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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: 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.
Date: Fri, 17 Nov 2017 13:08:25 +0100

Nicosia, Nov 17, 2017 (AFP) - Cyprus has smashed its record for annual tourist arrivals with two months to spare, with the total reaching 3.4 million at the end of October, official figures showed on Friday.   The eastern Mediterranean island has benefited from its reputation as a regional safe haven as unrest has hit the tourism sectors of its traditional competitors Egypt, Tunisia and Turkey.   Arrivals in the first 10 months already comfortably exceeded the record 3.18 million registered in the whole of 2016.

Cyprus has benefited from a boom in visitors from its largest market, Britain -- up nearly eight percent for January-October -- along with a revival in those coming from Germany (up 60 percent), second largest market Russia (up 5.2 percent) and Israel (up 80.8 percent).   The surge has helped Cyprus return to growth following a 10-billion-euro bailout to rescue its crumbling economy and insolvent banks in March 2013.   Income from tourism accounts for about 12% of the country's gross domestic product and is credited with underpinning a quick recovery.
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Kazakhstan

Kazakhstan US Consular Information Sheet
October 02, 2008
COUNTRY DESCRIPTION:
Kazakhstan is a constitutional republic with a strong presidency and a market economy. Kazakhstan's tourist facilities are not highly developed; the availabilit
of goods and services is better than in most neighboring countries, but not up to the standards found in North America and Western Europe. Internal travel and travel to neighboring countries, by air and land, can be subject to delays due to infrastructure shortcomings and winter weather. Read the Department of State Background Notes on Kazakhstan for additional information.
ENTRY/EXIT REQUIREMENTS: A valid passport and visa are required. The Embassy of Kazakhstan in Washington, D.C. and the Consulate of Kazakhstan in New York issue visas. The Embassy of Kazakhstan is located at 1401 16th Street NW, Washington, DC 20036, telephone (202) 232-5488 or 550-9617, fax (202) 232-5845 and the Consulate at 866 United Nations Plaza, Suite 586 A, New York, N.Y. 10017, telephone (212) 230-1900 or 230-1192, fax (212) 230-1172. An invitation is not required for single-entry business and tourist visas, but multiple-entry visas require an invitation from an individual or organizational sponsor in Kazakhstan. The U.S. Embassy in Astana and the U.S. Embassy Branch Office in Almaty do not issue letters of invitation to citizens interested in private travel to Kazakhstan. All travelers, even those simply transiting Kazakhstan, must obtain a Kazakhstani visa before entering the country. Travelers should be aware that overstaying the validity period of a visa will result in fines and delays upon exit. Travelers may be asked to provide proof at the border of their subsequent travel arrangements. Travelers transiting through Kazakhstan are reminded to check that their visas allow for a sufficient number of entries to cover each transit trip and to check the length of validity of the visa. Crossing the land border to and from the neighboring Kyrgyz Republic can result in delays or demands from border officials to pay fines.
Tourist visas cannot be extended in Kazakhstan. Business visas can be extended for up to 6 months total validity upon submission of a contract with a sponsoring Kazakhstani organization. Work visas can be extended in Kazakhstan up to the expiration date of the holder’s work permit, a separate document issued only in Kazakhstan.

NOTE: Due to changes in the labor law, foreigners who work in Kazakhstan for registered non-profit organizations and NGOs, other than designated Chief Representatives of those organizations, are no longer exempt from work permit regulations.

Travel to certain areas bordering China and cities in close proximity to military installations require prior permission from the Kazakhstani government. In 2001, the government declared the following areas closed to foreigners: Gvardeyskiy village, Rossavel village, and Kulzhabashy railway station in Zhambyl Oblast; Bokeyorda and Zhangaly districts in Western Kazakhstan Oblast; the town of Priozersk and Gulshad village in Karaganda Oblast; and Baykonur, Karmakshy, and Kazakly districts in Kyzylorda Oblast. Americans traveling within Kazakhstan have on occasion reported local officials demanding documentation authorizing travel within their area of jurisdiction, even though they received permission from the Department of Migration Police (formerly OVIR), currently part of the Ministry of Internal Affairs. Americans should report any trouble with local authorities to the U.S. Embassy in Astana or the U.S. Embassy Branch Office in Almaty.
Registration of American passports is conducted at the same time as the issuance of the visa in one of Kazakhstan’s embassies and consulates abroad or at the time of a border crossing. Americans are not required to register in Kazakhstan upon arrival at a local office of the Department of Migration Police. All registrations are valid for three months, regardless of where they are issued. To extend your registration beyond three months, please contact your local office of the Department of Migration Police. However, if you are not sure if you have been properly registered at the time of visa issuance or border crossing, please contact your local office of the Department of Migration Police.
Visitors to Kazakhstan engaging in missionary work or other religious activities must register with the Department of Justice office in the region (Akimat) where the activities will take place. This applies even if the religious activities are not the primary purpose of the visit. Attendance at a religious service does not itself require registration, however participation in the delivery of the service may. Americans have been fined and deported from Kazakhstan for addressing a congregation, leading prayers, and performing religious music without proper religious worker registration. In addition, representatives of faith-based non-governmental organizations are often considered subject to the registration requirement even if their activities are not religious in nature. If in doubt whether registration is required, visitors should contact the Department of Justice office responsible for the area of Kazakhstan where they intend to engage in religious activities and request a written decision. Religious worker registration is only valid for the locality where it is granted and visitors must register in each jurisdiction where they wish to engage in religious activities.
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. All children adopted in Kazakhstan after May 2003 must obtain exit stamps from both the Ministry of the Interior and Ministry of Foreign Affairs before departing the country.
Visit the Embassy of Kazakhstan’s web site at http://www.kazakhembus.com 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:
Supporters of extremist groups such as the Islamic Jihad Union, the Islamic Movement of Uzbekistan, al-Qaeda, and the Eastern Turkistan Islamic Movement remain active in Central Asia. These groups have expressed anti-U.S. sentiments and may attempt to target U.S. Government or private interests in the region, including in Kazakhstan. Attacks against foreign interests in Central Asia have occurred and new tactics, including the use of suicide bombers, have been employed by extremists in neighboring Uzbekistan. Terrorists do not distinguish between official and civilian targets. Because of increased security at official U.S. facilities, terrorists are also targeting “soft” civilian targets such as residential areas, clubs and restaurants, places of worship, hotels, schools, outdoor recreation events, resorts, beaches, maritime facilities, and aircraft.
Kazakhstani security personnel may at times place foreign visitors under surveillance. Hotel rooms, telephones and fax machines may be monitored, and personal possessions in hotel rooms may be searched. Taking photographs of anything that could be perceived as being of military or security interest may result in problems with authorities.
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: Travelers in Kazakhstan should exercise the same precautions concerning personal safety and protection of valuables as they would in any major U.S. city. Using good judgment and avoiding high-risk areas can reduce the crime threat. The most common crimes foreign tourists encounter are purse snatching, pick pocketing, assaults, and robberies. Pick pocketing or robberies occur most frequently in the vicinity of Western hotels, transportation sites, and at open-air markets, including the central open-air market in Almaty (known locally as the "green market"). Americans are advised to exercise caution in the vicinity of hotels, bus or train stations, and when shopping. The U.S. Embassy strongly recommends that Americans do not carry large sums of money on the street.
Identification checks by the police are common practice. U.S. visitors must produce either a passport or an Embassy-certified copy thereof upon request. Police are not required to demonstrate probable cause or reasonable suspicion to initiate ID checks. Given concerns with crime, the U.S. Embassy has made arrangements with the Kazakhstani Government to allow Americans in the Almaty Oblast to carry a certified copy of their passport and visa rather than the original. These copies can be obtained from either the U.S. Embassy’s Consular Section in Astana or the Branch Office in Almaty during business hours Monday to Friday, 9:00 a.m. to 5:00 p.m.
Be wary of persons representing themselves as police or other local officials. It is not uncommon for Americans to become victims of harassment and extortion by imposters, genuine law enforcement and other officials. A genuine police official should always present his own credentials when approaching someone on the street. If the officer cannot produce identification, he is most likely an imposter. Never voluntarily hand over your wallet to a police officer. If pressured, tell the officer that you will report his behavior to the U.S. Embassy and his supervisors. Authorities are concerned about these incidents and have cooperated in investigating such cases. Try to obtain the officer's name, badge number, and license plate number, and note where the incident happened because this information assists local officials in identifying the perpetrators. Report crimes committed against you by persons presenting themselves as police or other governmental authorities to a police station and the U.S. Embassy.
The "lost wallet" scam continues to be common in Kazakhstan. One version of this swindle involves the discovery of a lost wallet in your presence. A first person will discover the wallet and offer to divide its contents with you. Then, a second person will appear, claim to be the owner of the wallet, and demand compensation for the missing money. A second version involves a person looking for a lost wallet, asking you if have seen it. The person asks you to reveal the contents of your pockets or bag to prove that you do not have the missing wallet. The wallet seeker will then surreptitiously steal your exposed valuables. When initially approached by the “finder” or “seeker” of the lost wallet, simply walk away.

The embassy highly discourages taking private gypsy cabs in lieu of licensed taxicabs while in Kazakhstan. This applies especially to travel from the airport to the city upon arrival, where men posing as "meet and greet" airport facilitators have lured foreigners into cars purportedly to take them to their hotels. However, the driver then takes the passengers to a secluded destination and demands approximately $100 for gas to take the foreigner back to the city. All travelers should make prior arrangements with their contacts in Almaty for concrete identification upon arrival at the airport. Americans should not leave with anyone who does not show pre-arranged identification, even if the person is holding a sign with the traveler's name.
The Embassy has received reports from American residents and visitors being victims of violent, late-night muggings. Americans are advised to travel in groups or pairs. Lone individuals often make easy targets for muggers. At night, try to remain in well-lit, populated areas. Visitors are encouraged to leave restaurants or bars if fights break out.
Corruption by public officials, including law enforcement, has been reported frequently, especially at the airport in Almaty. Some foreigners have been told by customs or border guard officials that they must pay a $50-$500 fine for violating an undisclosed local regulation, despite the fact that the foreign citizen has fully complied with local laws. Some Americans have reportedly been asked to pay a large fine upon exiting Kazakhstan. When encountering such irregularities, U.S. citizens are advised to seek clarification from supervisory airport officials or contact the U.S. Embassy before paying.
INFORMATION FOR VICTIMS OF CRIME: The loss or theft abroad of a U.S. passport should be reported immediately to the local police and the nearest U.S. Embassy or Consulate. If you are the victim of a crime while overseas, in addition to reporting to local police, please contact the nearest U.S. Embassy or Consulate for assistance. The Embassy/Consulate staff can, for example, assist you to find appropriate medical care, contact family members or friends, and explain how funds could be transferred. Although the investigation and prosecution of the crime is solely the responsibility of local authorities, consular officers can help you to understand the local criminal justice process and to find an attorney if needed.

The local equivalent to the “911” emergency line in Kazakhstan is: 03
See our information on Victims of Crime.
MEDICAL FACILITIES AND HEALTH INFORMATION: Medical care in Kazakhstan is limited and well below North American and Western European standards. The U.S. Embassy maintains a list of English-speaking physicians. Basic medical supplies, including disposable needles, anesthetics, and antibiotics can be in short supply. Elderly travelers and those with pre-existing health problems may be at risk due to inadequate medical facilities. Most resident Americans travel to Western Europe for serious medical treatment. Such travel can be extremely expensive if undertaken under emergency conditions. Travelers requiring prescription medications or specific brand-name medicines should bring sufficient supplies of medications and not rely on local availability.
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.
Tuberculosis is an increasingly serious health concern in Kazakhstan. For further information, please consult the CDC's Travel Notice on TB at http://wwwn.cdc.gov/travel/yellowBookCh4-TB.aspx.

Some HIV/AIDS restrictions exist for foreign residents of Kazakhstan. Visitors applying for a work or residency permit, required for Americans who wish to spend more than 6 months in Kazakhstan, must submit negative HIV test results with their application to the Migration Police in the city where they intend to work or reside. The results must be less than three months old. The city HIV clinic in the place of registration can conduct the test or may certify test results performed abroad. If the original test results are in a language other than Russian or Kazakh, they must be accompanied by an official translation. If a foreigner tests positive for HIV in Kazakhstan, he or she must depart the country. Please verify this information with the Kazakhstani sponsoring organization that can provide more information on the specific HIV testing procedures in the region of Kazakhstan where you intend to reside.

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 Kazakhstan is provided for general reference only, and may not be totally accurate in a particular location or circumstance.
Roads in Kazakhstan are in poor repair, especially in rural areas. Street lighting, especially on side streets, may be turned off at night. Drivers often ignore lane markings. Potholes are common, and are often dangerously deep. Pedestrians frequently dart out in front of cars. Visitors should drive defensively at all times as many local drivers do not follow traffic laws. Special caution should particularly be taken if driving at night. Road rage can be a problem, especially in and around Almaty, and a non-confrontational response to such behavior is strongly recommended. Accidents involving severe injury and/or death are common. Traffic police have reportedly stopped cars to extort bribes on main city streets and at periodic checkpoints on major highways.
The road between Almaty and Bishkek, Kyrgyzstan, is especially treacherous at night or during poor weather. Americans and other travelers have been killed in traffic accidents on that road, and travel at night should be undertaken with great caution or avoided.
Travelers should be particularly careful when using public transportation and taxis. Buses tend to be very crowded and can be unsafe and unreliable. Due to the danger of theft or assault, travelers should be selective regarding which taxi they contract and always avoid entering a cab that already contains persons other than the driver.
Americans wishing to drive in Kazakhstan should possess a valid international driver's license. For specific information, travelers may contact the Embassy of the Republic of Kazakhstan at 1401 16th Street NW, Washington, DC 20036, telephone (202) 232-5488.
Please refer to our Road Safety page for more information. Visit the web site of Kazakhstan’s national tourist office and national authority responsible for road safety at http://www.kazakhembus.com
AVIATION SAFETY OVERSIGHT: As there is no direct commercial air service to the United States by carriers registered in Kazakhstan, the U.S. Federal Aviation Administration (FAA) has not assessed Kazakhstan’s Civil Aviation Authority for compliance with International Civil Aviation Organization (ICAO) aviation safety standards. For more information, travelers may visit the FAA’s web site at http://www.faa.gov/safety/programs_initiatives/oversight/iasa.

SPECIAL CIRCUMSTANCES:
Kazakhstan remains largely a cash economy. Traveler's checks and credit cards are not widely accepted, except at large hotels and restaurants catering to international visitors. U.S. dollars can easily be exchanged for the local currency (Tenge) at local and authorized currency exchanges, but all denominations of U.S. currency except $1 bills must be new series (large portraits) and all must have been issued after 2000 and be in good condition (not worn or torn and without any writing or marks).
Kazakhstan, especially in the mountainous southeast region, is an earthquake-prone country. The U.S. Department of State has ranked the earthquake threat level within Almaty as a Level 4 (the highest level assigned). Building practices within Kazakhstan do not generally meet U.S. seismic standards. In addition, local authorities do not have sufficient resources to respond to a large-scale disaster. American citizens traveling to Kazakhstan are encouraged to register with either the U.S. Embassy or the U.S. Embassy’s Branch Office’s Consular Section to facilitate contact in the event of an emergency. 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.
Kazakhstani customs authorities may enforce strict regulations concerning export from Kazakhstan of items such as antiquities. Foreigners must complete a customs declaration upon entering Kazakhstan and may face fines upon departure if unable to produce certificates verifying legal conversion of foreign currency. Travelers are strongly encouraged to declare all valuables, including computers, video cameras, and mobile telephones, upon entry in order to avoid paying duty on those items upon departure. Tenge, Kazakhstan's currency, can be exported by residents of Kazakhstan (including foreigners) in amounts up to $3,000 without declaration and without written certification of the origin of funds. Residents exporting between $3,000 and $10,000 must complete a customs declaration and prove the origin of the funds (e.g. proof of locally-paid salary). Travelers visiting Kazakhstan for short periods of time may not leave the country with more currency than they declared when entering Kazakhstan. For legal requirements on the export of Tenge, travelers should consult with local Customs officials. In practice, however, travelers should be wary of such officials at the airport, as visitors have been erroneously charged duty on Tenge exports or asked to surrender Tenge in the past. It is advisable to contact the Embassy of the Republic of Kazakhstan in Washington, D.C. for specific information at 140116th Street NW, Washington, DC 20036, telephone (202) 232-5488. Please see our Customs Information.
Foreigners are required to carry a valid passport while in Kazakhstan. American citizens are strongly urged to have a certified copy of their U.S. passport made at the either the U.S. Embassy’s Consular Section in Astana or the Branch Office in Almaty. Having a certified copy in their possession satisfies the local requirement to carry a passport and reduces the chances of a passport being lost or stolen.
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 Kazakhstan’s laws, even unknowingly, may be expelled, arrested or imprisoned. Penalties for possession, use, or trafficking in illegal drugs in Kazakhstan 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 Kazakhstan 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 Kazakhstan. By registering, American citizens make it easier for the Embassy or Consulate to contact them in case of emergency. The U.S. Embassy in Astana and the U.S. Embassy Branch Office in Almaty are 11 hours ahead of U.S. Eastern Standard Time. The U.S. Embassy in Astana is located at Akbulak-4, St. 22-23, Building 3, 010010, Astana, tel. 7-7172-70-21-00, fax 7-7172-70-22-80, e-mail USAKZ@state.gov, or web site at http://kazakhstan.usembassy.gov. The U.S. Embassy Branch Office in Almaty is located at 97 Zholdasbekov St., Samal-2, Almaty 050059, tel. 7-727- 250-49-00, 250-49-01, fax 7-727-250-48-84.
* * *
This replaces the Country Specific Information dated February 05, 2008 to update the sections on Entry/Exit Requirements, Crime, Information for Victims of Crime, and Medical Facilities and Health Information.

Travel News Headlines WORLD NEWS

Date: Tue 17 Sep 2019, 10:07 AM
Source: AKIpress [edited]

A total of 4 shepherds were hospitalized with anthrax in Zhambyl region, Informbureau reports. The diagnosis was confirmed by laboratory examination. Patients came to the hospital with eruptions on their bodies.

"The patients work on one of the farms and have direct contact with animals. All of them were took part in the slaughtering of a cow, and 7-10 days after that they started complaining of these signs," said Gulfaira Mirzabekova, an employee of the Zhambyl regional infectious hospital. According to doctors, those infected sought medical aid in time. Anthrax just started damaging the organs. They will be treated for at least 10 days, they said.

Local authorities are not going to quarantine in the village of Shakpak, where the patients were infected. No anthrax cases were registered among cattle, they claim.
Date: Wed 19 Aug 2019, 12:48 PM
Source: Kazakh Telegraph Agency [edited]

A total of 4 anthrax cases have been confirmed in the Akmola region, reports the health care department. "Up to [now] 5 [suspected cases of] anthrax have been recorded; lab tests have confirmed 4. The cause of contamination was cow butchering without a veterinary certificate in a private yard," said the interlocutor.

"Epidemiological situation in the Akmola region and Nur-Sultan is stable," said the department. "The situation is being constantly monitored by the committee," said Ludmila Burabekova, chairfigure of the committee of quality control and goods safety. "Anti-epidemic and anti-epizootic arrangements have been organized in the area," she added.
*****************************
Date: Wed 19 Aug 2019, 12:04 PM GMT
Source: Radio Free Europe [edited]

A village near the Kazakh capital, Nur-Sultan, is under quarantine after lab tests confirmed anthrax infections in several people.

The Health Ministry said on [19 Aug 2019] that 5 residents of the village of Olginka, 100 km [about 62 mi] east of Nur-Sultan, have been hospitalized in recent days with anthrax symptoms, 4 of whom tested positive for _Bacillus anthracis_ -- the bacterium that causes the infectious disease. According to the statement, the situation in the village in the Aqmola region is under the control of the authorities and all necessary measures are being taken to prevent the possible spread of the disease.

In 2016, in nearby Qaraghandy Oblast, 2 people died as a result of anthrax infections.

According to the United States Centers for Disease Control and Prevention (CDC), domestic and wild animals -- such as cattle, sheep, goats, antelope, and deer -- can become infected by inhaling or ingesting spores in contaminated soil, plants, or water. CDC says all types of anthrax infections can cause death if they are not treated with antibiotics.
========================
[Olginka is in north-central Kazajhstan; see:

There is a measure of rural poverty in northern half of Kazakhstan, with the result that sick and moribund animals get butchered and eaten. Fortunately, as this village is within 100 Km [about 62 mi] of the Kazakh capital the affected have had the advantage of hospital care and proper laboratory confirmation. The coincident 5th person may have just shown a fever when the medical authorities were looking for clinical cases or it may be a false negative.

Folk have a habit of self-treating with antibiotics and this would have reduced the number of circulating vegetative cells available to testing. My friend Benyamin Cherkasskyi, the Soviet anthrax expert, used to tell me that only some 30%-40% of cutaneous cases would test positive. You have to know to insert your needle in under the lesion to draw out the fluid there which will contain cells, blood, and toxins. - ProMED Mod.MHJ]

[HealthMap/ProMED map available at:
Date: Thu 27 Sep 2018
Source: Informburo.kz [in Russian, ProMED Mod.AS, edited]

The quarantine, introduced because of anthrax in the East Kazakhstan region, will be removed on [5 Oct 2018], said Tursyn Kabduldanov, deputy chairman of the Committee for Veterinary Control and Supervision of the Ministry of Agriculture of the Republic of Kazakhstan.  "In case of anthrax, quarantine lasts only 15 days. It is not foot and mouth disease, nor nodular dermatitis. Quarantine is removed after the last case of cattle [animal death in fact as cases are not always clear. - ProMED Mod.MHJ]. We conduct quarantine measures, forced vaccination, disinfection and removal quarantine. In East Kazakhstan, we will remove quarantine on [5 Oct 2018]," added Tursyn Kabduldanov at a briefing in the press centre of the Ministry of Agriculture of the Republic of Kazakhstan.

According to him, without the knowledge of the veterinarian, a 4 month old bull was killed [by the disease]. On the question of whether this case may affect the supply of beef to China, the deputy head of the committee responded that he "would not particularly be affected".  As of today [Thu 27 Sep 2018], 30 Kazakhstani enterprises have submitted applications for beef exports to the PRC. They will be able to supply products after the inspection of their Chinese colleagues, which will be held in late October [2018]. A spokesman for the Ministry of Agriculture Rak Saken Kalkamanov said that this case should not affect the issuance of permits to Kazakhstani enterprises for the export of meat, since the cattle are vaccinated and there is no threat of the spread of the disease.

On [24 Sep 2018], it was reported that a citizen who died of anthrax had been treated by a healer for a week and did not go to doctors. Moreover, he escaped from the infectious disease ward, after which he was returned to the district hospital by the police [and died]. The 47 year old, head of a peasant farm in Katon-Karagai district, ate some of the meat and left the house, selling the rest to the inhabitants of the village of Malonarymka. The 1st symptoms of the disease appeared on [12 Sep 2018].

On [21 Sep 2018], a man died in the infectious diseases hospital of Ust-Kamenogorsk. The source of infection was the burial site of livestock that died from anthrax in 1972, 5 km [about 3 mi] from the current place of slaughter of the sick young bull.  [byline: Baurzhan Mukanov]
=====================
[Unless someone had been digging at that old 1972 anthrax burial site, I very much doubt that it was in fact the source. The cumulative effects of daily temperature changes, dry spells and UV light is enough to decontaminate surface soils within at most 3 years. Spore survival is seen in deeply buried spores in alkaline soils. And anthrax in calves is rare as they are still suckling, even at 4 months, and learning to graze. And at that age he would not have been vaccinated. If I were to guess, this calf got infected as the result of a previous adult anthrax case but as it did not involve humans, it was unobserved and unreported. Only when a human got infected did the bureaucratic system kick into gear.

Katon-Karagai is the site of the previous report of a bovine case to OIE: 27 Sep 2018 Anthrax - Kazakhstan (02): (EK) bovine, OIE
http://promedmail.org/post/20180927.6056669.

To find Katon-Karagai either check the OIE report, where it is mapped, or go to

My thanks to my colleague Arnon for the translation. - ProMED Mod.MHJ]
Date: Thu 7 Jun 2018
Source: mz.gov [in Kazakh, machine trans., summ., edited]

Epidemiological situation on meningococcal infection:
Since the beginning of 2018, 59 cases of meningococcal infection have been registered in the Republic of Kazakhstan, including 21 cases among children under 14 years of age. 13 of them have died: Almaty -- 6 cases; in Almaty region -- 4 cases; in South Kazakhstan -- 2 cases; and in Kyzylorda region -- 1 case.

The situation is under the control of the Ministry of Health.
-----------------------------------
communicated by:
Irene Lai, MD
International SOS
Global Medical Director
Sydney, Australia
********************************
Date: Wed 6 Jun 2018
Source: mz.gov [in Kazakh, machine trans., summ., edited]

Epidemiological situation with meningococcal infection: In the Republic of Kazakhstan, 58 cases of meningococcal infection have been registered since the beginning of 2018, including 21 cases among children under 14 years of age. 13 of them have died: Almaty -- 6 cases; in Almaty region -- 4 cases; in South Kazakhstan -- 2 cases; and in Kyzylorda region -- 1 case.

In May [2018], in the Republic of Kazakhstan meningococcal infection morbidity has increased. From [30 Apr to 5 May 2018] cases have been registered in the cities of Almaty, Astana, and Almaty and Kyzylorda oblasts.

The greatest number of people infected with meningococcal infections [is] in Almaty. From [30 Apr to 5 May 2018], 92 people were diagnosed with meningitis, 44 of whom were diagnosed with other diseases, 32 were diagnosed with meningococcal infection, and 16 cases were undergoing laboratory tests. The frequency of morbidity in 2011 -- 44 cases; in 2012 -- 23 cases; in 2013 -- 49; in 2014 -- 36 cases; in 2015 -- 66 cases; and in 2016 -- 16 cases.

In order to stabilize the situation, the Ministry of Health has approved a comprehensive plan for preventive and anti-epidemic measures.
---------------------------------------------
communicated by:
Irene Lai, MD
International SOS
Global Medical Director
Sydney, Australia
===========================
[We are not told the meningococcal serogroup(s) identified for the 2018 cases or if there is an outbreak strain with same genotype. We are also not told whether there are any epidemiological linkages among the cases. More information on this outbreak from knowledgeable sources would be appreciated.

Descriptions of the public health response of Kazakhstan authorities can be found at the source URLs above [in Kazakh]. A discussion of meningococcal outbreak management can be found in my moderator comments in ProMED-mail post Meningitis, meningococcal - Fiji (02): fatal, children http://promedmail.org/post/20180409.5735431.

Kazakhstan is divided administratively into 14 regions and 3 cities: Almaty, the largest city in Kazakhstan, with a population of about 1.8 million residents (about 8 per cent of the country's total population), Astana (the capital), and Baikonur. The regions are further subdivided into districts. Almaty is located within the Almaty region in the south east of the country, and Astana is located within the Akmola region in the north central part of the country. A map of Kazakhstan that shows the administrative regions and cities can be seen at <https://en.wikipedia.org/wiki/Regions_of_Kazakhstan>.

A HealthMap/ProMED-mail map can be seen at
<http://healthmap.org/promed/p/56>. - ProMED Mod.ML]
Date: Tue 29 May 2018
Source: AKIpress [edited]

Eight people have died of meningococcal disease in Kazakhstan since the start of 2018, chief sanitary doctor Jandarbek Bekshin said.

62 meningococcal disease cases were registered in total, including 29 cases in Almaty, 4 cases in East Kazakhstan, South Kazakhstan regions and Astana each, and 3 cases in Almaty region, he said.

"Of the 8 lethal cases registered since start of the year [2018], 4 cases were registered in Almaty and 2 cases in Almaty region and South Kazakhstan region each," the chief sanitary doctor said.

The Public Health Department of Almaty has asked people to wear facemasks while visiting mosques amid the outbreak of meningococcal disease.

30 patients with confirmed meningococcal disease still remain in hospitals.

The Health Department has asked the public to refrain from visits to crowded places, sport events, and swimming pools.
=======================
[Kazakhstan is divided administratively into 14 regions and 3 cities: Almaty (the largest city in Kazakhstan, with a population of about 1.8 million residents), about 8% of the country's total population, Astana (the capital), and Baikonur (<https://en.wikipedia.org/wiki/Regions_of_Kazakhstan>). The regions are further subdivided into districts. Almaty is located within the Almaty Region in the southeast of the country, and Astana is located within the Akmola Region in the north-central part of the country. A map of Kazakhstan that shows the administrative regions and cities can be found at <https://en.wikipedia.org/wiki/Regions_of_Kazakhstan>.

According to another news report, about 1/3rd (21 cases) of the 62 cases of meningococcal disease reported in the 1st 5 months of 2018, including 3 of the 8 fatal cases, occurred in the month of May 2018 (<https://www.interfax.kz/?lang=eng&int_id=21&news_id=31438>). However, we are not told the frequency of meningococcal meningitis in Kazakhstan in prior years for comparison or whether the 2018 cases had the same meningococcal serogroup or the same genotype, which, if they do, would suggest a common source outbreak. We are also not told whether there are any epidemiological linkages among the cases. A discussion of meningococcal outbreak management can be found in my moderator comments in a prior ProMED-mail post: "Meningitis, meningococcal - Fiji (02): fatal, children  http://promedmail.org/post/20180409.5735431."

More information on this outbreak would be appreciated from knowledgeable sources. - ProMED Mod.ML]

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

Moldova

Moldova - US Consular Information Sheet
October 10, 2008
COUNTRY DESCRIPTION:
Moldova is a republic with a freely elected government. It has been an independent nation since 1991. Its capital, Chisinau, offers adequate hotels and restauran
s, but tourist facilities in other parts of the country are not highly developed, and many of the goods and services taken for granted in other countries are not yet available. Read the Department of State Background Notes on Moldova for additional information.
ENTRY/EXIT REQUIREMENTS: Since January 1, 2007, citizens of the United States, EU member states, Canada, Switzerland, and Japan do not require visas to enter Moldova. For more information on entry requirements, please contact the Moldovan Embassy, 2101 S Street N.W., Washington, D.C. 20008, telephone: (202) 667-1130, (202) 667-1131, or (202) 667-1137, fax: (202) 667-1204, e-mail: moldova@dgs.dgsys.com. Travelers may also wish to consult the Embassy of Moldova’s web site at http://embassyrm.org/en/cons-serv/visas.html for general information on Moldovan visas and for application forms.

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:
The U.S. Government has no information related to the targeting of U.S. citizens, interests or facilities by terrorist organizations in Moldova, and no Americans have been killed or injured as a result of terrorist activity in Moldova. However, the U.S. government remains deeply concerned about the heightened threat of terrorist attacks against U.S. citizens and interests abroad. Americans are reminded to remain vigilant with regard to their personal security and to exercise caution. Because Moldovan Government authorities often ask to see identification on the street, Americans should carry a copy of their passport with them at all times.
There is a separatist regime in control of the Transnistria region that is not recognized by the United States. Consular assistance to American citizens in that region cannot be ensured. Travelers should exercise caution when visiting or transiting Transnistria. Travelers should be aware that there are numerous road checkpoints along roads leading into and out from Transnistria. Taking photographs of military facilities, public buildings, and security forces, including checkpoints along roads leading into and out from Transnistria, is strictly prohibited.

Racially motivated incidents against foreigners and persons of color have occurred in Moldova. Persons of African, Asian, or Arab heritage may be subject to various types of harassment, such as verbal abuse, and denied entrance into some clubs and restaurants. These Americans are also at risk for harassment by police authorities.

In some instances, Americans have become victims of harassment, mistreatment and extortion by Moldovan law enforcement and other officials. Low-level bribery attempts are commonplace in Moldova. These encounters should always be reported to the U.S. Embassy. Moldovan authorities have cooperated in investigating such cases, but those investigations enjoy the greatest chance of success when the officer is identified by name, physical description, or other identifying characteristics. Please note this information if you ever have a problem with police or other officials. Americans who have refused to pay bribes in Moldova generally report no consequences beyond being delayed or inconvenienced.
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: Moldova’s economic difficulties, as well as organized criminal activity and more frequent travel by foreigners to Moldova, contribute to the risk visitors face from street crime, some potentially violent. While this risk is no greater than in most cities in the United States, many Americans have reported theft of money and small valuables from hotel rooms and local apartments. Cases of breaking and entering into homes and offices have occurred. Sexual assault against foreigners is rare. Travelers are wise to exercise the same precautions with regard to personal safety and protection of valuables in Chisinau that they would in any major U.S. city.
Precautions should also be taken when using ATMs in Moldova. Some Americans have reported unauthorized withdrawals from their accounts after using ATMs. Instances have been reported of PIN theft from use of ATMs in Moldova, either by “skimming” devices, which record the ATM card information while in use, or by surreptitious observation.

Train and bus services are below Western European standards and some U.S. citizens have been victims of crimes involving thefts while traveling on international trains to and from Moldova.
Americans who use the Moldovan postal service report frequent losses from international letter and package mail.
Internet Fraud Warning: The Embassy is aware of various confidence schemes that have taken advantage of American citizens, frequently via the Internet. In some cases these involve the purchase or sale of items on the Internet in which the payment or shipment of goods was not completed by a Moldovan counterpart. In the spring of 2006, Moldovan police recovered over $250,000 in jewelry that was sent to “buyers” in Moldova from the United States via fake online escrow companies. Substantial criminal enterprises specializing in this type of crime (Internet auction fraud) have emerged in Moldova. In other cases, American citizens, particularly males, have met potential Moldovan fiancé(e)s on the Internet who have convinced them to send hundreds or even thousands of dollars, but have no intention of a serious relationship. Once the American citizen starts to question the reason for sending the money, the Moldovan fiancé(e)s suddenly ends his/her contact. On occasion, American citizens who come to Moldova to visit someone they have first met over the Internet have reported becoming subject to crimes such as extortion and involuntary detention. American citizens should be aware that any such activity committed by individuals in Moldova is subject to the Moldovan legal system and could prove difficult to prosecute. In the vast majority of cases, there is little that the U.S. Embassy can do to assist American citizens who are defrauded by Moldovans via the Internet.
Please see our information on International Financial Scams.
INFORMATION FOR VICTIMS OF CRIME: The loss or theft abroad of a U.S. passport should be reported immediately to the local police and the nearest U.S. Embassy or Consulate. If you are the victim of a crime while overseas, in addition to reporting to local police, please contact the nearest U.S. Embassy or Consulate for assistance. The Embassy/Consulate staff can, for example, assist you to find appropriate medical care, contact family members or friends and explain how funds could be transferred. Although the investigation and prosecution of the crime is solely the responsibility of local authorities, consular officers can help you to understand the local criminal justice process and to find an attorney if needed.

The local equivalent to the “911” emergency line in Moldova is: 9-0-2 (Police Assistance) or 9-0-3 (Ambulance Assistance)
See our information on Victims of Crime.
MEDICAL FACILITIES AND HEALTH INFORMATION: Medical care in Moldova is substandard throughout the country, including Chisinau. In the event of serious medical conditions every effort should be made to go to Western Europe. In the event of emergency, travelers should attempt first to contact the local ambulance service, which is trained to determine which medical facility is most appropriate for treatment and will transport the injured or sick person to that location. Hospital accommodations are inadequate throughout the country and advanced technology is lacking. Shortages of routine medications and supplies may be encountered. Elderly travelers and those with existing health problems may be at particular risk due to inadequate medical facilities. The U.S. Embassy maintains lists of medical facilities and English-speaking doctors, but cannot guarantee or endorse competence. Visitors to Moldova are advised to bring their own supply of both prescription and common over-the-counter medications. Pharmacies are not stocked to Western standards and products are not labeled in English. Poor quality and/or fraudulent medications have been reported.
HIV/AIDS restrictions: Some HIV/AIDS entry restrictions exist for visitors to or foreign residents of Moldova. Short term visitors (periods of less than 90 days) do not require HIV testing. Applicants for residence permits, however, are required to submit to a HIV test and demonstrate that they are HIV negative. Please verify this information with the Embassy of Moldova at www.embassyrm.org before you travel.

Medical Information: Tuberculosis is an increasingly serious health concern in Moldova; the World Health Organization (WHO) has placed it in its “highest risk” category. Travelers planning to stay in Moldova for more than 3 months should have a pre-departure PPD skin test status documented. Given the way TB is transmitted, travelers should consider limiting their exposure to TB by avoiding crowded public places and public transportation whenever possible. Domestic help should be screened for TB. For further information, please consult the CDC's Travel Notice on TB at http://wwwn.cdc.gov/travel/yellowBookCh4-TB.aspx.
Other major health concerns include Hepatitis A (food-borne), Hepatitis B, and Hepatitis C (blood- and body fluids-borne). The incidence of sexually transmitted diseases is as "high" as it is in most developing countries.

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 WHO’s 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 if 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 Moldova is provided for general reference only, and may not be totally accurate in a particular location or circumstance.
Moldova’s highway infrastructure consists mainly of two-lane roads that often lack markings or signage, are unevenly maintained, and seldom have lighting. Caution should be taken to prevent collisions with agricultural vehicles and/or livestock. Urban roads in Moldova are infrequently maintained and often lack clear signs or lane markings. Travel outside of urban areas before dawn and after dusk should be avoided if at all possible. Drivers and pedestrians should exercise extreme caution to avoid accidents, which are commonplace. Many Moldovan drivers would be considered aggressive or erratic by American standards. Many accidents involve drunk drivers. The quality and safety of public transportation vary widely. Trains, trolleybuses, and buses are often old and may frequently break down. Taxis are available in most urban areas, and vary from old Soviet-era vehicles to newer, Western European or American model vehicles. Emergency services are generally responsive. Police emergency assistance can be called at 902 and emergency ambulance at 903.
Please refer to our Road Safety page for more information. Visit the web site of the Moldova’s national tourist office at http://www.turism.md/
AVIATION SAFETY OVERSIGHT: As there is no direct commercial air service to the United States by carriers registered in Moldova, the U.S. Federal Aviation Administration (FAA) has not assessed Moldova’s Civil Aviation Authority for compliance with International Civil Aviation Organization (ICAO) aviation safety standards. For more information, travelers may visit the FAA’s web site at http://www.faa.gov/safety/programs_initiatives/oversight/iasa.
SPECIAL CIRCUMSTANCES: Travelers are advised to register any foreign currency brought into Moldova with customs authorities upon entering the country. It is advisable to contact the Embassy of Moldova in Washington for specific information regarding customs requirements. Please see our Customs Information.
Visas and residency: Current Moldovan Government (GOM) border registration procedures will remain unchanged under the new immigration law. As of January 1, 2007, U.S. and most other foreign nationals arriving in Moldova do not require a visa and are permitted stays of up to 90 days in any given six-month period. At the point of entry (i.e., airport or border), the Border Guard Service enters the traveler’s personal data into a computer program and transfers the data to the GOM’s Population Register. Visitors are not given a paper “registration receipt.” U.S. citizens are able to enter Moldova through Transnistria. However, because they will not have been registered at the border, they will still have to register with the nearest office of the Ministry of Information Development (MID) within three days of arrival in right-bank (western) Moldova.

For stays exceeding 90 days, foreign nationals are required to obtain “immigration certificates” and residence permits from the National Bureau for Migration. Foreign nationals planning to work in Moldova must also obtain a work permit. Immigration, residence and work permits usually need to be extended annually, but may be issued for up to five years.
For more information on registering with Moldovan authorities, U.S. citizens are encouraged to call the Consular section of the U.S. Embassy in Chisinau at (373) (22) 40-83-00.
Requirement to Carry Documentation: As noted above, Moldovan police have the right to request identity documents from any person. Individuals who fail to produce appropriate ID upon request may be subject to detention and fines. Therefore, Americans are advised to carry their U.S. passports (or a copy of their passport’s biographic information page) with registration card, if applicable, or a Moldovan-issued identification document when in public.
Consular Access: Moldovan law enforcement authorities, particularly in the Transnistria region, have an uneven record of reporting the arrest or detention of American citizens to the U.S. Embassy, as required under international agreements. American citizens are therefore advised that if they are detained or arrested by Moldovan authorities, they should immediately request that the U.S. Embassy be contacted. Moldovan authorities have generally respected such requests in a prompt manner.
Photography: Americans who choose to travel in Transnistria should be aware that foreigners have reported being detained or harassed by authorities for taking photographs of military facilities or public buildings. Photography of checkpoints along roads leading into and out from the Transnistria region, or the personnel working there, is prohibited.
Dual Nationality: Recent Moldovan legislation allows dual citizenship. There is no requirement that dual nationals enter Moldova on their Moldovan passports. For further questions, please contact the Moldovan Embassy in Washington, D.C.

Telephone and Postal Services: Outside of Chisinau, travelers may have difficulty finding public telephones and receiving or making international and local calls. Losses have been reported from international letter and package mail, both of which are subject to a customs inspection before delivery. “Express” mail services such as DHL and Federal Express are available in Chisinau, although in most instances prices are high, and shipments arrive from (or reach) the United States in no less than five (5) business days.
Disabled Access: Persons with disabilities should be aware that public facilities and transportation in Moldova are rarely designed or built in a way that allows for wheelchair access. Wheelchair entrances, ramps, lifts or similar accommodations are rare; those that do exist are often below Western standards and/or poorly maintained. Most streets, sidewalks and other public paths are not well maintained and can be hazardous, particularly in poor weather conditions.
Commercial Transactions: Although still generally a cash-only economy, traveler’s checks and credit cards may be accepted in Chisinau, although locations that will accept them outside the capital are still rare. Some vendors require the customer dial in a PIN to authorize a sale by credit card. Caution is advised, however, as some travelers have reported incidents of unauthorized expenditures made on credit cards during or following their use in Moldova, and there have also been reported incidents of fraud and account theft using bank machines (ATMs – see “CRIME” above).
Business in Transnistria: As noted in the Safety and Security section above, a separatist regime controls a narrow strip of land in eastern Moldova known as Transnistria ("Pridnestrovie" in Russian). Individuals considering doing business in Transnistria should exercise extreme caution. The Embassy may not be able to offer consular or commercial services to Americans in Transnistria. Moldovan law requires firms (including those located in Transnistria) to register with the Moldovan Government and to use Moldovan customs seals on their exports. Under a December 2005 agreement between Moldova and Ukraine, Ukrainian customs and border officials require Moldovan customs seals on goods exported from Moldova, including Transnistria, and are enforcing this requirement with EU assistance. Transnistrian firms not legally registered with Moldovan authorities operate in contravention of Moldovan law, which may complicate or prevent the import or export of goods. The Government of Moldova has indicated that it will not recognize the validity of contracts for the privatization of firms in Transnistria that are concluded without the approval of the appropriate Moldovan authorities. A number of Internet fraud schemes have originated in Transnistria.
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 Moldovan laws, even unknowingly, may be expelled, arrested or imprisoned. Penalties for possession, use, or trafficking in illegal drugs in Moldova are severe, and convicted offenders can expect long jail sentences and heavy fines. Engaging in illicit 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 Moldova are encouraged to register with the U.S. Embassy through the State Department’s travel registration web site, and to obtain updated information on travel and security within Moldova. Americans without Internet access may register directly with the U.S. Embassy. By registering, American citizens make it easier for the Embassy to contact them in case of emergency. The U.S. Embassy is located in Chisinau, Moldova, Strada Alexei Mateevici 103; telephone: (373)(22) 23-37-72, after-hours telephone: (373)(22) 23-73-45; Consular Section Fax: (373)(22) 22-63-61. The Embassy’s web site is http://moldova.usembassy.gov
* * *
This replaces the Consular Information Sheet dated January 18, 2008, to update sections on Entry/Exit Requirements, Safety and Security, Medical Facilities and Health Information, and Special Circumstances.

Travel News Headlines WORLD NEWS

Date: Wed 10 Sep 2014
Source: Jurnal.md [in Romanian, transl., edited]

Cahul: 3 [more] people hospitalized with anthrax
------------------------------------------------
The number of cases of anthrax in the South [of Moldova] increased from day to day. According to the National Center for Public Health, a further 3 people infected with anthrax, cutaneous form, were admitted to the infectious diseases ward in Cahul District Hospital.

Two patients, one woman and her son, were infected from slaughtering a sick sheep. The case was registered for the village of Vadul Isaac, where 6 other people were earlier infected with the same disease after killing [and butchering] a sick calf.

The 3rd patient is a native of the village of Crihana. He became ill after visiting a cattle farm where an animal was slaughtered and butchered in Vad Isaac, which is under quarantine. He was also admitted to the District Hospital in Cahul.

Initially, a man infected with cutaneous anthrax came to the Crihana village hospital. Health of all patients is satisfactory. They are to be discharged after 2 weeks.
-------------------------------------
Communicated by:
Sabine Zentis
Castleview English Longhorns
Gut Laach
D-52385 Nideggen
Germany
======================
[To find Cahul district in south west Moldova on the Romanian border, go to:

So to date we have 9 cases, with one dying. This is probably a sound conservative set of numbers when considering what one sick animal, apparently a "calf", can do. Where more care is taken handling dead animals, the number can be flipped to have one human case for every 10 sick animals butchered or rendered. When there is a bias to only report human cases, it can be a guessing game as to the numbers of animals involved. With thanks, as usual, to Sabine. - ProMed Mod.MHJ]

[A HealthMap/ProMED-mail map can be accessed at:
Date: 5 Sep 2014
Source: Itar-Tass [edited]

A total of 6 workers of a livestock farm in the Cahul district of Moldova have been hospitalized on the suspicion of contracting anthrax, the national Healthcare Ministry said on Friday [5 Sep 2014].

"The patients are in a satisfactory condition, and the illness makes itself manifest mostly in skin lesions, but they have a normal temperature," Viktor Dyatishin, the head doctor of the infectious diseases hospital in Chisinau told reporters. "They will stay at hospital for about 2 weeks until full recovery."

The previous case of anthrax in Moldova was reported last year [2013]. The experts point to the numerous livestock burial sites -- from where anthrax spores can be washed out on to fields and into rivers by rainwater -- as the main source of the incident.

Moldova's sanitary, veterinary and epidemiological services were taking urgent steps on Friday [5 Sep 2014] to localize the dangerous infection.
-----------------------------
communicated by:
Sabine Zentis
Castleview English Longhorns
Gut Laach
D-52385 Nideggen, Germany
******************************
Date: 5 Sep 2014
Source: Press.try.md [edited]

Five people were diagnosed with anthrax yesterday [4 Sep 2014] at the Chisinau infectious diseases hospital. All patients are residents of the Cahul district.

The 1st ill person with symptoms of an open form of anthrax was delivered on Wednesday [3 Sep 2014] to a hospital in the Cahul village of Vadul. He is known to the employee of a private farm in the village.

Under suspicion of doctors were another 4 people. Their relatives say that the 1st symptoms appeared a few days ago, but local doctors gave them the wrong diagnosis. "[He had a fever]; he was sick; his appetite disappeared. [They] gave him headache tablets, but he still complained of feeling unwell."

The woman and her son ate food prepared from contaminated meat. Now they are under the supervision of doctors. "[We bought] half of the cow's head; someone took the other. He has some kind of sore on his leg."

Accidentally or not, one of the men who participated in the slaughter of cattle died. "He died at the hospital. We were not allowed to visit him. The cause of death not reported. He had some sores on his feet."

The mayor of the village said that the owner of the farm knew that the cows were sick but had not reported it to the authorities. "The 1st cases in animals appeared on 9 Aug 2014. Cows died, but the incident was [not] reported to any veterinary service or to the National Centre of Public Health," said the mayor of the village of Vadul.

All 5 were hospitalized in the capital hospital. "The patients are satisfactory; [their] temperature is normal. They will stay with us for about 2 weeks for treatment until they are cured," said the director of the hospital.

Representatives of the agency's food safety say that animals that carry the dangerous disease have not been vaccinated. "The animals were vaccinated. Still, cows were not vaccinated, because they have entered a period of maturation" [whatever that might mean. - ProMed Mod.MHJ], said the head of the agency's food security, Gregory Porchesku.

Epidemiologists went from Chisinau to study the situation on the ground in the Cahul district. Everyone who has been in contact with patients is under the supervision of physicians. A vaccination [campaign] for all the cattle in the village has still to occur.
---------------------------------------------------
communicated by:
Sabine Zentis
Castleview English Longhorns
Gut Laach
D-52385 Nideggen, Germany
==========================
[These Moldovan accounts are confused. The simplest explanation would be that 5 patients are in hospital under treatment doing well and for some reason will be released in 2 weeks time, which is a fair period if they are without a raised temperature. At some point, a 6th person died who had skin lesions. As "suspected" is used in relation to their diseased conditions, it would seem that if any samples were taken for laboratory analysis, the results are not back yet -- that is, the diagnoses were symptomatic, thus the prescription for headache. - ProMed Mod.MHJ]

[A HealthMap/ProMED-mail map can be accessed at:
Date: Sun, 27 Apr 2014 14:12:01 +0200 (METDST)

BRUSSELS, April 27, 2014 (AFP) - Citizens of Ukraine's neighbour Moldova will be granted visa-free travel from Monday to most European Union nations as part of the country's bid to sign an association deal with the EU bloc.

The decision shows that "closer relations with the European Union do bring tangible benefits to all," said the EU's home affairs commissioner Cecilia Malmstroem.   Under the deal, Moldovans carrying a biometric passport will be authorised to travel without a visa for short stays to the Schengen zone, which currently comprises 26 countries, 22 of them members of the 28-nation EU.   Between 50,000 and 55,000 Moldova nationals apply for short-term visas into the EU each year.

Moldova is one of the six former Soviet satellites that the EU hoped to draw into a wide-ranging Eastern Partnership programme on its eastern flank until Armenia, Azerbaijan and Belarus decided to turn back towards Moscow, and Ukraine's ousted leader Viktor Yanukovych too backed out in November at Russia's behest.

Moldova and Georgia however stood firm, initialling the partnership programme in November. They are expected to sign a final association deal with the EU in June.   Wedged between Romania to the west and Ukraine to the east, Moldova's 3.5 million people are Europe's poorest.   In the capital Chisinau there was a mixed response to the new visa-free travel, with a poll showing 50 percent of respondents underwhelmed on the grounds they were either too poor to travel or already owned a Romanian passport opening the door to the EU.
Date: Sun 7 Jul 2013
Source: Liga Novosti [in Russian, trans. ProMed Mod.NP, edited]

The Ministry of Health of Moldova has reported an outbreak of anthrax in the village of Veden, in Soroca district, located in northeast Moldova close to the border with Ukraine. Results of an epidemiological survey of several inhabitants of the village revealed the 4 patients were infected after a meal in which the main dish was freshly cooked beef.

All patients were hospitalized to the Republican Infectious Diseases hospital: one of them is in critical condition and the other 3 are in the moderately severe condition.

Specialists of Ministry of Agriculture of Moldova are providing the measures for the localization of the infection to prevent the spread of infection. [Presumably livestock vaccination and destruction of any contaminated meat. - ProMed Mod.MHJ]
==================
[This outbreak is to the north of the previous report of human cases in Dubasari district (Transnistria) and probably reflects an ongoing problem which gathers few reports.

>From their reports to OIE, anthrax in Moldova is sporadic with few outbreaks. And yet it receives considerable government attention via vaccination. For example, in 2012 vaccination coverage for cattle was 226 871/221 113 (103 percent), sheep & goats 937 421/908 079 (103 percent), horses 40 722/49 319 (83 percent), and pigs 3636/496 634 (0.7 percent). Outbreaks occur among pigs almost as frequently as reported for cattle. The last reported outbreak in sheep and goats was in 2004. With this level of vaccination the disease is clearly of concern, and possibly the problem is of poor reporting and poor usage of the vaccines distributed.

A HealthMap/ProMED-mail interactive map of Moldova can be seen at <http://healthmap.org/r/7ytP>.

To find Soroca district in northeastern Moldova, go to

Our thanks to Natalia for the translation. - ProMed Mod.MHJ]
Date: Tue 18 Jun 2013
Source: EVZ.ro [in Romanian, trans., edited]

A suspected case of anthrax has been recorded in Dubasari in Transnistria, in a private household.  According to Tiraspol press, the results of laboratory tests are currently expected to determine if it really is about the disease "mad cow". [Why is "mad cow" not explained? - ProMed Mod.MHJ]

The Regional Veterinarians normally take preventive measures to avoid the possible spread of the disease. Local media did not specify what it is, and the Dubasari President, Gregory Policinschi, did not know any details.

The last case of anthrax disease of animals in Moldova was registered in March last year [2012, in Riscani], and in 2011, 2 [porcine] cases were reported. Anthrax is a potentially fatal disease caused by the bacterium _Bacillus anthracis_. It occurs in cattle, horses, sheep, and goats.  [Byline: Roxana Roseti]
-----------------------------------------------
Communicated by:
Sabine Zentis
Castleview Pedigree English Longhorns
Gut Laach
52385 Nideggen
Germany
cvlonghorns@aol.com
=========================
[As at least one of the 2 cases in Dubasari has died I think we can presume that this report refers to livestock cases, and as they quote "mad cow" probably bovine.  A HealthMap/ProMED-mail interactive map of Moldova can be seen at <http://healthmap.org/r/7pn0>. For the location of Dubasari and Transnistria in a map of Moldova, go to <http://www.lib.utexas.edu/maps/commonwealth/moldova_pol01.jpg>; Dubasari Province is currently under the administration of the breakaway government of the Moldovan Republic of Transnistria. - ProMed Mod.MHJ]
More ...

British Virgin Islands

British Virgin Islands US Consular Information Sheet
February 26, 2009
COUNTRY DESCRIPTION:
The British Virgin Islands (BVI) are a British overseas territory, part of the British West Indies, lying about 60 miles east of Puerto Rico.
here are about 50 islands in the BVI, many of them uninhabited.
Tortola is the main island; other islands include Virgin Gorda, Jost Van Dyke, and Anegada.
Tourist facilities are widely available. Read the Department of State Background Notes on the United Kingdom for additional information.
ENTRY/EXIT REQUIREMENTS:
The Intelligence Reform and Terrorism Prevention Act of 2004 requires all travelers to and from the Caribbean, Bermuda, Panama, Mexico and Canada to have a valid passport to enter or re-enter the United States. U.S. citizens must have a valid U.S. passport if traveling by air, including to and from Mexico.
If traveling by sea, U.S. citizens can use a passport or passport card.
We strongly encourage all American citizen travelers to apply for a U.S. passport or passport card 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.

As of June 1, 2009, sea travelers must have a valid U.S. passport or passport card.
While a U.S. passport is not mandatory for sea travel to the BVI, it is required to return to the U.S.
In addition to other documentary requirements, U.S. Citizens should also present onward or return tickets, and sufficient funds for their stay.
Upon initial entry, no more than 60 days will be granted.
At the end of 60 days, visitors must report to the Immigration Department's main office in Road Town for an extension.
Extensions of up to 90 days are issued at the discretion of the Immigration Officer subsequent to an interview.
Visitors entering the BVI by yacht during daylight hours are required to proceed directly to a port of entry and clear immigration controls.
Visitors arriving by yacht outside of business hours should register with Immigration at opening of business the following business day.
Failure to comply with these regulations can lead to heavy fines or imprisonment.

Visit the Embassy of the United Kingdom’s web site at http://www.britainusa.com 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:
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 Public Announcements, including the Worldwide Caution Public Announcement, 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:
Thefts, armed robberies, and other violent crimes do occur in the BVI.
Visitors should take common-sense precautions against petty crime.
Travelers should avoid carrying large amounts of cash and use hotel safety deposit facilities to safeguard valuables and travel documents.
Do not leave valuables unattended on the beach or in cars, and do not leave them in plain view in rental properties.
Always lock up boats when going ashore.

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

The local equivalent to the “911” emergency line in the BVI is: 999 or 911.
See our information on Victims of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION:
Medical care in the BVI consists of a small general hospital, Peebles Hospital (Telephone (284) 494-3497), with an emergency room staffed 24 hours a day by physicians, several clinics on Tortola, and one clinic in Virgin Gorda.
Both islands are served by ambulances staffed with paramedics.
There are no medical facilities on the other islands.
A volunteer organization, Virgin Islands Search and Rescue (VISAR), responds 24 hours a day to medical emergencies at sea or on outer islands.
VISAR transports casualties to the nearest point for transfer to ambulance.
To reach VISAR, dial SOS (767) or call on Marine Channel 16.

There is no hyperbaric chamber in the BVI.
Patients requiring treatment for decompression illness are transferred to St. John, U.S. Virgin Islands.
Most sensitive medical cases are transferred to San Juan, Puerto Rico.

Some HIV/AIDS entry restrictions exist for visitors to and foreign residents of the BVI.
Anyone who does not appear to be in good health may be required to undergo a medical exam, including HIV test, prior to being granted or denied entry.
Please verify this information with the Embassy of the United Kingdom at http://www.britainusa.com before you 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 hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747) or via the CDC’s website at http://wwwn.cdc.gov/travel/default.aspx.
For information about outbreaks of infectious diseases abroad consult the World Health Organization’s (WHO) web site at http://www.who.int/en.
Further health information for travelers is available at http://www.who.int/ith/en
MEDICAL INSURANCE:
The Department of State strongly urges Americans to consult with their medical insurance company prior to traveling abroad to confirm whether their policy applies overseas and whether it will cover emergency expenses such as a medical evacuation.
Please see our information on medical insurance overseas.

TRAFFIC SAFETY AND ROAD CONDITIONS:
While in a foreign country, U.S. citizens may encounter road conditions that differ significantly from those in the United States.
The information below concerning the British Virgin Islands is provided for general reference only, and may not be totally accurate in a particular location or circumstance.
Vehicles drive on the left (the British side) with most steering wheels on the left (the “American” side).
Road signs are limited and seatbelts are required by law.
Drivers often fail to yield the right-of-way to pedestrians, even at painted crosswalks.
Speeding and reckless driving are fairly common in the BVI.
Drivers can encounter nighttime drag racing on main thoroughfares and livestock on roads.
Roads in Tortola's interior can be steep and extremely slippery when wet.
Travelers planning to drive across the island should consider requesting four-wheel drive vehicles and should ensure that tires and brakes are in good operating condition on any rental vehicle.
Please refer to our Road Safety page for more information, as well as the BVI Tourist Board web site.
AVIATION SAFETY OVERSIGHT:
Civil aviation operations in the British Virgin Islands fall under the jurisdiction of British authorities.
The U.S. Federal Aviation Administration (FAA) has assessed the Government of the United Kingdom’s Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for oversight of the UK’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:
The removal of any marine organism from BVI waters is illegal for non-BV Islanders without a recreational fishing permit.
Fishing without a permit, even for sport, may lead to heavy fines or imprisonment.
Contact the Ministry of Natural Resources and Labour at (284) 468-3701 ext. 2147 for information.
Please see our Customs Information sheet..

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 BVI laws, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in BVI 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 the British Virgin Islands are encouraged to register with the the U.S. Embassy in Bridgetown, Barbados through the State Department’s travel registration website so that they can obtain updated information on travel and security within the BVI.
Americans without Internet access may register directly with the Embassy.
By registering, American citizens make it easier for the Embassy to contact them in case of emergency.
The U.S. Embassy is located in the Wildey Business Park in St. Michael, Barbados.
The Consular Section can be reached by telephone at 1-246-431-0225, by fax at 1-246-431-0179, contact them by e-mail.
* * * * * * *
This replaces the Country Specific Information for the British Virgin Islands dated April 2, 2008 to update sections on Entry/Exit Requirements, Crime, and Medical Facilities and Health Information.

Travel News Headlines WORLD NEWS

Date: Sat, 16 Sep 2017 22:00:48 +0200
By Cécile AZZARO

Pointe-à-Pitre, Sept 16, 2017 (AFP) - The French-Dutch island of St Martin, where white sands and turquoise waters once drew foreign visitors in droves, is now attracting a different kind of population: rats and mosquitoes.   Just over a week after Hurricane Irma devastated the island and neighbouring St Barthelemy, killing 15 people, pools of stagnant water and mounds of trash seem to be the new normal.   Add to that the absence of fresh running water, and the situation is ripe for a health epidemic.   "Yes, there are risks of outbreaks," said Annick Girardin, the French minister for overseas affairs, who spent a week on St Martin following the Category five storm.   "There is an existing problem on the issue of contaminated water, the issue of trash, basically the issue of hygiene."

In poorer neighbourhoods where many families were not able to evacuate, residents fear the spread of mosquitoes -- which can carry diseases ranging from Zika and dengue fever to Chikungunya.   "My son has a fever maybe due to a mosquito," said Natacha, a resident in the Sandy Ground neighbourhood near Marigot. "We will have to clean to prevent too many mosquitoes, or else there will be outbreaks. But it's difficult without water."   "If we get sick, we'll have to go to Guadeloupe".   According to an AFP journalist, in some neighbourhoods like Concordia, control programs had begun on Wednesday.

- Boiling water -
The island, which is still struggling to get its electricity and telecommunications systems back up and running, has found it difficult to reach residents and warn them about the potential health risks.   To get the word out, the French government has distributed notices and posters in French, Spanish, English and Creole.

Still, French health minister Agnes Buzyn said, "We realise there are people on the island, in certain neighbourhoods, who are not following health instructions".   One of the most important notices reminds people that only bottled water is safe to consume, and that if it is unavailable, boiling water before use is paramount.   "We hand out fresh water all over the territory, but it remains difficult," Buzyn said. "There are zones not easily accessed, people that maybe we haven't been able to reach."   According to the government, 150,000 bottles of water are being distributed to residents every day.   But some people have still been fetching water directly from a reservoir.

A desalination plant destined for St Martin arrived Friday on Pointe-a-Pitre, on the French island of Guadeloupe, about 300 kilometres (185 miles) away.   It will continue its journey to the hurricane-hit island by barge and is expected to be operational by September 25, the authorities said.   Meanwhile drinking water has returned to St Barts, which is now able to produce about 800 cubic metres (176,000 gallons) a day.   "We are not yet at a level of signalling an outbreak, far from it," Buzyn said. "Today, it's mostly an individual risk, which means it is essential that people who live on St Martin drink the bottled water that is distributed".   Buzyn had said last Wednesday that there had been some cases of children with diarrhoea, but did not mention any signs of an outbreak.

- Racing the clock -
Medical epidemiologists are aware of and on the lookout for any sign of outbreaks, and will regularly track patients using health surveys, said Guadeloupe's public health director Patrice Richard.   On Saturday, St Martin's health services coordinator Sergio Albarello said there had been no cases of outbreak on the island.   "As of now, there have been no reported cases" of outbreak, he told reporters, adding that as far as mosquitoes, "we are not talking about carriers of genes that are epidemiologically relevant".   And while many buildings were flattened by the storm, the St Martin hospital is still able to treat people "in excellent conditions", even though one of its buildings was partially destroyed.   Philippe Gustin, the French envoy in charge of the islands' reconstruction, said the immediate plan was to fix the damaged buildings.

According to Gustin, about 30 percent of the buildings on the French side of the island were completely destroyed, but he cautioned that teams were still putting together a final estimate of damages -- which has been put at one billion euros ($1.2 billion) or more for roads and buildings.   But repairing them before the high season, which usually starts in November and runs until April, seems nearly impossible.   Cleaning up also remains a priority for St Martin, particularly in areas where rats could proliferate.   Home to some 35,000 people, St Martin -- whose livelihood rests almost entirely on tourists -- attracts around two million visitors a year, most of them American cruise ship passengers.   While visiting St Barts this past week, French President Emmanuel Macron promised emergency financial aid for those "who have lost everything".   As for the Dutch side of the island, the Dutch Red Cross said Saturday that it had collected 13.3 millions euros following a weeklong donation drive.
Date: Tue, 12 Sep 2017 16:18:07 +0200

London, Sept 12, 2017 (AFP) - Over 100 high-risk prisoners escaped in the British Virgin Islands during Hurricane Irma, a British junior minister said on Tuesday, as he raised the death toll in British territories to nine.   "We had a serious threat of a complete breakdown of law and order in the British Virgin islands (BVI)," junior foreign minister Alan Duncan told parliament.   "The prison was breached, over 100 very serious prisoners escaped," he said.

Duncan said Royal Marines were deployed to cope with the threat but did not disclose how many prisoners had been recovered or how many were still at large.   "We have maintained and kept law and order on the BVI, which at one point, could have dramatically threatened the already unfortunate plight of those who had been hit by the hurricane," he said.   Contacted by AFP, the foreign ministry declined to comment.

The Daily Telegraph said notes from a cabinet meeting that were leaked to the press on Tuesday suggested as many as 60 had yet to be recaptured.   "We are working with St Lucia and BVI authorities to secure the transfer to St Lucia of 40 high-risk prisoners that have escaped in BVI," the briefing notes were reported as saying.   Duncan said a total of nine people died in British Caribbean territories -- five in the BVI and four in Anguilla. The authorities had previously reported one person killed in Anguilla.

Britain's response to Irma has been criticised by some local inhabitants as too slow with some complaining about a breakdown of law and order and being left to fend for themselves.   Briton Claudia Knight said her partner Leo Whitting, 38, was stranded on the island of Tortola in the British Virgin Islands archipelago.   "Everyone's turned feral and no-one's going out without being armed... It's turning really nasty," she told the Press Association news agency.   "Leo carries a knife with him," she said.   But Duncan said he "wholeheartedly and comprehensively reject the criticism".   "I think they are unjustified," he added.
Date: Mon 13 Jan 2014
Source: Government of the British Virgin Islands [edited]

The Ministry of Health and Social Development has confirmed 3 cases of chikungunya [virus infections], following reports of confirmed cases in St Martin and increased surveillance throughout the Virgin Islands. Dr Ronald Georges, medical officer of health in the Ministry of Health and Social Development said, "We have confirmed 3 cases on Jost Van Dyke."

Chikungunya is a viral disease transmitted to humans by the bite of infected mosquitoes.

"It is important to note that these confirmed cases were not exposed to travel, which alerts us that the virus is already in our mosquito population," Dr Georges stated.

According to Dr Georges, the ministry has been coordinating a response with the Environmental Health Division to minimise the impact of chikungunya [virus infections]. He is reminding the public to take appropriate measures to minimise exposure to mosquitoes. As such, the health division has stepped up its fogging programme and will be addressing "hotspot" areas known for mosquito breeding.

Dr Georges explained that chikungunya [virus infection] causes symptoms similar to dengue fever, which last 2-5 days. Symptoms include rash, arthritis-like pain affecting multiple joints, headaches, conjunctival infection, back pain, nausea, vomiting, polyarteritis, and a fever of 102 deg F [39 deg C] or higher. "Anyone experiencing one or more of these symptoms should contact their healthcare provider immediately," he said, adding, "Persons are urged to be vigilant in inspecting their premises for mosquito breeding sites."

He said that measures should also be taken to keep mosquitoes out of homes for example: removing catchment of still water, cover containers storing water, and more importantly necessary precautions should be taken to protect babies by placing a protective net over cribs. In addition the use of insect repellent on adults and children is also useful.

Clinicians and health care providers are asked to continue to report syndromic data to the Surveillance Unit in the Ministry of Health and Social Development, especially fever surveillance within 24 hours for continuous monitoring.

The Environmental Health Division will continue surveillance and control measures at ports of entry. However, residents are asked to remain vigilant in preventing mosquitoes from breeding around their homes and businesses.
------------------------------
communicated by:
Roland Hubner
Superior Health Council
Brussels
Belgium
==================
[Spread of chikungunya virus to other islands continues. In the absence of a commercially available vaccine, mosquito vector control and avoidance of mosquito bites are the only preventive measures that can be taken as noted in the report above. Fogging provides no long-term vector control. Breeding sites must be eliminated or treated with larvicides for effective control. That requires public cooperation and participation. Arrival of chikungunya virus in the dengue virus endemic areas of mainland Americas is probably more a matter of "when" than of "if".

Maps of the British Virgin Islands can be accessed at
Date: Wed, 15 Oct 2008 14:38:28 +0200 (METDST) MIAMI, Oct 15, 2008 (AFP) - Hurricane Omar moved toward the Virgin Islands Wednesday gaining power as warnings were issued across the Caribbean over the latest storm. With its center around 310 miles (495 kilometers) southwest of Puerto Rico's capital San Juan, the US National Hurricane Center said: "Additional strengthening is forecast in the next 24 to 36 hours." The hurricane -- with maximum sustained winds of near 120 kilometers (75 miles) per hour -- was moving slowly northeast toward San Juan. Hurricane warnings were issued for the US Virgin Islands, the British Virgin Islands, Saint Martin, Anguilla and Saint Kitts. "A hurricane warning could be required for Puerto Rico Wednesday morning," the NHC said. On the forecast track, the center of Omar was expected to move over or near the Leeward Islands -- just east of Puerto Rico -- by late Wednesday, the NHC said. Authorities also issued a hurricane warning for the French resort island of Saint Barthelemy, and tropical storm warnings for Antigua, Barbuda and Montserrat. Heavy rain was already falling across far northern Venezuela, where it could produce total rainfall of up to 15 centimeters (six inches), the NHC said. Up to 51 centimeters (20 inches) of rain "will be possible across Puerto Rico and the northern Leeward Islands," the NHC said. "These rains could produce life-threatening flash floods and mud slides," it warned. The busy 2008 hurricane season has included devastating Hurricanes Gustav and Ike, which caused millions of dollars in damage in Haiti, Cuba and the United States. Hurricanes and tropical storms have killed hundreds across the Caribbean and Mexico, with Haiti the worst hit.
Date: July 2008 Source: CAREC Surveillance Report - Communicable Diseases Vol. 28 No. 4 [edited] During epidemiological weeks 1-24, 2008, dengue virus type 2 was identified in the British Virgin Islands, Cayman Islands, Dominica, Grenada, St. Lucia and Trinidad & Tobago. Dengue virus type 4 was also identified in the British Virgin Islands, and virus type 1 was identified in Anguilla and Antigua & Barbuda. ------------------------ [This brief report does not indicate which of the islands had only imported dengue cases and which had local dengue virus transmission. As of mid-December 2007, the Cayman Islands only had imported dengue cases and had mounted an active surveillance and mosquito vector control campaign (see ProMED archive no. 20071218.4074). It would be interesting to know whether the 2008 cases were also all imported cases. An interactive ProMED HealthMap showing the location of the Cayman Islands can be accessed at: . - ProMed Mod.TY]
More ...

World Travel News Headlines

Date: Fri, 17 Jan 2020 17:48:09 +0100 (MET)

Barcelona, Jan 17, 2020 (AFP) - Spain's Balearic Islands passed a bill Friday aimed at clamping down on alcohol-fuelled holidays in the Mediterranean archipelago which bans happy hours when drinks are offered a discount and open bars.   "This is the first law adopted in Europe which restricts the sale and promotion of alcohol in certain touristic areas," the regional government of the Balearic Islands which have long been a magnet for young German and British tourists, who often drink heavily and enjoy rowdy late-night clubbing.

The restrictions will apply to three areas with a reputation for excess: San Antoni on the island of Ibiza and El Arenal and Magaluf -- which has been nicknamed "Shagaluf" because of its reputation for drunken casual sex -- on Mallorca, the largest of the Balearic's four islands.   The law, which was drawn up in consultation with the tourism industry also bans pub crawls and two-for-one drink offers, prohibits the sale of alcohol in shops between 9:30 pm and 8 am and forbids advertising party boats in the designated areas.   Establishments that break the new rules risk fines of up to 600,000 euros ($669,000) and the threat of being closed down for three years.

The new law also takes aim at the so-called "balconing" craze, the term given to holidaymakers who decide to jump into a swimming pool from a hotel or apartment balcony, a stunt which claims several lives every year.   It bans "balconing" across the entire archipelago and requires hotels to evict anyone who does it. Those caught jumping from balconies face fines of up to 60,000 euros ($67,000).   Up until now only some resorts on the Balearics imposed fines for "balconing".

The regional government of the Balearics said the law, which stiffens measures already introduced in 2015, will "fight excesses in certain tourist zones" and "force a real change in the tourism model of those destinations".   Magaluf made global headlines in 2014 after a video showing a young woman performing oral sex on several men on the dance floor of a nightclub went viral.   Local shops sell souvenir T-shirts with the catchphrase "On it 'till we vomit".

The four islands which make up the Balearics -- Palma de Mallorca, Ibiza, Menorca and Formentera, received nearly fourteen million tourists in 2018, drawn by their crystal clear waters, and in many cases by all-inconclusive package holidays.   The archipelago is Spain's second most visited region. Spain is the world's second most visited country after France.
Date: Fri, 17 Jan 2020 12:55:16 +0100 (MET)

Rennes, France, Jan 17, 2020 (AFP) - Several oyster farmers along France's Atlantic and Mediterranean coasts have been forced to halt sales since December after their sites were contaminated by the highly contagious norovirus, which they blame on overflowing sewage treatment plants.   Authorities ordered the suspensions at 23 of the country's 375 designated fields, and recalls of affected oysters as well as mussels and clams, after tests revealed the virus, which can cause severe vomiting and diarrhoea.

The move came just before the year-end holidays, when oysters are a traditional delicacy on millions of French tables.   "The oysters are not sick. They're carrying the virus because it's in the water they are constantly filtering," Philippe Le Gal, president of France's national shellfish council (CNC), told AFP this week.   "They were in the wrong place at the wrong time," he said, adding the ban had prompted many people to stop eating oysters altogether.   Local officials say oyster farmers are paying the price of insufficient spending on wastewater treatment, with facilities strained to the limit even as development of coastal areas has surged in recent years.

Heavy rains before Christmas prompted treatment basins to overflow, they say, spilling tainted water into rivers.   "This was predictable -- they've kept issuing building permits even though treatment sites are already at full capacity," said Joel Labbe, a senator for the Morbihan region in Brittany.   Oyster farmers are demanding compensation, and a delegation met with agriculture ministry officials in Paris last week warning that more than 400 businesses had been impacted by the sales ban.

This week, angry growers dumped trash bins full of oysters and mussels in front of the offices of the regional ARS health authority in Montpellier over the decision to halt sales from a nearby basin on the Mediterranean coast.   "We're the victims, and we shouldn't have to suffer any financial damages," Le Gal said.
Date: Fri, 17 Jan 2020 04:44:41 +0100 (MET)

Suva, Fiji, Jan 17, 2020 (AFP) - Fiji opened evacuation centres and warned of "destructive force winds" Friday as a cyclone bore down on the Pacific island nation for the second time in three weeks.   Two people were missing after attempting to swim across a swollen river late Thursday when heavy rain fell ahead of the advancing Cyclone Tino, police said.   On the outer islands, locals prepared to go to emergency shelters while many tourists fled beach resorts and made their way to the capital Suva before regional flights and inter-island ferry services were suspended.

The Fiji Meteorological Service said Tino was strengthening as it headed for Fiji's second-largest island, Vanua Levu, warning of wind gusts of up to 130 kilometres per hour (80 mph), heavy rain, coastal flooding and flash flooding in low lying areas.    "I'm preparing to go to an evacuation centre soon with my family and wait for the cyclone to pass," Nischal Prasad, who lost his home in northern Vanua Legu when Cyclone Sarai struck just after Christmas, told AFP.   "Sarai destroyed my house and almost left my family homeless. My daughters had to hide under their bed from the strong winds. It was a scary experience," he said.

Russian tourist Inna Kostromina, 35, said she sought safety in Suva after being told her island resort was in the path of the cyclone.   "We didn't want to get stuck in there and with the authorities warning of coastal flooding, anything can happen. So we decided to move to Suva for now. I think we will be much safer here."    Police said a man and his daughter, believed to be aged nine or 10, were attempting to swim across a flooded river when they were caught in the strong currents.    The incident happened on Thursday before the storm developed into a tropical cyclone, but a police spokesman linked the tragedy to "heavy rain brought about by the current weather system (which) raised the river level".   Although the Pacific islands are popular tourist destinations in summer it is also the cyclone season, and Fiji is being targeted for the second time in three weeks.

In late December, Tropical Cyclone Sarai left two people dead and more than 2,500 needing emergency shelter as it damaged houses, crops and trees and cut electricity supplies.    On its present track, Tino would hit Tongatapu, the main island of neighbouring Tonga, on the weekend.    Two years ago, Tongatapu was hit by Cyclone Gina, with two people killed and nearly 200 houses destroyed.
Date: Thu, 16 Jan 2020 16:38:39 +0100 (MET)
By Hiroshi HIYAMA

Tokyo, Jan 16, 2020 (AFP) - Japan has confirmed a case of a mystery virus that first emerged in China and is from the same family as the deadly SARS pathogen, authorities said Thursday.   It appears to be only the second time the novel coronavirus has been detected outside China, after the World Health Organization (WHO) confirmed a case in Thailand.   Japan's health ministry said a man who had visited the central Chinese city of Wuhan, the apparent epicentre of the outbreak, was hospitalised on January 10, four days after his return to Japan. He reported a persistent fever.

Tests on the patient, who was released from hospital on Wednesday, confirmed he was infected with the new virus.   "This is the first domestic discovery of a pneumonia case related to the new coronavirus," the ministry said in a statement.   "We will continue active epidemiological research while also coordinating efforts with the World Health Organization and related agencies to conduct a risk assessment."   The outbreak has killed one person so far, with 41 patients reported in Wuhan.

The outbreak has caused alarm because the new virus is from the same family as the pathogen that causes SARS (Severe Acute Respiratory Syndrome), which killed 349 people in mainland China and 299 in Hong Kong in 2002 and 2003.   Authorities in Wuhan said a seafood market was the centre of the outbreak. It was closed on January 1.   Japanese authorities said the man had not visited the market and that it was possible he had been in contact with a person infected with the virus while in Wuhan.

- Outbreak in Japan 'unlikely' -
Health ministry official Eiji Hinoshita told reporters that the risk of the disease spreading from the patient was considered low, with careful checks done on those who had been in close contact with him.   "At this point, we feel it is unlikely this will lead to a dramatic outbreak," he said, adding that the patient was no longer suffering a fever and was recuperating at home.

Officials declined to give further information on the man, including his nationality, citing privacy concerns.   Local media said the patient was a Chinese national in his 30s living in Kanagawa, just southwest of Tokyo.   Public broadcaster NHK said he had already recovered and was resting at home, as quarantine officials at Tokyo's Narita airport boosted health checks on all travellers.

The health ministry urged people who develop a cough or fever after visiting Wuhan to wear a surgical mask and "swiftly visit a medical institution".   Hinoshita said Japan would need to be on guard ahead of the Lunar New Year, a popular travel period in China.   "It is expected that Japan will see many visitors from China," he said.   It is not yet clear whether the mystery virus can be transmitted between humans, but on Wednesday authorities said it was possible it had spread inside a family.

The woman diagnosed in Thailand, who is in a stable condition, also said she had not visited the Wuhan seafood market.   And WHO doctor Maria Van Kerkhove on Tuesday said she "wouldn't be surprised if there was some limited human-to-human transmission, especially among families who have close contact with one another".   Hong Kong authorities on Tuesday said several dozen people had been hospitalised with fever or respiratory symptoms after travelling to Wuhan, but no cases of the new virus have so far been confirmed.
Date: 20 Jan 2020
Source: News Joins [In Korean, machine trans. edited]
----------------------------
An unexplained pneumonia in China caused the Korean quarantine authorities to strengthen the quarantine, and a fever-sensing camera is installed to monitor the body temperature of Chinese tourists who entered Korea at Incheon Port 1 International Passenger Terminal. 

Pneumonia confirmed by the new coronavirus, which is prevalent in Wuhan, China, was confirmed for the first time on [20 Jan 2020]. According to health officials, a Chinese woman, A, who arrived at Incheon International Airport on a plane from Wuhan last weekend, was confirmed with pneumonia. The patient showed signs of pneumonia, including high fever and cough. The health authorities entered the airport at the same time, confirmed the symptoms of high fever, suspected pneumonia, and went into quarantine and testing. The Centers for Disease Control immediately quarantined A and entered treatment with a nationally designated quarantine bed. The Centers for Disease Control will hold an emergency press conference at 1:30 pm on [20 Jan 2020] and release the reporter A.
 
Meanwhile, Beijing's Daxing District Health and Welfare Committee said 2 fever patients who had been to Wuhan were confirmed as a new pneumonia patient on [19 Jan 2020]. They are currently being treated at a designated hospital and said they are stable. Daxing District is where Beijing New Airport opened last year [2019]. The Guangdong Provincial Health and Welfare Committee said on [19 Jan 2020] that a 66-year-old man who had visited a relative's home in Wuhan showed fever and lethargy and was diagnosed with Wuhan pneumonia. Confirmation patients have also emerged in Shenzhen, a neighbouring Hong Kong province in southern China, raising concerns that the new pneumonia has already spread throughout China.
 
The Chinese government has said that "there is no basis for human-to-human propagation," but domestic experts pointed out that "the nature of coronavirus is less likely to prevent human-to-human propagation."   [Byline: Esther Toile]
========================
[This is now the 4th international identification of the 2019-nCoV (novel coronavirus) associated illness reported outside of China.  To date, all 4 cases have reported being in Wuhan China in the 14 days preceding onset of illness.  Illness in each involved a history of fever and dry cough.  Cases were reported by Thailand (2 cases) and Japan, and now South Korea.  An update following a Ministry of Health Korea press conference mentioned that there were 5 individuals accompanying this woman, none of whom were currently showing symptoms. (<http://news1.kr/articles/?3821049>).

As mentioned in an earlier post (see Novel coronavirus (10): China (HU, GD, BJ) http://promedmail.org/post/20200119.6898567), there have also been cases confirmed in China outside of Wuhan City, with cases reported in Beijing, Guangdong and possibly Shanghai. It is becoming more difficult to conclude that there has been limited person-to-person transmission as the case numbers are climbing both inside of Wuhan City, elsewhere in China, and in individuals travelling from Wuhan China to other countries (Japan, Thailand and South Korea).

A map of South Korea can be found at:
Date: 15 Jan 2020
Source: Fox News [edited]

CDC is facing criticism over its response to a polio-like illness. The Centers for Disease Control and Prevention has confirmed 10 additional cases of acute flaccid myelitis.  An Ohio teen is determined to walk again despite doctors' warnings that she may not after she contracted a rare polio-like illness that's left her paralyzed from the waist down.  IK, a catcher on her middle school's softball team, said it started with what felt like a cramp in her leg on Christmas. "I just thought, 'Oh gosh, it's just growing pains or a Charley horse,'" NK, the 13-year-old's mother, told News 5 Cleveland.  But the next day, IK couldn't stand on her own, and her worried parents rushed her to Akron Children's Hospital, where she was diagnosed with acute flaccid myelitis (AFM). It's a rare but serious condition that affects the nervous system, specifically the grey matter of the spinal cord, which weakens the body's muscles and reflexes.

Health officials have noticed an increase of cases in children occurring every 2 years since 2014, according to the Centers for Disease Control and Prevention (CDC). And while it often is referred to as a "polio-like" illness, tests so far have tested negative for poliovirus.  Symptoms typically begin with sudden onset of arm or leg weakness and loss of muscle tone and reflexes, but can also include facial droop or weakness, difficulty moving eyes, drooping eyelids, difficulty swallowing,  slurred speech, and pain in the arms and legs.  Severe symptoms may include respiratory failure, or serious neurological complications, according to the CDC. Parents are encouraged to seek medical care right away if a child is suspected of developing any symptoms

Since her diagnosis, IK has been working in physical therapy and has received steroid treatments as well as multiple plasma exchange, according to the news outlet. Her mother said it's been like "a bad dream" for the family as they watch her struggle to gain strength.  "It's a lot, but I just try to go with the flow, just to push through," IK, who has received support from her teammates, classmates and members of the community, told News 5 Cleveland.  [Byline: Alexandria Hein]
======================
[Acute flaccid myelitis (AFM) is a rare but serious condition. It affects the nervous system, specifically the area of the spinal cord called gray matter, which causes the muscles and reflexes in the body to become weak.

In 2019, there were 33 total confirmed cases in 16 US states
[<https://www.cdc.gov/acute-flaccid-myelitis/cases-in-us.html>].

The case definition for AFM is based on clinical and lab criteria

Clinical Criteria: An illness with onset of acute flaccid limb weakness.
Laboratory Criteria:
Confirmatory Laboratory Evidence: a magnetic resonance image (MRI) showing spinal cord lesion largely restricted to grey matter and spanning one or more vertebral segments. Supportive Laboratory Evidence: cerebrospinal fluid (CSF) with pleocytosis (white blood cell count over 5 cells/mm3) Case Classification:
- Confirmed: Clinically compatible case AND Confirmatory laboratory evidence: MRI showing spinal cord lesion largely restricted to grey matter and spanning one or more spinal segments.
- Probable: Clinically compatible case AND Supportive laboratory evidence: CSF showing pleocytosis (white blood cell count over 5 cells/mm3)

With the high number of cases reported in 2018 and 2019, CDC enhanced AFM surveillance through collection of data at the national level by encouraging healthcare providers to recognize and report to their health departments all patients whom they suspect may have AFM; health departments are being asked to send this information to CDC to help us understand AFM activity nationwide. - ProMED Mod.UBA]

[HealthMap/ProMED map available at:
Date: Sat 18 Jan 2020
From: Guido Calleri <guidocalleri@aslcittaditorino.it> [edited]

90 persons presented to the Infectious Diseases Hospital Amedeo di Savoia, Torino, North-West Italy between 24 Dec 2019 and 10 Jan 2020 after consuming raw sausages from a wild boar hunted in the area of Susa Valley, 50 km [31.1 mi] away from Torino, in late November 2019.

All of them either were symptomatic (fever, muscle and/or abdominal pain, nausea) or had peripheral blood eosinophilia over 500/cmm, or both. IgG serology for trichinella was performed by immunoblot (Trichinella E/S IgG kit, EFFEGIEMME, Milan, Italy) and resulted positive in 48/90 (53.3%), allowing a diagnosis of confirmed trichinella infection.

Otherwise, a diagnosis of suspected trichinella infection was made with a negative serology, probably due to performing the test too early, before the development of antibodies or possibly a false negative result. In a few cases (under 10 cases) an alternative diagnosis was considered.

All patients were treated with oral albendazole 400 mg twice daily for 10 days and prednisone 50 mg/day.

Most likely, all patients were infected after eating meat from a single animal, given the low prevalence of the infection in this area: no human case has ever been detected in Torino province, and only one wild boar has been found positive for trichinella at microscopy in Susa valley in the last 10 years.
---------------------------------------
Guido Calleri, Filippo Lipani, Giovanna Paltrinieri, Silvia Faraoni,
Valeria Ghisetti
ASL Citta di Torino, Infectious Diseases Unit and Microbiology Lab,
and ASL TO3,
Department of Prevention
Torino, Piedmonte, Italy
======================
[ProMED thanks Guido Calleri, Filippo Lipani, Giovanna Paltrinieri, Silvia Faraoni, and Valeria Ghisetti for sending us this information. The report underlines that _Trichinella_ are found in wild boars in Europe and should be assessed by a certified laboratory for _Trichinella_ before used for human consumption. Sausages made of smoked meat are especially dangerous, because the temperatures seldom reach what is needed to kill the trichinella larvae. - ProMED Mod.EP]

[HealthMap/ProMED map available at:
Date: Fri 17 Jan 2020
Source: Outbreak News Today [edited]

Media sources in Bangladesh are reporting a Nipah virus infection in the city of Khulna. The reported case is a 20-year-old female who has been hospitalized since last Saturday [11 Jan 2020] at the Khulna Medical College Hospital (KMCH).

"A medical board has confirmed her infection by Nipah virus. As her infection is a risk to other patients, she is being treated separately at the hospital's Medicine unit 1," said SM Kamal Hossain, chief of KMCH Medicine Department.

According to the World Health Organization (WHO), in the Bangladesh and India outbreaks, consumption of fruits or fruit products (e.g. raw date palm juice) contaminated with urine or saliva from infected fruit bats was the most likely source of infection. Fruit bats of the family Pteropodidae -- particularly species belonging to the _Pteropus_ genus -- are the natural hosts for Nipah virus. There is no apparent disease in fruit bats.

In more recent outbreaks of the disease, person-to-person transmission has been seen in Bangladesh and India.

The disease in humans can range from asymptomatic infection to fatal encephalitis. Encephalitis and seizures occur in severe cases, progressing to coma within 24 to 48 hours.

The case fatality rate is estimated at 40% to 75%; however, this rate can vary by outbreak depending on local capabilities for surveillance investigations, according to the WHO.

Those who survive acute encephalitis make a full recovery, but around 20% are left with residual neurological consequences, such as persistent convulsions and personality changes.

There is no treatment or vaccine available for either people or animals.
======================
[Nipah virus infections occur sporadically in Bangladesh in a geographic area termed the Nipah belt and during certain seasons of the year when the reservoir fruit bat is abundant. As noted in the previous comment (ProMED-mail archive no. http://promedmail.org/post/20150204.3143251), giant fruit bats or flying foxes (_Pteropus_ of several species) are reservoirs of Nipah virus, and they contaminate date palm sap or fruit. This is the season for cases of Nipah virus infection to occur. The transmission season is usually January to April.

As noted earlier, it is unfortunate that the public awareness efforts have not prevented these cases from occurring. Perhaps because cases are sporadic and geographically scattered there is little public perception of risk of infection and serious disease. Until effective public education to prevent infection by avoiding eating contaminated fruit or date palm sap is implemented, sporadic cases will continue to occur.

Interestingly, a simple skirt constructed out of locally available materials can prevent access of the bats to the palm sap collecting pots, but apparently they are not commonly used. Boiling the palm sap would inactivate the virus, but local consumers indicated that it alters the flavour of the sap.

An image of a _Pteropus_ fruit bat can be found at

[HealthMap/ProMED map available at:
Khulna, Khulna, Bangladesh: <http://healthmap.org/promed/p/14886>]
Date: Wed 15 Jan 2020
Source: Hindustan Times [edited]

Government High School, Tajpur village, has been put under surveillance after 16 students of the school were found to be infected with mumps, a viral infection that swells up the saliva-producing glands of a person.

A rapid response team had been dispatched to the school last week, after the students, all aged between 11 and 14, were found infected. The school currently has 106 students [enrolled], and all are under observation. The team had also surveyed the entire village and collected samples, to be sent to the Integrated Diseases Surveillance Program (IDSP) lab for testing.

Lack of measles, mumps, and rubella [MMR] vaccination is what leaves a person prone to the infection. Mumps virus spreads from person to person through infected saliva. If an individual is not immune, they can contract the viral by breathing in saliva droplets from an infected person.

Dr. Divjot Singh, epidemiologist, district health department, said the situation is now under control. "We have asked the school's principal to relieve all students infected with mumps. The school will remain under surveillance for 15 more days. Medical officers are also carrying out awareness drive at the school and the village against mumps," said Dr. Divjot Singh.

Last year [2019], a mumps outbreak was reported from 2 areas of the district, including Andlu village in Raikot and Red Cross Bhavan, Sarabha Nagar, Ludhiana.  [Byline: Harvinder Kaur]
Date: Wed 15 Jan 2020
Source: Devon Live [abridged, edited]

An outbreak of 19 new cases of mumps has been reported across Devon in the last week. The contagious viral disease particularly affects under 25s. The new mumps figures have been released in the official Government weekly Statutory Notifications of Infectious Diseases report, with the highest number in Exeter.

It follows a warning that mumps is on the rise, particularly in university towns. Traditionally known as the "kissing disease" because it spreads fast between groups of young people, mumps is a contagious viral infection recognisable by the painful swellings in the side of the face under the ears (the parotid glands), giving a person a distinctive "hamster face" appearance.

In severe cases, it can develop into viral meningitis if it moves in the outer layer of the brain. Other complications include swelling of the testicles or ovaries (if the affected person has gone through puberty), which may affect a person's fertility.  [Byline: Colleen Smith]