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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: Thu, 2 Apr 2020 12:24:14 +0200 (METDST)

Dubai, April 2, 2020 (AFP) - Emirates Airline said Thursday it is to resume a limited number of outbound passenger flights from April 6, less than two weeks after its coronavirus-enforced stoppage.   "Emirates has received approval from UAE authorities to restart flying a limited number of passenger flights," its chairman, Sheikh Ahmed bin Saeed Al-Maktoum, said on Twitter.   "From April 6, these flights will initially carry travellers outbound from UAE," he said, adding that details would be announced soon.      Dubai-owned carrier Emirates, the largest in the Middle East with 271 wide-body aircraft, grounded passenger operations last week as the UAE halted all passenger flights to fight the spread of coronavirus.

The UAE, which groups seven emirates including Dubai, has declared 814 coronavirus cases along with eight deaths.   It has imposed a sweeping crackdown, including the flight ban and closure of borders.   Sheikh Ahmed said Emirates, which owns the world's largest fleet of Airbus A-380 superjumbos with 113 in its ranks, was looking to gradually resume passenger services.   "Over the time, Emirates looks forward to the gradual resumption of passenger services in line with lifting of travel and operational restrictions, including assurance of health measures to safeguard our people and customers," he said.

When Emirates suspended flights, it cut between 25 percent and 50 percent of the basic salary of its 100,000-strong staff for three months, saying it wanted to avert layoffs.   Dubai's crown prince, Sheikh Hamdan bin Mohammed bin Rashid Al-Maktoum said Tuesday that Dubai will support the airline by injecting new capital.   Tourism, aviation, hotels and entertainment are key contributors to Dubai's mostly non-oil economy.
Date: Mon, 23 Mar 2020 00:45:56 +0100 (MET)

Dubai, March 22, 2020 (AFP) - The United Arab Emirates announced on Monday it will temporarily suspend all passenger and transit flights amid the novel coronavirus outbreak.    The Emirati authorities "have decided to suspend all inbound and outbound passenger flights and the transit of airline passengers in the UAE for two weeks as part of the precautionary measures taken to curb the spread of the COVID-19", reported the official state news agency, WAM.   It said the decision -- which is subject to review in two weeks -- will take effect in 48 hours, adding: "Cargo and emergency evacuation flights would be exempt."

The UAE, whose international airports in Abu Dhabi and Dubai are major hubs, announced on Friday its first two deaths from the COVID-19 disease, having reported more than 150 cases so far.   Monday's announcement came hours after Dubai carrier Emirates announced it would suspend all passenger flights by March 25.    But the aviation giant then reversed its decision, saying it "received requests from governments and customers to support the repatriation of travellers" and will continue to operate passenger flights to 13 destinations.

Emirates had said it will continue to fly to the United Kingdom, Switzerland, Hong Kong, Thailand, Malaysia, the Philippines, Japan, Singapore, South Korea, Australia, South Africa, the United States and Canada.   "We continue to watch the situation closely, and as soon as things allow, we will reinstate our services," said the airline's chairman and CEO, Sheikh Ahmed bin Saeed Al-Maktoum.   Gulf countries have imposed various restrictions to combat the spread of the novel coronavirus pandemic, particularly in the air transport sector.   The UAE has stopped granting visas on arrival and forbidden foreigners who are legal residents but are outside the country from returning.
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:
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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 ...

Spain

Spain and Andorra US Consular Information Sheet
January 13, 2009
Spain and Andorra are both advanced stable democracies and modern economies. Spain is a member of North Atlantic Treaty Organization (NATO) and the European Union.
Read the D
partment of State Background Notes on Spain and Andorra for additional information.

ENTRY/EXIT REQUIREMENTS:
Spain is a party to the Schengen agreement.
As such, U.S. citizens may enter Spain for up to 90 days for tourist or business purposes without a visa.
The passport should be valid for at least three months beyond the period of stay.
For further details about travel into and within Schengen countries, please see our Schengen Fact Sheet.

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 not present.
Having such documentation on hand, even if not required, may facilitate entry/departure.
For further information concerning entry requirements for Spain, travelers should contact the Embassy of Spain at 2375 Pennsylvania Avenue NW, Washington, DC 20037, telephone (202) 452-0100, or the nearest Spanish Consulate in Boston, Chicago, Houston, Los Angeles, Miami, New Orleans, New York, San Francisco, or San Juan.
Spanish government web sites with information about entry requirements (in Spanish) can be found at http://www.mae.es and http://www.mir.es.
Additional information may be obtained from the Tourist Office of Spain in New York, telephone (212) 265-8822, or online at http://www.spain.info/.
For further information on entry requirements to Andorra, travelers should contact the Andorran Mission to the UN, 2 U.N. Plaza, 25th floor, New York, NY 10018, telephone (212) 750-8064 or online at http://www.andorra.ad.
Visit the Embassy of Spain and Andorra web sites 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:
Spain and Andorra share with the rest of the world an increased threat of international terrorist incidents.
Like other countries in the Schengen area, Spain's open borders with its Western European neighbors allow the possibility of terrorist groups entering and exiting the country with anonymity.
Spain’s proximity to North Africa makes it vulnerable to attack from Al Qaeda terrorists in the Maghreb region.
Americans are reminded to remain vigilant with regard to their personal security and to exercise caution.

In the deadliest terrorist attack in recent European history, in March 2004, Islamist extremists bombed four commuter trains entering Madrid, causing 191 deaths and over 1,400 injuries.
Spanish authorities tried the suspected terrorists and their co-conspirators in February 2007 and convicted in October 2007.
The Basque Fatherland and Liberty (ETA) terrorist organization remains active in Spain.
ETA has historically avoided targeting foreigners, directing their attacks against the police, military, local politicians, and Spanish government targets as well as attempts to disrupt transportation and daily life. However, foreigners have been killed or injured collaterally in ETA attacks.
Two examples of this are the Barajas Airport bombing in December 2006, in which two Ecuadorian nationals were killed and the bombing at the University of Navarre in October 2008, in which 17 students were injured including one American student.
In addition, bombs have been used as part of criminal extortion of businesses, particularly in the Basque region. The risk of “being in the wrong place at the wrong time” in event of an ETA action is a concern for foreign visitors and tourists.
U.S. tourists traveling to Spain should remain vigilant, exercise caution, monitor local developments, and avoid demonstrations and other potentially violent situations.

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:
Andorra has a low rate of crime.
While most of Spain has a moderate rate of crime and most of the estimated one million American tourists have trouble free visits to Spain each year, street crimes against tourists occur in the principal tourist areas.
Madrid and Barcelona, in particular, report incidents of pick-pocketing, mugging and occasional violent attacks, some of which require the victim to seek medical attention.
Although crimes occur at all times of day and night and to people of all ages, older tourists and Asian Americans seem to be particularly at risk.
Criminals frequent tourist areas and major attractions such as museums, monuments, restaurants, outdoor cafes, Internet cafes, hotel lobbies, beach resorts, city buses, subways, trains, train stations, airports, and ATMs.

In Madrid, incidents have been reported in all major tourist areas, including the area near the Prado Museum, near Atocha train station, in Retiro Park, in areas of old Madrid including near the Royal Palace and in Plaza Mayor.
There have been a number of passport and bag thefts reported at Madrid’s Barajas Airport, local hotels, as well as in El Rastro (Madrid’s flea market) and in the Metro.

In Barcelona, the largest number of incidents reported also occurred in major tourist areas, on Las Ramblas, Barcelona’s El Prat airport, Sants train station, Metro stations, in the Sagrada Familia Area, in the Gothic Quarter, in Parc Güell, in Plaza Real, and along Barcelona’s beaches.
There has been a rise in the number of thefts reported at the Port Olimpic Area and nearby beaches.

Travelers should remain alert to their personal security and exercise caution. Travelers are encouraged to carry limited cash, only one credit card, and a copy of their passport; leaving extra cash, extra credit cards, passports and personal documents in a safe location.
When carrying documents, credit cards or cash, you are encouraged to secure them in a hard-to-reach place and not to carry all valuables together in a purse or backpack.
Thieves often work in teams of two or more people.
In many cases, one person distracts a victim while the accomplices perform the robbery.
For example, someone might wave a map in your face and ask for directions, “inadvertently” spill something on you, or help you clean-up bird droppings thrown on you by a third unseen accomplice.
While your attention is diverted, an accomplice makes off with the valuables.
Thieves may drop coins or keys at your feet to distract you and try to take your belongings while you are trying to help.
Attacks are sometimes initiated from behind, with the victim being grabbed around the neck and choked by one assailant while others rifle through or grab the belongings.
A group of assailants may surround the victim in a crowded popular tourist area or on public transportation, and only after the group has departed does the person discover he/she has been robbed.
Purse-snatchers may grab purses or wallets and run away, or immediately pass the stolen item to an accomplice.
A passenger on a passing motorcycle sometimes robs pedestrians.
There have been reports of thieves posing as plainclothes police officers, beckoning to pedestrians from cars and sometimes confronting them on the street asking for documents, or to inspect their cash for counterfeit bills, which they ultimately “confiscate” as evidence.
The U.S. Embassy in Madrid has received reports of cars on limited access motorways being pulled over by supposed unmarked police cars.
The Spanish police do not operate in this fashion.
American citizens are encouraged to ask for a uniformed law enforcement officer if approached.
Theft from vehicles is also common.
“Good Samaritan" scams are unfortunately common, where a passing car or helpful stranger will attempt to divert the driver’s attention by indicating there is a flat tire or mechanical problem.
When the driver stops to check the vehicle, the “good Samaritan” will appear to help the driver and passengers while the accomplice steals from the unlocked car. Drivers should be cautious about accepting help from anyone other than a uniformed Spanish police officer or Civil Guard.
Items high in value like luggage, cameras, laptop computers, or briefcases are often stolen from cars. Travelers are advised not to leave valuables in parked cars, and to keep doors locked, windows rolled up, and valuables out of sight when driving.
While the incidence of sexual assault is statistically very low, attacks do occur.
Spanish authorities warn of the availability of so-called "date-rape" drugs and other drugs, including "GBH" and liquid ecstasy.
Americans should not lower their personal security awareness because they are on vacation.
A number of American citizens have been victims of lottery or advance fee scams in which a person is lured to Spain to finalize a financial transaction. Often the victims are initially contacted via Internet or fax and informed they have won the Spanish Lottery (El Gordo), inherited money from a distant relative, or are needed to assist in a major financial transaction from one country to another.
For more information, please see the Bureau of Consular Affairs web site on International Financial Scams.

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.
The Embassy’s U.S. Commercial Service receives reports of a type of scam targeting U.S. businesses, utilizing the name of a legitimate Spanish concern and legitimate-appearing Spanish bank references.
The scam usually involves a temptingly large order or business proposal.
The U.S. Commercial Service in Spain at http://www.buyusa.gov/spain/en/ stands ready to counsel any U.S. firm which would like to verify the legitimacy of an unsolicited business proposal purporting to come from a Spanish firm.

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, help you 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.
Spain does have a Crime Victim’s Assistance program.
More information can be obtained at http://www.mjusticia.es/Directorio/Victimas?menu_activo=1057821035144&lang=es_es.

The local equivalent to the “911” emergency line in Spain is 112.
Please see our information on Victims of Crime, including possible victim compensation programs.
MEDICAL FACILITIES AND HEALTH INFORMATION:
Good medical care is available in both Spain and Andorra.
Regulations regarding medications may vary from those in the United States; Americans with need for specific medications are encouraged to bring a supply sufficient for their anticipated period of stay, as the medication may not be available and customs regulations may prohibit certain medications to be mailed from the United States to Spain or Andorra.
The Department of State strongly urges Americans to consult with their medical insurance companies prior to traveling abroad to confirm whether their policy applies overseas and if it will cover emergency expenses such as a medical evacuation.
U.S. medical insurance plans may not cover health costs incurred outside the United States unless supplemental coverage is purchased.
Further, U.S. Medicare and Medicaid programs do not provide payment for medical services outside the United States. You should contact your insurance provider before departure so appropriate arrangements can be made.
Many travel agents and private companies offer insurance plans that will cover health care expenses incurred overseas, including emergency services such as medical evacuations.

When making a decision regarding health insurance, Americans should consider that many foreign doctors and hospitals require payment in cash prior to providing service and that a medical evacuation to the United States may cost well in excess of $50,000.
Uninsured travelers who require medical care overseas often face extreme difficulties, whereas travelers who have purchased overseas medical insurance have found it to be life saving when a medical emergency has occurred.
When consulting with your insurer prior to your trip, please ascertain whether payment will be made to the overseas healthcare provider or if you will be reimbursed later for expenses that you incur.
Some insurance policies also include coverage for psychiatric treatment and for disposition of remains in the event of death.

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

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

TRAFFIC SAFETY AND ROAD CONDITIONS:
While in a foreign country, U.S. citizens may encounter road conditions that differ significantly from those in the United States.
The information below concerning name of country is provided for general reference only, and may not be totally accurate in a particular location or circumstance.
Traffic in Madrid and Barcelona is faster-paced than in U.S. cities and can be unnerving due to unfamiliar signs or motorbikes weaving between traffic lanes.
Drivers should always obey the closest traffic light, as there are separate pedestrian lights in the city.
Drivers should be alert when driving at night in urban areas, due to the possibility of encountering drivers or pedestrians under the influence of alcohol.
Night driving in isolated rural areas can be dangerous because of farm animals and poorly marked roads.
Rural traffic is generally heavier in July and August as well as during the Christmas and Easter seasons.
Traffic regulations in effect in Spain include the prohibition on the use of a mobile phone without a hands-free device while driving a car.
There is a fine of 300 euros for violation of this regulation and loss of driving privileges.
In addition, all drivers and passengers are required to carry a reflective vest and put it on if they need to stop on the roadside.
A reflective triangle warning sign for a vehicle stopped on the side of the road is also mandatory.
Those renting vehicles are encouraged to check with the rental company about traffic regulations and safety equipment.
U.S. citizens using U.S. issued drivers licenses must obtain International Driving Permits prior to their arrival if they plan to drive in Spain.
Pedestrians should use designated crossing areas when crossing streets and obey traffic lights.
Public transportation in large Spanish cities is generally excellent.
All major cities have metered taxis, in which extra charges must be posted in the vehicle.
Travelers are advised to use only clearly identified cabs and to ensure that taxi drivers always switch on the meter.
A green light on the roof indicates that the taxi is available.
Rail service is comfortable and reliable, but varies in quality and speed. Intercity buses are usually comfortable and inexpensive.
Please refer to our Road Safety page for more information.
For specific information concerning Spanish driving permits, vehicle inspection, road tax and mandatory insurance, please contact the Spanish National Tourist Organization offices in New York at http://www.spain.info/us/TourSpain.
For information about driving in Andorra, refer to http://www.andorra.ad/en-US/Pages/default.aspx.

AVIATION SAFETY OVERSIGHT:
The U.S. Federal Aviation Administration (FAA) has assessed the Government of Spain’s Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for oversight of Spain’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.

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 offences.
Persons violating the laws of Spain or Andorra, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in Spain and Andorra are severe, and convicted offenders can expect long jail sentences and heavy fines. The cities of Madrid and Barcelona and The Balearics Regional Government have banned the consumption of alcohol in the street, other than in registered street cafes and bars.
Visitors to Madrid, Barcelona, Mallorca, Ibiza, and Menorca should be aware that failure to respect this law might result in the imposition of 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 Spain or Andorra are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department’s travel registration web site to obtain updated information on travel and security within Spain or Andorra.
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 Serrano 75; telephone (34) (91) 587-2200, and fax (34) (91) 587-2303. U.S. citizens who register in the Consular Section at the U.S. Embassy, Consulate General, or one of the Consular Agencies listed below can obtain updated information on travel and security within Spain or Andorra.
Additional information and appointments for routine services are available through the U.S. Embassy’s home page at http://madrid.usembassy.gov.
Appointments are required for routine Consular Services.
To make an appointment, go to https://evisaforms.state.gov/acs/default.asp?postcode=MDD&appcode=1.
The U.S. Consulate in Barcelona is located at Paseo Reina Elisenda 23-25; telephone (34) (93) 280-2227 and fax (34) (93) 205-5206.
Visitors to Barcelona can access additional information from the Consulate General’s web page at http://madrid.usembassy.gov/barcelonaen.html.
There are six consular agencies in Spain, which provide limited services to American citizens, but are not authorized to issue passports.
Anyone requesting service at one of the consular agencies should call ahead to verify that the service requested will be available on the day you expect to visit the agency.
Fuengirola (in Malaga Province), at Avenida Juan Gomez Juanito #8, Edificio Lucia 1C, Fuengirola 29640 Spain. Telephone (34) (952) 474-891 and fax (34) (952) 465-189.
Hours 10:00 a.m. to 2:00 p.m.
La Coruna, Calle Juana de Vega 8, 5º Piso, Oficina I, La Coruna 15003 Spain.
Telephone (34) (981) 213-233 and fax (34) (981 22 28 08).
Hours 10:00 a.m. to 1:00 p.m.

Las Palmas, at Edificio Arca, Calle Los Martinez de Escobar 3, Oficina 7, Las Palmas, Gran Canaria 35007 Spain.
Telephone (34)(928) 222-552 and fax (34)(928) 225-863.
Hours 10:00 a.m. to 1:00 p.m.
Palma de Mallorca, Edificio Reina Constanza, Porto Pi, 8, 9-D, 07015 Palma de Mallorca 07015 Spain.
Telephone (34) (971) 40-3707 or 40-3905 and fax (34) (971) 40-3971.
Hours 10:30 a.m. to 1:30 p.m.
Seville, at Plaza Nueva 8-8 duplicado, 2nd Floor, Office E-2 No.4, Sevilla, 41101 Spain. Telephone: (34) (65) 422-8751 and fax (34) (91) 422-0791.
Hours: 10:00 a.m. to 1:00 p.m.
Valencia, at Doctor Romagosa #1, 2-J, 46002, Valencia 46002 Spain.
Telephone (34) (96)-351-6973 and fax (34) (96) 352-9565.
Hours 10:00 a.m. to 2:00 p.m.
For Andorra, please contact the U.S. Consulate in Barcelona.
*

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This replaces the Country Specific Information for Spain and Andorra dated July 15, 2008, to update sections on Safety and Security and Medical Facilities and Health Information.

Travel News Headlines WORLD NEWS

Date: Wed, 20 May 2020 10:16:50 +0200 (METDST)

Madrid, May 20, 2020 (AFP) - Everyone in Spain aged six and above must wear a mask in public places where social distancing is not possible, officials said on Wednesday.   A government decree declared the new rule would be enforced from Thursday, without specifying penalties for failing to comply.   Commuters are already obliged to wear masks on public transport in Spain, one of the hardest-hit countries with almost 28,000 deaths from the pandemic.

But the death rate has slowed and the  strict lockdown measures are being gradually eased, although population centres including Madrid and Barcelona have not been allowed to relax their rules.   "Using masks will be compulsory on the street, in open spaces and any closed place of public use... when it is not possible to maintain a safe distance of at least two metres," the decree said.   It affects everyone aged six years and older, but people with breathing difficulties or other issues of necessity are exempt.

Virus transmission in Spain has slowed considerably since mid-March, when officials imposed one of the strictest lockdowns in the world.    On Tuesday, the death toll remained below 100 for the third consecutive day, down from a high of more than 900 a day in early April.
Date: Fri, 15 May 2020 17:29:08 +0200 (METDST)

Madrid, May 15, 2020 (AFP) - Spain began on Friday to beef up screening of international travellers arriving at its airports, taking their temperature and imposing a 14-day quarantine to prevent a resurgence of the coronavirus in the country.

The government also began to restrict arrivals of foreigners who do not usually reside in Spain, with the exception of border workers, health personnel, diplomats and transporters.   The new measures will remain in force until June 15, the interior ministry said Friday.   Spain closed its land borders with France and Portugal on March 17 but until now had not imposed any restrictions on arrivals from the passport-free Schengen zone, which counts 26 member states.

One of the world's worst-hit countries in which the virus has killed nearly 27,000 people, Spain has begun a cautious process of slowly lifting its stringent mid-March lockdown.   The government is due to decide on Friday whether to ease lockdown measures in new regions as it already has for half of Spain's 47 million people.   Since Monday, those Spaniards can meet up to 10 people and return to café terraces.

The country's two largest cities, Madrid and Barcelona, have asked the government for permission to loosen restrictions which are among the strictest in the world.   Of the 138 daily new deaths recorded in 24 hours, nearly two-thirds were in the Madrid region and in Catalonia, which includes Barcelona.   "The risk of resurgence exists," warned Fernando Simon, the health ministry's emergencies coordinator, adding that in some places the threat remained "very high".

The government released a video on Friday of travellers having their temperatures taken and filling out forms at the Madrid-Barajas international airport.   Interior Minister Fernando Grande-Marlaska said that passengers were asked for contact information and details of where they would be quarantined.   Health officials have said they would track the travellers to ensure the quarantine was being followed, and that those affected would only be allowed out to buy essentials or for urgent medical care -- always wearing a mask.
Date: Tue, 12 May 2020 10:46:56 +0200 (METDST)

Madrid, May 12, 2020 (AFP) - People arriving in Spain will face a mandatory 14-day quarantine to slow the spread of the coronavirus, the government announced on Tuesday.    The measure comes into effect on Friday and will remain in force until May 24 when the state of emergency expires -- or beyond if the measure is extended, it said.    "This measure is considered proportionate to the gravity of the situation and in line with the controls re-established along internal borders by a large number of member states of the European Union," the order said.

"The favourable evolution of the epidemic in our country and the start of the rollback make it necessary to reinforce measures of control," it said.    "Given the global distribution of the virus and working from the principle of precaution, it is necessary that anyone coming from abroad observe a 14-day quarantine period."   During that time, they would only be allowed out to buy essentials or for urgent medical treatment and always wearing a mask.

The measure will not apply to cross-border workers, those transporting goods, airline staff and medical personnel arriving in Spain as long as they have not been in contact with anyone infected by the virus.    During the two-week period, the health care authorities "could make contact to ensure the quarantine is being followed", it warned.   Spain, one of the countries worst-hit by the virus which has so far claimed nearly 27,000 lives, closed its land border when the state of emergency was declared in mid-March.
Date: Fri, 8 May 2020 23:28:08 +0200 (METDST)

Madrid, May 8, 2020 (AFP) - Spain's two biggest cities Madrid and Barcelona will not enter the next phase out of coronavirus lockdown along with many other regions next week, the government said Friday.   One of the worst-hit countries by the pandemic, Spain is enacting a four-phase transition to lift its strict measures to be completed by the end of June.

The health ministry announced Friday that around half of the country's 47 million population could enter the next phase from Monday.    But the Madrid region, which has recorded a third of the country's 26,299 coronavirus-linked deaths, was excluded.   It was rebuffed despite the regional government requesting the central administration relax the capital's lockdown, which led to a dispute over which Madrid's top health official reportedly resigned.   "We felt it was not appropriate to move to the next phase... This is not a race," said Health Minister Salvador Illa.

The second most-affected region Catalonia including its capital Barcelona will also have to wait, but it had not requested measures to be eased. However many other parts of the country, such as southern city Seville or Bilbao in the north, will enter the new phase, which allows family or friends to meet in groups of up to 10, as well as travel within provinces.   In those regions, small shops will reopen without appointments and bars and restaurants can open on terraces -- with spaced seating.

Hotels will also be able to open, but will have to keep their communal areas shut.   Spain, which now has nearly 223,000 confirmed COVID-19 infections, has seen its death rate slow after entering the strict lockdown on March 14.   It recorded 229 new deaths on Friday -- slightly higher than the previous day's 214.   The number has hovered around 200 over the last few days, far from the peak of 950 seen in early April.
Date: Wed, 6 May 2020 19:17:16 +0200 (METDST)

Madrid, May 6, 2020 (AFP) - Spain's parliament on Wednesday voted to extend the country's state of emergency, allowing stringent coronavirus lockdown measures to remain in place for at least two more weeks.   The government imposed a nation-wide lockdown nearly eight weeks ago to curb the outbreak, which has killed more than 25,000 people and infected over 220,000 in the country -- one of the hardest hit in the world.

Spanish Prime Minister Pedro Sanchez warned that abruptly ending the strict lockdown would be "unforgivable", ahead of a parliamentary vote Wednesday to further extend the state of emergency.    "Ignoring the risk posed by the epidemic and lifting the state of emergency very quickly would be absolutely wrong, a total, unforgivable error," he said.

Despite efforts by his right-wing opponents to block the move, parliament approved the extension by 178 votes in favour to 75 votes against, with 97 abstentions.    It was the fourth time the measure had been approved, meaning the restrictions will now remain in place until May 23 as Spain slowly moves through a staged rollback of the lockdown.

A state of emergency was first declared on March 14 in Spain, allowing the government to roll out confinement measures for its nearly 47 million citizens.    The country has only recently started ease some restrictions, allowing children outdoors and adults to leave the house to exercise.    Some small businesses have also been permitted to receive customers with a prior appointment.   "We have limited freedom of movement and the freedom to gather, that is certain. But we've done it to save lives," Sanchez said.    He insisted it was "the only way to guarantee a gradual and prudent transition" out of the lockdown.

The latest daily toll on Wednesday showed a slight increase in deaths, rising to 244 after three days when it stayed below 200 -- a far cry from the 950 deaths of April 2 when the epidemic peaked.    "We are progressing very well," said Fernando Simon, head of the health ministry's emergencies department.    "It would be very sad if through leaving the lockdown faster than recommended we lost everything we've worked for."

Earlier this week, Spain's main opposition Popular Party said it would not support any extension of the state of emergency.    But thanks to backing from the centre-right Ciudadanos and the Basque PNV, the government got enough support to push through the measure.     Last week, the government unveiled plans for a four-phase transition out of the lockdown that is to be completed by the end of June, with the country already engaged in the first preparatory stage.
More ...

Lithuania

Lithuania US Consular Information Sheet
May 19, 2008
COUNTRY DESCRIPTION:
Lithuania is a stable democracy undergoing rapid economic growth. Tourist facilities in Vilnius, the capital, and to a lesser extent in Kaunas and Klaipeda, are simi
ar to those available in other European cities. In other parts of the country, however, some of the goods and services taken for granted in other countries may not be available. Read the Department of State Background Notes on Lithuania for additional information.
ENTRY/EXIT REQUIREMENTS: A valid passport is required to enter Lithuania. As there are no direct flights from the U.S. to Lithuania, U.S. citizens should be aware of passport validity requirements in transit countries. American citizens do not need a visa to travel to Lithuania for business or pleasure for up to 90 days. That 90-day period begins with entry to any of the “Schengen Group” countries: Austria, Belgium, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Iceland, Italy, Latvia, Lithuania, Luxembourg, Malta, the Netherlands, Norway, Poland, Portugal, Slovakia, Spain, and Sweden. Multiple visits to Schengen countries may not exceed 90 days in any 6 month period. Travelers remaining in Lithuania for more than 90 days within any six-month period must apply for temporary residency.

Lithuanian authorities recommend applying or a residency permit through a Lithuanian embassy or consulate before initial entry into Lithuania, as processing times can run beyond 90 days. All foreigners of non-European Union countries seeking entry into Lithuania must carry proof of a medical insurance policy contracted for payment of all costs of hospitalization and medical treatment in Lithuania. Visitors unable to demonstrate sufficient proof of medical insurance must purchase short-term insurance at the border from a Lithuanian provider for roughly $1.00 per day. The number of days will be calculated from the day of entry until the date on the return ticket. Children residing in Lithuania must have written permission to travel outside the country from at least one parent if their parents are not accompanying them on their trip. This policy is not applicable to temporary visitors. See our Foreign Entry Requirements brochure for more information on Lithuania and other countries. Visit the Embassy of Lithuania web site at www.ltembassyus.org for the most current visa information.
Note: Although European Union regulations require that non-EU visitors obtain a stamp in their passport upon initial entry to a Schengen country, many borders are not staffed with officers carrying out this function. If an American citizen wishes to ensure that his or her entry is properly documented, it may be necessary to request a stamp at an official point of entry. Under local law, travelers without a stamp in their passport may be questioned and asked to document the length of their stay in Schengen countries at the time of departure or at any other point during their visit, and could face possible fines or other repercussions if unable to do so.
Information about dual nationality or the prevention of international child abduction can be found on our web site. For further information abut customs regulations, please read our Customs Information sheet.
SAFETY AND SECURITY: Civil unrest is not a problem in Lithuania, and there have been no incidents of terrorism directed toward American interests. Incidents of anti-Americanism are rare.

For the latest security information, Americans traveling abroad should regularly monitor the Department of State, Bureau of Consular Affairs’ web site, where the current Travel Warnings and Travel Alerts, including the Worldwide Caution, can be found.
Up-to-date information on safety and security can also be obtained by calling 1-888-407-4747 toll free in the U.S., 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: Lithuania is a relatively safe country. Visitors should maintain the same personal security awareness that they would in any metropolitan U.S. city. Large amounts of cash and expensive jewelry should be secured in a hotel safe or left at home. Crimes against foreigners, while usually non-violent, do occur. Pickpocketing and thefts are problems, so personal belongings should be well protected at all times. Theft from cars and car thefts occur regularly. Drivers should be wary of persons indicating they should pull over or that something is wrong with their car. Often, a second car or person is following, and when the driver of the targeted car gets out to see if there is a problem the person who has been following will either steal the driver’s belongings from the vehicle or get in and drive off with the car. Drivers should never get out of the car to check for damage without first turning off the ignition and taking the keys. Valuables should not be left in plain sight in parked vehicles, as there have been increasing reports of car windows smashed and items stolen. If possible, American citizens should avoid walking alone at night. ATMs should be avoided after dark. In any public area, one should always be alert to being surrounded by two or more people at once. Additionally, criminals have a penchant for taking advantage of drunken pedestrians. Americans have reported being robbed and/or scammed while intoxicated.
Following a trend that has spread across Eastern and Central Europe, racially motivated verbal, and sometimes physical, harassment of foreigners of non-Caucasian ethnicity has been reported in major cities. Incidents of racially motivated attacks against American citizens have been reported in Klaipeda and Vilnius.
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 these serious problems 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 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. For more information about assistance for victims of crime in Lithuania, please visit the Embassy’s web site at http://vilnius.usembassy.gov/service/crime-victim-assistance.html.
See our information on Victims of Crime.
MEDICAL FACILITIES AND HEALTH INFORMATION: Medical care in Lithuania has improved in the last 15 years, but medical facilities do not always meet Western standards. There are a few private clinics with medical supplies and services that nearly equal Western European or U.S. standards. Most medical supplies are now widely available, including disposable needles, anesthetics, antibiotics and other pharmaceuticals. However, hospitals and clinics still suffer from a lack of equipment and resources. Lithuania has highly trained medical professionals, some of whom speak English, but their availability is decreasing as they leave for employment opportunities abroad. Depending on his or her condition, a patient may not receive an appointment with a specialist for several weeks. Western-quality dental care can be obtained in major cities. Elderly travelers who require medical care may face difficulties. Most pharmaceuticals sold in Lithuania are from Europe; travelers will not necessarily find the same brands that they use in the United States. Serious medical problems requiring hospitalization and/or medical evacuation can cost thousands of dollars or more. Doctors and hospitals often expect immediate cash payment for health services, particularly if immigration status in Lithuania is unclear.

Tick-borne encephalitis and lyme disease are widespread throughout the country. Those intending to visit parks or forested areas in Lithuania are urged to speak with their health care practitioners about immunization. Rabies is also increasingly prevalent in rural areas.
The Lithuanian Government does not require HIV testing for U.S. citizens. However, sexually transmitted diseases are a growing public health problem.
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.
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. All foreigners of non-European Union countries seeking entry into Lithuania must carry proof of a medical insurance policy contracted for payment of all costs of hospitalization and medical treatment in Lithuania (please see entry/exit requirements above). 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 Lithuania is provided for general reference only, and may not be totally accurate in a particular location or circumstance.
The Police allow Americans to drive in Lithuania with an American driver’s license for up to 90 days. Americans who reside in Lithuania for 185 days or more in one calendar year and who wish to continue driving in Lithuania must acquire a Lithuanian driver's license. The foreign license must be given to the Lithuanian Road Police to be processed by the Consular Department of the Lithuanian Ministry of Foreign Affairs, which in turn sends it to the U.S. Embassy’s Consular Section, where the owner is expected to claim it.
Roads in Lithuania range from well-maintained two- to four-lane highways connecting major cities to small dirt roads traversing the countryside. Violation of traffic rules is common. It is not unusual to be overtaken by other automobiles, traveling at high speed, even in crowded urban areas. Driving at night, especially in the countryside, can be particularly hazardous. In summer, older seasonal vehicles and inexperienced drivers are extra hazards. Driving with caution is urged at all times. Driving while intoxicated is a very serious offense and carries heavy penalties. The speed limit is 50 km/hr in town and 90 km/hr out of town unless otherwise indicated. The phone number for roadside assistance is 8-800-01414 from a regular phone and 1414 from a GSM mobile phone.
Seatbelts are mandatory for the driver and all passengers except children under the age of 12. During the winter, most major roads are cleared of snow. Winter or all-season tires are required from November 10th through April 1st. Studded tires are not allowed from April 10th through October 31st. Drivers must have at least their low beam lights on at all times while driving. Public transportation is generally safe.
Please refer to our Road Safety page for more information. Visit the website of the country’s national tourist office and national authority responsible for road safety at www.tourism.lt and at www.lra.lt/index_en.html.
AVIATION SAFETY OVERSIGHT: As there is no direct commercial air service to the United States by carriers registered in Lithuania, the U.S. Federal Aviation Administration (FAA) has not assessed Lithuania’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 www.faa.gov/safety/programs_initiatives/oversight/iasa.
SPECIAL CIRCUMSTANCES: Lithuanian customs authorities may enforce strict regulations concerning the temporary importation into or export from Lithuania of items such as firearms and antiquities. Please see our Customs Information.
Telephone connections are generally good. American 1-800 numbers can be accessed from Lithuania but not on a toll-free basis; the international long distance rate per minute will be charged. Local Internet cafes offer computer access. ATMs are widely available. Most hotels and other businesses accept major credit cards.
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 Lithuanian laws, even unknowingly, may be expelled, arrested or imprisoned. Penalties for possession, use, or trafficking in illegal drugs in Lithuania are severe, and convicted offenders can expect long jail sentences and heavy fines. Engaging in sexual conduct with children or possessing or disseminating child pornography in a foreign country is a crime prosecutable in the United States. For more information about arrest procedures in Lithuania, please visit the Embassy’s web site at http://vilnius.usembassy.gov/arrests.html. Please see our information on Criminal Penalties.
CHILDREN'S ISSUES: For information on international adoption of children and international parental child abduction, see the Office of Children’s Issues web page.
REGISTRATION / EMBASSY LOCATION: Americans living or traveling in Lithuania 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 Lithuania. 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 Akmenu Gatve 6, tel. (370) (5) 266-5500 or 266-5600; fax (370) (5) 266-5590. Consular information can also be found on the Embassy Vilnius web site at http://vilnius.usembassy.gov/.
* * *
This replaces the Consular Information Sheet dated November 5, 2007 to update sections on Crime and Medical Facilities and Health Information.

Travel News Headlines WORLD NEWS

Date: Wed, 15 Apr 2020 16:49:12 +0200 (METDST)

Vilnius, April 15, 2020 (AFP) - The Lithuanian government said Wednesday it would relax some lockdown measures to help the economy as the number of new coronavirus infections slows.    The Baltic EU member has allowed retailers with a separate outdoor entrance to re-open starting Thursday, though non-food stores in shopping malls, sports clubs and restaurants remain closed for now.

Some services, including repair shops, cleaning and key making, will also resume but direct contact with the customer must not exceed 20 minutes.   Prime Minister Saulius Skvernelis said the shops will have to limit the number of customers at any one time to enforce social distancing rules.    "It is a small step in removing business restrictions. We will follow the situation closely," Skvernelis told reporters.

The eurozone nation of 2.8 million people had moved quickly to enforce lockdown as it closed all shops except for pharmacies and grocery stores on March 16.   As a result the virus has largely been kept under control in Lithuania, which has reported 1,091 confirmed cases, including 29 deaths.    The number of new cases has dropped to below 50 per day over the last 10 days.   Schools and universities are not expected to fully re-open until the next academic year in September.
Date: Fri, 10 Apr 2020 21:57:28 +0200 (METDST)

Vilnius, April 10, 2020 (AFP) - Lithuanian police set up hundreds of checkpoints nationwide on Friday to enforce an Easter travel ban imposed to curb the spread of the novel coronavirus.    "Police set up around 300 checkpoints across the country," spokesman Ramunas Matonis told AFP.    The Baltic EU state banned travel between municipalities from Friday evening to Monday to deter people from visiting their relatives and friends to celebrate Easter.   There are exceptions for people returning home, going to work or attending funerals.    Fines for breaking the rules start at 250 euros ($230).

The government also made wearing face masks mandatory in public.   Prime Minister Saulius Skvernelis said his cabinet could ease the coronavirus lockdown measures for small businesses from next week if the situation remains stable over the weekend.    Lithuania has been in lockdown since March 16, including the closure of all pubs, restaurants, schools, universities, kindergartens and most shops.    The Baltic country of 2.8 million people currently has 999 confirmed COVID-19 infections, with 22 deaths.
Date: Sat, 14 Mar 2020 21:41:50 +0100 (MET)

Vilnius, March 14, 2020 (AFP) - Lithuania said Saturday it would shut its borders to most foreign visitors while fellow Baltic EU members Estonia and Latvia imposed security measures of their own to stem the spread of the novel coronavirus.   Lithuanian Prime Minister Saulius Skvernelis said the country of 2.8 million people has decided to reinstate checks on its borders with Latvia and Poland, becoming the fifth nation to do so within the bloc's zone of free travel.

Foreigners will be banned from entering the country starting 1000 GMT on Sunday, with the exception of individuals with a residence permit, diplomatic workers and NATO troops.   Freight transport will not be affected, he added.   "Our goal is to delay the spread of the virus as long as possible inside the country and to reduce the negative consequences," Skvernelis said.

Lithuania, which has eight confirmed COVID-19 cases, has been on partial lockdown since Friday after the government shut down all schools, kindergartens and universities and banned large public events.   From Monday, the ban will also cover most shops, restaurants and pubs, although food delivery will be allowed. The measure does not concern grocery stores and pharmacies.   Skvernelis said his cabinet will approve an economic stimulus plan on Monday worth "at least one billion euros".

Fellow Baltic states Estonia and Latvia also imposed movement restrictions on Saturday but stopped short of border shutdown.   Latvia, which has a population of 1.9 million people and 26 confirmed cases of the coronavirus, said it will suspend all international flights, ferries, buses and trains from Monday.   "Border crossings by private car will continue, as well as international freight and cargo flow," Latvian Transport Minister Talis Linkaits told reporters.

Estonia, the northernmost Baltic state with 1.3 million people and 115 confirmed cases of COVID-19, banned travel to six of its islands for all but their permanent residents.   The government also decided to close down all leisure centres, sports clubs, spas and swimming pools.    Most of the measures will apply for a couple of weeks but will likely be prolonged according to Baltic authorities.
Date: Wed 7 Aug 2019 01:17:58 EEST
Source: Xinhua News Agency [edited]

The rate of tick-borne encephalitis in Lithuania remains the highest in Europe, announced the country's Center for Communicable Diseases and AIDS (ULAC) on [Tue 6 Aug 2019].

According to ULAC, the rate of tick-borne encephalitis cases was 16.6 cases per 100 000 population in 2017, based on the latest data provided by the European Center for Disease Prevention and Control (ECDC) in its latest annual epidemiological report.  "In Lithuania the rate of encephalitis remains the highest in Europe," said ULAC.

Lithuania was followed by the Czech Republic and Estonia with the rate of 6.4 cases per 100 000 population, according to ULAC.  ULAC notes the largest proportion of tick-borne encephalitis cases is at the age group of 45-64 years and the lowest among the children of the age of 0-4 years.  "ULAC medics remind vaccination is the most reliable protection from tick-borne encephalitis," said ULAC in the announcement, noting vaccines have a reliability rate of 98 percent.

ULAC's warning comes amid increasing number of tick-borne encephalitis cases this year [2019] in Lithuania, a Baltic country with a population of around 3 million.  More than 90 cases of tick-borne encephalitis were reported during the 1st half of the year [2019] in Lithuania, 1/3 more compared to the same period last year [2018], according to local data by ULAC.

According to the ECDC's report, the highest prevalence of tick-borne encephalitis historically is found in the Baltic countries. Tick-borne encephalitis usually reaches its seasonal peak during the warmest months -- July and August.

Tick-borne encephalitis is a human viral infectious disease of central nervous system caused by infected ticks, usually found in woodland habitats. The disease manifests itself with symptoms similar to fever, fatigue, headache, nausea, and can cause meningitis.
=====================
[Cases of tick-borne encephalitis (TBE) have been reported before (see ProMED mail archive Tick-borne encephalitis - EU (Czech Rep., Latvia, Lithuania) http://promedmail.org/post/20040624.1677). Given the high rate of TBE cases in Lithuania reported above, there doubtless have been cases occurring there annually in recent years.

A report in Eurosurveillance Weekly in 2004 stated, "Tick-borne encephalitis (TBE) is endemic in virtually all countries in Central and Eastern Europe. It is caused by several closely related but distinct flaviviruses. 3 subtypes are recognised at present: a Far-Eastern subtype, a Siberian subtype and a European subtype. The Siberian subtype is associated with Russian spring-summer encephalitis and is transmitted predominantly by the tick _Ixodes persulcatus_, whereas the European subtype causes central European encephalitis and is transmitted by _Ixodes ricinus_.

The clinical spectrum of acute TBE ranges from symptoms of mild meningitis to severe meningoencephalitis with or without myelitis. The incubation period of central European TBE is 7-14 days. Onset is generally biphasic. The 1st phase involves a non-specific influenza-like illness with fever, headache, nausea, and vomiting, lasting about a week. After a period of remission lasting a few days, the fever returns with aseptic meningitis or encephalomyelitis. The case fatality rate is 1-5 percent and about 20 percent of survivors have neurological sequelae. Residual motor defects are rare." - ProMED Mod.TY]

[HealthMap/ProMED-mail map of Lithuania:
Date: Wed, 3 Jul 2019 15:49:43 +0200

Vilnius, July 3, 2019 (AFP) - Lithuania declared an emergency on Wednesday as a severe drought hit the Baltic EU state, threatening to slash this year's harvest by up to half.   Apart from jeopardising crops, scant rainfall has also drastically reduced water levels in some rivers, threatening fish stocks and shipping activities.

The formal declaration of an "emergency situation" will allow the government to compensate farmers for some losses as well as help them to avoid EU financial sanctions should they fail to reach production goals.   "Farmers believe their harvest can be slashed by 40 percent or 50 percent, while fish stocks are also endangered," environment minister Kestutis Mazeika told AFP.

Mazeika said "nobody has any doubt" that global climate change is behind the prolonged and more intensive dry spells and heatwaves in recent years.   He also appealed to neighbouring Belarus to increase the water level in the Neris river by allowing more water to flow from its reservoirs.   Last month was the hottest June ever recorded with soaring temperatures worldwide capped off by a record-breaking heatwave across Western Europe, satellite data showed Tuesday.   Lithuania also registered its hottest-ever June, with a peak of 35.7 degrees Celsius (96.2 degrees Fahrenheit) recorded on June 12.

Over the last week, firefighters have fought wildfires triggered by the heat in peat bogs in western Lithuania and neighbouring Latvia.   Elsewhere in Central Europe, Polish authorities said this week that varying degrees of drought have put grain crops at risk in 14 of the EU country's 16 regional districts.   The Czech Academy of Sciences said it expects drought to affect the entire country, with 80 percent of the territory facing "exceptional to extreme drought".
More ...

Serbia

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

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

Travel News Headlines WORLD NEWS

Date: Fri, 24 Jan 2020 03:33:13 +0100 (MET)
By Rusmir SMAJILHODZIC with Emmy VARLEY in Belgrade

Sarajevo, Jan 24, 2020 (AFP) - As winter grips the Balkans, the poor are caught in a cruel bind, being forced to light fires at home for heating while fuelling a pollution crisis smothering the region.   In recent weeks, Balkan capitals from Belgrade and Sarajevo to Skopje and Pristina have been ranked among the world's top 10 most polluted major cities, according to the monitoring application AirVisual.

While these are small cities compared to leading Asian polluters like New Delhi and Dhaka, a combination of coal-fired power plants, old cars and fires to heat homes are pumping the air with toxins.   "I know it is polluting. I am not an idiot but my only other choice would be to heat this home with electricity and that is damn expensive," said Trajan Nestorovski, who like many in his working-class Skopje neighbourhood burns wood to stay warm in winter.   His wife Vera added: "There are a couple of factories near our neighbourhood that are burning God knows what in the evenings".

Thanks to the rise of mobile phone apps that measure air quality, like the local Moj Vozduh (My Air) created by a Macedonian developer, citizens are finally grasping the full extent of the crisis.    "Serbia is suffocating, has anyone seen the minister of the environment?", said a recent headline in Belgrade's local Blic newspaper, speaking of the fog and dirty air enveloping the city.   Protests have been erupting around the region in recent days.

In Skopje, the capital of North Macedonia, young people have taken inspiration from Swedish activist Greta Thunberg by holding a spate of protests on Fridays.    "Greta inspired all of us," said 17-year-old Iskra Ilieska.   "In winter, half of my school class is absent because of lung problems. That is not normal," she said.

In neighbouring Bosnia, several hundred people wearing face masks gathered in the city of Tuzla to demand a plan from authorities to tackle pollution and phase out coal-fired plants in the next five years.   "The only recommended measures are that we stay shut up at home... when you go out on the streets, in the playgrounds, you won't see children anywhere," said Alisa Kasumovic, a mother in her forties.

- Silent killer -
According to a recent UN environment report, air pollution causes nearly 20 percent of premature deaths in 19 Western Balkan cities.   The main sources of the dust, soot and smoke are low-grade coal plants and household heating, the report said.    More than 60 percent of people in the region rely on coal and firewood to heat their homes, the report said. Only 12 percent of buildings are connected to district heating systems.

Governments need to make "clean energy more accessible", ban old polluting vehicles and tighten regulations on industry emissions and power plants, the UN urged.    Many people cannot afford cleaner heating options at home in countries where average wages are around 500 euros or less.   Sali Ademi, a 78-year-old in Kosovo's capital Pristina, uses coal.     "There's no worse thing, but what can you do?" he said in a city whose air is already poisoned by two nearby coal-fired power plants running on outdated technology.

- Cable car escape -
Those who warm their homes with fires also bear the brunt of health risks, according to experts.   "Some of the emissions from these stoves stay in the house and poison them," warned Anes Podic, president of an environmental group in Bosnia who has called on the government to replace inefficient wood stoves in the country.

In cities like Sarajevo and Skopje, a circle of mountains helps trap the hazardous air in the valleys where residents live.   Sakiba Sahman, 60, is a Sarajevan taking advantage of a recent reduction on ticket prices for a cable car that rides to the top of the 1,160-metre-high (3,800-foot-high) Mount Trebevic, which peaks above the smog over the Bosnian capital.   "We've come to spend a few hours to ventilate the lungs," she told AFP.   Down below, "the pollution is enormous, there are a lot of cars, everything is dirty, grey and depressing."
Date: 29 Aug 2018
Source: DW [edited]

Health officials in Serbia have reported new deaths from West Nile virus, where over 200 people are confirmed to be infected. The disease has also claimed lives in several EU countries.

Serbian authorities announced on Wednesday [29 Aug 2018] that 6 people have died after being infected by the West Nile virus last week, bringing the current death toll to 21. Serbia, with 213 infected cases, is the European country worst-hit by the disease.

At the same time, Greece reported 5 deaths due to the West Nile virus during the past week. The overall toll now stands at 16, with 130 registered cases of infection.

At least 9 people have died from the disease in Italy and another 6 people in Romania. Two fatalities have also been reported in Kosovo.

The exact number of cases is likely much larger, as humans infected with the mosquito-borne virus typically show no signs of disease and require no treatment. Only about 20 percent of those infected exhibit symptoms similar to influenza, such as fever, headaches, fatigue and swelling of the lymph nodes. Less than one percent of patients develop encephalitis or meningitis, which could potentially lead to death.

The virus has been present in Serbia since 2012, according to infectious disease specialist Dragan Delic, as cited by the Serbian daily Blic. He warned that global warming is likely to boost the spread of other tropical diseases into new areas, including "malaria and dengue fever."

Health experts believe the West Nile virus expanded its foothold in Europe through migratory birds. While there is no vaccine for it, doctors say the risk of infection can be managed by using protection from mosquito bites.
========================
[WNV activity has been higher than in previous years, with cases reported from many countries, and Serbia has reported 213 cases to date according to the ECDC update in section [1] above.

Vector control and community mobilization, awareness, and support are the key steps to controlling disease transmission for WNV, as with other vector borne diseases such as dengue and chikungunya - ProMED Mod.UBA]

[HealthMap/ProMED maps available at:
Date: Mon, 18 Jun 2018 05:25:56 +0200
By Katarina SUBASIC

Belgrade, June 18, 2018 (AFP) - "Join us comrade!" tourists are warmly greeted, as they climb into a vintage car that is no longer produced for a visit back in time to a country that no longer exists.   As a symbol of the former Yugoslavia, the Yugo car is back in vogue on Belgrade's streets.  Like in other places once stranded behind the detested Iron Curtain, the Serbian capital has found a unique way to cater for a surge in interest and even nostalgia for life under communism.

On a three-hour tour, visitors see some of Yugoslavia's most significant sites, seated in one of the once ubiquitous Yugos, ending up at the Museum of History of Yugoslavia which holds dictator Josip Broz Tito's mausoleum.   "People come to experience rides in an iconic car and it is something they cannot experience anywhere else in the world actually," Jovana Stojiljkovic, who manages the Yugotour travel agency, told AFP.   The last Yugo cars were produced a decade ago, but, says Stojiljkovic, they are still a hit among tourists for the "Rise and Fall of a Nation" tour, on which most clients are foreigners.   "It's something similar to a Trabant (East German car) tour in Berlin," she says.

- Made in Yugoslavia -
For vintage car aficionados, Belgrade has a lot to offer, with sightings of American Chryslers or Ford limousines not uncommon.   And for the handful of "Made in Yugoslavia" makes of car, thousands still rumble around on Balkans roads more than 25 years after Yugoslavia's collapse.   As well as the Yugo, the small Fica and Zastava 101, all produced at the Zastava plant in the central town of Kragujevac, were the pride of communist Yugoslavia.

They were highly popular due to their low price.   But the Yugo car was also often the butt of jokes over its design and unreliability.   It even appeared in the 1995 Hollywood blockbuster "Die Hard With a Vengeance" with Bruce Willis and Samuel L. Jackson.   Now it is tourists from all over the world climbing into the Yugos, which in their heyday were exported from Yugoslavia to 74 countries, including Egypt, India and even the United States.   Described by the communist authorities as the "deal of the century" for the US market, the Yugo had only limited success there, however.

- 'View of history' -
When Stojiljkovic was born in 1992, Yugoslavia had already fallen apart in a series of bloody wars and most of its republics were already independent states.   But by the age of 25, she had launched a career in preserving the memory of the Socialist Federal Republic of Yugoslavia (SFRJ) and telling its story, coinciding with a wave of "Yugonostalgia" among some for a period viewed as having enjoyed peace and relative prosperity before the onset of the conflicts.   Dennis Bertelsen, a 38-year-old Dane on a weekend visit to the city, was among the hundreds of thousands of tourists descending on Belgrade -- it hosted one million last year, 835,000 of whom were from abroad, according to
official figures.

With his three friends, he said he took the tour "to get a view of the history and what actually had been the development and downfall of Yugoslavia".   The itinerary includes passing by the famous Hotel Jugoslavija on the Danube river bank, one of the country's most luxurious at the time.   Guests included US presidents Richard Nixon and Jimmy Carter as well as Britain's Queen Elizabeth II.   The hotel has been out of service since it was hit in a 1999 NATO bombing campaign to force the then Serbian strongman Slobodan Milosevic to withdraw his troops from Kosovo but the building still has a mythical status.

- 'Commercialisation' -
Polish student Dominik Wojciechowski came across the tour while researching the Fica car for his photo-art project on so-called Yugonostalgia, a feeling still present in all the countries that emerged after Yugoslavia's collapse, although much less in Croatia where a national sense of being Croat is ultra dominant.

"I am interested in this process of commercialisation of Yugonostalgia and how people today are trying to preserve knowledge of Yugoslavia, while the older generation even (attempts) to return to these times," the 25-year-old said.   For him, the most impressive part of the tour was a 30-floor twin tower called Genex, or Western Gates of Belgrade, still among the tallest in the city.   "You stand below it and look up how big it is and feel this grandiosity of Yugoslavia and how powerful it was," he said.   Most tourists know very little about Yugoslavia, its 22 million people and dictator Tito who led it from the end of World War II until his death in 1980.

A decade later, the federation comprising six republics -- Bosnia, Croatia, Macedonia, Montenegro, Serbia and Slovenia -- collapsed in a series of wars that claimed more than 130,000 lives.   Although Stojiljkovic never lived in Yugoslavia she said she nevertheless knows a lot about it.   "I have heard all the stories from my parents, their friends and the rest of my family, so based on their experience it was a really nice time, they had a good time," she said.   And she herself is now the proud owner of two Fica cars, which, she said, was "to show to the rest of the world what they meant to us".
Date: Tue, 20 Mar 2018 18:47:46 +0100

Belgrade, March 20, 2018 (AFP) - Serbian authorities said Tuesday they have launched an initial investigation of some public opponents of vaccination after 12 people, including two children, have died in an outbreak of measles.   "The prosecutor's office for high-tech crime is looking into whether there is criminal accountability by a number of public persons, opponents of vaccination of children," the Serbian prosecutors's office said in a statement.

The probe came about after a group of 270 parents last month accused 43 people of "causing panic", including a famous folk singer Jelena Krleusa, a writer and even a doctor who have publicly spoken against vaccination, local media has reported.   The prosecutor did not reveal the names of those being investigated.    According to Serbia's Institute of Public Health, more than 3,800 cases of measles, including a 15-day-old baby, have been recorded since the beginning of the outbreak in October.   The 12 people who died of the disease included two children, aged two and four, the Institute said on its web site.

Earlier this month Serbian Health Minister Zlatibor Loncar urged parents to vaccinate their children, saying "the outbreak of measles would have never happened  if they had listened to doctors and not celebrities."   The vaccination, including against measles, is mandatory for children in Serbia, but courts have rarely issued fines that are 30,000 to 150,000 dinars (250 to 1,250 euros/$300 to $1,550).   Measles has also struck in neighbouring Romania as well as Italy, France, Germany and Greece.
Date: Wed 27 Dec 2017, 10:41 AM
Source: B92 [edited]

A 20-year-old man from Belgrade has died in a hospital's intensive care unit from complications caused by measles, RTS is reporting. He is the first victim of measles in Serbia. The patient had not been inoculated against the infectious disease.

Since October [2017], a total of 630 persons in central Serbia and in Serb-majority areas in Kosovo and Metohija contracted the disease, the Public Health Institute Batut announced on [Tue 26 Dec 2017].

A total of 91 percent of those have either not been vaccinated against the disease, or have incomplete or uncertain vaccination status.

Since the measles epidemic was reported in late October [2017], there had been 259 cases in Serb and non-Albanian municipalities in Kosovo.

In early November [2017], an epidemic of the disease was also reported in central Serbia.
=================
[Measles can be a serious illness in all age groups. However, children younger than 5 years of age and adults older than 20 years of age are more likely to suffer from measles complications. Some people may suffer from pneumonia (infection of the lungs) and encephalitis (swelling of the brain). They may need to be hospitalized and can die.

According to the CDC:
As many as 1 out of every 20 children with measles gets pneumonia, the most common cause of death from measles in young children. About 1 child out of every 1000 who get measles will develop encephalitis (swelling of the brain) that can lead to convulsions and can leave the child deaf or with intellectual disability. For every 1000 children who get measles, 1 or 2 will die from it.

Measles may cause pregnant woman to give birth prematurely, or have a low-birth-weight baby.

(Excerpted/edited from

A Healthmap/ProMED of Serbia may be found at
More ...

French Guiana

French Guiana US Consular Information Sheet
August 14, 2006

COUNTRY DESCRIPTION: French Guiana is an overseas department of France. It is a sparsely populated tropical area located on the northern coast of South America. French is the pred
minant language; English is not widely spoken. Tourist facilities are available, especially in the larger cities such as Cayenne and Kourou, but in some instances are not highly developed.

ENTRY/EXIT REQUIREMENTS: Passports are required of U.S. citizens entering French Guiana. Visitors who arrive by land or on a commercial air carrier with a return ticket may enter for up to 90 days without a visa. See our Foreign Entry Requirements brochure for more information on French Guiana and other countries. Visit the Embassy of France web site at for the most current visa information, or contact the Embassy of France at 4101 Reservoir Road N.W., Washington, DC 20007; telephone (202) 944-6000; or the nearest French Consulate in Atlanta, Boston, Chicago, Houston, Los Angeles, Miami, New York, New Orleans or San Francisco.

Find more information about Entry and Exit Requirements pertaining to dual nationality and the prevention of international child abduction . For further information about customs regulations, please read our Customs Information .

SAFETY AND SECURITY: For the latest security information, Americans traveling abroad should regularly monitor the Department's Internet web site , where the current Worldwide Caution Public Announcement , Travel Warnings and Public Announcements 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., 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: Petty street crime occurs throughout the major cities. Individuals should make sure to keep valuables out of sight, especially if left unattended in an automobile.

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

See our information on Victims of Crime .
MEDICAL FACILITIES AND HEALTH INFORMATION: Medical care within French Guiana is limited, and hospital facilities are available only in major urban areas. Patients' rooms in hospitals are primarily open-air facilities; instead of glass panes, hospital windows are fitted with wooden slats.

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 Internet site at For information about outbreaks of infectious diseases abroad consult the World Health Organization's (WHO) website at http://www.who.int/en. Further health information for travelers is available at .

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 French Guiana is provided for general reference only, and may not be totally accurate in a particular location or circumstance.

Primary roads in French Guiana are well paved and well maintained. Emergency call boxes are available at regular intervals on the main highways. Roads in rural areas are less developed. Roads leading to more remote regions in the interior are often improved dirt roads. French Guiana has a relatively moderate to high volume of traffic and police enforce traffic safety. Night driving can be dangerous, especially in the remote interior regions or on less-developed rural roads. Public transportation in the form of taxis and vans is relatively safe.

Please refer to our Road Safety page for more information. Visit the website of the French National Tourist Organization at http://www.franceguide.com.

AVIATION SAFETY OVERSIGHT: The U.S. Federal Aviation Administration (FAA) has assessed the Government of France as being in compliance with ICAO international aviation safety standards for oversight of France's air carrier operations. For more information, travelers may visit the FAA's Internet web site at .
SPECIAL CIRCUMSTANCES: In addition to being subject to all French laws affecting U.S. citizens, dual nationals may also be subject to other laws that impose special obligations on French citizens. For additional information, please see our Dual Nationality flyer .
French customs authorities may enforce strict regulations concerning temporary importation into or export from French Guiana of items such as firearms, medications, animals, etc. It is advisable to contact the Embassy of France in Washington or one of the many French consulates in the United States for specific information regarding customs requirements.
Customs authorities encourage the use of an ATA (Admission Temporaire/Temporary Admission) Carnet for the temporary admission of professional equipment, commercial samples, and/or goods for exhibitions and fair purposes. ATA Carnet Headquarters , located at the U.S. Council for International Business , 1212 Avenue of the Americas, New York, NY 10036, issues and guarantees the ATA Carnet in the United States. For additional information call (212) 354-4480, e-mail atacarnet@uscib.org, or visit www.uscib.org for details. 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 French laws, even unknowingly, may be expelled, arrested, or imprisoned. Penalties for possession, use, or trafficking in illegal drugs in French Guiana 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 on international adoption of children and international parental child abduction, see the Office of Children's Issues website.

REGISTRATION / EMBASSY LOCATION: Americans living or traveling in Suriname are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department's travel registration website and to obtain updated information on travel and security within Suriname. 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 Dr. Sophie Redmondstraat 129, telephone (011)(597) 472-900, web site http://paramaribo.usembassy.gov. The Consular Section hours of operation for routine American citizen services are Mondays and Wednesdays from 1:30 pm - 3:30 pm, or by appointment, except on American and Surinamese holidays. U.S. citizens requiring emergency assistance evenings, weekends, and holidays may contact an Embassy duty officer by cell phone at (011)(597) 088-08302.
* * *
This replaces the Consular Information Sheet dated November 2, 2005 to update all sections.

Travel News Headlines WORLD NEWS

Date: Tue 14 Aug 2018
Source: France Guyane [in French, trans. ProMED Corr.SB, edited]
<http://www.franceguyane.fr/actualite/education-sante-environnement/un-cas-de-fievre-jaune-contracte-en-guyane-412398.php>

A 47-year-old man of Swiss nationality contracted yellow fever in French Guiana. He was diagnosed last weekend by the Institut Pasteur. The fact that he had been present in French Guiana for 4 months without having apparently left it makes it very likely that he contracted the virus in the department, and more precisely in the area of the County Bridge.

In a message addressed to certain health professionals, the Regional Health Agency (ARS) details the situation: "A new case of yellow fever was confirmed last weekend by the Pasteur Institute of Guyana, and after that diagnosed in France. After a visit to CHAR, the patient was transferred urgently to a liver resuscitation unit in Paris.

This is a 47-year-old man of Swiss nationality who had returned by land from Brazil but who had been in French Guiana for 4 months and who had not left the territory (of Guyana) since his arrival. Therefore, we can consider that this is a local infection. The patient was not vaccinated. According to information available at this stage, he was working on the marking of forest roads in the County Bridge area, and it can be assumed that he was infected in these areas, and investigations are underway to detect associated cases and to trace more closely the movements of the patient.

This new case confirms that yellow fever is present in Guyana. While awaiting more precise information, this also seems to indicate that the virus is present in the littoral zone and justifies the vaccination of the whole department's population.
========================
[Sylvatic yellow fever (YF) is endemic in areas of 13 countries and territories of the South American region, including Argentina, Brazil, Paraguay, Bolivia, Peru, Ecuador, Colombia, Venezuela, Panama, Guyana, Suriname, French Guiana and the island of Trinidad.

A 20 Mar 2018 PAHO/WHO Epidemiological Update on Yellow Fever stated that there were confirmed cases this year [2018] in several South American countries including French Guiana (see Yellow fever - Americas (22): South America http://promedmail.org/post/20180321.5699760). Individuals traveling, working or residing in these areas should be vaccinated against YF.

Unfortunately, the Swiss worker was not. The patient's condition was not mentioned, other than that he was transferred urgently to a liver resuscitation unit in Paris, but was still alive. - ProMED Mod.TY]

[HealthMap/ProMED maps available at: Switzerland:
<http://healthmap.org/promed/p/105>

Region d'outre-mer de French Guiana, France:
<http://healthmap.org/promed/p/577>]
Date: Sun, 26 Mar 2017 22:38:35 +0200
By Marion BRISWALTER

Cayenne, March 26, 2017 (AFP) - French Guiana came to a standstill Sunday on the eve of a major strike which has elbowed its way into France's presidential campaign.   Air France cancelled all flights to the South American territory for Sunday and Monday, when 37 labour unions were to launch a general strike demanding a "Marshall Plan" to improve public services and security.   Barricades have been erected on roads since last week, and the US State Department has warned travellers to stay away, citing the risk of violence.   The protests also led to the indefinite postponement of an Arianespace rocket launch at Europe's Guiana Space Centre in Kourou.

The French government has sent a delegation to negotiate with the strikers, asking them to lay out their demands.   But 13 of the territory's 22 mayors have refused to meet the delegation, demanding along with the strikers that French ministers come in person.   "This has gone on long enough! All we have is plundered, it's time to recognise the people of Guiana," a woman at the barricade blocking access to the airport at Cayenne, the capital, told AFP on Sunday.   "I am listening to the Guianans," said Ericka Bareigts, the minister of overseas territories, though she has ruled out travelling to the territory for now.   "We will be able to go to Guiana once the conditions are right and progress has been made," she said.   The road barricades were temporarily lifted Sunday and some stores opened so that people could stock up on food and other supplies before the strike began.

- 'Failed policies' -
The "Collective to Get Guiana Moving" has called for better access to health services and electricity, economic development and job creation programmes, and renewed efforts to keep children from dropping out of school.   The territory, with about 250,000 inhabitants, relies on huge injections of public funds.   "The government must respond rapidly to these requests," Segolene Royal, the French environment minister, said after a recent visit to the territory.   The visiting delegation has already had a scanner installed at the airport to help stop drug trafficking, and pledged to speed up the arrival of EU aide.   But several of the candidates seeking the French presidency have pounced on the crisis just a month before the first round of voting.   For Francois Fillon, the conservative candidate, "This situation is the consequence of the failed policies of Francois Hollande," the outgoing Socialist president.

Marine Le Pen, the far-right National Front candidate, condemned what she called an "cruel minimum service" of recent governments in Paris toward the territory.   In response, Bareigts, the overseas territories minister, and Interior Minister Matthias Fekl said Sunday after a meeting with Prime Minister Bernard Cazeneuve that "We will not tolerate any exploitation of this social crisis, neither to disrupt public order nor for campaign purposes."   A similar revolt gripped French Guiana in 2008 over soaring fuel prices, shutting down schools and the airport.   The strike ended after 11 days, when the government agreed to cut fuel prices.
Date: Mon, 21 Mar 2016 11:58:00 +0100

Paris, March 21, 2016 (AFP) - Up to a third of flights were cancelled at French airports on Monday as air traffic controllers entered a second day of strikes.    Low-cost airline Ryanair deplored what it said was the 41st strike by French air traffic controllers since 2009.   Around 140 passengers spent the night in Paris's Orly airport where half of flights were cancelled on the first day of strikes on Sunday.

Authorities Monday asked airlines to cut a third of flights at Orly and Marseille airports, and 20 percent at Lyon, Nice and Beauvais near Paris.    The striking union, which represents around a fifth of air traffic controllers, is campaigning against job cuts and the lack of investment in new technology.   Air France said journeys out of Paris's other main airport, Charles De Gaulle, were not facing cancellations, but last-minute delays were possible.    EasyJet said it had cancelled 90 flights and that more disruptions were possible.
Date: Wed 2 Sep 2015
Source: OIE WAHID, weekly disease information 2015; 28 (36) [edited]

Rabies, French Guiana
--------------
Information received on [and dated] 2 Sep 2015 from Dr Loic Evain, Directeur General adjoint, CVO, Direction generale de l'alimentation, Ministere de l'Agriculture, de l'Agroalimentaire et de la Foret, Paris, French Guiana.

Summary:
Report type: Immediate notification
Date of start of the event: 20 Aug 2015
Date of confirmation of the event: 31 Aug 2015
Reason for notification: Reoccurrence of a listed disease
Date of previous occurrence: October 2009
Manifestation of disease: Clinical disease
Causal agent: Lyssavirus (RABV vampire bat rabies types)
Serotype: RABV
Nature of diagnosis: Laboratory (advanced)
This event pertains to a defined zone within the country.

New outbreaks (1)
Summary of outbreaks:
Total outbreaks: 1
Outbreak 1: Cayenne, Cayenne
Date of start of the outbreak: 20 Aug 2015
Outbreak status: continuing (or date resolved not provided)
Epidemiological unit: Not applicable
Affected animals:
Species / Susceptible / Cases / Deaths / Destroyed / Slaughtered
Dogs / 1 / 1 / 1 / 0 / 0

Affected population: On Thu 20 Aug 2015, a 6-month-old dog was taken to the veterinarian since he was showing a decreased appetite without neurological signs and again the next day (Fri 21 Aug) following a deterioration of his general condition with convulsions, aggressiveness, visual loss and difficulties with movement. He was hospitalized and died on the night from Friday to Saturday. A rabies investigation was then launched and the Pasteur Institute confirmed the diagnosis on 31 Aug 2015.

Epidemiology:
Source of the outbreak(s) or origin of infection: unknown or inconclusive

Epidemiological comment: The virus isolated in the dog is a Lyssavirus of RABV species and of "vampire bat rabies" type. It is estimated that the virus excretion phase started on 5 Aug 2015. During this period, the dog was in a fully fenced house. No runaway was reported during the period. He just went out for some walks on a lead in the neighbourhood and some visits to the veterinarian. The dog did not bite but could have chewed or lick wounds or the face. The epidemiological investigation has identified to date 12 contact people and no contact animals. However, there are stray cats near the house where the rabid dog was. Although the origin of the contamination of the dog is still uncertain, the most likely hypothesis is the contact with a bat, since the dog has eaten dead animals found in the garden several times. Following confirmation of the diagnosis, a regulated zone was put in place in order to limit the movements of domestic carnivores, to establish increased surveillance and to strengthen the capture of stray animals. Carnivores improperly vaccinated that could have had contact with the case will be euthanized. Carnivores properly vaccinated that could have had contact with the case will be under clinical monitoring for 6 months.

Control measures
Measures applied: movement control inside the country; screening; quarantine; zoning; no vaccination; no treatment of affected animals Measures to be applied: No other measures.

Diagnostic test results:
Laboratory name and type:
Institute Pasteur (Paris) (National laboratory)Species / Test / Test date / Result
Dogs / direct fluorescent antibody (FAT) test / 28 Aug 2015 / Positive
Dogs / pathogen isolation on cell culture / 31 Aug 2015 / Positive

Future Reporting: The event is continuing. Weekly follow-up reports will be submitted.

The location of the outbreak can be seen on the interactive map included in the OIE report at the source URL above.
====================
[This immediate notification officially confirms the information communicated in the ProMED-mail report archive number 20150903.3620512.

"Rabies transmitted by the common vampire bat (_Desmodus rotundus_) is a major public health concern in subtropical and tropical areas of Latin America. Infected vampire bats can transmit rabies to domestic mammals and humans through their haematophagous behavior."  <https://www.aphis.usda.gov/wildlife_damage/nwrc/publications/12pubs/anderson121.pdf>

Pictures of the common vampire bat (_Desmodus rotundus_) can be seen at

[A HealthMap/ProMED-mail map can be accessed at:
Date: Tue 1 Aug 2015
Source: France-Guyane [in French, trans. ProMED CopyEd.LMI, edited]

Yesterday [31 Jul 2015], the Pasteur Institute in Paris confirmed a case of rabies in a 6-month old puppy living in Cayenne. The animal was hospitalized on 21 Aug 2015 at a veterinary hospital for nervous symptoms. He died the following night. 16 people in contact with the dog were sent to the anti-rabies center at the hospital in Cayenne.

The Director for Food, Agriculture and Forestry (Daaf) continues to investigate to discover the origin of the infection. He reminds people of the following guidelines:
- any sudden death of a domestic animal with no identified cause should be reported to a veterinarian;
- any dog, cat, monkey, bat, or other animal bite should be reported to the Daaf;
- early vaccination (starting at 3 months) of domestic animals, with a yearly booster shot is required.

As a precaution, a lot more will be done to catch stray animals in the neighbourhood and the entire area comprising the Zephyr bypass, Montabo, and Baduel roads, and Saint-Antoine path.
=================
[Cayenne is the capital of French Guiana (FG), an overseas region of France on the northeast coast of South America, bordering, on the west, Suriname and on the east and south, Brazil (the Amapa State). See maps at <http://geology.com/world/french-guiana-map.gif> and <http://healthmap.org/promed/p/3486>.

According to French Guiana's reports to the OIE, rabies has been absent there in domestic animals since 2003 and in wildlife since 2009.

According to Ref 1 below, on 28 May 2008, the French National Reference Center for Rabies (Institut Pasteur, Paris) confirmed the rabies diagnosis, based on hemi-nested polymerase chain reaction on skin biopsy and saliva specimens from a Guianan, who had never travelled overseas and died in Cayenne after presenting clinically typical meningoencephalitis.

>From the Author Summary:
"Until 2008, rabies had never been described within the French Guianan human population. Emergence of the 1st case in May 2008 in this French Overseas Department represented a public health event that markedly affected the local population, healthcare workers, and public health authorities. The anti-rabies clinic of French Guiana, located at Institut Pasteur de la Guyane, had to reorganize its functioning to handle the dramatically increased demand for vaccination. A rigorous epidemiological investigation and a veterinary study were conducted to identify the contamination source, probably linked to a bat bite, and the exposed population. Communication was a key factor to controlling this episode and changing the local perception of this formerly neglected disease. Because similar clinical cases had previously been described, without having been diagnosed, medical practices must be adapted and the rabies virus should be sought more systematically in similarly presenting cases. Sharing this experience could be useful for other countries that might someday have to manage such an emergence."

Results of the investigation into the source of infection of the 6-month old domestic dog reported above are anticipated with interest.

The increased incidence of rabies transmission to humans by vampire bats in Latin America, specifically in the Amazon region of Brazil, is discussed in Ref 2 below.

References
----------
1. Meynard J-B, Flamand C, Dupuy C, et al: First human rabies case in French Guiana, 2008: PLoS Negl Trop Dis. 2012;6(2):e1537. doi: 10.1371/journal.pntd.0001537; available at  <http://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0001537>.
2. Schneider MC, Romijn PC, Uieda W, et al: Rabies transmitted by vampire bats to humans: an emerging zoonotic disease in Latin America? Rev Panam Salud Publica. 2009; 25(3): 260-9; available at <http://www.scielosp.org/scielo.php?pid=S1020-49892009000300010&script=sci_arttext>. - ProMED Mod.AS]
More ...

Bosnia and Herzegovina

Bosnia & Herzegovina US Consular Information Sheet
December 01, 2008
COUNTRY DESCRIPTION:
Since the December 1995 signing of the Dayton Peace Accords, there has been significant progress in restoring peace and stability in Bosnia and Herze
ovina.
Significant progress has been made in reconstructing the physical infrastructure that was devastated by the war. Nonetheless, political tensions among the ethnic groups persist. Hotels and travel amenities are available in the capital, Sarajevo, and other major towns, but they are relatively expensive. In the more remote areas of the country, public facilities vary in quality.
For more details, read the Department of State Background Notes on Bosnia and Herzegovina.

ENTRY/EXIT REQUIREMENTS:
A passport is required for travel to Bosnia and Herzegovina. American citizens do not require a visa for tourist stays up to three months.
Travelers who are not staying at a hotel (i.e. a private residence) must register with the local police within 24 hours of arrival. U.S. citizens planning to remain in Bosnia and Herzegovina for more than three months must obtain a visa prior to travel, or apply for a temporary residence permit from the local police station having jurisdiction over their place of residence. Applications for temporary residence permits should be submitted 15 days prior to the expiration of the initial three month tourist visa. A police certificate indicating that the applicant has no criminal record is required for this permit and should be obtained from the applicant’s state of residence in the U.S.
For additional information please contact the Embassy of Bosnia and Herzegovina, at 2109 E. Street, NW, Washington, DC 20037, telephone 202-337-6473.
Visit the Embassy of Bosnia and Herzegovina web site at http://www.bhembassy.org for the most current visa information.

Beginning in May 2008, the immigration authorities of Bosnia and Herzegovina began to strictly enforce a provision of a Bosnian law that requires any unaccompanied minor (under 18) to have written permission from both parents in order to enter and leave the country.
If traveling with one parent only, the minor is required to have written permission for the trip from the non-traveling parent. 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:
Landmines remain a problem in Bosnia and Herzegovina. As of 2008, there are still an estimated 13,000 minefields and an estimated 222,000 active land mines.
The area of suspected landmine contamination is estimated at over 2000 square kilometers more than 4% of the country’s territory.
These devices have killed more than 400 people since 1996.
While most urban areas have been largely cleared, special care should be taken when near the former lines of conflict, including the suburbs of Sarajevo.
The de-mining community recommends staying on hard surfaced areas and out of abandoned buildings.
Families traveling with children in Bosnia and Herzegovina should be especially aware of the danger posed by mines and unexploded ordnances.
For more information about landmines please visit http://www.bhmac.org/en/stream.daenet?kat=19
Localized political difficulties continue and random violence may occur with little or no warning.

Bosnian criminals use firearms and explosives to settle personal, business, and political disputes.
In October 2008, an explosive device detonated in a public shopping mall in Vitez, killing a store security guard.
The foreign community is rarely the target of such violence, but there is always the danger of being in the wrong place at the wrong time.
While most Bosnian citizens appreciate the assistance of the international community, occasional anti-foreign sentiment is sometimes encountered.
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 overall crime rate throughout the country remains relatively low­the most common being confrontational crimes and residential break-ins.
Pick-pocketing and vehicle break-ins are also a problem. Most pickpockets operate in pairs and employ distraction methods to execute their craft.
There are also documented cases of pick-pocketing and other scams to get money from foreign passengers aboard public transportation.
Travelers should take normal precautions to protect their property from theft and exercise common sense personal security measures, traveling in groups, and staying in well-lighted areas after dark.
Confrontations with local citizens resulting from traffic incidents or public disagreements should be avoided.

INFORMATION FOR VICTIMS OF CRIME:
The loss or theft abroad of a U.S. passport should be reported immediately to the local police and the nearest U.S. Embassy or Consulate.
If you are the victim of a crime while overseas, in addition to reporting to local police, please contact the nearest U.S. Embassy or Consulate for assistance.
The Embassy/Consulate staff can, for example, assist you to find appropriate medical care, contact family members or friends and explain how funds could be transferred.
Although the investigation and prosecution of the crime is solely the responsibility of local authorities, consular officers can help you to understand the local criminal justice process and to find an attorney if needed.
See our Victims of Crime, including possible sources of U.S. assistance..
The local equivalent to the “911” emergency line in Bosnia and Herzegovina is: Police­122; Ambulance--124 and Fire­123.
MEDICAL FACILITIES AND HEALTH INFORMATION:
The lack of adequate medical facilities, especially outside Sarajevo, may cause problems for visitors.
Because many medicines are not obtainable, travelers should bring their own supply of prescription drugs and preventive medicines.
Private practitioners and dentists are becoming more common; however, quality of care varies and rarely meets U.S. or western European standards.
All major surgery is performed in public hospitals.
The U.S. Department of State is unaware of any HIV/AIDS entry restrictions for visitors to or foreign residents of Bosnia and Herzegovina

Information on vaccinations and other health precautions, such as safe food and water precautions and insect bite protection, may be obtained from the Centers for Disease Control and Prevention’s hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747) or via the CDC’s web site at http://wwwn.cdc.gov/travel/default.aspx.
For information about outbreaks of infectious diseases abroad consult the World Health Organization’s (WHO) web site at http://www.who.int/en.
Further health information for travelers is available at http://www.who.int/ith/en
MEDICAL INSURANCE:
The Department of State strongly urges Americans to consult with their medical insurance company prior to traveling abroad to confirm whether their policy applies overseas and whether it will cover emergency expenses such as a medical evacuation.
Please see our information on medical insurance overseas.

TRAFFIC SAFETY AND ROAD CONDITIONS:
While in a foreign country, U.S. citizens may encounter road conditions that differ significantly from those in the United States.
The information below concerning Bosnia and Herzegovina is provided for general reference only, and may not be totally accurate in a particular location or circumstance.
Road travel is possible throughout most of the country.
However, some roads are still damaged from the war, and poorly maintained.
Roads are sometimes blocked due to landslides, de-mining activity, and traffic accidents.
Bosnia and Herzegovina is among the rare countries in Europe that has fewer than ten kilometers of four-lane highway.
The existing, two-lane roads between major cities are quite narrow at places, lack guardrails, and are full of curves.
Travel by road can be risky due to poorly maintained roads, and morning and evening fog in the mountains.
Driving in winter is hazardous due to fog, snow, and ice.
Local driving habits are poor, and many vehicles are in bad condition.
Many accidents occur when drivers exceed safe speeds along winding mountain roads.
Accidents involving drunk driving are an increasing problem.
Driving after dark is especially dangerous, and street lighting is not common outside the major towns.
Road construction may be poorly marked, and automobiles share the road with heavy vehicles and agricultural equipment.
Travelers are encouraged to convoy with other vehicles, if possible, and to plan their trip to ensure they travel only during daylight hours.

Although the number of service stations outside major cities has increased in recent years, many do not offer mechanical or other services.
The emergency number for vehicle assistance and towing service is 1282; Speed limit traffic signs are not always obvious or clear.
The speed limit on the majority of roads is 60 km/h, and on straight stretches of road it is generally 80 km/h.
The use of seat belts is mandatory.
Talking on a cell phone while driving is prohibited.
The tolerated percentage of alcohol in the blood is .03%.

In order to drive legally in Bosnia and Herzegovina, you must have an international driving permit in addition to your U.S. license.

Please refer to our Road Safety page for more information.
Visit the web site of the Bosnia and Herzegovina’s national tourist office and national authority responsible for road safety at http://www.bihamk.ba
AVIATION SAFETY OVERSIGHT:
As there is no direct commercial air service to the United States by carriers registered in Bosnia and Herzegovina, the U.S. Federal Aviation Administration (FAA) has not assessed Bosnia and Herzegovina’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://faa.gov/safety/programs_initiatives/oversight/iasa .
During the winter months, flights into and out of Sarajevo are frequently delayed or canceled due to heavy fog.
Travelers should be prepared for last-minute schedule changes, lengthy delays, alternate routings, or time-consuming overland transportation.

SPECIAL CIRCUMSTANCES:
Bosnia and Herzegovina is still predominantly a cash economy.
Although the use of credit cards has become more widespread in recent years, travelers still should not expect to use them to cover all expenses. Automated Teller Machines (ATMs) are available in sufficient numbers at international banks in Sarajevo and other major cities and towns.
Traveler's checks can be cashed in banks in major cities, but often with delays of a few weeks or strict monthly limits.
Cash transfers from abroad may also involve delays.
The convertible mark, the national currency, is pegged to the euro under a currency-board regime, which guarantees its stability.
All official payments must be made in convertible marks, though many private stores and service providers also accept euros.
Any bank in Bosnia and Herzegovina should be able to exchange U.S. dollars into convertible marks with the usual bank commission (between 1% and 2%).

Photographing military installations, including airports, equipment, bridges, government checkpoints, troops and the U.S. Embassy, is forbidden.
If in doubt, please ask permission before taking photographs. 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 Bosnia and Herzegovina laws, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in Bosnia and Herzegovina 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 Bosnia and Herzegovina 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 Bosnia and Herzegovina.
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 Alipasina 43, telephone (387) (33) 445-700, fax: (387) (33) 221-837; http://sarajevo.usembassy.gov/.
On weekends, holidays, and after hours, an Embassy duty officer can be reached at telephone (387) (33) 445-700.
If after dialing you receive a recorded message, press “0”, and then ask for the duty officer.
* * *
This replaces the Consular Information Sheet dated March 11, 2008, to update sections on Country Description, Entry and Exit Requirements, Safety and Security; and Crime.

Travel News Headlines WORLD NEWS

Date: Tue, 14 May 2019 17:36:11 +0200

Sarajevo, May 14, 2019 (AFP) - Torrential downpour has flooded hundreds of homes and swamped roads in northern Bosnia, officials said Tuesday, as rescuers searched for a six-year-old boy swept away by a swollen stream.   The child went missing in the northern Zepce region, national television BHRT reported on Tuesday. 

The heavy rain, which started Sunday, has sparked fears of a repeat of the 2014 floods that devastated the Balkan region, killing 77 people.   Weather services have predicted the rain will taper off.   Several Bosnian towns in the hardest-hit north have declared a state of emergency and begun protective evacuations.

More than 200 people have been evacuated in villages around north-eastern Doboj, where two rivers have overflowed.   "About 100 houses were flooded, as well as the offices of five companies and 50 hectares of land," said civil defence official Senad Begic.    Floods have also hit around 200 households in northwest Prijedor and 100 east in the town of Celinac.    "The danger has not passed and I invite inhabitants to follow the instructions of the authorities, without panic," urged Radovan Viskovic, Prime Minister of Republika Srpska, Bosnian's Serb-run region.

Dozens of homes were also flooded in neighbouring Croatia, where eight tourists, including two children, were rescued by firemen at a campsite on the banks of the Korana river, national TV reported.   After rising rapidly overnight, water levels in major rivers are falling slightly or stagnating, according to weather services.   In the spring of 2014, the Balkans region was hit by its worst floods in more than a century, which affected 1.6 million people and caused an estimated two billion euros in damage, mostly to houses and farmland.
Date: Thu, 24 Dec 2015 20:40:42 +0100

Sarajevo, Dec 24, 2015 (AFP) - Air pollution forced Bosnian authorities to shut schools in the capital Sarajevo on Thursday, while smog levels also spiked in other parts of the Balkan country due to a lack of rainfall, local officials said.   The air quality index, whose "normal" levels range from 0 to 50, reached 94 in Sarajevo on Thursday, official data showed.   Registered levels had been even higher in recent days, with the index soaring above the dangerous 300 mark and the city literally shrouded in a smog.

Regional authorities in Sarajevo decided to close primary and secondary schools Thursday, they said in a statement, while the city council demanded an early start to the winter holiday, so that children would be spared from being exposed to the smog.   Winter holidays traditionally start later in Bosnia than in western Europe, just ahead of the New Year.

Health authorities urged citizens meanwhile, particularly those with health problems, pregnant women and children, to refrain from going out at all.   Red Cross and non-governmental activists distributed protective masks to people across the city, which is surrounded by mountains that lock in the air especially during dry spells.   Pollution levels were also exacerbated by fumes from heating tens of thousands of homes.

Weather forecasts indicate that smog levels are not expected to improve before January.   Several other Bosnian towns were also hit by smog, especially those with large industrial areas such as Lukavac and Tuzla, where the air pollution index reached 293 and 193 respectively on Thursday.
Date: Tue, 24 Nov 2015 11:23:17 +0100

Sarajevo, Nov 24, 2015 (AFP) - Bosnian prosecutors were investigating an explosion at a police station Tuesday which authorities said could be an act of "terrorism", days after two members of the country's military were shot dead.   Unknown perpetrators threw an explosive device on the roof of the station in the central town of Zavidovici in the early hours, causing minor damage but no injuries, police spokeswoman Aldina Ahmic said.   "There are indications that this case has elements of the criminal act of terrorism," said Ahmic.

The national prosecutor's office has taken over the case and formed a special team tasked with investigating.   The incident comes less than a week after two military men were killed on November 18 by a man who attacked them with automatic weapons near a barracks in Sarajevo before blowing himself up.   Authorities have said that the perpetrator had links to Islamist circles and that the attack was almost certainly a "terrorist act".

Muslims make up about 40 percent of Bosnia's 3.8 million people while the rest of the Balkan country is mostly Serb Orthodox or Catholic.   The vast majority of Bosnian Muslims are moderates but a tiny minority openly support radical Wahhabism.   After the deadly Islamic State attacks in Paris earlier this month, Bosnia's Islamic spiritual leader Husein Kavazovic urged Europe's Muslims to keep the peace, saying the killings were a "sin towards God".
Date: Mon 27 Apr 2015
Source: WBNS-TV, Associated Press (AP) report [edited]

Authorities in Bosnia's capital have declared a foodborne outbreak after nearly 200 preschool children became sick at public day care centers in Sarajevo. Local health minister Emira Tanovic-Mikulec declared the outbreak on Mon 27 Apr 2015. Lab tests show that the food the children ate last week [week of 20 Apr 2015] was infected with salmonella enteridis [see comment below]. Out of the 193 children with fever, diarrhea, and abdominal cramping, 51 had to be hospitalized but none are in a life-threatening condition, hospital officials say.

About 2900 kids eat food prepared in a central kitchen that supplies the 29 centers in Sarajevo. The symptoms started last Wed 22 Apr 2015, when macaroni with cheese and eggs was on the menu.
================
[Both cheese (especially if unpasteurized) and eggs (if undercooked or recontaminated from poor kitchen hygiene) are common reservoirs for salmonellosis. The serotype is not specially stated as, in the original post, the statement is "was infected with salmonella enteridis" which could mean salmonella enteritis (as the name of the condition) or _Salmonella_ Enteritidis (as the name of the organism). - ProMED Mod.LL]

[A HealthMap/ProMED-mail map can be accessed at:
Date: Thu 2 Apr 2015
Source: Outbreak News Today [edited]
-------------------------------------------------------------------------
The US Centers for Disease Control and Prevention (CDC) issued 3 travel notices Wednesday due to on-going measles outbreaks in Angola, Bosnia-Herzegovina and Ethiopia. In Angola, the US federal health agency says the country is experiencing an on-going measles outbreak. The number of confirmed measles cases increased from 6558 in 2013 to 12 036 in 2014; and cases continue to occur in 2015.

In Europe, as of February 2015, the Federal Institute of Public Health in the Federation of Bosnia and Herzegovina has reported more than 3800 cases since January 2014. Most of the cases have been in 3 Central Bosnia Canton municipalities: Bugojno, Fojnica, and Travnik.

Finally, on the Horn of Africa, Ethiopia is experiencing an on-going measles outbreak. The number of confirmed measles cases increased from 6100 in 2013 to more than 14,000 confirmed cases in 2014; cases continue to occur in 2015.

The CDC recommends that travellers to all 3 destinations protect themselves by making sure they are vaccinated against measles, particularly infants 6-11 months of age (1 dose of measles vaccine) and children 12 months of age or older (2 doses of measles vaccine). Clinicians should keep measles in mind when treating patients with fever and rash, especially if the patient has recently travelled internationally.  [Byline: Robert Herriman]
More ...

World Travel News Headlines

Date: Tue, 26 May 2020 09:15:57 +0200 (METDST)

Riyadh, May 26, 2020 (AFP) - Saudi Arabia will end its nationwide coronavirus curfew from June 21, except in the holy city of Mecca, the interior ministry said Tuesday, after more than two months of stringent curbs.   Prayers will also be allowed to resume in all mosques outside Mecca from May 31, the ministry said in a series of measures announced on the official Saudi Press Agency.   The kingdom, which has reported the highest number of virus cases in the Gulf, imposed a full nationwide curfew during Eid al-Fitr, the Muslim holiday that marks the end of the fasting month of Ramadan.

The ministry said it will begin easing restrictions in a phased manner this week, with the curfew relaxed between 6 am and 3 pm between Thursday and Saturday.   From Sunday until June 20, the curfew will be further eased until 8 pm, the ministry added.   The kingdom will lift the lockdown entirely from June 21.   "Starting from Thursday, the kingdom will enter a new phase (in dealing with the pandemic) and will gradually return to normal based on the rules of social distancing," Health Minister Tawfiq Al-Rabiah said on Monday.   Saudi Arabia has reported around 75,000 coronavirus infections and some 400 deaths from COVID-19.

In March, Saudi Arabia suspended the year-round "umrah" pilgrimage over fears of the disease spreading in Islam's holiest cities.   That suspension will remain in place, the interior ministry said.   Authorities are yet to announce whether they will proceed with this year's hajj -- scheduled for late July -- but they have urged Muslims to temporarily defer preparations for the annual pilgrimage.   Last year, some 2.5 million faithful travelled to Saudi Arabia from around the world to participate in the hajj, which Muslims are obliged to perform at least once during their lifetime.
Date: Tue, 26 May 2020 05:52:24 +0200 (METDST)

Santiago, May 26, 2020 (AFP) - Chile registered a new high for coronavirus cases on Monday, with nearly 5,000 infections in 24 hours, including two ministers in President Sebastian Pinera's government.   Health authorities announced 4,895 new infections in the South American country and 43 deaths.

Public Works Minister Alfredo Moreno and Energy Minister Juan Carlos Jobet said they were among those with the disease.   "I have been informed that the COVID-19 test I had a few days ago was positive," Moreno said on Twitter, adding that he had no symptoms so far.   The 63-year-old minister had placed himself in quarantine after one of his staff tested positive.  Jobet also tested positive after starting to quarantine preventatively on Saturday, "when he experienced mild symptoms, which could be associated with the disease," a statement from the Energy Ministry said.

The 44-year-old minister "has had no direct contact with President Sebastian Pinera or other cabinet members in recent days," the statement said, without specifying how he became infected.   Three other ministers, who had self-quarantined after being in contact with infected people, all tested negative and resumed work.

Chile suffered a surge in infections last week, prompting the government to order the lockdown of Santiago.   The capital is the main focus of the pandemic in Chile, with 90 percent of the country's 74,000 cases.   Last week, the Senate was closed after three senators tested positive for the coronavirus. Sessions were held by video conference.
Date: Tue, 26 May 2020 01:15:01 +0200 (METDST)

Quito, May 25, 2020 (AFP) - Demonstrators defied coronavirus restrictions to march in cities across Ecuador on Monday in protest against President Lenin Moreno's drastic economic measures to tackle the crisis.   Moreno last week announced public spending cuts including the closure of state companies and embassies around the world, but trade unions Monday said workers were paying a disproportionate price compared to Ecuador's elite.   "This protest is because the government is firing workers to avoid making the rich pay," Mecias Tatamuez, head of the county's largest union, the Unitary Front of Workers (FUT), told reporters at a march in Quito.

Around 2,000 people marched in the capital, waving flags and banners and shouting anti-government slogans.   The protesters wore masks and respected distancing measures recommended against the spread of the coronavirus that has caused at least 3,200 deaths in the country, making it South America's worst hit nation per capita. Authorities say more than 2,000 further deaths are likely linked to the virus.

Demonstrations took place in several other cities, including Guayaquil, the epicentre of Ecuador's health crisis, where union leaders said hundreds marched through the city.   Moreno ordered the closure of Ecuadoran embassies, a reduction in diplomatic staff and scrapped seven state companies as part of measures designed to save some $4 billion.    He also announced the liquidation of the TAME airline, which has lost more than $400 million over the last five years.

The government says the pandemic has so far cost the economy at least $8 billion.   Public sector working hours have been cut by 25 percent, with an accompanying 16 percent pay cut.   Moreno said on Sunday that 150,000 people had lost their jobs because of the coronavirus.   Ecuador was struggling economically before the pandemic hit, due to high debt and its dependence on oil.   The IMF predicts that the economy will shrink by 6.3 percent this year, the sharpest drop of any country in South America.
Date: Mon, 25 May 2020 22:20:46 +0200 (METDST)

Dublin, May 25, 2020 (AFP) - Ireland recorded no new deaths from the coronavirus on Monday for the first time since March 21.   Prime Minister Leo Varadkar called it a "significant milestone", adding on Twitter: "This is a day of hope. We will prevail."

The announcement came one week after Ireland, which has suffered 1,606 deaths from 24,698 infections, began to ease lockdown measures that had been in place for nearly two months.   Ireland entered lockdown in late March, recording a peak of 77 deaths on a single day on April 20.   "In the last 24 hours we didn't have any deaths notified to us," chief medical officer Tony Holohan said at a daily press briefing.   He warned that the zero figure could be a result of a lag in reporting of deaths over the weekend, but he added: "It's part of the continued trend that we've seen in (the) reduction in the total number of deaths."

Ireland has announced a five-step plan to reopen the nation by August and took the first steps last Monday -- allowing outdoor employees to return to work, some shops to reopen and the resumption of  activities such as golf and tennis.   While the news of no fresh deaths was greeted as progress, officials remain concerned there will be a "second wave" as the lockdown is loosened.   "The number of new cases and reported deaths over the past week indicates that we have suppressed COVID-19 as a country," Holohan added in a statement.   "It will take another week to see any effect on disease incidence that might arise from the easing of measures."
Date: Mon, 25 May 2020 21:59:40 +0200 (METDST)

Luxembourg, May 25, 2020 (AFP) - Luxembourg will ease its coronavirus restrictions on Wednesday, reopening cafes and restaurants and allowing civil and religious ceremonies under strict conditions, the government announced.   The tiny country has so far registered only 3,993 COVID-19 cases, of which 110 have been fatal. Four people are in intensive care and shops were closed on March 18 to slow the spread of the new coronavirus.

Prime Minister Xavier Bettel told a news conference on Monday that eateries could reopen terraces with a maximum of four people at a single table.   Indoor dining in cafes and restaurants will resume on Friday, he said, with social distancing of 1.5 metres (five feet) between groups.   Marriages and funerals will also be allowed if the attendees wore face masks and kept two metres distance from each other.   Bettel however said cafes and restaurants would have to close at midnight.

Francois Koepp, the general secretary of the Horeca federation grouping hotels, restaurants and cafes, welcomed the announcement, saying the sector had "greatly suffered from the confinement".   He said it provided employment to some 21,000 people in this nation of 620,000 inhabitants.   Cinema theatres and gyms will open at the end of the week but children's parks will remain closed.   The government has pledged to give every citizen over 16 a voucher worth 50 euros ( $54) to spend in hotels to provide a boost to the sector.   The vouchers will also be given to some 200,000 cross border workers from Belgium, France and Germany.
Date: Mon, 25 May 2020 20:36:16 +0200 (METDST)

Prague, May 25, 2020 (AFP) - The Czech Republic and Slovakia will reopen their border this week for those travelling to the other country for up to 48 hours, Czech Prime Minister Andrej Babis said Monday.   "This will be possible without tests or quarantine" starting Wednesday, he added in a message posted on Twitter.   The Czech Republic and Slovakia formed a single country until 1993. Babis himself was born in the Slovak capital of Bratislava.

Both countries have fared well in the current pandemic, with Slovakia posting the lowest death toll per capita in the EU and the Czech Republic keeping its COVID-19 figures down as well.   The Czech government will also open border crossings with Austria and Germany on Tuesday but will still require negative COVID-19 tests from those entering the country.   "We have negotiated similar conditions on the other side of the border with our German and Austrian colleagues," Interior Minister Jan Hamacek said.   The interior ministry said blanket border checks would be replaced by random ones and added it would still not allow tourists into the country.

Czech Health Minister Adam Vojtech said the government was working on other measures to ease the travel restrictions adopted in mid-March.   "We would like to introduce them next week," he added.   Vojtech said EU citizens could now come to the Czech Republic "on business or to visit their family for a maximum of 72 hours if they submit a negative coronavirus test."

The country is also accessible to non-EU citizens who do seasonal jobs there, on condition they have tested negative.   Czech restaurants, bars, hotels, castles, zoos and swimming pools have been open since Monday, when the government lifted many anti-virus measures.   Czechs also no longer have to wear face masks outside their homes, except in shops and on public transport.
Date: Mon, 25 May 2020 17:45:38 +0200 (METDST)
By Shafiqul ALAM

Dhaka, May 25, 2020 (AFP) - Some 15,000 Rohingya refugees are now under coronavirus quarantine in Bangladesh's vast camps, officials said Monday, as the number of confirmed infections rose to 29.   Health experts have long warned that the virus could race through the cramped settlements, housing almost a million Muslims who fled violence in Myanmar, and officials had restricted movement to the area in April.

Despite this, the first cases in the camps were detected in mid-May.   "None of the infections are critical. Most hardly show any symptoms. Still we have brought them in isolation centres and quarantined their families," Toha Bhuiyan, a senior health official in the surrounding Cox's Bazar area told AFP.   He said narrow roads to three districts of the camps -- where the majority of the infections were detected -- have been blocked off by authorities.

The 15,000 Rohingya inside these so-called blocks faced further restrictions on their movement, he said.   It comes as charity workers expressed fears over being infected in the camps as they worked without adequate protection.   Two of the areas under isolation are in Kutupalong camp, home to roughly 600,000 Rohingya.   "We are trying to scale up testing as fast as possible to make sure that we can trace out all the infected people and their contacts," Bhuiyan said.

Seven isolation centres with the capacity to treat more than 700 COVID-19 patients have been prepared, he said.   Officials hope to have just under 2,000 ready by the end of May, he added.   Mahbubur Rahman, the chief health official of Cox's Bazar, said authorities hoped this week they would double the number of tests being performed daily from 188.   He said further entry restrictions have been imposed on the camp, with a 14 day quarantine in place for anyone visiting from Dhaka.   "We are very worried because the Rohingya camps are very densely populated. We suspect community transmission (of the virus) has already begun," Rahman told AFP.

- 'Very little awareness' -
Bangladesh on Monday notched up a record single-day spike in coronavirus cases, with 1,975 new infections, taking the toll to 35,585 cases and 501 deaths.   In early April authorities imposed a complete lockdown on Cox's Bazar district -- home to 3.4 million people including the refugees -- after a number of infections.

But a charity worker with one of the many aid organisations active in the camps said Monday he and many others were "very worried".   "Fear and panic has gripped aid workers because many of us were forced to work without much protection," he told AFP without wishing to be named.   "Social distancing is almost impossible in the camps. There is very little awareness about COVID-19 disease among the refugees, despite efforts by aid agencies."

The lack of information is exacerbated by local authorities having cut off access to the internet in September to combat, they said, drug traffickers and other criminals.   More than 740,000 Rohingya fled a brutal 2017 military crackdown in Myanmar to Cox's Bazar, where around 200,000 refugees were already living.
Date: Mon, 25 May 2020 15:25:38 +0200 (METDST)

Antananarivo, May 25, 2020 (AFP) - Madagascar's government has announced it will dispatch troops and doctors to an eastern town after several bodies were found in the streets and where two people died from the novel coronavirus.   Madagascar's cabinet held a special meeting on Sunday to discuss the situation in Toamasina, the country's second largest city.   The Indian Ocean island nation has registered 527 infections and two deaths, both in Toamasina.

Since Thursday, more than 120 new cases were confirmed, and several bodies were found in the city's streets though the cause of death was not clear.   "Doctors must carry out thorough examinations to see if these deaths are caused by another illness (...) or if they are really due to severe acute respiratory problems which is the critical form of COVID-19," Professor Hanta Marie Danielle Vololontiana, spokesperson for the government's virus taskforce, said in a national broadcast on Sunday.   The government will send 150 soldiers to reinforce Toamasina, maintain order and enforce measures against the coronavirus such as mask wearing and social distancing.

The cabinet also fired Toamasina's prefect without providing any explanation.    A team was also ordered to distribute a drink based on artemisia, a plant recognised as a treatment against malaria, which the Malagasy authorities claim cures COVID-19.    The potential benefits of this herbal tea, called Covid-Organics, have not been validated by any scientific study.    The cabinet has also announced an investigation into the death of a doctor in Toamasina. According to local press, the victim was hospitalised after contracting COVID-19 and was found dead hanged in his room on Sunday morning.
Date: Mon, 25 May 2020 09:20:17 +0200 (METDST)
By Bhuvan Bagga with Indranil Mukherjee in Mumbai

New Delhi, May 25, 2020 (AFP) - Domestic flights resumed in India on Monday even as coronavirus cases surge, while confusion about quarantine rules prompted jitters among passengers and the cancellation of dozens of planes.   India had halted all flights within the country, and departing and leaving for abroad, in late March as it sought to stop the spread of coronavirus with the world's largest lockdown.   But desperate to get Asia's third-largest economy moving again, the government announced last week that around 1,050 daily flights -- a third of the usual capacity -- would resume on Monday.

Aviation Minister Hardeep Singh Puri said strict rules would include mandatory mask-wearing and thermal screenings, although middle seats on the aircraft would not be kept empty.   The announcement reportedly caught airlines and state authorities off-guard, with several local governments announcing that passengers would have to go into quarantine for two weeks on arrival.   Maharashtra, the Indian state with the highest number of coronavirus cases, capped at 50 the number of departures and arrivals in and out of its capital Mumbai.

Airlines scrapped dozens of flights on Monday while hundreds of passengers cancelled their bookings, reports said.   The NDTV news channel said 82 flights to and from New Delhi had been cancelled and nine at Bangalore airport.   Other flights from cities including infection hotspots Mumbai and Chennai were struck off, many at short notice, reports said.   At Mumbai airport social distancing was forgotten as irate passengers harangued staff after their flights were cancelled at the last minute.

- 'Really scary' -
At New Delhi airport, hundreds of people anxious to get home but apprehensive about the risks queued from before dawn -- all wearing masks and standing at least one metre (three feet) apart.   Security personnel behind plastic screens verified check-in documents and that passengers had the government contact tracing app, Aarogya Setu, on their phones.

"While I'm looking forward (to flying home), the idea of flying is really scary," student Gladia Laipubam told AFP as she stood in line.   "Anything can happen. It's very risky. I don't really know when I'll be able to come back to Delhi now. There is no clarity from the university too at this time."   One female airline employee wearing gloves, a mask and a protective face shield said she and many other colleagues felt "very nervous" about starting work again.   "Dealing with so many people at this time is so risky. I must have interacted with at least 200 people since this morning," she told AFP, not wishing to be named.

Cabin crew on the planes had to wear full protective suits with masks, plastic visors and blue rubber gloves, and many were also confused about the rules, the Press Trust of India reported.   "There is no clarity on whether I need to go into home quarantine for 14 days after returning to my base or show up for duty on Monday," one pilot told PTI.   New coronavirus cases in India crossed 6,000 for the third consecutive day on Sunday, surging to a record single-day spike of 6,767 infections.   The country has recorded almost 140,000 cases and over 4,000 deaths.   Singh has said that international flights could resume in June, although dozens of special flights have in recent weeks brought back some of the hundreds of thousands of Indians stuck abroad.
Date: Fri, 22 May 2020 11:02:28 +0200 (METDST)

Suva, Fiji, May 22, 2020 (AFP) - A huge fire at one of Suva's largest markets blanketed the Fijian capital in thick smoke before it was brought under control Friday, firefighters said.   The blaze engulfed the Suva Flea Market, a major tourist attraction near the waterfront, sending plumes of acrid black smoke into the air.   The National Fire Authority said an adjoining shop was also badly damaged but there were no reports of injuries.   "It's been stopped now and no one was injured but that's all we can say at the moment," a spokesman told AFP.   The said the cause of the fire was being investigated.