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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: Sat 24 Aug 2019 3:39:38 PM PKT
Source: Mena FN[edited]

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Somalia

Somalia US Consular Information Sheet
November 04, 2008
COUNTRY DESCRIPTION:
Since the collapse of the central government in 1991, Somalia has been subject to widespread violence and instability.
A Transitional Federal Government (TFG
was established in 2004 to guide the country through a transitional process to result in a new constitution and elections, planned for 2009.
However, the nascent TFG remains fragile and lacks the capacity to provide services inside Somalia.
General insecurity and inter- and intra-clan violence frequently occur throughout the country, and attacks and fighting between anti-government elements and TFG and Ethiopian forces take place regularly in Mogadishu and in regions outside the capital.
The United States has no official representation inside Somalia.

In 1991, the northwest part of the country proclaimed itself the Republic of Somaliland and maintains a separate regional governing authority; however, Somaliland has not received international recognition as an independent state.
The northeastern section of Somalia, known as the semi-autonomous region of Puntland, has also made efforts to establish a regional governing authority but has not claimed independence.
Somalia's economy was seriously damaged by the civil war and its aftermath, but the private sector is trying to reemerge.
Tourist facilities are non-existent.
Read the Department of State Background Notes on Somalia for additional information.

ENTRY/EXIT REQUIREMENTS:
A passport is required for travel to Somaliland and Puntland.
Both regions require a visa and issue their own at their respective ports of entry.
For travel to other parts of Somalia, including Mogadishu, a passport is required; however, there is no established governing authority capable of issuing a universally recognized visa.
Air and seaports are under the control of local authorities that make varying determinations of what is required of travelers who attempt to use these ports of entry.

Travelers may obtain the latest information on visas as well as any additional details regarding entry requirements from the Permanent Representative of the Somali Republic to the United Nations, telephone (212) 688-9410/5046; fax (212) 759-0651, located at 425 East 61st Street, Suite 702, New York, NY
10021.
Persons outside the United States may attempt to contact the nearest Somali embassy or consulate.
All such establishments, where they exist, are affiliated with the TFG, whose authority is not established throughout Somalia.

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:
Since the U.S. does not have an Embassy or any other diplomatic presence in any part of Somalia, including Somaliland and Puntland, the U.S. government cannot provide any consular services to U.S. citizens in Somalia.
Limited American Citizen Services are available for travelers to Somalia at the U.S. Embassies in Nairobi and Djibouti.

While Somaliland has experienced a level of stability that has not been present in other parts of Somalia, please note that the Department of State continues to warn U.S. citizens against all travel to Somalia, including the self-proclaimed “independent Republic of Somaliland”
-- see Department’s Travel Warning for Somalia.
Travelers insisting on traveling to Somaliland despite this warning should nevertheless always check current conditions in Somaliland before traveling.
Terrorist attacks have occurred against international relief workers, including Westerners, throughout Somalia, Puntland, and Somaliland.
In early 2006, an American citizen living and working in southern Somalia was kidnapped and held for ransom before being released.
In July 2007, kidnapping threats were issued against international humanitarian assistance workers in Puntland.
In 2007 and 2008, there were several violent kidnappings and eight assassinations of staff working for international organizations.
Additionally, there have been threats against Westerners in Somalia, including Somaliland. Terrorist operatives and armed groups in Somalia have demonstrated the intent to attack air operations at Mogadishu International Airport.
Additionally, a foreign terrorist organization is ostensibly in control of the southern port city of Kismayo and has openly threatened air traffic out of the local airport.
Armed conflict is commonplace in the capital city of Mogadishu.
All visitors are urged to restrict their movements in the region.
Persons traveling to or through this area should also be aware that incidents such as armed banditry, road assaults, kidnappings for ransom, shootings and grenade attacks on public markets, and detonations of anti-personnel and-vehicle land mines regularly occur.
Sporadic outbreaks of civil unrest persist and armed conflict also occurs in the rest of the country.
Also, illegal roadblocks remain common throughout Somalia and have resulted in serious injury or death.

Cross-border violence occurs periodically.
The area near Somalia’s border with Kenya has been the site of numerous incidents of violent criminal activity, including kidnappings and grenade attacks on hostels used by international aid workers.
U.S. citizens who decide to visit the area should be aware that they could encounter such criminal activity.

Americans considering seaborne travel around Somalia’s coastal waters should exercise extreme caution, given numerous recent incidents of vessel hijacking and/or piracy.
Since 2005 there have been numerous acts and attempted acts of piracy in Somalia's coastal waters, especially off of the Horn of Africa.
Piracy remains rampant off the shores of south central Somalia and Puntland.
Seaborne travelers should exercise extreme caution, as these groups have proven themselves well armed and dangerous.
When transiting in and around the Horn of Africa and/or in the Red Sea, it is strongly recommended that vessels convoy and maintain good communications contact at all times.
Marine channels 13 and 16 VHF-FM are international call-up and emergency channels and are commonly monitored by ships at sea.
2182 MHz is the HF international call-up and emergency channel.
In the Gulf of Aden, transit routes farther offshore reduce, but do not eliminate, the risk of contact with suspected assailants.
Wherever possible, travel in trafficked sea-lanes.
Avoid loitering in or transiting isolated or remote areas.
In the event of an attack, consider activating the “Emergency Position Indicating Radio Beacons (EPIRB).”
Vessels may also contact the Yemeni Coast Guard 24-hour Operations Center at (967) 1-562-402.
The Operations Center staff speaks English.
Due to distances involved, there may be a considerable delay before assistance arrives.

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

Up-to-date information on safety and security can also be obtained by calling 1-888-407-4747 toll-free in the U.S. 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:
Pervasive and violent crime is an extension of the general state of insecurity in Somalia.
Serious, brutal, and often fatal crimes are very common.
Kidnapping and robbery are a particular problem in Mogadishu and other areas of the south.

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

See our information on Victims of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION:
Medical facilities in Somalia are extremely limited.
Travelers should carry personal supplies of medications with them.

Malaria is endemic in many areas.
There have been outbreaks of cholera in Mogadishu, Kismayo in the south, and Puntland in the northeast.
For additional information on malaria and cholera, including protective measures, see the CDC travelers' health web page at http://wwwn.cdc.gov/travel/default.aspx.

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.
Travelers are strongly encouraged to purchase such insurance prior to traveling to East Africa if not already covered under their current medical plan.
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 Somalia is provided for general reference only, and it may not be totally accurate in a particular location or circumstance.

There are no traffic lights in the country except in Hargeisa in Somaliland.
The poor condition of most roads makes driving hazardous.
Night driving can be dangerous due to the absence of lighting.
Recent occurrences of land mine detonations on roads point to a potentially fatal risk for drivers.

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 Somalia, the U.S. Federal Aviation Administration (FAA) has not assessed Somalia’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:
Water and electricity systems are poor.
Functioning telecommunications systems exist in major towns in Somalia.

There is no organized system of criminal justice in Somalia, nor is there any recognized or established authority to administer a uniform application of due process.
Enforcement of criminal laws is, therefore, haphazard to nonexistent.
Locally established courts operate throughout Somalia under a combination of Somali customary and Islamic Shari'a law, some of which may be hostile towards foreigners.

The Somali shilling is the unit of currency except in Somaliland, which uses the Somaliland shilling.
U.S. dollars are accepted everywhere.
Credit cards are not accepted in Somalia.

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 laws in Somalia, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in Somalia are severe, and convicted offenders can expect long jail sentences and heavy fines.
Engaging in sexual conduct with children or using or disseminating child pornography in a foreign country is a crime, prosecutable in the United States.
Please see our information on Criminal Penalties.

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

In accordance with Somali customary law, any child whose father is a Somali citizen is also considered to be a Somali citizen.
Somali children require their father's permission to leave the country.

REGISTRATION / EMBASSY LOCATION:
There is no U.S. Embassy in Somalia.
U.S. citizens who plan to enter Somalia despite the current Travel Warning 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 Somalia.
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.
Travelers to Somaliland should register with the U.S. Embassy in Djibouti, and travelers to Puntland or southern Somalia should register with the U.S. Embassy in Nairobi.

The U.S. Embassy in Djibouti is located at Plateau du Serpent, Boulevard Marechal Joffre, Djibouti City; telephone (253) 35-39-95.
The after-hours telephone number is (253) 35-13-43.
The mailing address is Ambassade Americaine, B.P. 185, Djibouti, Republique de Djibouti.
The workweek in Djibouti is Sunday through Thursday.
The U.S. Embassy in Nairobi is located on United Nations Avenue, Gigiri, Nairobi, Kenya; telephone (254)(20) 363-6000; fax (254) (20) 363-6410.
In the event of an after-hours emergency, the Embassy duty officer is available at (254) (20) 363-6170.
The Embassy's mailing address is P.O. Box 606 Village Market, 00621 Nairobi, Kenya, or mail using U.S. domestic postage may be addressed to Unit 64100, APO AE 09831, USA.
*

*

*
This replaces the Country Specific Information for Somalia dated October 4, 2007 to update section on Safety and Security.

Travel News Headlines WORLD NEWS

Date: Wed, 24 Jul 2019 23:25:39 +0200

Mogadishu, July 24, 2019 (AFP) - Six people were killed and the mayor of Mogadishu was wounded in a bombing at the mayoral offices in the Somali capital on Wednesday, in an attack claimed by Al-Shabaab jihadists to have been targeting a UN envoy.   United Nations special envoy James Swan had met the mayor, Abdirahman Omar Osman, and left just before the blast at the headquarters of the Banadir district, which encompasses Mogadishu, according to the mission's Twitter account.   "Six people, including two district commissioners and three directors, were killed in the terrorist attack this afternoon," Information Minister Mohamed Abdi Hayir Mareye told reporters.

As well as the mayor, five others, including district commissioners, were injured in the blast and being treated by doctors.   "I deplore this heinous attack which not only demonstrates a violent disregard for the sanctity of human life, but also targets Somalis working to improve the lives of their fellow Somalis in the Mogadishu-Banadir region," Swan said in a statement, confirming he had been in the building earlier in the day.   The Al-Qaeda linked Al-Shabaab jihadist group claimed responsibility for the "well-prepared operation", saying they were targeting Swan.

A security source, who asked not to be named, said a suicide bomber had entered a hall where the officials were meeting and detonated the blast inside.    "The mayor was wounded in the blast and he is currently being treated. Some of the commissioners of Mogadishu district have also been wounded," deputy mayor Mohamed Abdullahi Tulah told the government's radio station Muqdisho.   Security forces are investigating the incident.

"The blast occurred inside but we are not sure what exactly caused it, some reports we are getting indicate it was caused by a suicide bomber... and there are casualties," said security official Mahdi Abdirahman.   "The blast was very heavy, and I saw people fleeing, some with shrapnel wounds, outside the Banadir administration headquarters," said witness Mohamud Shariif, referring to the regional government offices.   In a statement, Shabaab said they had "killed many of the enemy".   Mogadishu is regularly hit by attacks by the Shabaab, which has fought for more than a decade to topple the Somali government.   The city was on Monday struck by a car bomb that left 17 dead and more than two dozen wounded.
Wed 26/06/2019 15:03
http://www.emro.who.int/som/somalia-news/who-and-unicef-somalia-and-partners-call-on-all-somalis-to-vaccinate-children-against-polio.html
https://www.who.int/en/news-room/fact-sheets/detail/poliomyelitis

Mogadishu, 25 June 2019 - Health authorities rolled out a polio campaign yesterday in Puntland and Somaliland to vaccinate more than 940 000 children under 5 years of age to stop an ongoing outbreak of a strain of poliovirus.

The campaign runs from 24 to 27 June 2019, with support from the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF). It targets all children in 12 districts in Somaliland and 9 districts in Puntland.

By the numbers:
  • 945,480 children to be vaccinated
  • 3160 vaccinators knocking on doors
  • 677 team supervisors taking part
  • 1558 social mobilizers sharing messages on vaccination and children’s health
  • 15 children have been infected with the polioviruses so far, since outbreaks began
Somaliland, Puntland and other states in Somalia are currently experiencing outbreaks of 2 strains of poliovirus. Each strain requires a different vaccine. Children need several doses of each vaccine to boost immunity. Even though these viruses are not wild poliovirus, both these circulating strains can infect and paralyse children with low immunity. The last case of wild poliovirus in Somalia was in August 2014.

“It’s vital that parents ensure their children receive this vaccine because it builds immunity against a specific strain of poliovirus circulating in the country. I call upon all caregivers in the areas being covered in this campaign to please ensure children are at home and accept the oral polio vaccine when it is offered. Oral polio vaccines are stored and administered safely, and can save children from paralysis and permanent disability,” said Dr Mamunur Rahman Malik, WHO Representative for Somalia.

“The only way to protect children from all polioviruses is to ensure they receive multiple doses of polio vaccine, through campaigns and health facilities where possible,” said Werner Schultink, UNICEF Somalia Representative. “Caregivers need to ensure children receive this vaccine when it is available.”

Somalia’s polio programme has conducted 14 immunization campaigns, including 5 nationwide campaigns, since December 2017 to stop further spread of the outbreaks. Despite these efforts, not all Somalia’s children are being vaccinated, which has resulted in the polioviruses spreading across the country and spilling over to Ethiopia. To address this, polio teams from Somalia and Ethiopia conducted a joint planning workshop in Hargeisa last week, and are coordinating immunization activities along their shared border and in high-risk areas in each country during this round in order to prevent cross-border transmission and spill over.

Concurrent to the polio campaign, polio health workers have also been working to vaccinate more than 650 000 people aged one year and above against cholera in high-risk districts of Somalia.
Date: Tue 7 May 2019
Source: WHO Emergencies preparedness, response, Disease Outbreak News (DONs) [edited]

Outbreak update - Cholera in Somalia, 28 Apr 2019
-------------------------------------------------
The Ministry of Health (MoH) of Somalia has announced 36 new suspected cases of cholera, with no deaths, for epidemiological week 17 (22 to 28 Apr 2019) in 2019. No cases were reported between epidemiological weeks 1 and 7 due to closure of the main cholera treatment centre, from which data is collected. MoH has reported 7140 cases and 46 deaths since the beginning of this outbreak in December 2017.

During the reporting period, cases occurred in 11 out of 17 districts in Banadir region, the worst affected district are Hodan (728), Daynile (613), and Madina (595), and 66.66% of the cases (24) are children below 5 years of age.

WHO, MoH, and partners have contained the cholera outbreak in the districts of Jubaland, Hirshabelle, and South West states following implementation of oral cholera vaccination (OCV) campaigns and other health interventions. However, active transmission is ongoing in 11 districts in Banadir -- Darkenly, Daynile, Hodan, Madina, Hamarjabjab, Howlwadag, Bondere, Kahda, Kaaran, Waberi, and Warta nabada).

In 2019, 114 stool samples have been collected and tested in the National Public Health Laboratory in Mogadishu. During this reporting period, 10 cases were confirmed for _Vibrio cholerae_, serotype O1 Ogawa by culture.

WHO continues to provide leadership and support to health authorities and partners for outbreak mitigating measures. For disease surveillance, WHO supports the electronic Early Warning Alert and Response Network (eEWARN) system which is currently expanding to include all health facilities in Somalia. WHO and MoH continue to monitor outbreak trends via eEWARN, promptly investigating and responding to all alerts.
========================
[Maps of Somalia:
Date: Mon, 6 May 2019 13:40:39 +0200

Nairobi, May 6, 2019 (AFP) - Drought has left nearly two million Somalis in desperate need of food, a humanitarian agency warned Monday, as poor rainfall pushes communities to the brink across East Africa.   The Norwegian Refugee Council said hundreds of thousands of children were already suffering malnutrition in Somalia and millions had abandoned their homes in search of food in the arid, conflict-torn nation.   "The humanitarian situation has deteriorated at an alarming rate as a result of the drought," Victor Moses, the council's country director in Somalia, said in a statement.

The failure of the so-called long rains that usually sweep East Africa between March and May has caused widespread crop failures and heaped immense pressure on livestock-dependent communities in the greater region.   Somalia is enduring its third-driest long rains season since 1981.   The United Nations estimates that 1.7 million people are going hungry, with that figure expected to grow by another half a million come July.

Last week, the UN said 44,000 Somalis had left their homes in rural areas for urban centres just this year -- joining the estimated 2.6 million internally-displaced people across the country.   Close to a million children will need treatment for malnutrition in 2019.   "The deterioration has come much earlier than seen over the last decades and before affected communities could recover from the most recent drought," the UN Office for the Coordination of Humanitarian Affairs said.   But the hunger crisis could extend well beyond Somalia, with the entire Horn of Africa region at risk from drought and extreme weather exacerbated by climate change.   Almost 80 percent of the population in the Horn depend on farming for a living, said the UN's Food and Agriculture Organization.

The Famine Early Warning Systems Network said in April that if rains did not materialise in May "the season will have failed and the impact on food security outcomes would be more severe than currently anticipated".   The US-funded network warned more than 42 million people in Ethiopia, South Sudan, Somalia, Sudan, Kenya, Uganda and nearby Yemen were currently facing crisis levels of food insecurity.   In Kenya, considered the most dynamic economy in the region, the World Bank in April cited the impact of drought when trimming its growth forecast for the country in 2019.
Date: Thu, 7 Mar 2019 10:12:51 +0100

Mogadishu, March 7, 2019 (AFP) - A "heavy" explosion rocked central Mogadishu Thursday morning, leaving an unknown number of casualties, a security official and witnesses said.   "The blast occurred at a checkpoint close to the National Theatre, we don't have the details but there are casualties," said Mohamed Adam, a security official.   "The explosion was very heavy, and we could see the smoke and dust overwhelmed the whole area, it was a car bomb," said witness Ibrahim Farey.

Another witness, Aisha Hassan, said several vehicles were destroyed and buildings damaged, adding that ambulances were seen rushing to the scene "but it is impossible to get close to the area now".    The road in which the blast occurred is close to the presidential palace and home to restaurants and tea-shops.   Earlier this month, at least 20 people died in an attack in Mogadishu which saw Al-Shabaab jihadists battling security forces for nearly 24 hours.
More ...

Slovakia

Slovak Republic US Consular Information Sheet
July 09, 2008
COUNTRY DESCRIPTION:
The Slovak Republic is a rapidly developing European nation. Tourist facilities are not as developed as those found in Western Europe, particularly outside th
major cities, and some goods and services taken for granted in other European countries are occasionally unavailable.
Read the Department of State Background Notes on the Slovak Republic for additional information.

ENTRY/EXIT REQUIREMENTS: A passport is required. A visa is not required for stays for tourism or business up to 90 days within six months of the date of first entry into the Slovak Republic/Schengen zone. That period begins when you enter any of the Schengen countries: Austria, Belgium, the Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Iceland, Italy, Latvia, Lithuania, Luxembourg, Malta, the Netherlands, Norway, Poland, Slovakia, Slovenia, Spain and Sweden.
All foreigners seeking entry into the Slovak Republic must carry proof of a medical insurance policy contracted for payment of all costs for hospitalization and medical treatment in the Slovak Republic.
Border police have the right to request evidence of finances sufficient to pay for the proposed stay in the Slovak Republic in the amount of $50 per person per day.
Current information can be found on the Slovak Embassy’s web site at http://www.slovakembassy-us.org.

All persons in Slovakia over the age of 15 must carry official identification at all times. American citizens staying overnight in Slovakia must register with the local Border and Aliens Police within three working days.
Persons staying hotels are registered automatically.
Visit the Slovak Ministry of the Interior’s web site at http://www.minv.sk for the most current information.

NOTE: On December 21, 2007, Slovakia became a member of a group of countries collectively known as “Schengen countries” or the “Schengen zone.” Americans may enter and remain within the entire Schengen zone without a visa for no more than 90 days in any six-month period. If an American has just spent 60 days in another Schengen country, for example, he or she would be permitted to enter Slovakia only for the remaining 30 days. It is not possible to extend a tourist stay beyond 90 days in the Schengen zone. Once an American has used his/her 90 days, he/she cannot reenter Slovakia until he/she has spent at least three months outside the Schengen zone.

Although European Union regulations require that non-EU visitors obtain a stamp in their passport upon initial entry to a Schengen country, many borders are not staffed with officers carrying out this function. If an American citizen wishes to ensure that his or her entry is properly documented, it may be necessary to request a stamp at an official point of entry. Under local law, travelers without a stamp in their passport may be questioned and asked to document the length of their stay in Schengen countries, and could face possible fines or other repercussions if unable to do so.

Persons wishing to remain in Slovakia longer than 90 days or arriving for purposes other than tourism or business travel may apply for temporary residency and/or work permits shortly after arrival in Slovakia.
However, it is strongly recommended that such persons review the requirements and begin preparing their applications prior to travel, as many documents required of U.S. citizens are more easily obtained in the United States.
For example, U.S. citizens must submit a certificate not older than 90 days showing the result of a fingerprint records check by the FBI.
As authorities in Slovakia cannot take fingerprints for this purpose, it is extremely difficult to obtain this certificate after arrival in Slovakia.
In addition, Slovakia requires all documents (birth certificates, etc) intended for official use in Slovakia to be authenticated (e.g. to have an apostille). See our section on Judicial Assistance for more 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:
Taking photographs of security/military installations (for example, military bases, government buildings, nuclear power plants, etc.) is prohibited. Violation of this law may result in confiscation of the camera, film or memory card, a reprimand or fine, or even expulsion from the country. Serious cases may be reported to and handled by local and/or military police.

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

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

CRIME:
The Slovak Republic has a medium rate of crime. Police forces suffer from a lack of manpower resources and equipment. Local police are not likely to speak English. Western visitors, especially short-term visitors such as tourists and students, are the primary foreign targets of street crime. The majority of street crime is non-violent and ranges from pickpocketing (particularly in the summer) and purse and cellular telephone snatchings to mugging, armed robbery, shooting, drugging and robbing of unsuspecting victims at nightspots and bars. Most reported thefts occur at crowded tourist sites (such as Bratislava’s Old Town area) or on public buses or trains. Thieves in the Slovak Republic often work in groups or pairs. In most cases, one thief distracts the victim, another performs the robbery, and a third person hands off the stolen item to a nearby accomplice. Groups of street children are known to divert tourists’ attention so that a member of their group can pickpocket the tourists while they are distracted. Do not leave personal items in unattended vehicles, even if locked.
Reports of racially motivated incidents against foreigners and minorities, particularly perpetrated by groups with a history of targeting persons of Roma, African, or Asian descent, have occurred in the Slovak Republic. In addition to incidents of assault, persons of Roma, African, or Asian heritage may be subject to various types of harassment, such as verbal abuse.

Both indigenous and foreign organized crime groups are well-established in the Slovak Republic. They do not target U.S. or other foreign individuals and tend to co-exist peacefully in the tourist district so as not to scare away tourist dollars. Though not common, violent incidents sometimes do occur outside of Old Town Bratislava.

INFORMATION FOR VICTIMS OF CRIME: The loss or theft abroad of a U.S. passport should be reported immediately to the local police and the nearest U.S. Embassy or Consulate.
If you are the victim of a crime while overseas, in addition to reporting to local police, please contact the nearest U.S. Embassy or Consulate for assistance.
The Embassy or Consulate staff can, for example, assist you to find appropriate medical care, to contact family members or friends and explain how funds could be transferred.
Although the investigation and prosecution of the crime is solely the responsibility of local authorities, consular officers can help you to understand the local criminal justice process and to find an attorney if needed.
The local equivalent to the 911 emergency line in Slovakia is 155.
See our information on Victims of Crime.
MEDICAL FACILITIES AND HEALTH INFORMATION:
Medical facilities are available in the Slovak Republic, although the quality and availability varies within the country. Ambulances are only a means of transportation to the hospital; they may not have life support stabilization equipment on board. Only a limited number of doctors speak English.
Doctors and hospitals expect cash payment for health services unless the patient can present an insurance number from the Slovak National Insurance Company. Serious medical problems requiring hospitalization and/or medical evacuation to the United States can cost tens of thousands of dollars or more.

Medical prescriptions issued in the U.S. are not valid in the Slovak Republic. If needed, a local doctor must issue a prescription. Medicines are generally available locally, if not under the American name the doctor can be consulted for a substitute. The Ministry of Health of Slovak Republic administers the use of medicines and medicine brought to the Slovak Republic for personal use may become subject to comparison against the list of those authorized for use in the Slovak Republic.

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

Roads in the Slovak Republic typically are safe and well maintained. Four-lane highways exist in and around Bratislava. However, most roads outside of built-up areas are two lanes only, and aggressive drivers attempting to pass at unsafe speeds pose a serious hazard. Due to poor lighting and narrow, winding roads, nighttime driving outside of built-up areas is not recommended.

From November through March there is often heavy snowfall, which is not adequately cleared from many rural roads. Roads in the mountainous northern part of the country are particularly prone to hazardous conditions during winter months. Winter tires are recommended and chains are necessary in certain mountainous areas.

In the Slovak Republic, vehicles travel on the right side of the road. Headlights must be used at all times (day and night) from October 15 until March 15. The maximum legal speed on highways is 130 kilometers per hour (78 mph). On smaller roads the maximum speed in 90 kph (54 mph). The limit in towns is 60 kph (36 mph). Use of cellular phones while driving is strictly prohibited. Safety reflection vests and first aid kits are compulsory equipment of each vehicle.

Drivers must yield the right of way to all vehicles with flashing blue lights (police, ambulances, fire trucks, motorcades). Vehicles with yellow or orange lights usually mean that traffic must slow down. Drivers must always be cautious, however, as many slowly moving vehicles, such as agricultural vehicles, are not well marked.

Driving under the influence of alcohol is strictly prohibited. The blood alcohol tolerance level is zero percent.
Penalties for drivers involved in car accidents involving injury of death are decided by a court of law. Penalties for minor offenses are not generally large, but foreigners are sometimes targeted for additional sums. Anyone suspecting this has occurred should ask for a written receipt and note the name and number of the traffic officer imposing the fine.

Gasoline is readily available, although many gas stations are closed on Sunday, especially in rural areas. Gas stations typically do not offer repair service; private mechanics must be found. Most gas stations accept credit cards, but mechanics less frequently accept them, so travelers should expect to pay for these services in cash.

A highway user decal must be purchased for travel on most major roads outside of Bratislava. The decal is valid for the calendar year in which it is purchased, and is available at gas stations, post offices and some newspaper kiosks. The cost is 1100 Sk (Slovak crowns) for all vehicles up to 3.5 tons. A short-term decal valid for 30 days may be purchased for 300 Sk and for 7 days for 150Sk.

Taxi companies provide generally reliable, safe, and economical services. Avoid independent cabs that do not prominently display a company name. Visitors should be alert to the potential for substantial overcharging by taxis, particularly in areas frequented by tourists. Radio-dispatched taxis are often much more reliable.

Buses, trolleys, and trams are mechanically safe, but there have been reports of thefts on city transportation and of harassment by the transport police. On public transportation it is obligatory to have a time-ticket validated after entering the vehicle (valid for 10, 30, or 60 minutes), or a prepaid zone ticket (valid for 24,.48,. or 68-hours, and 1 month, 3 months or 1 year). Children from 6 to 15 years of age pay reduced fares. Passengers who are traveling without a valid ticket will be fined by the ticker inspector. The ticket inspector has to have an identification card and must provide a ticket for the fine. More information is provided in English at www.imhd.sk.

Inter-city travel is widely available by bus, train, or taxi and is generally safe (inquire about taxi fares in advance). There are regular international trains and buses which are mechanically safe. However, there is a danger of theft, even from locked compartments, particularly on international night trains serving Warsaw, Prague and Budapest. Taxi drivers with special permits may provide international taxi service.

A motorcycle driver’s license and helmet are required. Small motorcycles are not allowed on highways. All traffic regulations apply.

Tourists coming to the Slovak Republic are required to have an International Drivers’ Permit. A U.S. driver’s license alone is not sufficient to drive in Slovakia. The U.S. driver’s license must be accompanied by an International Driver’s Permit, obtainable in the United States from the American Automobile Association and the American Automobile Touring Alliance.

A Slovak Driver’s License can be applied for at the Dopravny Inspektorat in the district of the applicant’s place of residence in the Slovak Republic. Completion of the regular driving course and a written examination (in Slovak) are required for issuance of a Slovak driver’s license. For specific information concerning Slovak driver’s permit, vehicle inspection, road tax and mandatory insurance, contact the Slovak Embassy in Washington, DC.

Please refer to our Road Safety page for information.

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

SPECIAL CIRCUMSTANCES:
Slovak customs authorities enforce strict regulations concerning temporary importation into or export from the Slovak Republic of items such as firearms, antiquities, medications, business equipment, etc. It is advisable to contact the Embassy of the Slovak Republic in Washington, D.C, or one of the Slovak consulates in the United States for specific information regarding customs requirements.

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 Slovak laws, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in Slovakia are strict and convicted offenders can expect jail sentences and heavy fines.
Engaging in illicit 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 AND CONSULATE LOCATIONS:
Americans living in the Slovak Republic are encouraged to register with the nearest U.S. Embassy of Consulate through the State Department’s travel registration web site so that they can obtain updated information on travel and security within the Slovak Republic.
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 Bratislava is located at Hviezdoslavovo namestie 4, Bratislava telephone (421) (2)5443 0861; (421) (2) 5443 3338, fax (421) (2) 5441 8861; mailing address: U.S. Embassy, P.O. Box 309, 814 99 Bratislava, Slovak Republic; e-mail: consul@usembassy.gov; web site:http://slovakia.usembassy.gov
* * * *
This replaces the Country Specific Information for Slovakia dated December 17, 2007 without substantive changes.

Travel News Headlines WORLD NEWS

Date: Thu 2 Jun 2016
Source: The Slovak Spectator [edited]
<http://spectator.sme.sk/c/20179834/number-of-people-infected-with-tick-borne-encephalitis-rises.html>

The number of people suffering from tick-borne encephalitis in Košice increased again on 1 Jun [2016]. So far 27 infected patients have been hospitalised at the Infectology and Travel Medicine Department (KICM) of the Louis Pasteur University Hospital (UNLP) while another 5 are being monitored by doctors at outpatient departments. "This number is not necessarily definitive, as the incubation period of the disease (between 7-14 days - ed. note) has not expired yet," said Ladislava Šustova¡, the hospital's spokesperson, as cited by the SITA newswire.

Some patients have been released from the hospital already while doctors have not recorded any complications in treatment so far. Local tick-borne encephalitis broke out in Košice last weekend [28-29 May 2016]. Consumption of cheese produced from unpasteurized sheep's milk is said to have caused the infection. Symptoms of this infectious viral disease come in 2 stages: "The 1st presents as a mild flu, including a loss of appetite and intestinal problems," explained Šustova.

"After 3 or 4 days these problems fade and the so-called asymptomatic phase occurs, which can last up to 20 days. Then a 2nd phase sets in abruptly, featuring high fever, persistent headaches, vomiting, sensitivity to light, a stiff neck, and other symptoms characteristic of the involvement of the central nervous system." One of the most serious complications of the disease is meningitis. KICM records 6 cases of tick-borne encephalitis on average per year.

"Such a mass outbreak of tick-borne encephalitis has not been recorded at this hospital for the past 5 years," said Šustová. In total, Slovak doctors diagnosed 88 cases of tick-borne encephalitis in Slovakia last year [2015], 17 of which were found to be contracted via food. So far this year [2016], except for the local epidemic in Košice, 8 people have contracted the disease, none of them via food, Martina Merková from the Public Health Authority (ÚVZ) told the TASR newswire.
=======================
[Central and Eastern Europe countries are endemic for the European subtype of tick-borne encephalitis (TBE) virus and cases occur yearly there. Although castor bean ticks, _Ixodes ricinus_, are the main vectors that transmit TBE virus to people, individuals can become infected by consumption of unpasteurized milk and milk products coming from infected animals -- goats in the situation above.

Presumably, the public will be warned of this risk and advised of measures to avoid tick bites and be vaccinated as people become more active out of doors with the onset of warmer weather. The Standing Commission on Vaccination Recommendations at the Robert Koch Institute recommends vaccination against TBE for people who live or work in areas at risk of TBE and who are at risk of tick bites, and for people in endemic areas for other reasons if they are at risk of tick exposure. - ProMed Mod.TY]

[Maps of Slovakia can be seen at <http://www.ezilon.com/maps/images/europe/Slovakian-political-map.gif> and <http://healthmap.org/promed/p/53556>. - ProMed Sr.Tech.Ed.MJ]
   Date: Tue 14 Oct 2014
Source: Czech News Agency [edited]

Sanitary authorities registered dozens of cases of hepatitis A in southern Slovakia over the past few weeks, and due to the local epidemic, they ordered the suspension of activity at some schools and vaccination in the afflicted localities, the health authority in Nitra said today, 14 Oct 2014.

The hepatitis mainly spread in the Zlate Moravce and Levice districts, afflicting all age groups, the office said. In Zlate Moravce, most of the cases were confirmed with the local Romas and the people living in very poor sanitary conditions. As many as 14 infected persons lived at the same address in the village of caradice, without water and toilets.

"The number of ill is rising," the head of the teaching hospital in Nitra, Jozef Valocky, is quoted as saying. So far, at least 50 people have contracted hepatitis. In the afflicted localities, the sanitary officers have ordered the vaccination of about 1000 people as well as preventative vaccination of the children living in poor sanitary conditions.
====================
[Hepatitis A is a liver infection caused by the hepatitis A virus. The virus is spread by faecal-oral transmission. Hepatitis A is closely associated with inadequate sanitation and poor personal hygiene. Unlike hepatitis B and C, hepatitis A infection does not cause chronic liver disease and is rarely fatal, but it can cause debilitating symptoms. Hepatitis A occurs sporadically and in epidemics worldwide, with a tendency for cyclic recurrences. Waterborne outbreaks are usually associated with sewage contaminated- or inadequately treated water.

Casual contact among people does not spread the virus. In developing countries (where sanitary conditions are poor), most children experience infection in early childhood. As a consequence of poor sanitary conditions and hygienic practices, most children (up to 90 percent) have been infected with the hepatitis A virus before the age of 10. Those infected in childhood do not experience any noticeable symptoms. Consequently, epidemics are uncommon because older children and adults are generally immune. Symptomatic disease rates in these areas are low, and outbreaks are generally rare, although one seems to have occurred here. - ProMed Mod.LL]

[A HealthMap/ProMED-mail map can be accessed at:
Date: Sat 10 Nov 2012
Source: NOVINY.SK [in Slovak, trans., edited]

Farm in Staskovce quarantined because of anthrax
------------------------------------------------
In the past few days 4 oxen have died on a farm in the village of Staskovce, Stropkov [district, Presov region]. The diagnosis has been confirmed in one of the animals.

The animals died over a short period of some 3-4 hours and the event took everyone by surprise. The farmers claim that they have seen nothing like this in the previous 20 years. And they take pride in the quality of livestock -- cattle, pigs, horses -- that they produce.

The veterinarians are on the farm and the affected herd has been quarantined in the farm stables. The affected animals had appeared to be healthy and the owner was taken by surprise.

Anthrax had been seen previously in the district of Svidnik 2 years ago.
----------------------------------------
communicated by:
Sabine Zentis
Castleview Pedigree English Longhorns
Gut Laach
52385 Nideggen
Germany
=====================
[This report is abstracted from a TV news report and if you go to the site you can hear the full report in Slovak.

In July 2010, 3 farms in Svidnik, Presov region, were reported with outbreaks and 9 animals were affected (see <http://www.oie.int/wahis_2/public%5C..%5Ctemp%5Creports/en_fup_0000010361_20110314_165943.pdf>). From the OIE reports and map they would appear to have been adjoining farms. These 2010 outbreaks were the first since 1995 in Slovakia, which is regarded as essentially free. But they had a human case in 2003, not otherwise explained, which suggests that the their freedom was conditional, that is, there were some unreported background cases. This could hint at the farmer having bought contaminated hay grown in one of those disturbed fields and the hay got soil contaminated -- this can happen if it rains during haymaking and mud gets included in the hay.

These outbreaks out of the blue usually are a result of earth moving activities on the farm, which resulted in an old anthrax grave being disturbed or of a waste-pit at a now closed tannery, which is much the same thing epidemiologically. However a new risk has shown itself latterly of contaminated imported bone meals. If this were the case there will be essentially simultaneous outbreaks on other dairy farms in the area from the same bone meal shipment.

Let us hope that the Slovak veterinarians are investigating this outbreak to discover the source of the infection.

Date: Tue, 18 Sep 2012 15:08:54 +0200 (METDST)

Bratislava, Slovakia, Sept 18, 2012 (AFP) - Slovakia banned alcohol from the Czech Republic Tuesday amid a wave of poisoning from methanol-tainted bootleg spirits that has claimed 21 Czech lives and put four Slovaks in hospital. "As a neighbouring country, which imports a quarter of Czech-made alcohol, we decided to ban the import and sale of Czech alcohol, effective as of 5 pm (1500 GMT) today," Agriculture Minister Lubomir Jahnatek told journalists.  "This is a precautionary measure after we learned that grocery chains were planning a big sale on Czech alcohol for tomorrow," he added. So far Slovakia, a nation of 5.4 million, has not recorded any bootleg-related deaths. Four people were hospitalised on Sunday after drinking a bottle of Czech-made plum brandy ordered over the Internet, but were reported to be in good condition.

The Slovaks had bought the liquor for a 50th birthday party via the Internet and received it in plastic bottles, local media reported. Poland banned the sale of all Czech-made alcohol except for beer and wine on Sunday after five deaths were recorded in the past two weeks, though they were not necessarily linked. On Friday, the Czech health ministry imposed a blanket ban on sales of spirits with over 20 percent alcohol content for the first time in the history of the nation of 10.5 million, which has the world's second highest adult alcohol intake after Moldova.

The ban could last for months, Health Minister Leos Heger said. A health ministry analysis showed most of those affected had drunk one of two types of tainted liquor -- vodka or a local rum dubbed "tuzemak". The Czech Association of Spirits Producers and Importers meanwhile said it estimated the bootleg liquor sold on the black market "made up 20 percent of total Czech alcohol consumption." Czech police were still looking Tuesday for the primary source of the poisonings but 23 suspected bootleggers and their distributors had faced charges as of Tuesday.
Date: Wed, 11 Jul 2012 21:56:23 +0200 (METDST)

BRATISLAVA, July 11, 2012 (AFP) - An 18-year-old Belgian boy scout was killed by a lightning while hiking in the High Tatra mountains in northern Slovakia on Wednesday, local media reported. "A group of Belgian boy scouts were hiking in the High Tatra mountains when a lightning struck one of them" on the summit of Slavkovsky Stit, 2,452 metres (8,045 feet) above sea level, the TASR news agency said. "The scouts called the emergency and started resuscitating him but neither they nor the emergency team that arrived by helicopter succeeded and the boy died," it added.
More ...

World Travel News Headlines

Date: Tue 17 Sep 2019
Source: Boston Globe [edited]

Rhode Island officials announced Tuesday [17 Sep 2019] that 2 more human cases of eastern equine encephalitis [EEE] were confirmed in the state.

The 2 people -- one a Coventry child younger than 10 and the other a person in their 50s from Charlestown -- have been discharged from the hospital and are recovering, according to a statement from the state's Department of Public Health.

Authorities think the 2 people contracted EEE in late August [2019]. The cases were confirmed by tests done at the Centers for Disease Control and Prevention. There have been 3 confirmed EEE cases in Rhode Island this year [2019]. A West Warwick resident diagnosed with the mosquito-borne illness died this month [September 2019].

All 3 people contracted EEE before areas at critical risk for the disease were aerially sprayed with pesticide, state officials said.

EEE is a rare but potentially fatal disease that can cause brain inflammation and is transmitted to humans bitten by infected mosquitoes, according to federal authorities. About 1/3 of infected people who develop the disease will die, officials have said, and those who recover often live with severe and devastating neurological complications. There is no treatment for EEE.

"This [2019] has been a year with significantly elevated EEE activity, and mosquitoes will remain a threat in Rhode Island until our 1st hard frost, which is still several weeks out," said Ana Novais, the deputy director for the state's health department. "Personal mosquito-prevention measures remain everyone's 1st defence against EEE. If possible, people should limit their time outdoors at sunrise and sunset. If you are going to be out, long sleeves and pants are very important, as is bug spray [repellent]."

EEE was also confirmed in a deer in Exeter this week [week of Mon 16 Sep 2019].

In Massachusetts, 8 human cases of EEE have been confirmed this year [2019]. Last month [August 2019], a Fairhaven woman with EEE died.
========================
[The 1st Rhode Island case died. Now there are 2 additional EEE cases who have recovered sufficiently to have been discharged from the hospital. Although most reported cases of EEE this year [2019] have occurred in horses, there have been several recent human cases as well. Individuals living in areas where human or equine EEE cases have occurred should heed the above recommendations to prevent mosquito bites. Avoidance of mosquito bites is the only preventive measure available. Fortunately, horses can be vaccinated, but there is no vaccine available for humans.

The risk of EEE virus infection for humans and horses will continue in Rhode Island and the other affected states until the 1st killing frosts occur, likely in October (2019). - ProMED Mod.TY]

[HealthMap/ProMED-mail map:
Rhode Island, United States: <http://healthmap.org/promed/p/241>]
Date: Tue 17 Sep 2019
Source: Detroit Free Press [edited]

State health officials said Tuesday [17 Sep 2019] that 3 Michiganders have died from the rare and dangerous mosquito-borne virus eastern equine encephalitis [EEE], and 4 others have been sickened by the disease, amid the biggest outbreak in more than a decade.

Those who live in all 8 of the affected counties -- Kalamazoo, Cass, Van Buren, Berrien, Barry, St. Joseph, Genesee, and Lapeer counties -- are urged to consider canceling, postponing, or rescheduling outdoor events that occur at or after dusk, especially those that involve children, according to the Michigan Department of Health and Human Services. This would include events such as late-evening sports practices or games or outdoor music practices "out of an abundance of caution to protect the public health, and applies until the 1st hard frost of the year [2019]," according to an MDHHS news release.

The 3 people who died were all adults and lived in Kalamazoo, Cass, and Van Buren counties, [respectively], said Bob Wheaton, a spokesman for the Michigan Department of Health and Human Services. The 4 other confirmed cases are in Kalamazoo, Berrien, and Barry counties.

Animals have also been confirmed to have the virus in St. Joseph, Genesee, and Lapeer counties.

The Kalamazoo County Health and Community Services Department also issued a recommendation to local communities and school districts to consider canceling outdoor events at dusk or after dark, when mosquitoes are most active, or move [the events] indoors.  "Michigan is currently experiencing its worst eastern equine encephalitis outbreak in more than a decade," said Dr. Joneigh Khaldun, MDHHS chief medical executive and chief deputy for health. "The ongoing cases reported in humans and animals and the severity of this disease illustrate the importance of taking precautions against mosquito bites."

EEE is one of the deadliest mosquito-borne viruses in the US. One in 3 people who are infected with the virus die. The only way to prevent it is to avoid mosquito bites. The MDHHS says residents should
- apply insect repellents that contain the active ingredient DEET or other US Environmental Protection Agency-registered product to exposed skin or clothing, and always follow the manufacturer's directions for use;
- wear long-sleeved shirts and long pants when outdoors. Apply insect repellent to clothing to help prevent bites;
- maintain window and door screening to help keep mosquitoes outside;
- empty water from mosquito breeding sites around the home, such as buckets, unused kiddie pools, old tires, or similar sites where mosquitoes may lay eggs; and
- use nets and/or fans over outdoor eating areas.

Symptoms of EEE include
- sudden onset of fever, chills;
- body and joint aches, which can progress to a severe encephalitis;
- headache;
- disorientation;
- tremors;
- seizures;
- paralysis; and
- coma.

Anyone experiencing these symptoms should visit a doctor.

[Byline: Kristen Jordan Shamus]
=======================
[The number of human cases remains at 7. However, 3 of these have died since the 6 Sep 2019 report (see Eastern equine encephalitis - North America (18): USA human, horse, deer http://promedmail.org/post/20190910.6667626). However, even among the survivors, there is a significant risk of permanent neurological damage following clinical encephalitis. CDC reports that many individuals with clinical encephalitis "are left with disabling and progressive mental and physical sequelae, which can range from minimal brain dysfunction to severe intellectual impairment, personality disorders, seizures, paralysis, and cranial nerve dysfunction. Many patients with severe sequelae die within a few years" (<https://www.cdc.gov/easternequineencephalitis/tech/symptoms.html>). - ProMED Mod.TY]

[HealthMap/ProMED-mail map:
Michigan, United States: <http://healthmap.org/promed/p/225>
Michigan county map:
Date: Mon 16 Sep 2019
Source: Patch [edited]

The state Department of Public Health is warning that an adult resident of East Lyme has tested positive for eastern equine encephalitis (EEE). This is the 1st human case of EEE identified in Connecticut this season [2019].  The patient became ill during the last week of August [2019] with encephalitis and remains hospitalized. Laboratory tests, which were completed today at the Centers for Disease Control and Prevention (CDC) Laboratory in Ft. Collins, Colorado, confirmed the presence of antibodies to the virus that causes EEE.  "EEE is a rare but serious and potentially fatal disease that can affect people of all ages," said DPH commissioner Renee Coleman Mitchell in a release. "Using insect repellent, covering bare skin, and avoiding being outdoors from dusk to dawn are effective ways to help keep you from being bitten by mosquitoes."  The EEE virus has been identified in mosquitoes in 12 towns and in horses in 2 other towns.

Towns where mosquitoes have tested positive for EEE include Chester, Haddam, Hampton, Groton, Killingworth, Ledyard, Madison, North Stonington, Plainfield, Shelton, Stonington, and Voluntown. Horses have tested positive for EEE virus in Colchester and Columbia this season, and the virus has been detected in a flock of wild pheasants.  Other states throughout the northeast are also experiencing an active season for EEE. In addition to the virus being found in mosquitoes, there have been a total of 8 human cases of EEE infection in Massachusetts and one human case in Rhode Island, with one case in each state resulting in a fatality. "This is the 2nd human case of EEE ever reported in Connecticut," said Dr. Matthew Cartter, director of infectious diseases for the DPH. "The 1st human case of EEE reported in Connecticut occurred in the fall of 2013."

The DPH advises against unnecessary trips into mosquito breeding grounds and marshes, as the mosquitoes that transmit EEE virus are associated with freshwater swamps and are most active at dusk and dawn. Overnight camping or other substantial outdoor exposure in freshwater swamps in Connecticut should be avoided. Even though the temperatures are getting cooler, the DPH is advising that mosquito season is not over, and residents should continue to take measures to prevent mosquito bites, including wearing protective clothing and using repellents.  Although EEE-infected mosquitoes continue to be detected in the south-eastern corner of the state, the numbers are declining, and we are not experiencing the excessively high levels of activity seen in Massachusetts. There are currently no plans to implement widespread aerial pesticide spraying in the state.

Severe cases of EEE virus infection (involving encephalitis, an inflammation of the brain) begin with the sudden onset of headache, high fever, chills, and vomiting. The illness may then progress into disorientation, seizures, and coma. Approximately 1/3 of patients who develop EEE die, and many of those who survive have mild to severe brain damage, according to the DPH.

There is no specific treatment for EEE. Antibiotics are not effective against viruses, and no effective anti-viral drugs have been discovered. Severe illnesses are treated by supportive therapy, which may include hospitalization, respiratory support, IV fluids, and prevention of other infections. It takes 4-10 days after the bite of an infected mosquito to develop symptoms of EEE.

The management of mosquitoes in Connecticut is a collaborative effort involving the Department of Energy and Environmental Protection, the Connecticut Agricultural Experiment Station, and the DPH, together with the Department of Agriculture and the Department of Pathobiology at the University of Connecticut. These agencies are responsible for monitoring and managing the state's mosquito population levels to reduce the potential public health threat of mosquito-borne diseases.

Information on what can be done to prevent getting bitten by mosquitoes and the latest mosquito test results and human infections is available online.  [Byline: Rich Kirby]
===========================
[This has been an active year for EEE virus transmission in the eastern USA from the upper Midwest to the northeastern states and south to Florida. Although historically, EEE human cases in Connecticut have been very rare, the occurrence of a human case in the state this year (2019) is not surprising. There have been equine and/or human EEE cases this summer (2019) in the 3 bordering states: Rhode Island, Massachusetts, and New York. Interestingly, pheasants are mentioned in the above report. They are susceptible and, after being infected with the virus from the bite of an EEE-carrying mosquito, become ill or moribund with viremia titers that can reach 10^9 per ml. Ill or moribund pheasant can be attacked and cannibalized by pen mates that, in turn, are infected orally and may become ill and die as well. As the above report cautions, the only way to avoid infection is for people to avoid mosquito bites. Although the incidence of EEE cases and virus-positive mosquitoes may be declining, there is a risk of infection until the 1st killing frost occurs in autumn, when the mosquitoes are no longer active. - ProMED Mod.TY]

[HealthMap/ProMED-mail map:
Connecticut, United States: <http://healthmap.org/promed/p/210>]
Date: Wed 11 Sep 2019
Source: BBC Afrique [In French, trans. Mod.LXL, edited]

At least 18 people died in 10 days after eating pesticide-contaminated food in 2 localities in Burkina Faso. A dozen still remain under observation in hospitals, according to the Minister of Health.  The 1st cases were reported on [1 Sep 2019] in the town of Didyr in the centre-west of the country, said Professor Claudine Lougue, Minister of Health.  About 15 members of the same families felt unwell after eating local dishes made from bean leaves and small millet seeds, which are actually seed remains. Thirteen died later despite medical care.

On Monday [2 Sep 2019], the ministry received another alert, this time from the central-eastern region. Here again, 14 people from the same family were admitted to the health centres. Five have lost their lives. After analysis, doctors diagnosed massive food poisoning, said the minister. Complementary examinations incriminate pesticides, she said.  "Investigations have been made on samples of biological products such as blood and urine, and we found an unusually high level of pesticides in foods that were consumed. There was an abnormally high level of pesticides, and these pesticides were strongly incriminated," said the minister.

The remains of food have been secured, announced Professor Lougue, who calls on citizens to observe strict hygiene measures in the use of plant leaves for consumption. Pesticides are used for the needs of field work, especially in the countryside during this period of wintering.
Date: Wed, 18 Sep 2019 16:44:19 +0200 (METDST)

London, Sept 18, 2019 (AFP) - British Airways pilots on Wednesday cancelled a strike that had been due September 27, the British Airline Pilots Association union said after two walkouts last week that cost the company dear.   "Someone has to take the initiative to sort out this (pay) dispute and with no sign of that from BA the pilots have decided to take the responsible course," BALPA General Secretary Brian Strutton said in a statement.    The union chief added that the airline's "passengers rightly expect BA and its pilots to resolve their issues without disruption and now is the time for cool heads and pragmatism to be brought to bear.    "I hope BA and its owner IAG show as much responsibility as the pilots," he added.   It was now "time for a period of reflection before the dispute escalates further and irreparable damage is done to the (BA) brand."

However the union added that should the airline "refuse meaningful new negotiations, BALPA retains the right to announce further strike dates".   British Airways, which likes to call itself "the world's favourite airline", flew into turbulence last week as pilots staged a costly and historic two-day strike, tarnishing its global reputation according to aviation analysts.   Pilots walked out for the first time in the company's 100-year history, sparked by a bitter and long-running feud over pay.   BA faced the embarrassment of grounding its entire UK fleet on September 9 and 10, causing the cancellation of about 1,600 flights.   The move sparked travel chaos for about 200,000 passengers who had been due to fly in and out of London's Gatwick and Heathrow airports.

The disruption continued into September 11 because half of BA's 300 aircraft and more than 700 pilots were mostly in the wrong place.   As a result, BA was forced to cancel approximately ten percent of its daily 850 flights in and out of Britain that day.    BALPA and its members are demanding a bigger share of British Airways profits.   The airline has offered a salary increase of 11.5 percent over three years, which it argues would boost the annual pay of some captains to £200,000 ($250,000 or 226,000 euros).   However, the union has rejected the proposal made in July.   BALPA meanwhile estimates that last week's 48-hour strike cost the airline £80 million.   BA is owned by IAG, which was formed in 2011 with the merger of British Airways and Spain's Iberia. IAG has since added other carriers, including Austria's Vueling and Ireland's Aer Lingus.
Date: Wed, 18 Sep 2019 12:26:37 +0200 (METDST)
By Sam Reeves

Kuala Lumpur, Sept 18, 2019 (AFP) - Toxic haze from Indonesian forest fires closed schools and airports across the country and in neighbouring Malaysia Wednesday, while air quality worsened in Singapore just days before the city's Formula One motor race.   Illegal fires to clear land for agriculture are blazing out of control on Sumatra and Borneo islands, with Jakarta deploying thousands of security forces and water-bombing aircraft to tackle them.

Indonesian blazes belch smog across Southeast Asia annually, but this year's are the worst since 2015 and have added to concerns about wildfire outbreaks worldwide exacerbating global warming.   On Wednesday, air quality deteriorated to "very unhealthy" levels on an official index in many parts of peninsular Malaysia, to the east of Sumatra, with the Kuala Lumpur skyline shrouded by dense smog.    Nearly 1,500 schools were closed across Malaysia due to the air pollution, with over one million pupils affected, according to the education ministry.

A growing number of Malaysians were suffering health problems due to the haze, with authorities saying there had been a sharp increase in outpatients at government hospitals -- many suffering dry and itchy eyes.   Indonesian authorities said hundreds of schools in hard-hit Riau province on Sumatra were shut, without providing a precise number, while about 1,300 were closed in Central Kalimantan province on Borneo.    Borneo is shared between Indonesia, Malaysia and Brunei.   Poor visibility closed seven airports in the Indonesian part of Borneo, the transport ministry in Jakarta said. Scores of flights have already been diverted and cancelled in the region in recent days due to the smog.

- Singapore smog race? -
Air quality in Singapore worsened to unhealthy levels and a white smog obscured the striking waterfront skyline, featuring the Marina Bay Sands casino resort with its three towers and boat-shaped top level.    The worsening pollution increased fears that this weekend's Formula One race may be affected. Organisers say the possibility of haze is one of the issues in their contingency plan for Sunday's showpiece night race, but have not given further details.

The city-state's tourism board said spectators would be able to buy masks as protection from the haze if conditions did not improve and assistance would be provided for those who feel unwell, the Today news portal reported.   The fires have sparked tensions between Indonesia and Malaysia.    Indonesia's environment minister initially suggested the haze was from Malaysian fires despite satellite data showing hundreds of blazes in Indonesia and only a handful in its neighbour, prompting anger from her Malaysian counterpart.

Indonesia later sealed off dozens of plantations where it said fires were blazing, including some owned by Malaysia-based firms, deepening the row.   But Prime Minister Mahathir Mohamad, who has struck a diplomatic tone throughout the crisis, said Malaysia may pass legislation forcing its companies to tackle fires on plantations abroad.   Malaysia wants its firms with sites overseas to put out blazes contributing to the haze, he said, adding: "Of course, if we find they are unwilling to take action, we may have to pass a law to make them responsible."

The Indonesian government has insisted it is doing all it can to fight the blazes. But this year's fires have been worsened by dry weather and experts believe there is little chance of them being extinguished until the onset of the rainy season in October.   Indonesia's meteorology, climate and geophysics agency said Wednesday that over 1,000 hotspots -- areas of intense heat detected by satellite that indicate a likely fire -- had been sighted, most of them on Sumatra.
Date: Wed, 18 Sep 2019 12:14:44 +0200 (METDST)
By Aishwarya KUMAR

New Delhi, Sept 18, 2019 (AFP) - India announced on Wednesday a ban on the sale of electronic cigarettes, as a backlash gathers pace worldwide due to health concerns about a product promoted as less harmful than smoking tobacco.   The Indian announcement, also outlawing production, import and distribution, came a day after New York became the second US state to ban flavoured e-cigarettes following a string of vaping-linked deaths.   "The decision was made keeping in mind the impact that e-cigarettes have on the youth of today," Finance Minister Nirmala Sitharaman told reporters in New Delhi.

E-cigarettes do not "burn" but instead heat up a liquid -- tasting of everything from bourbon to bubble gum and which usually contains nicotine -- that turns into vapour and is inhaled.   The vapour is missing the estimated 7,000 chemicals in tobacco smoke but does contain a number of substances that could potentially be harmful.   They have been pushed by producers, and also by some governments including in Britain, as a safer alternative to traditional smoking -- and as a way to kick the habit.

However critics say that apart from being harmful in themselves, the flavours of e-cigarette liquids appeal particularly to children and risk getting them addicted to nicotine.   Some 3.6 million middle and high school students in the United States used vaping products in 2018, an increase of 1.5 million on the year before.   The New York emergency legislation followed an outbreak of severe pulmonary disease that has killed seven people and sickened hundreds.   President Donald Trump's administration announced last week that it would soon ban flavoured e-cigarette products to stem a rising tide of youth users.

- Big E-Tobacco -
Although few Indians vape at present, the Indian ban also cuts off a vast potential market of 1.3 billion consumers for makers of e-cigarettes.   Tobacco firms have been investing heavily in the technology to compensate for falling demand for cigarettes due to high taxes and public smoking bans, particularly in the West.

In 2018 Altria, the US maker of brands such as Marlboro and Chesterfield, splashed out almost $13 billion on a stake in one of the biggest e-cigarette makers, Juul.   A few Indian states have already banned e-cigarettes although the restrictions have been ineffective since online sale of vaping products continue.   The new ban does not cover traditional tobacco products in India.   According to the World Health Organization, India is the world's second-largest consumer of tobacco products, killing nearly 900,000 people every year.

Nearly 275 million people over 15, or 35 percent of adults, are users, although chewing tobacco -- which also causes cancer -- is more prevalent than smoking.   India is also the world's third--largest producer of tobacco, the WHO says, and tobacco farmers are an important vote bank for political parties.   According to the Associated Chambers of Commerce and Industry, an estimated 45.7 million people depend on the tobacco sector in India for their livelihood.   Tobacco is also a major Indian export, and the government holds substantial stakes, directly or indirectly, in tobacco firms including in ITC, one of India's biggest companies.
Date: Wed, 18 Sep 2019 03:56:31 +0200 (METDST)

Washington, Sept 18, 2019 (AFP) - Hurricane Humberto strengthened to a major Category 3 storm on Tuesday and was expected to pass near Bermuda, threatening it with dangerous waves and heavy rain, the US National Hurricane Center said.   "Hurricane conditions are expected to reach Bermuda by Wednesday night and continue into early Thursday morning," the Miami-based NHC said.   "Some fluctuations in intensity are likely during the next day or so, but Humberto should remain a powerful hurricane through Thursday," it said.   As of 8:00 pm (0000 GMT), the storm had maximum sustained winds of 115 miles per hour (185 kilometers per hour) and was moving east-northeast at 12 miles per hour.
Date: Wed, 18 Sep 2019 01:36:21 +0200 (METDST)

Dakar, Sept 17, 2019 (AFP) - Four people died after a boat carrying dozens of tourists capsized during heavy storms in Senegal, authorities and emergency services said Tuesday.   The death toll could rise as three passengers were said to be missing after the accident.  The boat was carrying several Senegalese nationals, six French people, two Germans, two Swedes and one person from Guinea-Bissau, when it turned over Monday in driving rain and a heavy swell, fire department chief Papa Angel Michel Diatta said.   All the dead were Senegalese, officials and emergency services said.

Two worked in a national park, one was a woman and the other victim was a child, Diatta said.   The boat was heading for the Madeleine islands, site of an offshore national park popular with tourists who travel from Dakar, coastal capital of the West African country.   Senegalese President Macky Sall appealed for "greater caution and respect for existing security norms duing the rainy season" in a tweet.

Emergency services continued to look for those missing on Tuesday. AFP journalists saw a dozen divers at the scene. Distressed families were waiting on the shore to get news of their loved ones.    "The gendarmerie called us at 5:00 am (GMT and local time). My brother was on the boat. The worst thing is not knowing," said Aminata Diop, who was among the relatives on the beach.   There are "four dead bodies and between three and four people are missing. Thirty-five people were on the boat. Search and rescue operations are continuing this morning," Interior Minister Aly Ngouille Ndiaye told AFP by telephone.

The causes of the accident were unclear. The interior minister told Senegalese media overnight that several tourists were worried about the heavy rains and wanted to return to the pier but others wanted to stay on the boat.   The survivors spent the night on the island, Ndiaye told local radio on Tuesday. Blankets and food were sent to them and they were to be ferried back to the mainland in the morning, he added.   The rainy season arrived late this year and heavy storms have resulted in several casualties this month.    Two fishermen were killed on their canoe in the same area nearly two weeks ago.
Date: Tue, 17 Sep 2019 15:38:37 +0200 (METDST)

Jakarta, Sept 17, 2019 (AFP) - Massive forest fires in Indonesia that have caused a toxic haze to spread as far as Singapore and peninsular Malaysia are also seriously affecting endangered orangutans and their habitat, a rescue foundation said Tuesday.   Jakarta has deployed thousands of troops as temporary fireman and deployed dozens of water-bombing aircraft to battle blazes that are turning pristine forest into charred landscape in Sumatra and Borneo islands.   The fires -- usually started by illegal burning to clear land for farming -- have unleashed a choking haze across parts of southeast Asia.

The Borneo Orangutan Survival Foundation said Tuesday that the haze was affecting hundreds of great apes in its care at rescue centres and wildlife re-introduction shelters.   "The thick smoke does not only endanger the health of our staff... but also it affects the 355 orangutans we currently care for", the foundation said in a statement, referring to just once cetre in Kalimantan   "As many as 37 young orangutans are suspected to have contracted a mild respiratory infection," it added.   Conditions were so bad at their Samboja Lestari facility in East Kalimantan that outdoor activities for the animals had been restricted to a few hours a day.

Orangutans have been particularly vulnerable to commercial land clearances and have seen their natural habitat shrink dramatically in the last few decades.   The population of orangutan in Borneo has plummeted from about 288,500 in 1973 to about 100,000 today, according to the International Union for Conservation of Nature.   The toxic smoke caused by the forest fires is an annual problem for Indonesia and its neighbours, but has been worsened this year by particularly dry weather.   On Borneo island, which Indonesia shares with Malaysia and Brunei, pollution levels were "hazardous", according to environment ministry data.   Hundreds of schools across Indonesia and Malaysia were shut.