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United Arab Emirates

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

See our information on Victims of Crime.

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

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

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

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

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

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

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

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

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

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

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

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

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

Please see our Customs Information.

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

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

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

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

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

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

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

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

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

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

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

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

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

Travel News Headlines WORLD NEWS

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

[Maps of United Arab Emirates:
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Paraguay

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Please see our information on Criminal Penalties.

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

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

Travel News Headlines WORLD NEWS

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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/.
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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
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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
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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
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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
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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)
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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: Sat, 16 May 2020 19:50:13 +0200 (METDST)

Harare, May 16, 2020 (AFP) - Zimbabwe's President Emmerson Mnangagwa said Saturday the lockdown imposed to control the spread of coronavirus would stay in place for the moment, but would be reviewed every two weeks.   The restrictions have so far borne fruit as transmission has not been widespread and numbers remain lower than had been initial projections, he added.   From more than 25,000 tests conducted, the country has so far detected 42 cases, four of which proved fatal.

Mnangagwa said the World Health Organisation had classified coronavirus transmission in Zimbabwe as "sporadic, with one or more cases imported or locally detected.   "This may suggest that despite the small numbers tested, our country might have a reduced COVID-19 trajectory," he said in a speech broadcast on public television.

Other, similar sub-Saharan countries had recorded similar trajectories, he added.   "Zimbabwe will therefore continue on lockdown for an indefinite period. We shall have two-week interval reviews to assess progress, or lack of it."    Zimbabwe imposed its lockdown on March 30.   Local doctors have warned that Zimbabwe's poorly equipped health service could not cope with a coronavirus pandemic.
Date: Fri, 1 May 2020 19:29:22 +0200 (METDST)

Harare, May 1, 2020 (AFP) - Zimbabwe's President Emmerson Mnangagwa on Friday extended a COVID-19 lockdown for two weeks from Monday ahead of a gradual easing of restrictions.   The landlocked southern African country has reported 40 infections of coronavirus, including four deaths.

The partial lockdown imposed on March 30 was due to end on May 3.    But "noticing that there is now a gradual infection increase, the lockdown will continue for the next 14 days," Mnangagwa told journalists at State House in the capital Harare.   However coronavirus restrictions will be relaxed to allow large corporations to operate -- under strict conditions.   "All people must wear masks of any type, including home-made ones, outside their homes," the president said.   Previously wearing masks in public places was not mandatory.

Mnangagwa further instructed companies to ensure mandatory rapid diagnostic testing of all employees, as well as  social distancing and sanitisation in the workplace.   Large gatherings of more than 50 people and operations by small and informal businesses remain banned.   The president praised the ban on unnecessary movement, saying it had proved effective in containing the spread of the disease.  But cautioned that a continued partial lockdown was "critical" and that government "would rather err on the side of caution and not on the side of recklessness."
 
Zimbabwe last week observed thee 40th anniversary of its independence without the usual celebrations, while May Day went by without the traditional rallies.
Date: Fri, 24 Apr 2020 17:28:27 +0200 (METDST)

Harare, April 24, 2020 (AFP) - Already battling to contain the novel coronavirus, Zimbabwe health authorities are also facing a surge in malaria cases which has claimed 152 lives this year, a doctor said Friday.   The increase in malaria cases has raised concerns that some coronavirus cases may go unrecognised since some symptoms of the two diseases are similar.   As the country entered its fourth week of a five-week lockdown imposed to control the spread of the virus, the government announced a 45 percent rise in malaria cases compared to 2019 as the number of deaths increased more than 20 percent.   "This year the cumulative malaria cases in the country stand at 170,303 and the deaths are 152 compared to 117,715 and 127 in 2019 over the same period," the health ministry announced on twitter.

The figures were released early this week.   "We are beginning to see the cases rising," Norman Matara, secretary general of the Zimbabwe Association of Doctors for Human Rights told AFP on Friday.   "Unfortunately this is happening at a time we are battling with another health crisis -- the COVID-19 pandemic.    "One of the conditions can be mistaken for the other because some of the symptoms tend to be similar," said Matara.   Zimbabwe was already battling with an ailing health system, suffering from mass shortages of medicines and equipment, and strikes by doctors and nurses.

On Thursday, the World Health Organisation said the new coronavirus pandemic could severely disrupt the anti-malaria fight in sub-Saharan Africa. It warned that malaria deaths risked doubling if efforts are not urgently scaled up.   The UN health agency called on countries in sub-Saharan Africa -- where nearly 95 percent of all the world's malaria cases and deaths occur -- to ensure malaria prevention and treatment tools are in place, before they are swamped with coronavirus cases.   Sub-Saharan Africa has reported relatively few cases in the COVID-19 pandemic but the agency has long warned that weak health systems in the region risked becoming seriously overwhelmed as cases increase.
Date: Sun, 19 Apr 2020 19:05:13 +0200 (METDST)

Harare, April 19, 2020 (AFP) - Zimbabwean President Emmerson Mnangagwa on Sunday extended by two weeks a lockdown imposed on March 30 to curb the spread of COVID-19 which has killed three in the country.   "Government has decided to extend with immediate effect the lockdown by a further 14 days," Mnangagwa told journalists at State House in the capital.    "The country is yet to meet the conditions for lifting the lockdown announced by the World Health Organization (WHO)."

The WHO stipulated that infections should be declining and there should be adequate and well-equipped treatment and quarantining facilities before measures should be relaxed.   The southern African country has so far recorded 25 cases of the respiratory disease including three fatalities.   Even before the virus, Zimbabwe was already battling with an ailing health system suffering from mass shortages of medicines and equipment, and strikes by doctors and nurses.

The government has been taken to court by the union for healthcare workers which accuses it of failing to provide doctors working on the frontline of the pandemic with protective gear.   Mnangagwa announced that government has decided to allow the mining sector to "resume or scale up their operations," as a reprieve because it is aware of the need to "keep the economy running, "be it at subdued levels".

Zimbabwe on Saturday observed its 40th anniversary of independence without the usual spectacle of celebrations.   On the anniversary Mnangagwa, who had initially imposed a three-week lockdown that will now lapse at the end of April thanks to the extension, thanked citizens and donor countries "for the collective response" in trying to fighting the pandemic.    "May this national character continue to grow and flourish," he added.
Date: Tue, 7 Apr 2020 16:21:31 +0200 (METDST)

Harare, April 7, 2020 (AFP) - Zimbabwean doctors have filed a lawsuit aimed at compelling the government to beef up coronavirus protection for public hospitals and healthcare workers.   In an application filed to the High Court on Sunday, the doctors said the government had failed to set in place "measures to ensure that health practitioners across the country, who include nurses, nurse aides and pharmacists among others, are adequately protected".   The case is being led by the Zimbabwe Association of Doctors for Human Rights (ZADHR).   The doctors, according to a statement on Tuesday by country's human rights lawyers, said there was a "dire shortage" of ventilators, oxygen tanks, biohazard suits and N95 facemasks.   Doctors and nurses staged a walkout last month in protest over a lack of protective clothing to care for coronavirus patients.

Zimbabwe has so far recorded 10 cases of infection, including one fatality.   In their case, the doctors also raise concerns over the scarcity of quarantine and isolation facilities, which they say are only found in the capital Harare and the country's second largest city, Bulawayo.   The ZADHR also complained about inadequate screening of people for coronavirus symptoms across the country.   Zimbabwe has only one COVID-19 test centre, situated at a government hospital in Harare.   The public healthcare system in the country already faces shortages of basic drugs and lacks essential equipment and even running water.   A hearing date is yet to be set. The health ministry could not be immediately reached for comment.
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British Virgin Islands

British Virgin Islands US Consular Information Sheet
February 26, 2009
COUNTRY DESCRIPTION:
The British Virgin Islands (BVI) are a British overseas territory, part of the British West Indies, lying about 60 miles east of Puerto Rico.
here are about 50 islands in the BVI, many of them uninhabited.
Tortola is the main island; other islands include Virgin Gorda, Jost Van Dyke, and Anegada.
Tourist facilities are widely available. Read the Department of State Background Notes on the United Kingdom for additional information.
ENTRY/EXIT REQUIREMENTS:
The Intelligence Reform and Terrorism Prevention Act of 2004 requires all travelers to and from the Caribbean, Bermuda, Panama, Mexico and Canada to have a valid passport to enter or re-enter the United States. U.S. citizens must have a valid U.S. passport if traveling by air, including to and from Mexico.
If traveling by sea, U.S. citizens can use a passport or passport card.
We strongly encourage all American citizen travelers to apply for a U.S. passport or passport card well in advance of anticipated travel.
American citizens can visit travel.state.gov or call 1-877-4USA-PPT (1-877-487-2778) for information on how to apply for their passports.

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

Visit the Embassy of the United Kingdom’s web site at http://www.britainusa.com for the most current visa information.

Information about dual nationality or the prevention of international child abduction can be found on our web site.
For further information about customs regulations, please read our Customs Information sheet.
SAFETY AND SECURITY:
For the latest security information, Americans traveling abroad should regularly monitor the Department of State, Bureau of Consular Affairs’ website at http://travel.state.gov, where the current Travel Warnings and Public Announcements, including the Worldwide Caution Public Announcement, can be found.
Up-to-date information on safety and security can also be obtained by calling 1-888-407-4747 toll-free in the U.S. and Canada or, for callers outside the U.S. and Canada, a regular toll line at 1-202-501-4444.
These numbers are available from 8:00 a.m. to 8:00 p.m. Eastern Time, Monday through Friday (except U.S. federal holidays).

The Department of State urges American citizens to take responsibility for their own personal security while traveling overseas.
For general information about appropriate measures travelers can take to protect themselves in an overseas environment, see the Department of State’s pamphlet A Safe Trip Abroad.
CRIME:
Thefts, armed robberies, and other violent crimes do occur in the BVI.
Visitors should take common-sense precautions against petty crime.
Travelers should avoid carrying large amounts of cash and use hotel safety deposit facilities to safeguard valuables and travel documents.
Do not leave valuables unattended on the beach or in cars, and do not leave them in plain view in rental properties.
Always lock up boats when going ashore.

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

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

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

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

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

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

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

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

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

Travel News Headlines WORLD NEWS

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Date: Mon, 1 Jun 2020 10:23:53 +0200 (METDST)

Yerevan, June 1, 2020 (AFP) - Armenian Prime Minister Nikol Pashinyan and his family have tested positive for the coronavirus, he said Monday, as the rate of new infections soared in the Caucasus nation.   "My coronavirus test was positive yesterday," Pashinyan said in a self-recorded video message on Facebook, adding that his family were also infected.   He said he had no "viable symptoms" of the virus and would be working from home.   The prime minister and his wife Anna Hakobyan, who is a journalist, have four children.   The ex-Soviet republic of some three million has so far reported 9,492 cases of the coronavirus and 139 deaths.

Coronavirus patients have overwhelmed Armenia's hospitals and last week health officials said that intensive care treatment could be soon restricted to patients with the best chance of survival.   Pashinyan's announcement came nearly one month after Armenia on May 4 lifted a state of emergency imposed in March to slow the spread of the coronavirus.

The prime minister acknowledged his government had failed to enforce anti-virus measures and there had been widespread quarantine violations.   Pashinyan was elected prime minister in the wake of mass popular protests he led two years ago against veteran leader Serzh Sarkisian and his Republican Party.   He has since led a relentless crusade against graft and initiated sweeping judicial reforms.
Date: Mon, 1 Jun 2020 09:17:15 +0200 (METDST)

San Salvador, June 1, 2020 (AFP) - Tropical Storm Amanda triggered flash floods, landslides and power outages as it barrelled through El Salvador and Guatemala Sunday, killing 14 people, authorities said, warning of further heavy rain to come.   El Salvador President Nayib Bukele declared a 15-day state of emergency to cope with the effects of the storm, which he estimated to have caused $200 million in damage, but which weakened later in the day as it moved into Guatemala.

Amanda, the first named storm of the season in the Pacific, unleashed torrents of floodwater that tossed vehicles around like toys and damaged about 200 homes, the head of the Civil Protection Service William Hernandez said.   The fatalities were all recorded in El Salvador, Interior Minister Mario Duran said, warning that the death toll could rise.   One person is still missing, senior government official Carolina Recinos added.   "We are experiencing an unprecedented situation: one top-level emergency on top of another serious one," San Salvador mayor Ernesto Muyshondt said, referring to the coronavirus pandemic.

He added that half of those killed died in the capital, and that 4,200 people had sought refuge in government-run shelters after losing their homes or being forced to leave because they were in high-risk areas.   In some flooded areas, soldiers worked alongside emergency personnel to rescue people.   "We lost everything, we've been left with nowhere to live," said Isidro Gomez, a resident of hard-hit southeastern San Salvador, after a nearby river overflowed and destroyed his home.

Another victim, Mariano Ramos, said that at dawn residents of his San Salvador neighborhood were slammed by an avalanche of mud and water. An elderly man died in the area, officials said.   El Salvador's environment ministry warned residents of the "high probability" of multiple landslides that could damage buildings and injure or kill people.

Nearly 90 percent of El Salvador's 6.6 million people are considered vulnerable to flooding and landslides due to its geography.   In neighboring Guatemala, officials said roads had been blocked by at least five landslides and some flooding was reported, but no evacuations were underway.   Even though Amanda weakened to tropical depression status, Guatemalan officials warned that heavy rain would continue, with swollen rivers and possible "landslides affecting highways ... and flooding in coastal areas."
Date: Mon, 1 Jun 2020 06:55:18 +0200 (METDST)

Lima, June 1, 2020 (AFP) - Peru on Sunday reported 8,800 new COVID-19 infections, setting a new daily record for a country that already has the second highest number of novel coronavirus cases in Latin America after Brazil.   The death toll is now at 4,506, the third highest in the region -- itself the new hotspot of the deadly disease -- after Brazil and Mexico, with President Martin Vizcarra warning the country is only halfway through the crisis.

Infections have jumped in Peru despite a months-long mandatory lockdown and a nigh time curfew and the government ordering international borders to be closed.   The spike is concentrated around the capital Lima, where one third of the population lives, and put tremendous strain on Peru's economy and healthcare system.   Four out of every ten Peruvians lost their source of income when the lockdown began, according to one study, and last week Peru secured a two-year, $11 billion credit line from the International Monetary Fund.

- 'Tremendous challenge' in Chile -
Neighbouring Chile on Sunday reported 57 more fatalities in the past 24 hours, a new record that brings the country's COVID-19 death toll to 1,054.   "We are facing the largest pandemic of the past 100 years," said Deputy Health Minister Paula Daza, as she announced the latest figures.    "It is a tremendous challenge; we are living very difficult times in our country."

In Santiago, where the 80 percent of the virus cases were reported, 96 percent of the emergency room beds were taken, officials said.   Officials reported a sharp increase in cases over the past two weeks.   In early May the government of President Sebastian Pinera said that the number of virus cases had hit a plateau, and lockdown restrictions would be loosened.
Date: Mon, 1 Jun 2020 03:38:38 +0200 (METDST)
By Anna SMOLCHENKO

Moscow, June 1, 2020 (AFP) - Shopping malls and parks are set to reopen in Moscow on Monday as the Russian capital eases coronavirus restrictions despite having the world's third-largest caseload.   The relaxation of the confinement orders in Moscow, the epicentre of Russia's outbreak with a population of more than 12 million, comes after President Vladimir Putin announced the epidemic had passed its peak in the country.

Under lockdown since March 30, residents of Europe's most populous city were until now only allowed to leave their homes for brief trips to shop, walk dogs or travel to essential jobs with a permit.   While Muscovites welcomed the opportunity to return to parks and malls after weeks of being cooped up at home, many ridiculed the Moscow mayor's "experiment" aimed at regulating people's walks and exercise.

As a two-week test measure, Sergei Sobyanin said residents of Moscow will be allowed to take walks according to a staggered schedule based on their home address.   "Regular walks are allowed between 9am and 9pm but no more than three times a week -- twice on weekdays and once on a weekend," said Sobyanin on his blog, adding that a detailed schedule would be released separately.   People can jog or exercise between 5am and 9am but must wear masks, according to the new rules.   Sobyanin said he feared that without limits on walking, people would throng the streets in scenes reminiscent of May Day outpourings in Soviet times.

- 'Sheer lunacy' -
The new regulations unleashed a flood of mockery on social media, with political commentator Alexander Golts calling them "sheer lunacy".   Critics quipped that life in Moscow was beginning to imitate dystopian fiction such as the novels of Aldous Huxley and Yevgeny Zamyatin.

Popular comedian Maxim Galkin, who has nearly eight million followers on Instagram, released a sketch in which Putin and Sobyanin discuss a "breathing schedule" for Moscow residents.   The five-minute parody has been viewed nearly six million times over the past few days.   When the restrictions are relaxed, dry-cleaners, laundry services and repair workshops will be allowed to reopen, while restaurants, cafes and cinemas will remain closed for now.

Moscow authorities also said that no mass gatherings would be allowed during the city-wide quarantine that will remain in place until at least June 14.   On Thursday authorities sentenced prominent reporter and activist Ilya Azar to 15 days in jail for staging a lone protest in central Moscow.   Dozens of his supporters have also been briefly detained over the past few days.   Rights organisations including Amnesty International and the Council of Europe have warned Moscow against using the coronavirus lockdown as a pretext to muzzle activists.

Many critics have also questioned the move to lift the restrictions as Russia reported more than 9,000 new infections on Sunday.   With more than 405,000 confirmed infections and over 4,600 deaths, the country has the world's third-largest caseload after the United States and Brazil.   Analysts say Putin is keen to open up the Russian economy and has recently ordered a World War II victory parade postponed by the contagion to be held on June 24.   The 67-year-old leader is also widely expected to announce a new date for a vote on constitutional reforms that could pave the way for him to potentially stay in power until 2036.
Date: Sun, 31 May 2020 11:16:20 +0200 (METDST)

Mogadishu, May 31, 2020 (AFP) - At least 10 people died and 12 were wounded when an explosive device ripped through a minibus outside the Somali capital Mogadishu on Sunday, the government said.   The deadly explosion occurred near Lafole village along the Afgoye-Mogadishu where the passenger bus was travelling early in the day.   "At least 10 civilians were killed in an explosion at Lafole area this morning, those who died were all civilians," the information ministry said in a statement, adding that the victims were on their way to a funeral.

Witnesses said the minibus was completely destroyed, and described an horrific scene with everyone on board either dead or wounded and many bodies ripped apart or burned beyond recognition.   "This was a horrible incident this morning, the explosive device went off as the bus was passing by the area and destroyed it completely," said Daud Doyow, a witness.   "Bodies of civilians were strewn in pieces and most of the people died," he added.   "There were more than 20 people on board and 10 of them were confirmed dead while the rest are seriously wounded and taken to hospital, this is a horrible scene here," said another witness, Abdirisak Adan.   No group immediately claimed responsibility for the bombing, but Somalia's al Qaeda-aligned Shabaab group carries out regular attacks in and around the capital, often killing civilians.
Date: Wed, 27 May 2020 17:58:12 +0200 (METDST)

Nairobi, May 27, 2020 (AFP) - Kenya said Wednesday it had documented a record 123 cases of coronavirus in the past 24 hours, a "staggering" figure although one also explained in part by wider testing.   "Today, I come to you with sombre news," Health Minister Mutahi Kagwe said.   "Our figures today are staggering. Out of the 3,077 samples tested, we have 123 positive cases. For the first time we have hit a triple digit.    "This is the highest number of positive cases we have ever recorded in a single day since we recorded the first case on March 13."

A total of 1,471 cases of COVID-19 have been recorded in Kenya since the start of the epidemic. Of these, 55 have been fatal.   The tally of infections has doubled since mid-May but the country has also tripled its number of daily tests, from less than 1,000 to nearly 3,000, which has helped unearth more cases.

Kagwe sounded a warning about the vulnerability of crowded slums in the capital Nairobi, which leads the list of new cases followed by the port city of Mombasa.   "There is a raging number of infections in these areas," he said, adding: "No-one should have a false sense of security about their immunity to COVID-19."   Among its anti-coronavirus measures, Kenya has a national 7pm-5am curfew, which is currently in force until June 6, and has a ban on entering or exiting the cities of Nairobi, Mombasa, Kilifi, Kwale and Mandera.
Date: Wed, 27 May 2020 16:38:21 +0200 (METDST)

Nicosia, May 27, 2020 (AFP) - Cyprus hopes to attract tourists after its coronavirus lockdown by paying the medical costs of anyone who tests positive for COVID-19 while holidaying on the island, officials said Wednesday.   The plan was outlined in a letter to tour operators and airlines detailing the measures Cyprus is taking to ensure the safety of its tourism sector.   The letter was made public Wednesday and signed by the ministers of foreign affairs, transport, and tourism.

The Mediterranean island is marketing itself as a safe holiday destination during the global pandemic.   The Republic of Cyprus has reported 939 novel coronavirus cases and only 17 deaths.   The government said it is "committed to taking care of all travellers who test positive during their stay, as well as their families and close contacts".   It pledged to cover accommodation, dining and medical care if a tourist falls ill with the virus.   The "traveller will only need to bear the cost of their airport transfer and repatriation flight," it said.

- 'Quarantine hotels' -
A 100-bed hospital will be available exclusively for tourists who test positive, with more beds available "at very short notice if required".   An additional 112 beds in intensive care units with 200 respirators will be reserved for critically ill patients.   Designated "quarantine hotels" will have 500 rooms available for family members and close contacts of patients.

Other hotels on the island will be allowed to remain open if a guest tests positive, but their room will "undergo a deep clean".   Authorities have forecast a 70 percent decline in tourist arrivals in 2020.    Tourism earned Cyprus EUR2.68 billion ($2.94 bn) in 2019 -- about 15 percent of gross domestic product -- down one percent from the previous year, which was bolstered by a record 3.97 million arrivals.   Cyprus plans to reopen its airports on June 9 to arrivals from 13 countries considered low risk.   These include Israel, Greece, Germany, Austria and Malta but the island's two biggest markets Britain and Russia are not on the approved list.

hose arriving between June 9-19 will need to provide a health certificate proving they do not have the virus.   That requirement will be dropped from June 20, when another six countries will be added to the approved list, including Switzerland and Poland.   Cyprus says it will update the list of approved countries on a weekly basis based on scientific advice.

Officials will administer temperature checks and free random testing of arrivals.   Having tested over 10 percent of its population, Cyprus says it has one of the lowest coronavirus infection rates in Europe.   "Very few countries worldwide, especially in the Mediterranean, can boast about such statistics," the letter said.
Date: Wed, 27 May 2020 14:45:11 +0200 (METDST)

Stockholm, May 27, 2020 (AFP) - Airline SAS said Wednesday it would resume flights on several domestic and international routes in June, over two months after the operator grounded most of its fleet over the new coronavirus' impact on travel.   "This primarily includes domestic flights within and between the Scandinavian countries, but flights to New York, Chicago and Amsterdam from Copenhagen are also set to resume," SAS said in a statement.

The Scandinavian airline announced in mid-March it was halting most of its traffic and furloughing around 90 percent of its staff.   In late April the airline, whose two largest shareholders are the Swedish and Danish states, announced it was laying off about 5,000 people, representing 40 percent of the company's workforce.

In early May the company secured a state-guaranteed credit line of 3.3 billion Swedish kronor ($344 million or 313 million euros) to help it navigate the impact of the new coronavirus.   Even with the resumption of some flights, the airline continues to operate at a reduced capacity, but the added routes means an effective doubling of the aircraft in use from 15 to 30, according to SAS.   Finnair, of Nordic neighbour Finland, announced early last week it would start resuming its long-haul flight to Asia in July.
Date: Wed, 27 May 2020 14:25:21 +0200 (METDST)

Yerevan, May 27, 2020 (AFP) - Virus cases have overwhelmed Armenia's hospitals, officials said Wednesday, raising the prospect that intensive care treatment could be restricted to patients with the best chance of survival.   The tiny Caucasus nation of some three million has so far reported 7,774 coronavirus cases and 98 deaths.   At a cabinet meeting on Wednesday, Prime Minister Nikol Pashinyan said "the situation with the coronavirus pandemic is very severe in Armenia."

Health ministry spokeswoman Alina Nikoghosyan told AFP: "if the current situation persists, in the coming days, intensive care will only be available for the patients with the best survival chances."   Health Minister Arsen Torosyan said Sunday that out of the country's 186 intensive care beds for coronavirus patients, only 32 remained empty and would soon be filled.

The prime minister called for stricter enforcement of measures aimed at containing the outbreak such as the wearing of face masks in public spaces.   This comes after the country lifted a state of emergency on May 4 which it had declared in March because of the pandemic.   Pashinyan said his government had failed to enforce anti-virus measures and there had been widespread quarantine violations.   "Our mistake was that we put too much trust in our citizens' sense of responsibility," he said.

Deputy Prime Minister Tigran Avinyan said he did not rule out that the government could have to impose a fresh nationwide lockdown.   Analysts have criticised the government's handling of the crisis, saying a decision to close borders was taken too late and officials sent the public "confusing messages."   "Officials were calling for the wearing of face masks, but they themselves didn't wear them until recently," said analyst Tatul Hakobyan.
Date: Wed, 27 May 2020 09:53:01 +0200 (METDST)

New Delhi, May 27, 2020 (AFP) - India is wilting under a heatwave, with the temperature in places reaching 50 degrees Celsius (122 degrees Fahrenheit) and the capital enduring its hottest May day in nearly two decades.   The hot spell is projected to scorch northern India for several more days, the Meteorological Department said late Tuesday, "with severe heat wave conditions in isolated pockets".   As global temperatures rise, heatwaves are a regular menace in the country -- particularly in May and June. Last year dozens of people died.

Met officials said Churu in the northern state of Rajasthan was the hottest place on record on Tuesday, at 50 Celsius, while parts of Punjab, Haryana and Uttar Pradesh sweltered in the high 40s.   Parts of the capital, New Delhi, recorded the hottest May day in 18 years with the mercury hitting 47.6 Celsius.   No deaths have been reported so far this year, but last year the government said the heat had killed 3,500 people since 2015. There have been fewer
fatalities in recent years.

The country of 1.3 billion people suffers from severe water shortages with tens of millions lacking running water -- to say nothing of air conditioning.   Parts of Delhi and elsewhere regularly see scuffles when tankers arrive to deliver water. Last year Chennai made international headlines when the southern city ran out of water entirely.   The heatwave adds to problems the country already has dealing with the spread of coronavirus.   India now has the 10th highest number of coronavirus cases globally, climbing above 150,000 on Wednesday with almost 4,500 deaths.

Last week cyclone Amphan killed more than 100 people as it ravaged in eastern India and Bangladesh, flattening villages, destroying farms and leaving millions without power.   Huge swarms of desert locusts, meanwhile, have destroyed nearly 50,000 hectares (125,000 acres) of crops across western and central India, and may enter Delhi in coming days.   The north-eastern states of Assam and Meghalaya are also currently experiencing floods, with more heavy rainfall forecast in the coming days.