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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 ...

Turkey

Geographical Information:
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Turkey is officially known as the Republic of Turkey and is bordered on the northwest by Bulgaria and Greece, on the north by the Black Sea and on the south by Syria, Iraq and t
e Mediterranean Sea. The capital is Ankara with a population of about 2.5 million though Istanbul is a much larger city (6.6 million). The population of the country is estimated at 62 million with the majority in the cities and along the costal regions.
Climate:
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The Mediterranean and Aegean shores of Turkey have long and hot summers with a milder winter. In Istanbul the average July temperature reaches 230C while in January it can drop to 00C. Throughout the country the annual rainfall is about 29". This is mainly during the months of December and January.

Health Care Facilities:
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The level of adequate health facilities vary considerably within the country. Most of the better hotels will have access to English speaking doctors but care may be required if hospital admission is required.
Disease Profile:
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Cholera and other water borne diseases are frequently reported from Istanbul. In the southeastern city of Diyarbakir there are regular reports of dysentery, typhoid, meningitis and other contagious diseases.

General Food & Water Hygiene:
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There can be little doubt that travellers to Turkey who disregard basic hygiene precautions will run a risk of developing significant illness and a ruined holiday. With simple general care most tourists will remain healthy.

Food Rules:
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Always eat in clean restaurants and hotels. Eat freshly cooked hot food. Stay away from cold salads, especially lettuce. Don’t eat any of the bivalve shellfish dishes such as oysters and mussels. Never eat food prepared by street vendors. Always peel your own fruit if at all possible.
Water Rules:
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Never use the hotel tap water for drinking or brushing your teeth unless you can easily smell chlorine. Don’t allow ice in your drinks and be wary of the hotel water jug which may be in your room each day. Any of the canned drinks or bottles are usually quite safe. Just check the seal first!
Rabies in Turkey:
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This disease is only a particularly risk for travellers who plan to have extended trekking holidays throughout Turkey. Most tourists travelling for a ‘sun’ holiday would be very unfortunate to be exposed but nevertheless care should be taken at all times to ensure that there is no contact with warm blooded animals. This is mainly true for dogs and cats but any infected
warm blooded animal can transmit the disease through its saliva. Any bite, lick or scratch should be treated seriously.
*
Wash out the area
*
Apply an antiseptic
*
Attend for urgent medical attention
Sun Stroke:
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The immense strength of the sun in the Middle East can often be underestimated by the Irish traveller. This is especially true for small children and the elderly. Try and stay out of the direct sunlight between 11am to 4pm. Use a wide brimmed hat if possible to protect yourself. Drink plenty of fluid (about 2 or 3 times as much as in Ireland) and remember to increase your salt intake unless this is contraindicated because of high blood pressure or heart disease etc. Any signs of dehydration should be recognised and treated early (dry lips, headache etc.).
Anthrax:
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This bacterial disease is sometimes contracted by travellers who purchase untreated leather goods while abroad.
Drug Trafficking:
*****************************************
Remember that Turkey is regarded as a gateway to Europe. Never agree to carry belongings for others unless you are certain of the contents.
Malaria in Turkey:
*****************************************
The risk of malaria in Turkey is very limited and transmission usually only occurs between the months of March to November in the Çukurova / Amikova areas and from mid-March to mid-October in southeast Anatolia. These are mainly away from the standard tourist routes and so prophylaxis will usually not be required. Nevertheless there may be an abundant supply of mosquitoes and other insects around. Travellers should carry insect repellents and wear longer sleeved clothing when at risk.
Vaccinations for Turkey:
*****************************************
There are no compulsory vaccines for entry to Turkey from Ireland. However, travellers are advised to ensure that they are adequately covered against Poliomyelitis, Typhoid, Tetanus and Hepatitis A. Those spending longer in the country or undertaking a trekking holiday may also need to consider vaccination cover against Rabies and Hepatitis B .
Further Information:
*****************************************
Travellers can obtain further health information for overseas travel by contacting either of our offices. Useful web sites for information on Turkey include;

www.WHO.int
www.CDC.gov
www.FCO.gov.uk

Travel News Headlines WORLD NEWS

Date: Mon 5 Aug 2019 20:42 TRT
Source: Daily Sabah [edited]

A group of Turkish scientists has identified 4 rare viruses in Turkey that cause haemorrhagic fever and lead to death due to renal failure, a scientist said [Mon 5 Aug 2019].

A team from the Biology Department of Bulent Ecevit University, led by Professor Mehmet Ali Oktem of Dokuz Eylul University's Medical Virology Department, conducted research on hantavirus types that develop in rodents and small mammals in Turkey and 4 particular subspecies that can cause human disease.

Oktem said he has been doing fieldwork on the hantavirus since 2000, adding that the presence of the virus in rodents was discovered in Turkey for the 1st time in 2004 in the Black Sea region. Meanwhile, the 1st cases in which the viruses developed in humans were reported in 2004 in the Aegean region, and subsequently in Zonguldak and Bartin provinces in the western Black Sea region in 2009.

The newly-identified rare viruses which can be transmitted to humans from rodents, have been named after the provinces or towns they were found in, namely the "Dobrava Hantavirus Igneada", "Dobrava Hantavirus Giresun", "Puumala Hantavirus Bartin", and "Tuula Hantavirus Palandoken."
=====================
[Cases of hantavirus haemorrhagic fever with renal syndrome have been reported in Turkey previously. In January-March 2009 there were 12 laboratory confirmed cases that were serologically positive for Puumala virus subtype.

Reference
---------
Ertek M, Buzgan T; Refik Saydam National Public Health Agency; Ministry of Health, Ankara, Turkey: An outbreak caused by hantavirus in the Black Sea region of Turkey, January-May 2009. Euro Surveill. 2009; 14(20). pii: 19214;  <https://www.eurosurveillance.org/content/10.2807/ese.14.20.19214-en>

Finding Puumala virus in rodents in Turkey is not surprising, since it has caused human cases there in the past. Dobrava-Belgrade orthohantavirus (DOBV) was first isolated from yellow-necked mice (_Apodemus flavicollis_) found in Dobrava village, Republic of Slovenia. It was subsequently isolated in striped field mice in Russia and other parts of Eastern Europe and this rodent occurs in Turkey. The report above indicates that it harbors DOBV in Turkey. It will be interesting to see a genomic comparison of these viruses from Turkey with sequences of these same viruses from other geographic areas. - ProMED Mod.TY]

[HealthMap/ProMED-mail map of Turkey:
Date: Tue 30 Jul 2019
Source: Time Turk [in Turkish, machine trans., edited]
<https://www.timeturk.com/mus-ta-15-kisi-brucella-hastaligina-yakalandi/haber-1150899>

A total of 15 people engaged in animal fattening in the town and highlands of Kirkoy have been infected with brucellosis. A resident of the town said that many small ruminants in the town had suffered a miscarriage during the birth season and that 4 people in one family are now being treated for brucellosis. The patients had been seen at the Elazig Ataturk Research Hospital and "the doctors made the examinations and tests and as a result a brucellosis diagnosis was made. The patients were constantly sluggish and sleepy.

Currently, 15 people are receiving treatment for the same disease, "he said. Mus Provincial Health Director Serdal Turkoglu stated that 119 cases were encountered in Muay in 2019 and that the patients were treated in the hospitals in the province and that they made the necessary studies and tests on the subjects in the field. He reminded that the source of animal products should not be consumed in order to prevent the disease: "cheese, cream, butter, cream, ice cream made from pasteurized or well boiled milk should be preferred. Pickled cheeses should be consumed after waiting for at least 3 months. Frequent abortions and stillbirths should be examined by a veterinarian immediately.

The animals' wastes and the feeds that these wastes come into contact with, should be buried in sealed bags. Animals should be vaccinated against brucella," he said. -- Communicated by: ProMED-mail <promed@promedmail.org> [This infection, a bacterial zoonosis, is classified among the category B biowarfare agents. Natural transmission to humans occurs after occupational exposure or through ingestion of contaminated food products. Although brucellosis has become a rare entity in the United States and many industrialized nations because of animal vaccination programs, this condition remains a significant health problem in many developing countries.

Each species of _Brucella_ has a specific animal reservoir in which chronic disease is present. The bacilli tend to localize in the reproductive organs of the animals, causing sterility and abortions, and are shed in large numbers in the animal's urine, milk, and placental fluid. This localization allows for efficient spread to farmers, veterinarians, slaughterhouse workers, and consumers.

Among the 4 species known to cause disease in humans, _Brucella melitensis_ (from goats, sheep, or camels) may be the most virulent, producing the most severe and acute cases of brucellosis with disabling complications. A prolonged course of illness, which may be associated with suppurative destructive lesions, is associated with _B. suis_ (from feral or commercially raised pigs) infection. _B. abortus_ (from cattle, buffalo, and camels) is associated with mild-to-moderate sporadic disease that is rarely associated with complications. - ProMED Mod.LL]

[HealthMap/ProMED map available at: Turkey:
<http://healthmap.org/promed/p/87>]
19th June 2019
https://www.dailysabah.com/turkey/2019/06/18/heavy-rainfall-floods-parts-of-northeastern-turkeys-trabzon-killing-7

emAA Photo/em

At least seven people were killed in north-eastern Turkey's Trabzon province after heavy rainfall triggered flash floods on Tuesday. Interior Minister Süleyman Soylu had previously announced that four people were killed in the province's Araklı district, while three others were injured and six people were missing. Agriculture and Forestry Minister Bekir Pakdemirli said three bodies were found in the area later on Wednesday, bringing the death toll to seven with three others unaccounted for.  Trabzon Governor Ismail Ustaoğlu said search and rescue efforts had been launched by Disaster and Emergency Management Authority (AFAD) units to locate the missing.

The floods hit Araklı's Çamlıktepe and Yeşilyurt neighbourhoods after a nearby stream overflowed following sudden and heavy rainfall.  Firefighters were immediately dispatched to the scene but had difficulty reaching the affected areas as debris brought by the floods blocked the roads.  AFAD and gendarmerie units were also called in to help with the rescue efforts. The governor said the floods also destroyed four houses and offices in the district.  Finance and Treasury Minister Berat Albayrak offered condolences for those that perished in the disaster and said all available resources were being made available to assist the rescue operation.

Date: Sat 23 Feb 2019
Source: Xinhua [abridged, edited]

Turkey's experts recently warned that epidemic diseases such as measles that have been off the grid for years might come back amid decreasing vaccination rates in the country in the past few years under the influence of anti-vaccine discourse. The anti-vaccination trend started with 183 people in 2011, reaching 980 in 2013 and 5091 in 2015. In 2017, a total of 23 600 families declined compulsory vaccine, professor Mehmet Ceylan, head of paediatric infectious diseases at Ankara's Hacettepe Medical Faculty, said.

The expert warned of an epidemic outbreak if vaccination rates falls under 95 per cent, or some 50 000 people in Turkey. Ceylan said that diseases such as diphtheria and tetanus, which have been off the grid in Turkey for years, might show up again.
 
WHO also voiced concern about the increasing anti-vaccination movement in Turkey. An increasing number of groups were "misleading" the public about the effects of vaccines, harming their trust in getting vaccinated, WHO said.
Turkish health ministry has set up a special website to inform the public about vaccines and to fight false facts. But the anti-vaccination movement is increasingly active on social media, with slogans such as "I have no obligation to vaccinate". A great majority is concerned with the content of the vaccines such as use of mercury or aluminum.

It's obligatory in Turkey that a baby be given a total of 16 different types of vaccination in the 1st 24 months. Parents have to sign an official document holding them responsible, if they reject vaccination. Professor Ata Nevzat Yalcin from Akdeniz University's Faculty of Medicine, Infection Diseases and Clinical Microbiology, warned against the latest trend of increasing measles in Turkey. "The worldwide increase in the disease in 2017 was also observed in our country," he said. There were 572 measles cases in 2014, 342 in 2015, 9 cases in 2016, 69 cases in 2017. In the 1st 9 months of 2018, the number of the cases exceeded 500, he added. Measles arises especially in the spring and winter months, and can cause recurrent epidemics every 2 to 3 years, Yalcin said.

According to the Health Ministry's figures, the measles vaccination rate was 97 per cent in 2015, 98 per cent in 2016, and 96 per cent in 2017. Turkey faced a measles outbreak, which was off the grid for many years, compounded by the arrival of millions of refugees after civil war erupted in neighbouring Syria.

Some 7415 people were diagnosed with measles in Turkey in 2013, but the epidemic was prevented after an intense vaccination program. The number of people diagnosed with measles disease reached 510 in the 1st 9 months of 2018 in Turkey, a recent report of WHO said. According to WHO, the number of global measles cases doubled to 229 068 in 2018, and 82 596 of them were in Europe, mostly caused by stalled vaccination levels.
Date: Wed, 13 Feb 2019 13:01:04 +0100

Beijing, Feb 13, 2019 (AFP) - Beijing has warned its citizens in Turkey to "be more vigilant", as bilateral tensions rise after strong Turkish criticism of China's treatment of its minority Uighur community.   Nearly one million Uighurs and other Turkic-speaking minorities are being held in extrajudicial detention in camps in Xinjiang, according to a UN panel of experts, where most of China's more than 10 million Uighurs live.

Beijing has admitted to placing people in "vocational education centres" to prevent radical Islamism. Critics however allege Uighurs in the camps are being brainwashed in a massive campaign to enforce conformity with Chinese society and abandon Islam.   The northwestern Xinjiang region -- home to some 10 million Uighurs -- has long suffered from violent unrest, which China claims is orchestrated by an organised "terrorist" movement seeking the region's independence.

Turkey, which has its own significant Uighur population, said on Saturday China's treatment of the Uighurs was "a great embarrassment for humanity".   It also called on the international community and the UN "to take effective steps to end the human tragedy in Xinjiang region".   China's embassy to Turkey wrote on its website: "We call once more on Chinese citizens in Turkey and Chinese tourists going to Turkey to be more vigilant and pay attention to their personal security as well as the security of their belongings."

The warning was posted on Sunday, the day after the declarations by the Turkish Ministry of Foreign Affairs.   Violent anti-China protests against the county's treatment of the Uighurs have previously broken out in Turkey. In 2015, militant Turkish nationalists burnt a Chinese flag in front of China's embassy in Ankara.   A popular Chinese restaurant in Istanbul also had its windows smashed and a group of South Korean tourists who were visiting the city was attacked because they were mistaken for Chinese.
More ...

Canada

Canada - US Consular Information Sheet
February 17, 2009
COUNTRY DESCRIPTION: Canada is a highly developed, stable democracy. Tourist facilities are widely available in much of the country, but the northern and wilderness areas are less develop
d and facilities there can be vast distances apart. Read the Department of State Background Notes on Canada for additional information.
ENTRY/EXIT REQUIREMENTS: Entry into Canada is solely determined by Canadian Border Services Agency (CBSA) officials in accordance with Canadian law. Canadian law requires that all persons entering Canada carry both proof of citizenship and proof of identity. A valid U.S. passport, passport card or NEXUS card (see below) satisfies these requirements for U.S. citizens. If U.S. citizen travelers to Canada do not have a passport, passport card or approved alternate document such as a NEXUS card, they must show a government-issued photo ID (e.g. Driver’s License) and proof of U.S. citizenship such as a U.S. birth certificate, naturalization certificate, or expired U.S. passport. Children under sixteen need only present proof of U.S. citizenship.

It is very important to note that all Americans traveling to the U.S. by air, including from Canada, must present a valid U.S. passport to enter or re-enter the U.S. Effective June 1, 2009, a similar requirement goes into effect for entry into the U.S. via land and sea borders. All Americans will need to present a U.S. passport, passport card, NEXUS card, Enhanced Drivers License or other Western Hemisphere Travel Initiative (WHTI)-compliant document in order to enter the U.S. by land or sea. American travelers are urged to obtain WHTI-compliant documents before entering Canada well in advance of their planned travel. For the most recent information on WHTI and WHTI-compliant documents, please see our web site.

One of the WHTI-compliant documents for crossing the land border is the U.S. Passport Card. The card may not be used to travel by air and is available only to U.S. citizens. You can read further information on the U.S. Passport Card on our web site. We strongly encourage all American citizen travelers to apply for a U.S. passport well in advance of anticipated travel. American citizens can visit travel.state.gov or call 1-877-4USA-PPT (1-877-487-2778) for information on how to apply for their passports.

Both the U.S. and Canadian governments urge frequent travelers to join the NEXUS trusted traveler program. NEXUS members receive a special travel card that allows expedited border crossings for both private and commercial travelers through both U.S. and Canadian border controls very quickly. The CBP has detailed information about the NEXUS program.
U.S. citizens entering Canada from a third country must have a valid U.S. passport. A visa is not required for U.S. citizens to visit Canada for up to 180 days. Anyone seeking to enter Canada for any purpose other than a visit (e.g. to work, study or immigrate) must qualify for the appropriate entry status, and should contact the Canadian Embassy or nearest consulate and visit the Canadian immigration web site.

Anyone with a criminal record (including misdemeanors or Driving While Impaired (DWI) charges may be barred from entering Canada and must obtain a special waiver well in advance of any planned travel. To determine whether you may be inadmissible and how to overcome this finding, refer to the Canadian citizenship and immigration web site.
For further information on entry requirements, travelers may contact the Canadian Embassy at 501 Pennsylvania Avenue NW, Washington DC 20001, tel. (202) 682-1740; or the Canadian consulates in Atlanta, Boston, Buffalo, Chicago, Dallas, Detroit, Los Angeles, Miami, Minneapolis, New York, San Juan or Seattle.

Information about dual nationality or the prevention of international child abduction can be found on our web site. For further information about customs regulations, please read our Customs Information sheet.
SAFETY AND SECURITY: For the latest security information, Americans traveling abroad should regularly monitor the Department of State, Bureau of Consular Affairs’ web site, where the current Travel Warnings and Travel Alerts, as well as the Worldwide Caution, can be found.

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

The Department of State urges American citizens to take responsibility for their own personal security while traveling overseas. For general information about appropriate measures travelers can take to protect themselves in an overseas environment, see the Department of State’s A Safe Trip Abroad.
CRIME: Although Canada generally has a lower crime rate than the U.S., violent crimes do occur throughout the country, especially in urban areas. Visitors to large cities should be aware that parked cars are regularly targeted for opportunistic smash-and-grab thefts, and they are cautioned to avoid leaving any possessions unattended in a vehicle, even in the trunk. Due to the high incidence of such crimes, motorists in Montreal, Vancouver and some other jurisdictions can be fined for leaving their car doors unlocked or for leaving valuables in view. Auto theft in Montreal and Vancouver, including theft of motor homes and recreational vehicles, may even occur in patrolled and apparently secure parking lots and decks. SUVs appear to be the particular targets of organized theft. While Canadian gun control laws are much stricter than those of the U.S., such laws have not prevented gun-related violence in certain areas.
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. Each of Canada’s provinces has a Crime Victim Compensation Board from which American victims of crime in Canada may seek redress.

As in the U.S., emergency assistance can be reached by dialing “911.
See our information on Victims of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION: The level of public health and sanitation in Canada is high. Canada’s medical care is of a high standard but is government-controlled and rationed. Quick and easy access to ongoing medical care is difficult for temporary visitors who are not members of each province’s government-run health care plans. Many physicians will not take new patients. Access to a specialist is by only by referral and may take months to obtain. Emergency room waits can be very long. Some health care professionals in the province of Quebec may speak only French. No Canadian health care provider accepts U.S. domestic health insurance, and Medicare coverage does not extend outside the United States. Visitors who seek any medical attention in Canada should be prepared to pay in cash in full at the time the service is rendered. Traveler’s medical insurance is highly recommended even for brief visits.

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

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. For information about outbreaks of infectious diseases abroad, consult the World Health Organization’s (WHO) web site. Further health information for travelers is available from the WHO.

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 Canada is provided for general reference only, and may not be totally accurate in a particular location or circumstance. As in the United States, all emergency assistance in Canada can be reached by dialing 911.

Transport Canada is the Canadian federal government agency responsible for road safety, although each province or territory has the authority to establish its own traffic and safety laws and issue driving licenses. For detailed information on road conditions throughout Canada, as well as links to provincial government web sites, please see the Transport Canada web site or the Canadian Automobile Association web site. The CAA honors American Automobile Association membership. Some automobile warranties of vehicles purchased in the U.S. may be invalid in Canada; please check the warranty of your vehicle.

Driving in Canada is similar to driving in many parts of the United States. Distances and speeds, however, are posted in kilometers per hour, and some signs, particularly in Quebec, may only be in French. U.S. driver’s licenses are valid in Canada. Proof of auto insurance is required. U.S. auto insurance is accepted as long as an individual is a tourist in Canada. U.S. insurance firms will issue a Canadian insurance card, which should be obtained and carried prior to driving into Canada. For specific information concerning Canadian driving permits, mandatory insurance and entry regulations, please contact the Canadian National Tourist Organization.
Unless otherwise posted, the maximum speed limit in Canada is 50km/hr in cities and 80km/hr on highways. On rural highways, the posted speed limit may be 100km/hr (approximately 60 miles/hr). Seat belt use is mandatory for all passengers, and child car seats must be used by children under 40 pounds. Some provinces require drivers to keep their vehicles’ headlights on during the day. Motorcycles cannot share a lane, and safety helmets for motorcycle riders and passengers are mandatory. Many highways do not have merge lanes for entering traffic. Tailgating and rapid lane-changes without signaling are common. Emergency vehicles frequently enter the oncoming traffic lane to avoid congestion. Drivers should be aware that running a red light is a serious concern throughout Canada, and motorists are advised to pause before proceeding when a light turns green.
Driving while impaired (DWI) is a criminal offense in Canada. Penalties are heavy, and any prior conviction (no matter how old or how minor the infraction) is grounds for exclusion from Canada. Americans with a DWI record must seek a waiver of exclusion from Canadian authorities before traveling to Canada, which requires several weeks or months to process. It is illegal to take automobile radar detectors into Quebec, Ontario, Manitoba, the Yukon or the Northwest Territories, regardless of whether they are used or not. Police there may confiscate radar detectors, operational or not, and impose substantial fines.

Winter travel can be dangerous due to heavy snowfalls and hazardous icy conditions. Some roads and bridges are subject to periodic winter closures. Snow tires are required in some Provinces. The Canadian Automobile Association has tips for winter driving in Canada. Travelers should also be cautious of deer, elk and moose while driving at night in rural areas.

Highway 401, from Detroit to Montreal, is one of the busiest highways in North America. It has been the scene of numerous, deadly traffic accidents due to sudden, severe and unpredictable weather changes, high rates of speed, and heavy truck traffic. There have been numerous incidents involving road racing and dangerous truck driving. Drivers tend to be aggressive, often exceeding speed limits and passing on both sides, and police enforcement is spotty. In addition, approaches to border crossings into the United States may experience unexpected traffic backups. Drivers should be alert, as lane restrictions at border approaches exist for drivers in NEXUS and FAST expedited inspection programs.
Please refer to our Road Safety page for more information. Visit Canada’s national authority responsible for road safety.

AVIATION SAFETY OVERSIGHT: The U.S. Federal Aviation Administration (FAA) has assessed the Government of Canada’s Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for oversight of Canada’s air carrier operations. For more information, travelers may visit the FAA web site.
SPECIAL CIRCUMSTANCES: IMPORTATION OF FIREARMS: Firearms are much more strictly controlled in Canada than in the United States. Violation of firearms restrictions may result in prosecution and imprisonment. As of January 1, 2001, visitors bringing any firearms into Canada, or planning to borrow and use firearms while in Canada, must declare the firearms in writing using a Non-Resident Firearm Declaration form. Visitors planning to borrow a firearm in Canada must obtain in advance a Temporary Firearms Borrowing License. These forms must be signed before a Canadian Border Services Agency (CBSA) officer at the border and no photocopies are available at the border. Full details and downloadable forms are available from the Canada Firearms Program. Canadian law requires that officials confiscate firearms and weapons from persons crossing the border who deny having the items in their possession. Confiscated firearms and weapons are never returned. Possession of an undeclared firearm may result in arrest and imprisonment.

Canada has three classes of firearms: non-restricted, restricted, and prohibited. Non-restricted firearms include most ordinary hunting rifles and shotguns. These may be brought temporarily into Canada for sporting or hunting use during hunting season, use in competitions, in-transit movement through Canada, or personal protection against wildlife in remote areas of Canada. Anyone wishing to bring hunting rifles into Canada must be at least 18 years old, must properly store he firearm for transport, and must follow the declaration requirements described above. Restricted firearms are primarily handguns; however, pepper spray, mace, and some knives also are included in this category. A restricted firearm may be brought into Canada, but an Authorization to Transport permit must be obtained in advance from a Provincial or Territorial Chief Firearms Officer. Prohibited firearms include fully automatic, converted automatics, and assault-type weapons. Prohibited firearms are not allowed into Canada.
SPECIAL CIRCUMSTANCES: PORNOGRAPHY AND CONTROLLED SUBSTANCES: Canada has strict laws concerning child pornography, and in recent years there has been an increase in random checks of electronic media of travelers entering Canada. Computers are subject to search without a warrant at the border, and illegal content can result in the seizure of the computer as well as detention, arrest and prosecution of the bearer.

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 Canada’s laws, even unknowingly, may be expelled, arrested or imprisoned. Penalties for possession, use, or trafficking in illegal drugs in Canada 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.
Canadian law prohibits the unlawful importation or trafficking of controlled substances and narcotics. A number of travelers, including Americans, have been arrested for attempting to smuggle khat, a narcotic from East Africa, into Canada. Smugglers risk substantial fines, a permanent bar from Canada and imprisonment.

Please also see our information on Criminal Penalties.

CHILDREN'S ISSUES: For information see our Office of Children’s Issues web pages on intercountry adoption and international parental child abduction.
REGISTRATION / EMBASSY LOCATION: Americans living or traveling in Canada are encouraged to register with the U.S. Embassy or nearest U.S. Consulate through the State Department’s travel registration web site, and to obtain updated information on travel and security within Canada. By registering, American citizens make it easier for the Embassy or Consulate to contact them in case of emergency.

The U.S. Embassy is in Ottawa, Ontario, at 490 Sussex Drive, K1N 1G8, telephone (613) 238-5335, fax (613) 688-3082. The Embassy's consular district includes Ottawa, Easter Ontario (Kingston, Lanark, Leeds, Prescott, Refrew, Russell, and Stormont); and those parts of the Quebec Regions of Outaouais and Abitibi-Temiscamingues near Ottawa.
U.S. Consulates General are located at:
Calgary, Alberta, at 10th Floor, 615 Macleod Trail SE, telephone (403) 266-8962; emergency-after hours-to report the death or arrest of an American (403) 2 66 -8962 then press '0'; fax (403) 264-6630. The consular district includes Alberta, Manitoba, Saskatchewan, and the Northwest Territories, excluding Nunavut.
Halifax, Nova Scotia, at 1969 Upper Water Street, Suite 904, Purdy's Wharf Tower II, telephone (902) 429-2480; emergency-after hours-to report the death or arrest of an American (902) 429-2485; fax (902) 423-6861. The consular district includes New Brunswick, Newfoundland, Nova Scotia, Prince Edward Island and the French islands of Saint Pierre and Miquelon.

Montreal, Quebec, at 1155 St. Alexander Street, telephone (514) 398-9695; emergency-after hours-to report the death or arrest of an American (514) 981-5059; fax (514) 398-0702. The consular district includes Greater Montreal and the regions of Southern Quebec Province (Laurentides, Lanaudiere, Laval, Montreal, Montregie, Estrie, and the southern parts of Centre-du-Quebec); including Joliete, Drummondville and Sherbrooke.
Quebec City, Quebec, at 2 rue de la Terrasse Dufferin, telephone (418) 692-2095; emergency-after hours-to report the death or arrest of an American (418) 692-2096; fax (418) 692-4640. The consular district includes Quebec City and those regions of Quebec Province to the North and East of the Montreal and Ottawa Districts (indicated above), plus the Territory of Nunavut.

Toronto, Ontario, at 360 University Avenue, telephone (416) 595-1700; emergency-after hours-to report the death or arrest of an American (416) 201-4100; fax (416) 595-5466. The consular district includes the province of Ontario except the six counties served by the U.S. Embassy in Ottawa.

Vancouver, British Columbia, at 1095 West Pender Street, telephone (604) 685-4311; fax (604) 685-7175. The consular district includes British Columbia and the Yukon Territory.

All visa applicants are seen by appointment only. Information on visa appointments is available from www.nvars.com. Information on visa services for foreigners and consular/passport services for Americans who live in Canada is available from the U.S. Embassy web site. No visa or consular/passport information is available by calling the embassy or consulate switchboards.
* * *
This replaces the Country Specific Information for Canada dated December 11, 2007, to update sections on Entry/Exit Requirements, Crime, Traffic Safety and Road Conditions, and Registration/Embassy Location.

Travel News Headlines WORLD NEWS

Date: Thu 22 Aug 2019
Source: The Canadian Jewish News [abridged, edited]

About 350 children in the Tosh Hasidic community north of Montreal have been vaccinated against measles, after 5 cases of the disease were confirmed there this summer (2019).

The 2nd of 2 temporary clinics set up by the public health authority within the community closed on [16 Aug 2019] after vaccinating at least 150 youngsters over 4 days, said Isaac Weiss, who is one of the people responsible for security and public safety in the community, which is located in the town of Boisbriand, Quebec. He said the 1st clinic took place about a month earlier, after "one suspected case" was discovered. About 200 children were vaccinated at that time. The immunization was offered to those whose medical records showed they were unvaccinated or not up to date, but was voluntary.

Community leaders are co-operating fully with the CISSS des Laurentides, which ran the clinics, said Weiss. The public health director, Dr Eric Goyer, said these were the 1st cases of measles in the region since 2011. There are about 500 Tosh families in Boisbriand, or 3000 people.
 
No one knows for sure how the infection spread. Weiss said it is thought that a young man from the community who went to New York to take part in a recreational after-school program may have contracted the virus and brought it back to Boisbriand. It appears that he had been vaccinated, but his shots were not up to date.
The community's leaders are informing members about the necessity of vaccinations and trying to dispel any fear about the risk of negative side effects. Unvaccinated children will not be permitted to attend the community's schools until the outbreak is deemed contained, Weiss said, but parents can only be persuaded, not forced, to vaccinate their children.

A father of 5 who asked that his name not be published, said, "We are outraged that there are parents -- a few -- who are so irresponsible as to refuse (vaccination). The rabbis are talking about it, everyone is talking about it, but some are difficult to convince."

Last spring (2019), when there was a serious measles outbreak in New York, Montreal public health authorities stepped up an educational campaign targeting ultra-Orthodox communities. While the rate of vaccination among those communities is believed to be similar to that of the general population, there is frequent contact between the Montreal and New York communities.

At the time, Rabbi Yonasan Binyomin Weiss, who serves as the chief rabbi of Montreal and heads the medical ethics committee of the Jewish Community Council, stated, "From a religious perspective, and also from an ethical and moral perspective, our message is very clear: families are required to follow the directions of the health authorities."

In April (2019), many Montreal doctors were among over 500 medical professionals serving Orthodox Jewish communities throughout North America who signed a public letter confirming the need for everyone to be vaccinated according to US Centers for Disease Control and Prevention guidelines. The doctors rejected "the dangerous misinformation campaign being spread and reject any unproven unscientific statements that contradict all available current science-based studies on vaccinations" against measles and other illnesses.  [byline: Janice Arnold]
Date: Fri, 2 Aug 2019 04:54:00 +0200 (METDST)
By Julien BESSET

King's Point, Canada, Aug 2, 2019 (AFP) - At dusk, tourists marvel at the sensational collapse of an iceberg at the end of its long journey from Greenland to Canada's east coast, which now has a front row seat to the melting of the Arctic's ice.   While the rest of the world nervously eyes the impact of global warming, the calving of Greenland's glaciers -- the breaking off of ice chunks from its edge -- has breathed new life into the remote coastal villages of Newfoundland and Labrador.

Once a hub of cod fishing, the province now plays host to hordes of amateur photographers and tourists hoping to capture the epic ice melt for posterity. As winter ends, iceberg spotting begins.   "It keeps getting better every year," says Barry Strickland, a 58-year-old former fisherman who now takes tourists in his small boat around King's Point in the north of the province.    "We've got 135, 140 tour buses with older people coming into the town every season so it's great for the economy."   For the past four years, Strickland has taken visitors to bear witness to the death throes of these ice giants, which can measure dozens of meters in height and weigh hundreds of thousands of tons.    Winds and ocean currents bring the icebergs from northwest Greenland, thousands of kilometers (miles) away, to Canada's shores.    In a matter of weeks, ice frozen for thousands of years can quickly melt into the ocean.

- 'Incredible' rise in tourism -
Strickland's boat excursions are often fully booked during the high season from May to July, with tourists coming from all around the world to King's Point, a village of just 600 inhabitants.   The villagers keep track of the icebergs on an interactive satellite tracking map put online by the provincial government.   "There's not much in these small outport towns anymore to keep people around, so tourism is a big part of our economy," said Devon Chaulk, who works in a souvenir shop in Elliston, a small town of 300 on "Iceberg Corridor," as the coastline is now known.   "I've lived here my entire life, and the increase in tourism around here in the past 10 to 15 years has been incredible. It's not surprising to have thousands of people here over the next couple of months," said the 28-year-old.    Last year, a total of 500,000 tourists visited Newfoundland and Labrador, a number roughly equivalent to the province's total population.    Those visitors spent nearly Can $570 million (US $433 million), government figures show.

- Melting ice -
The tourism boom has helped offset the decline in the region's traditional fishing industry, which is in crisis because of overfishing at the end of the last century.   Some are even marketing "iceberg water" as the purest on Earth -- and selling it as a high-end luxury item. The melt is also used in vodka, beer and cosmetics.    But beneath the shiny surface of economic success is the dark truth that the area is in part profiting from accelerated global warming in the Arctic, and that the industry is precarious at best.

In the village of Twillingate, employees at the Auk Island Winery -- which makes its product from iceberg water and locally picked wild berries -- have already seen that business can be unpredictable.   "We see the difference in the number of tourists from year to year, depending on the amount of icebergs in the area," says Elizabeth Gleason, who works at the winery.   "This year was a good year. Last year, we had almost none."   The Arctic is warming three times faster than the rest of the world. In mid-July, record temperatures were recorded near the North Pole.   In recent years, the icebergs have drifted further and further south, posing a threat to shipping on this busy route between Europe and North America.

For now, tourists are enjoying the view and the experience while they can.    "The prevalence of icebergs has good things and bad things about it," says Melissa Axtman, an American traveller.   Laurent Lucazeau, a 34-year-old French tourist, says seeing an iceberg was sobering.   "It is a concrete image of global warming to see icebergs making it to these places where the water is warm," he told AFP.   "There's something mysterious and impressive about it, but knowing too that they are not supposed to be here makes you wonder, and it's a little scary."
Date: Thu 1 Aug 2019
Source: CBC [abridged, edited]

Cristin Muecke, the deputy chief medical officer of health, is urging anyone who develops pneumonia-like or respiratory symptoms to promptly seek medical care.

There is an outbreak of Legionnaires' disease in the greater Moncton area, with 7 confirmed cases of the severe pneumonia in the past month, New Brunswick's deputy chief medical officer of health announced on Thursday [1 Aug 2019].

Public Health is working with "multiple partners" to investigate the source of the _Legionella_ bacteria, which can be found in both natural bodies of water and human-made water systems, such as large air-conditioning units, said Dr. Cristin Muecke.  [Byline: Bobbi-Jean MacKinnon]
======================
[Moncton, with a population of 71 889 residents (2016), is the largest city in the Canadian province of New Brunswick and the inland centre of the Maritime Provinces (New Brunswick, Nova Scotia, and Prince Edward Island); Greater Moncton, encompassing Moncton, and the towns of Riverview and Dieppe, has a population of 144,810 (<https://en.wikipedia.org/wiki/Moncton>).

A map showing the location of Moncton can be found at

Genotyping the clinical isolates of _Legionella_ from the 7 cases of Legionnaires' disease in the Greater Moncton area in the past month will help confirm whether this is a common source outbreak if the genotypes match. Matching the genotypes of clinical and environmental isolates of _Legionella_ will identify the environmental source for the individual cases. However, if the diagnosis of Legionnaires' disease was based only on a positive urinary antigen assay, there will be no clinical isolates for genotyping. - ProMED Mod.ML]

[HealthMap/ProMED-mail map:
New Brunswick Province, Canada: <http://healthmap.org/promed/p/269>]
Date: Tue 30 Jul 2019
Source: CBC [edited]

Three people are being treated for possible exposure to rabies after a rabid bat was found in their barn. It's the 1st time a rabid bat has been confirmed in Dufferin County in nearly 30 years. Wellington-Dufferin-Guelph Public Health officials said all 3 people that were exposed were part of the same family.

Health officials are reminding the public that if they come in contact with a bat indoors that they shouldn't touch it and should instead call a local animal control agency. Anyone who has direct contact with a bat should call their doctor or visit an emergency room. People who believe an animal is acting strangely should stay away from it, health officials added.

Rabies is a fatal virus that is spread by raccoons, skunks, foxes and bats through the saliva of an infected animal. That can happen through bites, scratches, open wounds or even mucous membranes near the mouth nose or eyes.

Health officials say rabid bats in Ontario are relatively rare. Last year [2018], 31 bats tested positive for rabies in Ontario. Since 2017, a total of 3 rabid bats have been found in the City of Guelph.
========================
[For information on bats as reservoirs of rabies in North America, go

Despite its ability to infect all mammals, rabies virus persists in numerous species-specific cycles that rarely sustain transmission in alternative species. Rabies viruses recovered from bats were shown to be distinct from rabies viruses recovered from terrestrial mammals, suggesting that these viruses evolved within their bat hosts. Genetic evidence suggests that rabies is an old disease for bats in the New World. Bats from most of the bat species in North America, when sampled in sufficient numbers, have been found to be infected with rabies virus.

Bat rabies viruses are genetically diverse, exhibiting mutations characteristic to each host bat species. It should be taken into account, however, that bat rabies can be transmitted to humans and their domestic animals, with infections almost always fatal unless treated. Also, a dog, cat or ferret infected with a bat rabid virus can infect a human. - ProMED Mod.PMB]

[HealthMap/ProMED-mail map:
Ontario Province, Canada: <http://healthmap.org/promed/p/260>]
Date: Mon 15 Jul 2019
Source: The Star Phoenix [edited]

A British Columbia man has died of a rare viral rabies infection, the 1st such case in the province since 2003. Provincial health officer Dr Bonnie Henry says the man was in contact with a bat in mid-May [2019] and developed symptoms compatible with rabies 6 weeks later. She says in a news release that while the exposure in this case was on Vancouver Island, bats in all areas of BC are known to carry rabies.

The Health Ministry is not releasing further information about the man to ensure privacy for his family. The news release says family members, close community contacts, and healthcare workers who cared for the man are being assessed and given post-exposure rabies preventative measures if needed. Overall in Canada, there have been only 24 known cases of viral rabies infections since the 1920s, and the most recent cases were in Ontario in 2012 and Alberta in 2007.

"If anyone in BC comes in contact with a bat (even if there is no obvious bite or scratch), wash the area with soap and water. Then consult a healthcare provider or local public health department immediately. They will assess the risk of rabies and may provide a vaccine to prevent infection," the release says. It adds that bats are the only known carriers of the rabies virus in the province, and about 13% of bats tested in BC are positive for rabies.

"This presents an ongoing risk for people and for companion animals, such as cats and dogs. It is important to ensure pets' rabies vaccinations are up-to-date. If you believe your pet has had contact with a bat, consult your veterinarian." [Livestock such as cattle and horses are also at risk. There are vaccines for these animals as well. - ProMED Mod.TG]
======================
[HealthMap/ProMED-mail map of Vancouver Island, British Columbia,
More ...

World Travel News Headlines

Date: Mon, 16 Sep 2019 08:19:07 +0200 (METDST)

Tokyo, Sept 16, 2019 (AFP) - Almost 80,000 homes are still without power a week after a powerful typhoon battered eastern Japan, authorities said Monday, with sustained heavy rain prompting evacuation orders and hampering recovery efforts.    Typhoon Faxai powered into the Tokyo region in the early hours of Monday last week, packing record winds that brought down power lines, disrupted Rugby World Cup preparations and prompted the government to order tens of thousands of people to leave their homes.

The storm killed two people, with at least three elderly later confirmed dead due to heatstroke as temperatures soared to above 35 degrees Celsius (95 degrees Fahrenheit) in areas affected by a post-typhoon blackout.   Some 78,700 households were still without power in Chiba, southeast of the capital, Tokyo Electric Co. (TEPCO) spokesman Naoya Kondo told AFP.   "A complete recovery is still unlikely until September 27 as we have difficulties in mountain areas," he added.   Some 16,700 households were also without water because several water purification plants had no power, a local official said.   With help from the military, officials were dispatching water tanker trucks to the affected areas.

The national weather agency Monday issued new warnings for heavy rain in Chiba, while local authorities issued non-compulsory evacuation orders to 46,300 people due to the risk of landslides.   "A delay in recovery work is expected due to heavy rain," said Kenta Hirano, a disaster management official in Futtsu in Chiba, where more than 1,000 houses were damaged by the typhoon.   Local media showed residents in Chiba hurriedly covering broken roofs with blue tarps.   "We are at a loss as we can't live there again," a 66-year-old man told public broadcaster NHK after the typhoon ripped off the roof of his house.
Date: Sun, 15 Sep 2019 15:38:29 +0200 (METDST)

Athens, Sept 15, 2019 (AFP) - More than 160 firefighters on Sunday battled to contain a large fire near Athens blazing for a second day amid gale force winds, officials said.   And in another emergency, authorities evacuated dozens of people from two villages and a hotel on the island of Zakynthos after a new fire broke out on Sunday.

The fire department said the blaze near Athens burned in the mountains above Loutraki, a coastal resort some 60 kilometres (35 miles) west of Athens.   "The fire is burning near the top of the mountain," Stefanos Kolokouris, the fire department's deputy chief of operations, told state TV ERT.   "We are trying to create a perimeter but the terrain is very difficult, with ravines," he said.   Four water bombers and six helicopters were participating in operations. Given a lack of roads in the area, two squads of firefighters had to be carried to the mountaintop by Super Puma helicopter, state agency ANA said.   Officials had already evacuated 50 people from a local monastery when the fire broke out on Saturday, but stressed that other inhabited areas were not in danger.

On Zakynthos, officials ordered the evacuation of the villages of Agalas and Keri in the south of the island. Some 120 tourists were also relocated to a safe area.   The Greek fire department on Sunday said it had been called to nearly 80 fires over the past 24 hours.   It has already faced more than 9,600 rural and urban fires this year.
Date: Sat, 14 Sep 2019 16:08:47 +0200 (METDST)

Singapore, Sept 14, 2019 (AFP) - Pollution from forest fires in Indonesia pushed Singapore's air quality to unhealthy levels for the first time in three years on Saturday, the government said, a week ahead of the Formula One night race in the city.   The toxic smoke caused by burning to clear land for plantations is an annual problem for Indonesia's neighbours, but has been worsened this year by particularly dry weather.   "There has been a deterioration in the haze conditions in Singapore this afternoon," the National Environment Agency (NEA) said in a statement.   "This was due to a confluence of winds over the nearby region that led to more smoke haze from Sumatra being blown toward Singapore," it said, referring to one of the Indonesian islands where fires are raging.

The NEA said the pollutant standards index (PSI) worsened to 112 in parts of the island Saturday night.   An index reading between 101-200 is considered unhealthy, with residents advised against doing prolonged strenuous exercises outdoors.   Singapore may continue to experience hazy conditions over the next few days, the agency warned.   The city-state of 5.6 million people was shrouded in a thin white haze, with a few residents seen wearing face masks, but there was no major disruption to daily activities.   The F1 race is scheduled from Friday to Sunday on a street circuit in the Marina Bay financial district.

Singapore GP, the Formula One organisers, said the possibility of haze is one of the potential issues covered in their contingency plan for this year's grand prix.   "The plan was formulated and refined with stake holders, government bodies and the Formula One community," Singapore GP said in an emailed statement.   "In the event that the haze causes visibility, public health or operational issues, Singapore GP would work closely with the relevant agencies before making any collective decisions regarding the event."

Neighbouring Malaysia has also been affected by the smoke, with air quality in parts of the country including the capital Kuala Lumpur reaching unhealthy levels over the past few days and triggering a diplomatic row with Jakarta.   In 2015, the index reached "hazardous" levels of more than 300 in Singapore, forcing the closure of schools. Indonesian forest fires were the worst in two decades that year, firing up smog that blanketed large parts of Southeast Asia for weeks.
Date: Sat, 14 Sep 2019 11:16:53 +0200 (METDST)

Bangkok, Sept 14, 2019 (AFP) - Floods in northeastern Thailand have submerged homes, roads and bridges, leaving more than 23,000 people in evacuation shelters as anger grows over the government's "slow" emergency response.   Torrential rain has lashed the country for the last two weeks, causing flash floods and mudslides in almost half its provinces, with families evacuated from their homes in boats or makeshift rafts.   Since August 29, 32 people have been killed in the deluge, said a statement from the disaster department on Saturday that also gave the number of people staying in emergency shelters.   Two weather events are behind the widespread floods, the department said -- Storm Podul and a tropical depression that formed over the South China Sea called Kajiki.

Local media reports from the worst-hit province of Ubon Ratchathani showed people wading through chest-deep water and rescuers in boats trying to steer buffalo to higher ground.   Flooding in the province, which borders Laos and Cambodia, has been exacerbated by rising water levels in the Moon and Chi rivers.   "It will take three weeks to drain the floodwater" from up to 90 percent of inundated households, said provincial governor Sarit Witoon.   "The water has slightly receded about four centimetres today and I think it will keep going down," he added.

But the situation is already "unlivable" for families in one-storey homes, said Pongsak Saiwan, local director of opposition party Future Forward.   Access to an entire district is currently cut off due to flood waters, which are about two metres (6.5 foot) deep in the main town, while three major bridges are "impassable", he said.   "The government has been very slow in responding to the situation since the floods started in the beginning of September," Pongsak told AFP.   Ubon Ratchathani's plight started trending on Twitter this week with the hashtag #SaveUbon.   Aerial shots of the flood-hit plains blanketed with muddy river water were widely shared, as well as photos of stray dogs being rescued by passing boats.

One Twitter user compared the flood response to how quickly the government had mobilised and saved 12 young boys and their football coach from a waterlogged cave last year -- an incident that catapulted Thailand to international attention.   "Only 13 lives stuck in the cave and it was still very high-profile, but this is hundreds of thousands of lives," tweeted Yosita8051. "It's not okay."   Thailand's junta leader-turned-premier Prayut Chan O-Cha tweeted on Saturday that he has told agencies to "expedite assistance" to those in the affected areas.
Date: Fri, 13 Sep 2019 16:44:33 +0200 (METDST)

Niamey, Sept 13, 2019 (AFP) - Niger launched a campaign on Friday to vaccinate more than four million children against measles, one of the biggest causes of child mortality in the country, the health ministry said.

The one-week nationwide vaccination programme aims to "eliminate measles by the end of 2020", Health Minister Illiassou Mainassara said, adding, it "will reach 4.254 million children" aged from 9 months up to the age of five.   "Despite all the efforts made in the fight against communicable diseases, we still note the persistence of localised measles epidemics (in Niger)," Mainassara said on his way to the capital Niamey to launch the campaign.    But some experts say the vaccination programme should have kicked in sooner    "The delay of this campaign which should have happened in 2018 has resulted in ...the emergence of epidemics in several health districts," said Niger's UNICEF representative, Felicite Tchibindat.

Since January this year, 9,741 suspected cases have been documented in Niger resulting in 53 deaths, she said.   "Measles is a serious and extremely contagious viral disease and remains one of the leading causes of early childhood death, while it can be prevented by vaccination," TchibiNdat said.    She believes the children of migrants, refugees and displaced people will especially benefit from the campaign.    Niger's vaccination programme is supported by the World Health Organization (WHO), UNICEF (United Nations Children's Fund) and the Gavi vaccine Alliance.
Date: Fri, 13 Sep 2019 16:08:16 +0200 (METDST)

Nairobi, Sept 13, 2019 (AFP) - Kenya on Friday became the third country to start routinely innoculating infants against malaria, using the world's first vaccine to combat a disease that kills 800 children globally every day.   The vaccine -- lab name RTS,S -- targets the deadliest and most common form of malaria parasite in Africa, where children under five account for two-thirds of all global deaths from the mosquito-born illness.

Kenya joins Malawi and Ghana, which commenced their own pilot programs for the vaccine supported by the World Health Organization (WHO) earlier this year.   The vaccine will be introduced in phases across malaria-endemic parts of western Kenya near Lake Victoria, starting with Homa Bay, the country's health ministry said.   "It's an exciting time for Kenya as we roll out this vaccine in parts of the country where the burden of malaria is the highest," Health Minister Sicily Kariuki said in a statement.   RTS,S will be added to the national immunisation schedule in these areas, given alongside other routine shots for children under two.

The health ministry said 120,000 Kenyan children were expected to be vaccinated under the pilot programme.   The country has distributed insecticide-treated mosquito nets, fumigated homes and improved diagnostics in its fight against malaria.   But the disease remains stubborn. The health ministry says malaria claimed more than 10,000 lives in 2016, and infected millions more.   As in the rest of the world, children in Kenya bear the brunt of the disease.    Up to 27 percent of Kenyan children under five have been infected with the disease, the health ministry said.   "This vaccine represents an additional tool that will boost Kenya's efforts in reducing malaria infections and deaths among children," Kariuki said.   WHO says a child dies roughly every two minutes from malaria somewhere in the world.

- 30 years in making -
Known under its commercial name as Mosquirix, the vaccine was developed over 30 years by British pharmaceutical giant GlaxoSmithKline in partnership with nonprofit PATH and African research institutes.   It is the only vaccine to date to show a protective effect against malaria in young children, WHO says.   It acts against Plasmodium falciparum, the deadliest malarial parasite and the most prevalent in Africa, where illness and death from the disease remain high despite some gains.   The shots, administered over four doses, have been shown in clinical trials to significantly reduce cases of malaria, and malaria-related complications, in young children.   The vaccine prevented about four in 10 cases of malaria and three in 10 cases of the most severe, life-threatening form of the disease, within the trial group, WHO says.

Evidence gained from the vaccine pilot schemes could guide decisions about whether RTS,S is rolled out more widely in future, WHO says.   "This is the most advanced malaria vaccine that we have today. It has been in the making for the last almost three decades," Dr Richard Mihigo, WHO's co-ordinator of immunisation and vaccine development programme, told AFP before the Kenyan launch.   "Children are the most vulnerable group to this severe disease that is malaria, so protecting children can make a big impact in preventing malaria."   The disease kills more than 400,000 people around the world every year. Of these about 290,000 are under five.    Most are in Africa, where more than 90 percent of the world's malaria cases -- and fatalities -- occur.
Date: Fri, 13 Sep 2019 11:40:02 +0200 (METDST)

London, Sept 13, 2019 (AFP) - British Airways has cancelled all its scheduled UK flights for September 27, when company pilots will again strike in a long-running row over pay.   It comes after the carrier cancelled all flights departing and arriving in the UK on Monday and Tuesday owing to BA's first strike by pilots in the company's 100-year history.

In a statement released late Thursday, BA called on the British Airline Pilots Association (BALPA) union "to call off their strike and return to negotiations".    The airline added: "We are very sorry that BALPA's actions will affect thousands more travel plans."   This week's strike sparked travel chaos for about 200,000 passengers, mostly using London's Gatwick and Heathrow airports.   BALPA estimates that the 48-hour strike cost the airline £80 million ($99 million, 89 million euros), but BA has yet to provide a figure.
Date: Tue, 10 Sep 2019 13:02:19 +0200 (METDST)

Khartoum, Sept 10, 2019 (AFP) - Sudan reported four confirmed cases of cholera in Blue Nile Tuesday and said three people had also died of acute diarrhoea in the war-torn state.   Health Minister Akram al-Toum has asked the World Health Organization to send supplies of cholera vaccine immediately, the ministry said.

Ministry and WHO officials have been sent to the affected area.   "There are 37 cases of acute diarrhoea in Blue Nile... There have been three deaths," the ministry said in a statement.   Dozens of people died from acute diarrhoea in Sudan in 2016 after thousands of cases were reported nationwide.   Blue Nile state, which has a large ethnic minority population, has been the focus of a rebellion by the Sudan People's Liberation Army-North since 2011.   The army declared a ceasefire after the  overthrow of veteran president Omar al-Bashir earlier this year.
Date: Sat 14 Sep 2019
Source: Vax Before Travel [edited]

A new report from Japan's National Institute of Infectious Disease (NIID) indicates the Rubella virus outbreak continues to spread. As of [4 Sep 2019], there have been 2156 Rubella cases reported by the NIID during 2019.

This is an increase of about 260 rubella cases in Japan since July 2019. On a local basis, the city of Tokyo has reported 37% of Japan's 2019 Rubella cases.

Since Rubella is very dangerous for a pregnant woman and her developing baby, the US Centers for Disease Control and Prevention (CDC) said on [7 Aug 2019], "pregnant women who are not protected against rubella through either vaccination or previous rubella infection, should not travel to Japan during this outbreak."

But, pregnant women should not get a Rubella vaccination with the measles-mumps-rubella (MMR) says the CDC. This is because the MMR vaccine is an attenuated "live virus" vaccine.

The CDC says "pregnant women who are not vaccinated should wait to get [the] MMR vaccine until after they have given birth. And, women of childbearing age should avoid getting pregnant for at least 4 weeks after receiving the MMR vaccine."

Additionally, the CDC says "if a pregnant woman contracts the rubella virus, her baby could have birth defects such as deafness, cataracts, heart defects, mental disabilities, and organ damage."

And, when a rubella infection occurs during early pregnancy, serious consequences, such as miscarriages, stillbirths, and severe birth defects in infants, which are known as Congenital Rubella Syndrome (CRS), [may result].

This new NIID report indicates there have been 3 CRS cases in Japan during 2019. As a comparison, during 2005-2015 in the USA, only 8 babies with CRS were reported.

Moreover, [fewer] than 10 people in the USA are reported as having rubella each year. Since 2012, all rubella cases had evidence that they were infected when they were living or traveling outside the USA.

To alert international travellers, the CDC issued a Level 2 Travel Alert regarding Japan's ongoing Rubella virus outbreak in August 2019. This "Practice Enhanced Precautions" Travel Alert says "travellers to Japan should make sure they are vaccinated against rubella with the MMR vaccine before visiting Japan." This CDC Travel Alert is important since approximately 4.5 million US citizens visit Japan annually.

Additionally, the Public Health Agency of Canada and the UK Foreign Travel Advice recommend "pregnant women who are not protected against rubella avoid traveling to Japan."

In the USA, there are 2 approved rubella vaccines: MMR II-Rubella and ProQuad. Both rubella vaccines are available at most pharmacies. Travelers to Japan can request a rubella vaccine counselling appointment with a local pharmacist.

Rubella vaccines, like any medicine, can produce side effects. [People] are encouraged to report vaccine side effects to a healthcare provider or the CDC.  [Byline: Dani Reiter]
========================
[See discussion of rubella in ProMED-mail Rubella - Japan (02)

[HealthMap/ProMED-mail map:
Date: Tue 10 Sept 2019
Source: Focus Taiwan [edited]

Taiwan's enterovirus cases continued to increase last week, bringing the total number to nearly 20 000 between [1 and 7 Sep 2019], the Centers for Disease Control (CDC) said Tuesday [10 Sep 2019].

A total of 19 254 patients sought outpatient or emergency treatment at hospitals for enterovirus infection around the country, up 4% from the figure recorded the previous week [25-31 Aug 2019] and the highest over the same period in nearly 5 years, according to CDC data.

CDC physician Lin Yung-ching said there were 2 severe cases recorded last week, one of which involved an 8-month-old girl and the other a 4-year-old boy, both in central Taiwan. The 2 children were reported in stable condition after treatment.

Some of the 2 patients' family members or classmates with whom they had had contact have also been confirmed as enterovirus cases, and the CDC judged that the infection might have been spread through contact, Lin said.

A total of 303 cases of enterovirus-71 (EV-71), the most severe enterovirus strain, have been reported so far this year [2019], the highest in the same period from 2016 to 2018.

Meanwhile, a total of 36 cases with severe complications have been recorded nationwide, including 27 EV-71 cases, according to CDC statistics.

EV-71 is a neurological disease that attacks the nervous system, and infants under the age of 5 are at highest risk of developing severe complications from this type of infection.

In extreme cases, EV-71 can cause polio-like permanent paralysis, according to the CDC. As Taiwan is still in the peak season for enterovirus infection, CDC Deputy Director-General Philip Lo urged the public to take precautions against the spread of the illness, especially among children.

Children infected with enterovirus should be kept away from school so as to prevent the spread of the disease, as enterovirus is highly contagious, Lo advised.  [Byline: Chen Wei-ting and Evelyn Kao]
=====================
[The enteroviruses are spread from person to person by coughs, sneezes, or touching objects or surfaces that have the virus on them. Therefore, practicing good personal hygiene -- washing hands regularly and thoroughly with soap and water -- is the best way to prevent from getting and spreading the infectious disease.

However, most people infected with non-polio enteroviruses do not get sick, or present with mild illness, like the common cold. Infants, children, and teenagers are more likely than adults to get infected and become sick because they do not yet have immunity (protection) from previous exposures to the viruses. Adults can get infected too, but they are less likely to have symptoms, or their symptoms may be milder. Symptoms of mild illness may include fever; runny nose, sneezing, and cough; skin rash; mouth blisters; and body and muscle aches.

Some non-polio enterovirus infections can lead to:
- Viral conjunctivitis;
- Hand-foot-mouth disease;
- Viral meningitis (infection of the covering of the spinal cord and/or brain);
- Viral encephalitis (infection of the brain);
- Myocarditis (infection of the heart);
- Pericarditis (infection of the sac around the heart);
- Acute flaccid paralysis (a sudden onset of weakness in one or more arms or legs);
- Inflammatory muscle disease (slow, progressive muscle weakness).

Infants and people with weakened immune systems have a greater chance of having these complications. People who develop myocarditis may have heart failure and require long-term care. Some people who develop encephalitis or paralysis may not fully recover.

Enterovirus cases were reported from Taipei, Taiwan in 2017 (Human enterovirus - Taiwan: alert http://promedmail.org/post/20170418.4978387), and health alerts like the one mentioned in report above were issued to the general public to observe proper hygiene to reduce disease transmission. Also the case number for EV-71 associated severe disease has also increased, which is a cause for public health concern. - ProMED Mod.UBA]

[HealthMap/ProMED-mail map: