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United Arab Emirates

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

See our information on Victims of Crime.

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

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

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

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

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

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

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

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

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

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

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

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

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

Please see our Customs Information.

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

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

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

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

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

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

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

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

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

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

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

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

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

Travel News Headlines WORLD NEWS

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Please see our information on Criminal Penalties.

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

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

Travel News Headlines WORLD NEWS

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Niue

No Profile is available at present

Travel News Headlines WORLD NEWS

20th July 2012

- Niue Island. 20 Jul 2012. Two tourists visiting Niue have been taken to hospital with dengue fever. More than 100 people, or about 8 percent of the population, are believed to be suffering from the fever, and visitors are being warned to use insect repellent during early morning and evening. Dengue, which does not often occur on Niue, has been afflicting  the island since February [2012]. It was originally confined to a small area of Niue's main village but has now spread throughout the island. One local man recently died from a serious form of the virus.
==================
[A HealthMap/ProMED-mail interactive map showing the location of Niue Island in the Pacific Ocean can be accessed at <http://healthmap.org/r/1ZWb>. - ProMed Mod.TY]
Monday 30th April 2012
A ProMED-mail post
<http://www.promedmail.org>

- Niue Island. 24 Apr 2012. The Niue Health Department says it believes the dengue outbreak has peaked. The department says there have been 47 recorded cases of dengue fever, but only one case has been picked up in the last 7 days. The Acting Director of Health, Manila Nosa, says it's a relief to see the wane in cases, but it's too early to say that dengue is completely gone. He said that there has been a lot of rain lately, and it's hoped this won't contribute to a further spread.
======================
[A HealthMap/ProMED-mail interactive map of Niue Island can be accessed at <http://healthmap.org/r/1ZWb>. - ProMed Mod.TY]
Monday 16th April 2012
A ProMED-mail post
<http://www.promedmail.org>

- Niue Island. 12 Apr 2012. Health authorities on Niue are confident that they are on top of the latest dengue outbreak that has infected 20 people to date. The chief medical officer, Dr Eddie Akau'ola, says this outbreak began about 3 weeks ago but they believe they have been able to contain it. He says it is peaking now and they expect a decline in a week or 2. Dr Akau'ola says none of the cases have been too serious.
====================
[A HealthMap/ProMED-mail interactive map showing the location of Niue Island in the Pacific can be accessed at <http://healthmap.org/r/2bMz>. - ProMed Mod.TY]
Tuesday 13th March 2012
A ProMED-mail post
<http://www.promedmail.org/>

- Niue Island. 6 Mar 2012. Niue health authorities are hopeful they've contained a rare outbreak of dengue fever on the island where 3 people were reported with dengue last week, with 2 admitted to hospital.
======================
[A HealthMap/ProMED-mail interactive map showing the location of Niue Island in the Pacific can be accessed at <http://healthmap.org/r/1ZWb>. - ProMed Mod.TY]
Date: Sun, 24 Jul 2011 10:42:49 +0200 (METDST)
by Neil Sands

ALOFI, Niue, July 23, 2011 (AFP) - In a once-thriving village on the Pacific island of Niue, homes lie abandoned, their stucco-clad walls mildewed and crumbling as the jungle slowly reclaims them. "These villages used to be bustling with people -- now you go there in the afternoon and there's no one," says the Niue Tourism Authority chairman Hima Douglas. The number of people living on the lush coral atoll, about 2,500 kilometres (1,550 miles) northeast of New Zealand, has been declining for decades as inhabitants seek a better life overseas.

The population, which peaked at more than 5,000 in the mid-1960s, has dwindled to just 1,200, according to a New Zealand parliamentary report, raising doubts about the island nation's economic viability.  Douglas said a major cyclone in 2004, which destroyed much of Niue's infrastructure, accelerated the exodus, and the threat of future natural disasters was discouraging people from returning. "Of course it's concerning but it's not something we can do too much about until we can build an economy that will give them the confidence to come back," Niue's Premier Toke Talagi told reporters this month. "There aren't simple and easy answers to people leaving. We've got to build a strong economy and hope to attract them back." Known locally as "The Rock", Niue was settled by Polynesian seafarers more than 1,000 years ago and the palm-dotted island's name in the local language means "behold, the coconut".

The British explorer captain James Cook tried to land there three times in 1774 but was deterred by fearsome warriors, eventually giving up to set sail for more welcoming shores and naming Niue "savage island" on his charts. But modern day Niueans are desperate for visitors, with Talagi unveiling plans this month to turn it into a boutique tourism destination in a bid to put his nation on a sound economic footing. Using aid from New Zealand, with which Niue has a compact of free association giving its people dual citizenship, Talagi has overseen construction of a new tourism centre and expansion of the island's Matavai Resort.

Paths have also been cut through the jungle to give visitors access to swimming spots on the rugged limestone coastline, and cruise liners are being encouraged to include Niue on their itineraries. "We can become self-sustaining in the long term (and) reduce New Zealand assistance to Niue," Talagi said, estimating that visitor numbers could quadruple to 20,000 a year in the next decade. Addressing a visiting delegation of New Zealand business executives this month, Talagi acknowledged doubts about the nation's ability to meet the challenge. "I know some of you are a bit sceptical about our ability to become self sustaining... (but) tourism is not going to fail and I don't expect it to fail given the numbers that are being generated," he said.

The New Zealand parliamentary report, released last December, estimates that about 50,000 Niueans and their children now live in Australia and New Zealand, creating a shortage of skilled labour in one of the world's smallest states. "Niue is caught in a vicious cycle, with its economic difficulties both exacerbated by, and reflected in, the long-term decline of its population," it said, adding that 40 years of New Zealand aid "has yielded almost no return". The report's authors suggested Niue should concentrate on promoting itself as a retirement destination for elderly New Zealanders, who could help revitalise the economy. "The climate is excellent, existing buildings could be brought into service, and health facilities are satisfactory," it said. "Retirees would bring steady cash flow and contribute to stable employment options."

Asked about the suggestion, Talangi said "we'll look at everything", although one long-time resident, who asked not to be named, was unenthusiastic at the prospect. "How depressing to think that we might be turned into a major geriatric ward," she said. "Not that I have anything against old people, mind." Another resident said that whatever steps Niue took to improve its economy must result in major changes, pointing out people could earn more by moving to New Zealand and claiming unemployment benefits than working on the island. "It's pretty hard when your cuzzies (cousins) call you and say 'we're getting more on the dole in Auckland than you're getting paid'," he said.
More ...

Israel

General Information:
***************************************
The Middle East is a favourite destination for many Irish holiday makers. The combination of a beautiful climate linked with such historical richness is hard to beat. Unfortunately the
security situation throughout the region has led to some significant concerns over the years. Nevertheless, in the vast majority of cases those visiting the region will not encounter any particular concerns in this regard. It is a wise precaution to ensure that your passport is valid for at least a further six months beyond the time of your holiday as otherwise you may be refused entry.
Security Situation:
***************************************
Security throughout the Middle East is generally tight. Carry some means of identification at all times in case you are requested to produce it by police or army personnel. In Jerusalem the city has been divided and it is sensible to remember which quarter you are in at all times.
Health Facilities:
***************************************
Generally the health facilities throughout the region are excellent. However, when visiting certain rural regions you may find it difficult to obtain hospital care similar to that at home. In Israel, travellers can find information in English about emergency medical facilities and after-hours pharmacies in the "Jerusalem Post" and English language "Ha'aretz" newspapers.
Food & Water Facilities:
***************************************
Again, this depends on your location and the facilities which are there at the time of the year you visit. Bottled water is easily available and food hygiene is usually excellent throughout all the main tourist destinations. However, it is generally wiser not to drink hotel tap water and only to use it for brushing your teeth if there is a clear smell of chlorine. When on organised trips tourists are sometimes offered local tea or other drinks. Generally this will be safe as the water is boiled but take care that the cup hygiene is acceptable.
Sun Exposure:
***************************************
The climatic conditions in the Middle East vary considerably throughout the year. Many tourists visit in late autumn or early spring. At these times the climate is much cooler and the evenings can be distinctly chilly. However, during the main tourist season (May to September) the temperatures rise high into the 80’s or 90’s and dehydration can easily occur. Increasing fluid and salt intake is important under these circumstances. It is essential that travellers are aware of the climatic conditions which should be present for their trip and that sensible clothing is used at all times.
Rabies:
***************************************
Tourists should avoid all animals as this viral disease is transmitted through the bite, lick or scratch of any infected warm blooded animal. In Israel the most common animals involved are foxes and jackals and in Jordan, dogs tend to be the main culprits.
Exploring the Region:
***************************************
Leaving the main tourist routes is unwise. There are a number of security risks which have to be considered and there are also significant health concerns which may be encountered. In July 2000 an 18 year old American tourist died of sunstroke when she became separated from her group in the Dead Sea region of Israel. Those exploring caves and parts of the desert areas also run the risk of diseases like Borreliosis and Rabies.
Walking & Trekking:
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For many going to these countries their trip will involve visiting some of the major ruins and archeological sites. This will involve a good deal of walking and trekking. Good supporting foot wear is essential and it would be wise to carry a crepe bandage in case of a sprained ankle. Having a suitable painkiller or anti-inflammatory medication would also be advantageous. Check your health will be up to the journey.
Swimming:
***************************************
Pools are usually very well maintained and the risk of disease is small. Those swimming in the sea should remember that the Mediterranean is home to many jelly fish. Swim with others and never alone and especially after alcohol or a heavy meal.
Anthrax:
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This bacterial disease is rare in the Middle east though travellers should be aware that it can be transmitted through unprepared leather goods usually bought in the local market places. Typically the disease may then present with a black ulcerated skin lesion.

Malaria:
***************************************
Fortunately this disease does not occur in Israel or Jordan. However other mosquito and sandfly diseases do occur and so protection against their bites should be used when necessary.
Hepatitis:
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There are many forms of this disease but the most common is Hepatitis A, often known as Infectious Jaundice. This disease can keep an infected individual off work for many weeks and it is wise to consider vaccination cover before exposure. In Israel approx 65% of the population will have been infected before 18 years of age.
Vaccinations:
***************************************
There are no essential vaccines for entry/exit however most Irish tourists are recommended to receive cover against; Poliomyelitis, Typhoid, Tetanus and Hepatitis A. Those living in these countries or planning an extended trip should also consider cover against Hepatitis B and Rabies.
Summary:
***************************************
Due to the unrest within Israel there are concerns regarding the safety of tourists at this time. If you are travelling to this region it is wise to ensure that your insurance policy is sufficient if your circumstances or travel plans change.

Travel News Headlines WORLD NEWS

Date: Thu 5 Sep 2019
Source: Newsweek [abridged, edited]

The Israeli Health Ministry recorded more than 4300 cases between July 2018 and July 2019, representing a monumental uptick from the year prior, when only about 30 cases were reported.

A 43-year-old flight attendant with El Al died last month [August 2019] after reportedly contracting measles from a passenger in March [2019].

[She] was admitted to Petah Tikva's Rabin Medical Center-Beilinson Campus with a high fever, then fell into a coma and had to be placed on a respirator. Tests indicated she had been vaccinated against the measles with only a single shot, instead of the recommended 2.

The Health Ministry also issued warnings this year [2019] about potential measles exposures on El Al flights from London and Thailand, at medical centers, public transportation stops and at Eilat's Underwater Observatory Marine Park.

Despite the outbreaks, Israel's immunization rates are among the highest in the world: According to The World Bank, 98% of Israeli children between 12 and 23 months have measles vaccinations.

The immunization gap, say health experts, is within the country's Haredi, or ultra-Orthodox, population. Israel's measles outbreak began in March 2018 in a Haredi community in Safed in northern Israel.

But the lack of vaccinations isn't because of any religious prohibition. "In general, those closed communities use our health care system much less than nonreligious people," Dr. Roy Zucker, a specialist in internal medicine in Israel, told Newsweek.

As of July 2019, there have been more than 1400 cases reported in Jerusalem, plus 400 in Beit Shemesh, 279 in Safed and 212 in Bnei Brak -- all of which have heavily Orthodox populations.  [Byline: Daniel Avery]
Source: Arutz Sheva 7 [edited]
Date: Tue 13 Aug 2019

A stewardess of Israel's El Al airline died Tuesday [13 Aug 2019], following a months-long battle with measles. The 43-year-old stewardess was infected with the measles virus during a flight from New York to Israel 5 months ago.

After she was infected, the stewardess was hospitalized in serious condition at Meir Medical Center in Kfar Saba in central Israel after she was found unconscious and struggling to breathe. During her hospitalization, the stewardess' condition deteriorated, and she was transferred to the quarantine section of the hospital's intensive care wing.

On Tuesday [13 Aug 2019], doctors at Meir hospital declared her death, following the 5-month struggle.  [Byline: Orly Harari]
===========================
[This is a very sad outcome, and our condolences go out to the family of the flight attendant, who worked for El Al, the Israeli national airline. It is not clear whether she contracted the virus in New York, in Israel, or on a flight between the two locations. The flight attendant received only one dose of the measles vaccine when she was a child. It wasn't discovered until later that one dose is only about 93% effective. More recently -- in the USA, starting in 1989 -- children have been given 2 doses, which is about 97% effective, according to the CDC. See Measles update (27) http://promedmail.org/post/20190418.6429834 for an earlier report on the flight attendant. - ProMED Mod.LK]
Date: Wed, 14 Aug 2019 17:55:43 +0200 (METDST)

Jerusalem, Aug 14, 2019 (AFP) - An Israeli flight attendant has died months after contracting measles on a flight from New York to Tel Aviv, Israel's health ministry and local media said Wednesday.   Rotem Amitai, 43 and a mother of three, was hospitalised in March following the flight with Israeli airline El Al, Israeli media reported.

She died on Tuesday at a hospital near the coastal city of Tel Aviv, a hospital spokeswoman said.   The health ministry confirmed her death and said her condition had been complicated by encephalitis, inflammation of the brain.   "The immediate cause of death was not defined as measles," it said in a statement. "However, the disability (caused by) the disease was a secondary cause."

The World Health Organization said Tuesday that measles cases had nearly tripled globally during the first seven months of the year compared to the same period in 2018.   The global body warned against "misinformation about vaccines".   The so-called anti-vax movement -- driven by fraudulent claims linking the MMR vaccine against measles, mumps and rubella to a risk of autism in children -- has gained traction.

So far this year, 364,808 measles cases have been reported around the world, compared to 129,239 cases during the first seven months a year earlier -- the highest registered since 2006.   Amitai's death was the first related to measles in Israel this year, following two last year, according to the ministry.   The highly contagious disease can be entirely prevented through a two-dose vaccine.   Amitai had only received one dose, Israeli media reported.

The Democratic Republic of Congo, Madagascar and Ukraine registered the highest number of cases, WHO said.   The United States has registered 1,164 cases so far this year, up from 372 for the whole of 2018 and the highest number on record in a quarter-century.   Nearly 90,000 cases have been registered in Europe this year -- well above the 84,462 cases registered last year.   The airborne infection, which causes fever, coughing and rashes that can be deadly in rare cases -- had been officially eliminated in many countries with advanced healthcare systems.
Date: Fri, 26 Jul 2019 15:53:07 +0200

Jerusalem, July 26, 2019 (AFP) - A forest fire in northern Israel's Galilee region is threatening a church where Christians believe the transfiguration of Jesus took place, the fire service said Friday.    It said in a statement that the blaze broke out on Thursday and monks were evacuated from the  Basilica of the Transfiguration overnight.

Fanned by strong winds the flames still menaced the church on Friday afternoon, fire service spokesman Dudi Peretz told AFP.   "An additional front of the fire is at the moment advancing  toward the church," he said in Hebrew.   "The fire's centre is far from main roads and the topography of the area and difficulty of access are hindering the work of the firefighting teams."    He said that the church itself had so far not been damaged.   Police said that arson was not suspected.   Israel has been gripped by record high temperatures accompanied by drought and strong winds over the past week, with wildfires reported across the country.

The basilica, built in 1924, by the Roman Catholic Franciscan order, sits atop the wooded Mount Tabor at a site where the Christian gospels say that Jesus -- accompanied by disciples Peter, John and James -- glowed with light and spoke with the prophets Moses and Elijah.   Hundreds of thousands of pilgrims visit the church every year, according to the Franciscan Custody of the Holy Land, which oversees Roman Catholic properties in the area.   In a statement Friday it accused Israeli authorities of neglecting essential infrastructure at the site, failing to provide a proper water supply.   The fire, it said,"is a direct consequence of state negligence".
Date: Wed 17 Apr 2019
Source: Jerusalem Post [abridged, edited]

More than 2 million Israelis [population 8.2 million] are either unvaccinated or only partially vaccinated for the measles, according to a Channel 13 report. An outbreak of the measles has been worrying Israelis for months as it spread throughout the country, as well as in the rest of the world. But Israeli media reports on Tuesday night [16 Apr 2019] exposed the severity of the situation and the difficulty in solving the crisis.

The Health Ministry claims that it has only 115,000 doses of measles, mumps and rubella (MMR) vaccine available and 100,000 additional doses of the MMRV vaccine, which combines the diminished measles, mumps, rubella and varicella vaccine with the addition of chickenpox vaccine, according to Channel 13.

State comptroller Yosef Shapira has considered examining the Health Ministry's handling of the recent measles outbreak, according to a report released in January [2019].

The comptroller's office contacted infectious disease and public health experts and is working on compiling data about past efforts regarding the measles outbreak, examining if they were sufficient. However, no formal decision has been made so far over the next steps to take in combating the outbreak.

The ministry released a statement in the past warning the general public about the dangers of measles, including that one out of every 10 patients requires hospitalization after contracting the virus. Nearly 3% of hospitalized patients also have encountered issues with pneumonia. According to data presented at that time, 3 have contracted meningitis, and 2 measles cases resulted in fatalities.

The ministry has been facing intense criticism for its "ineffective" efforts in containing the outbreak. Critics cite the delayed start of vaccination efforts in the Jerusalem area, the city with the largest amount of unvaccinated people. Moreover, those born between 1957 and 1977 only received one dose of the measles vaccine and are only partially protected.

For years, the ministry has also not taken action against doctors who distributed false information about vaccines and has not worked to exhort the public to vaccinate their children. Finally, critics mentioned the lack of government support for Tipat Halav (early childhood clinics), where most infants receive their 1st vaccinations.

The measles surfaced due to the failure of thousands of parents to vaccinate themselves or their children, particularly among the Haredi (ultra-Orthodox) communities in Jerusalem, according to Health Ministry officials. Community leaders and rabbis in recent months have sent mobile units to entire neighbourhoods to vaccinate citizens living in the affected areas.

Several members of Knesset have reacted to the outbreak in the past.

The Health Ministry has since shown their inability to contain the outbreak within Israel's affected communities, and at the moment, there have been 2000 reported cases of Israelis who have contracted measles during the last few months, according to Israel Hayom.

The Health Ministry has not held any informational seminars to encourage these parents to immunize their children, and even though the Health Ministry offers to pay for these services, the parents still decline them just the same, according to Israel Hayom.  [Byline: Zachary Keyser]
More ...

Austria

Austria - US Consular Information Sheet
July 29, 2008
COUNTRY DESCRIPTION:
Austria is a highly developed, stable democracy with a modern economy.
Tourism is an important pillar of the Austrian economy and facilities are widely availab
e.
Read the Department of State Background Notes on Austria for additional information, or see the information at the Austrian National Tourist Office web site, http://www.austria.info.
ENTRY/EXIT REQUIREMENTS:
A valid passport is required. U.S. citizens can stay without a visa for tourist/business for up to 90 days in each six-month period. That 90-day period begins when you enter any of the Schengen countries: Austria, Belgium, the Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Iceland, Italy, Latvia, Lithuania, Luxembourg, the Netherlands, Norway, Poland, Portugal, Slovakia, Slovenia, Spain, and Sweden.
Note:
Although European Union regulations require that non-EU visitors obtain a stamp in their passports 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 passports 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.
There are no vaccination requirements for international travelers.
Visit the Embassy of Austria web site at http://www.austria.org/ for the most current visa information. There are four Austrian Consulates General in the United States. As each one serves clients from a particular region, please contact the appropriate office for assistance. If you reside outside the U.S. please contact the responsible Austrian Embassy or Consulate in your country of residence.
A list of Austrian Embassies/Consulates is available at http://www.bmeia.gv.at/aussenministerium/buergerservice/oesterreichische-vertretungen.html.
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:
Austria remains largely free of terrorist incidents. However, like other countries in the Schengen area, Austria’s open borders with its Western European neighbors allow the possibility of terrorist groups entering/exiting the country with anonymity. Americans are reminded to remain vigilant with regard to their personal security and to exercise caution.

Austrian intelligence experts have registered increased radicalization of immigrant Muslim individuals and of small conspiratorial groups, as well as intensified use of the Internet as a propaganda and communications platform. Despite some terrorism-related incidents in 2007 directed against individual Austrian nationals or the Government of Austria, authorities overall believe the likelihood of terrorist attacks in Austria remains relatively low; the State Department rates Austria as a “Medium” threat for transnational terrorism.

Every year, a number of avalanche deaths occur in Austria's alpine regions. Many occur when skiers/snowboarders stray from the designated ski slopes. Leaving the designated slopes to ski off-piste may pose serious risks and may delay rescue attempts in case of emergency. Skiers/snowboarders should monitor weather and terrain conditions, and use the available avalanche rescue equipment. Avalanche beepers (transceivers) are the most common rescue devices and, when properly used, provide the fastest way of locating an avalanche victim, usually enabling authorities to begin rescue operations within minutes.

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 pamphlet A Safe Trip Abroad.
CRIME:
Austria has one of the lowest crime rates in Europe, and violent crime is rare. However, crimes involving theft of personal property have increased in recent years.
As such, most crimes involving Americans are crimes of opportunity involving theft of personal belongings. Travelers are also targets of pickpockets who operate where tourists tend to gather. Some of the spots where such crimes are most frequently reported include Vienna’s two largest train stations, the plaza around St. Stephan’s Cathedral and the nearby pedestrian shopping areas (in Vienna’s First District).

There has been an increase in thefts and pick-pocketing on public transportation lines, especially on those lines coming into and out from the city center. U.S. citizens are advised to secure personal belongings and always take precautions while on public transportation and in public places such as cafes and tourist areas. Many citizens have had to disrupt travel plans while awaiting replacements for lost and stolen passports since emergency passports are generally only authorized in rare circumstances such as critical medical emergencies.
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.
Information on the Austrian crime victim compensation program can be found on the U.S. Embassy web site at http://vienna.usembassy.gov/en/embassy/cons/compens.htm.
The local equivalent to the 911 emergency line in Austria is 133.See our information on Victims of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION:
There are an adequate number of hospitals available in Austria. Local hospitals will not settle their accounts directly with American insurance companies. The patient is obliged to pay the bill to the local hospital and later claim a refund from his/her insurance carrier in the United States. MEDICARE payments are not available outside the United States.

The Austrian Medicine Import Act generally prohibits the import of prescription drugs into Austria, with two exceptions:
A) Travelers residing outside the European Union are allowed to carry with them (as part of their personal luggage) drugs and medicines, but only the quantity that an individual having a health problem might normally carry; and,
B) Travelers while staying in Austria may receive drugs and medicines for their personal use by mail. The quantity is limited to the length of their stay in Austria and must never exceed three packages.
Generally, it is recommended that travelers have either a prescription or written statement from their personal physician that the medicines are being used under a doctor's direction and are necessary for their physical wellbeing while traveling.
Public health conditions in Austria are excellent. The level of community sanitation in Vienna meets or exceeds that of most large American cities. Disease incidence and type are similar to that seen in the major cities of Western Europe and the United States. At the present time, air pollution is not a major health problem in Vienna.

The U.S. Department of State is unaware of any HIV/AIDS entry restrictions for visitors to or foreign residents of Austria.

Information on vaccinations and other health precautions, such as safe food and water precautions and insect bite protection, may be obtained from the Centers for Disease Control and Prevention’s (CDC) hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747) or via the CDC’s 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.

Any person, regardless of citizenship, who wants to take up residence in Austria, must be covered by some health insurance plan that covers full medical treatment in Austria. American citizens interested in joining the health insurance plan under the Austrian system should apply to the Health Insurance Agency (Gebietskrankenkasse) in the province (Bundesland) where they reside.
Further information may be obtained from the appropriate “Gebietskrankenkasse” http://www.sozialversicherung.at/portal/index.html?ctrl:cmd=render&ctrl:window=esvportal.channel_content.cmsWindow&p_menuid=955&p_tabid=6&p_pubid=687.
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 Austria is provided for general reference only, and may not be totally accurate in a particular location or circumstance.
Road conditions in Austria are generally excellent. During the winter, however, roads in alpine areas may become dangerous due to snowfall, ice, or avalanches. Some mountain roads may be closed for extended periods and tire chains are often required. Drivers should exercise caution during the heavily traveled vacation periods (December-February, Easter, July-August). Extra caution is recommended when driving through autobahn construction zones, particularly on the A-1 East/West Autobahn. Reduced lanes and two-way traffic in these zones have resulted in several deadly accidents in recent years. Traffic information and road conditions are broadcast on the English language channel fm4, located between 91 and 105 FM depending on the locale.

A U.S. driver’s license alone is not sufficient to drive in Austria. The U.S. driver’s license must be accompanied by an international driver’s permit (obtainable in the U.S. from American Automobile Association and the American Automobile Touring Alliance) or by an official translation of the U.S. driver’s license, which can be obtained at one of the Austrian automobile clubs (OEAMTC or ARBOE). This arrangement is only acceptable for the first six months of driving in Austria, after which all drivers must obtain an Austrian license.

Austria requires all vehicles using the autobahn to display an “Autobahn Vignette” highway tax sticker on the inside of the vehicle’s windshield. The sticker may be purchased at border crossings, gas stations in Austria, and small “Tabak” shops located in Austrian towns. Fines for failing to display a valid autobahn vignette on the windshield of your car are usually around $120.

Austrian autobahns have a maximum speed limit of 130 km/hr, although drivers often drive much faster and pass aggressively. The use of hand-held cell phones while driving is prohibited. Turning right on red is also prohibited throughout Austria. The legal limit for blood alcohol content in Austria is .05 percent and penalties for driving under the influence tend to be stricter than in many U.S. states.

Tourists driving rented vehicles should pay close attention to the provisions of their rental contract. Many contracts prohibit drivers from taking rented vehicles into eastern European countries. Drivers attempting to enter countries listed as “prohibited” on the car rental contract may be arrested, fined, and/or charged with attempted auto theft. Austrian police are authorized to hold the rented vehicle for the car rental company.
Emergency roadside help and information may be reached by dialing 123 or 120 for vehicle assistance and towing services (Austrian automobile clubs), 122 for the fire department, 133 for police, and 144 for ambulance.
The European emergency line is 112.
Austrian Federal Railroads (Österreichische Bundesbahnen) offer excellent railroad service to all major towns of the country and also direct connections with all major cities in Europe. Trains are well maintained and fares are reasonable. There is also an extensive network of bus lines operated by the Austrian Postal Service (Österreichische Post). All major cities also offer excellent public transportation services.
Please refer to our Road Safety page for more information. Visit the web-site of Austria’s national tourist office (Österreich Werbung) at http://www.austria.info and the national authority responsible for road safety (Kuratorium für Verkehrssicherheit) at http://www.kfv.at/.

AVIATION SAFETY OVERSIGHT The U.S. Federal Aviation Administration (FAA) has assessed the Government of Austria’s Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for oversight of Austria’s air carrier operations.
For more information, travelers may visit the FAA’s web site at: http://www.faa.gov/safety/programs_initiatives/oversight/iasa.
SPECIAL CIRCUMSTANCES:
Travelers using U.S. issued debit cards in Austrian Automatic Teller Machines (ATMs) may encounter problems. If the request for cash is rejected, travelers should check their accounts immediately to see whether the money was in fact debited from their account. If this is the case, they should notify their banking institution immediately. Prompt action may result in a refund of the debited amount. Receipts should always be requested and kept for verification with your home bank.
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 Austrian laws, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in Austria 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 Austria 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 Austria.
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 Consular Section of the U.S. Embassy is located at Parkring 12a, tel. +43- 1-31339-7535, fax: +43-1-5125835, web site: http://vienna.usembassy.gov/en/index.html
*

*

*
This replaces the Country Specific Information sheet for Austria dated January 23, 2008, without substantive changes.

Travel News Headlines WORLD NEWS

Date: Mon, 18 Nov 2019 16:10:29 +0100 (MET)

Vienna, Nov 18, 2019 (AFP) - A man died on Monday in a landslide that destroyed much of his home in southern Austria, which has been hit by heavy rainfall and snow affecting transport and electricity.   The retiree was behind his house in Carinthia state when part of the hill above it slid off, killing the 79-year-old, police said.   Earlier Monday, two women were rescued from the rubble of two houses after another landslide, this one in the spa town of Bad Gastein in Salzburg state.   Salzburg, Tyrol and Carinthia states have all seen heavy rain and snowfall since last week, leading to power cuts in thousands of homes.   Many roads and railway lines have also been cut, and several schools in these areas remained closed on Monday.
Date: Tue, 27 Aug 2019 13:51:00 +0200 (METDST)

Vienna, Aug 27, 2019 (AFP) - An Austrian court has ruled that a German hiker who was trampled to death by cows was partly to blame for the accident in a case which has sparked national debate.   A lower court ordered the cows' owner in February to pay the woman's family 180,000 euros ($200,000) plus a monthly pension of 1,500 euros.

The verdict was seen as potentially harmful for agriculture and tourism in the Alpine country known for its picturesque mountains and cows grazing freely on their slopes in the summer.   A higher court however ruled that the 45-year-old who was hiking with her dog bore 50 percent of the blame as she needed to be aware of the risks cows, especially those with calves, posed when confronted by dogs, a court official said Tuesday.   She also did not heed warning signs to keep a distance from the herd. The farmer in turn had known his cows with calves to be aggressive and should have fenced off part of his pasture, the official said.   The decision means the compensation will also be cut by half. Both parties can appeal the verdict.

The incident took place in July 2014 in the Pinnistal Valley in Tyrol when a herd of cows suddenly surrounded the hiker and trampled her. She died of her injuries at the scene.   Her husband and son had accused the farmer of negligence, while the farmer insisted he had put up warning signs on the pasture.   The February ruling led to Tyrol's farmers describing it as a threat to their livelihood and threating to close off their lands to hikers.   Following the outcry, the government published a "code of conduct" for hikers.   The guidelines include keeping a distance from cows and walking dogs on a short lead but unleashing them in case of attack.
Date: Tue, 2 Jul 2019 18:26:36 +0200

Vienna, July 2, 2019 (AFP) - Smoking in Austrian bars and restaurants will be banned as of November following a vote in parliament on Tuesday, after years of protracted debate on the issue.   Only MPs from the far-right Freedom Party (FPOe) voted against the ban, which looks set to finally rid Austria of its status as the "ashtray of Europe".

The FPOe -- whose former leader Heinz-Christian Strache is himself a keen smoker -- had stymied a previous attempt to ban smoking in pubs and restaurants when it entered government in December 2017.   That prompted a backlash from large sections of the public and the Austrian medical association, which organised a petition in favour of the ban signed by almost 900,000 people, or around 14 percent of voters.

However, in May the FPOe left government under the shadow of a corruption scandal implicating Strache, paving the way for the smoking ban to come back before parliament.   "We are going to protect the health of hundreds of thousands of Austrians and prolong their lives," Pamela Rendi-Wagner, head of the main opposition Social Democrats (SPOe) -- and herself a doctor -- said after the vote.

Austria is currently led by a technocratic government after the so-called "Ibiza-gate" corruption scandal brought down the coalition between the FPOe and the centre-right People's Party (OeVP) and triggered early elections to be scheduled for September.   The scandal emerged when footage in May showed Strache in a luxury villa on the island of Ibiza appearing to offer public contracts to a fake Russian backer in an elaborate sting operation, forcing him to step down from all his posts.

Austria was one of the last European countries where smoking was still permitted in bars and restaurants, despite calls for bans dating back more than a decade.   Up until now, smoking has been legal in such establishments as long as it was done in a separate area -- although this rule was not always rigidly implemented.   No separate area was necessary in establishments smaller than 50 square metres (540 square feet) if the owner was happy to allow smoking on the premises.   However, a growing number of restaurants and cafes had already banned smoking of their own accord.
Date: Wed, 10 Apr 2019 16:33:41 +0200

Vienna, April 10, 2019 (AFP) - The Austrian city of Klagenfurt indefinitely suspended its bus services Wednesday after a case of measles was detected in one of the drivers.   "All bus traffic is suspended until further notice in order to prevent infection," the city's KMG public transport operator announced.

The company runs all public transport in the southern city of 100,000 inhabitants, which is also the state capital of Carinthia.   It took the unusual measure after it was revealed that one driver had been diagnosed with measles on 3 April.   Since then two further suspected cases have been reported.   KMG said it was working to establish "the vaccination status of all drivers" before authorising bus services to restart and was embarking on a deep clean of its vehicles.

The resurgence of measles, a once-eradicated and highly-contagious disease, is linked to a growing anti-vaccine movement in richer nations -- which the World Health Organization has identified as a major global health threat.   On Tuesday, New York mayor Bill de Blasio declared a public health emergency in parts of the city, ordering all residents of certain districts in Brooklyn to be vaccinated to fight a measles outbreak concentrated in the ultra-Orthodox Jewish community.
Date: Sun, 3 Mar 2019 04:10:56 +0100
By Sophie MAKRIS

Vienna, March 3, 2019 (AFP) - It looks like a scene from the halcyon days of the railways: travellers finding their sleeper berth, turning on the reading light and stowing their cases under the bed.    But it's still a common nightly ritual at Vienna's main station, where overnight train routes have endured in the age of low-cost flights -- and are even expanding.   From early evening onwards, the departures board at Vienna's "Hauptbahnhof" station becomes a roll call of destinations to whet the appetite of any globetrotter: Venice, Rome, Zurich, Berlin, Warsaw...   It's an unusual sight in a continent where budget airlines and faster trains have become the norm and led to the closure of many slower overnight routes.

But Austria's state railway company OeBB is looking to expand its network.   It already runs 26 such routes, either on its own or in partnerships with other operators.   In late 2016, OeBB bought the night train operation of its German counterpart Deutsche Bahn, which was looking to offload a department it judged insufficiently lucrative.   Around 60 percent of DB's overnight routes were preserved, including a revamped Vienna-Berlin service which started a few months ago.   Pointing to the "moderate growth" in passenger numbers -- more than 1.4 million used the services in 2018 -- OeBB has ordered 13 new trains equipped with state-of-the-art sleeper carriages.

- Eco-friendly -
It's no surprise then that Austria has become the poster child for rail enthusiasts, who say it provides an example of how overnight train travel can provide an alternative to air travel and even help in the fight against climate change.    "With regard to the target of becoming carbon-neutral by 2050, night trains which run on renewable energy are an attractive alternative," according to Thomas Sauter-Servaes, transport expert at the Zurich University of Applied Sciences.

But as with all those who have researched the sector, he admits that cross-border overnight rail travel can represent a logistical and financial challenge.   The profits per passenger take a hit from the extra space that sleeper compartments require, on top of the higher labour costs for those who have to work on the trains overnight and money spent on laundry.   And that's before you take into account the hefty fees sometimes charged by other network owners for use of the rails, the technical difficulty of decoupling and then re-attaching carriages, and navigating the myriad of different rules a train has to adhere to over a long journey.

Sauter-Servaes points out that international air transport has a big commercial advantage in being exempt from VAT and fuel taxes.   Among those preparing to board at Vienna station to spend a night on the rails on a recent evening, some told AFP they had chosen a night train with the environment in mind.   "It's a small gesture, and it won't stop me taking the plane for my holiday in Madagascar this autumn, but it's better than nothing," said Austrian traveller Yvonne Kemper.   David, a 42-year-old from Germany, said he was using the Hamburg service because he needed to get to Goettingen in Germany for a business trip -- a medium-sized town which, typically, is served by night trains but has no airport.

- An Austrian tradition -
OeBB spokesman Bernhard Rieder explained that Austria's attachment to night trains is down to "a tradition stemming from Austria's mountainous terrain, which limited the development of high-speed lines".   He added that "the night train sector is distinct in that it can't function without strong cross-border cooperation."   "Night trains are and will continue to be a niche market, but that doesn't mean a niche market can't be profitable."   But Poul Kattler, from the pan-European "Back on Track" group which campaigns for more cross-border night trains, says the sector should be more ambitious.   "If national railway companies were more aggressive in the market and the EU built a truly common rail policy, we could offer a real transport alternative and a very popular European project," he says.
More ...

Czech Republic

Czech Republic US Consular Information Sheet
May 31, 2007
COUNTRY DESCRIPTION:
The Czech Republic is located in the heart of Europe. Tourist facilities in Prague are at the level of those found in most European capitals, while travelers ca
expect lower standards outside of Prague. Travelers are encouraged to be vigilant as pick-pocketing and petty theft occurs often in crowded tourist areas, restaurants and on public transportation. More information can be found in the section on crime. Please read the Department of State Background Notes on the Czech Republic for additional information.

ENTRY REQUIREMENTS: A passport is required and must be valid for 3 months beyond the intended stay. Visas are not required for U.S. citizens for tourist, short study or business visits of up to 90 days. Visas are required for longer stays and for any gainful activity. See our Foreign Entry Requirements brochure for more information on the Czech Republic and other countries.
Visit the Embassy of the Czech Republic’s website at http://www.mzv.cz/washington for the most current visa information.
The Czech Government requires that proof of finances to pay for your stay and for you to have travel/health insurance and is requiring proof of medical insurance for travelers to the Czech Republic. Minimum coverage of the insurance has to be at least $35,000.

According to the Czech Government, a health insurance card or an internationally recognized credit card with health insurance included will generally be accepted as proof of insurance to enter the Republic.

The health insurance requirement does not apply to those who have visas permitting them to work.
See Entry and Exit Requirements for more information pertaining to dual nationality and the prevention of international child abduction.
Please refer to our Customs Information
to learn more about customs regulations.

SAFETY AND SECURITY:
Civil disorder is rare in the Czech Republic, although strikes and demonstrations may occur. U.S. citizens should be vigilant in protecting their security, bearing in mind that even demonstrations meant to be peaceful may turn violent. Americans are advised to avoid street demonstrations.

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 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:
The Czech Republic generally has a low rate of crime. However, street crime-particularly pick-pocketing and occasional mugging-is a problem, especially in major tourist areas in Prague. Travelers are encouraged to be especially vigilant in Prague’s restaurants, train stations, and on public transportation around the city center.
Incidents of pick pocketing were reported in significant numbers during 2006. Incidents of violent crime, while still relatively infrequent, are becoming more common in Prague. Travelers should be aware of the reported use of rohypnol, and other “date rape” drugs in the Czech Republic. Caution should be used when accepting open drinks at bars or clubs. Travelers should be very careful while riding trains, trams or metro, where most crime occurs. Travelers should keep a copy of their passport in a safe place separate from the passport itself; this copy can help you to apply for a new passport if yours is lost or stolen. Visitors should be alert to the potential for substantial overcharging by taxis, particularly in areas frequented by tourists. Radio-dispatched taxis are often much more reliable. It is also advisable to set the price in advance.

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 or 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 for Victim’s of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION:
Prague has good Western-style medical clinics with English-speaking doctors and dentists. However, staff members at the majority of Czech medical facilities do not speak English. Doctors and hospitals often expect cash payment for health services, though some facilities do accept credit cards. Hospitalization in the Czech Republic is much more liberal that in the United States; conditions that would be treated on an outpatient basis in the United States are often treated on an inpatient basis in the Czech Republic.
Ambulance services are not on a par with U.S. standards. Response time can sometimes be slow, and different ambulances are dispatched depending on the perceived severity of the patient’s condition.
Many ambulance companies expect payment at the time of delivery. Serious medical problems requiring hospitalization and/or medical evacuation to the United States can cost thousands of dollars or more.
Please note that because euthanasia is not permitted under Czech law, U.S. living wills providing for no exceptional interventions to prolong life cannot be honored in the Czech Republic.

People traveling from April through October who plan to participate in camping or hiking in long grass or woodlands run the risk of both tick-borne encephalitis and Lyme disease. All travelers should take precautions to prevent tick bites. There is a vaccine for the former, but not for Lyme disease.

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-TRTP (1-877-394-8747) or via the CDC’s Internet site at http://www.cdc.gov/travel.
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 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 Czech Republic is provided for general reference only, and may not be totally accurate in a particular location or circumstance.

Travelers should note that road fatalities are occurring at an increasing rate in the Czech Republic, placing it amongst the most lethal places to drive in Europe. First-class roads in the Czech Republic generally meet European standards. However, on side roads, drivers should be prepared to encounter uneven surfaces, irregular lane markings and sign placements that are not clear. Streets in towns are not always in good condition. U.S. drivers should pay special attention to driving on cobblestone and among streetcars in historic city centers. Traffic lights are placed before the intersection and not after as in the United States. Speed limits are 50 km/h in towns, 90 km/h outside of towns and 130 km/h on highways. An International Driving Permit (IDP), available from AAA (in the United States only), must accompany a U.S. driver’s license; failure to have the IDP with a valid license may result in denial of an insurance claim after an accident.

Persons driving into the Czech Republic should be aware that a road usage tax sticker is required to drive legally on major highways. Signs stating this requirement are posted near the border, but they are easy to miss. The stickers are available at gasoline stations. The fine for failing to display a motorways toll sticker is assessed on the spot.

For specific information concerning Czech requirements for driver’s permits, vehicle inspection, road tax and mandatory insurance, please contact the Czech Tourist Authority offices in New York by telephone at (212)288-0830 or via email at infor@czechcenter.com.

Visit the websites of the Czech Republic’s national tourist office and national authority responsible for road safety at http://www.turistik.cz and http://www.mdcr.cz .

Please refer to our Road Safety page for information.

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

SPECIAL CIRCUMSTANCES:
Czech customs authorities enforce strict regulations concerning temporary importation into or export from the Czech Republic of items such as firearms, antiquities, medications, business equipment, etc. It is advisable to contact the Embassy of the Czech Republic in Washington, D.C, or the Consulates General of the Czech Republic in New York and Los Angeles for specific information regarding customs requirements.

Please see our information on Customs Regulations.

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 Czech Republic laws, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in the Czech Republic are strict and convicted offenders can expect jail sentences and heavy fines.
Engaging in sexual conduct with children or using or disseminating child pornography in a foreign country is a crime, prosecutable in the United States.

Please see our information on Criminal Penalties.

CHILDREN'S ISSUES:
For information on international adoption of children and international parental child abduction, see the Office of Children’s Issues website.

REGISTRATION/EMBASSY AND CONSULATE LOCATIONS:
Americans living in the Czech Republic are encouraged to register with the U.S. Embassy through the State Department’s travel registration website, and to obtain updated information on travel and security within the Czech Republic.
Americans without Internet access may register directly with the U.S. Embassy.
By registering, American citizens make it easier for the Embassy to contact them in case of emergency.
The U.S. Embassy in Prague is located at Trziste 15, 118 01 Prague, Czech Republic; telephone (420)257 530 663; for after-hours emergencies only, telephone (420 257 532 716; Consular Section’s fax (420) 257 534 028; webpage: www.usembassy.cz.
*

*

*
This replaces the Consular Information Sheet dated October 31, 2006, to update information in the Crime section.

Travel News Headlines WORLD NEWS

Date: Fri 24 May 2019
Source: Radio Praha [edited]

The Czech Republic recorded the highest number of tick-borne encephalitis (TBE) cases in the EU last year [2018]. In the whole of Europe, only Russia recorded more cases of the potentially deadly disease.

There were 712 recorded TBE cases in the country last year [2018], the highest number since 2011, a Czech member of the International Scientific Working Group on TBE (ISW-TBE) said in a press release on Thursday [23 May 2019].

Only about one-quarter of inhabitants of the Czech Republic are vaccinated against TBE, a low percentage compared to other EU countries. Within the bloc, the 2nd-highest number of TBE cases was recorded in Germany, which has a population 8 times larger.

Encephalitis patients suffer from fever, headache, aching joints, and muscles. It can develop into meningitis.  [Byline: Brian Kenety]
========================
[Given the large number of tick-borne encephalitis (TBE) virus infection in the Czech Republic last year (2018), it seems curious that the above report makes no mention of preventive measures such as vaccination and avoidance to tick bites that could be taken currently to avoid infection. The TBE virus transmission season is beginning at this time. TBE virus is endemic in the Czech Republic, and cases occur there annually. A 2016 ProMED-mail post indicated that although Central and Eastern Europe countries are endemic for the European subtype of TBE virus and cases occur there yearly, cases have declined significantly in Austria and remain low in Germany, Poland, and Slovakia, while remaining high in recent years in the Czech Republic [see Tick-borne encephalitis - Czech Republic (02): background http://promedmail.org/post/20160210.4009410].

WHO has stated that "Approximately 10 000-12 000 clinical cases of tick-borne encephalitis are reported each year, but this figure is believed to be significantly lower than the actual total. Immunization offers the most effective protection. Currently, there are 4 widely used vaccines of assured quality: FSME-Immun and Encepur, manufactured in Austria and Germany, respectively, and based on European strains of the virus; and TBE-Moscow and EnceVir, manufactured in the Russian Federation and based on Far-Eastern strains. The 4 vaccines are considered to be safe and efficacious" (<https://www.who.int/immunization/diseases/tick_encephalitis/en/>).

TBE is a virus infection caused by one of 3 TBE virus subtypes belonging to the Flaviviridae family: Central European, Siberian, and Far Eastern (formerly known as Russian spring-summer encephalitis). It is transmitted to humans through the bite of infected _Ixodes_ ticks. - ProMED Mod.TY]

[HealthMap/ProMED-mail map:
Date: Sat 27 Apr 2019
Source: Food Safety News [edited]

_Salmonella_ in chicken has been linked to over 70 cases in the Czech Republic. Health authorities in the city of Zlin reported the outbreak in the middle of March 2019 at Tomase Bati Regional Hospital. A total of 68 people, of whom 38 were patients and 30 staff, were found to be connected with the salmonellosis outbreak. In addition, 4 people -- 1 staff member and 3 other patients -- were hospitalized in the town of Uherske Hradiste.

A common vehicle of infection was a chicken and rice dish served for lunch on 14 Mar 2019. An epidemiological survey found that all patients consumed this lunch. The alarm was raised on 15 Mar 2019 by the hospital in a message to health authorities. The next day, _Salmonella_ Enteritidis was detected in faecal samples. Samples of raw materials and swabs from the kitchen and storage areas were taken. Sanitation and disinfection of all kitchen and storage areas were ordered. The chicken used in the meals was also destroyed.

Symptoms of _Salmonella_ infection usually appear 12 to 72 hours after infection and include fever, abdominal pain, diarrhoea, nausea and sometimes vomiting. The illness usually lasts 4 to 7 days, and most people recover without treatment. The laboratory analysis at the Institute of Public Health in Ostrava and in the State Veterinary Institute in Olomouc did not confirm _Salmonella_ in any sample of frozen chicken available during the investigation. Clinical material from patients was sent to the lab of the Veterinary Research Institute in Brno.

In an updated statement concluding the investigation, health authorities in Zlin reported that _ S._ Enteritidis, identical to the strain grown from clinical cases, was confirmed in a chicken and rice sample.

In a statement, officials from the hospital said they had introduced strict measures for food after the _Salmonella_ infection, including strengthening controls on the defrosting and cooking of meat so procedures are monitored consistently. Officials said while the hospital cannot influence the incidence of _Salmonella_ in raw materials supplied to the hospital, they want to focus consistently on the correct procedures for processing. The hospital is also considering buying cameras and putting them in areas where hospital food is being prepared so human error can be detected in time and eliminated in the future.
=======================
[Hospital food remains a particular problematic source for foodborne pathogens given the cohort of individuals who may consume it and their comorbidities. Minimizing salmonellosis spread from fowl requires adequate cooking and appropriate kitchen hygiene. - ProMED Mod.LL]

[HealthMap/ProMED-mail maps:
Zlin District, Czech Republic: <http://healthmap.org/promed/p/62211>]
Date: Tue, 2 Apr 2019 14:58:37 +0200

Prague, April 2, 2019 (AFP) - Czech veterinary authorities said Tuesday they had detected another 510 kilos of chicken breast from Poland tainted with the dangerous salmonella bacteria, following a rift over meat imports.   "The meat has been distributed and... most probably consumed," the State Veterinary Administration (SVS) said in a statement.   Meat from Poland caused a stir in the Czech Republic after local vets slapped mandatory laboratory checks on Polish beef in February following the discovery of a salmonella-tainted batch.

That same month, vets said they had found 1,200 kilos (some 2,600 pounds) of Polish chicken containing salmonella, part of which had already been distributed.   They lifted the measure last week but insisted they would continue random sample checks on imports, especially of beef and poultry from Poland.   SVS spokesman Petr Vorlicek told AFP that vets were not contemplating mandatory lab checks on Polish poultry now.   He noted that salmonella is not uncommon in poultry.   "We are closely monitoring all imports, that's why we have also detected this batch," he added.

The scandal erupted when the TVN24 commercial news channel aired footage of apparently sick or lame cows being butchered at a small slaughterhouse in northeast Poland in secret late at night when veterinary authorities were unlikely to visit.   In January, Poland exported 2.7 tonnes of suspect beef to around a dozen fellow EU members, triggering a probe.   Poland is a leading producer and exporter of meat in Europe, turning out around 600,000 tonnes of beef per year and exporting most of it to the EU, according to meat producer associations.
Date: Thu 20 Dec 2018
Source: Radio Praha [edited]

More than 690 people in the Czech Republic were infected with tickborne encephalitis between January and November this year [2018], which is more or less the same as for the whole of 2017. The figure is also the highest since 2006, according to data published by the National Institute of Public Health on Thursday [20 Dec 2018].

The Czech Republic, along with the Baltic States, has the highest number of tickborne encephalitis cases in Europe. There is no cure for encephalitis, but an increasing number of Czechs get themselves vaccinated against the disease.  [byline: Ruth Frankova]
==========================
[Tickborne encephalitis (TBE) virus is endemic in the Czech Republic, and cases occur there annually. A 2016 ProMED-mail post indicated that although Central and Eastern Europe countries are endemic for the European subtype of TBE virus and cases occur there yearly, cases have declined significantly in Austria and remain low in Germany, Poland, and Slovakia, while remaining high in recent years in the Czech Republic [see Tick-borne encephalitis - Czech Republic (02):  background http://promedmail.org/post/20160210.4009410].

WHO has stated that "Approximately 10 000-12 000 clinical cases of tick-borne encephalitis are reported each year, but this figure is believed to be significantly lower than the actual total. Immunization offers the most effective protection. Currently, there are 4 widely used vaccines of assured quality: FSME-Immun and Encepur, manufactured in Austria and Germany, respectively, and based on European strains of the virus; and TBE-Moscow and EnceVir, manufactured in the Russian Federation and based on Far-Eastern strains. The 4 vaccines are considered to be safe and efficacious"  (<https://www.who.int/immunization/diseases/tick_encephalitis/en/>).

TBE is a virus infection caused by one of 3 TBE virus subtypes belonging to the _Flaviviridae_ family: Central European, Siberian, and Far Eastern (formerly known as Russian spring-summer encephalitis). It is transmitted to humans through the bite of infected ixodes ticks. - ProMED Mod.TY]

[HealthMap/ProMED-mail map: Czech Republic:
Date: Sun 16 Dec 2018
Source: Radio Praha [edited]

While last year [2017], 142 cases of measles were detected in the Czech Republic, 182 cases had been detected as of 4 Dec 2018, according to the State Health Institute. Doctors warn that although it is mandatory to vaccinate children against measles, many are not [vaccinated]. The disease is preventable through 2 doses of a safe and effective vaccine.

The highly contagious, airborne disease experienced an unprecedented resurgence in 2017 in the Americas, Eastern Mediterranean and Europe, according to the World Health Organization. It can cause debilitating or fatal complications, including encephalitis (an infection that leads to swelling of the brain), severe diarrhoea and dehydration, pneumonia, ear infections and permanent vision loss.  [byline: Brian Kenety]
More ...

World Travel News Headlines

Date: Thu, 13 Feb 2020 13:58:41 +0100 (MET)
By Suy SE

Sihanoukville, Cambodia, Feb 13, 2020 (AFP) - A US cruise ship blocked from several Asian ports over concerns that a passenger could have been infected with the new coronavirus docked at a Cambodian pier Thursday, as frustrated holidaymakers expressed hope their ordeal may soon be over.   The Westerdam was supposed to be taking its 1,455 passengers on a dream 14-day cruise around east Asia, beginning in Hong Kong on February 1 and disembarking on Saturday in Yokohama, Japan.   But the ship was turned away from Japan, Guam, the Philippines, Taiwan and Thailand over fears of the novel coronavirus epidemic that has killed more than 1,300 people in China.

Cruise operator Holland America has insisted there are no cases of the SARS-like virus on board and Cambodia announced Wednesday that the boat would be able to dock in Sihanoukville, on its southern coast.   By evening, the ship moved into the beach town's port, moving past the small fishing vessels that usually ply the waters.   As it slowly approached the pier, people onshore snapped selfies of themselves with the massive vessel.   The mood was equally buoyant on the boat.   "Thank you Cambodia! You believed in us when no one would!" tweeted passenger Lydia Miller around 7 pm (1200 GMT). "We promise to spend lots of money in your country."

Fellow cruiser Christina Kerby -- who has been posting light-hearted updates from the Westerdam -- tweeted she was "feeling rebellious tonight so I'm wearing sneakers in the dining room".   But all passengers would have to remain onboard until flights have been arranged, said provincial governor Kuoch Chamroeun.    "The arrangement of the planes to take them from (Sihanoukville) airport to Phnom Penh airport is underway," he said, explaining that three flights were scheduled Friday morning.    Buses were lined up by the pier ready to transfer passengers to Sihanoukville's airport. Holland America has said they would foot the bill to return all guests.

- 'Disease of fear' -
Before the ship docked, doctors conducted health checks for the passengers.    The samples of 20 on board who were sick were sent to the Pasteur Institute in Phnom Penh to test for the virus, said transport minister Sun Chanthol.    Cambodian premier Hun Sen is a staunch Chinese ally and has been vocal in his support of Beijing's handling of the epidemic, even going so far as to visit China last week in a show of solidarity.   "The permission to dock is to stop the disease of fear that is happenin
around the world," he told state-affiliated media website Fresh News on Wednesday.    "We must help them when they asked us for help," he added.   Neighbouring Thailand, which blocked the Westerdam from docking in its eastern seaboard port, on Thursday received two cruise liners in holiday resort town Phuket. 

Both Seabourne Ovation and Quantum of the Seas were allowed to dock, and passengers to alight for roughly 10 hours as part of the scheduled stop.    "They were all checked by their doctors on the ship, and we also examined them when they disembarked," Phuket governor Pakapong Tawipat told AFP.    He added that the passengers and the crew members "were not Chinese", and that Phuket was part of their regular routes, unlike the Westerdam.    Japan's premier Shinzo Abe expressed worries last week over a possible infection on the Westerdam, and said measures will be taken to "reject entries" for foreigners into the country.    Cambodia, which has one confirmed case of the virus, is the recipient of billions of dollars in soft loans, infrastructure, and investment from China.
Date: Thu, 13 Feb 2020 11:14:36 +0100 (MET)

Jakarta, Feb 13, 2020 (AFP) - Indonesia's Mount Merapi, one of the world's most active volcanoes, erupted Thursday as fiery red molten lava streamed down from the crater and it belched clouds of grey ash 2,000 metres (6,500 feet) into the sky.   Authorities did not raise the rumbling volcano's alert status after the early-morning eruption, but they advised commercial planes to take caution in the area.   But any activity at Merapi raises concern and local residents were ordered to stay outside a three-kilometre no-go zone around the rumbling crater near Indonesia's cultural capital Yogyakarta.    Volcanic ash rained down on a 10-square kilometre area, according to the Volcanology and Geological Hazard Mitigation Centre.

Mount Merapi's last major eruption in 2010 killed more than 300 people and forced the evacuation of some 280,000 residents.   It was Merapi's most powerful eruption since 1930, which killed around 1,300 people, while another explosion in 1994 took about 60 lives.   The Southeast Asian archipelago has more than 17,000 islands and islets -- and nearly 130 active volcanoes.   It sits on the Pacific "Ring of Fire", a vast zone of geological instability where the collision of tectonic plates causes frequent quakes and major volcanic activity.
Date: Thu, 13 Feb 2020 08:13:16 +0100 (MET)

Sydney, Feb 13, 2020 (AFP) - Australia on Thursday announced a ban on travellers from China would extend for at least a week beyond Saturday's planned deadline, as the death toll from the coronavirus soared.    Prime Minister Scott Morrison said the government would maintain "entry restriction on foreign nationals who have recently been in mainland China" for further week "to protect Australians from the risk of coronavirus".   A decision to extend the ban further will be taken week-to-week, he said.   The decision is a blow to Australian tourism operators who have seen business from Chinese visitors dry up, as well as for tens of thousands of Chinese students hoping to return to Australia for the new academic year.

China's official death toll and infection numbers from a new coronavirus spiked dramatically on Thursday after authorities changed their counting methods, fuelling concern the epidemic is far worse than being reported.   The virus has now officially killed more than 1,350 people in China and the World Health Organisation has warned the disease has not yet peaked.   "I just want to assure all Australians, that we are doing everything we can to keep Australians safe at this time, and to ensure that we are mitigating everything that is possible to address any of the threats," Morrison said.
Date: Thu, 13 Feb 2020 06:46:12 +0100 (MET)

Sydney, Feb 13, 2020 (AFP) - Dams near Sydney overflowed Thursday after days of torrential rain, as Australia braced for more storms expected to bring dangerous flash flooding to the country's east.   Recent downpours have brought relief to areas ravaged by bushfires and drought -- as well as chaos and destruction to towns and cities along the eastern seaboard.   On Thursday, Nepean Dam south of Sydney was at full capacity and spilling over, with video footage showing excess water cascading over the dam wall and downstream.   Two other dams in New South Wales, Tallowa and Brogo, were also overflowing and more dams could reach capacity in the coming days, a WaterNSW spokesman told AFP.

Sydney's dams have seen water levels spike dramatically -- the Nepean was just a third full less than a week ago -- though many inland areas are facing severe water shortages missed out on the flows.   A devastating months-long bushfire crisis that killed 33 people has effectively been ended by the downpours, with just one blaze yet to be brought under control in New South Wales.   Hundreds of people have been rescued from floodwaters in recent days.   Police said a man's body was discovered in a flooded river on Queensland's Sunshine Coast on Thursday, though the cause of his death was not immediately clear.

Wild weather is set to ramp up again from Friday, with the Bureau of Meteorology forecasting ex-Tropical Cyclone Uesi would bring "damaging to destructive winds" and heavy rainfall to remote tourist destination Lord Howe Island.   Senior meteorologist Grace Legge said storms were also expected for Queensland and New South Wales -- with areas still recovering from bushfires likely to be hit again.   "Any showers and thunderstorms that do develop are falling on already saturated catchments, so there is a risk with severe thunderstorms of flash flooding," she said.   Emergency services have warned residents in affected areas to be cautious in the dangerous conditions.
Date: Thu, 13 Feb 2020 06:24:23 +0100 (MET)

Vinh Phuc, Vietnam, Feb 13, 2020 (AFP) - Vietnam announced Thursday that a commune of 10,000 people will be placed under quarantine due to fears over the spread of the new coronavirus.    "As of February 13, 2020, we will urgently implement the task of isolation and quarantine of the epidemic area in Son Loi commune," said a health ministry statement.    "The timeline... is for 20 days".    There are 15 confirmed cases of the COVID-19 virus in Vietnam, five of them in Son Loi commune.
Date: Wed, 12 Feb 2020 21:09:17 +0100 (MET)

Geneva, Feb 12, 2020 (AFP) - The UN health agency on Wednesday said it was extending its global emergency designation for the Ebola outbreak in the Democratic Republic of Congo but said the sharp decline in cases was "extremely positive".   The recent outbreak was first identified in August 2018 and has since killed more than 2,300 people in eastern DR Congo -- an area where several militia groups are operating.   "As long as there is a single case of Ebola in an area as insecure and unstable as eastern DRC, the potential remains for a much larger epidemic," WHO chief Tedros Adhanom Ghebreyesus told reporters in Geneva.

The WHO, however, said it was downgrading the national and regional risk of the disease from very high to high, while it kept the global risk at low.    Tedros also voiced hope that the emergency could be lifted within the next three months on the advice of the WHO's Emergency Committee of international experts.   The World Health Organization last July declared it a "public health emergency of international concern" -- a designation that gives the WHO greater powers to restrict travel and boost funding.   Tedros, who will be travelling to DRC on Thursday to meet President Felix Tshisekedi, on Tuesday said only three cases had been reported in the past week.

But for the epidemic to be declared over, there have to be no new cases reported for 42 days -- double the incubation period.   The health emergency designation last year came a few days after a patient was diagnosed with the virus in the provincial capital Goma -- the first case in a major urban hub.   More than a month before that, the WHO reported that the virus had spread to Uganda for the first time.   The Ebola virus is passed on by contact with the blood, body fluids, secretions or organs of an infected or recently deceased person.   The death rate is typically high, ranging up to 90 percent in some outbreaks, according to the WHO.

This is the second worst outbreak of the disease since 2014 when it killed about 11,000 people -- mostly in Guinea, Liberia and Sierra Leone.   Efforts to contain the current outbreak have been hindered by attacks on health workers and conflicts in the east.   The WHO said in November it had moved 49 staff out of the Beni region in eastern DRC because of the insecurity.   The Beni region, straddling the North Kivu and Ituri provinces, has been repeatedly attacked by the Allied Democratic Forces (ADF) rebel group, which activists say has massacred more than 300 people since October.
Date: Wed, 12 Feb 2020 11:48:53 +0100 (MET)

Tomohon, Indonesia, Feb 12, 2020 (AFP) - Bats, rats and snakes are still being sold at an Indonesian market known for its wildlife offerings, despite a government request to take them off the menu over fears of a link to the deadly coronavirus.   Vendors at the Tomohon Extreme Meat market on Sulawesi island say business is booming and curious tourists keep arriving to check out exotic fare that enrages animal rights activists.   But scientists are debating how the new virus, which has killed more than 1,100 people in China and spread to dozens of countries around the world, was transmitted to humans.

A wildlife market in Wuhan, the epicentre of the virus, is thought to be ground zero and there is suspicion it could have originated in bats.    The possible link wasn't on many radar screens at the Indonesian market, however.   Its grubby stalls feature a dizzying array of animals including giant snakes, rats impaled on sticks and charred dogs with their hair seared off by blowtorches -- a gory scene described by some critics as "like walking through hell".

Bat seller Stenly Timbuleng says he's still moving his fare for as much as 60,000 rupiah ($4.40) a kilogram to buyers in the area, where bats are a speciality in local cuisine.   "I'm selling between 40 and 60 kilograms every day," the 45-year-old told AFP.   "The virus hasn't affected sales. My customers still keep coming."   Restaurateur Lince Rengkuan -- who serves bats including their heads and wings stewed in coconut milk and spices -- says the secret is preparation.   "If you don't cook the bat well then of course it can be dangerous," she said.   "We cook it thoroughly and so far the number of customers hasn't gone down at all."

This despite a request from the local government and the health agency to take bats and other wildlife out of circulation -- a call that has been all but ignored.   "We're also urging people not to consume meat from animals suspected to be carriers of a fatal disease," said Ruddy Lengkong, head of the area's government trade and industry agency.   Indonesia has not yet reported a confirmed case of the virus.   In the capital Jakarta, vendors selling skinned snakes and cobra blood on a recent Saturday night didn't have any trouble finding takers.   "It's good for you, sir," said one vendor of his slithering fare.   "Cures and prevents all diseases."
Date: Mon, 10 Feb 2020 17:59:57 +0100 (MET)

Malé, Maldives, Feb 10, 2020 (AFP) - The Maldives' speaker of parliament on Monday apologised to a British tourist after footage of her arrest by several policemen triggered a social media storm.   Tourism is a major earner for the Maldives, a tropical island paradise in the Indian Ocean popular with honeymooners and celebrities.   Police said the bikini-clad woman, who was walking on a main road, was "inappropriately" dressed and allegedly unruly and drunk when she was detained after refusing to comply with requests to cover up on Thursday.   The Maldives previously confined tourists to resort islets separate from the local Muslim population, but in recent years has allowed foreigners to stay on inhabited islands.

Tourists can wear swimwear such as bikinis in the resorts but are subject to local dress codes elsewhere.   Videos shared on social media showed three men trying to detain the traveller, while a fourth person tried to cover her with a towel.   The woman was heard shouting "you're sexually assaulting me" during the incident.   The speaker, Mohamed Nasheed, told parliament he was extending an apology to the woman over the incident, which saw her detained by police for two hours before they released her.

The tourist has since left the nation of 340,000 Sunni Muslims, but Nasheed said he hoped tourism authorities would invite her to return to the luxury vacation spot.   Maldives Police Service Commissioner Mohamed Hameed said on Twitter after the footage was shared online that the incident "seems to be badly handled".   "I apologise to the tourist & the public for this. The challenge I have taken up is to professionalise the police service & we are working on that. This matter is being investigated."   A police statement on Friday called on tourists to respect "cultural sensitivities and local regulations".

The video of the incident also sparked anger among Maldivians. Some took to social media to criticise the tourist's behaviour after other videos showed her grabbing the sunglasses of a police officer.   Former foreign minister Dunya Maumoon criticised both the tourist and the police.   "She should have respected the religious and cultural norms of the country in terms of modest attire in a residential area," Maumoon said on Twitter.   "Condemn the man-handling by the Maldivian police. It could have been handled better and more professionally."
Date: Fri 7 Feb 2020
Source: Food Safety News [edited]

Almost 250 new infections have been recorded in a multi-country outbreak of salmonellosis linked to eggs from Poland. The European Centre for Disease Prevention and Control (ECDC) and European Food Safety Authority (EFSA) reported that as of January 2020, 18 countries have reported 656 confirmed and 202 probable cases since February 2017. There are 385 historically confirmed and 413 historical probable cases going as far back as 2012, making it the largest European _Salmonella_ Enteritidis outbreak ever recorded. However, ECDC officials said the true extent of the outbreak was likely underestimated. Since the last update in November 2018, 248 new cases have been reported, of which 124 were confirmed, 36 probable, 42 historical-confirmed and 46 historical-probable infections.

Belgium, Croatia, Czech Republic, Denmark, Finland, France, Greece, Hungary, Ireland, Italy, Luxembourg, Netherlands, Norway, Poland, Romania, Slovenia, Sweden and the UK have recorded 1656 infections since 2012. The UK has the most with 688 confirmed and probable cases, Netherlands has 280, Belgium has 202 and Czech Republic has 111. Information on hospitalization is available for 427 patients in 12 countries, and 136 needed hospital treatment among the confirmed and historical-confirmed cases. Two historical-confirmed deaths, a child and an elderly patient, were also reported.

In each year from 2016 to 2018, outbreak cases peaked in September, with large waves reported between late spring and early autumn. Such a large seasonal increase was not seen in 2019. Epidemiological, microbiological and food tracing investigations have linked cases before 2018 to eggs from laying hen farms of a Polish consortium. Despite control measures in 2016 and 2017, farms of the Polish consortium were positive in 2018 and 2019 with outbreak strains, suggesting persistent contamination, according to officials. Investigations on the laying hen production and feed supply chains did not find the possible origin of contamination.

One of the outbreak strains was found from 2017 to 2019 in primary production in Germany. This outbreak strain represents two-thirds of confirmed cases.

In September 2018, a cluster of 9 confirmed cases was associated with the consumption of an RTE raw liquid egg-white drink distributed by Dr. Zak's. _Salmonella_-positive samples of RTE liquid egg whites from 2 batches matched those from this outbreak cluster. Both batches were produced by a French company. One was produced with raw materials such as pasteurized white egg from a Spanish company. The other used raw materials from 13 German laying hen farms and 11 Dutch laying hen farms. An investigation of this outbreak showed positive batches were produced with eggs from Spain, the Netherlands and Germany, who all supplied _Salmonella_-free eggs to the French company.

On the same day as production of one of the contaminated batches, a different batch of liquid eggs was produced at the French company with eggs supplied by a Polish packing center from a Polish laying farm belonging to the Polish consortium. However, the possibility of cross-contamination was ruled out due to the different production line used with different equipment (tanks, filling machine) and because of heat treatment on packaged products.

Investigations in the UK identified 14 cases potentially part of the outbreak travelling to Cyprus and staying in the same place between end of May and end of June 2018. This site received eggs from a Polish laying farm through the Polish packing center and a Dutch wholesaler.

Measures taken in 2016 and 2017, including depopulation of positive flocks, were not enough to eliminate contamination in the Polish consortium. So, the laying hen farms of this group were still positive for outbreak strains in 2018 and 2019. Between August 2018 and December 2019, 7 of 13 sampled Polish laying hen farms belonging to the Polish consortium tested positive for _Salmonella_ Enteritidis. >From November 2019 to January 2020, all flocks belonging to the Polish group were tested in accordance with Regulation 2160/2003, but _Salmonella_ was not detected.

Polish authorities reported that all _Salmonella_ Enteritidis positive flocks belonging to the Polish consortium were depopulated, including flocks found positive in May 2019. From 2015 to 2019, 16 laying hen farms, 13 of which belonged to the Polish consortium, were positive for at least one of the 4 SNP addresses causing human infections. Four rearing farms belonging to the Polish company were positive for _Salmonella_ Enteritidis between January 2017 and July 2019.

ECDC officials said the outbreak was still ongoing, and more infections were expected. "Since no evidence has been provided that the source of contamination has been eliminated, it is expected that further infections will occur and that new cases will be reported in the coming months. Additional investigations are necessary to identify the source of contamination."  [Byline: Joe Whitworth]
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[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 egg shell was formed. To avoid this, uncooked eggs should be used only as an ingredient, if pasteurized.

The continuing outbreak was summarized in this 2019 report: Pijnacker R, Dallman TJ, Tijsma ASL, et al. An international outbreak of _Salmonella enterica_ serotype Enteritidis linked to eggs from Poland: a microbiological and epidemiological study. Lancet Infect Dis. 2019;19(7):778-786.

Abstract
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Background: _Salmonella_ spp. are a major cause of food-borne outbreaks in Europe. We investigated a large multi-country outbreak of _Salmonella enterica_ serotype Enteritidis in the EU and European Economic Area (EEA).

Methods: A confirmed case was defined as a laboratory-confirmed infection with the outbreak strains of _S._ Enteritidis based on whole-genome sequencing (WGS), occurring between 1 May 2015 and 31 Oct 2018. A probable case was defined as laboratory-confirmed infection with _S._ Enteritidis with the multiple-locus variable-number tandem repeat analysis outbreak profile. Multi-country epidemiological, trace-back, trace-forward, and environmental investigations were done. We did a case-control study including confirmed and probable cases and controls randomly sampled from the population registry (frequency matched by age, sex, and postal code). Odds ratios (ORs) for exposure rates between cases and controls were calculated with unmatched univariable and multivariable logistic regression.

Findings: A total of 18 EU and EEA countries reported 838 confirmed and 371 probable cases; 509 (42%) cases were reported in 2016, after which the number of cases steadily increased. The case-control study results showed that cases more often ate in food establishments than did controls (OR, 3.4 [95% CI, 1.6-7.3]), but no specific food item was identified. Recipe-based food trace-back investigations among cases who ate in food establishments identified eggs from Poland as the vehicle of infection in October 2016. Phylogenetic analysis identified 2 strains of _S._ Enteritidis in human cases that were subsequently identified in _Salmonella_-positive eggs and primary production premises in Poland, confirming the source of the outbreak. After control measures were implemented, the number of cases decreased but increased again in March 2017, and the increase continued into 2018.

Interpretation: This outbreak highlights the public health value of multi-country sharing of epidemiological, trace-back, and microbiological data. The re-emergence of cases suggests that outbreak strains have continued to enter the food chain, although changes in strain population dynamics and fewer cases indicate that control measures had some effect. Routine use of WGS in _Salmonella_ surveillance and outbreak response promises to identify and stop outbreaks in the future. - ProMED Mod.LL]

[HealthMap/ProMED-mail map:
Date: Sun 9 Feb 2020
Source: San Francisco (CA) Chronicle [subscription required, edited]

Several cases of hepatitis A were confirmed in customers who ate in the same California restaurant, health officials said. The Long Beach Department of Health and Human Services announced [Fri 31 Jan 2020], that the patients ate at 555 East American Steakhouse on or around [24 Dec 2019], KABC-TV reports.

The department did not disclose how many cases were diagnosed. The source of the illness is still under investigation, officials said.

Hepatitis A can be transmitted through consumption of contaminated food or water. Symptoms can include fatigue, low appetite, stomach pain, dark urine, nausea, and jaundice. Most patients eventually recover completely, but some may require hospitalization or develop severe illness, health officials said.

The restaurant's management and staff are cooperating with health officials and there is no continuing risk to the public, officials said.

"We are notifying the public of the exposure so that people can immediately seek medical care if they begin to develop symptoms," Long Beach health officer Dr. Anissa Davis said in a statement. "Individuals who have been vaccinated for hepatitis A or have had the disease are protected," Davis said. "Those who are not immune to hepatitis A should consult their medical provider if they develop symptoms, and let their provider know they may have been exposed to hepatitis A."
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[This cluster (the number of cases is not stated) may be related to an HAV-contaminated food (such as shellfish) or an infected food service worker. If the former were the case, one might expect to see cases related to other restaurants. It would be interesting to know if the HAV strain is that from the still on-going multistate outbreak. This outbreak has been controlled in California and involved primarily homeless and substance abusing individuals and is related to poor sanitation rather than food/water vehicles. - ProMED Mod.LL]

[HealthMap/ProMED map available at:
California, United States: <http://healthmap.org/promed/p/204>]