "will go by quickly," he said optimistically.   Pedro Velasco, the leading neighbourhood Catholic priest, said that one week ago they warned emergency officials that the river was about to overflow and asked for trucks to deliver aid and help evacuate people.   "They didn't move until Monday, but by then it was already too late and they couldn't come in" because of the flooding, Velasco said.   Roa said that his office will deliver 400,000 of food in the next days in coordination with the Paraguayan military.
Date: Thu 28 Feb 2019
Source: Hoy [in Spanish trans. Mod.TY, edited]

Patients who present with febrile symptoms and who reside in the area where the 1st positive case was reported positive request tests for hantavirus [infection]. Until now there are 5 cases, 3 were positive in initial laboratory tests and 2 are suspect cases that will be tested outside [the country] because the Central Laboratory does not do confirmatory tests.

The febrile cases of residents in Capiata [Central department], the area where the 1st cases of hantavirus occurred, are adding up and now Health Surveillance has reported 2 more suspected cases, all children between 2 and 7 years old living in the same city; community intervention continues in search of possible cases.

The 1st cases confirmed in a private laboratory remain hospitalized in intensive care and the others who have improved are now receiving ambulatory treatment, stated Dr Sandra Irala of Health Surveillance.

"The clinical picture of hantavirus [infection] is that of a patient with a temperature above 38 deg C [100.4 deg F] and respiratory difficulty is another characteristic in the endemic area such as that of Chaco. In the non-endemic area [hantavirus infection] is suspected if the patient presents with fever and other possible causes are eliminated," the doctor indicated in a press conference.

The rodents that transmit the hantavirus do not inhabit urban areas and the way in which the disease [virus] is acquired is through contact with excreta and other secretions such as saliva and urine of these [infected] rodents.

Irala pointed out that the cases that are initially positive should have a cross-section of studies for final confirmation, so the samples were sent to Argentina, where there is a reference laboratory for the detection of this type of virus.

The person acquires the virus by inhaling air contaminated with the virus that is transported through dust particles, which is why it is recommended before cleaning, especially of storage buildings, to open doors and windows to ventilate the environment and moisten the soil to before proceeding with the sweeping.

The possibility of acquiring a hantavirus [infection] is if you have a history of having visited the Chaco area or if you were in a country that registers outbreaks of hantavirus, such as southern Argentina.

The disease has a 30% mortality rate and in Paraguay every year about 20 cases are registered, all in the Chaco region.

Alerting symptoms
-----------------
The symptoms of hantavirus [infection] are similar to other infectious diseases and include fever, headache, and gastrointestinal problems and, according to the development and the seriousness of the case, the patient may present with respiratory manifestations.

Before the appearance of any of these or other symptoms [the Ministry of Health] urges the public to go to the nearest health service to make the appropriate diagnosis and appropriate treatment. Under no circumstances should self-medication be used as this could aggravate the picture and obstruct the actual diagnosis of the disease.
=====================
[The active surveillance efforts in the neighborhood of the initial case has detected more patients now with a total 3 confirmed and 2 suspected. The tests used in the private laboratory to determine that 3 cases as confirmed are not indicated, nor if samples of these 3 cases were sent to the reference laboratory in Argentina for confirmation.

Most of the previous cases of hantavirus infection in Paraguay have been diagnosed in Boqueron department in the north western part of the country. This is the 1st report of hantavirus infections in the Central department of Paraguay. The possible hantavirus involved in this suspected case is not stated. A 2011 report indicated that Leguna Negra hantavirus was responsible for hantavirus pulmonary syndrome (HPS) cases in Presidente Hayes department. In addition to Laguna Negra virus (rodent host _Calomys laucha_), other hantaviruses that can cause HPS and are found in Paraguay (and their rodent hosts) include Juquitiba (_Akodon cursor_), Ape Aime-Itapua (_Akodon montensis_), Araucaria (_A. montensis_, _Oligoryzomys nigripes_), Jabora and Jabora-like (_A. montensis_), Alto Paraguay (_Holochilus chararius_), and Lechiguanas (_Oligoryzomys nigripes_). - ProMED Mod.TY]

[Maps of Paraguay:
Date: Tue 12 Jun 2018
Source: WHO, Malaria [edited]

- What were the key elements to Paraguay's malaria elimination success that helped the country reach zero indigenous cases of the disease?
Paraguay is the 1st country in the Americas since Cuba in 1973 to be certified malaria-free, representing a significant public health achievement not only for Paraguay but for the Americas as a whole. Achieving elimination in Paraguay required substantial levels of political commitment and leadership, as well as sustained investments in its national malaria programme over a period spanning more than 50 years. Notable aspects of its approach include:

Rapid and targeted response
---------------------------
With free universal health services in Paraguay and a strong malaria surveillance system, malaria cases were detected early, investigated promptly, and classified correctly.

Dedicated elimination strategy
------------------------------
After reporting its last case of malaria in 2011, Paraguay launched a 5-year plan to consolidate the gains, prevent re-establishment of transmission, and prepare for elimination certification. Activities centred on strengthening epidemiological surveillance, robust case management, and a public information campaign on the diagnosis, treatment, and prevention of malaria to promote behaviour change among populations in at-risk areas.

Integration
-----------
During 2015 and 2016, as part of a broader health reform, malaria surveillance, diagnosis, and treatment activities were integrated within Paraguay's general health services, with the aim of expanding health coverage to at-risk populations and preventing re-establishment.

Strengthening surveillance skills
---------------------------------
A 3-year initiative to hone the skills of front-line health workers in the country's 18 health regions was launched in 2016 to keep the malaria surveillance system sustainable over the long term. Supported by The Global Fund to Fight AIDS, Tuberculosis and Malaria, the project addresses disease prevention, identification of suspected cases, accurate diagnosis and prompt treatment to respond to the on-going threat of malaria importation from endemic countries in the region and Africa.

- How has Paraguay managed to stay malaria-free since 2012? What are the systems in place that made this possible and how long will the country keep those systems operational?
As part of the WHO elimination certification process, countries must demonstrate that they have the capacity to prevent the re-establishment of malaria transmission. The availability of free universal health services in Paraguay and a strong malaria surveillance system ensure imported cases of malaria are detected and responded to in a timely manner to prevent local transmission.

The inclusion of the national malaria programme within the National Malaria Eradication Service (SENEPA, in the Spanish acronym), the institution within the ministry of health responsible for the control of vector-borne diseases, helps guarantee the programme's future existence.

Further, congressional legislation provides predictable and long-term financing for the national malaria programme: by law, 1.5 percent of annual income from Paraguay's social security programme is allocated to SENEPA. Together, these elements ensure that efforts to prevent the re-establishment of malaria transmission can be sustained in the decades to come.

- What are the benefits of malaria elimination for Paraguay?
Eliminating malaria in Paraguay means that no one will fall ill or die from local transmission of the disease, bringing about tangible health benefits at the individual and community levels, as well as broader socio-economic outcomes.

- What role did national leadership, political will, civil society and international partners play in Paraguay's success?
Eliminating malaria is a collective effort, requiring the sustained engagement of many partners at the national, regional and global levels. However, achieving elimination is a country-driven process. For elimination efforts to succeed, government stewardship is essential, together with the engagement and participation of affected communities.

- Does Paraguay coordinate cross-border surveillance activities to prevent importation of malaria cases and do they provide antimalarial treatment to visitors and migrants?
Paraguay provides free treatment to all citizens, visitors, and migrants, regardless of their nationality or residency status. The national malaria programme has identified 3 populations at greatest risk: the military, Brazilian students attending universities in Paraguay, and Paraguayans travelling to Africa. Targeted interventions include strengthening passive detection systems, promotion of health education, and providing prophylaxis to travellers heading to and returning from malaria-endemic regions in Africa.

To step up cross-border collaboration, the Pan American Health Organization (PAHO) funded a project focused on strengthening entomological surveillance and control of vector-borne diseases in the 'triple border' area of Argentina, Brazil, and Paraguay. A key outcome of the project, which ran from 2010 to 2012, was the development of an _Anopheles_ mosquito range map, a tool that shows the geographic distribution of malaria-carrying mosquitoes.

- What are the lessons learned from Paraguay's experience that can be applied in other countries looking to eliminate malaria?
Paraguay provides universal free health services to all, one of the critical elements that helps drive a country towards malaria elimination. Sustained political commitment and robust financial support are further keys to success. Continued surveillance of suspected cases, targeted community engagement and education, as well as strengthening skills of front-line health workers, are recommended strategies that WHO encourages countries to adopt as part of their national malaria elimination programmes.
 
- Is Paraguay replicating its elimination strategy with other infectious and mosquito-borne diseases?
Paraguay has an integrated approach to entomological surveillance activities, taking into account several vector-borne diseases including dengue, leishmaniasis, and Zika virus. Integration of malaria surveillance into the general health system had been a challenging task in Paraguay, but the lessons and experiences learned from other vector-borne diseases have contributed to the smooth integration and transition of the malaria programme. At the same time, the approach used to eliminate malaria is now being applied to eliminate Chagas disease and schistosomiasis.
======================
[ProMED congratulates Paraguay for this important public health achievement. It is important to demonstrate that malaria eradication is possible, and the achievement could be an inspiration for the countries in southeast Asia experiencing a decline in artemisinin susceptibility. - ProMED Mod.EP]

[HealthMap/ProMED-mail map of Paraguay:
More ...

Cyprus

Cyprus US Consular Information Sheet
December 30, 2009

Since 1974, Cyprus, a Mediterranean island nation, has been divided de facto into a government-controlled area comprising the southern two-thirds of the island, and a northern third (t
e self-declared “Turkish Republic of Northern Cyprus"), administered by Turkish Cypriots. The United States does not recognize the “Turkish Republic of Northern Cyprus” nor does any country other than Turkey. Facilities for tourism in Cyprus are highly developed. Cyprus joined the European Union in 2004. Read the Department of State Background Notes on Cyprus for additional information.
ENTRY/EXIT REQUIREMENTS: A passport is required for travel to Cyprus. A visa is not required for a stay of up to 90 days. For longer stays, a visa or residence permit is required. U.S. citizens should be mindful that the Government of Cyprus does not recognize the residence permits issued by Turkish Cypriot authorities for the portions of the island under Turkish Cypriot administration. The Government of Cyprus does not issue residency permits to individuals who live in the areas outside government control.
On occasion, Americans who resided in the area administered by Turkish Cypriots for more than 90 days without a Republic of Cyprus residence permit have been detained by officials at Larnaca airport and denied entry into the government-controlled area. They also may be subject to prosecution.

The U.S. Embassy encourages travelers to read the “Special Circumstances” section of this fact sheet for important additional information about entry requirements into the Turkish Cypriot-administered areas.
For further information on entry requirements for Cyprus, travelers can contact the Embassy of the Republic of Cyprus at 2211 R Street NW, Washington, DC 20008-4082, tel. (202) 462-5772, or the Cypriot Consulate in New York at 13 East 40th St., 5th Floor, New York, NY 10016, tel. (212) 686-6016/17. Visit the Embassy of Cyprus’ web site at http://www.cyprusembassy.net for the most current visa information.

Information about dual nationality or the prevention of international child abduction can be found on our web site. For further information about customs regulations, please read our Customs Information sheet.
SAFETY AND SECURITY: Do not, under any circumstances, attempt to enter the U.N. buffer zone at any place other than a designated crossing point. This area is mined and militarized.
Never photograph military installations or anything that could be perceived as being of security interest (especially in the area administered by Turkish Cypriots). Pay particular attention to areas marked with “no photography” signs. Police on both sides strictly enforce these restrictions.

For the latest security information, Americans traveling abroad should regularly monitor the Department of State’s Bureau of Consular Affairs web site at http://travel.state.gov, where the current Travel Warnings and Travel Alerts, as well as the Worldwide Caution, can be found.
Up-to-date information on safety and security can also be obtained by calling 1-888-407-4747 toll free in the U.S and Canada, or for callers outside the U.S. and Canada, a regular toll-line at 1-202-501-4444.
These numbers are available from 8:00 a.m. to 8:00 p.m. Eastern Time, Monday through Friday (except U.S. federal holidays).

The Department of State urges American citizens to take responsibility for their own personal security while traveling overseas. For general information about appropriate measures travelers can take to protect themselves in an overseas environment, see the Department of State’s A Safe Trip Abroad.
CRIME: The crime rate in Cyprus is low. Visitors in urban areas should take the normal precautions they would take in any large city. Americans frequenting bars should avoid so-called “cabarets,” which sometimes employ women brought to Cyprus for sexual exploitation. These establishments can also present foreign patrons with grossly inflated bar tabs, threatening those customers who refuse to pay.

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

The local equivalent to the “911” emergency line in the Republic of Cyprus is 199 or 112.

Emergency assistance is available in the area administered by Turkish Cypriots by calling 155.
Also see our information on Victims of Crime.
MEDICAL FACILITIES AND HEALTH INFORMATION: Medical care is available at both government hospitals and private clinics. Emergency rooms offer adequate care to stabilize patients, most of whom are then transferred to private hospitals. Many of the private-sector doctors have been trained in the United Kingdom or the United States. While fees are generally lower than those in the United States, medical supplies are often more expensive. Paramedics do not staff ambulances. The standard of medical care in the area administered by Turkish Cypriots is improving but still falls below that found in the government-controlled area. The World Health Organization considers Cyprus to be one of the healthiest areas of the Mediterranean. Water supplies are potable, and the refuse collection/sewage disposal system is adequate. Communicable diseases such as typhoid are rare. Respiratory ailments and allergies are sometimes exacerbated by the dry and dusty climate.

Some HIV/AIDS entry restrictions exist for visitors to and foreign residents of Cyprus.
Legislation mandates that aliens known to have certain communicable diseases and HIV be denied entry into the country.
American citizens who think they may be included in this restriction are encouraged to check with the Embassy of Cyprus at http://www.cyprusembassy.net before they travel.
Information on vaccinations and other health precautions, such as safe food and water precautions and insect bite protection, may be obtained from the Centers for Disease Control and Prevention’s (CDC) hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747) or via the CDC’s site at http://wwwn.cdc.gov/travel/default.aspx. For information about outbreaks of infectious diseases abroad consult the World Health Organization’s (WHO) web site at http://www.who.int/en. Further health information for travelers is available at http://www.who.int/ith/en.
MEDICAL INSURANCE: The Department of State strongly urges Americans to consult with their medical insurance company prior to traveling abroad to confirm whether their policy applies overseas and whether it will cover emergency expenses such as a medical evacuation. Please see our information on medical insurance overseas.

TRAFFIC SAFETY AND ROAD CONDITIONS: While in a foreign country, U.S. citizens may encounter road conditions that differ significantly from those in the United States. The information below concerning Cyprus is provided for general reference only, and it may not be totally accurate in a particular location or circumstance.
In recent years, Cyprus ranked among the top three countries in Europe, on a per capita basis, in traffic fatalities. Speeding, tailgating, overtaking, and the running of caution lights are commonplace and major causes of accidents. Emergency assistance is available in the Republic of Cyprus by calling 112 or 199.
Emergency assistance is available in the area administered by Turkish Cypriots by calling 155.
There are few public buses and no rail lines. Taxis are widely available. Traffic moves on the left side of the road, British style, and modern motorways link the major cities. Secondary roads, especially in mountainous areas, tend to be narrow and winding, and they are not as well maintained as major highways. Traffic laws, signs and speed limits are consistent with the standards used throughout Europe. Traffic circles (roundabouts) are often utilized at major intersections.

The use of seat belts (in front seats) and child car seats is required. Motorcyclists are required to wear helmets and the use of cellular phones while driving is prohibited unless used with some form of hands-free kit. Liability insurance is mandatory.

Road safety conditions in the area administered by Turkish Cypriots are similar to conditions in the south, except that the road network is less developed. Insurance purchased in the government-controlled area is not valid in the area administered by Turkish Cypriots, but insurance for that area may be purchased near the U.N. "buffer zone" checkpoints.
Please refer to our Road Safety page for more information. For specific information concerning driving permits, vehicle inspection, road tax and mandatory insurance in Cyprus, contact the Cyprus Tourism Organization at 13 East 40th Street, New York, NY 10016, tel. (212) 683-5280, email: gocyprus@aol.com, web site: http://www.visitcyprus.com/wps/portal.
AVIATION SAFETY OVERSIGHT: As there is no direct commercial air service to the United States by carriers registered in Cyprus, the U.S. Federal Aviation Administration (FAA) has not assessed Cyprus’ Civil Aviation Authority for compliance with International Civil Aviation Organization (ICAO) aviation safety standards. For more information, travelers may visit the FAA’s web site at http://www.faa.gov/safety/programs_initiatives/oversight/iasa.

SPECIAL CIRCUMSTANCES: Since 1974, the Republic of Cyprus has designated Larnaca and Paphos international airports, and the seaports of Limassol, Larnaca, and Paphos, as the only legal points of entry into and exit from Cyprus. These ports are all in the government-controlled southern part of the island. Entry or exit via any other air or seaport is considered an illegal act by the Republic of Cyprus. Formerly, visitors choosing to arrive at non-designated airports and seaports in the area administered by Turkish Cypriots were not allowed to cross the U.N.-patrolled “buffer zone” to the government-controlled area in the south. Since 2004, when the Republic of Cyprus implemented new EU-related crossing regulations, Americans (and citizens of other non-EU countries not requiring visas) have been able to cross regardless of their port of entry into Cyprus.

Most American visitors to Cyprus are able to cross the “buffer zone” without hindrance, although on occasion difficulties are encountered at both the government and Turkish Cypriot checkpoints. Cypriot officials at the “buffer zone” checkpoints or at airports and seaports in the government-controlled area may detain and prosecute Americans who have been present for more than 90 days in the area administered by Turkish Cypriots if they do not possess a residency permit issued by the Government of Cyprus.

For visits of less than 90 days, American citizens may enter the Turkish Cypriot-administered area by displaying a valid U.S. passport.
Stays for 90 days or longer require a “temporary residency visa” issued by Turkish Cypriot authorities.
Turkish Cypriot authorities have deported foreigners who violate this law.
Turkish Cypriot authorities emphasize that the requirement to obtain a temporary residency visa within 90 days of arriving in the Turkish Cypriot-administered area cannot be avoided by periodically visiting the southern part of the island controlled by the Republic of Cyprus.
Policy and procedures regarding travel across the “buffer zone” are subject to change. More information on current procedures may be obtained at the U.N. “buffer zone” Ledra Palace checkpoint in Nicosia.
In an effort to prevent international child abduction, many governments have initiated strict identification procedures at entry/exit points. These often include requiring documentary evidence of relationship and permission for the child's travel from the parent(s) or legal guardian, if not present. Having such documentation on hand, even if not required, may facilitate entry and departure. Although Cyprus is party to the Hague Convention on the Civil Aspects of International Child Abduction, the Convention cannot be used effectively to recover a child abducted to the area administered by Turkish Cypriots.

Cyprus customs authorities enforce strict regulations concerning temporary importation into or export from Cyprus of items such as firearms. There are no restrictions on contemporary religious materials and medication for personal use; however, Cyprus does restrict the export of Byzantine era ecclesiastical material.
It is advisable to contact the Embassy of the Republic of Cyprus in Washington, DC for specific information regarding customs requirements or visit http://www.mof.gov.cy/mof/customs/ced.nsf/DMLindex_en/DMLindex_en?OpenDocument.
In many countries around the world, counterfeit and pirated goods are widely available. Transactions involving such products are illegal and bringing them back to the United States may result in forfeitures and/or fines. Cyprus restricts the export of Byzantine period ecclesiastical material and all archaeological material, including ancient coins. The U.S. Customs Service may impose corresponding import restrictions in accordance with the Convention on Cultural Property Implementation Act. Also see our Customs Information.

In addition to being subject to all Cypriot laws affecting American citizens, individuals who also possess Cypriot nationality may be subject to laws that impose special obligations on citizens of Cyprus. For example, American citizens whom the Republic of Cyprus considers to be Cypriot citizens may be subject to compulsory military service and other aspects of Cypriot law while in Cyprus. American citizen males between the ages of 16 and 26 years who reside in the United States and whose parents or grandfather were Greek Cypriots or have Greek Cypriot names are advised to obtain a written confirmation that they reside permanently outside of Cyprus from the Cypriot Embassy in Washington, D.C. before they travel to Cyprus.
After their arrival in Cyprus, the young men should present their foreign residency confirmation statement to the Cypriot National Guard Registration office to obtain an exit permit. Those who believe they may be affected should inquire at the Embassy of the Republic of Cyprus regarding their status. American citizens whom the Turkish Cypriot authorities consider to be "citizens" may also be subject to compulsory military service in the area administered by Turkish Cypriots. The U.S. Embassy is unable to exempt dual nationals from such service.
For additional information, please see our dual nationality flyer.

American Citizens who buy or lease property, particularly in the area administered by Turkish Cypriots, may find their ownership challenged by people displaced as a result of the 1974 conflict. Prospective property buyers should always seek legal advice before buying. On October 20, 2006, the government of the Republic of Cyprus passed Article 303A of the Criminal Code which makes it a felony to buy, rent or sell property in Cyprus without the consent of the registered owner. Cypriot courts have used the law to prosecute people involved in the sale or purchase of property in the area administered by the Turkish Cypriots. The government of Cyprus has also attempted to enforce Cypriot legal judgments in property matters in other EU countries. Cypriot customs authorities routinely detain anyone arriving in Cyprus or crossing the buffer zone found to be in possession of documents relating to property purchases in the area administered by Turkish Cypriots.

In June 2006 the "Turkish Republic of Northern Cyprus" amended the laws governing its "Immovable Property Commission" to enable the Commission to accept claims for compensation or restitution from Greek Cypriots for property in the north.
The Government of the Republic of Cyprus does not recognize the legitimacy of the "Immovable Property Commission."
Some Greek Cypriots who have filed claims with the Commission have been subjected to intensive governmental and public pressure to withdraw their claims.
CRIMINAL PENALTIES: While in a foreign country, American citizens are subject to that country's laws and regulations, which sometimes differ significantly from those in the United States and may not afford the protections available under U.S. law. Penalties for breaking the law can be more severe than in the United States for similar offenses. Persons violating Cypriot laws, even unknowingly, may be expelled, arrested or imprisoned. Penalties for possession, use, or trafficking in illegal drugs in Cyprus are strict, and convicted offenders can expect jail sentences and heavy fines. Engaging in sexual conduct with children or using or disseminating child pornography in a foreign country is a crime, prosecutable in the United States. Please see our information on Criminal Penalties.

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

REGISTRATION / EMBASSY LOCATION: Americans living or traveling in Cyprus are encouraged to register with the U.S. Embassy through the State Department's travel registration web site
in order to obtain updated information on travel and security within Cyprus. Americans without Internet access may register directly with the nearest U.S. Embassy or Consulate. By registering, American citizens make it easier for the Embassy or Consulate to contact them in case of emergency.

The U.S. Embassy is located at Metochiou and Ploutarchou Streets, Engomi, Nicosia, tel. 357-22-39-3939; fax 357-22-39-3344; e-mail consularnicosia@state.gov; web site http://cyprus.usembassy.gov/
The U.S. Government also maintains an office in the area administered by Turkish Cypriots. The office is located at 6 Serif Arzik Street, Koskluciftlik, Nicosia.
The telephone number when calling from the United States or the Republic of Cyprus is 0090-392-227-3930. When calling within the area administered by Turkish Cypriots, please dial 227-3930.
* * * * * *
This replaces the Country Specific Information dated June 27, 2008
to update sections on Entry and Exit Requirements, Information for Victims of Crime,
Special Circumstances, and Registration/Embassy Location.

Travel News Headlines WORLD NEWS

Date: Fri, 31 Jan 2020 20:08:08 +0100 (MET)

Nicosia, Jan 31, 2020 (AFP) - Cyprus said on Friday it was treating its first suspected case of coronavirus after a man arrived from China showing signs of the illness.   A statement by the Mediterranean island's Ministry of Health said: "A Chinese citizen residing in Cyprus who had visited China in the past few days presented symptoms similar to that of the coronavirus." Authorities in the European Union member state said all protocols were followed for dealing with coronavirus and the man was hospitalised in the capital Nicosia.   "The possibility of influenza A was ruled out after conducting the relevant examinations," the ministry said.   The ministry said it would "further investigate" the incident over the following days while the patient is kept in hospital for treatment.   "This is a suspected case (of coronavirus) and not confirmed," the ministry said.  "We will keep the public informed of any developments," it added.   According to Cypriot daily Phileleftheros, the man was quarantined after arriving at the airport where screening showed he had a high fever.
Date: Thu, 18 Oct 2018 07:16:17 +0200

Larnaca, Cyprus, Oct 18, 2018 (AFP) - Cypriot low-cost carrier Cobalt Air announced it was cancelling all flights from Thursday after just two years in operation, leaving passengers stranded and scrambling to get their money back.   The airline warned customers its offices would no longer be staffed and urged them to seek refunds through their travel agent or credit card company.   In a brief announcement issued on its website without prior warning late on Wednesday, the airline said it was cancelling all flights from 23:50 pm (2050 GMT) "due to indefinite suspension of Cobalt's operations".   "As a result, future flights or services provided by Cobalt will be cancelled and will no longer operate," it added without elaborating on the reasons.

The airline advised passengers who have tickets not to go to the Mediterranean holiday island's main airport at Larnaca on Thursday or attempt to contact its offices "as no Cobalt flights will operate and no Cobalt staff will be present".   "For refunds, please contact your credit card provider or travel agent," its statement said.   "We sincerely apologise once again and would like to thank our very loyal customers for their support over the last two years of Cobalt operations."   Cobalt, the largest Cypriot airline since the collapse of the state-owned flag carrier, ceased operations after reports that it had failed to reach a deal with a potential European investor.   It is not yet clear how many passengers have been affected by the sudden shutdown.   But the Cypriot transport ministry said passengers expecting to fly with Cobalt on Thursday should secure one-way tickets in economy class from another airline and keep their receipt to be reimbursed.

Nine flights had been scheduled to arrive and nine to depart from Larnaca airport on Thursday.   Transport Minister Vasiliki Anastasiadou said that any stranded passengers in Cyprus would be helped.   Reportedly, the company has only 15 million euros in its accounts, which it needed to pay its 200 staff.   There was speculation that the budget airline was facing cash flow problems after two of its aircraft were grounded for two days.   Although Cobalt refused to comment on the rumours, sources within the company reportedly attributed the liquidity problems to difficulties faced by Chinese investors in exporting capital due to Chinese government restrictions.   The airline's largest shareholder is AJ Cyprus, with 49 per cent of the shares. AJ Cyprus is owned by China's AVIC Joy Air.   Cobalt stepped in to replace bankrupt state-owned Cyprus Airways, which shut down in January 2015.   Cobalt started flight operations in 2016 and acquired six aircraft -- two Airbus 319s and four Airbus 320s -- flying to 23 destinations.
Date: Tue, 17 Jul 2018 16:48:37 +0200

Nicosia, July 17, 2018 (AFP) - More than 1.6 million tourists visited Cyprus in the six months to June, the largest number ever for the first half of the year, the island's statistics office said Tuesday.   Tourist arrivals in January-June rose 12.4 percent to 1.64 million from 1.46 million in the same period last year, according to the Cyprus Statistical Service (Cystat).   "This also outnumbers the total of arrivals ever recorded in Cyprus during the first six months of the year," it said.

An influx of tourists from main market Britain and an upswing from Sweden helped Cyprus mark another record as arrivals in June broke the 500,000 barrier, Cystat said.   "June 2018 had the highest volume of tourist arrivals ever recorded in Cyprus during the specific month," it said.   Arrivals reached 511,073 in June, an increase of 8.2 percent from last year's 472,450.   The statistical department noted however a 5.1 percent drop in the number of Russian tourists, as well as a 15.1 percent decrease in arrivals from Israel and a 11.3 percent decline from Germany.   Year-on-year tourist arrivals from number one market the United Kingdom rose by 9.9 percent in June to 164,477 while there was a 20.2 percent increase in tourists from Sweden.

Sweden has now become the island's third largest tourist market, with Russia still holding second place.   Industry officials argue that arrivals from Russia are down due to fluctuations of the ruble and the renewed popularity of Turkey -- a destination made more attractive by a weak Turkish lira.   The tourism boom has helped Cyprus return to growth following a 10-billion-euro bailout in March 2013 to rescue its crumbling economy and insolvent banks.   Income from tourism now accounts for about 15 percent of the eastern Mediterranean island's gross domestic product and is credited with underpinning a quick recovery.   A record 3.65 million tourists took holidays in Cyprus last year, spending an unprecedented 2.6 billion euros.
Date: Sun, 24 Jun 2018 22:13:43 +0200

Nicosia, June 24, 2018 (AFP) - A British tourist was killed in a hit-and-run incident on Sunday near the Cypriot resort city of Paphos, police said.    The 39-year-old man was found dead at the scene after police responded to reports of an incident in the south-western coastal resort of Peyia at around 2:30 am (1130 GMT on Saturday).   The car was later found by police after being dumped in the sea.   Police arrested a man and woman in connection to the man's death.

A Paphos court on Sunday extended their detention for eight days on suspicion of pre-meditated murder.    Police said a 32-year-old British man also hit by the car was being treated at hospital, describing his condition as "out of danger".   According to local media reports, the two suspects and the tourists were involved in an argument at a pub in Peyia earlier in the evening.   Neither the identity of the dead tourist nor the two suspects have been released.
Date: Mon, 5 Mar 2018 15:30:54 +0100

Nicosia, March 5, 2018 (AFP) - Cyprus saw its best ever receipts from tourism in 2017, official data showed on Monday, in a record year for the eastern Mediterranean holiday island considered a regional safe haven.   Tourism income last year reached 2.63 billion euros ($3.23 billion) beating the 2.36 billion record set in 2016, an 11.7 percent increase, according to the Cyprus statistical service.   The surge in tourist spending coincides with another record year in arrivals, with more than 3.65 million people visiting the island last year -- 14.6 percent up from the 3.18 million visitors in 2016.

The expenditure per person, per day for the period January to December 2017 recorded a decrease of 2.6 percent (from 78.07 euros to 76.07).   In December the Lebanese were the biggest spenders on an average 147.88 euros per day and the most frugal were the Norwegians on 25.81 euros per day.   The island has benefited from a surge in arrivals from its largest markets Britain and Russia as well as a revival in those coming from Germany, Sweden and Israel.

Cyprus is seen as a safe haven for tourists, with other traditionally popular destinations in the eastern Mediterranean having been hit by political upheaval and security fears.   The surge has helped Cyprus return to growth following a 10-billion-euro package to rescue its crumbling economy and insolvent banks in March 2013.   Income from tourism accounts for about 12 percent of the eurozone member's gross domestic product and is credited with ensuring a relatively quick recovery.
More ...

Belgium

Belgium - US Consular Information Sheet
October 03, 2008
COUNTRY DESCRIPTION:
Belgium is a highly developed and stable democracy with a modern economy. Tourist facilities are widely available.
Read the Department of State Background N
tes on Belgium for additional information.
ENTRY/EXIT REQUIREMENTS: Belgium is a party to the Schengen agreement. As such, U.S. citizens may enter Belgium for up to 90 days for tourist or business purposes without a visa. The passport should be valid for at least three months beyond the period of stay. Sufficient funds and a return airline ticket are required. For further details about travel into and within Schengen countries, please see our fact sheet. For further information concerning entry requirements, contact the Embassy of Belgium at 3330 Garfield Street NW, Washington, DC 20008, telephone (202) 333-6900; or one of the Belgian Consulates General in Atlanta, Los Angeles, or New York.Visit the Belgian Embassy web site at http://www.diplobel.org/usa for the most current visa information.
Belgian law requires that everyone carry some form of official identification at all times, which must be displayed upon request to any Belgian police official. A U.S. passport suffices for these purposes.
See the section on Special Circumstances for information on new business visitor and employee registration requirements.
Information about dual nationality or the prevention of international child abduction can be found on our web site. For further information about customs regulations, please read our Customs Information sheet.
SAFETY AND SECURITY: Belgium remains largely free of terrorist incidents. Belgian law enforcement and security officials, in close cooperation with neighboring countries, maintain a solid anti-terrorism effort and a peaceful environment for tourists and business. However, like other countries that are members of the Schengen Agreement on free cross-border movement, Belgium’s open borders with its European neighbors allow the possibility for terrorist groups to enter/exit the country with anonymity.
Prior police approval is required for public demonstrations in Belgium, and police oversight is routinely provided to ensure adequate security for participants and passers-by. Nonetheless, situations may develop that could pose a threat to public safety. U.S. citizens are advised to avoid areas where public demonstrations are taking place.
For the latest security information, Americans traveling abroad should regularly monitor the Department of State, Bureau of Consular Affairs’ web site at http://travel.state.gov, where the current Travel Warnings and Travel Alerts, as well as the Worldwide Caution, can be found.
Up-to-date information on safety and security can also be obtained by calling 1-888-407-4747 toll free in the U.S. and Canada, or for callers outside the U.S. and Canada, a regular toll-line at 1-202-501-4444. These numbers are available from 8:00 a.m. to 8:00 p.m. Eastern Time, Monday through Friday (except U.S. federal holidays).
The Department of State urges American citizens to take responsibility for their own personal security while traveling overseas. For general information about appropriate measures travelers can take to protect themselves in an overseas environment, see the Department of State’s pamphlet A Safe Trip Abroad.
CRIME: Belgium remains relatively free of violent crime, but low-level street crime is common. Visitors should always be watchful and aware of their surroundings, however, because muggings, purse snatchings, and pickpocketing occur frequently, particularly in the major cities. Transportation hubs like the Metro (subway) and train stations are also frequented by thieves who take advantage of disoriented travelers. In Brussels, pickpocketing, purse snatching, and theft of light luggage and laptops are common at the three major train stations -- the North Station (Noordstation or Gare du Nord), the Central Station (Centraal Station or Gare Central) and especially at the South Station (Zuidstation or Gare du Midi). The latter is a primary international train hub, and travelers are advised to pay very close attention to their personal belongings when in the station. Common ploys are to distract the victim by spraying shaving cream or another substance on his or her back or asking for directions while an accomplice steals the luggage. It is a good idea to remain in physical contact with hand luggage at all times, and not to place carry-on luggage on overhead racks in trains.
Another growing problem, especially in Brussels, is theft from vehicles, both moving and parked. Do not leave valuables in plain sight where a thief may spot them. Thieves will sometimes position themselves at stop lights to scan for valuables in stopped cars. If they see a purse or other valuable item they break the window and steal the item before the victim can even react. Expensive car stereos and GPS navigational devices left in plain sight are often stolen from parked cars. Always drive with windows up and doors locked.
Travelers to Brussels should be aware that small groups of young men sometimes prey on unwary tourists, usually at night and often in Metro stations. Items such as expensive mobile phones and MP3 players are often the target. Travelers should carry only a minimum amount of cash, credit cards, and personal identification. Wearing expensive jewelry and watches is discouraged.
INFORMATION FOR VICTIMS OF CRIME: The loss or theft abroad of a U.S. passport should be reported immediately to the local police and the nearest U.S. Embassy or Consulate. If you are the victim of a crime while overseas, in addition to reporting to local police, please contact the nearest U.S. Embassy or Consulate for assistance. The Embassy/Consulate staff can, for example, assist you to find appropriate medical care, contact family members or friends and explain how funds could be transferred. Although the investigation and prosecution of the crime is solely the responsibility of local authorities, consular officers can help you to understand the local criminal justice process and to find an attorney if needed. See our information on Victims of Crime.
MEDICAL FACILITIES AND HEALTH INFORMATION: Good medical facilities are widely available in Belgium. The large university hospitals can handle almost every medical problem. Hospitals in Brussels and Flemish-speaking Flanders will probably have English-speaking staff. Hospitals in French-speaking Wallonia may not have staff members who are fluent in English, however. The Embassy Consular Section maintains a list of English-speaking doctors, which can be found on the Embassy web site at http://brussels.usembassy.gov/medical_facilities.html.
Information on vaccinations and other health precautions, such as safe food and water precautions and insect bite protection, may be obtained from the Centers for Disease Control and Prevention’s hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747) or via the CDC’s web site at http://wwwn.cdc.gov/travel/default.aspx. For information about outbreaks of infectious diseases abroad consult the World Health Organization’s (WHO) web site at http://www.who.int/en. Further health information for travelers is available at http://www.who.int/ith/en.
MEDICAL INSURANCE: The Department of State strongly urges Americans to consult with their medical insurance company prior to traveling abroad to confirm whether their policy applies overseas and whether it will cover emergency expenses such as a medical evacuation. Please see our information on medical insurance overseas.
TRAFFIC SAFETY AND ROAD CONDITIONS: While in a foreign country, U.S. citizens may encounter road conditions that differ significantly from those in the United States. The information below concerning Belgium is provided for general reference only, and may not be totally accurate in a particular location or circumstance.
Belgian urban highways are generally well built and maintained with extensive lighting systems, but rain and fog often reduce visibility. Rural roads are less likely to be illuminated at night. Belgian rules for right-of-way differ from those in the U.S., and new drivers should thoroughly understand these rules before driving in Belgium. For instance, traffic coming from the right generally has priority at uncontrolled intersections and roundabouts, even if coming from a smaller street. The maximum speed limit on Belgian highways is 120 kilometers (72 miles) per hour, but is not always posted except at Belgium’s borders and on roads leaving major airports. The maximum speed in urban areas is normally 50 km (30 miles) per hour. While Belgian authorities strictly enforce speed limits, many Belgians still drive significantly faster than the posted limit. Claims of ignorance may not prevent a significant fine for speeding, which can also lead to the vehicle’s being impounded if the driver is unable to pay the fine on the spot. Belgian police also conduct breath analysis checks for alcohol use, particularly at night and during major holidays.
Roadside assistance and information on road conditions are available in English from Touring Mobilis, tel: 0900 10280. Belgian police will also provide information on road conditions, tel: 02-642-6666. Emergency services are efficient and responsive. By phone within Belgium, for police emergencies dial 101 and for all other emergencies,112.

Please refer to our Road Safety page for more information. Visit the website of Belgium’s national tourist office at http://www.visitbelgium.com/.
AVIATION SAFETY OVERSIGHT: The U.S. Federal Aviation Administration (FAA) has assessed the Government of Belgium’s Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for oversight of Belgium’s air carrier operations. For more information, travelers may visit the FAA’s web site at http://www.faa.gov/safety/programs_initiatives/oversight/iasa
SPECIAL CIRCUMSTANCES: While most forms of monetary transactions are available (cash, credit cards), U.S. money orders cannot be negotiated in Belgium. Personal checks may only be cleared through a bank at which a person holds an account and clearance can take from two to four weeks. Banks and exchange facilities may refuse U.S. dollar denominations of $50 and $100 if they are not equipped with devices to identify counterfeit currency. Automated Teller Machines (ATMs) are widespread in Belgium and accept most U.S. ATM cards to withdraw funds. Travelers seeking to purchase Euros are more likely to find a more favorable exchange rate at banks than at money exchange facilities located at tourist locations, train stations, and airports. Please see our Customs Information.
Non-EU citizens visiting Belgium and staying in a private residence are required by Belgian law to register with local Commune authorities within three days of their arrival. Any change in visa or resident status must also be requested through Commune authorities and must be completed prior to the expiration of the current status. Given the requirements to change status in Belgium, it is nearly impossible to do so within the 90 days permitted to remain in Belgium without a visa under the Visa Waiver Program.
BUSINESS VISITOR AND EMPLOYEE REGISTRATION REQUIREMENT: Since April 1, 2007 non-Belgian employers and self-employed persons or their employees who carry out short term assignments in Belgium must declare these activities in advance.
This mandatory "Limosa" declaration applies to: (1) Employees and apprentices, who come to Belgium to execute certain temporary work and who, because of the nature of their short term assignment, are not subject to the Belgian social security system; (2) Self-employed people and self-employed apprentices who come to work in Belgium temporarily, irrespective of whether they are subject to the Belgian social security system.
Some exceptions to this general obligation exist. Certain persons may be exempted, especially for short-term assignments. For more information about the Limosa declaration, visit http://www.limosa.be.
For more information about working in Belgium, please see http://www.employment.belgium.be/home.aspx.
CRIMINAL PENALTIES: While in a foreign country, a U.S. citizen is subject to that country's laws and regulations, which sometimes differ significantly from those in the United States and may not afford the protections available to the individual under U.S. law. Penalties for breaking the law can be more severe than in the United States for similar offenses. Persons violating Belgian laws, even unknowingly, may be expelled, arrested or imprisoned. Penalties for possession, use, or trafficking in illegal drugs in Belgium are severe, and convicted offenders can expect long jail sentences and heavy fines. Engaging in sexual conduct with children or using or disseminating child pornography in a foreign country is a crime, prosecutable in the United States. Please see our information on Criminal Penalties.

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

REGISTRATION / EMBASSY LOCATION: Americans living or traveling in Belgium are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department’s travel registration web site so that they can obtain updated information on travel and security within Belgium. Americans without Internet access may register directly with the nearest U.S. Embassy or Consulate. By registering, American citizens make it easier for the Embassy or Consulate to contact them in case of emergency. The U.S. Embassy in Brussels is located at 25 Boulevard du Regent. The telephone number from the U.S. is 011-32-2-508-2111. Within Belgium, the telephone number is 02-508-2111. The Embassy’s fax number is 02-511-2725. The Consular Section’s fax number is 02-513-0409. The American Citizen Services Unit of the Consular Section is open from 1:30 to 3:30 p.m. Monday through Friday, except for American and Belgian holidays. Further information can be obtained at the Embassy’s web site at http://belgium.usembassy.gov/
* * *
This replaces the Country Specific Information for Belgium dated March 13, 2008, to update sections on Entry/Exit Requirements.

Travel News Headlines WORLD NEWS

Date: Tue 22 Oct 2019
Source: The Brussels Times [abridged, edited]

Students from the UCLouvain [Catholic University of Leuven] have received an email warning of increased cases of mumps on the campus of Sint-Lambrechts-Woluwe and in the colleges in the municipality [of Brussels-Capital Region].

This information -- widely reported in Belgium -- was confirmed by the spokesperson for the University Isabelle Decoster to Belga.

The total number of infected is currently not known as students can go to doctors across the city. Sick students are asked to stay at home.  [Byline: Jules Johnston]
====================
[HealthMap/ProMED-mail map of Belgium:
Date: Thu 24 Oct 2019
Source: Brussels Times [edited]

Two people in Belgium have been infected with _Listeria_ bacteria that lead to the death of 3 people and a miscarriage over a 2-year period in the Netherlands, a sampling by a federal health centre showed. [See ProMED-mail post Listeriosis - Europe (15): (Netherlands) fatal, WGS, cold cuts http://promedmail.org/post/20191005.6711608, which described a listeriosis outbreak that affected 20 people, 3 of whom died and one woman had a miscarriage, over the past 2 years after eating cold cuts produced by Offerman, a Netherland-based producer. - ProMED Mod.ML]

The cases in Belgium affected a 97-year-old woman and a Dutch national who recently gave birth in Antwerp [Belgium], a study by federal health research centre Sciensano confirmed. Both women were infected with the bacteria in 2018, according to the study, which compared samples of bacteria in the Netherlands with those of Belgian patients infected, HLN reports.

The centre's study comes after three people died and one woman had suffered a miscarriage in the Netherlands after eating meat contaminated with _Listeria_ over a 2-year period, which was reportedly linked to Dutch meat producer Offerman.

In Germany, 2 _Listeria_-related deaths were also reported in the central state of Hesse. [See ProMED-mail post Listeriosis - Europe (16): (Germany) fatal, WGS, meat, healthcare facilities http://promedmail.org/post/20191019.6736570, which described a listeriosis outbreak that affected 40 people, 3 of whom have died, in 12 German states between 2014 and 2019, due to _Listeria_-contaminated meat products manufactured at a processing facility in the German state of Hesse and widely distributed to more than 20 European countries. This German outbreak associated with the Hesse-based meat processing facility is unrelated to the Netherlands/Belgium outbreak associated with the Netherlands-based meat processing facility. - ProMED Mod.ML]

News of the deaths led supermarkets in Belgium to issue recalls for pre-packaged meat, a move they said at the time was precautionary. Offerman, a subsidiary of Belgian food group Ter Beke, has since been shut down in the Netherlands.

The Sciensano study could not identify the cause of the infections in Belgium, since isolated cases, unlike outbreaks, are not subject to follow-ups, Het Nieuwsblad reports.  [Byline: Gabriela Galindo]
==================
[The incriminated meat is refrigerated cold cuts that are not cooked before eating (i.e., ready-to-eat). Cold cuts are well-recognized sources for listeriosis. Even if initial contamination adds only a few _Listeria_ organisms to the food, the contamination can be significant for refrigerated foods because _L. monocytogenes_ can subsequently multiply at refrigerator temperatures to a sufficient number to cause disease. People at increased risk for disseminated listeriosis, which include pregnant women (and their new-borns), adults aged 65 years or older, and people with weakened immune systems, should avoid eating food potentially contaminated with _Listeria_. - ProMED Mod.ML]

[HealthMap/ProMED maps available at:
Date: Wed 25 Sep 2019
Source: Food Safety News (FSN) [edited]

A _Salmonella_ outbreak that sickened almost 200 people at a Belgian school was likely caused by eggs used to make a tartar sauce, according to authorities. The Agency for Care and Health (Zorg en Gezondheid) and Federal Agency for the Safety of the Food Chain (FASFC) investigation detected _Salmonella_ in the freshly prepared tartar sauce. Findings from an online survey of students and teachers also reached the same conclusion on the source.

The Agency for Care and Health had previously received information about a number of students from the school complaining of gastrointestinal illness. Since 14 Sep 2019, no new cases of illness have been reported so the Spermalie Hotel and Tourism School in Bruges [West Flanders] has been allowed to resume normal operation. About 200 students and teachers from the school became ill from 6 Sep 2019 onward. Laboratory analyses of stool samples revealed students and teachers had been affected by _Salmonella_.

The Agency for Care and Health handled the online survey part of the investigation, FASFC took samples of meals served on Tuesdays, Wednesdays, and Thursdays at the school restaurant. The samples were sent to the lab of Sciensano, the Belgian Institute for Health. The online survey showed the tartar sauce was the most likely source of the outbreak.

A total of 65 samples were sent to Sciensano and after analysis of the different dishes, _Salmonella_ was detected in the freshly prepared tartar sauce. Bacteria present in the food appeared to be the same as in the stool samples from patients.

Staff and students were asked to pay particular attention to hand hygiene and those sick were encouraged to stay at home. The kitchen of the school restaurant and all kitchens and related equipment have been cleaned and disinfected. The sale of any raw food was also suspended. Control measures have been verified by environmental sampling and no _Salmonella_ has been detected in lab analysis of these samples.

Belgium reported 2698 confirmed salmonellosis cases in 2016 compared to 3050 the year before.
===========================
[Tartar sauce (<https://en.m.wikipedia.org/wiki/Tartar_sauce>) is based on either mayonnaise (egg yolk, mustard or vinegar, bitartrate, oil) or aioli (olive oil, garlic), with certain other ingredients added. In the UK, recipes typically add to the base capers, gherkins, lemon juice, and dill. US recipes may include chopped pickles or prepared green sweet relish, capers, onions (or chives), and fresh parsley. Chopped hard-boiled eggs or olives are sometimes added, as may be Dijon mustard and cocktail onions.

Salmonellosis is often thought to be associated with cracked eggs or eggs dirty with fecal matter, a problem controlled by cleaning procedures implemented in the egg industry. It is clearly the case, however, that most of the salmonellosis outbreaks linked to eggs were associated with uncracked, disinfected grade A eggs, or foods containing such eggs. The undamaged eggs become contaminated during ovulation, and thus were contaminated with the bacteria before the eggshell was formed. To avoid this, uncooked eggs should only be used as an ingredient, if pasteurized. - ProMED Mod.LL]

[HealthMap/ProMED-mail map of Belgium:
Date: Thu, 25 Jul 2019 15:48:48 +0200

Brussels, July 25, 2019 (AFP) - Belgian meteorologists registered record high temperatures on Thursday as western Europe sweltered under a multi-day heatwave that has disrupted transport and triggered safety warnings.   David Dehenauw, chief forecaster at the Royal Meteorological Institute, said a high of 40.6 degrees Celsius (105 Fahrenheit) had been recorded on the Kleine-Brogel military base, in northeastern Belgium.

"New Belgian national record: 40.6 in Kleine Brogel now and it's not finished yet! Unbelievable!" Dehenauw said on Twitter.   The temperature in Belgium exceeded 40 degrees for the second day in a row after it reached 40.2 degrees in Liege, the previous record, on Wednesday.  Thursday's new record is likely to be temporary as temperatures continued to rise in the middle of the afternoon.

In Brussels, the country's reference station, it was a record 38.8 degrees at 15:00 (1300 GMT), compared to 36.8 degrees an hour earlier in Europe's unofficial capital.  Since the beginning of official temperature records in 1833, it has never been so hot.    The previous record of 36.6 was set on in June, 1947.
Date: Fri 17 May 2019
Source: [in French, trans. Corr.SB, edited]

An additional patient, the 19th, was admitted to the hospital in Flanders, [East Flanders province] suffering from legionellosis.

This case comes in addition to the 18 others who have been exposed to _Legionella_ bacteria in the Evergem area [East Flanders], right next to Ghent, and who developed legionnaires' disease, a lung disease that is not transmitted from human to human.

Of the total of 19 patients, 2 men died: one Monday night [20 May 2019] and the other [Wed 22 May 2019], in 2 different Ghent hospitals.

The exact source of _Legionella_ causing the [legionellosis] outbreak in the region has not yet been located. The bacterium normally contaminates people via inhalation of water vapor or micro-droplets, but many exposed individuals do not develop disease.
========================
[This news report above adds 3 cases since the last report posted by ProMED-mail (Legionellosis - Europe (01): Belgium (OV) http://promedmail.org/post/20190514.6468996) for a total now of 19 cases. At the time of the initial report, cooling towers in the vicinity of the Ghent Canal were suspected to be the source of this outbreak. The Ghent Canal separates the town of Evergem, where 7 cases occurred, from the town of Oostakker, where 2 cases occurred. The Ghent-Terneuzen Canal, links Ghent in Belgium to the port of Terneuzen in the Netherlands, thereby providing Ghent with access to the sea (<https://en.wikipedia.org/wiki/Ghent-Terneuzen_Canal>).

A map showing the location of Evergem and this area can be found at
<https://goo.gl/maps/y9Z1tQzbKJa1NkSm7>.

The news report above fails to state where the new cases reside, if _Legionella_ genotypes of the clinical isolates match each other, which would indicate a common source outbreak, and the results of environmental testing for _Legionella_. We await the results of the ongoing investigation. - ProMED Mod.ML]

[HealthMap/ProMED-mail map of Belgium:
More ...

Saint Pierre and Miquelon

Travel News Headlines WORLD NEWS

UK Department of Foreign Affairs 18/09/2002 10:15:53 Most visits to St Pierre and Miquelon are trouble-free. ENTRY REQUIREMENTS ************************************************* St Pierre and Miquelon is an Collectivité territoriale of France. UK citizens with a valid passport do not need a visa to enter St Pierre and Miquelon. Visitors intending to work or to remain in St Pierre and Miquelon for more than three months should apply for a residence permit at the local Préfecture. GENERAL ************************************************* The E111 medical form does not provide any health cover in St Pierre and Miquelon. It is recommended therefore that all visitors take out comprehensive travel and medical insurance. CONTACT DETAILS ************************************************* There is no resident British Diplomatic Mission in St Pierre and Miquelon. Routine consular matters are covered by the British Consulate-General in Paris, 35 rue du Faubourg St Honore, 75383 Paris Cedex 08; (tel: +33 1 44 51 31 00; fax: +33 1 44 51 31 27). In case of real emergency (death or serious accident), the British High Commission in Ottawa may be able to provide some assistance; 80 Elgin Street, Ottawa, Ontario KIP 5K7 (tel: +1 613 237 1530; fax: +1 613 237 6537).
More ...

Mongolia

Mongolia US Consular Information Sheet
November 21, 2008
COUNTRY DESCRIPTION:
Mongolia is a vast country of mountains, lakes, deserts and grasslands approximately the size of Alaska.
It peacefully abandoned its communist system in 199
and has been successfully making the transition to a parliamentary democracy.
Economic reforms continue, although the country’s development will depend on considerable infrastructure investment, particularly in the mining, energy, transportation, and communication sectors.
Travelers to Mongolia should be aware that shortcomings in these areas might have an impact on travel plans.
Read the Department of State Background Notes on Mongolia for additional information.

ENTRY/EXIT REQUIREMENTS:
A valid passport is required for American visitors.
No visa is required for Americans visiting for fewer than 90 days; however, visitors planning to stay in Mongolia for more than 30 days are required to register with the Office of Immigration, Naturalization and Foreign Citizens in Ulaanbaatar within the first seven days of arrival.
American visitors who fail to register and who stay longer than 30 days, even for reasons beyond their control, will be stopped at departure, temporarily denied exit, and fined.
It is recommended that visitors who will be in Mongolia beyond 30 days register with the Office of
Immigration, Naturalization and Foreign Citizens within the first seven days of their arrival.

Americans planning to work or study in Mongolia should apply for a visa at a Mongolian embassy or consulate outside of Mongolia.
Failure to do so may result in authorities denying registration, levying a fine, and requiring that the visitor leave the country.
Travelers arriving or departing Mongolia through China or Russia should be aware of Chinese and Russian visa regulations (transiting twice will require a double- or multiple-entry visa) and note that some land-entry points have varying days and hours of operation. Many small land border posts do not operate on a fixed schedule.
Travelers need to check with immigration authorities to make certain the post they intend to use will be open when they want to enter. Travelers planning travel to Russia should get visas prior to arriving in Mongolia, because they are difficult to obtain at the Russian Embassy in Mongolia. For more information on these requirements, see the Country Specific Information for Russia and China.

Travelers without Mongolian visas are subject to an exit tax payable either in U.S. dollars or Mongolian Tugrugs upon departure.
American citizen visitors to Mongolia do not require a visa if they stay less than 30 days and no fee is payable if they depart within the 30 day period.
If they stay longer without having registered with immigration, a penalty fee will be assessed at time of departure.
Travelers should inquire whether the exit tax is included with the price of the airline ticket at the time of purchase. In an effort to prevent international child abduction, many governments have initiated procedures at entry/exit points.
These often include requiring documentary evidence of relationship and permission for the child’s travel from the parent(s) or legal guardian if not present.
Having such documentation on hand, even if not required, may facilitate entry/departure.

Visit the Embassy of Mongolia web site at http://www.mongolianembassy.us for the most current visa information.
Travelers can also contact the Embassy of Mongolia at 2833 M Street NW, Washington, DC
20007, telephone (202) 333-7117 for the most current visa information.

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

SAFETY AND SECURITY:
There have been no significant acts of terrorism or extremism in Mongolia. There are no regions of instability in the country.
U.S. citizens are advised to avoid all protests, including political protests, and street demonstrations that occur occasionally in Ulaanbaatar, as the demonstrations may become violent.

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

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

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

CRIME:
Over the past few years there has been a significant rise in street crime in Mongolia, particularly in Ulaanbaatar, the capital.
Violent crime, particularly aggravated assault, is increasing, and it is not advisable to walk alone through the city after dark.
The most common crimes against foreigners are pick pocketing and bag snatching.
There are reports of organized groups operating in open areas, usually after dark, who surround, grab, and choke an individual in order to search the victim’s pockets.
Thieves have also sliced victims’ clothing in attempts to reach wallets, cell phones and other valuables.
U.S. citizens who detect pick pocket attempts should not confront the thieves, as they may become violent.
Caution is advised when using public transportation and in crowded public areas, such as open-air markets, the Central Post Office and the Gandan Monastery.
Crime rises sharply before, during and after the Naadam Summer Festival in July and throughout the summer tourist season, as well as during and after Tsagaan Sar, the Winter Festival, in January or February.

Travelers should be extremely cautious at these specific locations:
Chinggis Khan International Airport in Ulaanbaatar: tourists arriving at and departing from this airport are frequently targeted for robbery and pick pocketing by organized groups.
The State Department Store:
tourists are targeted by organized pick pocket gangs at the entries/exits/elevators and the area surrounding the store.
Naran Tuul Covered Market:
Organized criminal groups look for and target foreigners for robbery and pick pocketing.
INFORMATION FOR VICTIMS OF CRIME:
The loss or theft abroad of a U.S. passport should be reported immediately to the local police and the nearest U.S. embassy or consulate.
If you are the victim of a crime while overseas, in addition to reporting to local police, please contact the nearest U.S. embassy or consulate for assistance.
The embassy/consulate staff can, for example, assist you to find appropriate medical care, contact family members or friends and explain how funds could be transferred.
Although the investigation and prosecution of the crime is solely the responsibility of local authorities, consular officers can help you to understand the local criminal justice process and to find an attorney if needed.
American victims of crime in Mongolia should be prepared to hire their own translators and lawyers if they intend to pursue a criminal complaint against a Mongolian.

The local equivalent to the “911” emergency line in Mongolia are 102 to contact the police department and 103 for a medical emergency.

See our information on Victims of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION:
Medical facilities in Mongolia are very limited and do not meet most Western standards, especially for emergency health care requirements.
Many brand-name Western medicines are unavailable.
Ulaanbaatar, the capital, has the majority of medical facilities inside the country; outside of Ulaanbaatar, medical facilities and treatment are extremely limited or non-existent.
Specialized emergency care for infants and the elderly is not available.
Infectious diseases, such as plague, meningococcal meningitis, and tuberculosis, are present at various times of the year. Sanitation in some restaurants is inadequate, particularly outside of Ulaanbaatar.
Stomach illnesses are frequent.
Bottled water and other routine precautions are advisable.

Serious medical problems requiring hospitalization and/or medical evacuation to the United States can cost tens of thousands of dollars.
A June 2005 medical evacuation from Ulaanbaatar to Seoul, Korea, cost the patient $87,000.
Doctors and hospitals usually expect immediate payment in cash for health services.
Medical evacuation companies will not initiate an evacuation without a fee guarantee beforehand and in full.
Please see Medical Information for Americans traveling abroad.

Local hospitals generally do not contact the Embassy about ill or injured Americans in their care; hospitalized American citizens who need Consular assistance from the Embassy should ask the doctor or hospital to contact the U.S. Embassy in Ulaanbaatar.
For more information, please contact the U.S. Embassy in Ulaanbaatar, which has a list of medical facilities available to foreigners (also available on the U.S. Embassy web site at http://mongolia.usembassy.gov/) or the Centers for Disease Control and Prevention’s international traveler’s hotline (see below).
The U.S. Department of State is unaware of any HIV/AIDS entry restrictions for visitors to or foreign residents of Mongolia.

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

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

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

Driving in Ulaanbaatar can be extremely difficult due to poorly maintained streets, malfunctioning traffic lights, inadequate street lighting, a shortage of traffic signs, and undisciplined pedestrians.
There has been a dramatic increase in the number of vehicles on the roads in recent years, but the knowledge and skills of the driving population have not kept pace with the growth in the number of automobiles on the streets. There are many metered taxis in Ulaanbaatar.
There are a few car rental companies, but safety and maintenance standards are uncertain, and rental vehicles should be utilized with caution.
Cars with drivers can be obtained from local tourist companies.
Public transportation within the capital is extensive, cheap, and generally reliable, but it is also extremely crowded (see Information on Crime above), with the result that pickpockets often victimize foreigners.
For specific information concerning Mongolian drivers permits, vehicle inspection, road tax, and mandatory insurance, contact the Embassy of Mongolia at: 2833 M Street NW, Washington, DC
20007, telephone (202) 333-7117.

Please refer to our Road Safety page for more information.
Visit the web site of Mongolia’s national tourist office and national authority responsible for road safety at http://www.mongolianembassy.us/default.php.

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

The U.S. Embassy prohibits U.S. government personnel from using the domestic services of Mongolian International Air Transport (MIAT) for official travel because of uncertainties regarding service and maintenance schedules, aircraft certification and insurance status.
This prohibition does not extend to MIAT’s international flights or to the domestic flights of other carriers.
SPECIAL CIRCUMSTANCES:
Traveler’s checks in U.S. dollars are accepted at some hotels and may be converted to dollars or Tugrugs at several banks.
Credit cards can be used at a variety of hotels, restaurants, and shops in Ulaanbaatar.
Outside of the capital, travelers should have cash.
Cash advances against credit cards are available at some commercial banks such as Trade and Development Bank, Golomt Bank, Khan Bank, and Xac Bank.
International bank wire transfers are also possible.
There are a handful of VISA and Maestro/Cirrus ATM machines in Ulaanbaatar, but they do not always function and are not reliable.
ATM machines do not exist outside the capital.

U.S. consular offiers may not always receive timely notification of the detention or arrest of a U.S. citizen, particularly outside of Ulaanbaatar.
American citizens are encouraged to carry a copy of their passport with them at all times, so that, if questioned by local officials, evidence of identity and citizenship are readily available.
Severe fuel shortages and problems with central heating and electrical systems may cause seriously reduced heating levels and power outages in Ulaanbaatar and other cities during the winter.
Smaller towns in the countryside may have no heat or electricity at all.
The Embassy advises all American residents in Mongolia to be prepared to depart if there is a complete energy failure.
General information about natural disaster preparedness is available via the Internet from the U.S. Federal Emergency Management Agency (FEMA) at http://www.fema.gov/.

Mongolian customs authorities enforce strict regulations concerning import and export of items such as firearms, ammunition, and antiquities.
Import of firearms or ammunition requires prior approval from the Government of Mongolia.
Export of antiquities requires a special customs clearance certificate issued by authorized antique shops at the time of purchase. For additional information contact the Embassy of Mongolia at: 2833 M Street NW, Washington, DC
20007, telephone: (202) 333-7117.
Please see our Customs Information.

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

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

REGISTRATION / EMBASSY LOCATION:
Americans living or traveling in Mongolia are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department’s travel registration web site so that they can obtain updated information on travel and security within Mongolia.
Americans without Internet access may register directly with the nearest U.S. Embassy or Consulate.
By registering, American citizens make it easier for the Embassy or Consulate to contact them in case of emergency.
The U.S. Embassy is located at: at Micro Region 11, Big Ring Road, Ulaanbaatar.
The telephone number is (976) 11-329-095, the Consular Section fax number is (976) 11-353-788, and the Embassy’s web site is http://mongolia.usembassy.gov/.
The Consular Section can be emailed directly at cons@usembassy.mn.
The Consular Section is open for American Citizens Services Monday and Thursday from 1-3 p.m., except on U.S. and Mongolian holidays.
*

*

*
This replaces the Country Specific Information for Mongolia dated September 22, 2008 to update the sections on Safety and Security, and Aviation Safety Oversight.

Travel News Headlines WORLD NEWS

Date: Mon, 6 May 2019 17:00:57 +0200

Ulaanbaatar, May 6, 2019 (AFP) - A Mongolian couple has died of the bubonic plague after eating raw marmot kidney, triggering a quarantine that left tourists stranded in a remote region for days, officials said Monday.

The ethnic Kazakh couple died on May 1 in Mongolia's westernmost province of Bayan-Ulgii, which borders Russia and China.   "The two dead were local people," said local governor Aipiin Gilimkhaan. "There were no cases reported after them."   A six-day quarantine was declared on residents in the region, preventing nine tourists from Russia, Germany and Switzerland from leaving.   "We are all fine. No one is ill," said a German tourist named Teresa, who did not want to give her last name.

Sebastian Pique, a 24-year-old American Peace Corps volunteer who has lived in the region for two years, said he and the tourists were invited to the governor's office on Friday to be informed about the situation.    "After the quarantine (was announced) not many people, even locals, were in the streets for fear of catching the disease," Pique told AFP.   The quarantine was expected to be lifted late Monday after no other cases of the plague were reported.   Authorities have warned people against eating raw marmot meat because it can carry Yersinia pestis, the plague germ.

At least one person dies of the plague every year in Mongolia, mostly due to consuming such meat, according to the National Center for Zoonotic Disease.   Some people ignore the warnings as they believe that consuming the innards of the large rodent is good for their health.   The Black Death wiped out millions of people in the Middle Ages but cases are now very rare.    Its most common form is bubonic, which is spread by fleas and causes swelling of the lymph node. The more virulent form is pneumonic plague, which can be transmitted between humans through coughing.
Date: Fri 3 May 2019
Source: Mirror [edited]

A married couple has died, leaving their 4 children orphaned after an outbreak of the bubonic plague, which sparked plane panic.

The man, 38, named only as Citizen T, and his pregnant wife, 37, are thought to have fallen ill after hunting and eating contaminated marmot, a large species of squirrel, in Mongolia. The man died on 27 Apr [2019], and the woman died 3 days later, reports the Siberian Times.

The highly contagious bacterial disease is spread by fleas living on wild rodents. It has sparked fears of an outbreak, and urgent measures and precautions have been put in place to stop the infection spreading. Around 158 people have been put under intensive medical supervision after coming into contact directly or indirectly with the couple.

There were dramatic scenes when a flight from Bayan, Ulgii and Khovd in Mongolia -- the area where the couple fell ill -- was met by workers in white anti-contamination suits as [the plane] landed in the country's capital of Ulaanbaatar. Eleven passengers from the west of the country were held at the airport and sent immediately for hospital checks. Others were examined in a special facility at the airport. Paramedics in anti-contamination boarded the flight as soon as it landed.

Some frontier checkpoints with Russia are reported to have been closed, leading to foreign tourists being stranded in Mongolia.

Dr N. Tsogbadrakh, director of National Centre for Zoonotic Dermatology and Medicine, said, "Despite the fact that eating marmots is banned, Citizen T hunted marmot. He ate the meat and gave it to his wife, and they died because the plague affected his stomach. Four children are orphaned."

Bubonic plague is believed to be the cause of the Black Death that spread through Asia, Europe, and Africa in the 14th century, killing an estimated 50 million people.

The plague is a bacterial disease that is spread by fleas living on wild rodents such as marmots. The disease can kill an adult in less than 24 hours if not treated in time, according to the World Health Organisation.  [Byline: Will Stewart and Amber Hicks]
========================
[HealthMap/ProMED-mail map:
Bayan-Olgiy Aymag, Bayan-Olgiy, Mongolia:
Date: Fri, 15 Mar 2019 02:55:29 +0100
By Khaliun Bayartsogt

Bornuur, Mongolia, March 15, 2019 (AFP) - In the world's coldest capital, many burn coal and plastic just to survive temperatures as low as minus 40 degrees -- but warmth comes at a price: deadly pollution makes Ulaanbataar's air too toxic for children to breathe, leaving parents little choice but to evacuate them to the countryside.   This exodus is a stark warning of the future for urban areas in much of Asia, where scenes of citizens in anti-pollution masks against a backdrop of brown skies are becoming routine, rather than apocalyptic.   Ulaanbaatar is one of the most polluted cities on the planet, alongside New Delhi, Dhaka, Kabul, and Beijing. It regularly exceeds World Health Organisation recommendations for air quality even as experts warn of disastrous consequences, particularly for children, including stunted development, chronic illness, and in some cases death.

Erdene-Bat Naranchimeg watched helplessly as her daughter Amina battled illness virtually from birth, her immune system handicapped by the smog-choked air in Mongolia's capital.   "We would constantly be in and out of the hospital," Naranchimeg told AFP, adding that Amina contracted pneumonia twice at the age of two, requiring several rounds of antibiotics.   This is not a unique case in a city where winter temperatures plunge towards uninhabitable, particularly in the districts that rural workers moved to in search of a better life.   Here row upon row of the traditional tents -- known as gers -- are warmed by coal, or any other flammable material available. The resulting thick black smoke shoots out in plumes, blanketing surrounding areas in a film of smog that makes visibility so poor it can be hard to see even a few metres ahead.   Hospitals are packed and young children are vulnerable, common colds can quickly escalate into life-threatening illness.

- Birth defects -
The situation was so bad that doctors told Naranchimeg the only solution was to send her little girl to the clean air of the countryside.   Now aged five, Amina is thriving. She lives with her grandparents in Bornuur Sum, a village 135 kilometres away from the capital.   "She hasn't been sick since she started living here," said Naranchimeg, who makes the three-hour round trip to see Amina every week.   "It was very difficult in the first few months," she said. "We used to cry when we talked on the phone."   But like many parents in Ulaanbaatar, she felt the move was the only way to protect her child.

The levels of PM2.5 -- tiny and harmful particles -- in Ulaanbaatar reached 3,320 in January, 133 times what the World Health Organisation (WHO) considers safe.   The effects are terrible for adults but children are even more at risk, in part because they breathe faster, taking in more air and pollutants.   As they are smaller, children are also closer to the ground, where some pollutants concentrate, and their still-developing lungs, brains, and other key organs are more vulnerable to damage.   Effects to prolonged exposure range from persistent infections and asthma to slowed lung and brain development.   The risks apply in utero, too, because gases and fine particles can enter a mother's bloodstream and placenta, causing miscarriage, birth defects and low birth weights, which can also affect a child for the rest of their lives.   Researchers are now investigating whether pollution, like exposure to tobacco smoke, has health effects that could even be passed down to the next generation.

- 'Terribly afraid' -
Buyan-Ulzii Badamkhand and her husband need to stay in capital for work, but they have decided to send their two-year-old son Temuulen more than 1,000 kilometres away.   The 35-year-old mother-of-three struggled with the decision, even moving from one ger district to another in the hope her son's health would improve.   But successive bouts of illness, including bronchitis that lasted a whole year, finally convinced her to send Temuulen to his grandparents.   Hours after he arrived, she called her mother-in-law to discuss her son's medicines.   "But my mother-in-law asked me 'does he still need medicine? He isn't coughing anymore," she said.   "I tell myself that it doesn't matter that I miss him and who raises him, as long as he is healthy, I am content."   Respiratory problems are the most obvious effect of air pollution, but research suggests dirty air can also put children at greater risk for diabetes and cardiovascular disease later in life.   And the WHO links it to leukaemia and behavioural disorders.   When air pollution peaks in winter, Ulaanbaatar's playgrounds empty and those who are able to are increasingly travelling abroad to wait out the smog.

In desperation, Luvsangombo Chinchuluun, a civil society activist, borrowed money to take her granddaughter to Thailand for all of January.   "We can't let her play outside (in Ulaanbaatar) because of the air pollution, so we decided to leave," she said.   The persistent smog has caused tensions in the city, with those living in wealthier areas blaming the ger residents for the pollution and even calling for the tent districts to be cleared.   But the ger residents say coal is all they can afford.   "People come to the capital because they need sustainable income," said Dorjdagva Adiyasuren, a 54-year-old mother of six.   "It's not their fault," she added.    In a bid to tackle the problem, the local government banned domestic migration in 2017, and a ban on burning coal comes into force from May.   But it is unclear whether the moves will be enough to make a difference.   For Naranchimeg, the problems are serious enough to make her consider whether she wants more children.    She explained: "Now, I am terribly afraid of to give birth again. It is risky to carry a child and what will happen to the child after it is born in this amount of pollution?"
Date: Tue 19 Feb 2019
Source: AFP [edited]

Mongolian authorities have temporarily closed all KFC restaurants in the country after more than 200 customers suffered food poisoning symptoms, and dozens were hospitalized.

The 1st cases emerged earlier this month [February 2019], with 16 people showing symptoms of food poisoning, including diarrhoea, vomiting and high fever after eating at the fried chicken franchise. Ulaanbaatar's Metropolitan Professional Inspection Department said 247 similar cases have been reported, and 42 people have been hospitalized.

The department decided to shut down the country's 11 KFC restaurants, all based in the capital, while it investigates what happened.

A preliminary investigation found that 35 employees at a restaurant were not thoroughly vetted to handle food, with most of them having blank medical examination reports, which is illegal. The restaurant also lacked internal hygiene management.

A bacterium known as _Klebsiella_ spp was detected in water at the restaurant. Traces of _E. coli_ were also found in a soda machine, and 4 people contracted _Shigella, -- which causes diarrhoea and fever -- after coming into contact with KFC staff.
=========================
[The aetiology is not directly stated, but if contacts of the cluster have been diagnosed with shigellosis, the primary illness may well be the same.

Ulaanbaatar, formerly anglicized as Ulan Bator (literally "Red Hero"), is the capital and largest city of Mongolia. The city is not part of any aimag (province) (<https://en.wikipedia.org/wiki/Ulaanbaatar>). - ProMED Mod.LL]

[HealthMap/ProMED map available at:
Ulan Bator, Ulaanbaatar, Mongolia:
Date: Tue, 19 Feb 2019 11:40:36 +0100

Ulaanbaatar, Feb 19, 2019 (AFP) - Mongolian authorities have temporarily closed all KFC restaurants in the country after more than 200 customers suffered food poisoning symptoms and dozens were hospitalised.   The first cases emerged earlier this month, with 16 people showing symptoms of food poisoning, including diarrhoea, vomiting and high fever after eating at the fried chicken franchise.   Ulaanbaatar's Metropolitan Professional Inspection Department said 247 similar cases have been reported and 42 people have been hospitalised.   The department decided to shut down the country's 11 KFC restaurants -- all based in the capital -- while it investigates what happened.

A preliminary investigation found that 35 employees at a restaurant were not thoroughly vetted to handle food, with most of them having blank medical examination reports, which is illegal. The restaurant also lacked internal hygiene management.   A strong bacteria known as Klebsiella spp was detected in water at the restaurant. Traces of E-coli were also found in a soda machine, and four people contracted the Shigella germ -- which causes diarrhoea and fever -- after coming into contact with KFC staff.
More ...

Saint Lucia

St. Lucia US Consular Information Sheet
April 02, 2008
COUNTRY DESCRIPTION:
St. Lucia is an English-speaking, developing Caribbean island nation.
Tourist facilities are widely available.
Read the Department of State Background No
es on St. Lucia for additional information.

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

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

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

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

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

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

CRIME:
In 2006, there were five reported incidents of U.S. citizen visitors to St. Lucia staying in boutique hotels in rural areas being robbed at gunpoint in their rooms; some of the victims were assaulted and one was raped.
In September 2007, a U.S. citizen was robbed in her room at a resort hotel near Castries by armed men.
While authorities detained suspects in some of the cases, no one has been prosecuted.
Efforts by the Saint Lucian authorities to improve public safety on the island are ongoing.
Visitors should inquire about their hotel’s security arrangements before making reservations.
Valuables left unattended on beaches and in rental cars are vulnerable to theft.
Visitors should use caution, especially at night and in lightly frequented areas.

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

See our information on Victims of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION:
Medical care is limited.
There are two public hospitals and one private hospital in St. Lucia, neither of which provide the same level of care found in an American hospital.
The main hospital is Victoria Hospital (Telephone (758) 452-2421).
There is no hyperbaric chamber; divers requiring treatment for decompression illness must be evacuated from the island.
Serious medical problems requiring hospitalization and/or medical evacuation to the United States can cost thousands of dollars.
Doctors and hospitals often expect immediate cash payment for health services.

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

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

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

Vehicles travel on the left side of the road in St. Lucia.
Roads are reasonably well paved but poorly marked, narrow and winding, with steep inclines/declines throughout the island.
There are few guardrails in areas that have precipitous drop-offs from the road.
In spite of these conditions, drivers often travel at excessive speed, and accidents are common.
St. Lucia is served by privately owned and operated mini-buses, plying licensed designated routes.
While most of these services operate only on weekdays during daylight hours, some may operate at night and on weekends and holidays.
Taxis are available at generally reasonable rates, but tourists are vulnerable to being overcharged.
When using minibus or taxi services, travelers should agree to a fare ahead of time. When hiring a service at night, travelers should take precautions such as having their hotel call a reputable company for service.

Please refer to our Road Safety page for more information.
Visit the web site of the country’s national tourist office and national authority responsible for road safety at http://www.stlucia.org/
AVIATION SAFETY OVERSIGHT:
The U.S. Federal Aviation Administration (FAA) has assessed the Government of St. Lucia’s Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for oversight of St. Lucia’s air carrier operations.
For more information, travelers may visit the FAA’s web site at http://www.faa.gov/safety/programs_initiatives/oversight/iasa.

SPECIAL CIRCUMSTANCES:
There is no U.S. Embassy or Consulate on St. Lucia.
The U.S. Embassy in Bridgetown, Barbados is responsible for consular issues on St. Lucia, including American citizen services.
U.S. citizens are encouraged to carry a copy of their U.S. passports with them at all times, so that, if questioned by local officials, proof of identity and U.S. citizenship is readily available.
Please see Customs Information.

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

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

REGISTRATION / EMBASSY LOCATION:
Americans living or traveling in St. Lucia are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department's travel registration web site , and to obtain updated information on travel and security within St. Lucia.
Americans without Internet access may register directly with the nearest U.S. Embassy or Consulate.
By registering, American citizens make it easier for the Embassy or Consulate to contact them in case of emergency.
The U.S. Embassy is located in Barbados in the Wildey Business Park, Wildey, St Michael, telephone 1-246-436-4950, web site http://barbados.usembassy.gov/.
The telephone number for the Consular Section is 1-246-431-0225.
The Consular Section fax number is 1-246-431-0179.
Hours of operation are 8:30 a.m. to 4:00 p.m. Monday-Friday, except Barbados and U.S. holidays.
*

*

*
This replaces the Country Specific Information for St. Lucia dated June 6, 2007, to update sections on Entry/Exit Requirements, Safety and Security, Crime, and Medical Facilities and Health Information.

Travel News Headlines WORLD NEWS

Date: Sat 10 Aug 2019
Source: Coherent Magazine [abridged, edited]

Off the Caribbean islands, the measles-stricken cruise ship, reportedly owned by the Church of Scientology, has been quarantined. A female crew member has been confirmed as a measles case, causing the ship to quarantine since 29 Apr 2019. According to reports, over 300 passengers are on board. According to Church of Scientology's website, the vessel is 440 ft [134 m] long and named Freewinds; [the vessel] hosts religious retreats ministering the most advanced level of spiritual counselling in the Scientology religion. The ship has been quarantined in a port in the Caribbean Island's capital since the officials discovered infected patients.

St. Lucia's chief medical officer Dr. Merlene Fredicks-James said, "Because of the risk of potential infection, not just from the confirmed measles case but from other persons who may be on the boat at the time, we thought it prudent to make a decision not to allow anyone to disembark." St. Lucia was declared measles free since 2016, which means it has been free from local measles transmission as it was last reported in 1991. However, health officials, there is extremely [caution] over travellers importing highly infectious reporters.

"Due to the high intensity of international travel related to the large tourism sector, the Caribbean region remains at high risk for the importation of measles and rubella cases," said Dr. C. James Hospedales, executive director of the Caribbean Public Health Agency.

The measles outbreak is not restricted to St. Lucia; the World Health Organization, [in] April 2019, reported a 300% increase in global measles cases. Moreover, the US has currently 700 confirmed cases of measles in 2019, the highest number of cases since 1994. A lot of health officials around the world are blaming the hesitance toward the vaccination for this outbreak.

The major cause behind the measles outbreak is hesitance toward vaccination and misinformation spread about its efficacy.  [Byline: Sagar Jagtap]
Date: Fri, 3 May 2019 17:56:40 +0200

Castries, Saint Lucia, May 3, 2019 (AFP) - A cruise ship owned by the Church of Scientology that was quarantined in St Lucia for two days because of a measles case has left the Caribbean island and was headed toward Curacao on Friday, maritime tracking services said.   The Freewinds left the port capital Castries on Thursday at 11:15pm (0315 GMT Friday) and was cruising toward Willemstad in Curacao, a distance it previously covered in two days, according to myshiptracking.com and cruisin.me.

A spokeswoman for St Lucia's health ministry confirmed that the ship had left the island. The Church of Scientology says the 440-foot (134-meter) vessel is used for religious retreats and is normally based in Curacao.   The vessel had arrived in St Lucia from Curacao on Tuesday, when it was placed under quarantine by health authorities because of a measles patient -- a female crew member, according to Merlene Fredericks-James, St Lucia's chief medical officer.

Resurgence of the once-eradicated, highly-contagious disease is linked to the growing anti-vaccine movement in richer nations, which the World Health Organization (WHO) has identified as a major global health threat.   There were about 300 people aboard the ship, according to Saint Lucia authorities, which said they provided 100 doses of measles vaccine at no cost.   The church, founded by science fiction writer L Ron Hubbard in 1953, did not respond to requests for comment.   Its teachings do not directly oppose vaccination, but followers consider illness a sign of personal failing and generally eschew medical interventions.
Date: Thu 2 May 2019
Source: Reuters [abridged, edited]

A cruise ship quarantined for a reported case of measles left the Caribbean island of St. Lucia late on Thu [2 May 2019] after health officials provided 100 doses of vaccine to the ship, media reports said.

The Church of Scientology cruise ship was confined in port this week by island health officials after the highly contagious disease was detected on board.

CNN reported the ship had left St. Lucia, and online ship traffic data showed that the vessel was underway and headed for the island of Curacao.

One case of measles had been confirmed on the ship docked in port near the capital of Castries since Tuesday [30 Apr 2019], Dr. Merlene Frederick-James, St. Lucia's chief medical officer, said in a video statement.

"The confirmed case as well as other crew members are presently stable, but remain under surveillance by the ship's doctor," she said, noting that the incubation period of measles is 10-12 days before symptoms appear.

NBC News reported that nearly 300 passengers and crew were aboard the vessel, with one female crew member diagnosed with measles.
========================
[Also see
- Rapp. Mary Marshall.

According to the church's website, Scientologists use prescription drugs and are treated by medical doctors, but the church has not expressed a specific position on vaccinations. In a statement to The Hollywood Reporter in 2016, the church said it "takes no position one way or the other on this issue," despite several high-profile celebrities in the church speaking out against vaccines. - Mod.LK]

Update on cruise ship:
Date: 4 May 2019
Source: USA Today [2019]

Authorities worry that people aboard the ship might have been exposed after a female crew member was diagnosed with measles after coming back from Europe.

Authorities in Curacao boarded a ship that arrived in the Dutch Caribbean island under quarantine, to start vaccinating people to prevent a measles outbreak.

Health officials said only those who already have been vaccinated or have previously had measles will be free to leave the 440-foot (134-meter) ship, Freewinds, which reportedly belongs to the Church of Scientology.

Curacao epidemiologist Dr. Izzy Gerstenbluth told The Associated Press that a small team is assessing more than 300 people aboard the ship, and that the process might take more than a day.
Date: Wed 1 Nov 2017
Source: St Lucia Times [edited]

The Ministry of Health and Wellness has noted a reported increase in the cases of leptospirosis. Though increases in the number cases of leptospirosis is not unusual after periods of heavy rains or flooding it, remains an issue of concern to health authorities.  Leptospirosis is a disease caused by a bacterium, which can be found in some animals, which include rats, cattle, pigs, horses, and dogs. Persons can become ill if they are in contact with urine, water, food, or soil through breaks in the skin, mouth, eyes, or nose.

Symptoms can range from a mild flu-like illness with high fever, chills, headache, muscle pains, red eye, sore throat, and occasionally rash, which may worsen with time. In the more severe phase the disease can affect the liver causing jaundice (which is dark urine and the yellowing of the white part of the eye and the skin), and anaemia. If left untreated the disease can affect organs such as the brain, kidneys, lungs, and other internal organs. In some instances this may result in death.

This condition can be treated effectively with antibiotics if diagnosed on time. Seeking medical care early when these symptoms are noticed can prevent the disease from worsening.

Persons at greatest risk of getting leptospirosis are farmers and agricultural workers, sanitation workers, and sewer workers. However, anyone exposed to rat contaminated water and soil is also at risk of contracting the disease. The Ministry of Health has an established Rodent Reduction Programme, which will be further enhanced to respond to the current increase in leptospirosis. The ministry will also be working with a number of agencies including Ministry of Agriculture, farmer organizations and local government in order to heighten awareness of the disease to persons most at risk of contracting the disease.

The Ministry of Health advises all to take the following measures to reduce the risk of becoming ill with leptospirosis: wear protective clothing, shoes, gloves to avoid coming into contact with contaminated surfaces, soil, water source, or food; avoid contact with surfaces and water sources that may be contaminated with rat urine; keep your home and surroundings free of garbage; avoid leaving food where rats can get to it; keep food in covered containers; cover opened wounds properly; and visit your nearest health facility if there is any suspicion you might have been exposed to leptospirosis.

For further information, please contact the acting National Epidemiologist, Dr Gemma Chery, at telephone numbers 468-5325 and 285-4773.
==================
[Saint Lucia, with a population of 165,595 residents in the 2010 census, is a sovereign island country in the Windward Island chain (Dominica, Martinique, Saint Lucia, Saint Vincent and the Grenadines, and Grenada) that forms the eastern Caribbean Sea boundary with the Atlantic Ocean; the capital of St Lucia is Castries (<https://en.wikipedia.org/wiki/Saint_Lucia>).

A map of the island can be seen at
<http://www.geographicguide.com/america-maps/images/political-saint-lucia.jpg>.

The Windward Islands are the southern islands of the Lesser Antilles, within the West Indies, between the Leeward Islands to the north and Trinidad & Tobago to the south and west of Barbados.

A map of the Caribbean Islands can be found at
<https://en.wikipedia.org/wiki/Windward_Islands#/media/File:Caribbean_general_map.png>.

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.

Hurricane Maria reached Category 5 strength on 18 Sep 2017 upon making landfall on Dominica, 172 km (107 mi) to the north of St Lucia, compounding recovery efforts in the areas of the Leeward Islands already struck by Hurricane Irma just 2 weeks prior (<https://en.wikipedia.org/wiki/Hurricane_Maria>). - ProMED Mod.ML]

[A HealthMap/ProMED-mail map can be accessed at:
1 Sep 2014: (SNO )
A ProMED-mail post
<http://www.promedmail.org>

The Ministry of Health has activated an EVD medical team at the Hewanorra International Airport. ...
Reports are that the officials at the airport were planning a protest on Sat [30 Aug 2014] since there was no medical team in place to deal with an international flight that had African nationals who could be possible EVD victims. ...
<http://www.stlucianewsonline.com/ebola-medical-team-activated-at-hewanorra-international/#sthash.DvfoxQER.dpuf>
More ...

World Travel News Headlines

Date: Mon, 17 Feb 2020 11:56:28 +0100 (MET)

Tokyo, Feb 17, 2020 (AFP) - Organisers said Monday they are cancelling the amateur portion of the Tokyo marathon, affecting around 38,000 runners, on fears about the spread of the new coronavirus in Japan.   "We reached the conclusion that unfortunately it is difficult to organise the event... after several cases (of the virus) were confirmed in Tokyo," the Tokyo Marathon Foundation said in a statement.
Date: Mon, 17 Feb 2020 10:59:27 +0100 (MET)

Cairo, Feb 17, 2020 (AFP) - Egypt's Sharm el-Sheikh has welcomed the first British charter flights since 2015, when the Islamic State group's bombing of a Russian airliner dealt a devastating blow to the Red Sea resort.   Britain halted flights to Sharm el-Sheikh following the attack, which killed all 224 people on board the plane that took off from the resort, long popular with British tourists.

After multiple airport inspections and visits by aviation security experts, Britain announced in October that it was lifting the flight restrictions.   "Sharm el-Sheikh airport received the first two direct charter flights... from London's Gatwick airport carrying 184 passengers and Manchester airport carrying 190 passengers," Egypt's civil aviation ministry said in a statement late Sunday.    The flights were operated by Britain's biggest travel agency, TUI.

The company has scheduled three flights a week between London's Gatwick Airport and Sharm el-Sheikh until late March, the statement said.   British budget airline easyJet said in January it would restart flights to the resort town in June.   On Sunday, flag carrier EgyptAir said it would start operating a weekly flight between London and Sharm el-Sheikh later this month.   British tourists have long been vital to the tourism industry in Sharm el-Sheikh, which was left reeling after the airliner bombing.

Egypt has since sought to lure tourists back, boosting airport security and allowing international inspections of security procedures there.   Russia, another major source of tourists to Egypt, initially suspended all direct flights to the North African country following the attack.   It resumed direct flights to Cairo in 2018 but has yet to restart them to popular Red Sea resorts.   Egypt's tourism industry has shown signs of recovery in recent years with arrivals reaching 11.3 million in 2018, compared with 5.3 million in 2016.
Date: Mon, 17 Feb 2020 10:43:58 +0100 (MET)

Hong Kong, Feb 17, 2020 (AFP) - A gang of knife-wielding men jumped a delivery driver in Hong Kong and stole hundreds of toilet rolls, police said Monday, in a city wracked by shortages caused by coronavirus panic-buying.   Toilet rolls have become hot property in the densely packed business hub, despite government assurances that supplies remain unaffected by the virus outbreak.   Supermarkets have found themselves unable to restock quickly enough, leading to sometimes lengthy queues and shelves wiped clean within moments of opening.

There has also been a run on staples such as rice and pasta, as well as hand sanitiser and other cleaning items.     Police said a truck driver was held up early Monday by three men outside a supermarket in Mong Kok, a working-class district with a history of "triad" organised crime gangs.   "A delivery man was threatened by three knife-wielding men who took toilet paper worth more than HK$1,000 ($130)," a police spokesman told AFP.   A police source told AFP the missing rolls were later recovered and two suspects were arrested on scene although it was not clear if they were directly involved in the armed robbery.

Footage from Now TV showed police investigators standing around multiple crates of toilet roll outside a Wellcome supermarket. One of the crates was only half stacked.   Hong Kongers reacted with a mixture of bafflement and merriment to the heist.   One woman passing by the scene of the crime who was interviewed by local TV station iCable quipped: "I'd steal face masks, but not toilet roll."   The city, which has 58 confirmed coronavirus cases, is currently experiencing a genuine shortage of face masks.    The hysteria that has swept through Hong Kong since the coronavirus outbreak exploded on mainland China is partly fuelled by the city's tragic recent history of confronting a deadly disease.

In 2003, some 299 Hong Kongers died of Severe Acute Respiratory Syndrome (SARS), an outbreak that began on the mainland but was initially covered up by Beijing -- action that left a lasting legacy of distrust towards the authorities on public health issues.   The new coronavirus outbreak also comes at a time when the city's pro-Beijing leadership has historic low approval ratings after refusing to bow to months of angry pro-democracy protests last year.   Authorities have blamed online rumours for the panic-buying and say supplies of food and household goods remain stable.   But the panic-buying has itself created shortages in one of the world's most densely populated cities where supermarkets and pharmacies have limited
floor space.

Photos posted online have shown some people proudly stuffing their cramped city apartments with packets of hoarded toilet rolls.    On Sunday, the head of the city's Consumer Council warned people not to stockpile toilet rolls in their flats as they were prone to mould in the notoriously humid climate.   She also reiterated that there were ample stocks of paper.    Supermarket chain Wellcome called Monday's robbery a "senseless act", and called on people not to bulk buy or hoard toilet roll.    "We want to emphasize that we have sufficient toilet roll supply to meet demand," it said in a statement. "The temporary shortage was caused by the sudden and unusual surge in demand."
Date: Mon, 17 Feb 2020 10:11:30 +0100 (MET)

Tokyo, Feb 17, 2020 (AFP) - An additional 99 people have tested positive for coronavirus on a cruise ship off the Japan coast, Japanese media said Monday, citing new figures from the health ministry.   That would take the total number of positive cases on the Diamond Princess to 454. The health ministry declined to confirm the reports immediately.   It was also not clear whether the figures included 14 US citizens who tested positive for the virus but were allowed to board evacuation flights home.

The Diamond Princess vessel moored in Yokohama near Tokyo has become the second-largest cluster of coronavirus cases outside the epicentre in China.    Passengers have been largely confined to quarters since February 5 with only brief and occasional breaks to take air on deck -- with face masks.   The quarantine period is over on Wednesday but many countries have decided to repatriate their citizens after an alarming climb in cases on board.

The US was the first country to evacuate its citizens from the ship but Australia, Canada, Italy and Hong Kong have indicated they will follow suit.   On land, cases in Japan have risen to 65, with authorities warning that the outbreak is entering a "new phase" and advising people to avoid large gatherings.    A public celebration of the new emperor's birthday on Sunday has been scrapped and organisers of the Tokyo Marathon scheduled on March 1 are reportedly considering cancelling the amateur part of the race.
Date: Sat, 15 Feb 2020 15:25:00 +0100 (MET)
By Benoît Pavan à Moûtiers avec Thomas Rossi dans les Pyrénées

Moûtiers, France, Feb 15, 2020 (AFP) - French protests at planned labour reforms hit ski resorts on Saturday, with chairlift operators and other seasonal staff downing tools over fears their livelihoods could be on a slippery slope.   Hundreds of staff at a clutch of resorts in the Alps and Pyrenees walked out in response to calls for action by the CGT and FO unions, forcing some runs to be closed or partially closed.   They are concerned that reforms extending the required period of employment before people are eligible for benefits, set to take effect from April 1, could stop thousands of seasonal workers from claiming.

Some voiced their protest in song at the bottom of pistes at Serre-Chevalier close to the Italian border, chanting: "We're going down the mountain to get rid of Macron," referring to French President Emmanuel Macron.   The French leader's attempts to overhaul pensions and welfare have led to months of bitter protests and strikes.    "Our situation will become even more precarious with these reforms," explained Christophe Dupuis, who works as a ski patroller at La Plagne, one of the world's most popular ski areas.   "We will need six months instead of four before we can apply for unemployment benefit," added Dupuis, who works as a lifeguard during the summer.   "We don't have six-month seasons, not least as the winter seasons are tending to get shorter rather than longer," said Maud Goret, a seasonal worker and CGT member at Font-Romeu in the Pyrenees -- where half the workforce had downed tools.

Many relatively low altitude resorts are suffering from a lack of snow owing to climate change, compounding fears over what the future holds.   As the workers voiced their grievances, further signs of the shortage of snow increasingly hitting resorts came as local authorities at Luchon-Superbagneres in the French southwest told AFP they had decided to have extra snow helicoptered in to three areas running short.

A union official said some 50 tons were being brought in for between 5,000 and 6,000 euros ($5,500-6,500) "in the knowledge that in terms of return on the investment you need to multiply that at least by ten," for an operation lasting around two-and-a-half hours.   He added that it might not be a "particularly ecological" solution but "we had no choice" at the height of the season when many children in French are on half-term holiday.
Date: Wed 12 Feb 2020
Source: Teresina Municipal Health Foundation [in Portuguese, machine trans., edited]

Health Surveillance Directorate - Epidemiology Management
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Given the laboratory confirmation of 5 human cases of melioidosis (ICD-10 A24.4) that occurred in the state of Piaui in 2019 (including one death), the FMS Health Surveillance Directorate recommends Hospital Infection Control Commissions, to the Hospital Surveillance Centers, public and private microbiology laboratories, infectious disease specialists, pulmonologists, microbiologists, biochemists and physicians in general who are attentive, immediately report any case with a result of a culture of biological material (blood culture, urine culture, wound culture, tracheal secretion, cerebrospinal fluid, bronchial lavage, ascitic fluid, abscess, tissues, etc.) positive for the bacterium _Burkholderia pseudomallei_ (or _Burkholderia_ sp.). The notification must be made through the individual notification form of SINAN (available at <http://portalsinan.saude.gov.br/images/documentos/Agravos/NINDIV/Notificacao_Individual_v5.pdf>) and sent to the FMS, with the code appended ICD10: A24.4.

The positive bacterial isolate should be sent to the Central Public Health Laboratory, Dr. Costa Alvarenga (LACEN - PI) for confirmatory examination (Nested - PCR), upon registration in the GAL system (research: _Burkholderia pseudomallei_ sample: swab), in swab with Stuart's medium, at room temperature, along with a copy of the notification form.
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[This 2016 article (Limmathurotsakul D, Golding N, Dance DA, et al., Predicted global distribution of _Burkholderia pseudomallei_ and burden of melioidosis. Nat Microbiol. 2016;1:15008. <https://doi.org/10.1038/nmicrobiol.2015.8>; article available at <http://www.nature.com/articles/nmicrobiol20158.pdf>) for 2015 estimates the burden of melioidosis for the areas of major and some risk as follows:

Area / Population at risk in millions / Melioidosis cases in thousands / Melioidosis deaths in thousands
South Asia / 1525 / 73 / 42
East Asia and Pacific / 858 / 65 / 31
Sub-Saharan Africa / 602 / 24 / 15
Latin America and Caribbean / 246 / 2 / 1
Middle East and North Africa / 49 / less than 1 / less than 1

Although a classical infection in eastern Asia and northern Australia, cases have been acquired in Africa, the Caribbean basin, Central America, and, as in this case, South America. - ProMED Mod.LL]

Date: Tue 11 Feb 2020
Source: SABC News [edited]

A 56-year-old was admitted at the Klerksdorp Tshepong Hospital on Saturday [8 Feb 2020] with a history of tick bite followed by flulike symptoms including headaches and fatigue.

The North West Health Department says while no active bleeding was noted, treatment was started immediately.

Crimean-Congo fever, also known as Congo fever/haemorrhagic fever, is a disease caused by a tick-borne virus with a case fatality rate of 10% to 40%.

Transmission to humans occurs through contact with infected animal blood or ticks. It can be transmitted from one infected human to another by contact with infectious blood or body fluids.

Symptoms include high fever, vomiting and abdominal pain, but as the illness progresses, large areas of severe bruising and severe nosebleeds are also common.

Clinical Manager at the Klerksdorp Hospital Dr. David Leburu says: "Crimean-Congo fever can make a person bleed. It can make people bleed just like Ebola but not as aggressive as Ebola."
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[Occupational groups such as herders, farmers, abattoir workers, veterinarians/animal health workers, hunters and persons informally slaughtering domestic/wild animals are at higher risk of infection. These persons often have exposure to ticks on the animals and in the animal environment, and also often have exposure to animal blood/tissues (e.g., during castration of calves, vaccination, notching/tagging of ears, slaughtering).

Humans can become infected in the following ways:
- Being bitten by infected ticks;
- Squashing infected ticks (if fluid from the ticks enters into cuts/grazes on the skin, or splashes onto mucous membranes, including the eyes, nose and mouth);
- If blood/tissue from infected animals (during the short period that the animals have virus in circulation) comes into contact with cuts/grazes on the skin, or splashes onto mucous membranes, including the eyes, nose and mouth;
- Needle-stick/sharps injuries in healthcare workers from infected patients.

The patient in the above report had a history of tick bite, but no other epidemiological information is available.

Human CCHF cases have been reported annually from South Africa since 1981, when it was first recognized in the country; between 0 and 20 cases of CCHF are reported each year. Through nearly 30 years of passive surveillance, more than 180 cases have been laboratory-confirmed. Although cases have been reported from all 9 provinces in the past 30 years, more than half of the cases originate from the semi-arid areas of Northern Cape Province (31.5% of cases) and Free State Province (23% of cases) (<http://www.nicd.ac.za/assets/files/CCHF_FAQ-General_Public.pdf>). - ProMED Mod.UBA]

[HealthMap/ProMED-mail maps:
North West Province, South Africa:
Date: Wed 12 Feb 2020 05:23 PM EST
Source: ABC27/WHTM [edited]

Two Newberry Township [York County] men are getting treatments for rabies after a coyote that attacked them tested positive for the deadly virus.

One man was with his dog when the coyote attacked [Mon 10 Feb 2020] on Red Bank Road. The 2nd man was working nearby in his garage when the coyote entered and bit him.

A neighbour shot and killed the coyote the following day and gave the carcass to the Pennsylvania Game Commission. A test confirmed the animal was rabid.
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[[HealthMap/ProMED-mail map of Pennsylvania, United States:
Pennsylvania county map:

Rabies is a serious disease, and is always fatal in animals. In humans there is post exposure prophylaxis (PEP), which must be given within a prescribed amount of time. Individuals bitten by a rabid animal who do not seek treatment within the narrow window for PEP in all likelihood will die if they develop rabies. Heroic measures have succeeded in preserving the lives of only a handful of individual, and yet their live is never a complete return to normal.

Rabies is a serious disease and should be taken seriously by all individuals, whether you are a pet owner or not. Animal owners, regardless of whether your animal is a horse, or dog, or cow, or cat, or goat, or other animal, vaccinate the animal against this fatal disease. Protect your investment in your farm animals, and protect yourself by vaccinating farm animals and pets.

Rabies can be in wildlife, as these stories note. However, we seldom get one involving an otter. While otters are cute and playful on the nature programs, they are susceptible to rabies, as is any mammal, so it is imperative we be alert to the animals around us, no matter where we are or what animal is involved. - ProMED Mod.TG]
Date: Sat 8 Feb 2020 05:16 PM EST
Source: Fox 8 [edited]

A Florida mom says she had to tackle an otter to protect her daughter and dog, WFLA reports. We don't often hear about aggressive river otters. But by fighting its way inside a home in Florida, experts say the otter was definitely not acting normal.  "My husband's like 'you just alligator wrangled an otter in the living room!'" [CE] said. The otter learned to not mess with a mother's instincts. "I think life is full of surprises, and you should just be ready for whatever," [she] said.

The story starts after 17-year old [GE] let their dog Scooter out before dawn Tuesday morning [4 Feb 2020]. Scooter had found an enemy.  "I sprinted to the backdoor, and I was like 'Scooter!' All I saw was like a big black ball just all over the place. So he stumbled in the door, and I tried to shut it as fast as possible, but then the otter got stuck," [GE] said.

By this time, the whole house is awake and her mother bursts in.  "I snatched it by the tail," [CE] said. "And then I held it up like a prize. And the otter's going crazy. It was like clawing at me and grabbing on to the backs of the furniture in my house." [CE] tossed the otter outside and discovered it had bit her daughter in the leg.

Several rabies shots later, [GE] and Scooter are on the mend. Now Florida Fish and Wildlife is trying to find the otter. It is unknown whether the otter has rabies because it has not been caught. His behaviour was definitely abnormal.  "Any time an otter's onshore going for a human, there's something not right. Usually, they see you, they're gone," said Dustin Hooper, an animal trapper, and owner of All Creatures Wildlife Control.
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[HealthMap/ProMED-mail map of Florida, United States:
Florida county map:
Date: Tue 4 Feb 2020
Source: Robesonian [edited]

A 9-year-old boy is undergoing treatment after being bitten by a rabid fox, according to the [Robeson] County Department of Public Health.

The boy was riding his bicycle Sunday evening [2 Feb 2020] on Barnhill Road in Lumberton when he was attacked by a fox, according to the Health Department. The fox was killed at the scene and its head was submitted for testing on [Mon 3 Feb 2020]. The results came back positive for rabies on [Tue 4 Feb 2020].

The boy will undergo a series of shots to prevent the onset of rabies, according to the Health Department. Area residents have been alerted and advised to monitor their children's and pets' activities.

According to the Health Department release, Sunday's bite case was properly reported "and as such, the system responded correctly. After-hour calls go to communications who contact the Animal Control officer on call."

Sunday's attack by a rabid wild animal is the 1st confirmed case of rabies in Robeson County this year [2020], said Bill Smith, Health Department director.

"I believe we had 3 this past year," he said. Those cases were animal-on-animal attacks, Smith said. "I think they were all pets last year," he said.

County residents need to be aware there are many more rabid animals in the area, he said. But the rate of confirmed contact between rabid animals and humans or pets is low because Robeson County is a rural county with large tracts of forests.

In rural areas the most likely scenario is an animal attacking a pet or human and then running into the woods, where it will die without anyone knowing if it had rabies or not, Smith said. In urban areas, there is more contact between humans and pets and animals known to be rabid because the attacking animal has no woods into which to run and hide. Therefore, the animal is easier to catch and test.

If someone is bitten by an animal that runs into the woods and is not caught and tested then precautions have to be taken, he said.

"We would treat that as a rabid animal," Smith said.

Sunday's incident prompted the county Health Department to issue the following advisories:
- all dogs, cats, and ferrets 4 months and older are required to be vaccinated against rabies and wear a current rabies vaccination tag per North Carolina law;
- if an animal is destroyed, try not to damage the head because it jeopardizes the testing of the brain;
- avoid feeding wild animals. Foxes and raccoons are the main sources of rabies in the Robeson County area and feeding them increases the likelihood of interaction between the wildlife and dogs, cats and humans.
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North Carolina county map: