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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, 23 Mar 2020 00:45:56 +0100 (MET)

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

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

Emirates had said it will continue to fly to the United Kingdom, Switzerland, Hong Kong, Thailand, Malaysia, the Philippines, Japan, Singapore, South Korea, Australia, South Africa, the United States and Canada.   "We continue to watch the situation closely, and as soon as things allow, we will reinstate our services," said the airline's chairman and CEO, Sheikh Ahmed bin Saeed Al-Maktoum.   Gulf countries have imposed various restrictions to combat the spread of the novel coronavirus pandemic, particularly in the air transport sector.   The UAE has stopped granting visas on arrival and forbidden foreigners who are legal residents but are outside the country from returning.
Date: Mon, 6 Jan 2020 17:38:26 +0100 (MET)

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

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

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

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

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

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

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

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

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

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

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

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

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

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

[Maps of United Arab Emirates:
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."
More ...

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 ...

Sao Toma and Principe

Sao Tome and Principe US Consular Information Sheet
August 15, 2008
COUNTRY DESCRIPTION:
São Tomé and Príncipe is a developing nation, comprising the islands of São Tomé and Príncipe, located off the western coast of central Africa.<
R />Facilities for tourism are limited, but adequate.
Read the Department of State Background São Tomé and Príncipe for additional information.

ENTRY/EXIT REQUIREMENTS:
A passport, visa, and evidence of yellow fever vaccination are required for entry.
Visas must be obtained in advance.
Travelers can obtain visas and the latest information on entry requirements from the Permanent Mission of São Tomé and Príncipe to the UN, 400 Park Ave., 7th Floor, New York, NY
10022, telephone (212) 317-0533, fax (212) 317-0580.
Travelers transiting through Gabon can also obtain visas and the latest information on entry requirements from the São Tomé and Príncipe Embassy to Gabon, B.P. 49, Libreville, Gabon, telephone (241) 72-15-27, fax (241) 72-15-28.
Overseas, inquiries should be made at the nearest São Toméan and Príncipian embassy or consulate.

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 should maintain security awareness at all times.
There have been recent, isolated incidents of civil unrest in the capital city.
Large gatherings or any other events where crowds have congregated to demonstrate or protest should be avoided.

Americans may contact the U.S. Embassy in Gabon for the most up-to-date information on safety and security.
The Embassy informs the registered resident U.S citizen community of security matters through a warden system (please see the Registration/Embassy Location section below for more information).

In the event of a fire, dial 112 on the telephone.
For the latest security information, Americans traveling abroad should regularly monitor the Department of State, Bureau of Consular Affairs’ web site at http://travel.state.gov, where the current Travel Warnings and Travel Alerts, as well as the Worldwide Caution, can be found.

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

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

CRIME:
Crimes such as burglary, pick-pocketing and armed robberies in homes do occur on the islands, particularly around the winter holidays.
Such crimes can occur anywhere, but are more prevalent in public places, such as in markets, on the streets, or near hotels.
Do not display large amounts of cash in public.
If possible, leave valuables and extra cash at your hotel while sightseeing or visiting the beach.
When dining in restaurants or visiting markets, it is recommended that one carry only minimal amounts of cash and avoid wearing excessive amounts of jewelry.
If involved in an attempted robbery or carjacking, Americans are encouraged to comply with the attacker to avoid injury and to report all incidents to the police and the U.S. Embassy in Libreville.
Police response time to reports of crime can be slow.

While scams and confidence schemes are not common, travelers should exercise caution.
The prevalence of sexual assault is low, and no specific groups seem to be targets for victimization.

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

The local equivalent to the “911” emergency line in São Tomé and Príncipe to reach the police is 22-22-22.
See our information on Victims of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION:
Medical facilities in São Tomé and Príncipe are extremely limited.
There is one hospital in the country, on the island of São Tomé, and several foreign-run clinics.
However, the level of care is low.
For all but minor medical needs, it is necessary to travel to Libreville (Gabon), Lisbon (Portugal), or elsewhere.
Additionally, some medicines are not available; travelers should carry properly labeled required medicines and medications with them.

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

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

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

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

Streets in the city of São Tomé are paved, but large potholes are common.
Major roads outside of town are also paved.
Pedestrians, bicyclists, motorcyclists, and animals on the roads can be a major hazard.
Outside of the city of São Tomé, there are no sidewalks or shoulders along the side of roads.
In rural areas outside of the capital city, drivers are expected to honk the car’s horn periodically as a warning signal of their approach.
There is no street lighting outside of the capital.
Some roads may be impassable without a four-wheel-drive vehicle.

Only a few miles of improved roads exist on the island of Príncipe; the conditions are similar to those found on São Tomé.
Although taking taxis is fairly safe, it is advisable to rent a car instead.
If you must take a taxi, exercise caution, and negotiate the rate before entering the taxi.

Please refer to our Road Safety page for more information.

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

SPECIAL CIRCUMSTANCES:
São Tomé and Príncipe is a lusophone country; travelers who do not speak Portuguese may face difficulties associated with the language barrier.

Americans should always carry identification with them in the event they are stopped by police.

Taking photographs of military or government buildings is strictly forbidden.
São Tomé and Príncipe is largely a cash economy.
Credit cards are accepted at only a few major hotels.
Travelers’ checks can be cashed or dollars exchanged for dobra at hotels and at one private bank in São Tomé city, but transaction fees can be high.
U.S. dollars are widely accepted at tourist establishments.

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 São Toméan and Príncipian laws, even unknowingly, may be expelled, arrested, or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in São Tomé and Príncipe 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:
Although there is no U.S. Embassy in São Tomé and Príncipe, the U.S. Embassy in Libreville, Gabon is also accredited to São Tomé and Príncipe and can provide assistance to Americans there.
All Americans in São Tomé and Príncipe are encouraged to register with the U.S. Embassy in Gabon through the State Department’s travel registration web site so that they can obtain updated information on travel and security within São Tomé and Príncipe.
Americans without Internet access may register directly with the nearest U.S. Embassy or Consulate.
By registering, Americans make it easier for the Embassy or Consulate to contact them in case of emergency.

The U.S. Embassy is located in downtown Libreville on the Boulevard du Bord de Mer.
The mailing address is Centre Ville, B.P. 4000, Libreville, Gabon.
The telephone numbers are (241) 76-20-03 or (241) 76-20-04.
The fax numbers are (241) 74-55-07 or (241) 76-88-49 and the web site is http://libreville.usembassy.gov/.
*

*

*
This replaces the Country Specific Information dated November 8, 2007 to update sections on Entry/Exit Requirements, Safety and Security, Crime, Information for Victims of Crime, Medical Facilities and Health Information, Traffic Safety and Road Conditions, Special Circumstances, and Registration/Embassy Location.

Travel News Headlines WORLD NEWS

Date: Tue, 12 Dec 2017 02:47:28 +0100
By Caroline CHAUVET

Sao Tome, Sao Tome and Principe, Dec 12, 2017 (AFP) - A big roadside poster announces a "Pest Control Campaign" in Sao Tome and Principe, with a man in a white face mask wielding an insecticide spray fuelled by a tank on his back.   The island nation in the Gulf of Guinea is at war against malaria, as it has been twice a year since 2003, with such success that the disease no longer routinely claims lives.   In mainland central Africa, the incidence of malaria spread by infected female mosquitos is among the highest rates in the world.

Malaria killed some 445,000 people around the planet in 2016, according to the World Health Organisation (WHO), out of 216 million estimated cases that year.   "Our last death was in 2016. It was a Portuguese man who failed to take measures for prevention and treatment," said Hamilton Nascimento, coordinator of the National Programme to Fight Paludism (PNLP) in Sao Tome.   In 2005, malaria claimed more than 5,000 lives out of about 50,000 infected people in Sao Tome and Principe, according to the WHO.   The humid tropical climate of the islands provides an ideal breeding ground for the female mosquitos that carry the parasitic infection from one person to another with their bloodsucking bites.

- National priority -
Yet since 2014, the number of deaths has fallen to none on Sao Tome, apart from the Portuguese victim. On Principe, lying to the north, malaria has been eradicated, in official terms.   The government wants to wipe it out everywhere by 2025, but the WHO has warned that a sizeable part of future funding is at risk.   The battle against a once endemic disease began as a national priority in the 1980s, in the wake of independence from Portugal in 1975, Nascimento told AFP.

The islands of Sao Tome and Principe, which have a combined land surface of 1,000 square kilometres (386 square miles), benefit from their offshore location west of Gabon and from a small population of less than 200,000 inhabitants.   "We have three strategies: spraying inside houses, distributing mosquito nets impregnated (with insecticide) and the fight against larvae using a biological insecticide that we spread in stagnant waters," Nascimento said.   The population of Sao Tome also has access to free medication to treat malaria and to testing campaigns nationwide. If a case of malaria is detected, "the hospital follows up the patient for 28 days," he added.   "Sick people are given free care by the health centres and medicine is
accessible everywhere in the country."

For all the successes in tackling a disease that has no available vaccine and is prone to mutate, residents of the islands have begun to grow weary of the repeated campaigns.   "The number of people who open their doors to the mosquito sprayers has gone down," Health Minister Maria Jesus Trovoada said, concerned that this refusal to take part "puts all the efforts of the government in peril".   Authorities in Sao Tome and Principe have been clear about their desire to reduce dependence on foreign aid, which accounts for about 90 percent of the nation's resources, and the battle with malaria is part of that goal.   At the end of the 1980s and again in 2012-2013, the disease ravaged the country because of a shortfall in funding and spreading resistance to insecticides, Hamilton said.   "We must often -- about every 10 years -- change the insecticide, because the mosquitos develop resistance," he explained.

- Funding cuts? -
While the government recently stepped up its contribution, the Global Fund to Fight AIDS, Tuberculosis and Malaria, a foundation partnered with the WHO, finances most measures to beat the disease on the islands.   The grant from the Global Fund may be slashed by more than 50 percent, the WHO warned in a recent report. Sao Tome and Principe would then "need more or less $5 million (4.2 million euros) between 2018 and 2021 to go on getting good results".   "The impact of lack of funding is unknown. However, if current efforts to control malaria have to be reduced due to lack of funds a high risk of a relapse exists," Rebekka Ott, the Global Fund representative on Sao Tome, told AFP.

The foundation is also concerned about Sao Tome's cutting of diplomatic ties with Taiwan at the end of 2016 in order to develop relations with China. Taiwan previously paid more than 30 percent of the cost of fighting malaria.   China, whose flag has already been mounted at the National Centre for Endemics, is expected to take up the baton, but by providing "technical assistance" rather than financial aid.   Whatever the obstacles, the WHO announced in April 2016 that 21 countries in the world may eliminate malaria by 2020. Six of those nations are in Africa: Algeria, Botswana, Cape Verde, Comoros, Swaziland and South Africa.
Date: Wed 8 Feb 2017
From: Raquel Tavares <raquelmrtavares@gmail.com> [edited]
[Re: ProMED-mail posts Buruli ulcer - Sao Tome and Principe
http://promedmail.org/post/20170208.4824961 and http://promedmail.org/post/20170210.4830051]
----------------------------------------------------------------------
In March 2016 we started following a patient from Sao Tome with severe leg ulcer, complicated with bacterial infection and extension to bone. In December 2016, an _Aspergillus fumigatus_ DNA was found in a bone biopsy. The patient has improved since, with anti-fungal therapy (first with itraconazole and in the last 2 months changed to voriconazole). I think this is a possible aetiology. It was a very difficult diagnosis, because normal fungal cultures were negative. We also did DNA and culture for _Mycobacterium ulcerans_ and it was negative.
------------------
Raquel Tavares,
MD Infectious Diseases Specialist
Hospital Beatriz Angelo
Loures Portugal
raquelmrtavares@gmail.com
Date: Fri 3 Feb 2017 13:46 CET
Source: L'Express, Agence France-Presse (AFP) [in French, machine trans., edited]
<http://goo.gl/DUrF3d>

A disease of unknown origin, manifested by a violent cutaneous ulcer, torments the inhabitants of Sao Tome. 1094 cases have been registered since October [2016] among a population of less than 200,000 inhabitants, the health authorities of the small African archipelago announced this [Fri 3 Feb 2017]. The authorities have requested support from the World Health Organization (WHO), which has sent a Benin specialist in Buruli ulcer.
=======================
Dr Irene Lai International SOS
irene.lai@internationalsos.com
=======================
[ProMED-mail thanks Irene Lai for submitting the news report above. Sao Tome, with a population of 56,945 residents, is the capital city of the island nation of Sao Tome and Pri­ncipe, in the Gulf of Guinea, off the western equatorial coast of Central Africa. (<https://en.wikipedia.org/wiki/Sao_Tome>). Buruli ulcer (also known as the Bairnsdale ulcer in Australia) is a chronic skin and soft tissue infection due to _Mycobacterium ulcerans_ with large ulcers usually on the legs or arms that can lead to adjacent bone infection and permanent disfigurement and disability.

Buruli ulcer is named after a county in Uganda. _M. ulcerans_ needs a temperature between 29-33 deg C (84.2-91.4) to grow in vitro (<http://jcm.asm.org/content/36/11/3420.full>). The organism produces a unique toxin -- mycolactone, which causes tissue damage and inhibits the immune response. Local immunosuppressive properties of the mycolactone toxin enable the disease to progress with no pain and fever.

The diagnosis can be confirmed by polymerase chain reaction (PCR), direct microscopy, histopathology, and culture. Buruli ulcer has been reported in over 30 countries usually with tropical climates in Africa, South America, Asia, and Western Pacific regions, as well as Australia. Countries in West and Central Africa -- Benin, Cameroon, Cote d'Ivoire, Democratic Republic of the Congo and Ghana -- report the majority of cases. In Africa, most cases occur in children under 15 years, whereas in Australia, only 10 per cent are children under 15 years; and in Japan, 19 per cent are children under 15 years.

_M. ulcerans_ has been identified in fresh and brackish water and soil in swampy areas. Abrasions of the skin after contact with contaminated water, soil, or vegetation are likely routes of entry. _M. ulcerans_ is not believed to be transmitted from person to person; but the exact mode of transmission is unknown and may vary by geographic region. Vectors, in particular aquatic insects and mosquitoes, may also play a role in some locations.

In south-eastern coastal Australia, possums, which have laboratory-confirmed _M. ulcerans_ skin lesions and/or _M. ulcerans_ PCR-positive faeces, may be a reservoir (ProMED-mail post Buruli ulcer - Australia: (VI) M. ulcerans, possum faeces http://promedmail.org/post/20140913.2771412).

Buruli ulcer has been reported to develop in travellers at the site of a trauma after having left a disease-endemic area. 80 per cent of cases detected early can be cured with a combination of antibiotics; however, late diagnosis can result in long and costly hospitalizations with significant morbidity and disability.

Medical treatment is rifampin, combined with either streptomycin, clarithromycin, or moxifloxacin for 8 weeks, in addition to surgical wound management.

Pictures of Buruli ulcers can be seen at (<https://www.youtube.com/watch?v=XCQ67NGmytI>). - ProMED Mod.ML]

[A HealthMap/ProMED-mail map can be accessed at: <http://healthmap.org/promed/p/63>.]
Date: Thu, 5 Jan 2006 From: ProMED-mail Source: Adventist Development and Relief Agency (ADRA) [edited] In response to a cholera outbreak that struck Sao Tome and Principe in Oct 2005, the Adventist Development and Relief Agency (ADRA) is helping to control the outbreak by distributing disinfectants among the community, as well as promoting improved health and sanitation practices through campaigns that teach villagers how to prevent the transmission of this contagious disease. ADRA has organized an awareness campaign among 50 rural community groups targeting 1000 women, focusing primarily on the districts of MeZochi and Caue. With this training, the women become health promoters in their communities, teaching other people the same health and hygiene practices they have been taught. Each woman will receive training on how cholera is transmitted, how it can be treated, and how to prevent it. They will also receive bottles of lye, which they will use to safely disinfect water, food, and any other potential contaminant. In addition, ADRA will distribute 10 health education leaflets to each woman; one for her personal use, and 9 additional leaflets to share among her community. ADRA will also perform a theatre play that will be performed in 24 communities to educate the community on the cholera outbreak. As of 1 Jan 2006, nearly 30 people have succumbed to the disease, since the outbreak began 3 months ago, out of an estimated 1849 severe cases that have been reported since its inception.
Date: Tue, 20 Dec 2005 From: ProMED-mail Source: XinHuaNet.com [edited] The 2-month-old cholera epidemic sweeping Sao Tome and Principe shows no sign of letup, having claimed 5 more lives and doubling the number of reported cases. According to reports reaching here on Mon, 19 Dec 2005, the spokesman for the national committee overseeing the anti-cholera campaign, Jose Manuel de Carvalho, said that 5 more people had died from the disease in the preceding 2 weeks for a total of 25 fatalities. In the same period, de Carvalho added, the number of cases more than doubled to 1374 from 650. The outer island of Principe has so far been spared. He repeated government appeals for increased attention to personal and public hygiene to help staunch the highly infectious disease. Last week, a riot erupted in the archipelago's capital when a police officer tried to enforce a ban on the sale of street food at a Sao Tome market.
More ...

Zimbabwe

General
**********************************************
This southern African country is a popular destination for travellers from Ireland. Victoria Falls must be one of the main tourist attractions but many other visitors will explore the rich s
fari parks and many other attractions, which Zimbabwe has to offer. Unfortunately the stability throughout the country has decreased considerably during the past two years and it will be essential that travellers stay within well defined itineraries agreed with recognised tour operators.
Safety & Security
**********************************************
The level of petty crime is increasing throughout the country as stability decreases. Muggings and pickpocketing occur too often in the main urban areas and especially in the capital - Harare. Care should be taken when getting money from ATM’s or when leaving the banks. Try to have a companion with you and avoid busy market places and crowded local transport. Use hotel safe boxes and don’t leave personal belongings on view where possible. Avoid flaunting personal wealth, only use authorised taxis and take care if visiting late-night bars etc. Credit care fraud is becoming more common so ensure that your card never leaves your sight.
Travel in Zimbabwe
**********************************************
Hiring cars or motorbikes is unwise as the number of serious accidents involving tourists is considerable. Many hazards occur along the roads including unlit abandoned trucks, stray livestock and pedestrians and poor fuel supplies. Many roads are in a poor state of repair and those requiring assistance may have to wait many hours in a deserted location. Car jacking and theft from cars is increasing. If driving long distances you should ensure that you have sufficient fuel and adequate supplies of food and water in case of emergency. A torch and sensible medical kit are also prerequisites.
Health Facilities
**********************************************
Outside of the main urban centres of Harare and Bulawayo the level of healthcare for tourists may be very limited. Even in the cities shortages of some main medications may lead to inadequate treatment and evacuation to South Africa may become necessary. Any tourist on personal medication (asthma, diabetes, contraceptive pill etc) should make certain that they have sufficient supplies with them to complete their journey through Zimbabwe.
Rabies
**********************************************
The risk of rabies occurs throughout the country for those exposed to infected warm-blooded animals. This will be mainly following a bite from an infected dog but cats and monkeys and many other animals also carry the disease. Returning to Harare and possibly to South Africa will be essential to ensure adequate early treatment.
Playing Golf in Zimbabwe
**********************************************
Many tourists visiting Zimbabwe will play golf on some of their many courses. Golf tends to be played during the hours soon after dawn and towards dusk when mosquitoes may abound. They should be aware that there is an increased risk of malaria from mosquito bites (in infected regions) but also of wandering into the rough to retrieve a ball and being bitten by snakes or ticks or stung by scorpions. Avoiding the rough is a wise precaution!

White Water Rafting & Bungee Jumping
**********************************************
Many tourists to the Zambezi region partake of adventure sports including white water rafting and bungee jumping. Check whether of not your travel insurance covers these activities and be aware that both activities can carry significant risks. The bungee jump at Victoria Falls is recognised as one of the highest in the world at 111 metres. Generally the safety and security is good but accidents do occur. The risks of serious injury from white water rafting are also present both from direct trauma (eg bruising, drowning, fractures etc) and also from exposure to Schistosomiasis in the calm fresh water regions along the Zambezi. This parasitic disease is more common in those who swim in Lake Malawi but does occur in Zimbabwe. Serious long-term effects are regularly reported in those returning after fresh water contact in Africa.
Food & Water Facilities
**********************************************
Despite the diminishing security situation throughout the country and the food shortages which have been reported among the local population, the main tourist hotels are still receiving sufficient supplies. This situation may change and travellers should be aware that the level of service may be affected. Lettuce and cold foods may not be adequately treated and should be avoided. Unpeeled fruits should be fine but tap water should not be used for brushing your teeth unless you can easily smell chlorine.
Insect & Mosquito Bites
**********************************************
The Zambezi valley region (including Victoria Falls) is probably the single highest risk region for tourists developing malaria throughout the world. It is essential that adequate malaria prophylaxis is used at all times of the year for those visiting this region. Those remaining in the central highlands (cities of Harare and Bulawayo) will not need prophylaxis as the risk of this mosquito borne disease is very small. Tsetse flies transmit sleeping sickness and this may be a risk for those visiting some of the safari parks. Good repellent and adequate light coloured clothing is essential.
Sun Exposure & Dehydration
**********************************************
It is important to increase your intake of fluids and salt while perspiring significantly in a hot climate. Wearing a wide-brimmed hat is also important.
Vaccines for Zimbabwe
**********************************************
There are no essential vaccines for entry into Zimbabwe from Ireland. However those crossing into Zambia at Victoria Falls (and having their passport stamped) may find that the authorities demand evidence of cover against Yellow Fever before re-entry. Otherwise most tourists are advised to consider adequate cover against:
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Poliomyelitis (childhood booster)
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Tetanus (childhood booster)
*
Typhoid (food and water disease)
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Hepatitis A (food and water disease)
Those planning a longer or more rural trip will also need to consider cover against diseases like Hepatitis B and Rabies.
Summary
**********************************************
The majority of tourists visiting Zimbabwe will remain very healthy and well providing they remain conscious of the prevailing local uncertainty and follow some simple precautions against food and water disease, mosquito bites, and accidents.

Travel News Headlines WORLD NEWS

Date: Mon, 30 Mar 2020 11:21:42 +0200 (METDST)

Harare, March 30, 2020 (AFP) - Zimbabwean authorities on Monday began enforcing a three-week lockdown in its fight against the spread of coronavirus after the disease left one person dead and infected six others.   President Emmerson Mnangagwa declared a 21-day "total" lockdown from Monday curtailing movement within the country, shutting most shops and suspending flights in and out of Zimbabwe.    Police mounted checkpoints on routes leading to Harare's central business district, stopping cars and turning away pedestrians who had no authorisation to be in the area.

Elsewhere truckloads of metropolitan and national police armed with batons were on patrol, ordering people back to their homes.   "We don't want to see people here on the streets. We don't want to see people who have no business in town just loitering," a policewoman said through a loud hailer. "Everyone to their homes."   Her colleagues, in riot gear, dispersed people standing in small groups at the Copacabana minibus terminus, which is usually abuzz with people including foreign currency dealers.    In the township of Mbare, the usually bustling  terminus for long-distance buses was deserted with only municipal street cleaners sweeping the empty bus ranks.   A traditionally busy downtown area of Harare referred to as "The Third World" resembled a ghost town with few people on the streets. Most shops had their shutters down.

For many of the country's 16 million people, who are already suffering a grim economic recession, the lockdown means even tougher hardship.   With unemployment rate estimated at around 90 percent, most Zimbabweans have informal jobs to eke out a living and few have substantial savings.   Some were trying to leave the city for rural villages.   "We would rather spend the 21 days at our rural home, where we don't have to buy everything. I can't afford to feed my family here when I am not working," said Most Jawure.   "We have been waiting here for more than two hours but there are no buses," Jawure told AFP while standing with his wife and daughter beside a bulging suitcase.
Date: Fri, 20 Mar 2020 20:48:53 +0100 (MET)

Harare, March 20, 2020 (AFP) - Zimbabwe on Friday reported its first coronavirus case, a man who returned to his home in the tourist resort town of Victoria Falls from Britain at the weekend.   "The is the first case of Covid-19 in Zimbabwe," said Health Minister Obadiah Moyo on state television ZTV.    "The patient is a 38-year-old Caucasian man... who had travelled to Manchester in the UK on the 7th of March and returned to his home in Victoria Falls on the 15th of March via South Africa," he said.

The Zimbabwean government on Tuesday announced a raft of steps to prevent the virus from spreading - including the cancellation of public and sporting events, and constraints on gatherings. Schools will close on Tuesday.   The country's public health system, meanwhile, has been suffering for years from a lack of equipment and drugs.   It came under further strain last year when hundreds of junior doctors at state hospitals staged a three-month strike over conditions and pay - which then was less than $200 a month.
Date: Wed 18 Mar 2020
Source: All Africa [edited]

Mahusekwa villagers who are into cattle farming told 263Chat how they have been losing cattle on a daily basis due to anthrax adding that they are no longer consuming beef due to the outbreak. "You eat beef in Harare because you don't know the real situation here. Cattle are dying daily when the situation was bad, you could wake up only to find 5 or 6 cattle lying down in the kraal. Butchery owners would then come, and sometimes dig it up, skin it and carry the meat to Harare, that is the meat you are eating in butcheries," said one of the farmers who referred to himself as Chihota.

TM, another cattle farmer who is only left with one cattle out of 27 said that he is frustrated, even worse that there is no one who is helping them and giving them information on steps to take when finding your cattle dying. "It was so devastated to watch my cattle dying, I had invested everything. If I notice a sick cattle, I now call the butchery owners who come to buy, they do not pay much but at least I get to recover something to feed my family," said TM.

He added that some of the butchery owners used to come and ask them to show where they had buried their cattle, then dig it up and skin the meat for sale in Harare. "We had a buyer with a yellow bus, and another one with a blue truck who only wanted dead cattle because they said it was cheap and profitable, but these days they buy those ones in the early stage of sickness," added TM.

Anthrax is a life-threatening infectious disease caused by bacteria that normally affects animals, especially ruminants such as cattle, but being a bacteria, it is easily treatable with antibiotics if detected in time. Zimbabwe usually experiences anthrax outbreaks during the rainfall season because rains wash away the topsoil and expose spores that can remain dormant in the soil for over 40 years. Livestock, particularly cattle, take up anthrax bacteria while grazing on contaminated land. People get infected when they handle or eat anthrax-infected meat.

During this season, anthrax outbreaks have been recorded in Gokwe, Nkayi, Gutu, Bikita, Marondera, Mazowe, Chegutu, Makonde and Sanyati. In Makonde, there was an unconfirmed report of one person having died while 64 were hospitalized after eating beef from infected cattle.

Acting director for the Division of Veterinary Field Services Dr. Wilmot Chikurunhe said anthrax was being detected in traditional outbreak areas and not affecting the whole districts. "Cattle owners in anthrax areas should ensure their cattle are vaccinated against the disease once a year before the rain season. The department comes in to prevent massive outbreaks, but the primary responsibility for disease prevention lies with the owner," said Chikurunhe.

He urged cattle farmers to dispose of carcasses of cattle in a manner that does not leave the bacteria exposed to air. The best method is to burn the carcasses in a pit, then bury the ashes.  [Byline: Shorai Murwira]
=====================
[There has been some criticism in Zimbabwe when pictures of dead cows being loaded into trucks were being circulated. But the good news is that this authoritative report by a journalist has been published, and we might expect some action resulting. But obviously this is not a new phenomenon and street markets have been profiting with significant public risk and cost.

The government veterinary service can publicise this risk along with the public health services, but I suspect that the most cost-effective way of getting farmers to report unexpected deaths would be to reward them for confirmed anthrax cases by paying them a sum minimally equivalent to what they are getting from these itinerant butchers. This will certainly not be equivalent to an auction value of a live animal but a mere fraction, two2 digits, not 3. Back in the day in the mid-1960s the Canadian Dept of Agriculture turned anthrax from being a suspect but invisible disease into real numbers by paying C$500 per case. It has been probably the major cause why this disease has been controlled in Canada. Match plus what the itinerant butchers are paying, and then get the cattle at risk vaccinated pdq. Deeds are more effective than words. - ProMed Mod.MHJ]

[HealthMap/ProMED map available at:
Date: Sun 23 Feb 2020
Source: ZBC News [edited]

Mbire, Mashonaland Central Province has been affected by an outbreak of anthrax prompting the Veterinary Services Department to place an embargo on the movement of cattle from the province.

The acting provincial coordinator, Richard Chipfuwa, said 34 beasts had so far succumbed to the disease in the remote district, which sits on the border with Mozambique and Zambia. "These (the 34) are the reported cases, but we suspect there could be many more that were not reported. We have since mobilized vaccines to the district's 5 dip tanks: Nyatsengwa, Masomo, Tengu, Bonga and Sapa, so that farmers can have the remaining herd saved," he said.

But a poor road network in the district is making it difficult for veterinary officials to access some of the dip tanks, a situation made worse by the ongoing rains. The officials, in addition to treating infected animals, are also educating communities against consuming meat from dead animals, because this could pose health risks to people.

The anthrax outbreak in Mbire, an arid district rich in an assortment of wildlife, is suspected to have been passed on to livestock by infected wild animals such buffaloes, which are typical carriers of the disease. Last year [2019], the province lost nearly 1300 cattle due to anthrax and other livestock diseases.
=====================
[For a description of Mashonaland, go to: <https://en.wikipedia.org/wiki/Mashonaland>. It is in northern Zimbabwe and is made up of 3 provinces, East, West, and Central. For a map showing the location of Mashonaland Central Province go to: <https://en.wikipedia.org/wiki/Mashonaland_Central_Province>.

In these hard to reach areas, it is a constant concern knowing what is happening where. And this goes a long way as to why some 34 animals are reported affected and probably more. And why it is so important to get the necessary volumes of vaccine out to these communities as soon as possible. We wish the provincial veterinary service well and all the luck that they enjoy. - ProMED Mod.MHJ]

[HealthMap/ProMED map available at:
Mashonaland Central Province, Zimbabwe:
Date: Fri 17 Jan 2020
Source: The Herald [edited]

At least 177 cattle have died from anthrax while 87 people were treated for the disease in various clinics and hospitals after eating meat from cattle that died from the infection during this season. Anthrax is a bacterial disease that affects a wide range of animals and human beings.

Livestock, particularly cattle, take up anthrax bacteria during grazing, while people get infected when they handle or eat anthrax-infected meat. Anthrax disease occurs throughout the year, but in Zimbabwe, most cases start from onset of rainy season. It is rare to see an animal showing signs of the disease; animals are often found dead. [Actually once it gets started, ranchers will start seeing sick animals; watching more carefully, longer incubation periods. - ProMED Mod.MHJ]

Division of Veterinary Field Services, Acting Director, Dr. Wilmot Chikurunhe has told The Herald that anthrax outbreaks have been recorded in Gokwe, Nkayi, Gutu, Bikita, Marondera, Mazowe, Chegutu, Makonde and Sanyati. He said the disease is being detected in traditional outbreak areas and not affecting the whole district as it may seem from information circulating. "Even in the affected dip tanks, the disease is restricted to certain areas, although the vaccination coverage is then extended to a wider area to contain the outbreak.

"Cattle owners in anthrax areas need to ensure that their cattle are vaccinated against the disease once a year before the rainy season starts. The Department of Veterinary Services comes in to prevent massive outbreaks, but the primary responsibility for disease prevention lies with the owner," he said.

Dr. Chikurunhe said anthrax carcasses must be disposed of safely in a manner that does not leave the bacteria exposed to air. "The best method is to burn the carcasses in a pit, then bury the ashes. However, some parts of the country have firewood problems. In these areas it is recommended to dig a pit 6 feet [1.8 m] deep, bury the carcass, cover the carcass completely with soil and apply a layer of agricultural lime before filling the rest of the pit with soil. This is best done under supervision of veterinary personnel," said Dr. Chikurunhe.  [Byline: Elita Chikwati]
==================
[For maps clearly showing the locations of the individual provinces, go to <https://en.wikipedia.org/wiki/Provinces_of_Zimbabwe>. The districts mentioned are in the following provinces: Bikita (Masvingo), Chegutu (Masonaland West), Gotwe (Midlands), Gutu (Masvingo), Makonde (Masonaland West), Marondera (Masonaland East), Mazowe (Masonaland Central), Nkayi (Matabeleland North), and Sanyati (Masonaland West).

The survival of anthrax spores is location dependent, and this facilitates mapping where the disease might be found and where control should be centered. For some relevant maps, see:
1. Carlson CJ, Kracalik IT, Ross N, et al. The global distribution of _Bacillus anthracis_ and associated anthrax risk to humans, livestock, and wildlife. Nat Microbiol 2019;4:1337-43. doi:10.1038/s41564-019-0435-4
2. Blackburn JK, Odugbo MO, Van Ert M, et al. _Bacillus anthracis_ diversity and geographic potential across Nigeria, Cameroon and Chad: further support of a novel West African lineage. PLOS Negl Trop Dis

As Dr. Wilmot Chikurunhe comments, while vaccination should center on these enzootic areas, one should extend the vaccination cover outwards because of the risk from female biting tabanid flies with contaminated mouthparts and non-reporting neighbours. Annual vaccination prior to the anthrax season protects the livestock at a minimal cost, as Sterne vaccine is extraordinarily cheap. And eradication follows from successful control. Country after country, province after province are realising the truth of this. I just wish the ranchers would be as enthusiastic. It is the procrastinators' livestock that come down, demonstrating a local persistence of risk. Experience shows that once you have gone 8-10 years without outbreaks, you can step back to just high awareness of unexpected deaths (for checking).

The spores have a reputation for "immortality", which is exaggerated. Archived spores have a 3% annual mortality. On my 1st field investigation of this disease, Max Sterne told me that in his experience the contaminated soil will present a risk for 3 months to 3 years; we repeatedly sampled the bloody soil site at that outbreak and found no live spores after 90 days, but we might have just run out of contaminated soil thanks to the repeated sampling. A study by one of my students showed the spore count decreasing by 30% per year. But in general this is an aspect of the epidemiology of this disease that is understudied. And another aspect is that over 5 to 6 years the spores in the soil lose their plasmids and become apathogenic.

The genetics of spore survival depend on a matching of the strain with the soil, Darwin again.

See: Mullins JC, Garofolo G, Van Ert M, et al. Ecological niche modeling of _Bacillus anthracis_ on three continents: evidence for genetic-ecological divergence? PLoS One 2013;8:e72451. <https://doi.org/10.1371/journal.pone.0072451>

Remember, graduate students need fresh air and mud on their boots. - ProMED Mod.MHJ]

[HealthMap/ProMED-mail map:
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World Travel News Headlines

Date: Tue, 31 Mar 2020 10:27:16 +0200 (METDST)

Nairobi, March 31, 2020 (AFP) - Six of Africa's 54 nations are among the last in the world yet to report cases of the new coronavirus. The global pandemic has been confirmed in almost every country, but for a handful of far-flung tiny island states, war-torn Yemen and isolated North Korea.  In Africa authorities claim they are spared by god, or simply saved by low air traffic to their countries, however some fear it is lack of testing that is hiding the true impact.

- South Sudan -
The east African nation is barely emerging from six years of civil war and with high levels of hunger, illness and little infrastructure, observers fear the virus could wreak havoc.   Doctor Angok Gordon Kuol, one of those charged with overseeing the fight against the virus, said the country had only carried out 12 tests, none of which were positive.   He said the reason the virus has yet to reach South Sudan could be explained by the low volume of air traffic and travel to the country.   "Very few airlines come to South Sudan and most of the countries affected today they are affected by... people coming from abroad."   He said the main concern was foreigners working for the large NGO and humanitarian community, or people crossing land borders from neighbouring countries.   South Sudan has shut schools, banned gatherings such as weddings, funerals and sporting events and blocked flights from worst-affected countries. Non-essential businesses have been shuttered and movement restricted.   The country can currently test around 500 people and has one isolation centre with 24 beds.

- Burundi -
In Burundi, which is gearing up for general elections in May, authorities thank divine intervention for the lack of cases.   "The government thanks all-powerful God who has protected Burundi," government spokesman Prosper Ntahorwamiye said on national television last week.   At the same time he criticised those "spreading rumours" that Burundi is not capable of testing for the virus, or that it is spreading unnoticed.   Some measures have been taken, such as the suspension of international flights and placing handwashing stations at the entrances to banks and restaurants in Bujumbura.   However several doctors have expressed their concerns.   "There are zero cases in Burundi because there have been zero tests," a Burundian doctor said on condition of anonymity.

- Sao Tome and Principe -
Sao Tome and Principe -- a tiny nation of small islands covered in lush rainforest -- has reported zero cases because it is unable to test, according to World Health Organisation representative Anne Ancia.   However "we are continuing preparations," with around 100 people in quarantine after returning from highly-affected countries, and the WHO keeping an eye on cases of pneumonia.   With only four ICU beds for a population of 200,000 people, the country is desperate to not let the virus take hold and has already shut its borders despite the importance of tourism to the local economy.

- Malawi -
Malawi's health ministry spokesman Joshua Malango brushed aside fears that Malawi might not have registered any Covid-19 cases due to a lack of testing kits: "We have the testing kits in Malawi and we are testing."   Dr Bridget Malewezi from the Society of Medical Doctors told AFP that while "we may not be 100 percent ready", government was gearing up for the arrival of the virus.   She suggested it may only be a matter of time before the pandemic hits Malawi.    "It's only been in the past few weeks that it has been rampantly spreading across Africa so most people feel it will get here at some point...," she said.   Malawi has asked people coming from hard-hit countries to self-quarantine, which Malawezi said had helped "safeguard the country from any possible spread of the virus".

- Lesotho -
Tiny Lesotho, a kingdom encircled by South Africa with only two million inhabitants, went into national lockdown on Monday despite registering zero cases.   Until last week the country had no tests or testing centres, and received its first kits thanks to a donation by Chinese billionaire Jack Ma.   Authorities had reported eight suspected cases which they had not been able to test and the first results are expected soon.

- Comoros -
The Indian Ocean island nation of the Comoros, situated between Madagascar and Mozambique, has yet to detect a single case of the virus, according to the health ministry.   One doctor in the capital Moroni, Dr Abdou Ada, wonders if it may not be because of the wide use of the drug Artemisinin to treat malaria.   "I believe that the mass anti-malarial treatment explains the fact that the Comoros are, at least for now, spared from Covid-19. it is a personal belief that needs to be confirmed scientifically."
Date: Tue, 31 Mar 2020 09:50:04 +0200 (METDST)
By Sophie DEVILLER with Dene-Hern CHEN

Bangkok, March 31, 2020 (AFP) - Underfed and chained up for endless hours, many elephants working in Thailand's tourism sector may starve, be sold to zoos or be shifted into the illegal logging trade, campaigners warn, as the coronavirus decimates visitor numbers. Before the virus, life for the kingdom's estimated 2,000 elephants working in tourism was already stressful, with abusive methods often used to 'break them' into giving rides and performing tricks at money-spinning animal shows.   With global travel paralysed the animals are unable to pay their way, including the 300 kilograms (660 pounds) of food a day a captive elephant needs to survive.

Elephant camps and conservationists warn hunger and the threat of renewed exploitation lie ahead, without an urgent bailout. "My boss is doing what he can but we have no money," Kosin, a mahout -- or elephant handler -- says of the Chiang Mai camp where his elephant Ekkasit is living on a restricted diet.   Chiang Mai is Thailand's northern tourist hub, an area of rolling hills dotted by elephant camps and sanctuaries ranging from the exploitative to the humane.   Footage sent to AFP from another camp in the area shows lines of elephants tethered by a foot to wooden poles, some visibly distressed, rocking their heads back and forth.

Around 2,000 elephants are currently "unemployed" as the virus eviscerates Thailand's tourist industry, says Theerapat Trungprakan, president of the Thai Elephant Alliance Association. The lack of cash is limiting the fibrous food available to the elephants "which will have a physical effect", he added.  Wages for the mahouts who look after them have dropped by 70 percent.   Theerapat fears the creatures could soon be used in illegal logging activities along the Thai-Myanmar border -- in breach of a 30-year-old law banning the use of elephants to transport wood.  Others "could be forced (to beg) on the streets," he said. It is yet another twist in the saga of the exploitation of elephants, which animal rights campaigners have long been fighting to protect from the abusive tourism industry.

- 'Crisis point' -
For those hawking a once-in-a-lifetime experience with the giant creatures -- whether from afar or up close -- the slump began in late January.   Chinese visitors, who make up the majority of Thailand's 40 million tourists, plunged by more than 80 percent in February as China locked down cities hard-hit by the virus and banned external travel. By March, the travel restrictions into Thailand -- which has 1,388 confirmed cases of the virus -- had extended to Western countries.

With elephants increasingly malnourished due to the loss of income, the situation is "at a crisis point," says Saengduean Chailert, owner of Elephant Nature Park.   Her sanctuary for around 80 rescued pachyderms only allows visitors to observe the creatures, a philosophy at odds with venues that have them performing tricks and offering rides.   She has organised a fund to feed elephants and help mahouts in almost 50 camps nationwide, fearing the only options will soon be limited to zoos, starvation or logging work.  For those restrained by short chains all day, the stress could lead to fights breaking out, says Saengduean, of camps that can no longer afford medical treatment for the creatures.

Calls are mounting for the government to fund stricken camps to ensure the welfare of elephants. "We need 1,000 baht a day (about $30) for each elephant," says Apichet Duangdee, who runs the Elephant Rescue Park. Freeing his eight mammals rescued from circuses and loggers into the forests is out of the question as they would likely be killed in territorial fights with wild elephants. He is planning to take out a two million baht ($61,000) loan soon to keep his elephants fed.   "I will not abandon them," he added.
Date: Tue, 31 Mar 2020 07:10:34 +0200 (METDST)
By Bernadette Carreon

Koror, Palau, March 31, 2020 (AFP) - A coronavirus-free tropical island nestled in the northern Pacific may seem the perfect place to ride out a pandemic -- but residents on Palau say life right now is far from idyllic.   The microstate of 18,000 people is among a dwindling number of places on Earth that still report zero cases of COVID-19 as figures mount daily elsewhere.   The disparate group also includes Samoa, Turkmenistan, North Korea and bases on the frozen continent of Antarctica.

A dot in the ocean hundreds of kilometres from its nearest neighbours, Palau is surrounded by the vast Pacific, which has acted as a buffer against the virus.   Along with strict travel restrictions, this seems to have kept infections at bay for a number of nations including Tonga, the Solomons Islands, the Marshall Islands and Micronesia.   But remoteness is not certain to stop the relentless march of the new disease. The Northern Mariana Islands confirmed its first cases over the weekend, followed by a suspected death on Monday.

Klamiokl Tulop, a 28-year-old artist and single mum, is hopeful Palau can avoid the fate of Wuhan, New York or Madrid -- where better-resourced health services were overrun.   But she describes a growing sense of dread, a fear that the virus is coming or could already be on the island undetected.   "You can feel a rising tension and anxiety just shopping," she told AFP. "Stores are crowded even more during non-payday weeks."   There have been several scares on Palau, including a potential case that saw one person placed into quarantine this week as authorities await test results.

- Antarctic seclusion -
Inside Australia's four remote Antarctic research bases, around 90 people have found themselves ensconced on the only virus-free continent as they watch their old home transform beyond recognition.   There is no need for social distancing in the tundra.   "They're probably the only Australians at the moment that can have a large dinner together or have the bar still open or the gym still open," Antarctic Division Operations manager Robb Clifton told AFP.   The bases are now isolated until November, so the group is safe, but Clifton admits "the main thing that's on the mind of expeditioners is how their loved ones are going back home."

In some places, reporting no cases does not always mean there are no cases to report.   North Korea has portrayed emergency measures as an unqualified success in keeping COVID-19 out, despite sustained epidemics in neighbouring China and South Korea.   But state media also appears to have doctored images to give ordinary North Koreans face masks -- handing sceptics reason to believe the world's most secretive government may not be telling the whole truth.

- 'Waiting for the inevitable?' -
While Palau has no confirmed cases, it has still been gripped by the society-altering fears and economic paralysis that have affected the rest of the world.   Supermarket aisles in the country's largest town Koror have seen panic buying and there are shortages of hand sanitisers, masks and alcohol.   The islands depend heavily on goods being shipped or flown in, meaning supplies can quickly run low.

United Airlines used to fly six times a week from nearby Guam -- which has seen more than 50 cases -- but now there is just one flight a week.   "Look at how bad we coped when shipments were late before this pandemic happened," Tulop said. "Everyone was practically in uproar."   Residents have been practising social distancing. Doctors are waiting for test kits to arrive from Taiwan. The government is building five isolation rooms that will be able to hold up to 14 patients.   It all feels like waiting for the inevitable.   "I would like to be optimistic we won't get the virus," Tulop said. "But Palau would most definitely get it. We rely heavily on tourism and most of us even need to travel for work."

Rondy Ronny's job is to host big tourist events, but work has already dried up, and he admits to being "very anxious".   "I have loans and bills and payments due," he said. "This will definitely put me back, I hope the government will do something about our economy too, to help it recover."   Palau's biggest test may yet come with the first positive case.   But even in the most remote corners of the world, the impact of this truly global pandemic is already being felt.   Nowhere, it seems, is truly virus-free.
Date: Tue, 31 Mar 2020 04:46:26 +0200 (METDST)

Panama City, March 31, 2020 (AFP) - The government of Panama on Monday announced strict quarantine measures that separate citizens by gender in an effort to slow the spread of the novel coronavirus.   From Wednesday, men and women will only be able to leave their homes for two hours at a time, and on different days.   Until now, quarantine regulations were not based on gender.

Men will be able to go to the supermarket or the pharmacy on Tuesdays, Thursdays and Saturdays, and women will be allowed out on Mondays, Wednesdays and Fridays.   No one will be allowed to go out on Sundays.

The new measures will last for 15 days.   "This absolute quarantine is for nothing more than to save your life," security minister Juan Pino said at a press conference.   According to Pino, more than 2,000 people were detained last week for not abiding by the quarantine.   Since the first case was reported on March 10, Panama has confirmed 1,075 cases of the coronavirus, 43 of which are in intensive care, and 27 deaths.
Date: Tue, 31 Mar 2020 00:54:08 +0200 (METDST)
By Celia Lebur with AFP Africa Bureaux

Lagos, March 30, 2020 (AFP) - More than 20 million Nigerians on Monday went into lockdown in sub-Saharan Africa's biggest city Lagos and the capital Abuja, as the continent struggles to curb the spread of coronavirus.   President Muhammadu Buhari ordered a two-week "cessation of all movements" in key cities to ward off an explosion of cases in Africa's most populous country.

Businesses are being closed, non-food shops shut and people required to stay at home as officials look to track down possible carriers of the disease after reporting 131 confirmed cases and two deaths so far.   Enforcing the restrictions in sprawling Lagos will be a mammoth challenge as millions live crammed into slums and rely on daily earnings to survive.

In the ramshackle outdoor markets of Lagos Island, anxious locals complained they did not have the money to stock up, while at higher-end supermarkets better-off residents queued to buy supplies.    "Two weeks is too long. I don't know how we will cope," said student Abdul Rahim, 25, as he helped his sister sell foodstuffs from a stall in Jankarra market.    "People are hungry and they won't be able to stock food."

City officials have pledged to provide basic provisions to 200,000 households but the central government in Africa's largest oil producing nation is already facing financial strain as the price of crude  has collapsed.    The streets of Ghana's capital Accra were also empty as most people in two regions appeared to be following a presidential order to stay indoors after it went into force.

- Zimbabwe locks down -
Dozens of African nations have imposed restrictions ranging from night-time curfews to total shutdowns.    Zimbabwe, which is already suffering a recession, began enforcing a three-week lockdown after the disease left one person dead and infected six others.   Police mounted checkpoints on routes leading to Harare's central business district, stopping cars and turning away pedestrians who had no authorisation to be in the area.   "We don't want to see people here on the streets. We don't want to see people who have no business in town just loitering," a policewoman said through a loud hailer. "Everyone to their homes."

Some people were trying to head for villages.   "We would rather spend the 21 days at our rural home, where we don't have to buy everything. I can't afford to feed my family here when I am not working," said Most Jawure.   "We have been waiting here for more than two hours but there are no buses," Jawure told AFP while standing with his wife and daughter beside a bulging suitcase.

For many of Zimbabwe's 16 million people, the lockdown means serious hardship.   With the unemployment rate estimated at around 90 percent, most Zimbabweans have informal jobs to eke out a living and few have substantial savings.   As a similar scenario played out in other poor nations, the UN on Monday called for a $2.5-trillion aid package to help developing countries weather the pandemic, including debt cancellation and a health recovery "Marshall Plan".

- 'A matter of time' -
Experts warn that Africa is highly vulnerable to COVID-19 given the weak state of health systems across the continent.    The number of infections lags far behind Europe but testing has been limited and the figures are growing rapidly.    Angola and Ivory Coast on Sunday became the latest countries to record their first deaths, bringing the number of African fatalities to around 150 of nearly 4,800 recorded cases.

In Democratic Republic of Congo, two new cases were reported in the volatile South Kivu region and an adviser to the nation's president announced he had tested positive.

Ugandan President Yoweri Museveni ordered a 14-day lockdown in a bid to halt the spread of the disease after reporting 33 infections.    Police in South Sudan, one of a few nations in Africa yet to confirm a case, enforced strict new rules, shutting shops selling non-essential items and limiting passengers in public transport.   Mauritius, which has 128 cases -- the highest in East Africa -- has extended its lockdown to April 15.

South Africa's defence minister Nosiviwe Mapisa-Nqakula on Monday denounced alleged intimidation by security forces after videos emerged showing some forcing civilians to squat or roll on the ground for allegedly violating restrictions.   In an interview with local Newzroom Afrika television channel, she said she was aware of two videos "which have circulated where clearly there (is) some abuse".   "I'm saying I condemn that, we will not allow that to continue," she said.
Date: Mon, 30 Mar 2020 21:41:43 +0200 (METDST)

Kampala, March 30, 2020 (AFP) - Ugandan President Yoweri Museveni on Monday ordered an immediate 14-day nationwide lockdown in a bid to halt the spread of the coronavirus which has so far infected 33 people in the country.   Uganda last week banned public transport and sealed its borders and urged the population to stay home, but stopped short of a full shutdown.

Museveni said that from 10:00pm Monday private vehicles would also be banned, seeking to avoid give a more advanced warning that would see people flee the city, as has happened across the continent where many poor residents see better chances of survival in the countryside.   "I would have given the public time to adjust but... a longer time would give people time to go to the villages and in so doing they would transfer the very sickness we're trying to prevent. This freezing of movement will last for 14 days," he said in a televised address.

Museveni also ordered a 14-day nationwide curfew from 7:00pm.   Shopping malls and businesses selling non-food items were ordered to close.   Food market vendors who continue to trade are forbidden to return to their homes for the duration of the 14-day lockdown, while factories could stay open if remain on the premises for the duration of the shutdown.

People are still allowed to move around on foot but not gather in groups of more than five at a time.    In recent days, opposition leaders Kizza Besigye and Bobi Wine had undertaken small-scale food deliveries to people who had ost their incomes due to earlier restrictions but Museveni criticised such actions as "cheap politics".   "I direct the police to arrest the opportunistic and irresponsible politicians who tried to distribute food," he said.   "Anybody arrested in that effort will be charged with attempted murder."   Museveni said the government would begin distributing food to those who needed it, without providing details.

A weary looking Museveni, 75, pleaded with the population to change their behaviour in the face of the threat from the virus.   "This virus would not do much damage if it was not for the carelessness of people. Don't go into a group of people if you have a cold. Stay at home," he pleaded.   Last week police and Local Defence Units (LDUs) -- a uniformed militia under the control of the military - violently cleared streets in central Kampala.   Following a public outcry, army chief General David Muhoozi on Monday apologised for those actions, describing them as "high-handed, unjustified and regrettable" and said the culprits would be "dealt with".
Date: Sun 29 Mar 2020
Source: Spanish government COVID-19 update 58 [in Spanish, trans. ProMed Mod.MPP, edited]

COVID-19 update 59 [data as of 28 Mar 2020 21:00 CET]
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Situation in Spain
------------------
In Spain, to date [28 Mar 2020], 78 797 cases have been reported, of which 6528 have died and 14,709 recovered (table 1 and figure 1 -- at source URL above). The Autonomous Communities with the greater cumulative incidence in the last 14 days are La Rioja 419.5 per 100,000 population), Madrid 287.1 per 100,000 population), Navarre (279.4 per 100,000 population), and Castile-La Mancha (238.3 per 100,000 population) (figures 2, 3). The distribution by age groups of hospitalized patients, those admitted to the ICU, and deaths is found in table 2.

Autonomous Community:
Total / last 24 hours / Incidence per 100,000 population in past 14 days

  • Madrid: 22,677 / 1157 / 287.14
  • Catalonia: 15,026 / 763 / 186.46
  • Basque Country: 5740 / 604 / 231.45
  • Castile and Leon: 5414 / 623 / 213.46
  • Castile-La Mancha: 5246 / 734 / 238.33
  • Valencia: 4784 / 750 / 87.43
  • Andalusia: 4682 / 405 / 50.45
  • Galicia: 3139 / 367 / 109.06
  • Navarre: 2011 / 182 / 279.42
  • Aragon: 1858 / 266 / 129.69
  • La Rioja: 1629 / 193 / 419.51
  • Extremadura : 1456 / 62 / 127.47
  • Canary Islands: 1125 / 100 / 47.18
  • Asturias: 1088 / 84 / 92.98
  • Cantabria: 1023 / 86 / 167.28
  • Balearic Islands: 958 / 96 / 79.69
  • Murcia: 872 / 70 / 53.62
  • Melilla: 48 / 3 / 46.25
  • Ceuta: 21 / 4 / 23.59
********
Total: 78,797 / 6549 / 151.04
======================
[Spain has been rapidly accelerating in terms of transmission of the SARS-CoV-2. As of today (29 Mar 2020), there have been a total of 78 797 cases and 6528 deaths reported, an increase from 72 248 cases with and 5690 deaths confirmed in the preceding 24 hours. The countrywide 2-week incidence per 100 000 population is 151. It is now 2nd in Europe, behind Italy, and 4th globally behind the USA, Italy, and China, in terms of absolute numbers of cases.

Of the 78,797 cases, 43 397 (55.1%) were hospitalized, 4907 (6.2%) were admitted to the ICU. The crude reported death rate was 8.3% with more deaths occurring than reported ICU admissions.

A map of Spain showing provinces (autonomous communities) can be seen at
and a HealthMap/ProMED-mail map at <http://healthmap.org/promed/p/43>.

La Rioja, Navarre, and Basque Country are located together in the north of the country. Madrid is in the northern part of central Spain and Castilla de la Mancha is just to the south of Madrid, with Toledo as its capital. - ProMed Mod.MPP]
Date: Sun 29 Mar 2020
Source: Worldometer [accessed 10:30 PM EDT]

USA cases by state
State: Total cases / New cases

  • New York: 59,648 / 6193
  • New Jersey: 13,386 / 2262
  • California: 6312 / 653
  • Michigan: 5486 / 836
  • Massachusetts: 4955 / 698
  • Florida: 4950 / 912
  • Washington: 4483 / 173
  • Illinois: 4596 / 1105
  • Louisiana: 3540 / 225
  • Pennsylvania: 3419 / 668
  • Texas: 2808 / 479
  • Georgia: 2683 / 237
  • Colorado / 2307 / 246
  • Connecticut: 1993 / 469
  • Tennessee: 1720 / 208
  • Ohio: 1653 / 247
  • Indiana: 1514 / 282
  • Maryland: 1239 / 247
  • North Carolina: 1167 / 145
  • Wisconsin: 1154 / 165
  • Nevada: 920 / 299
  • Arizona: 919 / 146
  • Missouri / 903 / 65
  • Virginia: 890 / 151
  • Alabama: 827 / 125
  • South Carolina: 774 / 114
  • Mississippi: 758 / 179
  • Utah: 719 / 117
  • Oregon: 548 / 69
  • Minnesota: 503 / 62
  • Arkansas: 449 / 40
  • Kentucky: 439 / 45
  • Oklahoma: 429 / 52
  • District of Columbia: 401 / 59
  • Iowa: 336 / 38
  • Kansas: 319 / 58
  • Idaho: 310 / 49
  • Rhode Island: 294 / 55
  • New Hampshire: 258 / 44
  • Maine: 253 / 42
  • New Mexico: 237 / 29
  • Vermont: 235 / 24
  • Delaware: 232 / 18
  • Hawaii: 175 / 24
  • Montana: 161 / 32
  • West Virginia: 124 / 11
  • Nebraska: 120 / 24
  • Alaska: 102 / 17
  • North Dakota: 98 / 15
  • South Dakota: 90 / 22
  • Wyoming: 87 / 3
  • Guam / 56 / 5
  • Northern Mariana Islands: 2
  • Puerto Rico: 127 / 27
  • US Virgin Islands: 21 / 0
  • Wuhan repatriated: 3 / 0
  • Diamond Princess Cruise: 46 / 0
**************
Total: 142 321 / 38 179
Total reported deaths: 2484
====================
[The above are the latest breakdowns of confirmed cases of SARS-CoV-2 infection in the USA, as per Worldometer data. The total number of confirmed cases in the USA and territories is now 142 321 including 2484 deaths. New York state, with 59 648 (41.9%) cumulative cases reports and 6193 (33.3%) newly confirmed cases over the past 24 hours, is clearly the epicenter of the outbreak in the USA, although case reporting elsewhere is showing increases. Daily reported case counts are accelerating in New Jersey, Michigan, Florida, Louisiana, Massachusetts, and Illinois.

The Centers for Disease Control and Prevention website (<https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/cases-in-us.html>) has 2 epidemic curves. One focuses on date of confirmation of disease, the other on date of onset of illness. The curve of interest, by date of onset of disease, is based on 14.6% of the number of cases plotted on the epidemic curve using date of confirmation of disease.

A map of the United States can be seen at
<http://www.mapsofworld.com/usa/> and a HealthMap/ProMED-mail map at
Date: Sun 29 Mar 2020 11:46 AM GST
Source: Reuters [abridged, edited]

Iran's coronavirus death toll has risen to 2640, a health ministry official said on Sunday [29 Mar 2020], as the Middle East's worst-hit country grapples with the fast-spreading outbreak. "In the past 24 hours we had 123 deaths and 2901 people have been infected, bringing the total number of infected people to 38 309," Alireza Vahabzadeh, an adviser to the health minister, said in a tweet. "12,391 people infected from the virus have recovered." Health ministry spokesman Kianush Jahanpur told state TV that 3467 of those infected were in "critical condition".  "I am happy to announce that also 12,391 people who had been infected across the country have recovered," Jahanpur said. "The average age of those who have died of the disease is 69."

President Hassan Rouhani urged Iranians to adapt to their new way of life, which was likely to continue for some time. "We must prepare to live with the virus until a treatment is discovered ... The new measures that have been imposed are for everyone's benefit ... Our main priority is the safety and the health of our people," Rouhani said during a televised meeting.

The government has banned inter-city travel after warning of a potential surge in coronavirus cases because many Iranians defied calls to cancel travel plans for the Persian New Year holidays that began on [20 Mar 2020]. The authorities told Iranians to stay at home, while schools, universities, cultural, religious, and sports centres have been temporarily closed.

To stem the spread of the virus in crowded jails, Iran's judiciary on Sunday [29 Mar 2020] extended furloughs for 100,000 prisoners. On [17 Mar 2020], Iran said it had freed about 85,000 people from jail temporarily, including political prisoners. "The 2nd wave of (the) temporary release of prisoners had already started and their (100,000 prisoners) furloughs have been extended until [19 Apr 2020]," judiciary spokesman Gholamhossein Esmaili was reported as saying by state television. Iran said it had 189,500 people in prison, according to a report submitted by the UN special rapporteur on human rights in Iran to the Human Rights Council in January [2020].  [byline: Parisa Hafezi]
===================
[In the 24 hours from 28 to 29 Mar 2020, the number of cases of COVID-19 confirmed in Iran grew from 35 408 to, 38 309, an increase of 2901 newly confirmed cases. The number of deaths has also increased from 2517 to 2640 an increase of 123 deaths in the 24-hour period. In terms of total numbers of confirmed cases, Iran ranks 7th globally behind USA, Italy, China, Spain, Germany and France. In early March 2020, Iran and Italy were on the same trajectory with respect to daily growth in cumulative newly confirmed cases, but starting 8 Mar 2020, Italy's daily reported newly confirmed cases accelerated at an alarming speed. By 14 Mar 2020, Italy was reporting almost twice as many cases as Iran on a daily basis.

A map of Iran showing provinces can be seen at
HealthMap/ProMED-mail map at <http://healthmap.org/promed/p/128>. - ProMed Mod.MPP]
Date: Sun 29 Mar 2020
Source: Italian Government Health Ministry [in Italian, machine trans., edited]

Cases in Italy as of 6:00 pm 29 Mar 2020
----------------------------------------
Regarding health monitoring related to the spread of the new coronavirus [SARS-CoV-2] on the national territory, there are a total of 97,689 cases. At the moment 73,880 people are positive for the virus; 13,030 people have recovered. There are 27,386 patients hospitalized with symptoms, 3906 are in intensive care, and 42,588 are in home isolation.

There have been 10,779 reported deaths, however, this number can only be confirmed after the Istituto Superiore di Sanita has established the actual cause of the death.

Case distribution by province:
number of cases (number of new cases in past 24 hours)

  • Lombardy: 41 007 (1592)
  • Emilia-Romagna: 13 119 (736)
  • Veneto: 8358 (428)
  • Marche: 3558 (185)
  • Piedmont: 8206 (535)
  • Tuscany: 4122 (305)
  • Campania: 1759 (167)
  • Lazio: 2706 (201)
  • Liguria: 3076 (254)
  • Friuli Venezia Giulia: 1480 (44)
  • Sicily: 1460 (101)
  • Apulia: 1549 (91)
  • Umbria: 1023 (54)
  • Abruzzo: 1293 (160)
  • Molise: 127 (4)
  • Trento: 1594 (89)
  • Bolzano: 1214 (105)
  • Sardinia: 638 (14)
  • Basilicata: 202 (20)
  • Aosta Valley: 584 (73)
  • Calabria: 614 (59)
*********
Total: 97,689 (5217)
======================
[The tally of confirmed cases of COVID-19 in Italy is now 97,689 cases, including 10,779 deaths, up from 92,472 cases and 10,023 deaths reported on 28 Mar 2020. The 24-hour change between 28 and 29 Mar 2020 was 5217 newly confirmed cases, compared with 5974 newly confirmed cases between 27 and 28 Mar 2020. Cases continue to be concentrated in Lombardy (41 007), the epicenter of the outbreak, Emilia-Romagna (13 119), and Veneto (8358), all in the northern part of the country. Those 3 provinces combined account for 52.8% of newly confirmed cases in the past 24 hours, representing a drop from the previous 24 hours when they represented 56.% of nationally reported cases. Another active province is Piemonte with a total of 8206 cases and represents 10.3% of newly reported cases. In the past 24 hours Tuscany has reported 5.9% of newly reported cases, a slight drop from the preceding day when it was reporting 6.1% of newly confirmed cases. There is an excellent interactive map at <http://opendatadpc.maps.arcgis.com/apps/opsdashboard/index.html#/b0c68bce2cce478eaac82fe38d4138b1> to visualize the caseloads per region in near real time.

On 9 Mar 2020, Italy announced a lockdown for the northern provinces where the outbreak was concentrated. On 10 Mar 2020, this was expanded to be countrywide. On 11 Mar 2020, Italy announced the closure of non-essential businesses. It is now 19 days since the start of the lockdown in the north and 18 days since the countrywide lockdown.

A map of Italy showing regions can be seen at
HealthMap/ProMED-mail map at <http://healthmap.org/promed/p/75>. - ProMed Mod.MPP]