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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: Fri, 8 Mar 2019 11:58:53 +0100
By Shatha Yaish

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

[HealthMap/ProMED-mail maps:
United Arab Emirates: <http://healthmap.org/promed/p/132]
Date: Wed 5 Sep 2018
Source: BBC [edited]

A total of 19 people have been taken ill after an Emirates airline plane landed in New York, officials say. The plane was quarantined at JFK airport as those on board were checked by health officials. As many as 10 were taken to hospital but others refused treatment.

The US Centers for Disease Control and Prevention (CDC) said that initially about 100 people including some crew had complained of illness. Flight 203 from Dubai landed at 09:10 (13.10 GMT) with 521 passengers.

Emergency vehicles were seen on the runway as it landed. Soon afterwards, Emirates airline tweeted that the sick passengers were being attended to and those who were unaffected would be allowed to leave the plane.

The CDC said in a statement that is was "aware of an Emirates flight from Dubai that arrived this morning at JFK".

"Approximately 100 passengers, including some crew on the flight, complained of illness including cough and some with fever.

"CDC public health officers are working with... officials to evaluate passengers including taking temperatures and making arrangements for transport to local hospitals those that need care."

Later Eric Phillips, spokesman for New York Mayor Bill de Blasio, confirmed that all the passengers were off the plane and the sick people had been taken to hospital.

He said that some of the passengers had originally come from the Saudi Arabian city of Mecca, which was currently experiencing a flu outbreak, and that the passengers' symptoms were "pointing to the flu".
Date: Mon 28 May 2018
Source: EMPRES-I (Global Animal Disease Information System) [edited]

According to an EMPRESS report issued today [Mon 28 May 2018], there was a human case of MERS-CoV infection confirmed by PCR testing in Gayathi, Abu Dhabi, United Arab Emirates. This report was based on an OIE report.

No further information was provided.
=====================
[The most recent confirmed human MERS-CoV infection in the UAE was reported in December 2017 and involved an Omani camel herder who was identified as an asymptomatic infection. This was detected as part of border screening of camels on entry to the UAE following the detection of positive MERS-CoV infection in the camels (see MERS-CoV (01): Malaysia (ex KSA), Saudi Arabia, UAE (ex Oman) http://promedmail.org/post/20180102.5532148).

I was unable to find more information on the case mentioned in the EMPRES report above, from either the HAAD (Health Authority of Abu Dhabi) website, or the OIE or EMPRES websites. Questions that come to mind include: demographics (age, sex); clinical picture (was this based on clinical illness in the human or was this part of screening after identification of MERS-CoV infected camels entering the UAE (where screening is typically done); possible high risk exposures (either contact with camels, contact with other known cases, contact with the health sector before onset of illness, or history of travel to other geographic areas where MERS-CoV circulation is known).

More information from knowledgeable sources would be greatly appreciated.

The HealthMap/ProMED map of the UAE can be found at:
Date: Thu 21 Sep 2017
Source: Eurosurveillance Edition 2017, 22(38) [edited]

ref: Dabrera G, Brandsema P, Lofdahl M, et al. Increase in legionnaires' disease cases associated with travel to Dubai among travellers from the United Kingdom, Sweden and the Netherlands, October 2016 to end August 2017. Euro Surveill. 2017; 22(38): pii=30618.
----------------------------------------------------------------------
Abstract
--------
Between 1 Oct 2016 and 31 Aug 2017, 51 legionnaires' disease (LD) cases from the United Kingdom (UK), Sweden, and the Netherlands were identified with associated travel to Dubai. Cases did not all stay in the same accommodation, indicating that no single accommodation could be the source for all these infections. While local investigations continue into other potential sources, clinicians should remain alert to the possibility of LD among travellers returning from Dubai with respiratory illness.

Introduction
------------
In December 2016, the European Centre for Disease Prevention and Control (ECDC) reported an increase in legionnaires' disease (LD) cases associated with travel to Dubai, United Arab Emirates (UAE) [1] based on cases reported to ELDSNet (European legionnaires' disease surveillance network), an ECDC-operated surveillance system among European Union (EU) countries, Iceland, and Norway [2] for laboratory-confirmed, travel-associated LD (TALD) cases who stayed in commercial accommodation site(s) (such as hotels) during the 2-10-day incubation period.

As this increase in Dubai-associated TALD cases continues, we describe cases reported with symptom onset between 1 Oct 2016 and 31 Aug 2017 among residents from the UK, Sweden, and the Netherlands (the 3 countries that were initially reporting the largest numbers of cases). We describe the ongoing situation as at 18 Sep 2017 to provide further insight into the observed increase and create awareness among physicians and travellers returning with compatible symptoms to consider legionella as a differential diagnosis [1].

[The full Eurosurveillance article can be accessed at the source URL above. - ProMED Mod.ML]
====================
[Dubai is one of the 7 emirates and the most populous city of the United Arab Emirates (UAE) (<http://en.wikipedia.org/wiki/Dubai>). Dubai has become a popular tourist destination. It is said to be the 4th most visited city in world, with over 15 million visitors in 2016, after London, Paris, and Bangkok (<https://www.khaleejtimes.com/listicles/dubai-worlds-fourth-most-popular-destination-in-2016>).

Overnight visitors in Dubai spent almost USD 11 billion in 2014

Dubai can be located on the HealthMap/ProMED-mail interactive map at

In 2009, ProMED-mail first reported legionnaires' disease in 3 travellers to Dubai, one of whom from the UK died (Legionellosis, fatal, hotel - United Arab Emirates: (Dubai) http://promedmail.org/post/20090205.0509). In December 2016, ProMED-mail reported an increase in the number of cases of legionnaires' disease in 2016, compared with previous years, in European travelers returning from Dubai, with 26 cases having their onset of illness since 1 Oct 2016 (Legionellosis - EU: EU travellers, ex United Arab Emirates (Dubai) susp http://promedmail.org/post/20161230.4733569). In June 2017, ProMED-mail reported that an additional 34 cases among European travelers to Dubai, with the most recent case becoming ill in May 2017, suggesting an ongoing exposure risk (Legionellosis - Europe (03): ex United Arab Emirates (Dubai) http://promedmail.org/post/20170602.5079438).

According to the Eurosurveillance report above on 51 legionnaires' disease cases with symptom onset between 1 Oct 2016 and 31 Aug 2017, from the UK, Sweden, and the Netherlands associated with travel to Dubai, of 43 cases staying in commercial accommodation only 15 stayed in sites where there were 2 or more cases, whereas 27 stayed in sites where there were no other cases. In addition, 3 of the 51 cases were associated with a foreign-travel related cluster in other countries.

Of the 51 cases of legionnaires' disease, 50 were infected by organisms speciated as _Legionella pneumophila_. However, the serogroup was known for only 16 cases: 13 of the 16 were serogroup 1, 2 were serogroup 13 and 1 was serogroup 2-14. Sequence-based typing (ST) was available for only 9 cases: 6 cases were ST616, and 3 cases were ST1327. ST616 was only observed in cases associated with travel to Dubai and ST1327 was associated with travel to Dubai for all but one case. Furthermore, 11 cases spent their entire incubation period in Dubai. These findings supported the assertion that at least some of these infections occurred within Dubai. However, the cases for whom sequence-based typing was available were all linked to different accommodations sites.

No increase in pneumonia notifications occurred locally in Dubai between October and December 2016, which suggested an environmental _Legionella_ source in Dubai that might have been frequented more often by foreign travelers than by local residents. Another explanation was that the local Dubai population is predominantly young, with only 8.7 percent in the 50 years or older age group in 2016, and therefore potentially at lower risk for legionnaires' disease than foreign travelers. Also, the investigators noted that the increase in cases of legionnaires' disease among European travelers to Dubai could not be fully explained by an increase in the number of European travelers to Dubai, but so far no environmental sources have been identified in Dubai. - ProMED Mod.ML]
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Senegal

Senegal - US Consular Information Sheet
July 08, 2008
COUNTRY DESCRIPTION: The Republic of Senegal is a developing West African country.
The capital is Dakar.
Facilities for tourists are widely available but vary in quality.
Read
the Department of State Background Notes on Senegal for additional information.
ENTRY/EXIT REQUIREMENTS:
A passport is required.
For U.S. passport holders, a visa is not required for stays of less than 90 days.
Current yellow fever vaccination is mandatory to enter Senegal and meningitis vaccination is highly recommended if the traveler is arriving from or has recently traveled to an endemic area.
Travelers unable to provide proof of vaccinations may be required to pay for and receive vaccinations at the Dakar airport.
Travelers should obtain the latest information on entry requirements from the Embassy of Senegal, 2112 Wyoming Avenue NW, Washington, DC 20008, telephone (202) 234-0540, and at the Senegal Tourism Authority's official web site, http://www.senegal-tourism.com.
Overseas inquiries should be made at the nearest Senegalese 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:
Public demonstrations, political gatherings, and student protests are relatively common in Senegal, both in Dakar and in outlying regions, particularly on Friday afternoons. In the past, these events have sometimes turned violent.
Due to the potential for violence, U.S. citizens should avoid political gatherings and street demonstrations, and maintain security awareness at all times.
For guidelines on dealing safely with public demonstrations, please see the American Citizen Services page of the U.S. Embassy Dakar web site at http://dakar.usembassy.gov/service.html.
Lac Rose (Pink Lake) is a popular tourist destination in Senegal.
The Lac Rose area has a large number of tourists and isolated beach areas, but lacks multiple exit and entry points.
The U.S. Embassy recommends that all visitors to Lac Rose and its surrounding beaches be particularly vigilant and not travel alone.
Banditry occurs with some regularity on the main highways after dark, particularly in the central and eastern area of Senegal, including around Tambacounda and Matam. Bandits often target RN2 (National Road) between Ndioum and Kidira and occasionally target RN1 between Kidira and Tambacounda.
The U.S. Embassy recommends that U.S. citizens avoid non-essential travel to the Casamance region west of the city of Kolda, except direct air travel to the Cap Skirring resort area or to the city of Ziguinchor.
If travel is deemed essential, the U.S. Embassy recommends that U.S. citizens carefully monitor the security situation before traveling.
There are currently instances of fighting in the Casamance region (composed of the Ziguinchor and Kolda regions) involving factions of the Casamance separatist MFDC (Mouvement des Forces Démocratiques de la Casamance) in southern Senegal and the Senegalese military. Some military and political leaders in the Casamance region have been killed.
In May 2008, rebels kidnapped 16 local residents 5 kilometers from Ziguinchor and then cut off their left ears before releasing them.
That same month two soldiers and a peasant were killed in other clashes near the same area.
Reports of banditry in the area remain high.
In addition, vehicles have been attacked by armed bandits even during daylight hours on well-traveled roads.
On February 14, 2007, four people were killed when their bus was attacked after being stopped at a roadblock.
Landmine explosions continue to plague inhabitants of the Casamance, with fatalities and serious injury continuing into 2008.
One man was killed in Tounkara, approximately 70 kilometers north of Ziquinchor.
A Senegalese soldier was injured by a landmine near Boutoupa-Camaracounda, on the border with Guinea Bissau.
Since 1990, more than 1,000 people have been killed by land mines in the Casamance. The U.S. Embassy strongly recommends that U.S. citizens remain on well-traveled routes at all times.
For the latest security information, Americans traveling abroad should regularly monitor the Department of State, Bureau of Consular Affair’s Internet site at http://travel.state.gov, where the current Travel Warnings and Public Announcements, including the Worldwide Caution, can be found.

Up-to-date information on safety and security can also be obtained by calling 1-888-407-4747 toll free in the U.S. 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:
Minor street crime is very common in Senegal, particularly in cities.
Most reported incidents involve pickpockets and purse-snatchers, who are especially active in large crowds and around tourists. Aggressive vendors, panhandlers and street children may attempt to divert the victim’s attention while an accomplice carries out the crime.
To avoid theft, U.S. citizens should avoid walking alone in isolated areas or on beaches, particularly at night, lock their doors and close their windows when driving, and avoid public transportation.
Americans should not walk on dark streets at night, even in groups.
To minimize inconvenience in the event of theft, U.S. citizens should carry copies, rather than originals, of their passports and other identification documents.
U.S. citizens should carry a credit card only if it will be used soon, rather than carrying it as a routine practice.
There is traditionally an increase in crime before major religious holidays.
U.S. citizens are encouraged to use common sense and situational awareness to ensure personal safety and to reduce the risk of becoming a crime victim.
Always be aware of the surroundings, especially in large cities and crowded places such as markets and taxi parks.
Keep a low profile, remain vigilant, and avoid potential conflict situations.
Do not wear flashy clothing or jewelry, and be cautious about displaying any amount of currency in public.
Use common sense when faced with something out of the ordinary or if someone is following you.
While violent crime is not common in Senegal, it does occur.
There have been incidents in the past year of Americans in groups of two or three being robbed at knife-point.
If confronted by criminals, remember that cash and valuables can be replaced, but life and health cannot.
U.S. citizens are encouraged to walk away from a criminal confrontation no matter the material cost.
Break-ins at residential houses occur frequently as in major cities everywhere.
Persons who plan to reside in Senegal on a long-term basis should take measures to protect their dwellings.
Long-term residents should consider installation of window grilles, solid core doors with well-functioning locks, and an alarm system.
In the past year, a number of American citizen residences have experienced burglaries.
No violence or personal injuries have been reported in these cases, in which the burglars appear to have been exclusively seeking financial gain.
Fraud is prevalent in Senegal and U.S. citizens are often the target of scams that may cause both financial loss and physical harm.
Typically, business scam operations begin with an unsolicited communication (usually by e-mail) from an unknown individual who describes a situation that promises quick financial gain, often by the transfer of a large sum of money or valuables out of West Africa.
The perpetrators of these scams often claim to be victims of various western African conflicts (notably refugees from Sierra Leone) or relatives of present or former political leaders.
There are many variations of these business scams.
In some cases, a series of “advance fees” must be paid in order to conclude the transaction, such as fees to open a bank account, or to pay certain taxes.
In fact, the final payoff does not exist since the purpose of the scam is simply to collect the advance fees.
Another common variation consists of a request for the U.S. citizen's bank account information, purportedly to transfer money into the account.
Once the perpetrator obtains this information, however, he or she then simply transfers all money out of the victim's account.
Other variations include apparently legitimate business deals requiring advance payments on contracts and offers to sell gold at a very low price.
In the last case, the seller may present real gold to be verified then substitute fake gold and disappear with the payment.
The best way to avoid becoming a victim of advance-fee fraud or business scam is to use common sense:
If an offer seems too good to be true, it is probably a scam.
You should carefully research any unsolicited business proposal originating in Senegal before you commit funds, provide goods or services, or undertake travel.

Visa scams take advantage of people who wish to travel to the U.S.
Generally, these scams "guarantee" a U.S. visa for participants who pay a large sum of money to register for a conference or attend an event in the United States.
In fact, only consular officers of the U.S. State Department may issue visas, so any offer that guarantees a U.S. visa is a scam.
Please refer to the State Department web site at http://travel.state.gov or the web site of the U.S. Embassy in Dakar at http://dakar.usembassy.gov/visas.html for authoritative information about the visa process and the costs involved.
In addition to business and visa scams, personal and dating scams are also prevalent. U.S. citizens should be wary of persons claiming to live in Senegal who profess friendship or romantic interest over the Internet.
A chat or e-mail exchange which quickly moves to discussion of intimate matters is often an indication of a scam.
Beware of any request or appeal for money.
In a typical personal scam, the scammer typically asks the U.S. citizen to send money for essential purposes: living or travel expenses, medical treatment, visa costs or bribes to free unjustly imprisoned family members.
Scammers often claim emergency circumstances, hoping that the intended victim will send money quickly and without careful consideration.
Many variations of these scams exist, all with the principal goal of soliciting money from the victim.
Several U.S. citizens in West Africa have reported losing thousands of dollars through such scams.
The anonymity of the Internet means that the U.S. citizen cannot be sure of the real name, age, marital status, nationality or even gender of the correspondent.
In some cases, the correspondent is a fictitious persona created only to lure the U.S. citizen into sending money.
U.S. citizens may prepay for a plane ticket directly with an airline rather than wiring money for transportation to the traveler.
U.S. citizens may also research the legitimate immigration process with the United States Citizenship and Immigration Services (USCIS) web site at http://www.uscis.gov.
U.S. citizens who are victims or witnesses of a crime are encouraged to report crimes to the police by telephoning 800-00-20-20; 800-00-17-00, Senegal's police hotline numbers. Another 24 hour phone number for the police in Senegal is 33-821-2431.
The Government of Senegal has also created a tourist police unit, which may be reached at (+221)33 860-3810.

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 Senegal is 800-00-20-20 and 800-00-17-00. See our information on Victims of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION:
Several hospitals and clinics in the capital, Dakar, can treat major and minor injuries and illnesses.
There is inadequate inpatient psychiatric care and limited office-based psychiatric treatment.
Public hospitals do not meet U.S. standards.
Medical facilities outside Dakar are limited.
French medications are far more readily available than American pharmaceuticals, and drugs in stock are often listed under the French trade name.
Medications may be obtained at pharmacies throughout Dakar and in other areas frequented by tourists, and are usually less expensive than in the U.S. Travelers should carry a supply of any needed prescription medicines, along with copies of the prescriptions, including the generic name for the drugs, and a supply of preferred over-the-counter medications.
Malaria is a serious risk to travelers in Senegal.
Travelers should consult their physician to discuss the benefits and risks of taking anti-malarial medication.
Travelers who become ill with a fever or flu-like illness while traveling in a malaria-risk area and up to one year after returning home should seek prompt medical attention and tell the physician their travel history and what anti-malarial medications they have been taking.
For additional information on malaria, protection from insect bites, and anti-malarial drugs, visit the CDC Travelers' Health web site at http://www.cdc.gov/malaria/faq.htm.
Water supplies in Senegal are not consistently free of disease-causing microorganisms.
For this reason, the Embassy recommends drinking filtered or boiled water, particularly for babies under one year of age.
Raw vegetables and fruits should be washed in a bleach solution before eating.
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 Senegal is provided for general reference only, and may not be totally accurate in a particular location or circumstance.
Driving in Senegal is very different from driving in the United States.
Many U.S. citizens find the traffic in Senegal chaotic, particularly in Dakar.
Drivers tend to exceed speed limits, follow other vehicles closely, ignore lane markings and attempt to pass even when facing oncoming traffic.
Many vehicles are not well-maintained; headlights may be either extremely dim or not used at all. Roadways are poorly lit and poorly marked and many sections have deteriorated surfaces.
Some roads have sidewalks or sufficient space for pedestrian traffic; others do not, and pedestrians are forced to walk along the roadway.
Due to limited street lighting, pedestrians are difficult to see at night.
Drivers in both rural and urban areas may expect to frequently encounter and share the road with motorcycles, bicyclists, pedestrians, livestock and animal carts.
Caution and defensive driving techniques are strongly recommended.
While most main roads in Senegal are in relatively good condition for daytime driving, smaller roads are poor by American standards.
During the rainy season, many roads are passable only with four-wheel drive vehicles.
Travelers may be stopped at police roadblocks throughout the country, where their vehicles and luggage may be searched.
Service stations are available along main roads.
Due to poor road conditions and the risk of crime, driving outside major cities at night is not recommended.
Due to language barriers (outside Dakar, relatively few Senegalese speak French) and the lack of roadside assistance, receiving help may be difficult in the event of distress.
For safety reasons, the Embassy recommends against the use of motorbikes, van taxis ("cars rapides"), and public transportation.
They can be dangerous due to overloading, careless driving, inadequate maintenance, and the lack of basic safety equipment such as seat belts.
Regulated orange-striped sedan auto taxis are safer, but make sure to agree on a fare before beginning the trip.
In Senegal, one drives on the right-hand side.
Vehicles give priority to traffic coming from the right, except at traffic circles, where vehicles already in the circle have the right of way.
Before January 2005, however, cars entering traffic circles had the right of way.
This change is not well known, so drivers should exercise extreme caution at traffic circles.
All drivers are expected to carry the following documents in their vehicles and present them at any time at the request of the police:
(1) valid driver's license; (2) valid insurance papers; (3) vehicle registration/immatriculation card ("carte grise"); (4) "vignette" tax disc for the current year; and (5) valid identification.
If Americans carry a copy of their U.S. passport, the copy must be clear enough to identify the driver of the vehicle.
Third-party insurance is required and will cover any damages if you are involved in an accident resulting in injuries, and found not to have been at fault.
If you are found to have caused an accident, the penalty ranges from five months to two years in prison, with a possible fine.
If you cause an accident which results in a death, the penalty can be as high as five years in prison.
For guidance on what to do if you are in an automobile accident in Senegal, please see the American Citizen Services page of the U.S. Embassy Dakar web site at http://dakar.usembassy.gov/service/living-in-senegal-and-guinea-bissau/driving-in-senegal.html.
Senegalese law prohibits the use of cell phones while driving, unless the driver is using “hands-free” equipment.
Protective helmets are mandatory for all bicycle, moped, scooter and motorcycle drivers/riders and passengers.
When police officers stop a vehicle for a traffic violation, the police officer will generally confiscate the driver’s license or ID card until the fine is paid.
We encourage you to comply with the request. Sometimes, police officers try to solicit bribes instead of or in addition to the fine.
The U.S. Embassy does not encourage paying bribes. 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 Senegal, the U.S. Federal Aviation Administration (FAA) has not assessed Senegal’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:
Senegalese law requires that all persons carry personal identification at all times, and all Senegalese law enforcement officials have the authority to challenge suspicious activity and to request personal identification.
Be aware that they may request personal identification even without cause, which is generally not the case in the U.S.
If a U.S. citizen does not cooperate and provide identification, s/he may be detained for up to 48 hours without the filing of formal charges.
The U.S. Embassy does not always receive timely notification by Senegalese authorities of the arrest of U.S. citizens. U.S. citizens are encouraged to carry a copy of their U.S. passports with them at all times, so that, if questioned by local officials, proof of identity and U.S. citizenship is readily available. If arrested, U.S. citizens should always ask to be allowed to contact the U.S. Embassy.
You may not bring several types of items into Senegal without clearance by Senegalese customs officials: these include computers and computer parts, video cameras and players, stereo equipment, tape players, auto parts, and various tools and spare parts.
Airport customs officials may hold such items if brought in as baggage or carry-on luggage.
Travelers should check with the Embassy of Senegal in Washington, DC, regarding these restrictions. (See Entry Requirements Section above for contact information.)
Senegalese customs authorities encourage the use of an ATA (Admission Temporaire/Temporary Admission) Carnet for the temporary admission of professional equipment, commercial samples, and/or goods for exhibitions and fair purposes.
ATA Carnet Headquarters, located at the U.S. Council for International Business, 1212 Avenue of the Americas, New York, NY 10036, issues and guarantees the ATA Carnet in the United States.
For additional information, call (212) 354-4480, send an email to atacarnet@uscib.org or visit http://www.uscib.org for details.
Travelers can obtain cash from some ATMs in Senegal.
Travelers can get cash and/or traveler's checks through international credit cards, such as Master Card, Visa, and American Express, by presenting their credit card at a local financial institution sponsoring their card. 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 Senegalese laws, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in Senegal 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 Senegal 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 Senegal.
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 Avenue Jean XXIII, Dakar; the mailing address is B.P. 49, Dakar, Senegal.
The telephone number is (221) 33 829-2100; after hours (221) 33 829 2209.
The U.S. Embassy web site is http://dakar.usembassy.gov/.
*

*

*
This replaces the Country Specific Information Sheet for Senegal dated November 08, 2007 to update sections on Country Description, Entry/Exit Requirements, Crime, Safety and Security, Information for Victims of Crime, Medical Facilities and Health Information, and Registration and Embassy Location.

Travel News Headlines WORLD NEWS

- National. 12 Nov 2018

Suspected cases totalling 2123 with 216 confirmed have been reported across 6 regions, with one death confirmed, as of 3 Nov 2018. The CDC has issued a travel warning. The 6 regions currently reporting confirmed cases are Diourbel (169), Fatick (34), St. Louis (6), Dakar (3), Louga (3) and Thies (1).

- National. 9 Nov 2018. The US Centers for Disease Control and Prevention (CDC) has issued a Level 1, Practice Usual Precautions, for the African country of Senegal, on 7 Nov 2018. Senegal, which is located on the north-west coast of central Africa, is an important partner of the US in promoting peace and security. Because dengue is a viral disease and spread by mosquito bites, all travellers to Senegal should prevent mosquito bites by using insect repellent and wearing protective clothing when outdoors, and sleeping in an air-conditioned or well-screened room or under an insecticide-treated bed net, said the CDC. Moreover, half of the world's population living in 128 countries is at risk of dengue.

[HealthMap/ProMED-mail map of Senegal:
Date: Sun, 21 Oct 2018 16:38:21 +0000
A ProMED-mail post

- National. 19 Oct 2018. In the capital of Sine, there are currently 31 cases. In the capital of Mouridism, there are 8 cases; 6 cases were counted in Rosso, Senegal.

- National. 15 Oct 2018. Dengue fever worries the population in several localities of Senegal. Fatick area has 3 cases. Currently, at least 23 dengue cases have been confirmed in the same region of Fatick (center), following tests on 487 suspected cases, revealed the chief of the commune, Mamadou Sarr at the beginning of October 2018.

In Senegal, dengue fever is concentrated this year [2018] in the Fatick region. In September 2018, 3 cases had been counted; the number rose to 23 cases in October 2018. According to the chief medical officer of the local area relayed by the Senegalese press agency: "Following tests on 487 suspected cases, at least 23 dengue cases were confirmed, and the average age of people affected by the disease varies between 20 and 40 years old. Most are women.

This is the 4th dengue epidemic in Senegal. On 19 Oct 2017, the disease was revealed to the public in the Louga region. The Institut Pasteur in Dakar confirmed the diagnosis of 9 cases of dengue fever out of a total of 24 samples received on 6 and 12 Oct 2017, respectively, which had been carried out at the Santhiaba health post in Louga commune, in northwest Senegal. On 27 and 28 Oct 2018, 2 other confirmed cases were recorded in the commune of Dahra, next to that of Louga. On 6 Nov 2017, the Senegalese health authorities recorded 79 confirmed cases out of 510 samples tested: 70 in Louga, 6 in Dahra, 2 in Coki, 1 in Keur Moma Sarr. "No serious case is noted so far. All the patients have been treated as outpatients," said the Ministry of Health and Social Action.

This is not the 1st time that an outbreak of dengue fever has been reported in the country. There were outbreaks also in 1981, 1984 and 2009, said Dr. Abdoulaye Bousso of the Center for Emergency Health Operations (COUS), an entity under the supervision of the Ministry of Health and Social Action in 2017. As of 30 Oct 2017, a total of 232 suspected patients, out of 36 positive cases (34 in Louga and 2 in Dahra), had been enumerated by the Senegalese health authorities. "No complication was noted in these patients; all patients diagnosed positive are doing well and have resumed their daily activities," said the Ministry of Health. For this year [2018], the number increased to 32 confirmed cases.
Date: Thu, 3 May 2018 17:48:15 +0200

Ziguinchor, Senegal, May 3, 2018 (AFP) - Armed men tried to blow up a key bridge in a touristy part of Senegal's restive Casamance region, killing a fisherman, a military source said on Thursday.   The overnight attack on the Niambalang bridge near the Casamance capital Zinguinchor was the first on the bridge since 1998.   "Armed men tried to blow up the bridge with explosives" but failed, a military source told AFP.

They torched the huts of eight fishermen living underneath the bridge, killing one, the source said. A relative of the fisherman confirmed this.   The bridge links Zinguinchor to the beach resort of Cap Skirring, which is popular with Western tourists.   Tensions have mounted in Casamance following the massacre of 14 young men in execution-style killings in a protected forest on January 6.   The bloodbath caused some to blame a group that has led a 35-year armed campaign for the region's independence.
Date: Fri 19 Jan 2018
Source: WHO [edited]

On [3 Jan 2018], the Ministry of Health of Senegal notified WHO of a case of Rift Valley fever (RVF) reported from a hospital in Dakar. On [29 Dec 2017], a blood sample taken from a 52-year-old Korean man, resident in the Gambia, done at the Institute Pasteur Dakar, was positive for RVF on IgM testing. Previous PCR testing had been negative for RVF and other arboviruses.

The case patient worked for a fishing company in the Gambia and had no known history of handling raw meat. On [5 Dec 2017], the case patient travelled with his brother and 2 colleagues from Banjul, the Gambia, to Ziguinchor, Senegal. On [8 Dec 2017], the case patient continued travelling with his brother, a colleague, and a driver, from Ziguinchor to Bissau, Guinea-Bissau, and continued to Buba the following day. On [10 Dec 2017], the case patient returned from Buba to Bissau, and presented with a dry cough, fever, headache, and joint pain. His brother and the driver also developed a dry cough on [10 Dec 2017], which improved the following day. The group returned to the Gambia (via Ziguinchor) on [12 Dec 2017].

The case patient, however, continued to suffer a persistent cough during this time. On his return to Banjul, he additionally developed fever, headache, and vertigo. He was hospitalized on [20 Dec 2017] and diagnosed with severe malaria. On [23 Dec 2017], he became delirious and developed psychomotor agitation, profuse mucousy diarrhoea, bile-stained vomiting, and haemorrhage. On [25 Dec 2017], he became comatose and was evacuated by ambulance to Dakar. His symptoms improved, and blood samples were taken on 26, 28, and 30 Dec 2017. However, he experienced a recurrence of haemorrhagic symptoms on 31 Dec 2017 and died the same day.

Public health actions
A case investigation was conducted by a multidisciplinary team from the Centre of Health Emergency Operations of the Ministry of Health of Senegal. As part of this investigation, blood samples were collected from the brother of the case and the colleague and driver who accompanied him to Guinea-Bissau. These samples were all negative for RVFV by PCR. The results of the investigation and recommendations for action from the Ministry of Health of Senegal are pending. A case investigation was conducted by a multidisciplinary team from the Epidemic and Disease Control Unit of the Ministry Health of the Gambia. Enhanced RVF surveillance in the animal population and community RVF sensitization have been implemented in the country.

Situation interpretation
Outbreaks of RVF are uncommon in the Gambia and its neighbouring countries. The last documented human case of RVF in the Gambia was reported in 2002. There is currently no indication of risk of a major RVF outbreak in the Gambia, Senegal, or Guinea-Bissau. Heavy rainfall, causing flooding and mass emergence RVF vectors, _Aedes_ and _Culex spp._ mosquitoes, is closely associated with RVF outbreaks. Uncontrolled movement of livestock can increase the risk of spread of the disease to new areas. RVF can cause trade reductions and important economic losses due to high mortality and abortion rates among infected livestock. Integrated control measures that address both human and animal health are therefore necessary (e.g. preventive animal vaccination, vector control, control of animal movements, educational campaigns for populations at risk).
====================
[The case, who travelled in 3 different countries (The Gambia, Senegal, and Bissau) was diagnosed as being affected by malaria. Later, this person and people accompanying him exhibited symptoms that can be attributed to RVF. However, all of the other 3 tested negative, while the case was diagnosed RVF positive on IgM testing and negative on PCR. The situation needs some clarification, especially since it is not the flooding season in the region, which favors the multiplication of disease vector insects and thereby precipitates the appearance of RVF in animals with possible contamination of humans. - ProMED Mod.AB]

[Rift Valley fever (RVF) virus can persist for a long time in some areas, maintained in _Aedes_ vector mosquitoes that deposit eggs in seasonally-flooded areas, where those eggs are transovarially infected with the virus. Adult female mosquitoes coming from infected eggs can transmit the virus during their 1st blood meals. Eradicating the virus from these areas is not possible with current technology.

Although ProMED-mail has not previously posted cases of RVF in the Gambia, there is a report from neighboring Senegal. - ProMED Mod.TY]

[Mauritania, a country in close proximity (neighboring with Senegal to its north) has also experience recurrent outbreaks of RVF (see prior ProMED-mail posts). - ProMED Mod.MPP]

[HealthMap/ProMED-mail map:
Date: Fri, 15 Dec 2017 17:03:27 +0100

Dakar, Dec 15, 2017 (AFP) - Flights to and from Dakar's brand-new airport were cancelled on Friday after air traffic controllers went on strike just eight days after it opened.   Controllers announced they would strike for 24 hours from 0001 GMT Friday, Blaise Diagne International Airport's operators, LAS, said in a statement.   The company "deplores the consequences of this movement, which strongly impacts the image of Senegal, as well as the service provided to passengers and airlines", it said.

The air traffic controllers' association, Asecna, did not immediately respond to a request for comment.   President Macky Sall had inaugurated the airport on December 7 in the presence of fellow heads of state from Gabon, Guinea-Bissau and The Gambia. He was due to return to the country on Friday evening after a trip abroad.

The Senegalese press say air traffic controllers are aggrieved over working conditions, especially the problem of getting to the airport which is much farther from the capital than the previous one.   The airport is located in Diass, 47 kilometres (29 miles) southeast of Dakar. Its predecessor,  Leopold Sedar Senghor international airport, now a military airport, is in Dakar's suburbs.
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World Travel News Headlines

Date: Tue, 21 May 2019 12:37:30 +0200

Khartoum, May 21, 2019 (AFP) - Sudanese protest leaders called on their supporters Tuesday to prepare for a general strike after talks with the country's military rulers stalled on who will lead an agreed three-year transition.   Protest leaders had reached agreement with the ruling military council on the other main aspects of the transition.   But early on Tuesday, the generals who overthrew veteran president Omar al-Bashir last month baulked at protesters' demands for a civilian head and a civilian majority for an agreed new sovereign council to lead the transition.

"In order to achieve a full victory, we are calling for a huge participation in a general political strike," said the Sudanese Professionals Association, which took the lead in organising the four months of nationwide protests that led to Bashir's ouster.   "The strike is our revolutionary duty and the participation in the sit-in ... is a crucial guarantee to achieve the goals of the revolution."

Protest leader Madani Abbas Madani told AFP the preparations for a "general political strike and civil disobedience" were already under way.   "Whenever we will decide on applying these plans, we will make an announcement," said Madani, a prominent leader of protest umbrella group the Alliance for Freedom and Change.   The two sides launched what had been billed as a final round of talks on the transition late on Sunday.

The military council has faced pressure from Western government and the African Union to agree to a civilian-led transition -- the central demand of the thousands of demonstrators who have spent weeks camped outside army headquarters in Khartoum.   When talks broke up early on Tuesday, neither side said when they would resume.

Protest leader Siddiq Yousef told reporters they had been suspended.   "The main point of dispute that remains is concerning the share of representatives of the military and the civilians in the council and who will be the head of the new body," the two sides said in a joint statement.   The military council has been pushing for its chairman General Abdel Fattah al-Burhan to head the new sovereign council but protest leaders want a civilian.
Date: Tue, 21 May 2019 05:22:30 +0200
By John WESSELS with Samir TOUNSI in Kinshasa

Butembo, DR Congo, May 21, 2019 (AFP) - People in Ebola-hit eastern DR Congo are struggling to come to terms with high-security burials that are part of a hard-pressed strategy to roll back the disease.   Anyone who dies of the highly infectious haemorrhagic fever has to be buried in carefully-controlled conditions designed to minimise the risk of infection from body fluids.   But that means ceremonies are carried out in sanitised conditions, with relatives and friends kept at a distance -- for many, a traumatic break with traditions that demand the body of a loved-one be seen or touched.   "We're astonished she's being buried like this," said Denise Kahambu as she watched the specially-prepared burial in Butembo of her 50-year-old cousin, Marie-Rose.   "They said she died of Ebola," she said sceptically.   First declared last August, the epidemic has now claimed nearly 1,200 lives -- 200 of them in May alone.    The outbreak is the second deadliest on record, after an epidemic that killed more than 11,300 people in West Africa in 2014-16.

The burial in Butembo followed strict precautions. A pick-up truck delivered the coffin to the burial site, where a grave had been prepared, as the family stood by at a distance.   Gloved Red Cross workers handled the burial, which took place in silence and without a religious ceremony.   A family member or loved one was allowed only to place a cross on the tomb, once they too had donned protective gloves.   Half a dozen police officers escorted the convoy and remained on guard throughout.    On Friday, two burial teams from the treatment centres were attacked by stone-throwing crowds at Butembo and Bunia, a little further north in Ituri province, according to the health ministry. One burial worker was injured.

- Culture shock -
"The custom is that the body of the deceased first returns to the home. And once people have mourned, they have the chance to touch the body for the last time," said Seros Muyisa Kamathe, a guide and interpreter in Beni and Butembo.   "Before going to the cemetery, you open the coffin so people can take one last look at the deceased."

And normally it would be the family and neighbours who would take responsibility for digging the grave -- and deciding where if should be.   Ebola experts say denial and resistance were familiar obstacles in the 2014-16 epidemic in the West African states of Guinea, Liberia and Sierra Leone.   The World Health Organization (WHO) has a 12-step protocol for dealing with burials so that handling of the remains is kept to a minimum, but it also emphasises the importance of respect and mourning.   "The burial process is very sensitive for the family and the community and can be the source of trouble or even open conflict," it acknowledges.    No burial should begin until family agreement has been obtained, and workers should engage with the community "for prayers to dissipate tensions
and provide respectful time," it says.

- Armed escorts -
The burial process is part of the notoriously time-consuming and labour-intensive task of combatting Ebola.   And in this troubled region, the challenge has been further complicated by bloody deadly attacks on Ebola treatment centres by local militias.   Suspicion, political infighting in the capital Kinshasa and militia violence provide a fertile breeding ground for the virus.   Sometimes local people cover the graves overnight as a sign of their opposition, the ministry said.   In Butembo, health workers need an armed escort when they go looking for cases of Ebola in some neighbourhoods, an AFP photographer noted during one outing Saturday evening.

WHO Director-General Tedros Adhanom Ghebreyesus, at the opening of the organisation's annual assembly on Monday, described the outbreak as "one of the most complex health emergencies any of us have ever faced."   "Unless we unite to end this outbreak we run the risk it will become more widespread and more expansive and more aggressive," he said.   "We are not just fighting a virus," Tedros insisted. "We're fighting insecurity. We're fighting violence. We're fighting misinformation... and we're fighting the politicisation of an outbreak."   On the plus side, health officials are keen to emphasise some important gains. More than 118,000 have been vaccinated against the virus, and no cases have been recorded in neighbouring Rwanda and Uganda.
Date: Mon, 20 May 2019 15:09:54 +0200

Milan, May 20, 2019 (AFP) - Alitalia has scrapped around half its flights scheduled for Tuesday after a call to strike by Italian pilots, cabin crew and ground staff.   The industrial action by employees of Alitalia, Blue Air and Blue Panorama was confirmed Monday over the future of the sector and specifically that of the troubled national carrier.   Alitalia has cancelled around half its flights on Tuesday, as well as some late Monday and early Wednesday. The company said it hoped to get 60 percent of passengers to their destination.

Unions lamented "on the one hand, a rising number of passengers and flights, and on the other a proliferation of bankruptcies", a statement said.   They are worried about Alitalia's future and want their jobs protected.   The Italian government earlier this month extended to June 15 a deadline for the state railway to submit a concrete takeover offer, following a request from Alitalia's administrators for more time.   Italy's state railway Ferrovie dello Stato (FS) floated a bid to buy Alitalia at the end of October, but it does not want to hold more than 30 percent in the airline.   The railway has been discussing a potential partnership with Atlanta-based Delta airlines, which is interested in a 15-percent stake.
Date: Sun, 19 May 2019 21:55:33 +0200

Giza, Egypt, May 19, 2019 (AFP) - A bomb blast hit a tourist bus near Egypt's famed Giza pyramids on Sunday, wounding some of them, including South Africans, in the latest blow to the country's tourism industry.   The roadside bomb went off as the bus was being driven in Giza, also causing injuries to Egyptians in a nearby car, medical and security sources said.   Security and medical sources in Egypt said 17 people were injured, without giving a breakdown of their nationalities. No deaths were reported.   South Africa said in a statement that the "bus explosion" injured three of its 28 citizens who were part of the tourist group.   They would remain in hospital while the rest would return home on Monday, said the statement from the department of international relations.   "A device exploded and smashed the windows of a bus carrying 25 people from South Africa and a private car carrying four Egyptians," the security source said.

Video footage captured by AFP showed the bus and car with broken windows on the side of the road.   According to the security source, the wounded were being treated for scratches caused by the broken glass.   Sunday's incident comes after three Vietnamese holidaymakers and their Egyptian guide were killed when a roadside bomb hit their bus as it travelled near the Giza pyramids outside Cairo in December.   It also comes just little more than a month before the African Cup of Nations hosted by Egypt is to kick off.   Egypt has been battling an insurgency that surged especially in the turbulent North Sinai region following the 2013 military ouster of Islamist president Mohamed Morsi, who was replaced by former army general Abdel Fattah al-Sisi.   In February 2018, the army launched a nationwide operation against militants, focusing mainly on the North Sinai region.

- Tourism recovery -
Some 650 militants and around 45 soldiers have been killed since the start of the offensive, according to separate statements by the armed forces.   Since first being elected in 2014, Sisi has presented himself as a bulwark against terrorism, promising stability and increased security.   Recently, the country's vital tourism industry has started to slowly rebound after suffering strong blows due to deadly attacks targeting tourists following the turmoil of the 2011 uprising that toppled longtime ruler Hosni Mubarak.   Figures by the official statistics agency showed that tourist arrivals reached 8.3 million in 2017, compared with 5.3 million the previous year.    Authorities have gone at great lengths to lure tourists back, touting a series of archaeological finds and a new museum next to the pyramids, as well as enhanced security at airports and around ancient sites.    But that figure was still far short of the record influx of 2010 when more than 14 million visitors flocked to see the country's sites.
Date: Sun, 19 May 2019 05:17:37 +0200

Tegucigalpa, May 19, 2019 (AFP) - Four Canadians and an American pilot died Saturday when their small plane plunged into the sea off the Honduran island of Roatan where they were vacationing, firefighters said.   The plane crashed near the town of Dixon Cove, a few minutes after taking off from the island's airport, rescuers said.   The dead were identified as Bradley Post, Bailey Sony, Tomy Dubler and pilot Patrick Forseth.

The other Canadian pilot, Anthony Dubler, briefly survived the crash but died at the Roatan hospital of his injuries.   The causes of the crash and the registration information for the aircraft were not immediately available.   It occurred as the tourists were headed toward the city of Trujillo, about 77 kilometres (48 miles) from Roatan.
Date: Fri, 17 May 2019 16:32:13 +0200

London, May 17, 2019 (AFP) - London warned British-Iranian dual nationals against all travel to Iran on Friday due to Tehran's "continued arbitrary detention and mistreatment" of such citizens.   The move comes as Britain continues to try to secure the release from jail of dual national Nazanin Zaghari-Ratcliffe.   Tehran has also recently sentenced an Iranian British Council employee, Aras Amiri, to 10 years in prison on charges of spying.   In a statement, the Foreign Office said British-Iranian dual nationals faced an "unacceptably higher risk of arbitrary detention and mistreatment" than nationals of other countries.   "The security forces may be suspicious of people with British connections, including those with links to institutions based in the UK, or which receive public funds from, or have perceived links to, the British government," the statement said.   British-Iranian mother Zaghari-Ratcliffe was arrested by Iranian authorities in 2016 as she was leaving Tehran.

Zaghari-Ratcliffe, who worked for the Thomson Reuters Foundation, was put on trial and is now serving a five-year jail sentence for allegedly trying to topple the Iranian government.   "Dual nationals face an intolerable risk of mistreatment if they visit Iran," Foreign Secretary Jeremy Hunt said.   "Despite the UK providing repeated opportunities to resolve this issue, the Iranian regime's conduct has worsened.   "Having exhausted all other options, I must now advise all British-Iranian dual nationals against travelling to Iran.   "The dangers they face include arbitrary detention and lack of access to basic legal rights, as we have seen in the case of Nazanin Zaghari-Ratcliffe, who has been separated from her family since 2016."   The Iranian government does not recognise dual nationality, meaning the Foreign Office's ability to provide consular support is limited.   Hunt added: "Regrettably, I must also offer a message of caution to Iranian nationals resident in the UK -- but who return to visit family and friends -- especially where the Iranian government may perceive them to have personal links to UK institutions or the British government."
Date: Fri, 17 May 2019 11:42:01 +0200

Nairobi, May 17, 2019 (AFP) - Flooding in Tanzania has killed five people and forced about 2,500 to flee their homes after a week of torrential rain in the country's south, an official said Friday.   Schools have closed in Kyela, a district on the border of Lake Malawi, and families fled to shelters after losing everything in the rising waters.   "The damage from these floods is enormous," Salome Magambo, the district's administrative secretary, told AFP.   "Since the beginning of the week we have reported five people killed and 2,570 homeless, some of whom are staying with friends or in schools and churches."

Food and medical services have been extended to those stranded, she added.   Farming land in the district known for its rice production has also been inundated, destroying crops and raising fears of food shortages in coming months.   In April 2018 at least 14 people were killed in torrential rains and flooding in Dar es Salaam, Tanzania's economic capital.
Date: Thu, 16 May 2019 23:41:35 +0200

Washington, May 16, 2019 (AFP) - The Church of Scientology said Thursday all the passengers from a cruise ship that was quarantined over a measles case had been cleared to leave.    "All passengers and crew (100%) of the Freewinds have been fully cleared of any possible risk of being infected by the measles or infecting others," the organization said in a statement.   "All passengers and crew are free to come and go as they wish," a spokesman added to AFP.

The infected individual was a member of the crew who, according to the Church, had fully recovered and was given a clean bill of health a week ago. She had been earlier confined on the ship.   The ship, which is based in Willemstad on the island of Curacao in the Dutch West Indies, was quarantined after its arrival in Saint Lucia on April 30.   It remained there for two days before returning to Willemstad on May 4 where local authorities ordered a fresh quarantine to give them time to confirm the passengers were either immunized or had no risk of contracting the virus.
Date: Thu, 16 May 2019 18:37:39 +0200

Bamako, May 16, 2019 (AFP) - Heavy floods claimed 15 lives Thursday in the Malian capital Bamako along with serious property damage, authorities said.   A statement said the flooding claimed a "provisional toll" of 15 dead and two injured.   "Teams are in place to rescue the distressed people," the government said, calling on residents to be "prudent" in the face of the disaster.   Flooding is common in Mali, located in the semi-desert Sahel region.
Date: Thu, 16 May 2019 04:40:13 +0200
By Ashraf KHAN

Rato Dero, Pakistan, May 16, 2019 (AFP) - Parents nervously watch as their children wait to be tested for HIV in a village in southern Pakistan, where hundreds of people have been allegedly infected by a doctor using a contaminated syringe.   Dispatched to keep order, police scan the anxious crowd as families hustle into one of five different screening rooms set up in the last month in the village of Wasayo, on the outskirts of Larkana in Sindh province.

Health officials say more than 400 people, many of them children, have tested HIV positive in recent weeks as experts warn of a surge in infection rates across Pakistan, due to the use of unsanitary equipment and rampant malpractice -- often at the hands of quack doctors.   Anger and fear continue to swell in the desperately poor village hit hard by the epidemic, which authorities say could be linked to either gross negligence or malicious intent by a local paediatrician.   "They are coming by the dozens," says a doctor at the makeshift clinic, beset by a lack of equipment and personnel to treat the surging number of patients.

Mukhtar Pervez waits anxiously to have her daughter tested, worrying a recent fever may be linked to the outbreak. For others, their worst fears have already become a reality.   Nisar Ahmed arrived at the clinic in a furious search for medicine after his one-year-old daughter tested positive three days earlier.   "I curse [the doctor] who has caused all these children to be infected," he says angrily.   Nearby Imam Zadi accompanies five of her children to be examined after her grandson tested positive.   "The entire family is so upset," she tells AFP.   Others worry their children's futures have been irreparably harmed after contracting HIV, especially in a country whose masses of rural poor have little understanding of the disease or access to treatment.   "Who is she going to play with? And when she's grown up, who would want to marry her?" asks a tearful mother from a nearby village, who asked not to named, of her four-year-old daughter who just tested positive.  

- 'Helpless'-
Pakistan was long considered a low prevalence country for HIV, but the disease is expanding at an alarming rate, particularly among intravenous drug users and sex workers.    With about 20,000 new HIV infections reported in 2017 alone, Pakistan currently has the second fastest growing HIV rates across Asia, according to the UN.   Pakistan's surging population also suffers the additional burden of having insufficient access to quality healthcare following decades of under-investment by the state, leaving impoverished, rural communities especially vulnerable to unqualified medical practitioners.    "According to some government reports, around 600,000 quack doctors are operating across the country and around 270,000 are practicing in the province of Sindh," said UNAIDS in a statement.

Provincial health officials have also noted that patients are at particular risk of contracting diseases or viruses at these clinics, where injections are often pushed as a primary treatment option.   "For the sake of saving money, these quacks will inject multiple patients with a single syringe. This could be the main cause of the spread of HIV cases," said Sikandar Memon, provincial programme manager of the Sindh Aids Control Programme.

The large number of unqualified doctors along with the "reuse of syringes, unsafe blood transfusions, and other unsafe medical practices" have all led to the spike in HIV cases in recent years, explains Bushra Jamil, an expert on infectious diseases at the Aga Khan University in Karachi.   "Rampant medical malpractices without any effective checks and balances are causing repeated outbreaks in Pakistan," said Jamil.   Authorities investigating the outbreak in Sindh say the accused doctor has also tested positive for HIV.

From a ramshackle jail cell in the nearby city of Ratodero, he denied the charges and accusations he knowingly injected his patients with the virus, while complaining of being incarcerated with common criminals.   But for the parents of the newly diagnosed, the ongoing investigation means little if they are unable to secure access to better information and the necessary drugs that can help stave off the deadly AIDS virus.   "We are helpless. I have other children and I am afraid they might catch the disease," says another mother whose daughter recently tested positive for HIV.   "[Please] send some medicine for our children so that they can be cured. If not, all of our children will die, right?"