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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: Tue 18 Jun 2019
Source: MENAFN [edited]

A new polio case has been reported by local officials in southern Uruzgan province. Dr. Saifudin, head of the polio campaign for Uruzgan, said on Tuesday [18 Jun 2019] that a 2-year-old child was affected by polio in Meher Abad village of Terinkot city, the provincial capital. "[The family] of the polio-affected kid lives on the outskirts of Terinkot city and they (family) did not have access to health facilities," he said.

Meanwhile, provincial healthcare officials said the anti-polio vaccine was not launched in Mehrab Abad village due to security conditions; thus, a number of children have not received the polio immunization. Also, the head of the immunization department for the southern provinces has expressed concerns over reports of polio cases in the southern parts of Afghanistan: "7 cases of polio have been registered before; this (polio) is a great threat to the Afghan children," he said.

In the past 3 months, 9 cases of polio have been registered so far: 3 polio cases in Uruzgan, 2 in Kandahar, 3 Helmand and 1 in Kunar.
=======================
[The statement "[The family] of the polio-affected kid lives on the outskirts of Terinkot city and they (family) did not have access to health facilities" should be coupled with the following sentence "Meanwhile, provincial healthcare officials said the anti-polio vaccine was not launched in Mehrab Abad village due to security conditions; thus, a number of children have not received the polio immunization," which strongly suggests that this child lives in an area with significant civil unrest where access to healthcare, both curative and preventive, is significantly limited. What needs to be emphasized is that while there isn't access to normal healthcare services and vaccinators are often unable to access these areas, the poliovirus is able to access these areas and circulate in the pockets of susceptible individuals living there. Until something can be done to convince the warring parties that children's health should not be held hostage for political gain, the goal of polio eradication will also remain hostage to the politics.

A Xinhua.net article on this case mentions that the age of the child is 2.5 years

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 (<https://www.afghana.com/GetLocal/Afghanistan/Provinces.htm>).

With the addition of this newly confirmed case, there have now been 9 cases of confirmed poliomyelitis reported from Afghanistan since the beginning of 2019. Add these to the 24 cases confirmed in Pakistan, and there are now 33 cases reported this year (2019) -- the same number as reported for the entire year of 2018. - ProMED Mod.MPP]

[HealthMap/ProMED-mail maps:
Oruzgan Province, Afghanistan: <http://healthmap.org/promed/p/1257>]
Date: Wed 29 May 2019 Source: Xinhua [edited] <http://www.xinhuanet.com/english/2019-05/29/c_138100250.htm>
A fresh positive polio case was detected in Afghanistan's eastern province of Kunar, bringing the number of confirmed cases of poliovirus to 8 since January this year [2019], a public health official said on Wednesday [29 May 2019]. "A new polio case has been reported from Watapur district of Kunar province which permanently paralyzed a 3-month-old boy," Wahidullah Mayar, spokesperson for the Ministry of Public Health, tweeted.
The latest case is the 1st case from the eastern Afghan region this year [2019], and the rest of 7 cases have been reported from southern provinces, he added. Poliovirus can be rapidly transferred, and the only way [to prevent the disease] is vaccination, according to the official.
The ongoing insurgency and conflicts have been hindering the efforts to stamp out the infectious disease in the mountainous country, as more than 1 million children from areas inaccessible to vaccination teams missed the latest vaccination drive.  [byline: Xuxin] ========================
[As this media report is based on a governmental announcement, I suspect this case will be in next week's global update, providing information on the date of onset of paralysis. It is noteworthy that this is the 1st case reported in Kunar province this year (2019). This represents the 8th case of WPV1-associated paralysis reported by Afghanistan with date of onset since 1 Jan 2019.
A map of Afghanistan showing provinces and districts can be found at <http://ontheworldmap.com/afghanistan/administrative-map-of-afghanistan-with-provinces-and-districts.jpg>.  Watapur district is located in the north central part of Kunar province. The southern and eastern districts of Kunar province border with Khyber Pakhtunkhwa and the tribal districts of Pakistan. The region is known for civil unrest. - ProMED Mod.MPP]
Date: Mon, 13 May 2019 18:12:22 +0200

Jalalabad, Afghanistan, May 13, 2019 (AFP) - At least three people were killed and another 20 wounded in a series of blasts in the eastern Afghan city of Jalalabad on Monday, an official said.   Nangarhar provincial spokesman Attaullah Khogyani said three blasts rocked the city centre, and had taken place near an armoured police vehicle.   "The nature of explosions is not clear, but it could be IEDs," Khogyani said, using the acronym for improvised explosive devices.   "So far we can confirm three people have been killed and 20 wounded."

No group immediately claimed responsibility for the attack, but the area around Jalalabad is home to fighters from both the Taliban and the Islamic State group's Afghan affiliate.   On March 6, at least 16 people were killed in a suicide attack on a construction company in Jalalabad, which is near the Pakistan border.   Violence in Afghanistan has continued apace even during the holy month of Ramadan, and despite government calls for a ceasefire.
Date: Sat, 11 May 2019 14:59:03 +0200

Ghazni, Afghanistan, May 11, 2019 (AFP) - A landmine explosion killed seven children and wounded two others in southern Afghanistan on Saturday, officials said, as war ordnance again claimed civilian lives.   The blast occurred in Ghazni province, south of the capital Kabul, when the children stepped on a landmine while playing near a main road, provincial spokesman Aref Noori told AFP.   "The mine was planted by the Taliban on a main road to inflict casualties on security forces," he said.   The Taliban did not immediately respond to a request for comment.   The insurgents often use roadside bombs and landmines to target Afghan security forces, but the lethal weapons also inflict casualties on civilians.   Amanullah Kamrani, a member of Ghazni provincial council, said the children were aged between seven and nine and at least four of them belonged to one family. 

Years of conflict have left Afghanistan strewn with landmines, unexploded mortars, rockets and homemade bombs -- and many are picked up by curious children.   Last month, seven children were killed and 10 more wounded in the eastern province of Laghman when a mortar shell exploded while they were playing with it.    According to the United Nations, 3,804 civilians -- including more than 900 children-- were killed in Afghanistan in 2018, with another 7,000 wounded. It was the deadliest year to date for civilians in Afghanistan's conflict.
Date: Tue, 16 Apr 2019 14:52:10 +0200

Kabul, April 16, 2019 (AFP) - Torrential rainstorms have lashed drought-stricken Afghanistan in recent days, bringing widespread flooding that has killed at least five people and washed away homes including in the capital Kabul, officials said Tuesday.   While some welcomed the wet weather after the punishing dry spell of recent years, residents complained about the lack of infrastructure and government assistance to help them clear up from the deluge.

Sixteen of Afghanistan's 34 provinces were hit in the past 24 hours, destroying or damaging hundreds of houses and sweeping away livestock, said Hashmat Bahaduri, a spokesman for Afghanistan's National Disaster Management Authority (ANDMA).   Hardest hit was Herat province in western Afghanistan, where at least five people were killed when their houses collapsed, Jilani Farhad, a spokesman for the local governor said.   Officials were also searching for 17 people whose minivan was swept away by flooding in the province's Obey district late Monday, Farhad added.    "There were women and children in the vehicle, we are searching but haven't found any sign of them yet," he said.

Extraordinary scenes played out in the capital, where the usually parched Kabul River swelled suddenly, bursting its banks in places and swamping surrounding streets and neighbourhoods with about one metre (three feet) of water in places.   Drug addicts who normally spend their time in the riverbed or hiding under bridges could be seen openly smoking opium at street level as water swirled around them.   By Tuesday, authorities were warning locals living along the river to be prepared to evacuate their homes as water levels surged.   Bahaduri said 113 houses had already been partially or completely destroyed in Kabul.

In the capital, a university student named Mujtaba bemoaned a lack of drainage canals, but others welcomed the rain.   "It is a bliss to have all this water and rain, we are thankful to God to have rain and get rid of the drought problems," Kabul resident Mansoor Majab told AFP.   Years of dry weather, combined with a booming population and wasteful consumption, have drained Kabul's water basin, forcing residents to drill ever-deeper wells.   This winter saw heavy snowfall across parts of Afghanistan, which had led to flash floods in the spring melt.   Over one hundred people had been killed as of March 28 due to flooding in Afghanistan so far this year, according to ANDMA.
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South Korea

General Information
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The land mass of Korea is currently divided into North and South since World War 11. The South is a democratic Republic and there are extensive tourist facilities available throughout
he main urban areas. The national tourism organisation (KNTO) operates an English language web site (http://www.knto.or.kr) which provides useful information for intending tourists.
Weather Profile
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South Korea has four distinct seasons throughout the year. The winters can be very cold while the summers hot and very humid. The rainfall is mainly concentrated during the summer season.
Overcoming Jet Lag
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ry to arrange your flights so that you arrive in plenty of time before the first match. Allow 48 hours if at all possible to get over the inevitable jet lag. Walk about on the flight, drink plenty of water and stay off the alcohol. Flight crews are understandably very sensitive nowadays about any disturbance and the last thing you will want is to be dumped off the flight to make your own way home. Sleep on the plane if possible though remember this may increase the risk of blood clots so move your legs about when awake. Talk to your doctor about taking aspirin if you are at higher than normal risk (older age group, over weight, on the contraceptive pill, varicose veins etc).
Arriving into Seoul
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The new Incheon international airport is an hour or two away from Seoul and there are no subways or rail systems connecting the airport to the city. However, buses and taxis are easily available. Customs facilities are good but careful so remember not to carry any parcels for another unless you are certain of the contents. A departure tax may be payable on leaving South Korea.
Personal Safety
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In Seoul, like any other major city, there is an increased risk of petty crime (pickpocketing, purse snatching etc) so take extra care of your belongings - especially in crowded places like markets, local buses and football matches! The Itaewon and other large markets are known risk areas for this type of activity. Use the hotel safe for your main valuables and carry little of importance while out and about.
Emergency Numbers
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In South Korea the emergency number for the main services is 112. The operators will usually speak good English. There is also a 24/7 service available through the Korean National Police where travellers can report crime etc. The number in Seoul is 313-0842 and in other regions 02-313-0842.
Medical Services
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Generally the level of health facilities throughout most of the main urban centres is excellent. However, treatment can be expensive and the medical providers will expect payment before treatment is started. Make sure your travel health insurance is adequate for your journey.
Road Safety
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The road infrastructure throughout most of South Korea is excellent. However, accidents do occur and if hiring a car ‘defensive’ driving is essential at all times while abroad. Safety belts are compulsory at all times for both front and rear seats. Any accident tends to lead to long delays as the paperwork is sorted out. The Koreans may at times drive their motorbikes and scooters on foot pavements so care should be taken at all times.
Customs Regulations
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The level of security at South Korean immigration is high so beware of the delays which may be incurred.
Food & Water Care
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While travelling it is essential that care is taken to protect your stomach against unnecessary risk. Generally tourists will be keen to try out the local cuisine but this can lead to days of illness. In most circumstances it is wise to stick to hot, freshly cooked food fruit you peel yourself. Bivalve shell fish (mussels, clams, oysters etc) are seldom cooked sufficiently to sterilise them completely and are best avoided. Undercooked fish (Sushi) or any meats should also be avoided.
Heat & Humidity
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The summer months in South Korea are hot and sticky. It will be important to have the right clothing (light weight loosely fitted cotton) and to drink plenty of water to replace what is lost through dehydration. Salt will also need to be replaced and providing there is no medical contraindication eating crisps, salted nuts etc is an excellent way to replenish your levels.
Avoiding Prickly Heat
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The term prickly heat is used in a variety of ways but the cause is generally the same. In a hot climate the body perspires to maintain the internal temperature at a correct level. In the perspiration there will be fluid and your personal salts. The fluid evaporates but the salt dries against the skin. It is your individual reaction to this salt that leads to the ‘prickly heat rash’. The reaction to these salts can be minimised by removing the salts from the skin surface as soon as possible. Change your clothes regularly, use plenty of talcum powder to absorb the perspiration and dry off well after showering.
Breathing the air
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Any of the airborne diseases are most commonly spread when folks crowd together. International football matches, market places, local transport and the cinema are times when exposure and infection are most likely. Carrying some simple cold remedies might be a wise precaution and avoid the crowds where possible!
Vaccines for your trip
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In most cases the only particular problem for those visiting either Japan or South Korea will be the risk of Hepatitis A (food and water spread). Of course Tetanus and various other food and water problems can occur but generally the risk is small providing a sensible approach is taken to act sensibly.

Travel News Headlines WORLD NEWS

Date: Sat 4 May 2019
Source: Outbreak News Today [edited]

Officials with the Korea Centers for Disease Control and Prevention (KCDC) report (computer translated) the 1st case of the tickborne infection, severe fever with thrombocytopenia syndrome (SFTS) in a 55-year-old female from Chungcheongnam-do (Chungnam) province in the west of the country.

This has prompted health officials to advise the public to take precautions when doing outdoor activities to avoid tick bites.

The patient was gardening prior to the appearance of symptoms. On 28 Apr [2019], she presented with symptoms of fever and erythema and was hospitalized at the medical institution. SFTS testing returned positive.

Severe fever with thrombocytopenia syndrome (SFTS) is a newly emerging infectious disease. Symptoms and laboratory abnormalities are fever, thrombocytopenia, leukocytopenia, and elevated serum enzyme levels. Multiorgan failure occurs in severe cases, and 6%-30% of case-patients die. The syndrome is caused by the SFTS virus (SFTSV) (genus _Phlebovirus_, family Bunyaviridae).  Ixodid tick species are implicated as vectors of SFTSV.
=======================
[SFTS has been occurring sporadically in South Korea since 2013 and is endemic there. SFTSV can cause a serious disease and is of significant public health concern. Although SFTS virus infections may be serious, there is evidence for subclinical or mild infections as well. There is also some previous evidence for person-to-person direct transmission of the virus, and a previous report provides more objective evidence that aerosol transmission could occur (see Severe fever w/ thrombocytopenia synd. - South Korea: poss. aerosol transmission http://promedmail.org/post/20190108.6248997).

SFTS virus is a tick-transmitted phlebovirus in the Bunyavirus family. Images of a _Haemaphysalis longicornis_ tick, the SFTS vector, can be seen at

[HealthMap/ProMED map available at:
Date: Wed, 21 Nov 2018 09:39:44 +0100

Seoul, Nov 21, 2018 (AFP) - Tens of thousands of workers launched a half-day strike across South Korea Wednesday, accusing the government of rolling back pro-labour policies in the face of deepening economic woes.   Some 40,000 of those who put down tools -- including some in the auto industry -- rallied in Seoul and 13 other cities, the Korean Confederation of Trade Unions (KCTU), a major labour umbrella group, said.   An AFP journalist in the capital said a crowd of around 10,000 workers gathered outside the country's parliament wearing red headbands, chanting slogans and waving banners, as hundreds of riot police took positions nearby.   The KCTU estimated 160,000 affiliated workers would join the walkout nationwide.

A government move to introduce greater flexibility to the country's maximum 52-hour work week -- to adjust to fluctuations in demand -- has particularly angered workers.    They are also calling for liberal president Moon Jae-in's government to deliver on election promises to raise the minimum wage from 7,530 won (US$6.66) to 10,000 won (US$8.85) by 2020.    Earlier this month, Moon sacked his top two economic officials, as the world's 11th-largest economy struggles with slowing growth, rising unemployment and persistent income gaps.   These difficulties have hit the president's approval ratings, now at 52 percent -- a drop of 13 percentage points over five weeks, according to Gallup Korea.
Date: Sat, 6 Oct 2018 13:31:00 +0200

Seoul, Oct 6, 2018 (AFP) - Two people died and one person is missing in South Korea as powerful typhoon Kong-Rey hit the country on Saturday, the government said.    A 66-year-old man died while crossing a bridge in the city of Gwangju, south of Seoul, the national disaster management agency said without elaborating on the cause of the death.

Another man, aged 83, was found dead after being washed away by a river in a southern county of Yeongdeok, while a 76-year-old went missing after falling into a river in the southern port of Pohang.    The powerful typhoon dumped heavy rain across the country from Friday before moving away from the peninsula Saturday afternoon. 
Date: Sat, 8 Sep 2018 13:02:52 +0200

Seoul, Sept 8, 2018 (AFP) - South Korea reported its first case of Middle East Respiratory Syndrome (MERS) in three years, health officials said on Saturday.   A 61-year-old businessman was diagnosed with the highly contagious viral respiratory illness, according to officials at the Korea Centers for Disease Control and Prevention (KCDC).   He returned to South Korea Friday from a business trip in Kuwait where he stayed for three weeks, the KCDC said a statement.

"Authorities have traced and separated 20 people who have come in close contact with the infected person," KCDC head Chung Eun-gyeong told journalists.   They include medical staff, flight attendants and passengers of the plane the man flew back to South Korea on, she said.    He was hospitalised with fever and phlegm and has been quarantined at a university hospital, she added.   It is the first case of MERS diagnosed in South Korea since 2015, when an outbreak killed 38 people and triggered widespread panic.
Date: Sat 8 Sep 2018
Source: Yonhap News (4th LD - update) [edited]

A patient in Seoul was diagnosed on Saturday [8 Sep 2018] with the 1st case of Middle East Respiratory Syndrome (MERS) in South Korea since 2015. The 61-year-old man, whose personal information was withheld for privacy reasons, was diagnosed with the disease at about 4 p.m. Saturday [8 Sep 2018], the Korea Centers for Disease Control and Prevention (KCDC) said. It is the 1st case of MERS diagnosed in South Korea since 2015, when an outbreak killed 38 people and triggered widespread panic.

According to the KCDC, the man took a business trip to Kuwait from [Thu 16 Aug 2018 to Thu 6 Sep 2018] and returned home via the United Arab Emirates on Friday [7 Sep 2018]. He visited a local hospital during his stay in Kuwait for diarrhea but showed the same symptom again on his way back home. He was rushed to the emergency room of Samsung Medical Center in southern Seoul upon his arrival at Incheon International Airport.

The Samsung hospital checked the patient in an isolated section of the emergency room and reported him to the health authorities as a suspected case of MERS for showing symptoms of fever, phlegm, and pneumonia. He was then moved to Seoul National University (SNU) Hospital in central Seoul and tested positive for the disease.

"The man currently is not in critical condition and does not have such symptoms as shortness of breath and a decrease in blood pressure, but we have to watch him closely, because his conditions may deteriorate in the next 1-2 weeks judging from our experiences from the previous outbreak," Kim Nam-jung, a doctor treating the patient at the SNU Hospital, said.

MERS is a viral respiratory disease with a fatality rate of 20-46 percent. It is caused by a novel coronavirus carried by camels and can be spread when someone is in close contact with a patient for a sustained period.

A total of 20 people, including flight attendants and medical staff, are under isolation at home for coming in close contact with the patient, but the number could rise in the future, the KCDC said.

The authorities believe there is a high chance that the patient was infected with the disease in Kuwait, because he stayed in Dubai for only a short time for a transfer. The government said it will try to find out if any Koreans were infected with the disease after being in close contact with him in Kuwait.

"We don't see that the patient was exposed much to regional society since he was isolated upon his arrival at the Samsung hospital," Jeong Eun-kyeong, director of the KCDC, said during a press briefing at the Central Government Complex in Seoul. "We'll do our best to investigate and manage people who contacted him in order to prevent any secondary infections."

As part of efforts to effectively control the new outbreak, the government raised the status of the KCDC to that of a vice-ministerial level organization. Prime Minister Lee Nak-yon instructed the Ministry of Health and Welfare to do all it can do to prevent the possible spread of the viral respiratory disease.

"We should prevent the possible spread of MERS by quickly and thoroughly conducting an epidemiological investigation," Lee told the health minister after being briefed on the new outbreak. Lee will preside over an emergency meeting of relevant ministers to discuss measures to prevent the disease's spread on Sunday [9 Sep 2018] afternoon, according to his office.
======================
[As a reminder, during the period of late May through early July 2015, there was a major outbreak of MERS-CoV in South Korea, with a total of 185 cases reported from South Korea and one additional case who travelled from South Korea to China, where he was diagnosed and treated. The index case was a business man who had travelled to the Middle East (multiple countries including Bahrain and Saudi Arabia). The index case did not give a history of travel to the Middle East when evaluated in the medical facilities he sought assistance. Unfortunately, he was a "superspreader," and a number of individuals he infected were also superspreaders. The situation of healthcare management and health facility-seeking behavior on the part of the population led to multiple hospitals involved in this outbreak and a total of 186 cases associated with this event. (I suggest a journey through the "see also" list below to see that outbreak as it unfolded.) Many lessons were learned from that outbreak that are reflected in the management of this current case as reported by the news media reports included above. A travel history of this current case was identified at the 1st encounter of this patient by the health sector, and the patient was evaluated in a secluded area of the emergency room (which was not the realities during the 2015 outbreak, as many patients roamed freely in emergency rooms when 1st seen by the health sector).

This current case gives a history of travel and work in Kuwait, with a short stopover in Dubai en route home. He also gives a history of being seen at a health facility in Kuwait with a diarrheal illness (diarrhea can be part of the presenting symptoms with a MERS-CoV infection), so it is possible he was already infected with the MERS-CoV leading to his medical visit in Kuwait. It is also possible that the diarrheal incident was not due to a MERS-CoV infection, and he may have been seen in a health facility where there was another patient with active MERS-CoV infection that had not been diagnosed. I suspect that over the next few days more information on this will become available and will be reflected in either direct Ministry of Health (MOH) press releases and/or a report from the MOH submitted to the WHO Emergencies, Preparedness and Response Disease Outbreak News.

According to the ECDC Risk Assessment of Fri 24 Aug 2018, Kuwait has reported 4 cases of MERS-CoV infection, and Dubai has not reported any cases since MERS-CoV was identified in September 2012 (see <https://ecdc.europa.eu/sites/portal/files/documents/RRA-Severe-respiratory-disease-associated-MERS-CoV-22nd%20update-29-aug-2018.pdf>). Of additional note is that Thailand reported a case of MERS-CoV infection ex Kuwait in 2016, suggesting that there is MERS-CoV transmission in Kuwait, albeit rarely reported through the years. Hence, it is highly likely transmission occurred during this patient's travel to and within Kuwait. - ProMED Mod.MPP]

[HealthMap/ProMED-mail maps:
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Somalia

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

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

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

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

Information about dual nationality or the prevention of international child abduction can be found on our web site.
For further information about customs regulations, please read our Customs Information sheet.
SAFETY AND SECURITY:
Since the U.S. does not have an Embassy or any other diplomatic presence in any part of Somalia, including Somaliland and Puntland, the U.S. government cannot provide any consular services to U.S. citizens in Somalia.
Limited American Citizen Services are available for travelers to Somalia at the U.S. Embassies in Nairobi and Djibouti.

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

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

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

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

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

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

CRIME:
Pervasive and violent crime is an extension of the general state of insecurity in Somalia.
Serious, brutal, and often fatal crimes are very common.
Kidnapping and robbery are a particular problem in Mogadishu and other areas of the south.

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

See our information on Victims of Crime.

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

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

Information on vaccinations and other health precautions, such as safe food and water precautions and insect bite protection, may be obtained from the Centers for Disease Control and Prevention’s hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747) or via the CDC’s web site at http://wwwn.cdc.gov/travel/default.aspx.
For information about outbreaks of infectious diseases abroad consult the World Health Organization’s (WHO) web site at http://www.who.int/en.
Further health information for travelers is available at http://www.who.int/ith/en
MEDICAL INSURANCE:
The Department of State strongly urges Americans to consult with their medical insurance company prior to traveling abroad to confirm whether their policy applies overseas and whether it will cover emergency expenses such as a medical evacuation.
Travelers are strongly encouraged to purchase such insurance prior to traveling to East Africa if not already covered under their current medical plan.
Please see our information on medical insurance overseas.

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

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

Please refer to our Road Safety page for more information.

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

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

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

Please see our Customs Information.

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

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

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

REGISTRATION / EMBASSY LOCATION:
There is no U.S. Embassy in Somalia.
U.S. citizens who plan to enter Somalia despite the current Travel Warning are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department’s travel registration web site and to obtain updated information on travel and security within Somalia.
Americans without Internet access may register directly with the nearest U.S. Embassy or Consulate.
By registering, American citizens make it easier for the Embassy or Consulate to contact them in case of emergency.
Travelers to Somaliland should register with the U.S. Embassy in Djibouti, and travelers to Puntland or southern Somalia should register with the U.S. Embassy in Nairobi.

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

*

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

Travel News Headlines WORLD NEWS

Wed 26/06/2019 15:03
http://www.emro.who.int/som/somalia-news/who-and-unicef-somalia-and-partners-call-on-all-somalis-to-vaccinate-children-against-polio.html
https://www.who.int/en/news-room/fact-sheets/detail/poliomyelitis

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Another witness, Aisha Hassan, said several vehicles were destroyed and buildings damaged, adding that ambulances were seen rushing to the scene "but it is impossible to get close to the area now".    The road in which the blast occurred is close to the presidential palace and home to restaurants and tea-shops.   Earlier this month, at least 20 people died in an attack in Mogadishu which saw Al-Shabaab jihadists battling security forces for nearly 24 hours.
Date: Fri 30 Nov 2018
Source: Outbreak News Today [edited]

The Ministry of Health of Somalia has announced 27 new suspected cases of cholera, with one death, reported in Banadir region for epidemiological week 46 (12 to 18 Nov) of 2018. Of these new cases, 44% (12) are female, and 44% (12) are children below 5 years of age.

During this reporting period, of the 7 stool samples collected from suspected cholera cases and tested in the National Public Health Laboratory (NPHL), 6 samples were positive for _Vibrio cholera_, serotype O1 Ogawa. The cumulative total of cases is 6587, including 45 associated deaths (case-fatality rate, 0.7%), since the beginning of the current outbreak in December 2017 along the Shabelle River.

The number of weekly suspected cases has declined from a peak of 296 cases in epidemiological week 23 to 27 cases this week. For the past 3 weeks, the number of reported weekly cases ranges between 19 and 27. Only Banadir region has reported cases for 6 consecutive weeks, and this week active transmission of suspected cholera cases has been reported in 7 districts in Banadir: Darkenley, Daynile, Hawlwadag, Hodan, Karran, Madina, and Waberi. None of the cases reported this week had received the oral cholera vaccination (OCV) in 2017.

WHO is providing leadership and support to the Ministry of Health response efforts to this continued outbreak. WHO has continued to support clinical care delivery, including supervision and monitoring of case management in cholera treatment centres. Surveillance and prompt rumour investigation have been ongoing.

All alerts have been responded to across the country through the early warning alert and response network (EWARN), and routine collection and analysis of stool samples have continued at the NPHL. An OCV campaign has been planned for February 2019, targeting 660 000 people living in internal displaced person camps in 6 high-risk districts in Lower Jubba, Middle Shabelle, Lower Shabelle, and Banadir regions. Also, an expansion of reporting sites through the EWARN system has been planned, adding another 400 health facilities in the country.
More ...

World Travel News Headlines

Date: Wed, 26 Jun 2019 15:37:17 +0200
By Julie Pacorel

Marseille, June 26, 2019 (AFP) - France's second city and key tourist hub Marseille has enforced temporary swimming bans on several beaches amid pollution concerns, disappointing locals and tourists hoping to take a dip as temperatures soar.   Seven of the city's 21 beaches have raised a purple flag -- which means no bathing -- since the start of the month, on days when hygiene inspections revealed high levels of faecal matter.   Marseille is a tourist hotspot, attracting five million visitors per year thanks to its Mediterranean coastline and sun-kissed climate.

But the city, France's largest port, struggles with pollution from industry and shipping.   "It's mostly caused by sanitation problems, but there are also increasing numbers of boats spewing out their grey and black waste before they enter the port," said Sarah Hatimi, head of the water quality programme at Surfrider Foundation Europe environmental group.   Swimming bans are nothing new in Marseille. Last year, authorities enforced 153 bans amid fears of a pollution spike after heavy rainfall.   "This year, we can't say it's because of the rain," Monique Daubet, local councillor responsible for public health, said, adding that spillages from swimming pools and "lots of animal faeces" are part of the problem.   But the city is "proactive", she said, going "even further" than weekly water inspections imposed by a European law to "pay for our own analysis to protect swimmers".

Every morning, inspectors take water samples from each of the city's beaches to test for E. coli and enterococci bacteria, which indicate human or animal defecation.   A laboratory can reveal test results the same morning, whereas the previous weekly tests "arrived far too late, two or three days later," Daubet said.   Despite efforts, Marseille authorities aren't hopeful they can secure a "blue flag" stamp of approval for beach hygiene.   "Our water quality doesn't meet the criteria, which includes, for example, keeping bins at least 100 metres away from the beach".   "Nobody is forcing us to do this," she said. "Rather than complaining, people should be grateful we're closing the beaches!"
Date: Wed, 26 Jun 2019 10:37:11 +0200
By Elizabeth Vuvu

Kokopo, Papua New Guinea, June 26, 2019 (AFP) - Papua New Guinea's volatile Ulawun volcano -- designated one of the world's most hazardous -- erupted Wednesday, spewing lava high in the air and sending residents fleeing.   A pilot for Niugini Helicopters flying near the crater witnessed a column of lava spurting vertically into the equatorial sky, along with ash that has been belching since early morning.   Ulawun, on the remote Bismarck Archipelago chain, is listed as one of 16 "Decade Volcanoes" targeted for research because they pose a significant risk of large, violent eruptions.   Witnesses said lava had cut off the main highway in north of the island.   "The volcanic activity at Mt Ulawun began at 7:00 am this morning after slight rumbling and light emission," Leo Porikura, an official with the West New Britain Disaster Office, told AFP earlier.   "The Rabaul Volcano Observatory has declared a stage one alert warning of a possible eruption."

Witnesses had reported ash spewing out of the 2,334 metre (7,657 foot) summit, sending trails spanning high overhead.    "The sky has turned black," said Kingsly Quou, manager of the nearby Mavo Estates palm plantation.   Quou said that villagers living at the base of the volcano had already been evacuated and he and his colleagues were gathering their belongings.   Japanese satellite imagery and sources on the ground had shown sulphur dioxide and now volcanic ash drifting from the crater.   Australia's Bureau of Meteorology said the ash reached more than 13 kilometres (44,000 feet) into the air.   The bureau's Darwin Volcanic Ash Advisory Centre issued a "red" warning to airlines, indicating the eruption was imminent, although there is not believed to be an immediate threat for flight routes.   Thousands of people live in the shadow of Ulawun, despite it being one of the most active volcanoes in the country.

Porikura said people living in the vicinity of the volcano had been instructed to move away to safer areas and a disaster team had been dispatched.   "The disaster team will liaise with the local community, local businesses and local level government authorities to prepare for a possible eruption," he said.   "Three crucial priority areas being addressed include transport plan, care centre preparations and getting the communities in the high-risk areas to prepare for an evacuation," Porikura said.   The nearby Rabaul Volcano Observatory said emissions from the volcano were getting darker, indicating a higher ash content -- which can cause breathing problems, eye irritation and skin irritation because of the high acid content.   A team of experts had visited earlier this month and reported the volcano was "quiet" adding "there is no indication of any change in its state of unrest."   The ash emissions had been proceeded by an increase in seismic activity, Porikura said.
Date: Wed, 26 Jun 2019 10:01:43 +0200

San José, June 26, 2019 (AFP) - A 6.2 magnitude earthquake hit the Panama-Costa Rica border around midnight on Tuesday, the US Geological Survey said, revising earlier warnings of "significant damage", as the tremor cut power supplies near the epicentre.   The quake struck at a depth of 26 kilometres (16 miles), about two kilometres from the nearest town of Progreso in Panama, USGS said, updating a previous alert that estimated the depth at 10 kilometres.

There were no immediate reports of casualties, and USGS said "the impact should be relatively localized", reversing an earlier advisory that "past events with this alert level have required a regional or national level response."   "Estimated economic losses are less than 1 percent of GDP of Panama," the website said.   According to the National Seismological Network (RSN) in Costa Rica, the quake struck at 0523 GMT Wednesday (11.23 pm Tuesday) with its epicentre located 11 kilometres east of the Panamanian border town of Puerto Armuelles.

The tremor was felt in Costa Rica's capital San Jose and in many parts of the Central American country, according to initial reports, but the national tsunami warning system said there was no risk of a tsunami.   Villagers in the south of Costa Rica fled their homes, fearing aftershocks. Two houses in the region were damaged by the quake, said Alexander Solis, president of the country's National Emergency Commission.

Costa Rica's President Carlos Alvarado said there were power cuts in several communities in the southwest of the country, near the epicentre.   In November 2017 a 6.5-magnitude quake on the Pacific coast of Costa Rica caused buildings to sway in San Jose and contributed to the deaths of two people who had heart attacks.   Further north, two months earlier a 7.1-magnitude earthquake killed more than 300 people in Mexico.
Date: Wed, 26 Jun 2019 03:43:29 +0200
By Béatrice DEBUT

eMalahleni, South Africa, June 26, 2019 (AFP) - Tumelo has again lost several days at school because of sickness.   "My eyes are burning. Sometimes I can't breathe," she coughs.   "The doc said there is nothing we can do," says her mother Nono Ledwaba. "We need to take her out of eMalahleni. When she goes to her grandma in Mafikeng, the symptoms disappear."

The 14-year-old lives in house number 3094 of eMpumelelweni township in eMalahleni, part of the Highveld region turned over to mines and power plants that, according to activists, are killing local people.   Her neighbour in 3095, Lifa Pelican, has similar symptoms, which badly set back his schooling. At 25, he never moves without his inhaler, even inside his chilly home with rough-hewn walls.   "If I don't have it with me, sometimes I can't breathe. Sometimes I feel I am going to die," he says.   "These mines get a lot of money and we suffer. There's solar power. We don't need to use these coal plants."   Green energy such as solar and wind power account for less than two percent of electricity production in South Africa, while coal still provides 86 percent.

Lifa's breathing troubles began after he moved to eMalahleni, at the mercy of gritty coal dust and thick whitish smoke of electricity power stations burning fuel day and night.   Relief comes when he visits his father in Nelspruit, about 200 kilometres (125 miles) away, trips that feel like a new lease on life. "I don't use the inhaler."   Tumelo's own troubles began when the family moved to eMalahleni in 2007, when she was a toddler.   The trips to Mafikeng are literally a breath of fresh air -- her grandmother's home is 400 kms from the mines.   "The only solution is to close down the plants, but will this happen?" Ledwaba asks.   eMalahleni, which means "the place of coal", is among the worst places in the world for pollution by nitrogen dioxide and sulphur dioxide, according to Greenpeace.

- 'Deadly pollution levels' -
South Africa, like many developing countries, has placed a heavy bet on coal for its development -- a fuel that is plentiful, cheap and locally-sourced.   But campaign groups say health and climate costs are high.   Two environmental non-governmental organisations, groundWork and Vukani, say they have identified the top culprits.   They include 12 coal-burning power stations run by state-owned Eskom along with a plant for liquefying coal and an oil refinery.   Pollution from these sites was responsible for between 305 and 650 premature deaths in 2016, say the two NGOs.   They have initiated a suit against the government for "violation of the constitutional right to clean air" -- a legal first in South Africa, the leading industrial power on the continent.

The NGOs contend that the government has failed to reduce deadly pollution levels in the area, just an hour and a half's drive from Johannesburg.   "It has evolved into a public health crisis," says Tim Lloyd, lawyer for groundWork and Vukani.   "The cost of the air pollution to our economy each year is around 35 billion rand (1.8 billion euros, $2 billion)."   In response to the accusations, an environment ministry spokesman told AFP that SO2 (sulphur dioxide) emissions have "shown improvements across all the five monitoring stations" in the worst-affected region of the Highveld.   Criticism by environmental groups "fails to recognise these improvements', the ministry stated, declining to give further details about the data.   "The reality is that the desired improvements will not happen over a short period of time," it said.   Eskom admitted the area's pollution problem "requires urgent attention", adding that domestic coal burning, traffic and mining dust were also to blame.

- 'The life of my kids' -
"When people from other provinces come, they start getting sick with respiratory issues," says Alexis Mashifane, a doctor with a busy practice in Middelberg, 30 kms from eMalahleni.   "When they leave this area, some of them get better."   But many have no choice, saying they are stuck in the toxic region for economic reasons.   "I wish to move away because this place is not right," says Mbali Mathebula, a single mother who is raising a small daughter and a baby girl, both suffering from asthma. "I don't have money to buy a house".

In Mathebula's home at the foot of the Schonland coal mine, five-year-old Princess plays with the useless mask given to her mother at hospital.   Mathebula, a supermarket employee, could not afford a 70-euro ($80) oxygen machine to attach to the mask.   If a child has an asthma attack in the night, Mathebula says she has to wait until the morning and then go to hospital. "Sometimes I don't have money to go there. I must borrow."   Her neighbour Cebile Faith Mkhwanazi has to cope with her three-year-old daughter's asthma attacks.   "I'm thinking of taking them to my mother," she adds, broken-hearted. "So that they stay there forever for their health."
Date: Tue, 25 Jun 2019 17:57:30 +0200
By Clare BYRNE

Paris, June 25, 2019 (AFP) - As Europe sizzled Tuesday at the start of a heatwave tipped to break records, drivers on Germany's famously speedy motorways were ordered to slow down and fans at the women's World Cup were showered in health warnings.

Meteorologists blamed a blast of torrid air from the Sahara for the unusually early summer heatwave, which could send thermometers above 40 degrees Celsius (104 Fahrenheit) in some places on Thursday and Friday.   Experts say such heatwaves early in the summer are likely to be more frequent as the planet heats up -- a phenomenon that scientists have shown to be driven by human use of fossil fuels.

In Germany, where forecasters have warned a June record of 38.5 degrees could be smashed, speed restrictions were placed on some stretches of "autobahns" as the unusually warm weather raised the risks of "blow-ups" -- the hot tarmac breaking up and shredding tyres.   A forest fire was raging north of Cottbus, the second-largest city in Brandenburg state, in an area that was just recovering from a fire in 2018.   It was deemed especially dangerous due to the risk of unexploded ammunition left in the area, which is home to a military training facility.

- 'Hell is coming' -
In Spain, TV weather presenter Silvia Laplana riffed on the doom-filled catchphrase "Winter is coming" from the blockbuster series Game of Thrones to describe what lay in store for the country.   "El infierno (hell) is coming," she tweeted alongside a weather map which showed most of the country coloured scarlet later in the week.   "Of course it's hot in summer but when you have a heatwave that is so extensive and intense, during which records are forecast to be beaten, it's NOT normal," she tweeted.   Temperatures are expected to be particularly sweltering in the northeast of Spain, with a stifling 45 degrees expected Friday in the city of Girona, and 44 degrees in Zaragoza at the weekend.   Five northern provinces were placed on an orange high alert for a heatwave on Wednesday, with another five to be added by the weekend.

- 'Overdoing' the warnings? -
Authorities were also taking no chances in France, where a heatwave in August 2003 was blamed for 15,000 deaths, many of them elderly people who were left to fend for themselves.   In a highly unusual move, Education Minister Jean-Michel Blanquer on Monday postponed national school exams to next week. Paris authorities have banned older models of diesel and petrol cars from Paris on Wednesday, fearing a build-up of pollution.   Health Minister Agnes Buzyn denied the government was being excessively vigilant.   "For all those who know (the risks), obviously it's too much, but if I can avoid unnecessary deaths, I will continue to communicate about prevention," Buzyn told LCI television, referring to the warnings on radio, TV and public transport.

The Red Cross meanwhile urged people to check on vulnerable neighbours, relatives and friends, saying the "coming days will be challenging for a lot of people, but especially older people, young children, and people with underlying illnesses or limited mobility."   Players and spectators at the women's football World Cup taking place in cities around France were also being inundated with messages about keeping hydrated.   In a rare gesture by FIFA on Monday evening, fans were allowed to bring their own bottles of water into the Paris stadium where Sweden took on Canada.   Phil Neville, the England coach, was sanguine about the impact of the weather on the tournament, however.   "There's no excuse, the players are ready for it."

Meanwhile, French beekeepers and farming groups said they were bracing for a "catastrophic" honey harvest this year after frost damage in winter, an unusually rainy spring, and, now, unusually high temperatures.   "In the hives, there is nothing to eat, beekeepers are having to feed them with syrup because they risk dying from hunger," added the union, which represents many small farms in honey-producing regions.   In the Baltic region of northeast Europe, crowds have flocked to lakes and rivers to cool down, leading to a spike in drownings.    Twenty-seven people were reporte to have drowned so far in Lithuania where the temperature soared to an unusual high of 35.7 degrees Celsius.
Date: Tue, 25 Jun 2019 15:49:33 +0200

The Hague, June 25, 2019 (AFP) - Dutch health authorities said Tuesday they are dealing with a measles outbreak in a devout Protestant fishing village where vaccination rates are among the lowest in the country.   Nine children and one adult have been diagnosed with the disease in the village of Urk, part of the so-called "Bible Belt" in the northern Netherlands, the Flevoland province health service said.

The health service said it was "actively monitoring the situation" and examining whether it was necessary to vaccinate or administer antibodies to people who have been in contact with the infected patients.   "In 2013 and previously, the disease occurred more often on Urk. Many people on Urk have experienced this disease and that means that a natural defence has built up," it said.   Only 61.1 percent of people are vaccinated against measles in Urk, one of the lowest rates in the Netherlands, where the national average is 92.9 percent, according to the National Public Health and Environment Institute.

Urk is regarded as one of the most devout of the villages in the "Bible Belt" of conservative Protestant communities running from Zeeland in the south of the Netherlands across the country to the north west.   Ninety-four percent of people in Urk regularly go to church, according to the Dutch Central Bureau of Statistics, compared to one in six of all Dutch people.

Dutch newspaper De Telegraaf said that in this devout community of Urk people believe that life and death are in God's hands, and so vaccinations are not permitted.   Urk is considered a "closed' community because of its fisheries culture and Protestant orthodox religion," a European Commission report from 2010 said.

The UN warned in April of a global resurgence of measles -- a highly contagious viral infection that can prove fatal -- amid a growing "anti-vax" movement worldwide.   The WHO says cases of the once all-but-eradicated disease surged 300 percent in 2018 across the globe.   The anti-vax phenomenon has adherents across Western countries but especially in the United States, where it has been fuelled by the spread on social media of claims that the jab could cause autism, which medical officials have found are baseless.
Date: Thu 13 Jun 2019
Source: I Am Expat [edited]
<https://www.iamexpat.de/expat-info/german-expat-news/giant-tropical-ticks-overwinter-germany-first-time>

Normally, the tropical tick species _Hyalomma [marginatum_] only arrives in Germany with the 1st wave of migratory birds. However, experts believe that this year [2019] the disease-carrying giant ticks have spent the winter here for the 1st time ever. The tropical tick species _Hyalomma_ is not native to Germany and was detected in the federal republic for the 1st time in 2017. The ticks only began to appear in large numbers last year [2018], when a total of 19 specimens were found in 8 of Germany's federal states.

This year [2019], however, discoveries of the ticks were reported unusually early, leading researchers at the University of Hohenheim in Stuttgart and the Munich Institute for Microbiology to conclude that the newly-arrived tropical tick species overwintered in Germany for the 1st time this year [2019]. Over the past few days, 6 of the spidery ticks have been discovered in Germany: 5 on a horse farm in the Lower Rhine and one on a horse in Lower Saxony. "After the 1st evidence of this year [2019], we must assume that these animals can winter in Germany," said Ute Mackenstedt, a parasitologist at the University of Hohenheim.

Accordingly, the ticks are "a significant step further towards establishing themselves here." The _Hyalomma_ tick is native to the dry and semi-arid areas of Africa, Asia, and southern Europe. It is distinctive for its long, spidery, striped legs and large body, and can grow up to 2 centimetres [about 0.8 in] in length, 2-3 times larger than their closest European relatives. Usually, the adult _Hyalomma_ ticks stick to sucking the blood of large animals, but they have been known to transfer themselves to human hosts too.

The major factor that distinguishes them from Germany's native tick population is the fact that they are able to actively sense, track, and hunt their warm-blooded hosts over dozens of meters. _Hyalomma_ ticks are also considered a major carrier of a dangerous virus that can cause Crimean-Congo haemorrhagic fever -- the most widespread viral disease carried by ticks. Currently, there is no vaccine for this, and 10 to 40 percent of cases are fatal.

However, at the moment there is no cause for alarm: none of the tick specimens that were discovered last year [2018] were found to be carrying infectious agents. The size of the ticks means that they are also easier for humans to detect and remove. Moreover, the early appearance of the ticks does not necessarily mean that they have already become native to [established in] Germany. For a significant population to develop, males and females would have to find each other. That can be a tall order when the population is still relatively small. Even if they did find each other, the unhatched larvae would have to rely on an animal host, such as a bird or hare, to develop. [Byline: Aby Carter]
========================
[Although there may not be immediate concern about _Hyalomma marginatum_ ticks posing a human or animal health danger in Germany, if they have truly become established there and their numbers increase, there is a risk of transmission of pathogens such as Crimean-Congo hemorrhagic fever, as occurred in Spain, or spotted fever rickettsia such as _Rickettsia aeschlimannii_ that has been found in these ticks in Germany.

The only documented _Hyalomma_ spp. tick in Germany was found on a human in the southern part of the country (Lake Constance area) in May 2006, but the possibility of tick transportation from Spain was not ruled out (1,2). The authors state that it is reasonable to suggest that the _Hyalomma_ spp. ticks that were examined had been transported by the birds from Africa.

The fact that a randomly caught bird was infested with _R. aeschlimannii_­-infected ticks is suggestive of the intensive stream of new pathogens transported through Europe by migrating birds

References
----------
1. Rumer L, Graser E, Hillebrand T, et al. _Rickettsia aeschlimannii_ in _Hyalomma marginatum_ ticks, Germany [letter]. Emerg Infect Dis. 2011; 17(2): 325-6; <https://dx.doi.org/10.3201/eid1702.100308>.
2. Kampen H, Poltz W, Hartelt K, et al. Detection of a questing _Hyalomma marginatum marginatum_ adult female (Acari, Ixodidae) in southern Germany. Exp Appl Acarol. 2007; 43(3): 227-31 <https://dx.doi.org/10.1007/s10493-007-9113-y>.

A map of the known distribution of _Hyalomma marginatum_ as of 2018 can be accessed at
<https://ecdc.europa.eu/en/publications-data/hyalomma-marginatum-current-known-distribution-january-2018>.

An image of _Hyalomma marginatum_ can be accessed at the source URL above. - ProMED Mod.TY]

[HealthMap/ProMED-mail map of Germany:
<http://healthmap.org/promed/p/101>]
Date: Mon 24 Jun 2019
Source: ABC News [edited]

India's Supreme Court on Mon 24 Jun 2019 directed state and national authorities to file reports to the court on an encephalitis outbreak in the eastern state of Bihar this month [June 2019] in which 152 children have died.

A senior health department official in Bihar, Sanjay Kumar, said the epidemic is showing signs of slowing with no new deaths on Monday [24 Jun 2019]. The fatalities have occurred in 20 of the state's 38 districts.

The outbreak has been exacerbated by a heatwave, with temperatures in Patna, Bihar's capital, reaching a high of 45.8 C (114.5 F).

"We're hoping with the onset of the monsoon, the epidemic will ease further," Kumar said.

More than 700 cases of encephalitis have been registered since the outbreak began on 1 Jun [2019], officials said. Young children are particularly vulnerable to the illness, which can cause swelling of the brain, fever, and vomiting.

The Supreme Court was responding to a petition filed by a lawyer. "The deaths of children are a direct result of negligence and inaction" on part of authorities, said Manohar Pratap, the petitioner.

The court expressed concern over the deaths and asked the governments to respond within 7 days with details on medical facilities, nutrition, sanitation and hygiene conditions in the state.

Thousands of Indians suffer from encephalitis, malaria, typhoid and other mosquito-borne diseases each year during the summer monsoon season.

India's central government has sent medical experts to Bihar to help doctors treat the patients.

The Bihar authorities have been sharply criticized because patients were sharing beds in crowded hospital wards with too few doctors. The families who could afford it transferred their children to private hospitals in Patna and other larger cities.

The Press Trust of India news agency on Mon 24 Jun 2019 reported that about 6000 deaths from encephalitis occurred in India between 2008 and 2014.
======================
[The number of cases has increased rapidly from 142 on 22 Jun 2019, to 152 in 2 days in the report above. However, the number of fatal cases reported last week varied widely, from 142 to 1349 (see Japanese encephalitis & other - India (07): (BR) http://promedmail.org/post/20190623.6534477).

One hopes that the assessment of the situation as slowing is accurate. There is no indication in the above report of the etiological agent(s) involved in these cases. Japanese encephalitis is one possibility. The majority of cases have been classified as acute encephalitis syndrome (AES). AES has continued to be attributed to a variety of etiologies, including Reye syndrome-like disease, possible enterovirus infection from polluted water, heatstroke, lychee fruit consumption (especially in recent reports), and scrub typhus (_Orientia tsutsugamushi_). A recent publication states that dengue virus is one of the 3 most common agents identified in AES, but existing surveillance for AES does not include routine testing for dengue. Until the etiology (or etiologies) of these AES cases is determined, effective and efficient prevention of these cases will not be possible. - ProMED Mod.TY]

[Maps of India:
Wed 26/06/2019 15:03
http://www.emro.who.int/som/somalia-news/who-and-unicef-somalia-and-partners-call-on-all-somalis-to-vaccinate-children-against-polio.html
https://www.who.int/en/news-room/fact-sheets/detail/poliomyelitis

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

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

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

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

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

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

Concurrent to the polio campaign, polio health workers have also been working to vaccinate more than 650 000 people aged one year and above against cholera in high-risk districts of Somalia.
Date: Mon, 24 Jun 2019 16:11:10 +0200

Kinshasa, June 24, 2019 (AFP) - More than 1,500 people have died in a nearly 10-month-old outbreak of Ebola in the Democratic Republic of Congo, the health ministry said Monday.   As of Sunday, 1,506 people have died out of 2,239 recorded cases, it said.   Earlier this month, the virus claimed two lives in neighbouring Uganda among a family who had travelled to the DRC.   Nearly 141,000 people have been vaccinated in the affected eastern DRC provinces of Ituri and North Kivu, the epicentre of the outbreak.

Ebola spreads among humans through close contact with the blood, body fluids, secretions or organs of an infected person, or objects contaminated by such fluids.   The current outbreak in the DRC is the worst on record after an epidemic that struck mainly in Liberia, Guinea and Sierra Leone between 2014-2016, killing more than 11,300 people.   Chronic violence and militia activity in Ituri and North Kivu as well as hostility to medical teams among locals have hampered the response.

On Monday, a crowd of people opposed to the burial of two Ebola victims in the Beni area burnt the vehicle of a health team, local police chief Colonel Safari Kazingufu told AFP.   He said a member of the medical team had been injured in the attack and taken to hospital.    The United Nations in May nominated an emergency coordinator to deal with the crisis. However, the World Health Organization (WHO) said this month the outbreak currently did not represent a global threat.