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Afghanistan

Afghanistal US Consular Information Sheet March 03, 2009


COUNTRY DESCRIPTION:


Afghanistan has made significant progress since the Taliban were deposed in 2001, but still faces daunting challenges, including de

eating terrorists and insurgents, recovering from over three decades of civil strife, dealing with years of severe drought and rebuilding a shattered physical, economic and political infrastructure. Coalition and NATO forces under ISAF work in partnership with Afghan security forces to combat Taliban and al-Qa’ida elements who seek to terrorize the population and challenge the government. Violence in 2008 reached unprecedented levels, as both ISAF/Afghan forces and the Taliban initiated more battles than ever before. President Hamid Karzai was sworn in as President of the Islamic Republic of Afghanistan on December 7, 2004 and the Afghan Parliament was subsequently convened in late 2005. The government is working to develop a more effective police force, a more robust legal system, and sub-national institutions that work in partnership with traditional and local leaders to meet the needs of the population. The U.S. works closely with the international community to provide coordinated support for these efforts. An Afghanistan-hosted Peace Jirga with Pakistan resulted in a commitment to cooperate in combating terrorism, facilitate the return of Afghan refugees, and support regional economic activity. Read the Department of State Background Notes on Afghanistan for additional information.


ENTRY/EXIT REQUIREMENTS:


 A passport and valid visa are required to enter and exit Afghanistan. Afghan entry visas are not available at Kabul International Airport or any other ports of entry in Afghanistan. American citizens who arrive without a visa are subject to confiscation of their passport and face heavy fines and difficulties in retrieving their passport and obtaining a visa, as well as possible deportation from the country. Americans arriving in the country via military air usually have considerable difficulties if they choose to depart Afghanistan on commercial air, because their passports are not stamped to show that they entered the country legally. Those coming on military air should move quickly after arrival to legalize their status if there is any chance they will depart the country on anything other than military air. Visit the Embassy of Afghanistan web site at http://www.embassyofafghanistan.org for the most current visa information. The Consular office of the Embassy of Afghanistan is located at 2233 Wisconsin Avenue NW, Suite 216, Washington, DC 20007, phone number 202-298-9125. 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:


The latest Travel Warning for Afghanistan emphasizes that the security situation remains critical for American citizens. The Taliban and associated insurgent groups, al-Qaida network terrorist organizations, and narco-traffickers oppose the strengthening of a democratic government. These groups aim to weaken or bring down the Government of Afghanistan and to drive Westerners out of the country. They do not hesitate to use violence, including targeting civilians. Terrorist activities may include, but are not limited to bombings -- including improvised explosive devices and car bombs -- assassinations, carjackings, rocket attacks, assaults and kidnappings. There were over 120 suicide attacks in 2008. There is an ongoing threat to attack and kidnap U.S. citizens and Non-Governmental Organization (NGO) workers throughout the country. In 2008,, more than 30 NGO workers were killed (six foreigners) and at least 78 NGO staff members (seven foreigners) were abducted. Over 25 other foreign civilians, including journalists, were kidnapped. Kabul continues to experience suicide bombings against Afghan government personnel and installations, Afghan and coalition military assets, and international civilians. Riots -- sometimes violent -- have occurred in response to various political or other issues. Crime, including violent crime, remains a significant problem. Official Americans' use of the Kabul-Jalalabad, Kabul-Kandahar highways and other roads throughout the country is often restricted or completely curtailed because of security concerns. Insurgents continue to use roadside and car bombs to conduct attacks and abductions along major highways. Millions of unexploded land mines and other ordinance present a constant danger. The country faces a difficult period in the near term, and American citizens could be targeted or placed at risk by unpredictable local events. Americans should not come to Afghanistan unless they have made arrangements in advance to address security concerns. The absence of records for ownership of property, differing laws from various regimes and the chaos that comes from decades of civil strife have left property issues in great disorder. Afghan-Americans returning to Afghanistan to recover property, or Americans coming to the country to engage in business, have become involved in complicated real estate disputes and have faced threats of retaliatory action, including kidnapping for ransom and death. Large parts of Afghanistan are extremely isolated, with few roads, mostly in poor condition, irregular cell phone signals, and none of the basic physical infrastructure found in Kabul or the larger cities. Americans traveling in these areas who find themselves in trouble may not even have a way to communicate their difficulties to the outside world. 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 pamphlet A Safe Trip Abroad.


CRIME:


 A large portion of the Afghan population is unemployed, and many among the unemployed have moved to urban areas. Basic services are rudimentary or non-existent. These factors may directly contribute to crime and lawlessness. Diplomats and international relief workers have reported incidents of robberies and household burglaries as well as kidnappings and assault. Any American citizen who enters Afghanistan should remain vigilant for possible banditry, including violent attacks.


INFORMATION FOR VICTIMS OF CRIME:


The loss or theft abroad of a U.S. passport should be reported immediately to the local police and to the U.S. Embassy in Kabul. If you are the victim of a crime while overseas, in addition to reporting to local police, please contact the U.S. Embassy in Kabul for assistance. The Embassy 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 provide a list of attorneys if needed. The local equivalent to the "911" emergency line in Afghanistan is: 119 Please see our information on Victims of Crime, including possible victim compensation programs in the United States.


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 Afghanistan’s laws, even unknowingly, may be expelled, arrested or imprisoned. During the last several years, there have been incidents involving the arrest and/or detention of U.S. citizens. Arrested Americans have faced periods of detention—sometimes in difficult conditions—while awaiting trial. Penalties for possession or use of, or trafficking in illegal drugs in Afghanistan are severe, and convicted offenders can expect long jail sentences and heavy fines. Another sensitive activity is proselytizing. Although the Afghan Constitution allows the free exercise of religion, proselytizing is often viewed as contrary to the beliefs of Islam and considered harmful to society. Proselytizing may lead to arrest and/or deportation. 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.


SPECIAL CIRCUMSTANCES:


Because of the poor infrastructure in Afghanistan, access to banking facilities is limited and unreliable. Afghanistan's economy operates on a "cash-only" basis for most transactions. Credit card transactions are not available. International bank transfers are limited. Some ATM machines exist at Standard Charter Bank and Afghan International Bank (AIB) in the Wazir Akbar Khan neighborhood of Kabul, but some travelers have complained of difficulties using them. International communications are difficult. Local telephone networks do not operate reliably. Most people rely on satellite or cellular telephone communications even to make local calls. Cellular phone service is available locally in Kabul and some other cities, but can be unreliable. Injured or distressed foreigners could face long delays before being able to communicate their needs to family or colleagues outside of Afghanistan. Internet access through local service providers is limited. In addition to being subject to all Afghan laws, U.S. citizens who are also citizens of Afghanistan may also be subject to other laws that impose special obligations on Afghan citizens. U.S. citizens who are also Afghan nationals do not require visas for entry into Afghanistan. The Embassy of Afghanistan issues a letter confirming your nationality for entry into Afghanistan. However, you may wish to obtain a visa as some Afghan-Americans have experienced difficulties at land border crossings because they do not have a visa in their passport. For additional information on dual nationality in general, see the Consular Affairs home page for our dual nationality flyer. U.S. citizens are encouraged to carry a copy of their U.S. passport with them at all times, so that, if questioned by local officials, proof of identity and U.S. citizenship is readily available. As stated in the Travel Warning, consular assistance for American citizens in Afghanistan is limited. Islam provides the foundation of Afghanistan's customs, laws and practices. Foreign visitors -- men and women -- are expected to remain sensitive to the Islamic culture and not dress in a revealing or provocative manner, including the wearing of sleeveless shirts and blouses, halter-tops and shorts. Women in particular, especially when traveling outside of Kabul, may want to ensure that their tops have long sleeves and cover their collarbone and waistband, and that their pants/skirts cover their ankles. Almost all women in Afghanistan cover their hair in public; American women visitors should carry scarves for this purpose. Afghan customs authorities may enforce strict regulations concerning temporary importation into or export from Afghanistan of items such as firearms, alcoholic beverages, religious materials, antiquities, medications, and printed materials. American travelers have faced fines and/or confiscation of items considered antiquities upon exiting Afghanistan. It is advisable to contact the Embassy of Afghanistan in Washington for specific information regarding customs requirements. Travelers en route to Afghanistan may transit countries that have restrictions on firearms, including antique or display models. If you plan to take firearms or ammunition to another country, you should contact officials at that country's embassy and those that you will be transiting to learn about their regulations and fully comply with those regulations before traveling. Please consult http://www.customs.gov for information on importing firearms into the United States. Please see our Customs Information sheet.


MEDICAL FACILITIES AND HEALTH INFORMATION:


Well-equipped medical facilities are few and far between throughout Afghanistan. European and American medicines are available in limited quantities and may be expensive or difficult to locate. There is a shortage of basic medical supplies. Basic medicines manufactured in Iran, Pakistan, and India are available, but their reliability can be questionable. Several western-style private clinics have opened in Kabul: the DK-German Medical Diagnostic Center (www.medical-kabul.com), Acomet Family Hospital (www.afghancomet.com), and CURE International Hospital (ph. 079-883-830) offer a variety of basic and routine-type care; Americans seeking treatment should request American or Western health practitioners. Afghan public hospitals should be avoided. Individuals without government licenses or even medical degrees often operate private clinics; there is no public agency that monitors their operations. Travelers will not be able to find Western-trained medical personnel in most parts of the country outside of Kabul, although there are some international aid groups temporarily providing basic medical assistance in various cities and villages. For any medical treatment, payment is required in advance. Commercial medical evacuation capability from Afghanistan is limited and could take days to arrange. Even medevac companies that claim to service the world may not agree to come to Afghanistan. Those with medevac insurance should confirm with the insurance provider that it will be able to provide medevac assistance to this country. There have been outbreaks of Avian Influenza in poultry in Afghanistan, to include the areas of Nangahar, Laghman, and Wardak provinces, and in the city of Kabul, however, there have been no reported cases of the H5N1 virus in humans. Updates on the Avian Influenza situation in Afghanistan are published on the Embassy’s web site at http://kabul.usembassy.gov/information_for_travelers.html. For additional information on Avian Influenza, please refer to the Department of State's Avian Influenza Fact Sheet available at http://travel.state.gov/travel/tips/health/health_1181.html Tuberculosis is an increasingly serious health concern in Afghanistan. For further information, please consult the CDC's Travel Notice on TB. http://wwwn.cdc.gov/travel/yellowBookCh4-TB.aspx| The U.S. Department of State is unaware of any HIV/AIDS entry restrictions for visitors to or foreign residents of Afghanistan. However, if one has questions, please inquire directly with the Embassy of Afghanistan at http://www.embassyofafghanistan.org before you travel. Information on vaccinations and other health precautions, such as safe food and water precautions and insect bite protection, may be obtained from the Centers for Disease Control and Prevention’s hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747) or via the CDC’s 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 Afghanistan is provided for general reference only, and may not be totally accurate in a particular location or circumstance. All drivers face the potential danger of encountering improvised-explosive devices and land mines that may have been planted on or near roadways. An estimated 5-7 million landmines and large quantities of unexploded ordinance exist throughout the countryside and alongside roads, posing a danger to travelers. Robbery and kidnappings are also prevalent on highways outside of Kabul. The transportation system in Afghanistan is marginal, although the international community is constructing modern highways and provincial roads. Vehicles are poorly maintained, often overloaded, and traffic laws are not enforced. Vehicular traffic is chaotic and must contend with numerous pedestrians, bicyclists and animals. Many urban streets have large potholes and are not well lit. Rural roads are not paved. Please refer to our Road Safety page for more information.


AVIATION SAFETY OVERSIGHT:


As there is no direct commercial air service to the United States by carriers registered in Afghanistan, the U.S. Federal Aviation Administration (FAA) has not assessed Afghanistan’s Civil Aviation Authority for compliance with International Civil Aviation Organization (ICAO) aviation safety standards. For more information, travelers may visit the FAA’s internet website at http://www.faa.gov/safety/programs_initiatives/oversight/iasa. U.S. Government personnel are not authorized to travel on Ariana Afghan Airlines or any other airline falling under the oversight of the Government of Afghanistan’s Civil Aviation Authority, owing to safety concerns; however, U.S. Government personnel are permitted to travel on international flights operated by airlines from countries whose civil aviation authorities meet international aviation safety standards for the oversight of their air carrier operations under the FAA’s International Aviation Safety Assessment (IASA) program.


CHILDREN'S ISSUES:


 For information see our Office of Children’s Issues web pages on intercountry adoption and international parental child abduction. R


EGISTRATION / EMBASSY LOCATION:


Americans living or traveling in Afghanistan are encouraged to register with the U.S. Embassy through the State Department’s travel registration web site and to obtain updated information on travel and security within Afghanistan. Americans without internet access may register directly with the U.S. Embassy. By registering, American citizens make it easier for the Embassy or Consulate to contact them in case of emergency. The U.S. Embassy is located in Kabul on Great Massoud (Airport) Road, local phone number 0700-108-001 or 0700-108-002, and for emergencies after hours 0700-201-908. The web site is http://kabul.usembassy.gov/ * * * * * This replaces the Country Specific Information dated June 16, 2008 to update sections on Country Description, Entry/Exit Requirements, Safety and Security, Information for Victims of Crime, Criminal Penalties, Special Circumstances, and Medical Facilities and Health Information.

Travel News Headlines WORLD NEWS

Date: Mon, 24 Feb 2020 09:00:05 +0100 (MET)

Kabul, Feb 24, 2020 (AFP) - Afghanistan has detected its first novel coronavirus case, the country's health minister said Monday, a day after Kabul announced it would suspend air and ground travel to Iran, where 12 people have died from the outbreak.   "I announce the first positive coronavirus (case) in Herat," health minister Firozuddin Feroz told a press conference, calling on citizens to avoid travel to the western province which borders Iran.
Date: Sat 15 Feb 2020 2:34:10 PM AFT
Source: MENAFN, Afghanistan Times News report [edited]

At least 35 people including women and children have died in the past few weeks due to pneumonia outbreak in Badakhshan Province in the north-western mountainous area, the provincial health department confirmed.

Dr Noor Khawari, head of the provincial public health department, said [Sat 15 Feb 2020] that the people had died in the Wakhan district, a remote area surrounded by high and impassable mountains.

He said that 15 of the dead were children, calling malnutrition and cold weather as the main reasons for the fatalities. A medical team had been dispatched to Wakhan to prevent further outbreak of the disease, according to Dr Khawari.

The provincial council had earlier said that at least 10 people had lost their lives since an unknown disease had broken out in the Yomgan district [Badakhshan Province].

The report caused panic and concerns among the residents as coronavirus [infection, COVID-19] in China that borders Badakhshan takes the lives of people every day.

But the ministry of public health denied outbreak of any unknown disease in Badakhshan, saying that the recent deaths happened only due to pneumonia and pertussis (whooping cough) as well as malnutrition. Badakhshan is one of the provinces where seasonal diseases like pneumonia and whooping cough break out during winter. The diseases claim the lives of people in the remote areas behind high mountains as the roads connecting them to the provincial capital are blocked by heavy snowfalls.

The provincial health department has deployed medical teams to the borders with China and Tajikistan to examine those entering from the neighbouring states and to prevent coronavirus [infection, COVID-9].
===========================
[We are told in the news report above that at least 35 people, including 15 children, died in the past few weeks due to a "pneumonia" outbreak in Wakhan district, a remote area surrounded by high and impassable mountains, with a population of about 14 000 residents. Wakhan is a narrow strip about 350 km (220 mi) long and 13-65 km (8-40 mi) wide that extends from Badakhshan Province in Afghanistan in the west to Xinjiang Autonomous Region in China in the east, separating the Pamir Mountains and Tajikistan to the north and the Karakoram Mountains and Pakistan to the south  (<https://en.wikipedia.org/wiki/Wakhan_Corridor>).

A trade route through this valley has been used by travellers since antiquity
(<https://caravanistan.com/afghanistan/wakhan-corridor/>).

A map of this region can be found at

The local residents are concerned that the novel coronavirus infection, COVID-19, may be the cause of the outbreak of pneumonia in Wakhan district. There are about 70 500 total cases of COVID-19 in China, mainly concentrated in Hubei Province in Central China.

Although Xinjiang in Western China has reportedly 75 confirmed cases of COVID-19 and 1 death (assessed 16 Feb 2020 at 9:43 PM EST) (<https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6>), spread of COVID-19 to this very remote region in Afghanistan, that is easily cut off from the rest of the world especially in winter, seems unlikely. Also, 43% of deaths (15/35) occurred in children, which would be unusual for COVID-19. However, we are not told the clinical presentation of the illness, nor how a diagnosis of "pneumonia" was made in this undeveloped region. Other diagnoses, such as influenza, are also possible. More information from knowledgeable sources would be appreciated. - ProMED Mod.ML]

[Maps of Afghanistan:
Date: Wed 11 Dec 2019
Source: MENA FN [edited]

Officials in the Ministry of Public Health has said that 2 fresh positive cases of polio have been registered in southern Uruzgan [Oruzgan] and northern Baghlan provinces.

According to health officials, the families of the polio-affected children live in Dand-e-Ghori [Dahana-i-Ghori] and Khas Uruzgan districts, [respectively], and the areas were out of the government's control and deprived of medical facilities.

Dr. Abdul Qayum Khplwak, head of the medical institute for the southern part of Afghanistan, said that one of the 2 children has been deprived of polio vaccination in Khas Uruzgan district of the province. He said that despite tremendous efforts towards fighting polio, there are great obstacles against the implementation of the process.

"Until every child receives polio vaccination, our efforts would not reach a complete goal," he said, adding that "the fresh case in Uruzgan shows that southern provinces are facing serious polio threats."

Meanwhile, a local medical in charge for polio affairs in Baghlan, Marjan Rasikh, has put the age of the polio-affected child at 4 years old, saying that the case has marked the initial positive polio in the province.

Over 24 positive polio cases have been recorded from the beginning of 2019: more than 8 cases in Uruzgan, 5 in Helmand, 4 in Kandahar, 2 in Paktia, and 3 other cases in Badghis, Nangarhar, and Kunar provinces.

To prevent the positive cases of polio, the health officials said that anti-polio vaccination should be implemented across the country.
===================
[The addition of these 2 newly confirmed cases will increase the total number of cases reported from Afghanistan with dates of onset during 2019 to 24. There was a newly confirmed case from Kandahar reported in last week's GPEI (Global Polio Eradication Initiative) report with date of onset 10 Nov 2019.

Again, the common denominator in the occurrence of WPV1 (wild poliovirus type 1)-associated AFP (acute flaccid paralysis) cases (presumed to be WPV cases) and in cVDPV (circulating vaccine-derived poliovirus)-associated cases is the presence of a significant susceptible population, or, in other words, areas with suboptimal vaccination coverages.

A map of Afghanistan showing provinces can be found at
The HealthMap/ProMED-mail map of Afghanistan can be found at
Date: Mon 2 Dec 2019
Source: China.org.cn, Xinhua News Agency report [edited]

One fresh polio case had been detected in Afghanistan's southern Kandahar province, a local newspaper reported on [Mon 2 Dec 2019].

"With this new case, the total number of polio cases in 2019 reaches 22 in the country. The latest polio case has been reported from Kandahar city, capital of Kandahar province which permanently paralyzed an 18-month-old child," Daily Afghanistan-e-Ma reported.

The paper added that polio is a crippling and potentially fatal infectious disease.

"Most of the Afghan children affected by poliovirus this year [2019] are living in areas where kids do not have access to health facilities and regular anti-polio vaccination campaign. However, this time a child has been affected in a large city where anti-polio vaccination had been conducted repeatedly this year," the report said.

There is no cure for polio and the polio vaccine is the only safe and effective way to protect children.

The ongoing conflicts have been hindering the efforts to stamp out the infectious disease in the mountainous country.
===================
[The addition of 3 newly confirmed cases of polio (all 3 due to WPV1, as per End Polio Pakistan <https://www.endpolio.com.pk/polioin-pakistan/polio-cases-in-provinces>) in Pakistan and one newly confirmed case of polio in Afghanistan brings the total number of WPV1 associated cases with date of onset in 2019 to 116 (94 in Pakistan and 22 in Afghanistan). The key question here is whether Afghanistan and Pakistan, with all the challenges in vaccinating the susceptible populations due to a variety of anti-vaccination impediments, will be able to interrupt transmission of the WPV1 in both countries simultaneously.

Maps of Afghanistan:
and <http://healthmap.org/promed/p/137>. - ProMED Mod.MPP]
Date: Sun 1 Sep 2019
Source: MENAFN - Afghanistan Times [edited]

Two new polio cases have surfaced separately in capital city of Tirinkot and Chora district of southern Uruzgan [Oruzgan] province, a statement from the relevant ministry said [Sun 1 Sep 2019].

A 30-month-old child and another 6-month-old infant were permanently paralyzed as a result of the polio virus.

According to a statement issued by the Ministry of Public Health (MoPH), the total number of polio cases in 2019 reached 15 with the 2 new cases, saying all of these cases had been reported from inaccessible areas.

"Of the 15 polio cases this year [2019], 14 have been reported from the southern region of Afghanistan,' the statement said, adding "7 positive cases came from [Oruzgan], 5 from Helmand, and 2 other from Kandahar."

Only 1 out of 12 polio cases was reported from eastern Kunar province while the rest happened in the southern zone.

"Access to health services is the right of every citizen of the country," said Dr Ferozuddin Feroz, the Minister of Public Health. "We are deeply concerned about the increasing polio cases and the number of children who still don't have consistent and proper access to vaccination," he added.

He said the virus could spread further in the country and more children would be affected and paralyzed by polio virus.

He called upon people to 'work together and protect innocent children against polio and facilitate a safe and secure environment for our frontline workers in order to enable them administer vaccine drops to children in every nook and cranny of the country."

Polio is a crippling and potentially fatal infectious disease. There is no cure and the vaccine is the only safe and effective way to protect children.

The polio vaccine is safe and harmless for new-born children whether they are sick or not. It is very important that new-borns and sick children get the vaccine because they may have lower immunity which makes them more susceptible to the virus.

Polio vaccination has also been strongly endorsed by national and global Islamic scholars.
========================
[As I mentioned in the moderator comment of the last post (Poliomyelitis update (71): global (Pakistan, Congo DR) http://promedmail.org/post/20190901.6651501), "While there have been no newly confirmed cases reported from Afghanistan this week nor have there been positive environmental samples reported from either Pakistan or Afghanistan, it doesn't mean the virus is not still circulating, just that there aren't new confirmations." Unfortunately there were cases under investigation.

As correctly stated in the media report above, the addition of these 2 newly confirmed cases brings the number of confirmed WPV1 cases reported by Afghanistan during 2019 to date to 15.

Oruzgan is located in the central part of Afghanistan, sharing southern and southwestern borders with Kandahar and Helmand provinces where other polio cases have been reported this year (2019) as well (<http://www.lib.utexas.edu/maps/middle_east_and_asia/afghanistan_admin-2009.jpg>).

HealthMap/ProMED-mail map of Afghanistan:
More ...

Comoros

Comoros US Consular Information Sheet
May 21, 2008
COUNTRY DESCRIPTION:
The Union of the Comoros is a developing nation located in the Indian Ocean off the east coast of Africa.
Comoros consists of three islands, Ngazidja (also known
s Grand Comore), Moheli, and Anjouan, that cover about 900 square miles.
A fourth island, Mayotte, is claimed by Comoros but remains a territory of France.
Ngazidja is home to the capital city, Moroni, and is the most developed of the three islands.
Facilities for tourism are limited and telecommunication links are unreliable.
French, Arabic, Swahili, and Comorian Creole are spoken.
Read the Department of State Background Notes on the Union of Comoros for additional information.
ENTRY/EXIT REQUIREMENTS:
A passport and onward/return ticket are required.
Visas are available from the Comoran Mission to the United Nations in New York; American citizens visiting Comoros can obtain a free, 24-hour transit visa upon entry.
The following day, visitors are required to go to the immigration office in Moroni to change their visa status.
A fee is charged, depending on length of stay.
Travelers should obtain the latest details from the Mission of the Union of Comoros, 420 East 50th Street, New York, NY 10022; telephone number (212) 972-8010, fax (212) 983-4712.

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:
Comoros has experienced frequent strikes and civil unrest, resulting in violent clashes between police and demonstrators.
The most recent unrest involved the de facto separation of Anjouan from the Union government.
In March 2008, Union forces re-took Anjouan and are preparing the island for elections.
The former leader of Anjouan, Mohamed Bacar, has applied for asylum with France and is being held on the French Island of Reunion while his asylum claims is adjudicated.
As the government completes the transition to constitutional federalism and as Bacar’s asylum claim is pending, periodic strikes and protests will likely continue to occur.
U.S. citizens should avoid political rallies and street demonstrations as even demonstrations intended to be peaceful can turn confrontational and possibly escalate into violence.
American citizens are therefore urged to avoid the areas of demonstrations if possible, and to exercise caution if within the vicinity of any demonstrations.
Conditions are subject to rapid change on each of the three islands of the Comoros due to weak political institutions and a lack of economic development.
In a rare, apparently religious-based attack, a clinic run by a foreign Christian organization was firebombed on the island of Grande Comore in August 2007.
Religious intolerance and religious-based violence remain very unusual in Comoros.

Although foreign residents and visitors have not been targeted, the potential for further outbreaks of civil disorder remains high, and Americans should exercise caution and good judgment, keep a low profile, and remain vigilant with regard to their personal security.
U.S. citizens are encouraged to register with the U.S. Embassy in Antananarivo, Madagascar, if visiting or residing in Comoros.
Embassy contact information is provided below.
For the latest security information, Americans traveling abroad should regularly monitor the Department’s web site, where the current Travel Warnings and Public Announcements, including the Worldwide Caution, can be found.
Up-to-date information on safety and security can also be obtained by calling 1-888-407-4747 toll free in the U.S. and Canada, or for callers outside the U.S. and Canada, a regular toll-line at 1-202-501-4444.
These numbers are available from 8:00 a.m. to 8:00 p.m. Eastern Time, Monday through Friday (except U.S. federal holidays).
The Department of State urges American citizens to take responsibility for their own personal security while traveling overseas.
For general information about appropriate measures travelers can take to protect themselves in an overseas environment, see the Department of State’s pamphlet A Safe Trip Abroad.
CRIME:
U.S. travelers are advised to be vigilant against pick-pocketing and other forms of petty crime when visiting crowded market areas, parks, and at the beaches.
Violent crime is uncommon.
The most commonly reported crime is breaking into homes.
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, help you 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:
Medical facilities in Comoros are poorly equipped.
Travelers should bring their own supplies of prescription drugs and preventive medicines. Malaria is prevalent in Comoros.
Travelers to Comoros should take malaria prophylaxis.
The serious and sometimes fatal strain of malaria, P. falciparum, is resistant to the anti-malarial drug chloroquine.
Because travelers to Comoros are at high risk for contracting malaria, the Center for Disease Control and Prevention (CDC) advises that travelers should take one of the following antimalarial drugs: mefloquine (Lariam™), doxycycline, or atovaquone/proguanil (Malarone™).
The CDC has determined that a traveler who is on an appropriate antimalarial drug has a greatly reduced chance of contracting the disease.
In addition, other personal protective measures, such as the use of insect repellents, help to reduce malaria risk.
Travelers who become ill with a fever or flu-like illness while traveling in a malaria-risk area and up to one year after returning home should seek prompt medical attention and tell the physician their travel history and what antimalarials they have been taking.
For additional information on malaria, protection from insect bites, and anitmalarial drugs, please visit the CDC Travelers' Health web pages.
The East African Indian Ocean islands have seen a rise in the cases of chikungunya, a viral dengue-like ailment, and dengue itself.
As with malaria, chikungunya and dengue are transmitted by mosquitoes.
Every effort should be made to use repellants, proper clothing and barriers that discourage/prevent mosquito bites.
The CDC web site contains further information on chikungunya at http://www.cdc.gov/ncidod/dvbid/chikungunya/ and dengue at http://wwwn.cdc.gov/travel/yellowBookCh4-DengueFever.aspx.
There have been occurrences of measles in Comoros, with outbreaks of greater severity on the islands of Anjouan and Moheli.
Travelers are advised to ensure that their measles vaccinations are up to date.
Further, information on vaccinations and other health precautions, such as safe food and water precautions and insect bite protection, may be obtained from the Centers for Disease Control and Prevention’s hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747) or via the CDC’s web site at http://wwwn.cdc.gov/travel/default.aspx.
For information about outbreaks of infectious diseases abroad consult the World Health Organization’s (WHO) web site at http://www.who.int/en.
Further health information for travelers is available at http://www.who.int/ith.
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 if 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 Comoros is provided for general reference only, and may not be totally accurate in a particular location or circumstance.
In Comoros, one drives on the right side of the street.
Roads are ill-maintained, congested, very narrow and poorly lit at night.
Travelers should exercise extreme caution when driving after dark.
Most urban roads are paved, but many rural roads are not.
Many roads are full of potholes and dangerous curves.
Most roads have no posted speed limits, but road conditions limit speeds to below 30 miles an hour.
Drivers and front seat passengers are required to wear seat belts.
There are no laws regarding child safety seats.
There are no organizations in Comoros that provide emergency or roadside assistance.
Individuals involved in accidents rely on passersby for assistance.
Taxis or a rental car with driver are preferable to public transportation.
Please refer to our Road Safety page for more information.
AVIATION SAFETY OVERSIGHT:
As there is no direct commercial air service to the United States by carriers registered in Comoros, the U.S. Federal Aviation Administration (FAA) has not assessed Comoros’ Civil Aviation Authority for compliance with International Civil Aviation Organization (ICAO) aviation safety standards. For more information, travelers may visit the FAA’s web site at http://www.faa.gov/safety/programs_initiatives/oversight/iasa.
SPECIAL CIRCUMSTANCES: While religions other than Islam are permitted in Comoros, evangelization is illegal.
Violators of this law can be fined or imprisoned.
Few establishments accept credit cards in the Comoros and most prefer Comoran Francs or Euros to dollars.
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 the laws of Comoros, even unknowingly, may be expelled, arrested, or imprisoned.
Penalties for possession, use or trafficking in illegal drugs in Comoros are strict, with convicted offenders receiving a mandatory minimum five-year jail sentence and heavy fines.
Engaging in sex with children or using or disseminating child pornography in a foreign country is a crime, prosecutable in the United States.
Please see our information on Criminal Penalties.
CHILDREN'S ISSUES:
For information see our Office of Children’s Issues web pages on intercountry adoption and international parental child abduction.
REGISTRATION / EMBASSY LOCATION:
The United States has no Embassy in Comoros.
Americans living or traveling in Comoros are encouraged to register with the U.S. Embassy in Antananarivo, Madagascar through the State Department's travel registration web site, and to obtain updated information on travel and security within Comoros.
Americans without Internet access may register in person at the U.S. Embassy in Antananarivo.
By registering, American citizens make it easier for the Embassy to contact them in case of emergency. The U.S. Embassy is located at 14-16 Rue Rainitovo, Antsahavola, Antananarivo.
The mailing address is B.P. 620, Antsahavola, Antananarivo, Madagascar; telephone [261] (20) 22-212-57; fax [261] (20) 22-345-39.
The Embassy web site is http://www.usmission.mg/.
*

*

*
This replaces the Country Specific Information dated October 26, 2007 to update the section on Safety and Security.

Travel News Headlines WORLD NEWS

Date: Sat 11 May 2019
Source: Revue Francophone des Laboratoires May 2019, no. 512, p. 18 [in French, transl., abridged, edited]

In February 2019, 63 cases of Rift Valley fever were diagnosed by PCR at the Mayotte hospital laboratory. The first 5 cases were detected in November 2018 by the hospital laboratory and confirmed by the Reunion Reference Center. The vector control center and the health emergency unit of the ARS OI [The Indian Ocean Health Agency] were able to analyze the epidemiology of 36 cases: 21 subjects had been in direct contact with animals and 5 others lived nearby; the last 5 declared no direct or indirect contact with animals. In addition, in 15 cases, patients had consumed raw or curdled milk. Finally, it is interesting to note that 21 patients resided in the communes of west-central Mayotte. With regard to the 63 confirmed cases, the average age of the patients was 38 years (range, 10 to 74 years), of which 16% were under 20 years, with a male/female sex ratio of 4. In addition, 29 patients lived in rural or semi-urban dwellings, 9 of whom lived in traditional huts. In terms of symptoms, 24 patients had headache, 19 arthralgia, 17 myalgia, 14 asthenia, 6 retro-orbital pain, and 6 nausea and vomiting. An entomological survey found several mosquito species, especially _Culex_, _Aedes_, _Anopheles_ and _Mansonia_.

At the same time, samples taken from farms in which abortions were reported identified 33 outbreaks of 1 to 6 animals, including 25 cattle and 8 small ruminants [the figures have increased since; see in comments].

Rift Valley fever, which has been present in Mayotte for a long time, had disappeared in the past decade, with 10 patients detected in 2008 following an epidemic in Kenya. Then there was a steady regression of verified seroprevalence on ruminants. But this seroprevalence rose to 3.6% in 2017 and then to 10.1% in 2018, indicating a new circulation of the virus. This is probably due to illegal and continuous importation of contaminated livestock.  [By: Dr. Patrice Bouree]
============================
[Mayotte's health authorities published on Sat 11 May 2019 the following update.

"Epidemiological situation as of May 10, 2019. In total, since the beginning of the epidemic (end of November 2018):
1. Animals.
Samples taken by veterinarians on sick animals or during abortions have identified 119 foci of sick animals (of which 95 are cattle and 24 small ruminants). Animal foci are mainly located in the center and northwest of the island. Additional outbreaks have appeared since the end of March [2019] in the communes of Dembeni, as well as on Petite Terre.
2. Humans.
The CHM laboratory reported 130 human cases of RVF [Rift Valley fever] at the monitoring and health emergencies platform of the ARS OI (CVAGS) of Mayotte.

The number of reported cases has remained stable since the beginning of April [2019] (on average, 4 to 5 reported cases per week). Since the beginning of the health alert, human cases have remained mainly in the center and northwest of the island." (<https://lejournaldemayotte.yt/2019/05/11/fievre-de-la-vallee-du-rift-a-mayotte-stabilite-du-nombre-de-nouveaux-cas/>).

Application of the following measures will contribute to the prevention of future RVF events in animals and humans in Mayotte:
1. Preventing illegal introduction of ruminants;
2. Preventive vaccination of cattle, sheep and goats (preferably, with an inactivated RVF vaccine; see http://promedmail.org/post/20190422.6434655). - ProMED Mod.AS]

[It would be of interest to know what role, if any, mosquito vectors are playing in transmission of RVF virus during the current outbreak. If _Aedes_ mosquitoes are involved, there is a risk of transovarial transmission of the virus that can persist for months in mosquito eggs with resumption of transmission when those eggs hatch and infected adult female mosquitoes emerge. - ProMED Mod.TY]

[HealthMap/ProMED-mail map:
Region d'outre-mer de Mayotte, France:
Date: Mon, 25 Mar 2019 15:42:31 +0100
By Philippe ALFROY

Bambao, Comoros, March 25, 2019 (AFP) - The Bambao hospital, nestled in a tropical forest on Anjouan island in the Comoros, was meant to bring state-of-the-art medical care to the poor Indian Ocean nation.   Just two years later, the hospital is deep in debt and shunned by potential patients who find it too costly.   "A poisoned chalice", "a colossus with feet of clay", "a sinking ship" are among the cliches that chief paediatrician Ahmed Rakibou used to describe the facility funded and built under a Chinese aid scheme.   "If they had consulted us while building it, this could have been a jewel," the doctor said, regretting that "today it's all going straight to hell".   The hospital is some 30 kilometres (about 20 miles) east of Mutsamudu, the capital of Anjouan, the poorest of the three islands comprising the Union of the Comoros.

The aim was to make the hospital a flagship of Comoran healthcare, with 120 beds in a brand-new building, a team of 167 staff, many recruited locally, and modern equipment including a digital radio scanner.   China's ambassador to the Comoros, Xiao Ming, hailed a "new page in the annals of cooperation" at the opening ceremony, saying "public health has always had a priority place in Sino-Comoran cooperation".   But a project that cost four billion Comoran francs (8.1 million euros, $9.2 billion) today looks more like a ghost ship, with a handful of patients wandering its corridors in stifling heat. For lack of funds, about 100 staff jobs have not been filled.

- 'Not many patients' -
In the emergency ward, a doctor silently examines a child's injured arm. The lethargic mood is broken only by the arrival of an ambulance carrying the victim of a motorcycle accident.   "Our activity is very varied," nurse Ali Mosthadoi says cautiously before going further. "In fact, we don't have many patients."

Deputy director Sidi Chaanbane was more forthcoming. Since the hospital was opened by President Azali Assoumani in 2017, it has faced mounting difficulties, he said.   "At the start, the road from Mutsamudu was in a very bad state and patients had trouble getting here," the administrator said. "It's been repaired since, but our real problem is that we sorely lack equipment and staff."   In addition to staff salaries, the Comoran state provides just five million francs (10,000 euros) a month, but the hospital needs three times as much to pay its bills.   "We can't balance the budget," Chaanbane said.

Day-to-day management is a nightmare. The scanner broke down soon after it was first used. Repairs were not covered by the Chinese cooperation agreement, so the hospital took out a loan to get the machine working again.   The main problem is the cost of treatment, which is not free in the former French colony, independent since 1975.   Much of the funding comes from the French Development Agency (AFD) in its aid budget. France still rules over the fourth major island in the archipelago, Mayotte.   The three islands forming Comoros lack the standard of living on Mayotte and are far from able to make up the remaining health budget.

- 'Expensive' -
Rakibou said the hospital charges 125,000 Comoran francs for a Caesarean birth.   "What Comoran can pay that?" he asks. "No -- this hospital is not made for the population."   Kanissa Adbou, 27, brought her eight-year-old daughter who trod on a nail to the hospital. "The treatment is expensive. If I could afford it, I would go to Mayotte because there, hospital is free."   Those who believed that providing a modern hospital on Anjouan would dissuade Comorans from trying their luck on Mayotte have been disappointed, although the trip is illegal.   "People here prefer to pay 1,000 euros to go to Mayotte by kwassa kwassa (human traffickers' dugouts) than to come to us," a nurse said. "They trust only white doctors."

The failure to put the sophisticated equipment at Bambao to regular good use enrages Ahmed Abdallah, secretary general of the Hombo public hospital in Mutsamudu.   "The money spent there would have been enough to repair our buildings, replace our equipment and build roads so that sick people could come from nearby villages," he said.   "We don't have even a single ambulance, yet the government has I don't know how many four-wheel drives."   Health Minister Fatma Mbaraka declined to respond to requests for comment from AFP.   But Rakibou refuses to throw in the towel. He hopes that the winner of Sunday's presidential election and the international community will come up with increased funding. "It wouldn't take much to change our lives!" he said.
Date: Fri 15 Mar 2019
Source: Le Journal de Mayotte [in French, trans. ProMED B, edited]

The circulation of Rift Valley fever (RVF) continues in Mayotte. An animal disease of viral origin, Rift Valley fever mainly affects domestic ruminants (cattle, sheep, goats), causing abortions and high mortality in young animals. It can be transmitted from the infected animal to humans.

In total, since the beginning of the epidemic (end of November [2018]),
- samples taken by veterinarians from sick animals or during abortions led to the identification of 8 new outbreaks this week [week of Mon 11 Mar 2019], for a total of 60 cases in animals (including 49 cattle). Animal foci are located mainly in the centre and north west of the island;
- a total of 101 human cases of RVF have been reported to the platform/cell watch and health emergencies of the ARS OI (CVAGS) of Mayotte by the CHM laboratory. Of those who could be interviewed, almost 80% report having been in contact with animals;
- since the beginning of the health alert, human cases have been located mainly in the centre and north west of the island, with nearly 60% of cases in Chiconi and Tsingoni.

Since 25 Feb 2019, the weekly number of new human cases has been on the decrease.  [byline: Anne Perzo]
========================
[This Rift Valley fever (RVF) outbreak has been going on since November 2018. The number of human cases of RVF has increased from 82 to 101 in about 2 weeks. However, it is good to learn that the number of new human cases is decreasing. The above report implies that the human infections are the result of contact with infected animals or their products, with fewer from virus transmission by mosquito vectors. The cattle cases certainly are the result of mosquito transmission.

Because RVF virus can be transovarially transmitted in populations of aedes mosquito vectors, and those resulting eggs can persist for a long period of time in nature, cases can occur periodically when the virus-containing eggs hatch, and infected adult females emerge from them. There is a risk that RVF will reappear on the island after the current outbreak has ended.

Recent studies have shown that RVF virus may severely injure human foetuses if contracted by mothers during pregnancy. There is no indication of whether any of the 101 RVF virus-infected people were pregnant. Abortions in infected livestock are common. There is no vaccine available for human use, but there is for livestock. There is no mention of whether the livestock populations in the area have been vaccinated.

The clinical findings related to the above human cases are not mentioned. In an earlier comment, ProMED noted that: "The most common complication associated with RVF is inflammation of the retina. As a result, approximately 1-10% of affected patients may have some permanent vision loss. Approximately 1% of humans that become infected with RVF virus die of the disease." - ProMED

[ealthMap/ProMED-mail map of Region d'outre-mer de Mayotte, France:
Date: Fri 22 Feb 2019
Source: Le Journal de Mayotte [in French, trans. ProMED Corr. SB, edited]

Rift Valley fever (RVF) continues to circulate in Mayotte among the herds of ruminants, and the number of human cases is increasing.

The prefecture of Mayotte, in collaboration with the ARS Indian Ocean and the Directorate of Food, Agriculture and Forestry of Mayotte (DAAF) reminds the population of the importance of implementing recommendations and preventive actions to avoid being ill.

Epidemiological situation as of 22 Feb 2019:
- Samples taken by veterinarians from sick animals or during abortions have identified 33 animal FVR outbreaks.
- Since late November [2018], 63 human cases of RVF have been reported to the monitoring and health emergencies platform of the ARS OI (CVAGS) of Mayotte by the CHM laboratory.

Rift Valley fever (RVF) is a zoonosis (infectious disease that can be transmitted from animals to humans) of viral origin, which mainly affects domestic ruminants (cattle, sheep, goats), causing abortions and high mortality in young animals.

Transmission to humans can occur in different ways:
- By contact with blood, body fluids, or tissues of a sick animal (during slaughter, cutting of meat, calving, care, etc.). The most exposed people are therefore professionals such as breeders, slaughterhouse employees, and veterinarians.
- By mosquito bite, vectors of the disease near infected flocks, often in the rainy seasons.
- When eating unboiled milk or unpasteurized curd from an infected animal.

There is no [direct] person-to-person transmission of RVF [virus].

The disease in humans is usually manifested by an influenza-like illness that clears in a few days and includes symptoms such as high fever (39 deg C [102 deg F]), muscle and / or joint pain, intense headaches, and fatigue. However, in 5% of cases, more serious forms may occur: ocular meningitis / meningoencephalitis, haemorrhagic fever.

Recommendations for protection against the disease-causing virus:

For farmers and people in contact with animals:
- Wash hands with soap after contact with domestic ruminants (cattle, sheep, goats).
- Do not handle unprotected or diseased animals or abortion products without protection.
- Do not handle animal carcasses without protection.
- Wear gloves, goggles, and especially a mask for the slaughter of any animal. Infected animals may have no signs, although they can transmit the virus.

For food consumption:
Transmission by ruminants
- Boil the milk
- Do not consume curd unless it has been boiled and curdled with lactic fermentation.
- Wash hands after cutting meat.
- Do not eat uncooked meat.
- Do not consume the meat of a sick animal.

To protect yourself from mosquito bites:
- Eliminate breeding sites; empty all containers that may contain water.
- Use mosquito nets and repellents.

In case of appearance of symptoms, consult your doctor immediately.

Management measures:
By the Directorate of Food, Agriculture, and Forestry: The monitoring of Rift Valley fever involves the monitoring of abortions. Farmers are asked to report to veterinarians without delay any abortions occurring in their animals in order to take samples for the disease. The prevalence of RVF in the exchange zone with Mayotte being important, the risk of spread of the disease is not negligible in case of uncontrolled import of animals.

By the Indian Ocean Health Agency: Since the1st report, each ill person is interviewed by the ARS Indian Ocean to identify the risk factors for the disease.

A treatment of larval breeding and a mosquito control are done by the service of the Anti-vector Fight [unit] to the homes of the sick persons and around the houses. Information to health professionals was made to strengthen surveillance and identification of human cases.  [Byline: Anne]
======================
[This Rift Valley fever (RVF) outbreak has been going on since November 2018. The numbers of human cases of RVF have increased from 31 to 63 in about 2 weeks. The above report does not indicate whether the human infections are the result of virus transmission by mosquito vectors, but the cattle cases certainly are. Because RVF virus can be transovarially transmitted in populations of _Aedes_ mosquito vectors, and those resulting eggs can persist for a long period of time in nature, cases can occur periodically when the virus-containing eggs hatch and infected adult females emerge from them. Recent studies have shown that RVF virus may severely injure human fetuses if contracted by mothers during pregnancy. There is no indication of whether any of the 63 RVF virus-infected people were pregnant. Abortions in infected livestock are common. There is no vaccine available for human use, but there is for livestock. There is no mention of whether the livestock populations in the area have been vaccinated.

The clinical findings related to the above human cases are not mentioned, but the symptoms associated with RVF infections in general are listed. In an earlier comment, Mod.CP noted that, "The most common complication associated with RVF is inflammation of the retina. As a result, approximately 1-10% of affected patients may have some permanent vision loss. Approximately 1% of humans that become infected with RVF virus die of the disease." - ProMED Mod.TY]

[HealthMap/ProMED-mail map:
Region d'outre-mer de Mayotte, France:
Date: Fri 1 Feb 2019
Source: Outbreak News Today [edited]

In the Indian Ocean, between Madagascar and the coast of Mozambique, sits the archipelago of Mayotte, a Department of France.  Health officials have reported an increase in autochthonous Rift Valley fever (RVF) cases in the past 6 weeks. Since the 1st human case was detected on [Tue 11 Dec 2018], health officials have reported 19 human cases. Most of the cases were located in the western part of the island.  Samples made on ruminants present around human cases were analyzed at CIRAD in Reunion for the search for the RVF virus. The results identified several positive animals in different villages located in west and center of the island.

In addition, an IgM-positive cattle has been reported in Mamoudzou. This 2-year-old cattle belongs to a breeding herd of 8 cattle, including 4 adults and 4 2-month-old calves. Biological control and investigations are underway.  ECDC reports that the detection of autochthonous Rift Valley fever cases on Mayotte is not unexpected, but the occurrence of 19 cases within a short time period is of concern, as current weather conditions (rainy season from November to March) are favorable for the vectors.

Rift Valley fever (RVF) is an illness that is primarily spread by direct contact with blood, fluids, or tissues of infected animals such as cattle, buffalo, sheep, goats, and camels. Less commonly, it can also be spread through mosquito bites.  Most people with RVF do not feel sick or have only mild illness. Symptoms of RVF include fever, weakness, back pain, dizziness, and weight loss. However, a small percentage (8-10%) of people may have more serious illness, such as severe bleeding, swelling of the brain, or eye disease. Approximately 1% of people who get RVF die from the disease.  [Byline: Robert Herriman]
*************************************
Date: Sat 2 Feb 2019
Source: ECDC Communicable Diseases Threats Report Week 5, 27 Jan - 2
Feb 2019 [edited]

According to Institut de Veille Sanitaire (InVS), from 11 Dec 2018 - 28 Jan 2019, 19 Rift Valley fever cases were confirmed on Mayotte. All cases were locally acquired. Among these cases, 14 are male and 5 are female, with an age range of 27-64 years.

Most of the cases were located in the western part of the island. Further investigations identified several positive ruminants in the western and central parts of the island.

According to CIRAD, Rift Valley fever seroprevalence among ruminants has decreased from 2008 to 2017, but significantly increased in 2017 and 2018 (3.6%, CI 95% [2.3-5.6%]) and 2018 and 2019 (10.1% CI 95% [6.5-15.3%]). In addition, according to InVS, one case imported from Comoros was reported by authorities on Mayotte in 2011.

The detection of autochthonous Rift Valley fever cases on Mayotte is not unexpected, but the occurrence of 19 cases within a short time period is of concern, as current weather conditions (rainy season from November to March) are favourable for the vectors.

ECDC will continue monitoring this event through epidemic intelligence activities and report again if there is a relevant epidemiological update.

[Map] Distribution of RVF human cases and ruminants, Mayotte, 11 Dec 2018 to 28 Jan 2019

[Graph] Distribution of RVF confirmed human cases, Mayotte, 11 Dec 2018 to 28 Jan 2019

Year-Week / Number of cases
2018-50 / 1
2018-51 / 0
2018-52 / 2
2019-01 / 2
2019-02 / 0
2019-03 / 2
2019-04 / 8
2019-05 / 4
========================
[It is not surprising to have both human and cattle Rift Valley fever (RVF) cases occur simultaneously. The above report does not indicate if the human infections are the result of virus transmission by mosquito vectors, but the cattle cases certainly are. Because RVF virus can be transovarially transmitted in populations of _Aedes_ mosquito vectors, and those resulting eggs can persist for a long period of time in nature, cases can occur periodically when the virus-containing eggs hatch and infected adult females emerge from them. Recent studies have shown that RVF virus may severely injure human fetuses if contracted by mothers during pregnancy. There is no indication if any of the 19 RVF virus-infected people were pregnant. Abortions in infected livestock are common. There is no vaccine available for human use, but there is for livestock.

The clinical findings related to the above human cases are not mentioned. In an earlier comment, ProMED Mod.CP noted that, "The most common complication associated with RVF is inflammation of the retina. As a result, approximately 1-10% of affected patients may have some permanent vision loss. Approximately 1% of humans that become infected with RVF virus die of the disease. - ProMED Mod.TY]

[HealthMap/ProMED-mail map:
Region d'outre-mer de Mayotte, France:
More ...

Equatorial Guinea

Equatorial Guinea US Consular Information Sheet
March 02, 2009
COUNTRY DESCRIPTION:
Equatorial Guinea is an oil-rich, developing country on the western coast of central Africa.
Its capital and main port, Malabo, is located on the isla
d of Bioko, off the coast of Cameroon.
A secondary port, Luba, is also on Bioko.
The mainland territory of Equatorial Guinea is bordered by Cameroon and Gabon.
The principal city on the mainland is Bata.
Facilities for tourism are limited but growing.
Official languages are Spanish, which is widely spoken, and French, which is not widely understood, but sometimes used in business dealings.
Read the Department of State Background Notes on Equatorial Guinea for additional information.

ENTRY/EXIT REQUIREMENTS:
A passport and evidence of a yellow fever vaccination are required to enter Equatorial Guinea.
Visas are not required for U.S. citizens unless the traveler will be there for an extended stay or is intending to work there.
U.S. citizens entering without a visa but staying longer than 90 days should register with the local police station.

Private vessels landing in an Equato-Guinean port must get clearance prior to approaching the shore.
Travelers should obtain the latest information and details from the Embassy of the Republic of Equatorial Guinea, 2020 16th Street NW, Washington, DC
20009, telephone (202) 518-5700, fax (202) 518-5252.

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:
Although large public demonstrations are uncommon, U.S. citizens should avoid large crowds, political rallies, and street demonstrations.

In February 2009, approximately 50 gunmen arriving by speedboats attacked government buildings in Malabo but were repelled by Equato Guinean military and police.

For the latest security information, Americans traveling abroad should regularly monitor the Department of State's, 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:
Violent crime is rare and the overall level of criminal activity is low in comparison to other countries in the region.
However, there has been a rise in non-violent street crime and residential burglaries.
Travelers should exercise prudence and normal caution, including avoiding dark alleys, remote locations, and traveling alone.

INFORMATION FOR VICTIMS OF CRIME:
The loss or theft abroad of a U.S. passport should be reported immediately to the U.S. Embassy in Malabo at (240) 098895; Embassy personnel will assist in contacting the local police.
If you are the victim of a crime while in Equatorial Guinea, please remember to report the incident to local police, and contact the U.S. Embassy in Malabo for assistance.
The Embassy staff can, for example, assist you in finding 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, the consular officer can help you understand the local criminal justice process and to find an attorney if needed.

Please see our information on Victims of Crime, including possible victim compensation programs in the United States.

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 Equato-Guinean laws, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in Equatorial Guinea 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.

SPECIAL CIRCUMSTANCES:
It is not uncommon for a uniformed member of the security forces to stop motorists on the pretext of minor or nonexistent violations of the local motor vehicle regulations in order to extort small bribes.
Visitors are advised not to pay bribes, and to request that the officer provide a citation to be paid at the local court.
If visitors encounter any of these problems they should contact the Embassy Consular Officer at 516008 and inform him/her of the situation.

Equatorial Guinea has a strictly cash economy.
Credit cards and checks are not accepted; credit card cash advances are not available and there are no ATMs.
In addition, most local businesses do not accept travelers' checks, dollars or euros.
However, dollars can be changed at local banks for CFA.
Cash in CFA is usually the only form of payment accepted throughout the country.

Special permits from the Ministry of Information and Tourism (or from the local delegation if outside Malabo) are required for virtually all types of photography.
Police or security officials may charge a fine, attempt to take a violator into custody, or seize the camera and film of persons photographing the Presidential Palace and its environs, military installations, airports, harbors, government buildings, and other areas.

Travelers are advised that the possession of camouflage-patterned clothing, large knives, binoculars, firearms, or a variety of other items may be deemed suspicious by the security forces and grounds for confiscation of the item and detention of the carrier.
Please see our Customs Information sheet.

MEDICAL FACILITIES AND HEALTH INFORMATION:
Medical facilities are extremely limited. Pharmacies in Malabo and Bata stock basic medicines including antibiotics, but cannot be counted on to supply advanced medications. Outside of these cities, many medicines are unavailable. Travelers are advised to carry any special medication that they require. The sanitation levels in even the best hospitals are very low though the new Israeli-built and staffed La Paz Hospital in Bata approaches European standards of sanitation and is reported by Red Cross officials to be the best in the region. Doctors and hospitals often require immediate payment for health services, and patients are often expected to supply their own bandages, linen and toiletries.
The Malabo hospital is likewise undergoing a complete update, with expected completion in late 2009.

Malaria is a serious and sometimes fatal disease. The national government, along with U.S. oil companies in the country, has taken aggressive steps to control the mosquito population and limit the impact of malaria on the population centers in Malabo and Bata.
Plasmodium falciparum malaria, the type that predominates in Equatorial Guinea, is resistant to the anti-malarial drug chloroquine. Because travelers to the country are at high risk for contracting malaria, the Centers for Disease Control and Prevention (CDC) advises that travelers should take one of the following anti-malarial drugs: mefloquine (Lariam™), doxycycline, or atovaquone/proguanil (Malarone™). Travelers who become ill with a fever or flu-like illness while traveling in a malaria-risk area and up to one year after returning home should seek prompt medical attention and tell the physician their travel history and what anti-malarials they have been taking.
Visit the CDC travelers’ health page for additional information on malaria, including protective measures.

There are periodic outbreaks of cholera in Equatorial Guinea. Yellow fever can cause serious medical problems, but the vaccine, required for entry, is very effective in preventing the disease.

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

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.
Hospitals, clinics, and other businesses and hotels do not accept credit cards.
If there are any concerns that travelers may need medical care or assistance while in Equatorial Guinea, they should make arrangements to have access to enough cash to cover possible expenses.
There are companies such as Western Union where international money orders can be arranged and cash obtained.
There are no ATM machines in the country (See SPECIAL CIRCUMSTANCES Section above).
You can see more 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 Equatorial Guinea is provided for general reference only, and may not be totally accurate in a particular location or circumstance.

Generally, Equatorial Guinea's road networks are underdeveloped.
There are few road and traffic signs, though more signs are becoming evident.
Livestock and pedestrians create constant road hazards.
During the rainy season, many roads are passable only with four-wheel-drive vehicles.
However, new road construction and repair is taking place all over the country and road conditions have improved markedly over the course of the past year.
If you plan on staying and driving around the country for any length of time you should attempt to purchase a cell phone for assistance in case of an emergency.

Travelers outside the limits of Malabo and Bata may expect to encounter occasional military roadblocks.
Travelers should be prepared to show proper identification (for example, a U.S. passport) and to explain their reason for being at that particular location.
The personnel staffing these checkpoints normally do not speak or understand English or French; travelers who do not speak Spanish would do well to have their reason for being in the country and their itinerary written down in Spanish before venturing into the countryside.

Please refer to our Road Safety page for more information.

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

Commercial air travel to and from Equatorial Guinea can be difficult.
Malabo is served by European airlines a few times per week.
The island of Bioko and the African mainland are connected by several small local airlines offering daily service.
Schedules are subject to change or cancellation without notice; flights are often overbooked and reservations may not guarantee seats.

Malabo Airport has navigational aids and can accommodate night landings.
There are no navigational aids at Bata Airport.
Special clearances are required to land in or overfly Equatorial Guinea territory.

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 Equatorial Guinea are encouraged to register with the U.S. Embassy in Malabo through the State Department’s travel registration web site so that they can obtain updated information on travel and security within Equatorial Guinea.
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 in Malabo to contact them in case of emergency.

The United States reopened its Embassy in Malabo in October 2003.
However, due to reduced staffing, it can offer only limited services to U.S. citizens in distress.
The U.S. Embassy in Malabo can be contacted at (240) 098-895.
Additional services are provided through the U.S. Embassy in Yaoundé, Cameroon, located on Avenue Rosa Parks in the Mbankolo Quartier, adjacent to the Mount Febe Golf Club; mailing address P.O. Box 817; embassy tel. (237) 2220-1500, fax: (237) 2220-1572.
The Embassy Branch Office in Douala, Cameroon, is located on Rue Flatters, in the Citibank Building, tel.: (237) 3342-53-31, fax: (237) 3342-77-90.
* * *
This replaces the Country Specific Information for Equatorial Guinea, dated November 15, 2007, to update sections on Country Description, Entry/Exit Requirements, Safety and Security, Crime, Information for Victims of Crime, Special Circumstances, Medical Facilities and Health Information, Medical Insurance, Traffic Safety and Road Conditions, and Registration/Embassy Location.

Travel News Headlines WORLD NEWS

Date: Wed, 15 Jan 2020 23:16:11 +0100 (MET)

Malabo, Equatorial Guinea, Jan 15, 2020 (AFP) - Firefighters battled to bring a blaze at Malabo's cathedral under control on Wednesday, as flames engulfed parts of the historic building, considered the most important Christian church in Equatorial Guinea.     Dozens of people gathered in silence near the cathedral in the early evening as the fire service sprayed water jets onto the century-old structure.

It was not immediately known whether anyone was hurt in the fire, in which huge flames consumed part of the facade of the building.       "We have just extinguished the fire, it's finished. The roof is gone, it is a catastrophe," firefighter Alfredo Abeso told AFP.   Another firefighter at the scene said: "The whole roof is gone, the interior is burned."   The cause of the fire is not known but the cathedral has been closed to the public since January 7 for restoration work.    Built in a neo-gothic style between 1897 and 1916, the cathedral is one of the central African country's main tourist attractions.

The blaze brought comparisons to the devastating fire that ravaged the 13th century Notre-Dame cathedral in Paris in April 2019.     The French Embassy in Malabo said the fire was a "cruel reminder" of the fire at Notre Dame.    "We share the emotion of our friends in Malabo and Equatorial Guinea and hope that the fire can be brought under control quickly," it said on Twitter.      Paris engineers are still working to stabilise the 13th century cathedral in the French capital after fire tore through its roof and dramatically toppled its spire last year.
Date: Sun, 26 May 2019 06:31:33 +0200
By Camille MALPLAT

Sipopo, Equatorial Guinea, May 26, 2019 (AFP) - Gleaming but eerily empty, the luxurious Sipopo resort with its five-star hotel and exclusive facilities rises from a tropical beach, symbolising the dilemma of Equatorial Guinea -- a notoriously closed country that has turned to tourism to help fill its coffers.  The purpose-built town was carved out of an ancient forest in 2011 at a cost of 600 million euros ($670 million), initially to host a week-long African Union summit and showcase the rise of the tiny oil-rich state.   A 16-kilometre (10-mile) drive from Equatorial Guinea's capital Malabo, the resort boasts a vast conference centre, the Sofitel Malabo Sipopo Le Golf hotel, as well as 52 luxury villas -- one for every head of state to attend the summit -- each with its own swimming pool.    There is also an 18-hole golf course, several restaurants and exclusive beaches guarded by police.

For almost a decade, Sipopo has been the crown jewel in a strategy to lure high-end visitors to Equatorial Guinea to diversify an economy badly hit by a slump in oil revenue.   But the town, visited by an AFP reporter two months ago, seemed quite empty -- an impression strengthened by conversations with people who live or who work there.   "It's depressing, there's no-one," said a visiting Gabonese consultant.   A worker, who asked not to be named, said the complex was quiet year-round: "You can hear the sound of your own footsteps."   The occasional visitors tend to be well connected, rich and in search of privacy, the sources said.    Many are guests of a government described by Human Rights Watch as corrupt and repressive.    One of the villas, according to the sources, was occupied by former Gambian dictator Yahya Jammeh after he fled his country in 2017.

- Empty lobby -
At Easter, the 200-room hotel's guests included a Spanish couple on honeymoon, a few families and some businessmen, who were all foreigners.   In the echoing lobby, a huge black and white portrait of the country's 76-year-old authoritarian president, Teodoro Obiang Nguema -- Africa's longest-serving ruler -- hung on the wall, watching over the vacant reception area.   A 1.5-kilometre (nearly mile-long) beach -- an artificial shore secluded from curious eyes -- was virtually deserted, in contrast to a public beach near the capital. The three-lane highway leading from Malabo to Sipopo was mostly empty of traffic.   A hospital was added after the villas were built, but is unused, the sources said.   In 2014, a mall was built at the resort to house 50 shops, a bowling alley, two cinemas and a children's play area.   But a hotel receptionist said the complex was not open yet, adding: "If you want to buy a souvenir, you will have to go to Malabo." At night-time, shiny limousines arrived at a luxury restaurant to drop off diners.

- Tourism hopes -
Located on the mid-Atlantic coast of central Africa, Equatorial Guinea has flooded social media with messages of its allure as a holiday destination.   Plans to build a new passenger terminal at the airport in Bata city have also just received a 120-million-euro ($133-million) injection from the Development Bank of Central African States.   Figures for visitors are unavailable, and the tourism ministry in Malabo did not respond to AFP's requests for information. In the latest global compilation of figures posted by the World Bank, the number of tourists for Equatorial Guinea has been left blank.   But much of the tourism in evidence are business people, such as oil company workers, relaxing for a few days, or attending energy or economic conferences. 

A few travel firms offer trips tailor-made for both luxury and adventure, but they also allude to the difficulties, notably of being allowed to enter the country.   "The country has been a mystery to outsiders, who were discouraged from entering by a difficult visa process and a lack of tourism infrastructure," says the website of British tour operator Undiscovered Destinations.   The firm claimed, however, that "things are changing fast... with an excellent road network and numerous hotels springing up seemingly overnight."   Few Equatoguineans have the chance of staying in such places. At Sipopo's hotel, a basic room costs the equivalent of more than 200 euros ($224) a night, while exclusive accommodation tops 850 euros.   The discovery of vast oil reserves off the coast in the mid-1990s has boosted the country's gross national income to a theoretical annual $19,500 per person per year, according to the UN Development Programme.   But that wealth benefits a small elite among the country's 1.2 million inhabitants. More than two-thirds of Equatoguineans live below the poverty line, and 55 percent of the population aged over 15 are unemployed.
Date: Wed 14 Jan 2015
Source: Eye Witness News [edited]

The Africa Cup of Nations (Afcon) finally gets underway on Sat [17 Jan 2015] after a controversial build-up to the 30th edition, which included a hasty late switch of hosts to Equatorial Guinea in the wake of concerns over the Ebola virus.

16 nations again line up for the biennial continental championship, seeking Africa's top sporting prize at the tournament, which starts on Sat [17 Jan 2015] and finishes on 8 Feb [2015].

Few previous editions have had such a dramatic backdrop, with the hosting of the 2015 finals being switched 2 months ago after Morocco asked for a postponement in the wake of the spread of the Ebola virus in West Africa. That request precipitated a crisis that left the tournament having to be organised almost from scratch in a few weeks.

Fears that travelling fans could spread Ebola and damage Morocco's tourist industry were seen as alarmist by the Confederation of African Football (CAF), who rejected the request and then stripped Morocco of their hosting rights.

>From a country with plentiful resources, who have previously bid to host the World Cup, Afcon is now being played in one of Africa's smallest and most enigmatic countries.

Equatorial Guinea is a family-ruled former Spanish colony which has newfound oil wealth and is reveling in rescuing the continent's most eagerly anticipated sporting event. ... - more
Date: Thu 17 Apr 2014
Source: WHO Global Alert and Response [edited]

Update on polio in central Africa -- polio confirmed in Equatorial Guinea, linked to outbreak in Cameroon
--------------------------------------------------------------------------------
In Equatorial Guinea, 3 new wild poliovirus type 1 (WPV1) cases have been reported, the 1st polio in the country since 1999. Genetic sequencing indicates these cases are linked to an on-going WPV1 outbreak in Cameroon which has subsequently been detected in Equatorial Guinea. The cases had onset of paralysis on [28 Jan 2014], [19 Jan 2014] and [24 Mar 2014], from Centro Sur, Bioko Norte and Litoral. Outbreak response in Equatorial Guinea is currently being planned, including National Immunization Days (NIDs) with bivalent oral polio vaccine (OPV) on [21-24 Apr 2014]. An estimated 40 percent of children are fully immunized against polio in the country.

On [17 Mar 2014], the World Health Organization (WHO) had elevated the risk assessment of international spread of polio from Cameroon to 'very high' (http://www.who.int/csr/don/2014_03_17_polio/en/). The risk assessment was elevated due to: confirmation of 3 additional WPV1 cases (with onset of paralysis on [6, 25 and 31 Jan 2014]) from 3 new regions of Cameroon, confirming continued WPV transmission and geographic expansion of infected areas following detection of 4 cases in October 2013; gaps in surveillance; and, influx of vulnerable refugee populations from Central African Republic. The confirmation of new cases in Cameroon resulted in planning additional emergency outbreak response activities, including converting a subnational immunization campaign to a full nationwide activity on [11-13 Apr 2014], and implementing nationwide campaigns in May and June 2014. Critical to success will be to ensure substantial improvement in the quality of immunization campaigns that reach all children multiple times with OPV. Equally important will be efforts to rapidly improve the quality of surveillance so that the full extent of the outbreak can be determined and tracked.

Immunity levels and surveillance sensitivity are also being assessed in neighbouring countries, in particular in Gabon and the Republic of Congo. In Gabon, a nationwide immunization campaign is planned for [22-26 Apr 2014] (targeting all children aged less than 15 years), and in the Republic of Congo, a nationwide activity will be conducted on 1 May 2014.

It is important that all countries, in particular those with frequent travel and contacts with polio-affected countries and areas, strengthen surveillance for acute flaccid paralysis (AFP) cases in order to rapidly detect any new virus importations and to facilitate a rapid response. Countries, territories and areas should also maintain uniformly high routine immunization coverage at the district level to minimize the consequences of any new virus introduction.

WHO's International Travel and Health (http://www.who.int/ith/chapters/en/) recommends that all travellers to and from polio-affected areas be fully vaccinated against polio.
Date: Sat 23 June 2012
Source: Guinea Equatorial [in Spanish, trans. ProMed Mod.JG, edited]

After the last measles vaccination campaign that took place last April 2012, a new outbreak of the disease has been reported in some communities in Malabo district, and for this reason, the Ministry of Health initiated a new vaccination campaign [Malabo is the capital of Equatorial Guinea, located on the northern coast of Bioko Island. - ProMed Mod.CP].

Activities started last Thursday, with the cooperation of the National Vaccination Programme (PAV, according to its Spanish initials). The campaign will concentrate its activities in the most severely affected communities, such as Santa Maria III, Lampert and Sunco.

Some medical officers gathered in Madre Bisila Health Centre in order to organise local vaccination units and to deal with mothers who brought their children to the Health Centre in order to have them vaccinated. Vaccine will be dispensed throughout the next 10 days, and subsequently, the vaccination campaign will continue in the Continental region of Equatorial Guinea.

Local officials from the Ministry of Health are inviting the population, particularly mothers, to bring their children to local health centres or to bring their children to mobile vaccination units when these teams arrive to their communities.
=====================
[According to La Voz de Rusia (<http://spanish.ruvr.ru/2012_06_22/Guinea-epidemia-sarampion/>), the last major measles epidemic in the country occurred in November 2008, when more than a dozen children died in various hospitals in Equatorial Guinea. No fatalities have been reported in the current outbreak so far.

Equatorial Guinea, officially the Republic of Equatorial Guinea, is a country located in central Africa. It has 2 parts: a Continental Region (Rio Muni), including several small offshore islands including Corisco, Elobey Grande and Elobey Chico; and an insular region containing Annobon island and Bioko island (formerly Fernando Po), where the capital Malabo is situated. A map of Equatorial Guinea can be accessed at: <http://www.africa.upenn.edu/CIA_Maps/Equatorial_Guinea_19871.gif>. - ProMed Mod.CP]

[The ProMED HealthMap for Equatorial Guinea can be found at
<http://healthmap.org/r/1KlO>.]
More ...

Netherlands Antilles

Netherland Antilles US Consular Information Sheet
May 12, 2008
COUNTRY DESCRIPTION:
The five islands of Bonaire, Curaçao, Saba, St. Eustatius (or “Statia”) and St. Maarten (Dutch side) comprise the Netherlands Antilles, an autonomous
art of the Kingdom of the Netherlands. Tourist facilities are widely available. Read the Department of State Background Notes on the Netherlands Antilles for additional information.
ENTRY/EXIT REQUIREMENTS: All Americans traveling by air outside the United States are required to present a passport or other valid travel document to enter or re-enter the United States. This requirement will be extended to sea travel (except closed loop cruises), including ferry service, by the summer of 2009. Until then, U.S. citizens traveling by sea must have government-issued photo identification and a document showing their U.S. citizenship (for example, a birth certificate or certificate of nationalization), or other document compliant with the Western Hemisphere Travel Initiative, such as a passport card for entry or re-entry to the U.S. Sea travelers should also check with their cruise line and countries of destination for any foreign entry requirements.

Applications for the new U.S. Passport Card are now being accepted. Based on current projections, we expect to begin production of the passport card in June 2008 and be in full production in July 2008. The card may not be used to travel by air and is available only to U.S. citizens. Further information on the Passport Card is available at http://travel.state.gov/passport/ppt_card/ppt_card_3926.html and upcoming changes to U.S. passport policy can be found on the Bureau of Consular Affairs web site at http://travel.state.gov/travel/cbpmc/cbpmc_2223.html. 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.
The U.S. Consulate recommends traveling in the Netherlands Antilles with a valid U.S. passport to avoid delays or misunderstandings. A lost or stolen passport is also easier to replace when outside the United States than other evidence of citizenship. Visitors to the Netherlands Antilles may be asked to show onward/return tickets or proof of sufficient funds for their stay. Length of stay is granted for two weeks and may be extended for 90 days by the head office of immigration. For further information, travelers may contact the Royal Netherlands Embassy, 4200 Linnean Avenue, N.W., Washington, D.C. 20008, telephone (202) 244-5300, or the Dutch Consulate in Los Angeles, Chicago, New York, Houston or Miami. Visit the web site for the Embassy of the Netherlands at http://www.netherlands-embassy.org/homepage.asp for the most current visa information.

We have more information pertaining to dual nationality and international child abduction. Please refer to our customs information to learn more about customs regulations.

SAFETY AND SECURITY:
Drug-related organized crime exists within the Netherlands Antilles but has not directly affected tourists in the past.
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, including the Worldwide Caution, can be found.
Up-to-date information on safety and security can also be obtained by calling 1-888-407-4747 toll free in the U.S., or for callers outside the U.S. and Canada, a regular toll-line at 1-202-501-4444. These numbers are available from 8:00 a.m. to 8:00 p.m. Eastern Time, Monday through Friday (except U.S. federal holidays).
The Department of State urges American citizens to take responsibility for their own personal security while traveling overseas. For general information about appropriate measures travelers can take to protect themselves in an overseas environment, see the Department of State’s pamphlet A Safe Trip Abroad.
CRIME: In recent years, street crime has increased, especially in St. Maarten. Valuables, including passports, left unattended on beaches, in cars and hotel lobbies are easy targets for theft, and visitors should leave valuables and personal papers secured in their hotel. Burglary and break-ins are increasingly common at resorts, beach houses and hotels. Armed robbery occasionally occurs. The American boating community has reported a handful of incidents in the past, and visitors are urged to exercise reasonable caution in securing boats and belongings. Car theft, especially of rental vehicles for joy riding and stripping, can occur. Incidents of break-ins to rental cars to steal personal items have been reported by American tourists. Vehicle leases or rentals may not be fully covered by local insurance when a vehicle is stolen. Be sure you are sufficiently insured when renting vehicles and jet skis.
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.
Please see our information for American Victims of Crime Overseas.
MEDICAL FACILITIES AND HEALTH INFORMATION: Medical care is generally good in Curaçao and St. Maarten, but may be limited on the other three islands. Hospitals have three classes of services i.e.: First Class: one patient to a room, air conditioning etc.; Second Class: two to six patients to a room, no air conditioning; Third Class: 15 to 30 people in one hall. Patients are accommodated according to their level of insurance.
Bonaire: The San Francisco hospital is a medical center (35 beds) with decompression facilities. The hospital has an air ambulance service to Curaçao and Aruba.
Curaçao: St. Elizabeth hospital is a public hospital that may be compared to midrange facilities in the United States. St. Elizabeth's hospital has a decompression chamber and qualified staff to assist scuba divers suffering from decompression sickness. Several private clinics provide good to excellent medical service.
St. Maarten: St. Maarten Medical Center (79 beds) is a relatively small hospital where general surgery is performed. Complex cases are sent to Curaçao.
Statia: Queen Beatrix Medical Center (20 beds) is a medical facility well equipped for first aid. Surgery cases are sent to St. Maarten.
Saba: Saba Clinic (14 beds) is a well-equipped first aid facility. Surgery cases are sent to St. Maarten. The Saba Marine Park has a decompression chamber and qualified staff to assist scuba divers suffering from decompression sickness.
Information on vaccinations and other health precautions, such as safe food and water precautions and insect bite protection, may be obtained from the Centers for Disease Control and Prevention’s hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747) or via the CDC’s web site at http://wwwn.cdc.gov/travel/default.aspx. For information about outbreaks of infectious diseases abroad consult the World Health Organization’s (WHO) web site at http://www.who.int/en. Further health information for travelers is available at http://www.who.int/ith.
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 Netherlands Antilles is provided for general reference only, and may not be totally accurate in a particular location or circumstance.
Driving in the Netherlands Antilles is on the right hand side. Right turns on red are prohibited, and traffic conditions require somewhat defensive driving. Local laws require drivers and passengers to wear seat belts and motorcyclists to wear helmets. Children under 4 years of age should be in child safety seats; children under 12 should ride in the back seat.
Nonexistent or hidden and poorly maintained street signs are the major road hazard in the Netherlands Antilles. Therefore, drivers should proceed through intersections with caution. Roads in the Netherlands Antilles are extremely slippery during rainfall. Night driving is reasonably safe in the Netherlands Antilles as long as drivers are familiar with the route and road conditions. Most streets are poorly lit or not lit at all. In Curacao, drivers should be aware of herds of goats that may cross the street unexpectedly. In Bonaire, wild donkeys may also cross the road.
Taxis are the easiest, yet most expensive form of transportation on the islands. As there are no meters, passengers should verify the price before entering the taxi. Fares quoted in U.S. dollars may be significantly higher than those quoted in the local currency. Vans are inexpensive and run non-stop during daytime with no fixed schedule. Each van has a specific route displayed in the front of the windshield. Buses, which run on the hour, have limited routes. The road conditions on the main thoroughfares are good to fair.
See road safety information at the following sites; http://www.curacao.com, http://www.statiatourism.com, http://www.sabatourism.com, http://www.infobonaire.com, http://www.st-maarten.com/.
Please refer to our Road Safety page for more information.
AVIATION SAFETY OVERSIGHT: The U.S. Federal Aviation Administration (FAA) has assessed the Government of the Netherlands Antilles’ Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for oversight of the Netherlands Antilles’ 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:
Dutch law in principle does not permit dual nationality. However, there are several exceptions. For example, American citizens who are married to Dutch citizens are exempt from the requirement to abandon their American nationality when they apply to become a Dutch citizen by naturalization. For detailed and specific information on this subject, contact the Embassy of the Netherlands in Washington or one of the Dutch consulates in the U.S. In addition to being subject to all Dutch laws affecting U.S. citizens, dual nationals may also be subject to other laws that impose special obligations on Dutch citizens.
Time-share buyers are cautioned about contracts that do not have a "non-disturbance or perpetuity protective clause" incorporated into the purchase agreement. Such a clause gives the time-share owner perpetuity of ownership should the facility be sold. Americans sometimes complain that the timeshare units are not adequately maintained, despite generally high annual maintenance fees. Because of the large number of complaints about misuse of maintenance fees, particularly in St. Maarten, prospective timeshare owners are advised to review the profit and loss statement for maintenance fees. Investors should note that a reputable accounting firm should audit profit and loss statements.
Potential investors should be aware that failed land development schemes involving time-share investments could result in financial losses. Interested investors may wish to seek professional advice regarding investments involving land development projects. Real estate investment problems that reach local courts are rarely settled in favor of foreign investors.
An unusually competitive fee to rent vehicles or equipment could indicate that the dealer is unlicensed or uninsured. The renter is often fully responsible for replacement costs and fees associated with any damages that occur during the rental period. Visitors may be required to pay these fees in full before leaving the Netherlands Antilles and may be subject to civil or criminal penalties if they cannot or will not make payment.
Netherlands Antilles customs authorities may enforce strict regulations concerning temporary importation into or export from the Netherlands Antilles. For example, it is strictly prohibited to export pieces of coral and/or seashells. Please see our information on customs regulations.
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 offences. Persons violating the laws of the Netherlands Antilles, even unknowingly, may be expelled, arrested or imprisoned. Penalties for possession, use, or trafficking in illegal drugs in the Netherlands Antilles are severe, and convicted offenders can expect long jail sentences and heavy fines. The Netherlands Antilles has strict gun control laws; even a stray bullet in a suitcase can trigger a fine or time in jail. Engaging in sexual conduct with children or using or disseminating child pornography in a foreign country is a crime, prosecutable in the United States. Please see our information on Criminal Penalties.
CHILDREN'S ISSUES: For information on international adoption of children and international parental child abduction, see the Office of Children’s Issues web site.
REGISTRATION / EMBASSY LOCATION:
American citizens residing or traveling in the Netherlands Antilles 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 Netherlands Antilles. 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. Consulate General is located at J.B. Gorsiraweg #1, Willemstad, Curaçao, telephone (599-9) 461-3066; fax (599-9) 461-6489; e-mail address: acscuracao@state.gov.
* * *
This replaces the Country Specific Information dated May 7, 2007, to update the Entry/Exit, Crime, Traffic Safety and Road Conditions, and Registry / Embassy Location sections.

Travel News Headlines WORLD NEWS

Date: Thu, 16 May 2019 23:41:35 +0200

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

The infected individual was a member of the crew who, according to the Church, had fully recovered and was given a clean bill of health a week ago. She had been earlier confined on the ship.   The ship, which is based in Willemstad on the island of Curacao in the Dutch West Indies, was quarantined after its arrival in Saint Lucia on April 30.   It remained there for two days before returning to Willemstad on May 4 where local authorities ordered a fresh quarantine to give them time to confirm the passengers were either immunized or had no risk of contracting the virus.
Date: Sat, 4 May 2019 20:37:18 +0200
By Sara MAGNIETTE

The Hague, May 4, 2019 (AFP) - The Dutch territory of Curacao said Saturday it would do what is needed to prevent measles spreading from a Scientology cruise ship, after a crew member came down with the disease.   The Freewinds, which left the Caribbean island of St. Lucia on Friday, arrived back in its home port of Curacao at around 9:00 am (1300 GMT) Saturday, according to myshiptracking.com.

The Curacao government said in a statement that it would "take all necessary precautions to handle the case of measles on board of the Freewinds," including vaccinations.   "An investigation will also be done to determine who will be allowed to leave the ship without (posing) a threat to the population of Curacao," it said.   "It is imperative to make all efforts to prevent a spread of this disease internationally."   Dutch broadcaster NOS reported that three health officials had boarded the boat to examine those on board. Only people able to prove that they have been vaccinated against measles or had already had the disease would be able to leave the boat, its correspondent there reported.

- Anti-vaccine movement -
The Church of Scientology says the 440-foot (134-meter) vessel is used for religious retreats and is normally based in Curacao.   The vessel had arrived in St Lucia from Curacao on Tuesday, when it was placed under quarantine by health authorities there because of a measles patient, said to be a female crew member.   According to NOS, the crew member concerned is a Danish national, who arrived in Curacao from Amsterdam on April 17. It was only when the boat was at sea, on route to St Lucia, that a doctor discovered she had measles, their correspondent said.

The resurgence of the once-eradicated, highly contagious disease is linked to the growing anti-vaccine movement in richer nations, which the World Health Organization (WHO) has identified as a major global health threat.   The authorities in Curacao nevertheless urged local people not to panic, as the risk of the disease spreading in this case was fairly low.   Several people did however visit the cruise ship between April 22 and April 28 before it set sail for St Lucia and the authorities asked them to make themselves known to health officials.

Officials said the Freewinds had travelled between Curacao, St Lucia and another Dutch-held island, Aruba, several times towards the end of April.   There were about 300 people aboard the ship, according to Saint Lucia authorities, which placed the vessel in quarantine. They said they provided 100 doses of measles vaccine at no cost.   The Scientology church, founded by science fiction writer L Ron Hubbard in 1953, did not respond to requests for comment.   Its teachings do not directly oppose vaccination, but followers consider illness a sign of personal failing and generally avoid medical interventions.
Date: 4 Jul 2017
From: Harry Vennema <harry.vennema@rivm.nl> [edited]

On several of the Caribbean islands, epidemics of viral conjunctivitis are ongoing. Recently, general practitioners in the overseas territories of the Netherlands reported an increased incidence of this syndrome.

As of 26 May 2017, an outbreak of conjunctivitis occurred in a nursing home on Bonaire. In total, 14 patients and 13 healthcare workers presented with conjunctivitis. Patients were between 71 to 94 years of age. The number of new cases peaked in week 20 through 22. After week 22, a significant reduction was seen (1-3 new cases per week). Initially, conjunctival swabs from 5 patients were tested for the presence of adenovirus by PCR; all 5 were negative.

Subsequently, swabs from 4 patients were analyzed for the presence of enterovirus by RT-PCR, and all 4 were positive. The enterovirus from 3 samples was further characterized by partial VP1 sequence analysis. In all 3 samples, the enterovirus was characterized as Coxsackievirus A24, which belongs to Enterovirus C. Coxsackievirus A24 has been identified frequently as the causative agent of epidemic viral conjunctivitis. The strain from Bonaire is at least 5 percent different from any of the previously isolated and sequenced CV-A24 strains available in Genbank in a 330nt VP1 fragment. The strain involved in the most recent outbreak of CV-A24 conjunctivitis on La Reunion in 2015 is 6 percent different from the Bonaire 2017 strain.

[Andert Rosingh, Yingbin Celestijn-Wu, Fundashon Mariadal Hospital, Clinical Microbiology, Kralendijk, Bonaire, Caribbean Netherlands Annelies Riezebos, University Medical Centre Utrecht, Medical Microbiology, Utrecht, Netherlands Harry Vennema, Kim Benschop, Johan Reimerink, Hans van den Kerkhof, National Institute for Public Health and the Environment, Centre for Infectious Disease Control, Bilthoven, Netherlands]
--------------------------------------------
Harry Vennema
National Institute for Public Health and the Environment
Centre for Infectious Disease Control
Bilthoven, Netherlands
=========================
[ProMED thanks Harry Vennema and colleagues for this report.  Acute hemorrhagic conjunctivitis (AHC) is characterized by sudden onset of painful, swollen, red eyes with subconjunctival haemorrhages and excessive tearing. Most cases are self-limited but highly contagious, with the potential for causing considerable illness. Adenoviruses and picornaviruses can cause AHC outbreaks (1). Among picornaviruses, enterovirus 70 and coxsackievirus A24 variant (CA24v) have caused large outbreaks of AHC[2].

Coxsackieviruses are transmitted primarily via the fecal-oral route and respiratory aerosols, although transmission via fomites is possible. The viruses initially replicate in the upper respiratory tract and the distal small bowel. They have been found in the respiratory tract up to 3 weeks after initial infection and in feces up to 8 weeks after initial infection[3]. The potential for exponential spread is, therefore, quite considerable.

It is important to understand that sequential outbreaks of AHC due to CA24v might occur in the same location after a considerable period, and public health precautions are necessary to control these outbreaks.

References:
1. Hierholzer JC, Hatch MH. Acute hemorrhagic conjunctivitis. In: Darrell RW, editor. Viral diseases of the eye. Philadelphia: Lea & Febiger; 1985. p. 165-96.
2. Kono R. Apollo 11 disease or acute hemorrhagic conjunctivitis: a pandemic of a new enterovirus infection of the eyes. Am J Epidemiol. 1975;101:383-90.

[A HealthMap/ProMED-mail map can be accessed at:
Date: Published ahead of print 7 Dec 2015
Source: American Journal of Tropical Medicine & Hygiene Published on line doi:10.4269/ajtmh.15-0308 [edited]

Noellie Gay, Dominique Rousset, Patricia Huc, Severine Matheus, Martine Ledrans, Jacques Rosine, Sylvie Cassadou, and Harold Noel. Seroprevalence of Asian Lineage Chikungunya Virus Infection on Saint Martin Island, 7 Months After the 2013 Emergence.

Abstract
--------
At the end of 2013, chikungunya virus (CHIKV) emerged in Saint Martin Island, Caribbean. The Asian lineage was identified. 7 months after this introduction, the seroprevalence was 16.9 percent in the population of Saint Martin and 39.0 percent of infections remained asymptomatic. This moderate attack rate and the apparent limited size of the outbreak in Saint Martin could be explained by control measures involved to lower the exposure of the inhabitants. Other drivers such as climatic factors and population genetic factors should be explored. The substantial rate of asymptomatic infections recorded points to a potential source of infection that can both spread in new geographic areas and maintain an inconspicuous endemic circulation in the Americas.
--------------------------------
Communicated by:
Roland Hubner
Superior Health Council
Brussels
Belgium
===================
[Asymptomatic or very mild infections may be an important source of infectious blood meals for vector mosquitoes. These infections should not be overlooked in epidemiological assessments of chikungunya virus outbreaks and implementation of control measures in the field. - ProMed Mod.TY]
Date: Wed, 26 Aug 2015 16:43:59 +0200 (METDST)

Miami, Aug 26, 2015 (AFP) - Tropical storm Erika took aim at the Lesser Antilles Wednesday as storm warnings went up there and in Puerto Rico in anticipation of heavy rains, US forecasters said.   With winds of 75 kilometres (45 miles) per hour, Erika was 540 kilometres (335 miles) east of Antigua at 1200 GMT, the Miami-based National Hurricane Center reported.

Advancing at a speed of 28 kilometres (17 miles) per hour, it was expected to sweep over the Lesser Antilles Wednesday night and then head toward Puerto Rico and the Virgin Islands.   Tropical storm warnings were up in Puerto Rico, the Virgin Islands, Antigua and Barbuda, Guadeloupe, Montserrat, St Kitts and Nevis, Anguilla, Saba, St Eustacia and St Maarten.

A US Air Force hurricane hunter aircraft that flew into the storm found it was slightly increasing in strength.   "Some slow strengthening is forecast during the next 48 hours," the hurricane centre said.   According to the NHC's projections, Erika could become a hurricane by the end of the week, or early next, as it nears Florida.   But "the intensity forecast remains very uncertain," it said.

Erika is arriving on the heels of Danny, the season's first hurricane which petered out before reaching the Caribbean.   Experts said earlier this month that there was a 90 percent chance the 2015 hurricane season in the Atlantic would be less active than usual.
More ...

Botswana

Botswana - US Consular Information Sheet
August 29, 2008
COUNTRY DESCRIPTION:
Botswana is a country in southern Africa with a stable democratic government and a growing economy. Facilities for tourism are widely available. Read the Departm
nt of State Background Notes on Botswana for additional information.

ENTRY/EXIT REQUIREMENTS: A passport with at least six months of validity remaining is required. U.S. citizens are permitted stays up to 90 days without a visa. For additional information on entry requirements, travelers may contact the Embassy of the Republic of Botswana, 1531-1533 New Hampshire Avenue NW, Washington, DC 20036, telephone (202) 244-4990/1, fax (202) 244-4164 or the Permanent Mission of the Republic of Botswana to the United Nations, 103 E. 37th St., New York, NY, 10016, telephone (212) 889-2277, fax (212) 725-5061. There are also honorary consuls in Los Angeles, San Francisco and Houston. Visit the Embassy of Botswana’s web site at http://www.botswanaembassy.org/ for the most current visa information. As a general precaution, all travelers are advised to carry a photocopy of the photo/bio information page of their passport and keep it in a location separate from the passport.

Visitors to Botswana who also intend to visit South Africa should be advised that the passports of all travelers to South Africa must contain at least two blank (unstamped) visa pages each time entry to South Africa is sought; these pages are in addition to the endorsement/amendment pages at the back of the passport. Otherwise, the traveler, even when in possession of a valid South African visa, may be refused entry into South Africa, fined, and returned to their point of origin at the traveler’s expense.

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:
Civil unrest and disorder are rare. U.S. citizens should avoid crowds, political rallies, and street demonstrations and maintain security awareness at all times.

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

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

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

CRIME: Crime is a serious concern in Botswana. Visitors must be vigilant and take common-sense security precautions. The criminal threat is very similar to that of any large urban area. Petty street crime and crimes of opportunity, primarily the theft of money and personal property, are not uncommon. Home invasions ‘smash and grabs’ from vehicles, and cell phone thefts, often at knife point, are routinely reported to the police. Visitors should use care when talking on a cell phone while walking. Urban areas are particularly dangerous at night; pedestrians are advised to avoid walking in Gaborone and other urban areas in Botswana at night. Except for visits to the Gaborone Yacht Club during daylight hours, U.S. Embassy personnel are prohibited from traveling to the area surrounding the Gaborone Dam and to the Kgale Hill area, a popular Gaborone hiking venue, because of multiple incidents of violent crime. American citizens are urged to avoid these areas.

Travelers arriving in Botswana via South Africa should be aware that there is a serious baggage pilferage problem at OR Tambo (Johannesburg) and Cape Town International Airports. Travelers are encouraged to use an airport plastic wrapping service and to avoid placing electronics, jewelry, cameras, designer athletic gear, or other valuables in checked luggage. Also, make an inventory of items in checked baggage to aid in claims processing if theft does occur.

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.

Botswana has three numbers equivalent to the “911” emergency line. For police assistance, dial “999.” For an ambulance, dial “997.” In the event of a fire, dial “998.”

See our information on Victims of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION: Medical facilities in Gaborone are adequate for simple medical problems, but facilities outside of Gaborone are limited. Adequately equipped emergency rooms and trained physicians are available in the capital but services are rudimentary elsewhere. Professional private emergency rescue services operate air and ground ambulances throughout the country, but care is rendered only after a patient’s ability to pay is established. Response times are often slow in less populated areas. Outside of Gaborone, most airports are either not equipped or have frequently malfunctioning night lighting capability, so airborne medical evacuations can usually only be conducted during daylight hours. Malaria is prevalent only in the north of the country, particularly around the Chobe and Okavango National Parks. Malaria prophylaxis is not required in Gaborone but is suggested for travel to the north. For advanced care Americans often choose to travel to South Africa. Many South African manufactured prescription drugs are available in Gaborone.

Approximately one-quarter of the population of Botswana is infected with HIV, the virus that causes AIDS. Travelers are advised to exercise appropriate precautions if engaging in sexual activity, or if exposed to blood products through injuries or rendering assistance to accident victims. Tuberculosis is also endemic to Botswana. Two cases of extensively drug resistant tuberculosis (XDR-TB) have been identified in Botswana since January 2008 when Botswana first obtained the ability to test for this form of TB. Individuals who plan to reside or stay in Botswana for extended periods are advised to obtain a tuberculosis skin test (PPD test) prior to arrival and again upon departure from Botswana.

There are occasional diarrhea outbreaks in areas affected by heavy rains. Travelers are encouraged to take necessary precautions when handling food and drinking water.

The Department of Immigration of Botswana does not impose any HIV/AIDS entry restrictions for visitors to or foreign residents of Botswana.

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

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

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

Driving in Botswana is challenging and motorists must drive defensively. Traffic circulates on the left in Botswana, as elsewhere in the region. While the roads in major population centers in Botswana are generally good, many roads have been damaged by heavy rains in December and January. Travel by automobile outside of large towns may be dangerous. The combination of long, tedious stretches of two-lane highways without shoulders, high speed limits, and poor lighting make driving at night on rural highways particularly hazardous. Recent rolling power outages mean that many traffic lights and street lamps do not work properly. Free-range domestic animals, even in urban centers, and large numbers of pedestrians and hitchhikers in the roadways make fatal accidents a frequent occurrence.

‘Smash and grab’ robberies from vehicles are not uncommon in Botswana, particularly in urban areas at traffic lights. Motorists should avoid carrying anything of value (hand bags, briefcases, purses, cell phones, etc.) in the passenger compartment that could attract potential assailants.

Please refer to our Road Safety page for more information. Visit the web site of Botswana’s national tourist office and national authority responsible for road safety at http://www.botswana-tourism.gov.bw.

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

SPECIAL CIRCUMSTANCES:
Since February 2008, rolling electric power outages have left many areas without power for several hours each week. This situation is likely to continue. Visitors are urged to carry flashlights. American citizens are also urged to be aware of how power outages might affect home security systems, garage doors and gates, and kitchen equipment, such as stoves and refrigerators. The power fluctuations could cause power surges that might harm computers, televisions, or other electrical appliances.

Botswana strictly enforces its laws controlling the trade in animal products. The hunting of lions is explicitly prohibited and leopards and elephants are covered under a strict quota regime. Botswana's Wildlife Conservation and National Parks Act makes it illegal to possess or remove from Botswana without a government permit any living or dead animal or animal trophy. A trophy is any horn, ivory, tooth, tusk, bone, claw, hoof, hide, skin, hair, feather, egg, or other durable portion of an animal, whether the item has been processed or not. Curio shops and vendors throughout the country sell items such as animal skins, plain and decorated ostrich eggs and eggshells, and carved bones or teeth of animals protected by this law. All of the souvenirs, although widely sold, are subject to this act. Travelers departing the country with a trophy must have a receipt from a store licensed to sell such items. Ivory and endangered rhinoceros horn products obtained in Botswana may not be removed from the country under any circumstances; elephant hair jewelry may be removed only with the appropriate license from the Department of Wildlife and National Parks. Trophies may not be taken from the wild without a permit. Violators are subject to arrest and may face a penalty of up to five years imprisonment and a substantial fine.

Wild animals may pose a danger to tourists. Tourists should bear in mind that, even in the most serene settings, the animals are wild and can pose a threat to life and safety. Tourists should use common sense when approaching wildlife, observe all local or park regulations, and heed all instructions given by tour guides. In addition, tourists are advised that potentially dangerous areas sometimes lack fences and warning signs. Exercise appropriate caution in all unfamiliar surroundings. 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 Botswana’s laws, even unknowingly, may be expelled, arrested or imprisoned. Penalties for possession, use, or trafficking in illegal drugs in Botswana are severe, and convicted offenders can expect long jail sentences and heavy fines. Engaging in sexual conduct with children or using or disseminating child pornography in a foreign country is a crime, prosecutable in the United States. Please see our information on Criminal Penalties.

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

REGISTRATION / EMBASSY LOCATION:
Americans living or traveling in Botswana are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department’s travel registration web site so that they can obtain updated information on travel and security within Botswana. Americans withoutInternet access may register directly with the nearest U.S. Embassy or Consulate. By registering, American citizens make it easier for the Embassy or Consulate to contact them in case of emergency. The U.S. Embassy is located in Gaborone on Embassy Drive in the Government Enclave. The mailing address is P.O. Box 90, Gaborone, telephone +267 395-3982; fax +267 318-0232; email consulargaborone@state.gov, and the after-hours emergency telephone is +267 395-7111.
* * *
This replaces the Country Specific Information for Botswana dated March 5, 2008, to update the sections on Information for Victims of Crime and Medical Facilities and Health Information.

Travel News Headlines WORLD NEWS

Date: Fri, 17 Jan 2020 19:10:08 +0100 (MET)

Tutume, Botswana, Jan 17, 2020 (AFP) - Packed with protein and calcium, mopane worms are a delicacy in Botswana, where they are stirred into chunky tomato and peanut stews.    In the north and centre of the country, the spiky black and green caterpillars are harvested to make relish and sold at markets.

But a regional drought has decimated the mopane population, sapping an important source of income for rural communities.   "(The mopane worm) is not in abundance just like in the past during the times of good rainfalls," said Onalethata Mbakile, a single mother of two in the central village of Goshwe, near the border with Zimbabwe.

Mbakile, 40, has been picking caterpillars off the branches of Mopane trees -- where they are usually found -- for more than two decades.   She travelled more than 440 kilometres (273 miles) to Botswana's capital Gaborone, where she charges 10 pula (80 euros cents) for small sachet of dried mopane -- a popular road-side snack.   "The rains are unreliable and unpredictable," Mbakile said. "We used to harvest it around December and April but it is no longer the case."

Southern Africa is grappling with one of its worst droughts in history, badly affected by a prolonged period of low rainfall and scorching temperatures.   The UN has warned that 45 million people in the region are in urgent need of food aid due to drought, flooding and economic hardship.   The harvest period for mopane worms has shrunk and sachets have doubled in price.
Date: Tue, 22 Oct 2019 18:42:15 +0200 (METDST)

Gaborone, Botswana, Oct 22, 2019 (AFP) - More than 100 elephants have died in two months in Botswana's Chobe National Park due to drought, which has also affected wildlife in other countries in the region, the government said Tuesday.   Several southern African countries are enduring one of the worst droughts in decades, caused by months of over-average temperatures and erratic rainfall.   The drought has wilted grasslands and dried up water holes, making it increasingly difficult for animals to survive.    Botswana's environment ministry said it has recorded a spike in the number of elephant and other animal deaths since May.    "More than one hundred elephants are estimated to have died naturally in the past two months," the ministry said in a statement, adding that 13 deaths were recorded just this week.

In neighbouring Zimbabwe, Its wildlife agency has recorded at least 55 elephant deaths over the past month due to lack of food and water.  Preliminary investigations in Botswana have also suggested some of the elephants may have died from anthrax.   "Due to the severe drought, elephants end up ingesting soil while grazing and get exposed to the anthrax bacteria spore," the ministry said in a statement.   "The animals are also travelling long distances in search of food which leaves some highly emaciated, ending in death."   Anthrax is an infectious disease found naturally in soil. It is generally contracted by herbivores and is a common cause of death for both wild and domestic animals around the world.      The environment ministry said it would be burning "anthrax related carcasses" to prevent the disease from spreading to other animals.   It warned the public not to touch any animal carcasses they might find and report them to the authorities.
Date: Tue 22 Oct 2019 9:28 PM CAT
Source: Reuters [edited]

More than 100 elephants have died in Botswana in the past 2 months partly because of a suspected anthrax outbreak, the government said on [Tue 22 Oct 2019]. "Preliminary investigations suggest the elephants are dying from anthrax whilst some died from drought effects," a Department of Wildlife and National Parks statement said. "Due to the severe drought, elephants end up ingesting soil while grazing and get exposed to the anthrax bacteria spore," it said.

Elephants Without Borders said an aerial survey showed fresh elephant carcasses increased by 593% between 2014 to 2018, mostly from poaching and illegal hunting, with drought also a contributing factor. The wildlife authority said the latest deaths were in the Chobe River front and Nantanga areas in northern Botswana, where 14 dead elephants were found this week. It said it would be burning the carcasses to prevent the anthrax infection from spreading to other animals.

According to the Centers for Disease Control and Prevention in the United States, anthrax is a bacterium found naturally in soil and commonly affects domestic and wild animals when they breathe in or ingest spores in contaminated soil, plants, or water. Anthrax is not contagious and humans can only get infected by ingesting the bacteria. It can be prevented in animals via regular vaccination.

Botswana is home to almost 1/3 of Africa's elephants, around 130,000.  Botswana has lifted a ban on big-game hunting to combat a growing conflict between humans and wildlife. Botswana and its neighbors in southern Africa are experiencing a severe drought because of below-average rainfall since an El Nino weather system struck in 2015.  [Byline: Brian Benza, writing: Mfuneko Toyana; editing: Grant McCool)
====================
[Check CBC
which has a nice picture of 2 Okavango Delta bull elephants.

Elephants can graze, although they are usually browsers of branches and vegetation off trees. They are attracted to water. So the source is presently uncertain but might have been a secondary spread from a prior wildlife case that resulted in contaminated browse from blow flies or water from a contaminating carcass. Until a cheap and effective wildlife oral vaccine can be developed, these cases in Chobe will be a constant sporadic event. As elsewhere, the best control is to burn any carcasses and disinfect any contaminated soil. -

Chobe is on the northern border of Botswana abutting the Caprivi Strip of Namibia; see

[HealthMap/ProMED-mail map of Botswana:
Date: Fri, 30 Aug 2019 11:13:54 +0200 (METDST)

Maun, Botswana, Aug 30, 2019 (AFP) - A calf struggles neck-high in the stew-like mud, kicking frantically to make its way across the mire.   Around 38,000 livestock depend on the waters of Lake Ngami in northern Botswana, but the animals -- like the lake itself -- have been stricken by a crippling drought.   Grazers have to walk long distances in hopes of finding anything to eat. Some succumb to the heat and vultures can be seen feasting on their corpses in the sludge of the lake bed.

In May, President Mokgweetsi Masisi officially declared Botswana to be in drought after months of unevenly distributed rains, heat waves and dry spells.   Rural households have been especially hit, and are looking to the government for help.   Southern Africa has been hard hit by intensifying extreme weather conditions such as drought and floods, leaving millions in need of food aid.

Zambia is in the throes of a drought which has affected the 2018/19 farming season. Around 2.5 million people are facing food shortages, according to official figures.

In Zimbabwe, nearly a third of the 16 million population are in need of aid and at least half of these face acute hunger, according to the World Food Programme (WFP).   Lake Ngami is also home to around 100 hippos, half of whom have cannily migrated to parts where life is easier.   "Only the livestock is trapped in the muddy waters," the acting director of wildlife and national parks,  Moeti Batshabang, told AFP.
Date: Wed 15 Nov 2017 20:00 pm (GMT +2)
Source: MMEGI online [edited]

Dozens of Nthompe Koma Primary School pupils on Monday night [13 Nov 2017] thronged Mahalapye health facilities following a food poisoning incident allegedly caused by rape they ate at school.

Classes came to a halt yesterday [14 Nov 2017] as more students showed signs of food poisoning while health workers were present at the school and hospital to establish what could have caused the incident that led to at least 26 pupils being admitted at Mahalapye Hospital. According to a source, it is suspected that the students were fed rape, which was recently sprayed with pesticides.

"The students started vomiting and having diarrhoea at their homes after school. A huge number of them were rushed to the hospital and it was said that the newly treated vegetable was given to them," the source said.

Mahalapye Hospital Superintendent, Dr Kumal Bose said they are yet to establish the cause of diarrhoea and vomiting, whether it is the food they ate or not. "We attended to a total of 82 students of whom 26 were admitted and others discharged. More students were coming in this morning [15 Nov 2017].

We have sent our public health team to the school to investigate all possible causes," he said. Mahalapye chief education officer,

Maria Dikeme [Principal Education Officer] confirmed the incident. "It is true that a lot of students from the school were taken to various health facilities yesterday [14 Nov 2017].

The students were fed sorghum and rape at break time and the sorghum has been taken for tests by the public health team. All of the rape was cooked yesterday. We will, however, go to the source if there is still any left so that it can be tested," she said.

Dikeme said more students were taken to the hospital the following day as some developed signs late.

"We do not have a certain number currently, but we have recorded over 100 cases with 11 pupils still admitted at the hospital," she said.

She said they kept the pupils within the school so they could monitor them rather than sending them home while parents are at work.

Dikeme said there were some pupils who were in school yesterday [14 Nov 2017] who were not affected and that there was no report of any adult person having been diagnosed with the same problem.  [Byline: Innocent Selatlhwa]
===================
[Rape seed and soybeans are both grains. This article says a possible pesticide. The class of chemicals causing these clinical signs would be organophosphates. Grains are often treated with chemicals to prevent insect infestation and ruination of the crop. Therefore it is possible an organophosphate was used on the grain, and not washed or cleaned before being put into human consumption, could produce vomiting and diarrhoea. These could be signs associated with organophosphates. There are likely other crop chemicals capable of producing this, but the organophosphate class is large with numerous chemicals.

The article does not tell us if the pupils are being treated or if they are, what they are being treated with.

Consequently, the results of the testing is very important. Hopefully the testing will reveal the cause of this situation. - ProMED Mod.TG]

[A HealthMap/ProMED-mail map can be accessed at:
More ...

Honduras

Honduras - US Consular Information Sheet
May 19, 2008

COUNTRY DESCRIPTION:
Honduras is a democracy with a developing economy. The national language is Spanish, although English is often spoken in the Bay Islands. The climate is genera
ly pleasant and temperate, with dry and wet seasons. During the dry season from February into May, widespread forest fires and agricultural burning can lead to severely degraded air quality throughout the country possibly causing respiratory problems and airport closures. The terrain includes mountainous areas, coastal beaches, and jungle lowlands. Facilities that would normally be used by tourists, including hotels and restaurants, are generally adequate in the capital city of Tegucigalpa, in San Pedro Sula, Tela, La Ceiba, the Bay Islands, and near the Copan ruins. Large sections of the country, however, lack basic public services or even a governmental presence. Currency exchange is readily available at banks and hotels in the major cities. Read the Department of State Background Notes on Honduras for additional information.

ENTRY/EXIT REQUIREMENTS: A U.S. passport valid for at least three months from the date of entry is required to enter Honduras. Though not required by law, some travelers have reported difficulty departing Honduras using a passport with less than three months of validity beyond the date of departure. A visa is not required, but tourists must provide evidence of return or onward travel. Parents should not rely on birth certificates for their children’s travel; rather, prior to travel they should obtain U.S. passports for infants and minors born in the United States. U.S. citizens are encouraged to carry a photocopy of their U.S. passports with them at all times, so that if questioned by local officials proof of identity and U.S. citizenship are readily available.

In June 2006, Honduras entered a “Central America-4 (CA-4) Border Control Agreement” with Guatemala, El Salvador, and Nicaragua. Under the terms of the agreement, citizens of the four countries may travel freely across land borders from one of the countries to any of the others without completing entry and exit formalities at Immigration checkpoints. U.S. citizens and other eligible foreign nationals who legally enter any of the four countries may similarly travel among the four without obtaining additional visas or tourist entry permits for the other three countries. Immigration officials at the first port of entry determine the length of stay, up to a maximum period of 90 days. Foreign tourists who wish to remain in the four country region beyond the period initially granted for their visit are required to request a one-time extension of stay from local immigration authorities in the country where the traveler is physically present, or travel outside the CA-4 countries and reapply for admission to the region. Foreigners “expelled” from any of the four countries are excluded from the entire “CA-4” region. In isolated cases, the lack of clarity in the implementing details of the CA-4 Border Control Agreement has caused temporary inconvenience to some travelers and has resulted in others being fined more than one hundred dollars or detained in custody for 72 hours or longer.

Dual Nationality: Honduran law permits dual nationality only for minors under the age of 21 and those Honduran-born citizens who have become naturalized citizens of other countries. U.S. citizens who become Honduran citizens by naturalization are not considered to have dual nationality under Honduran law. However, becoming a Honduran citizen will not cause U.S. citizens to lose their U.S. citizenship and all the accompanying rights and privileges. Dual nationals, in addition to being subject to all Honduran laws affecting U.S. citizens, may be subject to other laws that impose special obligations on Honduran citizens. For more information, please contact Honduran Immigration in Tegucigalpa (telephone 504-238-5613), San Pedro Sula (telephone 504-550-3728), Roatan (telephone 504-445-1226), La Ceiba (telephone 504-442-0638), or Puerto Cortes (telephone 504-665-0582).

For further information on dual nationality for U.S. citizens, see the Bureau of Consular Affairs dual nationality flier.

SAFETY AND SECURITY:
Political demonstrations sometimes disrupt traffic, but they are generally announced in advance and are usually peaceful. Travelers should avoid areas where demonstrations are taking place, and they should stay informed by following the local news and consulting hotel personnel and tour guides. Demonstrators frequently block public roads to press for concessions from the government of Honduras. These demonstrations may last several hours and the government rarely seeks to disperse the demonstrators. U.S. citizens should never try to pass such roadblocks. While the Honduran side of the Honduras-Nicaragua border has been largely cleared of land mines, travelers should exercise caution there. For more information, we strongly encourage travelers to visit the U.S. Embassy's web site at http://honduras.usembassy.gov/ and click on Crime and Security Matters. For the latest security information, American citizens 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 United States, or for callers outside the United States and Canada, a regular toll-line at 1-202-501-4444. These numbers are available from 8:00 a.m. to 8:00 p.m. Eastern Time, Monday through Friday (except U.S. federal holidays). The Department of State urges American citizens to take responsibility for their own personal security while traveling overseas. For general information about appropriate measures travelers can take to protect themselves in an overseas environment, see the Department of State’s pamphlet A Safe Trip Abroad.

CRIME: Crime is endemic in Honduras and requires a high degree of caution by U.S. visitors and residents alike. U.S. citizens have been the victims of a wide range of crimes, including murder, kidnapping, rape, assault, and property crimes. Sixty-two U.S. citizens have been murdered in Honduras since 1995; only twenty cases have been resolved. Four U.S citizens were murdered in Honduras in 2007, six in 2006, and ten in 2005. Kidnappings of U.S. citizens have occurred in Honduras, including two incidents in 2007. Poverty, gangs, and low apprehension and conviction rates of criminals contribute to a critical crime rate, including horrific acts of mass murder. With a total of 3,855 murders in 2007, and a population of approximately 7.3 million people, Honduras has one of the world’s highest per capita murder rates.

U.S. citizens are encouraged to follow local news reports and seek additional information in the resources listed above. Criminals and pickpockets also target visitors as they enter and depart airports and hotels, so visitors should consider carrying their passports and valuables in a concealed pouch. Two-man teams on medium-size motorcycles often target pedestrians for robbery. There have also been reports of armed robbers traveling in private cars targeting pedestrians on isolated streets. The Honduran government conducts occasional joint police /military patrols in major cities in an effort to reduce crime. Problems with the judicial process include corruption and an acute shortage of trained personnel, equipment, staff, and financial resources. The Honduran law enforcement authorities' ability to prevent, respond to, and investigate criminal incidents and prosecute criminals remains limited. Honduran police generally do not speak English. The government has established a special tourist police in the resort town of Tela and other popular tourist destinations, including Tegucigalpa, San Pedro Sula, La Ceiba, and Roatan, but the number deployed is small and coverage is limited. The San Pedro Sula area has seen occasional armed robberies against tourist vans, minibuses, and cars traveling from the airport to area hotels, even sometimes targeting the road to Copan. Armed men have forced vehicles transporting tourists off the road and robbed the victims, occasionally assaulting the driver or passengers. In past years, several U.S. citizens have been murdered in San Pedro Sula and La Ceiba shortly after arriving in the country. Assaults in these areas may be based on tips from sources at airport arrival areas, so visitors are strongly urged to exercise caution in discussing travel plans in public.

Copan, Roatan/Bay Islands, and other tourist destinations have a lower crime rate than other parts of the country, but thefts, break-ins, assaults, and murders do occur. Exercise particular caution walking on isolated beaches, especially at night. Coxen Hole on the island of Roatan should be avoided after dark.

The Government of Honduras has a very limited presence in Northern Olancho, Colon and Gracias a Dios Departments, which are well known for lumber and narcotics smuggling and violence. Travelers in those areas should use extra caution. See the description of highways/areas to be avoided in the Traffic Safety and Road Conditions section below for details.

Incidents of crime along roads in Honduras are common, including carjacking and kidnapping. There have been frequent incidents of highway robbery on a number of roads including Limones to La Union, Olancho (route 41) via Salama and northward to Esquipulas Del Norte. For more information, please see the section below on Traffic Safety and Road Conditions.

Travelers should always drive with their doors locked and windows rolled up to avoid potential robberies at traffic lights and other places, such as congested downtown streets. Avoid driving at night. All bus travel should be during daylight hours and on first-class conveyances, not on economy buses. Please choose taxis carefully, and note the driver's name and license number. Instruct the driver not to pick up other passengers, agree on the fare before you depart, and have small bills available for payment, as taxi drivers often do not make change.

Do not resist a robbery attempt. Most criminals have weapons, and most injuries and deaths have resulted when victims have resisted. In 2004, an American citizen was murdered while attempting to flee an armed robbery in progress and another American was shot while resisting a carjacking. Two American citizens were murdered while resisting armed robberies in 2005.

Do not hitchhike or go home with strangers, particularly from nightspots. Whenever possible, travel in groups of two or more persons. Use the same common sense while traveling in Honduras that you would in any high crime area in the United States: do not wear excessive jewelry; do not carry large sums of money, or display cash, ATM/credit cards, or other valuables you do not need.

Avoid walking at night in most areas of Honduras. Do not hike alone in backcountry areas, or walk alone on beaches, historic ruins, or trails.

Individuals and groups should register their travel plans with the State Department via the Internet at the Department’s secure travel registration web site, https://travelregistration.state.gov/. Travelers may also register by sending passport, date of birth, and emergency contact information to the American Citizens Services Unit of the U.S. Embassy in Tegucigalpa via fax at 011-504-238-4357, or e-mail at usahonduras@state.gov prior to travel. Individuals as well as groups should always keep in their possession a photocopy of their U.S. passport data page, carry an additional copy in their suitcase, and leave a copy at home with a friend or family member.

INFORMATION FOR VICTIMS OF CRIME: If you are the victim of a crime while in Honduras, contact local authorities immediately, either directly or through the national police emergency number: *199. In addition to reporting to the local police, please contact the U.S. Embassy in Tegucigalpa or the Consular Agency in San Pedro Sula for assistance. The theft of a U.S. passport should be reported immediately. The Embassy and Consular Agency staff can provide you with information about medical care, contacting family members or friends and explaining how funds could be transferred. Although the investigation and prosecution of most crimes are solely the responsibility of local authorities, Consular staff can provide you with a list of attorneys if needed. See our information on Victims of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION: Medical care in Honduras varies greatly in quality and availability. Outside Tegucigalpa and San Pedro Sula, medical care is inadequate to address complex situations. Support staff facilities and necessary equipment and supplies are not up to U.S. standards anywhere in Honduras. Facilities for advanced surgical procedures are not available. Wide areas of the country, including the popular tourist areas of the Bay Islands, do not have a general surgery hospital. Ambulance services are limited in major cities and almost non-existent elsewhere. Emergency services may be contacted directly through their local numbers.

Scuba diving is popular in the Bay Islands, but the limited medical facilities there pose a special risk in the event of an emergency. There is a decompression chamber on Roatan and Utila for divers, but no advanced medical care on either island for diving related accidents.

MEDICAL INSURANCE: The Department of State strongly urges American citizens 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. U.S. medical insurance plans seldom cover health costs incurred outside the U.S. unless supplemental coverage is purchased. Furthermore, U.S. Medicare and Medicaid programs do not provide payment for medical services outside the United States. However, many travel agents and private companies offer insurance plans that will cover health care expenses incurred overseas including emergency services such as medical evacuations. It is important to ensure that you have adequate medical evacuation coverage prior to your trip to Honduras.

When making a decision regarding health insurance, American citizens should consider that many foreign doctors and hospitals require payment in cash prior to providing service and that a medical evacuation to the U.S. may cost tens of thousands of dollars. Uninsured travelers who require medical care overseas often face extreme difficulties. When consulting with your insurer prior to your trip, ascertain whether payment will be made to the overseas healthcare provider or whether you will be reimbursed later for expenses you incur. Some insurance policies also include coverage for psychiatric treatment and for disposition of remains in the event of death.

Useful information on medical emergencies abroad, including overseas insurance programs, is provided in the Department of State's Medical Information for Americans Traveling Abroad.

OTHER HEALTH INFORMATION: Mosquito-borne illnesses are an ongoing problem in Honduras. All persons traveling in Honduras, even for a brief visit, are at risk of contracting malaria. Take a prophylactic regimen best suited to your health profile. The country regularly suffers from outbreaks of dengue fever. Unlike traditional mosquito-borne illnesses, there is no medicinal prophylactic or curative regimen for dengue fever. Travelers should take precautions against being bitten by mosquitoes to reduce the chance of contracting such illnesses, such as avoiding standing water even in the home, wearing long sleeves and pants in both day and night, and applying insect repellent regularly.

Severe air pollution, which can aggravate or lead to respiratory problems, is common throughout the country during the dry season due in large part to widespread forest fires and agricultural burning. Travelers with respiratory or cardiac conditions and those who are elderly or extremely young are at greatest risk for complications from air pollution, which may include coughing, difficulty breathing, wheezing, or chest pain. Acute respiratory infections are also widespread; more than 100,000 cases are reported annually.

Individuals traveling to Honduras should ensure that all their routine vaccinations are up to date. Vaccination against Hepatitis A, Hepatitis B, and Typhoid is strongly recommended for those traveling to Honduras from the United States. Honduras requires vaccination against Yellow Fever for those traveling to Honduras from countries where there is the risk of transmission. Travelers taking prescription medications should bring an adequate supply with them when coming to Honduras and ensure that they are properly labeled.

Honduras also has the highest adult HIV/AIDS prevalence rate in the region. Over 63,000 people in Honduras have HIV/AIDS.

Honduras lacks a substantial infrastructure for maintaining water purity. Travelers are strongly encouraged to avoid drinking tap water or a beverage that contains ice from an unknown source (even alcoholic drinks). Bottles and bags of purified water are widely available. It is also recommended that individuals traveling to Honduras avoid eating untreated raw vegetables, fruits that can’t be peeled on the spot, raw fish like ceviche and undercooked shellfish and products containing mayonnaise, pastry icing, and unpasteurized dairy products. Hot cooked food, fresh bread, dry foods such as crackers, bottled carbonated beverages, coffee, tea, and beer are usually safe, provided such food items are not purchased from street vendors. All fruits and vegetables should be washed thoroughly with detergent and running water. Those that will be cooked or peeled can then be stored in a sealed container until used. Those that will be eaten raw and will not be peeled should be soaked for 15 minutes in a solution of chlorine bleach (or 5% household bleach) in water (one tablespoon of Clorox per gallon of water), rinsed with potable water, and allowed to air dry.

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 web site at http://www.who.int/en. Further health information for travelers is available at http://www.who.int/ith.

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

Because of crime and poor road conditions, driving can be very dangerous, and travelers should carry a cellular phone in case of an emergency. Travelers should exercise extreme caution while driving on isolated stretches of road and passing on mountainous curves. Rockslides are common, especially in the rainy season (May through December). Traffic signs, even on major highways, are often inadequate, and streets in the major cities are often unmarked. Travelers should always drive with their doors locked and windows rolled up to avoid potential robberies at traffic lights and other places such as congested downtown streets. Please refer to our Road Safety page for more information.

Honduran roads are poorly lit and marked. Vehicles are often driven at night without adequate illumination, and animals and people wander onto the roads at all hours. For these reasons, and because of the high incidence of crime, the U.S. Embassy strongly discourages car and bus travel after dark.

Major cities are connected by an inconsistently maintained, two-lane system of paved roads. Many secondary roads in Honduras are unpaved. During the rainy season, even major highways are often closed due to rockslides and flooding from heavy rains. In the event of an accident, contact the Honduran Transit Authority (“Transito”) immediately. They may be contacted either directly through their local numbers, or through their national emergency number, *189. Honduran law requires that no vehicles involved in an accident be moved until Transit Agents arrive, not even to clear a traffic obstruction, unless you are in serious physical danger.

Some of the most dangerous stretches for road travel include: Tegucigalpa to Choluteca, because of dangerous mountain curves; El Progreso to La Ceiba, because of animal crossings and the poor condition of bridges from flooding; Route 39 through northern Olancho Department between Gualaco and San Esteban; and Limones to La Union, Olancho (route 41) via Salama and northward to Saba. Locals also refer to this latter stretch of road as the “Corridor of Death” because of frequent incidents of highway robbery. In March of 2008, 27 persons died when a bus overturned and rolled down a ravine in La Esperanza, Intibuca, on another infamous stretch of road called “Flight of the Angel.”

The Embassy has received reports of robberies on the road from Tegucigalpa to Danlí. The only recommended route to the north coast from the south is CA-5 to route 21 to CA-13 via Tela to La Ceiba and Trujillo. Hijackings of private and commercial vehicles from the United States to Honduras have occurred. While Honduras and the United States have signed and ratified a Stolen Vehicle Treaty, existing Honduran laws protect good faith buyers (even of stolen vehicles) so the recovery and return of these vehicles to their original owners is not guaranteed. Vehicle insurance may mitigate loss; please check with the National Insurance Crime Bureau at https://www.nicb.org, private insurance carriers, and our Embassy web site information on Commercial Vehicle Hijackings at http://honduras.usembassy.gov/english/mission/sections/RSO/comveh_highsec.htm for more information.

For additional general information about road safety, please see our Road Safety page, which includes links to foreign government sites. For specific information concerning Honduran driving permits, vehicle inspection, road tax, and mandatory insurance, please contact the Honduran National Tourist Organization offices in New York via the Internet at http://www.hondurastips.honduras.com/.

MARINE SAFETY AND OVERSIGHT: The areas off both coasts of Honduras are the subject of maritime border disputes between Honduras and its neighbors. The Honduran Navy patrols these areas, and all private vessels transiting Honduran territorial waters should be prepared to be hailed and possibly boarded by Honduran military personnel to verify documentation. While the Honduran Navy previously used private vessels as patrol vessels, this is no longer the case. In the event that any vessel is hailed in Honduran waters in the Caribbean by a non-military vessel or any suspicious vessel and directed to prepare for boarding, the vessel should immediately contact the U.S. Coast Guard Operations Center by radio or INMARSAT at 305-415-6800. Anyone needing more information can also contact the U.S. Embassy during working hours and request to speak with the U.S. Military Group (USMILGP) office.

There have been incidents of armed assaults against private sailing vessels by criminals posing as fishermen off the northeast coast of Honduras, particularly in the numerous small islands northeast of the Department of Gracias a Dios. Sailors should contact the Coast Guard and yacht facility managers in their areas of travel for current information.

AVIATION SAFETY OVERSIGHT: The U.S. Federal Aviation Administration (FAA) has assessed the Government of Honduras’ Civil Aviation Authority as not being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for the oversight of Honduras’ air carrier operations. For more information, travelers may visit the FAA’s web site at http://www.faa.gov/safety/programs_initiatives/oversight/iasa.

Severe air pollution often leads to the closing of some or all of Honduras’ four international airports during the dry season. Some travelers have been compelled to travel by bus to neighboring countries in order to catch onward flights.

SPECIAL CIRCUMSTANCES:

Real Estate Investment: U.S. citizens should exercise extreme caution before entering into any form of commitment to invest in real property, particularly in coastal areas and the Bay Islands. Honduran laws and practices regarding real estate differ substantially from those in the United States, and fraudulent deeds and titles are common; U.S. citizens considering investing or buying real estate in Honduras should be aware that rights to such property do not enjoy the same level of protection as in the United States. Historically, title insurance has not been available in Honduras. Recently, some American insurance companies have begun offering title insurance in cooperation with Honduran attorneys. However, approximately 80 percent of privately held land is untitled. In addition, there are complaints that the Honduran judicial system often prolongs disputed cases for many years before resolution. American citizens have spent thousands of dollars in legal fees and years of frustration trying to resolve property disputes, even in cases in which local attorneys and Honduran and U.S. real estate agents had given assurances to the investor. Violence has been used against American citizens involved in disputed property cases. Potential investors should engage competent local legal representation before making any commitments. Investors should thoroughly check references of attorneys and real estate agents.

Honduran law places certain restrictions on land ownership by foreigners in coastal and border areas. Squatters claim a number of properties owned by U.S. citizens. U.S. Government officials may not act as agents, attorneys, or in a fiduciary capacity. U.S. citizens who own property abroad and who thereby have assumed responsibilities concurrent with ownership of property in a foreign country should take steps on their own initiative to safeguard their interests and to employ private legal counsel when the need arises. For further information on investing in property in Honduras, please review the State Department’s Investment Climate Statement, part of the Country Commercial Guide at http://www.buyusa.gov/honduras/en/14.html. For information on contracting Honduran legal representation, please check with other investors. You may also refer to the list of attorneys available on the Embassy's home page at http://honduras.usembassy.gov/attorneylistoct07.pdf.

Financial Market Investment: Due to poor regulation and lack of guarantees, investment in the Honduran "Bolsa de Valores," or securities market, as well as banking institution bonds, “fideicomisos” (trusts), and certificates of deposit from uninsured financial institutions pose high risk to investors. Extreme caution should be exercised before and while undertaking such activities, as American citizens have lost large sums of money through investments in such precarious markets. For further information on investing in Honduras, please review the State Department’s Investment Climate Statement, part of the Country Commercial Guide at http://www.buyusa.gov/honduras/en/14.html.

Corruption: Many U.S. firms and citizens operating in Honduras have found corruption to be a serious problem and a constraint to successful investment. While some U.S. firms have satisfactorily resolved cases through the courts, the majority have difficulty navigating the legal system. There are complaints that the Honduran judicial system caters to favoritism, external pressure and bribes. Corruption appears to be most pervasive in government procurement, government permits, and in the buying and selling of real estate (land titling).

Customs Regulations: U.S. citizens who intend to stay in Honduras for an extended period of time and who bring vehicles or household goods into the country should consult Honduran customs officials prior to shipment. With the exception of “antique” cars, all vehicles imported into Honduras by foreigners must be less than ten (10) years old. For specific information regarding customs requirements, please contact the Embassy of Honduras in Washington, DC at http://www.hondurasemb.org/ for more information.

Honduran customs authorities may enforce strict regulations concerning temporary import and export of items such as antiquities, medications, and business equipment. For example, Honduran law prohibits the export of antiques and artifacts from pre-colonial civilizations. To protect the country's biodiversity, it is illegal to export certain birds, feathers, and other flora and fauna. For specific information regarding exportation requirements, please contact the Embassy of Honduras in Washington, DC at http://www.hondurasemb.org/.

The Government of Honduras is strictly enforcing the law that requires a Honduran permit for the importation of firearms into Honduras. Travelers must obtain a firearm importation permit from a Honduran Embassy, Consulate General, or Consulate located in the United States prior to bringing firearms into the country. Please note that a U.S. government-issued or airline-issued permit is not valid for importation of firearms into Honduras. Firearms that arrive without the requisite Honduran permit will be confiscated and the bearer will be prosecuted to the full extent of Honduran law.

For further information about customs regulations, please read our Customs Information sheet.

CRIMINAL PENALTIES: While in a foreign country, a U.S. citizen is subject to that country's laws and regulations, which sometimes differ significantly from those in the United States and may not afford the protections available under U.S. law. Penalties for breaking the law can be more severe than in the United States for similar offenses. Persons violating Honduran laws, even unknowingly, may be fined, expelled, arrested, or imprisoned. Penalties for possession, use, or trafficking in illegal drugs in Honduras are severe, and convicted offenders can expect long jail sentences and heavy fines. Assisting or participating in the distribution of illegal drugs is also a crime prosecutable in the United States, and may lead to fines, property seizure, or imprisonment. Anyone offering you illegal drugs should be considered extremely dangerous – there is no “safe” source of illegal drugs.

"Sexual tourists" travel alone or in groups to Honduras for the purpose of purchasing sexual favors from minors. This activity violates Honduran law, and American citizens are imprisoned in Honduras for sexual offenses involving minors. In addition, U.S. citizens and residents charged with these crimes are subject to prosecution upon their return to the United States, regardless of the outcome of the judicial proceedings overseas. Moreover, the prevalence of HIV/AIDS in sex workers in Honduras is estimated to be in excess of 10%. Using or disseminating child pornography in a foreign country is also a crime prosecutable in the United States. Please see our information on Criminal Penalties.

CHILDREN'S ISSUES: International adoptions from Honduras are very complex. Current information on Honduran adoption procedures and the immigrant visa application process is available from the Consular Section of the U.S. Embassy. Prospective adoptive parents are urged to check with the Consular Section to ensure that all required documentation has been approved by the U.S. Bureau of Citizenship and Immigration Services (USCIS) of the Department of Homeland Security and to confirm that their child's adoption is complete before traveling to Honduras to apply for their child's immigrant visa. Adoptive parents are also urged to carry with them complete adoption paperwork when traveling with their adopted child to, from, and within Honduras.

Honduras is a signatory to the Hague Convention on the Civil Aspects of International Child Abduction, but the U.S. Department of State has determined that Honduras has failed to comply with its obligations under the Convention. No child has ever been returned to the United States from Honduras under the provisions of the Convention.

For information on international adoption of children and international parental child abduction, please refer to the Office of Children’s Issues web pages on intercountry adoption and international parental child abduction, or telephone Overseas Citizens Services at 1-888-407-4747. This number is available from 8:00 a.m. to 8:00 p.m. Eastern Standard Time, Monday through Friday (except U.S. federal holidays). Callers who are unable to use toll-free numbers, such as those calling from overseas, may obtain information and assistance during these hours by calling 1-202-501-4444.

REGISTRATION / EMBASSY LOCATION:
American citizens residing or traveling in Honduras are encouraged to register their presence through the State Department’s travel registration web site, and to obtain updated information on travel and security within Honduras. American citizens without Internet access may register directly with the U.S. Embassy in Tegucigalpa. By registering, whether via the Internet or in person at the Embassy, American citizens make it easier for the Embassy to contact them in case of emergency.

U.S. Embassy location:
Avenida La Paz in Tegucigalpa, Honduras
Internet site: http://honduras.usembassy.gov/
Telephone: 011-504-236-9320 or 011-504-238-5114
Office hours are Monday through Friday from 8:00 a.m. to 11:30 am.
American Citizens Services Unit Fax: 011-504-238-4357

Consular Agency in San Pedro Sula location:
Banco Atlantida Building – 11th Floor
San Pedro Sula, Honduras
Telephone: 011-504-558-1580
Office hours are Mondays, Wednesdays and Fridays from 1:00 p.m. to 4:00 p.m.

The Consular Agent is available during limited hours to perform notarial services, assist U.S. citizens with emergencies, and accept U.S. passport and U.S. Report of Birth applications for adjudication at the Embassy in Tegucigalpa. The Consular Agent does not provide visa information or services. For more details about all U.S. Embassy and consular services in Honduras, please see the Embassy web site at http://honduras.usembassy.gov/ or visit the Bureau of Consular Affairs web site at http://travel.state.gov/.
* * *
This replaces the Country Specific Information dated October 12, 2007, to update sections on
Entry/Exit Requirements, Crime, Medical Facilities and Health Information, Other Health Information, and Traffic Safety and Road Conditions.

Travel News Headlines WORLD NEWS

Date: Fri, 26 Jul 2019 03:36:47 +0200
By Noe LEIVA

La Paz, Honduras, July 26, 2019 (AFP) - Of Honduras' 32 public hospitals, 26 are overflowing with patients due to what health authorities are calling the worst dengue fever epidemic in the past half century.   The disease has struck 28,000 people this year, of which 54, mostly children, have died.   The enormous case flow is evident in the western city of La Paz. Inside the local hospital's chapel, two tables are piled high with patient folders, which sit in front of a wooden depiction of Christ.   Even more telling are the beds lining the room, protected by red and blue mosquito nets, from which 10 women are being treated for some of dengue's typical symptoms: bone and joint pain, high fever, vomiting and dehydration.#

Officials have called a national emergency to fight the dengue-causing aedes aegypti mosquito and a fumigation program has been launched in homes and public buildings.   And yet the hospital bursts at the seams. On top of those housed in the chapel, six of the facility's eight rooms are taken up by those stricken by dengue, with some beds even in the corridors.   Three of the rooms house a total of 26 children, age two to 14 -- the most vulnerable group to dengue -- who are connected to IV bags and monitored by concerned parents.   "They're not all out of danger," said a nurse as she looked over the patients.

- 'We're overrun' -
Crista Alexandra Pineda, age seven, is one of the children whose health is worrying hospital staff the most.   She was admitted on Sunday suffering from bleeding, accompanied by her 59-year-old grandmother, Josefina Velasquez.   "We're overrun," hospital spokesman Marco Antonio Rodas told AFP.   "We had to postpone planned operations" to concentrate on the emergencies.   "In 20 years working here, I've never seen this," he added.

Over the last week, the number of patients rose from 53 to 78. The most serious cases were transferred by ambulance to the University Hospital in the capital Tegucigalpa, where already two have died, Rodas said.   He hasn't ruled out the possibility of taking over schools to accommodate patients who are "arriving in ever greater numbers."   Marta Zoila Lopez, 58, told AFP she was at home in Guajiquiro, close to a La Paz, on Sunday when she started feeling symptoms.   "At first I had pain in my stomach, head and bones, vomiting and bleeding" from her nose and gums. She was immediately taken to the hospital where nurses say she's still in a delicate condition.   President Juan Orlando Hernandez summoned all 298 municipal mayors to the capital on Monday and announced a special fund to combat the outbreak.

The only effective measure to halt the epidemic "is to destroy the mosquito's breeding grounds and this is something that every one of us has to do in our homes, where we work and also in every public area," said Hernandez.   He also announced a "massive mobilization" to fumigate and destroy those breeding grounds. Churches, press organizations and business leaders have committed to assisting the effort.   It's a critical situation with the three-month long rainy season about to begin, meaning that breeding grounds will soon proliferate and the mosquito's numbers could soar.
Date: Thu, 20 Jun 2019 09:02:06 +0200

Tegucigalpa, June 20, 2019 (AFP) - Thousands of Hondurans blocked streets across the country Wednesday night demanding the resignation of President Juan Orlando Hernandez as tensions mount over strikes by police and truckers.   Police spokesman Jair Meza told AFP that street occupations were reported in several areas of the country, but the force was working to restore order despite a sit-down strike by special operations units.

Meza said looters had raided and torched businesses in the capital, Tegucigalpa, while others blocked streets with bonfires made from tires and rocks.   He added that the police were receiving reinforcements from the armed forces to control the groups that, in their opinion, are made up of gangs and opponents demanding the resignation of President Hernandez.   Mezo said the striking officers -- mostly riot police -- claim "harassment in the workplace and abuse of authority by many chiefs," according to a statement.   The special forces police officers say they are given "terrible food," that they are sent on missions without their expenses being covered and that they are denied labour rights and salary increases.

The Ministry of Security responded in a statement that police bosses "ordered the review of work days," while recognizing that there had been extra shifts to address the demonstrations.   The conflict deepened when police chief Jose Aguilar visited the area where the strikers were holed up but had to flee after a tear gas canister was thrown at him, another police spokesman Orlin Cerrato told a press conference.

Meza said that there was also a strike by truck drivers, who since Monday have parked their rigs on roads near the capital, demanding a pay rise.    The blockage caused a shortage of fuel in some areas of the country, which in turn led to long lines of vehicles at gas stations, the spokesperson said.
Date: Sun, 19 May 2019 05:17:37 +0200

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

The other Canadian pilot, Anthony Dubler, briefly survived the crash but died at the Roatan hospital of his injuries.   The causes of the crash and the registration information for the aircraft were not immediately available.   It occurred as the tourists were headed toward the city of Trujillo, about 77 kilometres (48 miles) from Roatan.
Honduras. 21 Mar 2019. (Reported)

39 cases with 54% in children under 18 years; DHF/serious 12 cases in past week.

[An 18 Mar 2019 report indicates that there are 789 serious dengue cases with 12 deaths.
Date: Fri 18 May 2018 10:14 HS CST
Source: TVP [in Spanish, machine trans., edited]
<https://tvpacifico.mx/noticias/209149-honduras-acumula-diez-muertos-y-172-casos-confirmados-de-gripe-a>

Honduras has registered 10 deaths and 172 cases of influenza A, with 22 new infections confirmed in the last hours, reported today [18 May 2018] the national coordinator of Health Surveillance, Homer Meja. He also noted that 9 of the deceased patients had "more than one underlying disease, such as diabetes, hypertension, and heart disease." He added that the majority of these infections occurred in San Pedro Sula and Tegucigalpa, the 2 most important cities of the Central American country.

Meja indicated that there are also 2 people who are suspected of having contracted the disease in Comayagua, in the central region of Honduras, so they are being kept under surveillance. The official stressed that the influenza vaccination campaign began on [Mon 14 May 2018] in the main cities of the country, and recommended all pregnant women to be vaccinated because very few do so despite being at risk for the health of the baby. The official said that pregnant women should know that the disease can directly affect the baby, and insisted that these women should be vaccinated, regardless of the time of gestation.

People aged 59 and over, health workers, children under 5, the chronically ill, and pregnant women, are the most vulnerable groups who are receiving the dose first, he added. Mejía said that the vaccination centers have more than one million doses to vaccinate groups at risk and announced that in the 1st week of June [2018] the rest of the population will be vaccinated.

The main symptoms are fever of up to 39 deg C [102.2 deg F], chills, headache, muscle, sneezing, intense and persistent cough, runny nose, tearing, and mild pharyngitis, according to the authorities.
=========================
[There have been reports of increased influenza activity in various countries during the official influenza season in the southern hemisphere. The severity of the current season is similar to the trend seen in the northern hemisphere during the 2017-18 season. Vaccination, particularly for high risk groups, can help reduce morbidity and mortality, provided the vaccine strains are a close match to the circulating viruses. - ProMED Mod.UBA]

[HealthMap/ProMED-mail map Honduras:
<http://healthmap.org/promed/p/22>]
More ...

World Travel News Headlines

Date: Tue, 25 Feb 2020
13:15:00 +0100 (MET)
By Ella IDE and Jastinder KHERA

Rome, Feb 25, 2020 (AFP) - Italy's new coronavirus spread south on Tuesday to Tuscany and Sicily, as the civil protection agency reported a surge in the number of infected people and Rome convened emergency talks.    Prime Minister Giuseppe Conte has blamed poor management in a hospital in the country's north for the outbreak, which has caused seven deaths in Italy so far and infected the largest number of people in Europe.    Tuscany reported its first two cases, including one in the tourist destination of Florence, while Sicily marked one: a tourist from the worst-hit Lombardy region, where 212 people have tested positive. The female tourist in Sicily, who had been staying in a hotel in Palermo, tested positive on the first swab but was awaiting the definitive result from Italy's institute of infectious diseases, civil protection agency chief Angelo Borrelli said.

Health ministers from neighbouring countries were to meet in Rome as the 
number of confirmed infections jumped to 283, with over 50 new cases reported since Monday.    The EU's health commissioner and other international health officials were also expected in the Italian capital Tuesday.    Hundreds of people were confined to their rooms at a Tenerife hotel after an Italian tourist was hospitalised with a suspected case of coronavirus, health officials in the Canary Islands said.  While no neighbouring country has closed its borders with Italy, several governments have announced additional measures for travellers arriving from Italy, in particular from the two northern regions of Lombardy and Veneto.  They range from medical screening to recommendations to self-isolate.

- 'Mission Impossible' -
Several upcoming matches in Italian Serie A and the Europa League will be played behind closed doors to combat the spread of the disease.    Production of the latest "Mission: Impossible" film starring Tom Cruise in Venice has been stopped following the outbreak.    The main centre of infection in Italy has been the town of Codogno, a town of some 15,000 people around 60 kilometres (35 miles) to the south of Milan. Codogno and several others in northern Italy have been put under isolation in an attempt to stem the spread of the virus.

The 38-year-old man dubbed "Patient One" by Italian media was admitted to 
hospital last Wednesday in Codogno, and it is thought a large number of the cases in the worst-hit region of Lombardy can be traced back to him.    His heavily pregnant wife, several doctors, staff and patients at the hospital are thought to have caught the virus from him.    As well as the towns placed under quarantine, further wide-ranging measures have affected tens of millions of inhabitants in the north of Italy, with schools closed and cultural and sporting events cancelled.    Elsewhere in the country officials have also been recommending precautionary measures.  In Calabria in the south, bishops have asked their worshippers not to make the sign of peace during mass, media reported.    All seven of those who have died so far in Italy were either elderly or had pre-existing medical conditions.
Date: Tue, 25 Feb 2020 11:48:12 +0100 (MET)

Madrid, Feb 25, 2020 (AFP) - Hundreds of people were confined to their rooms at a Tenerife hotel Tuesday after an Italian tourist was hospitalised with a suspected case of coronavirus, health officials in the Canary Islands said.   "Hundreds of hotel clients are being monitored for health reasons and the degree of supervision will be assessed during the day, but so far, we're not talking about quarantine," health authority spokeswoman Veronica Martin told AFP, confirming that the Italian tourist "was staying at this hotel while on holiday in Tenerife".
Date: Tue, 25 Feb 2020 11:40:20 +0100 (MET)
By Laurent Thomet with Dario Thuburn in Geneva

Beijing, Feb 25, 2020 (AFP) - Fresh deaths and a surge in new coronavirus cases in Iran, Japan and South Korea on Tuesday fuelled fears of a pandemic, as the disease took root in some of the world's poorest -- and worst-equipped -- countries.  The rapid spread abroad came as the World Health Organization announced that the epidemic had peaked at its epicentre in China, where it has killed more than 2,600 people and infected over 77,000 others.

But the situation has worsened elsewhere with nearly 2,700 other cases and more than 40 deaths globally, prompting restrictions on travellers from infected nations, the cancellation of football matches and national efforts to isolate suspected patients.    South Korea, Italy and Iran have each logged sharp increases in infections and deaths, while several Middle Eastern countries also reported their first confirmed COVID-19 cases.

WHO chief Tedros Adhanom Ghebreyesus insisted the virus could still be contained, praising China's drastic quarantine measures in several cities for helping to prevent an even bigger spread.   "For the moment we are not witnessing the uncontained global spread of this virus and we are not witnessing large-scale deaths," Tedros told reporters in Geneva on Monday.   He added, however, that countries should do everything they can to "prepare for a potential pandemic" -- a term is used to describe an illness that spreads across numerous communities.   The White House plans to spend $2.5 billion to combat the epidemic, according to US media. There are 53 cases in the United States so far.

- Iran hotspot -
Iran has emerged as a major hotspot with the death toll rising to 15 on Tuesday as three more people succumbed to the disease.   The country has been scrambling to contain the epidemic since last week when it announced its first two deaths in Qom, a centre for Islamic studies and pilgrims that attracts scholars from abroad.

Iran has confirmed 61 cases so far, making its mortality rate exponentially higher than anywhere else in the world and raising suspicion that many more people have contracted the disease there.   A WHO team was due in Iran on Tuesday.   Several neighbours have enacted measures to block arrivals from Iran but the virus has already spread to Afghanistan and elsewhere in the Middle East.   The WHO has warned that poorer countries with weak health care systems are the most at risk.

- Games off -
South Korean President Moon Jae-in warned that the outbreak was "very grave" as the country's death toll rose to 10 and the number of confirmed infections approached 1,000 -- the largest total outside China.   Scores of events have been cancelled or postponed as the outbreak has spread in the world's 12th-largest economy, from K-pop concerts to the World Team Table Tennis championship.   Parliament closed for cleaning Tuesday after confirmation a person with the coronavirus had attended a meeting last week.   More than 80 percent of the infections have been in and around Daegu, South Korea's fourth-largest city.

Streets there have been largely deserted for days, apart from long queues at the few shops with masks for sale.   Most of the country's infections are linked to the Shincheonji Church of Jesus, an entity often accused of being a cult.   The US Centers for Disease Control warned Americans against "all nonessential travel to South Korea".   In Japan, a fourth former passenger of the coronavirus-stricken Diamond Princess cruise ship died, according to local media. The man was in his 80s.   Nearly 700 people from the quarantined ship have tested positive for the illness so far.

Infections have also spiked inside Japan, with at least 160 cases including one death.   The government has expanded the number of hospitals that can receive suspected patients and asked people with moderate symptoms to stay home.   Businesses were asked to "let people stay away from offices, to avoid rush hour commuting hours, and to encourage telecommuting," Health Minister Katsunobu Kato said.   Italy -- which has reported seven deaths and over 200 cases -- has locked down 11 towns, while upcoming football matches in its Serie A and the Europa League will be played behind closed doors.    Prime Minister Giuseppe Conte has said that residents could face weeks of lockdown.

- China cases slow -
In China, 508 new cases were reported, with all but nine at the outbreak's epicentre in central Hubei province.   The death toll nationwide reached 2,663 on Tuesday after 71 more people died, the lowest rise in almost three weeks.   Reassured by the official numbers, the country is gingerly returning to business.   Beijing is seeing more cars on the street, factories are resuming work, Apple is reopening several stores, and some regions are relaxing traffic restrictions.   But schools remain closed, the capital has a mandatory 14-day quarantine for returning residents, and authorities are keeping some 56 million people in Hubei under lockdown.
Date: Sun 23 Feb 2020
Source: ZBC News [edited]

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

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

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

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

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

[HealthMap/ProMED map available at:
Mashonaland Central Province, Zimbabwe:
Date: Mon, 24 Feb 2020 16:22:59 +0100 (MET)

Dubai, Feb 24, 2020 (AFP) - The new coronavirus hit four more Middle Eastern states on Monday, with Bahrain, Iraq, Kuwait and Oman reporting new cases and the UAE calling on its citizens not to travel to Iran and Thailand.   Oman also halted flights to and from Iran  -- which is battling the deadliest outbreak outside China --with immediate effect.   The move came shortly after two Omani women who had returned from Iran were diagnosed with the disease.

The three cases in Kuwait and the one in Bahrain were also in individuals who had returned from Iran, where the virus has claimed the lives of 12 people.   Bahrain also shut three schools after a man who had transported children to the institutions tested positive after returning from Iran on February 21 via Dubai airport, the health ministry said.

In Kuwait, a 53-year-old Kuwaiti, a 61-year-old Saudi national and a 21-year-old stateless Arab who tested positive had all returned from Iran's holy city of Mashhad, the Kuwaiti health ministry said.   In Iraq, the virus was confirmed in an Iranian national studying in the southern shrine city of Najaf, health officials said.   All seven bourses in the oil-rich Gulf states were down on Monday as fears of a pandemic hit crude prices. The Saudi stock exchange led the slide, shedding 2.95 percent.

- Travel bans -
Iran's confirmed death toll rose to 12 on Monday, with the government vowing to be transparent and dismissing a lawmaker's claim the toll could be as high as 50.   The outbreak has prompted travel bans from nearby countries.

Last week, Kuwait banned entry of all ships from the Islamic republic and suspended flights to and from the country.   Kuwait also banned non-citizens coming from Iran from entering the Gulf state and operated chartered flights to bring back hundreds of Kuwaiti Shiite pilgrims from the Islamic republic.

Around a third of Kuwait's 1.4 million citizens are Shiite Muslims, who travel regularly to Iran to visit religious shrines. Kuwait also hosts roughly 50,000 Iranian workers.   Over half of Bahrain's population of under one million are Shiites, who also travel frequently to Iran.   The United Arab Emirates has already announced 13 cases of the novel coronavirus, all of them foreigners. The latest were a 70-year-old Iranian man, whose condition is unstable, and his 64-year-old wife.

On Monday, Abu Dhabi authorities called on all UAE citizens "to not travel to Iran and Thailand at present and up until further notice" as part of its efforts to monitor and contain the spread of the disease.   UAE airlines have suspended most flights to China -- where the virus first emerged in December -- except to the capital Beijing, but have not yet taken any measures to restrict travel to and from Iran. Around half a million Iranians live and work in the UAE.

Two Gulf states -- Saudi Arabia and Qatar -- remain free of the virus, but all have suspended flights to China.   Qatar Airways said on Monday that people arriving from Iran and South Korea would be asked to stay in home isolation or a quarantine facility for 14 days.   China's death toll from COVID-19 rose to nearly 2,600 on Monday, while the virus has now spread to more than 30 countries.
Date: Mon, 24 Feb 2020 17:49:00 +0100 (MET)

Kolkata, Feb 24, 2020 (AFP) - Rangers have suspended safari rides in a popular nature reserve in eastern India after five one-horned female rhinoceroses died from a suspected infectious disease, officials said Monday.  The animals were found dead over four days last week in Jaldapara National Park, nearly 700 kilometres (434 miles) north of West Bengal state's capital Kolkata.

India is home to two-thirds of the world's remaining one-horned rhinos, a vulnerable species on the IUCN red list   "Blood smears from carcasses have been sent to a laboratory in Kolkata," the reserve's chief conservator Ujjal Ghosh told AFP.   "All the five dead rhinos were adult females. We have put our staff on alert."

The park -- spread over 200 square kilometres (77 square miles) in the foothills of the eastern Himalayas -- is home to 204 rhinos according to the last official count in 2015.  More than 70 captive elephants used for safaris and patrolling also live in the reserve. The safari rides are carried out on elephants.   Activists said the animals may have died from anthrax, a communicable disease that attacks herbivores.

Humans can contract anthrax directly or indirectly from animals or animal products.  "We suspect that the animals died from a communicable disease like anthrax. Jaldapara forest has the odd case of anthrax which killed animals earlier," wildlife activist Animesh Bose told AFP.   Rangers were riding on elephants to reach the rhinos and vaccinate them using dart guns, the Hindustan Times reported.   Drones would try to find out if other animals have died or fallen ill, the newspaper said.
Date: Tue, 25 Feb 2020 04:50:33 +0100 (MET)

Jakarta, Feb 25, 2020 (AFP) - Dozens of Jakarta neighbourhoods were flooded Tuesday after torrential rains pounded Indonesia's capital, less than two months after nearly 70 people were killed in some of the megacity's worst flooding in years.   There were no immediate reports of casualties after the latest deluge, but parts of the city ground to a halt as whole neighbourhoods were swamped in muddy water, while power outages hit some districts.   At least 81 neighbourhoods were inundated with a dozen toll roads closed and some commuter train lines shuttered, according to an announcement by Indonesia's Disaster Mitigation Agency.

More torrential rains were expected later in the day.    "So the flooding will likely spread," agency spokesperson Agus Wibowo said on Twitter.   Floodwaters in some districts were as high as 127 centimetres (4 feet).   The low-lying city is prone to flooding during the wet season which starts around November.   Torrential rain in January triggered flooding and landslides that killed nearly 70 people in and around Jakarta while thousands more were forced to evacuate to shelters.
Date: Mon 24 Feb 2020
Source: Dhaka Tribune [edited]

In Baliadanga upazila of Thakurgaon district, 2 members of a family have died and 3 other members fell sick of an unknown disease. The deceased are MB 35, wife of HI, and her sister in law PB, wife of H from Songaon village of the upazila.

Quoting family members, local schoolteacher SPL said: "MB fell sick and died on Friday [21 Feb 2020] and on Saturday [22 Feb 2020], PB fell sick. "She came back home after undergoing primary treatment at Baliadanga Health Complex; however, she died early Sunday [23 Feb 2020]."

Soon afterwards, 3 other members of the family -- TA, HK and AA -- fell sick and were taken to Adhunik Sadar Hospital, she added.

Thakurgaon Civil Surgeon Dr MD Mahfuzar Rahman Sarker said a representative team of the health department has visited the village to investigate the cause of deaths.

The reasons of the deaths are yet to be known; however, the ones who fell sick are in better condition now, he added.

In 2019, 4 members of a family died due to Nipah virus in the same upazila. Locals are assuming the current deaths are occurring for the same reason.
===================
[With these cases described only as fatal or ill without mention of symptoms, it is not possible to speculate on what the etiology of thisdisease might be. The above report does mention that 4 fatal Nipah virus infections occurred in the same locality last year (2019). Nipah virus must surely be on the list of rule-outs in these current cases. This is the season when Nipah virus is circulating in Bangladesh in giant fruit bats (_Pteropus_ species) with spill-over of the virus by the bats' contamination of fruit or of palm sap juice in collecting pots on the palms. Person-to-person transmission of the virus can also occur. The transmission season is usually January to April.

As noted earlier, it is unfortunate that the public awareness efforts have not prevented these cases from occurring. Perhaps because cases are sporadic and geographically scattered there is little public perception of risk of infection and serious disease. Until effective public education to prevent infection by avoiding eating contaminated fruit or date palm sap is implemented, sporadic cases will continue to occur.

An image of a Pteropus fruit bat can be found at

HealthMap/ProMED map available at:
A map showing the location of the area where the cases occurred can be accessed at the above URL. - ProMED Mod.TY]

24-02-2020 -- Italy has reported a rapid increase in cases of laboratory-confirmed coronavirus (COVID-19) since 21 February 2020. An initial investigation by Italian authorities has found several clusters of cases in different regions of northern Italy, with evidence of local transmission of COVID-19.

A WHO-led team of experts from WHO and the European Centre for Disease Prevention and Control (ECDC) arrived in Italy on Monday 24 February to support Italian authorities in understanding the situation. WHO experts are providing support in the areas of clinical management, infection prevention and control, surveillance and risk communication. At this stage the focus is on limiting further human-to-human transmission.

While limited local person-to-person transmission of COVID-19 in countries outside of China was expected, the rapid increase in reported cases in Italy over the past two days is of concern. However, it should also be noted that based on current data, in the majority of cases (4 out of every 5) people experience mild or no symptoms.

“COVID-19 is a new virus that we need to take very seriously. This mission to Italy is one of the ways in which WHO/Europe is supporting countries across the Region. We are working hard with our Member States to ensure that they are ready for COVID-19, preparing for the arrival of cases and possible localized spread. It is vital that we treat patients with dignity and compassion, put measures in place to prevent onward transmission, and protect health workers,” commented Dr Hans Kluge, WHO Regional Director for Europe.

Health authorities in Italy are implementing measures to prevent onward transmission, including closing of schools and bars and cancelling of sports events and other mass gatherings in the areas affected. This aligns with the containment strategy currently being implemented globally in an effort to stop the spread of COVID-19. “WHO stands by the Government of Italy in its efforts and commitment to mitigate this outbreak and manage the cases effectively. Now is the time for solidarity and cooperation, to work together to protect everyone’s health,” added Dr Kluge.

Countries across the European Region continue to prepare for and respond to cases of COVID-19. This includes establishing how to promptly detect sick people, testing samples from suspect cases, ensuring appropriate infection control and case management to minimize the risk of the virus spreading, and maintaining communication with the public.

Best Regards,
WHO Media Team

Date: Mon, 24 Feb 2020 12:29:01 +0100 (MET)
By David Vujanovic

Tehran, Feb 24, 2020 (AFP) - Iran's government vowed Monday to be transparent after being accused of covering up the deadliest coronavirus outbreak outside China, dismissing claims the toll could be as high as 50.

The authorities in the Islamic republic have come under mounting public pressure since it took days for them to admit to "accidentally" shooting down a Ukrainian airliner last month, killing 176 people.   The government said on Monday that Iran's coronavirus death toll had jumped by four to 12 -- by far the highest outside China -- as its neighbours closed their borders and imposed strict quarantine measures.

But Ahmad Amirabadi Farahani, a lawmaker from the holy city of Qom, south of Tehran, alleged the government was "lying" about the full extent of the outbreak.   The ILNA news agency, which is close to reformists, said the lawmaker spoke of "50 deaths" in Qom alone.   "The rest of the media have not published this figure, but we prefer not to censor what concerns the coronavirus because people's lives are in danger," ILNA editor Fatemeh Mahdiani told AFP.

Farahani was wearing a face mask during the closed session of parliament but left after speaking, as he felt unwell, state news agency IRNA reported, adding sanitary workers then cleaned his seat.   Iran's government rejected his claim that the virus had killed 50 in Qom.   "I categorically deny this information," Deputy Health Minister Iraj Harirchi said in a news conference aired live on state television.   "This is not the time for political confrontations. The coronavirus is a national problem," he added.

- Transparency pledge -
The government pledged transparency over the outbreak.   "We will announce any figures (we have) on the number of deaths throughout the country. We pledge to be transparent about the reporting of figures," its spokesman Ali Rabiei said.   Iran has been scrambling to contain the COVID-19 outbreak since it announced the first two deaths in the holy city of Qom on Wednesday last week.   Authorities have since ordered the closure of schools, universities and other educational centres across the country as a "preventive measure".

A spokesman for Iran's parliament, Assadollah Abbassi, announced the latest four deaths among more than 60 infections after Monday's closed-door gathering of lawmakers.   Citing Health Minister Said Namaki, he said that "the cause of coronavirus infections in Iran are people who have entered the country illegally from Pakistan, Afghanistan and China".   Iran has yet to give a breakdown of where the other deaths occurred.   The worst-hit province for infections is Qom, with 34 cases, according to health ministry figures.

The others are in Tehran with 13 infections, Gilan with six, Markazi with four, Isfahan with two and one each for Hamedan and Mazandaran.   But the health minister said that one person who died of coronavirus in Qom, south of Tehran, was a businessman who had made several trips to China.   Namaki had unsuccessfully pleaded in January for Iran's government to order the suspension of all commercial flights between Iran and China.   In his remarks to state television on Sunday, the minister said direct flights between Iran and China were now suspended, but the Qom businessman had travelled there "on a connecting flight".

- Border closures -
Since it emerged in December, the new coronavirus has killed more than 2,500 people in China.   Iran now accounts for nearly half of the deaths elsewhere in the world, which currently stand at 30.   Many of Iran's neighbours have reported cases of coronavirus in people who had travelled to the Islamic republic.   Afghanistan on Monday reported its first case in a person who had travelled to Qom.   Baghdad also reported its first case on Monday -- an elderly Iranian citizen living in the southern Iraqi city of Najaf.

Iraq has shut its border with the Islamic republic and imposed a travel ban.   Similar preventive measures were imposed by Afghanistan, Armenia, Pakistan and Turkey.    Qom is a centre for Islamic studies and pilgrims, attracting scholars from Iran and beyond.   Kuwait and Bahrain also confirmed their first novel coronavirus cases, all of whom had come from Iran.