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Antigua and Barbuda

Antigua and Barbuda - US Consular Information Sheet
April 02, 2008
COUNTRY DESCRIPTION:
Antigua and Barbuda is a dual island nation known for its beaches, and is a favorite destination for yachtsmen.
Tourist facilities are widely avai
able.
English is the primary language.
Banking facilities and ATMs are available throughout the island.
Read the Department of State Background Notes on Antigua and Barbuda for additional information.

ENTRY/EXIT REQUIREMENTS:
All Americans traveling by air outside the United States are required to present a passport or other valid travel document to enter or re-enter the United States.
This requirement will be extended to sea travel (except closed loop cruises), including ferry service, by the summer of 2009.
Until then, U.S. citizens traveling by sea must have government-issued photo identification and a document showing their U.S. citizenship (for example, a birth certificate or certificate of nationalization), or other WHTI compliant document such as a passport card for entry or re-entry to the U.S.
Sea travelers should also check with their cruise line and countries of destination for any foreign entry requirements.

Applications for the new U.S. Passport Card are now being accepted.
We expect cards will be available and mailed to applicants in spring 2008.
The card may not be used to travel by air and is available only to U.S. citizens. Further information on the Passport Card is available at http://travel.state.gov/passport/ppt_card/ppt_card_3926.html and upcoming changes to U.S. passport policy can be found on the Bureau of Consular Affairs web site at http://travel.state.gov/travel/cbpmc/cbpmc_2223.html.
We strongly encourage all American citizen travelers to apply for a U.S. passport well in advance of anticipated travel.
American citizens can visit travel.state.gov or call 1-877-4USA-PPT (1-877-487-2778) for information on how to apply for their passports.

Immigration officials are strict about getting exact information about where visitors are staying, and will often request to see a return ticket or ticket for onward travel, as well as proof of sufficient funds to cover the cost of the visitor’s intended stay.
There is a departure tax payable when departing the country.
For further information on entry requirements, travelers can contact the Embassy of Antigua and Barbuda, 3216 New Mexico Avenue NW, Washington, DC
20016, telephone (202) 362-5122, or consulates in Miami.
Additional information may be found on the home page of the Antigua and Barbuda Department of Tourism at http://www.antigua-barbuda.org.

Information about dual nationality or the prevention of international child abduction can be found on our web site.
For further information about customs regulations, please read our Customs Information sheet.

SAFETY AND SECURITY:
For the latest security information, Americans traveling abroad should regularly monitor the Department of State, Bureau of Consular Affairs’ web site at http://travel.state.gov, where the current Worldwide Caution, Travel Warnings, and Travel Alerts 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:
Petty street crime does occur, and valuables left unattended on beaches, in rental cars or in hotel rooms are vulnerable to theft.
There has been an increase in crime in Antigua, including violent crimes, in the last six months.
However, this increase has not, for the most part, affected visitors to the island.
The Government of Antigua and Barbuda has taken steps to improve the effectiveness of the police in responding to crimes.
As everywhere, visitors to Antigua and Barbuda are advised to be alert and maintain the same level of personal security used when visiting major U.S. cities.

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:
There are many qualified doctors in Antigua and Barbuda, but medical facilities are limited to a public hospital and a private clinic and are not up to U.S. standards.
The principal medical facility on Antigua is Holberton Hospital, on Hospital Road, St. John's (telephone (268) 462-0251).
There is no hyperbaric chamber; divers requiring treatment for decompression illness must be evacuated from the island, to either Saba or Guadeloupe.
Serious medical problems requiring hospitalization and/or medical evacuation to the United States can cost thousands of dollars.
Doctors and hospitals often expect immediate cash payment for health services, and U.S. medical insurance is not always valid outside the United States.
U.S. Medicare and Medicaid programs do not provide payment for medical services outside the United States.

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

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

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

Traffic in Antigua and Barbuda moves on the left.
Major roads are generally in good condition, but drivers may encounter wandering animals and slow moving heavy equipment.
There is relatively little police enforcement of traffic regulations.
Buses and vans are frequently crowded and may travel at excessive speeds.
Automobiles may lack working safety and signaling devices, such as brake lights.

Please refer to our Road Safety page for more information.
For specific information concerning Antigua and Barbuda driving permits, vehicle inspection, road tax, and mandatory insurance, contact the Antigua and Barbuda national tourist organization offices in New York via e-mail at info@antigua-barbuda.org.

AVIATION SAFETY OVERSIGHT:
The U.S. Federal Aviation Administration (FAA) has assessed the Government of Antigua and Barbuda’s Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for oversight of Antigua and Barbuda’s air carrier operations.
For more information, travelers may visit the FAA’s web site at http://www.faa.gov/safety/programs_initiatives/oversight/iasa.

SPECIAL CIRCUMSTANCES:
Like all Caribbean countries, Antigua can be affected by hurricanes. The hurricane season normally runs from June to the end of November, but there have been hurricanes in December in recent years.
General information about natural disaster preparedness is available via the Internet from the U.S. Federal Emergency Management Agency (FEMA) at http://www.fema.gov/.
Please see 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 Antigua and Barbuda laws, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in Antigua and Barbuda 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 information on Criminal Penalties.

CHILDREN'S ISSUES:
For information see our Office of Children’s Issues web pages on intercountry adoption and international parental child abduction.
REGISTRATION / EMBASSY LOCATION:
Americans living or traveling in Antigua and Barbuda are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department’s travel registration web site, https://travelregistration.state.gov/, and to obtain updated information on travel and security within Antigua and Barbuda.
Americans without Internet access may register directly with the nearest U.S. Embassy or Consulate.
By registering, American citizens make it easier for the Embassy or Consulate to contact them in case of emergency.
The U.S. Embassy in Bridgetown in located in the Wildey Business Park in suburban Wildey, south and east of downtown Bridgetown.
The main number for the Consular Section is (246) 431-0225; after hours, the Embassy duty officer can be reached by calling (246) 436-4950.
The web site for Embassy Bridgetown is http://barbados.usembassy.gov/. Hours of operation are 8:30 a.m. - 4:00 p.m., Monday-Friday, except local and U.S. holidays.

The U.S. Consular Agent, Rebecca Simon, in Antigua provides passport, citizenship and notarial services, and assists Americans in distress.
The Consular Agency is located in Suite #2, Jasmine Court, Friars Hill Rd, St. John’s, Antigua.
Contact information is as follows: telephone 1-268-463-6531, cellular 1-268-726-6531, or e-mail ANUWndrGyal@aol.com. The mailing address is P.O. Box W-1562, St. John’s, Antigua. The Consular Agent is available by appointment only.
The office is closed for local and U.S. Holidays.
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This replaces the Country Specific Information for Antigua and Barbuda dated April 2, 2007, to update sections on Entry/Exit Requirements, Safety and Security, Medical Facilities and Health Information, Traffic Safety and Road Conditions, and Crime.

Travel News Headlines WORLD NEWS

Date: Wed, 21 Mar 2018 18:14:27 +0100
By Gemma Handy

St. John's, Antigua and Barbuda, March 21, 2018 (AFP) - Voters in the hurricane-wracked twin island nation of Antigua and Barbuda headed to the polls Wednesday to elect a new government after Prime Minister Gaston Browne called snap elections.   Browne's Antigua Barbuda Labour Party, which has led the eastern Caribbean country since 2014, is widely expected to secure a second consecutive term.   The prime minister announced general elections on February 24, 15 months before a constitutionally mandated deadline, giving opposition parties less than four weeks to prepare.

And there will be no polling stations on Barbuda, which was battered by Hurricane Irma in September.    As a result, the estimated 400 Barbudans who have since returned home will have to travel to Antigua to cast their ballot. The government has promised to pay for related transport, accommodation and meal expenses.   Just over 51,000 Antiguans and Barbudans are eligible to vote. Voter turnout was around 90 percent in 2014.

Browne says the government wants to protect half a billion US dollars worth of developments currently under construction in the tourism-dependent country, and provide investors with stability.    One of the most prominent -- and controversial -- projects is a $250 million mega resort being built by Hollywood star Robert De Niro on Barbuda which was devastated by Hurricane Irma in September.   Lowering the cost of living in the country of 100,000 people is high on the
agenda.

- Ruling party dominates -
Browne, a former businessman and banker, has pledged to reduce electricity bills, along with the cost of land, and provide more affordable housing, under the slogan "Rebuilding Together." His wife Maria is also running for a seat on an ABLP ticket.   On Sunday, thousands of Browne's supporters donned the party's red colours and walked alongside a motorcade in an event that culminated in a public rally.   The "Delivering Hope" campaign of the main opposition group, the United Progressive Party (UPP), cites revitalization of the tourism and agricultural sectors as key priorities.

Fifty-three candidates will vie for seats in the 17 single-member constituencies -- of which the ABLP currently holds 14 -- in a first-past-the-post system.    The ruling party is alone in presenting a full slate of 17 candidates. The UPP, led by former finance minister Harold Lovell, has put forward 16.    A new party, the Democratic National Alliance, headed by current lawmaker and former UPP representative Joanne Massiah has registered 13 candidates.    There is a handful of smaller parties, a single independent runner and one representing the Barbuda People's Movement (BPM) contesting the small island's sole seat.

Polling stations opened at 6:00 am (1000 GMT) and are due to close at 6:00 pm. Alcohol sales are restricted during those hours and all public schools are closed, as many are serving as polling stations.   Teams representing the Caribbean Community (CARICOM) are observing the elections.   On its path through the Caribbean in September, Irma caused "absolute devastation" on Barbuda where up to 30 percent of properties were demolished, and 95 percent damaged, Browne had said at the time.    After a 10-year hiatus, voters returned Browne's Labour Party to power during the last ballot four years ago, when he pledged to economically transform the country.   The country became fully independent from Britain in 1981.
Date: Sun, 25 Feb 2018 08:04:27 +0100

Georgetown, Guyana, Feb 25, 2018 (AFP) - Antigua and Barbuda, a hurricane-ravaged Caribbean tourist destination, will go to the polls next month more than a year earlier than scheduled, the prime minister said on Saturday.   The two-island nation's parliamentary elections were scheduled for June 2019, but will now be held on March 21, Gaston Browne said.   Voters will select the 17 members of Antigua and Barbuda's House of Representatives, its lower house. Members of the Senate are appointed.   "Our primary focus for calling elections early is not about politics but is about your development. God forbid for there to be change in government," Browne said on radio.

After a 10-year hiatus, voters returned Browne's Labour Party to power during the last ballot in 2014, when he pledged to economically transform the country.   On Saturday, Browne said there had been "significant gains" since and that the government wanted to guard against unpredictability in the investment climate.   He cited cheaper housing for ordinary people, better roads, two Marriott-branded hotels, as well as a new airport on the island of Barbuda, which was battered last year by Hurricane Irma.   On its path through the Caribbean in September, Irma caused "absolute devastation" on Barbuda where up to 30 percent of properties were demolished, and 95 percent damaged, Browne had said at the time.    Labour has ruled Antigua and Barbuda almost continuously since 1949. The country became fully independent from Britain in 1981.
Date: Sat, 9 Sep 2017 18:35:21 +0200
By Gemma Handy

Codrington, Antigua and Barbuda, Sept 9, 2017 (AFP) - Homes, shops and government buildings were destroyed when Hurricane Irma slammed the Caribbean island of Barbuda this week, while a huge stretch of its once glorious 11-mile west coast beach has been wiped out.   Destruction was so widespread that authorities have ordered the entire population of 1,800 to evacuate as Hurricane Jose approached the island over the weekend. 

By mid-day Saturday Jose, a Category Four hurricane, was tracking towards the north-west and no longer expected to hit Barbuda, but it remained under a Tropical Storm warning.   Authorities on Barbuda -- one of the two islands that make up the nation of Antigua and Barbuda -- have only begun to measure the damage caused when Irma struck the island as a powerful Category Five hurricane overnight Tuesday to Wednesday.   "Terrifying," "horrific" and the "worst damage seen in a lifetime" were some of the descriptions from residents as they emerged from their shelters after Irma's passage.    A child died when Irma, the strongest storm ever recorded to form in the Atlantic, struck the island.   Authorities said 30 percent of properties were demolished by the monster storm.

- Surviving in a wardrobe -
Barbudans swapped tales of hiding in wardrobes and showers as 157 mile (252 kilometer) per hour wind from Irma ripped off roofs, uprooted trees and knocked down walls.   Sira Berzas, 40, spent more than an hour huddled in a wardrobe with a friend after Irma tore the roof off the home they were hiding in.   "I have never been so scared in my life. Jackie and I were holding on to each other and basically saying our goodbyes," Berzas told AFP.

When the eye of the hurricane came, she said, "we ran outside in our underwear screaming for help. Luckily there was a police truck which took us to a safer building."   In the rush to safety "we had to leave Jackie's kitten behind," said Berzas, who lost her Pink Sand Beach home, bar and restaurant to the disaster.   Thankfully Houdini lived up to his name. The kitten was later found crouched in a corner of the ruined house, trembling but alive.

- Fleeing Hurricane Jose -
Hundreds of Barbudans were transported on Friday to Antigua via a Venezuelan military plane for safety ahead of Hurricane Jose.   Many have family to visit on the sister island, but others had no idea where they would stay when they arrived.   "I don't know where we are going when we get to Antigua -- or how we will get there," said Beautymey John, who was on a dock waiting to board a boat to safety with her five children.   "I would rather stay here, it doesn't feel right to leave. We have to try and start again," she told AFP.

Other Barbudans also said they were determined to rebuild their homes and livelihoods.   Teacher Maurice George, 30, said the small bag he was taking to Antigua contained the bare essentials, but vowed to return as soon as the secondary school he works in reopens.   "It is heart-breaking to see our island looking like this," he said.   "But where some people see devastation, I see an opportunity to rebuild," he added.
Date: Sat, 19 Mar 2016 13:18:00 +0100

Washington, March 19, 2016 (AFP) - A 6.0-magnitude earthquake hit off the coast of the Caribbean island nation of Antigua and Barbuda Saturday, US experts said, but caused no tsunami warning or immediate reports of damage or injury.   The strong quake, which hit at 1126 GMT, struck at a depth of 24 kilometres (15 miles) with its epicentre located 153 kilometres northeast of the capital of Saint John's, according to the US Geological Survey.
Date: Mon 14 Dec 2015
Source: Antigua Observer [edited]

Prison sources are still complaining that, despite the alleged outbreak of chicken pox at Her Majesty's Prison (HMP), not much has been done to ensure that the virus does not affect more people who either work there or are in custody. A source said since Observer media reported on the incident, last Thu 10 Dec 2015 that there has been another suspected case, bringing the number of affected persons to 19.

The source explained that this occurred even while the other 18 infected persons were already in isolation in the chapel in the prison yard. That source is suggesting that health authorities should to go into the jail to "clean it and spray out the cells" because the virus, according to research, can be picked up from contaminated surfaces.

An official at HMP, who is not authorized to speak with the media, said although the affected inmates are being housed in the chapel away from the rest of the prison population, they are still able to come and go to other parts of the jail, including the washroom and for breaks. Another source indicated that most of the affected persons are on remand and it is highly likely they will be released at any time, and then the virus would likely spread to communities outside the prison walls.

Observer media was unable to reach the prison boss, Superintendent Albert Wade, for comment.

In the meantime, Attorney General Steadroy "Cutie" Benjamin, who has responsibility for the prison, has given assurance that prison authorities have taken adequate steps to control the spread of chickenpox.
======================
[Outbreaks of chickenpox are not uncommon in closed communities where contagious virus can spread rapidly. Chickenpox is a very contagious disease caused by varicella-zoster virus (VZV), a herpes virus. It causes a blister-like rash, itching, tiredness, and fever. Chickenpox can be serious, especially in babies, adults, and people with weakened immune systems. It spreads easily from infected people to others who have never had chickenpox or received the chickenpox vaccine. Chickenpox spreads in the air through coughing or sneezing. It can also be spread by touching or breathing in the virus particles that come from chickenpox blisters and can be transmitted by touching surfaces that have recently be contaminated by open lesions as well. Chickenpox most commonly causes an illness that lasts about 7-10 days.

The classic symptom of chickenpox is a rash that turns into itchy, fluid-filled blisters that eventually turn into scabs. The rash may 1st show up on the face, chest, and back, then spread to the rest of the body, including inside the mouth, eyelids, or genital area. It usually takes about a week for all the blisters to become scabs. Some people who have been vaccinated against chickenpox can still get the disease. However, the symptoms are usually milder with fewer blisters and mild or no fever. About 25 to 30 percent of vaccinated people who get chickenpox will develop illness as serious as chickenpox in unvaccinated persons.

Chickenpox vaccine is safe and effective at preventing the disease. Most people who get the vaccine will not get chickenpox. If a vaccinated person does get chickenpox, it is usually mild -- with fewer blisters and mild or no fever. The chickenpox vaccine prevents almost all cases of severe disease (for further information, see: <http://www.cdc.gov/chickenpox/index.html>). - ProMed Mod.LL]

[A HealthMap/ProMED-mail map can be accessed at:
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Congo, Republic of the

Republic of Congo US Consular Information Sheet
August 29, 2008
COUNTRY DESCRIPTION:
The Republic of the Congo (Congo-Brazzaville) is a developing nation in central Africa. The official language is French. The largest cities are the capita
, Brazzaville, on the Congo River, and Pointe Noire on the coast. Civil conflict in 1997 and again in 1998-99 damaged parts of the capital and large areas in the south of the country. The last rebel group still engaged in armed struggled signed a cease-fire accord with the government in March 2003. Facilities for tourism are very limited. Read the Department of State Background Notes on the Republic of the Congo (Brazzaville) for additional information.
ENTRY/EXIT REQUIREMENTS: A passport, visa and evidence of yellow fever vaccination are required for entry. Additional information on entry requirements may be obtained from the Embassy of the Republic of the Congo, 4891 Colorado Avenue NW, Washington, DC 20011, telephone (202) 726-5500, or from the Permanent Mission of the Republic of the Congo to the United Nations, 14 E. 65th St., New York, NY, 10021, telephone (212) 744-7840. Overseas, inquiries should be made at the nearest Congolese embassy or consulate.
Information about dual nationality or the prevention of international child abduction can be found on our web site. For further information about customs regulations, please read our Customs Information sheet.

SAFETY AND SECURITY:
As a result of past conflicts, there is extensive damage to the infrastructure in Brazzaville and in the southern part of the country, and the government is working to reconstruct roads and buildings. Fighting broke out in March and June of 2002 when rebel groups launched attacks first in the Pool region, and later, at the Brazzaville airport. The fighting in Brazzaville was quickly contained and the rebels were repulsed. In March 2003, the rebels and the government signed a cease-fire accord, which remains in effect, although there was some violence in Brazzaville in December 2003.

Occasionally, political unrest in neighboring Kinshasa can affect Brazzaville on the other side of the Congo River. For example, in 2007, stray small arms fire originating in Kinshasa landed in Brazzaville.

Continued security awareness remains a key consideration for all visitors. Night travel outside of cities should be avoided. U.S. citizens should avoid political rallies and street demonstrations and maintain security awareness at all times.
In the event of a fire, call the fire brigade at 81-53-87.
The Department of State suspended operations at the U.S. Embassy in Brazzaville in 1997. The Brazzaville U.S. Embassy interim offices are located in the B.D.E.A.C (Central African Development Bank) building in Brazzaville. A new embassy compound is under construction and slated to open in 2009. While Brazzaville is still not fully open for normal operations, Embassy personnel are present in Brazzaville to provide information and guidance to American citizens. Staff can be contacted through the Embassy’s interim offices (see Registration/Embassy Location section below). The reduced staff in Brazzaville has limited ability to provide emergency services and non-emergency services generally take a few days to coordinate through Embassy Kinshasa.
For the latest security information, Americans traveling abroad should regularly monitor the Department of State, Bureau of Consular Affairs’ web site at http://travel.state.gov, where the current Travel Warnings and Travel Alerts, as well as the Worldwide Caution, can be found.

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

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

CRIME: In the Congo, petty street crime targeting foreigners is rare. Incidents of mugging and pick pocketing happen frequently near the ports in Pointe Noire and Brazzaville, and sometimes in the Congolese neighborhoods surrounding Brazzaville's city center.

Criminal elements are known to target middle-class and affluent residences without 24-hour guards for burglary. Roadblocks and robberies by armed groups targeting travelers occur in the Pool region south of Brazzaville. Travel to the Pool region is discouraged due to these elements.

Travelers should note that in the case of theft and robbery, legal recourse is limited and therefore, they may wish to leave all valuable items at home.

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.

While there is no local equivalent to the “911” emergency line in Republic of the Congo, the Rapid Response Police Team can be reached at 665-4804. However, police resources are limited and response to emergency calls is often slow (15 minutes or longer).

See our information on Victims of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION: Medical facilities are extremely limited. Some medicines are in short supply, particularly outside the larger cities. Travelers should carry their own supply of properly labeled medications.
Malaria is a serious and sometimes fatal disease. Plasmodium falciparum malaria, the type that predominates in the Congo, is resistant to the antimalarial drug chloroquine. Because travelers to the Republic of the Congo are at high risk for contracting malaria, the Centers for Disease Control and Prevention (CDC) advises that travelers should take one of the following antimalarial drugs: mefloquine (Lariam™), doxycycline, or atovaquone/proguanil (Malarone™). Travelers who become ill with a fever or flu-like illness while traveling in a malaria-risk area and up to one year after returning home should seek prompt medical attention and tell the physician their travel history and what antimalarials they have been taking. For additional information on malaria, including protective measures, see the CDC Travelers’ Health web site at http://wwwn.cdc.gov/travel/yellowBookCh4-Malaria.aspx/.
The U.S. Department of State is unaware of any HIV/AIDS entry restrictions for visitors to or foreign residents of the DRC.

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

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

TRAFFIC SAFETY AND ROAD CONDITIONS: While in a foreign country, U.S. citizens may encounter road conditions that differ significantly from those in the United States. The information below concerning the Republic of the Congo is provided for general reference only, and may not be totally accurate in a particular location or circumstance.
Road conditions are generally poor and deteriorate significantly during the rainy season, November-May. Maintenance of the few paved roads is limited. Overland travel off the main roads requires a four-wheel drive vehicle. Poorly marked checkpoints, sometimes manned by undisciplined soldiers, exist in many areas of the countryside.

Taxis are considered an acceptable mode of transport due to availability and low cost. Registered public transportation vehicles are painted green with white roofs and striping. Security is not generally an issue with taxis but buses are often overcrowded and thus less secure. Mechanical reliability of both vehicle types remains in question.
Traffic safety in general is hazardous due to high speeds, aggressive driving, poorly maintained vehicles and general apathy for pedestrians and cyclists.

Roads are narrow, dangerously potholed, frequently wash out during rainy season and are often full of debris, and pedestrians.
Emergency services are limited. Please refer to the medical section above.
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 the Republic of the Congo, the U.S. Federal Aviation Administration (FAA) has not assessed the Republic of the Congo’s Civil Aviation Authority for compliance with International Civil Aviation Organization (ICAO) aviation safety standards. For more information, travelers may visit the FAA web site at http://www.faa.gov/safety/programs_initiatives/oversight/iasa.

SPECIAL CIRCUMSTANCES:
Ferry service between Brazzaville and Kinshasa normally operates from 8 A.M. to 4 P.M. Monday through Saturday and 8 A.M. to 12 P.M. Sunday, but it may close completely with minimal notice. A special exit permit from the Republic of the Congo’s Immigration Service and a visa from the Democratic Republic of the Congo’s embassy/consulate are required to cross the Congo River from Brazzaville to Kinshasa. Passenger travel on the railroad is discouraged, as there are frequent reports of extortion by undisciplined security forces and robberies by criminal elements along the route.
The Congo is primarily a cash economy and uses the Central African Franc (CFA), a common currency with Gabon, Chad, Cameroon, the Central African Republic, and Equatorial Guinea. U.S. dollars may be exchanged for local currency. Traveler’s checks can be cashed for a fee at some hotels. Two hotels in Brazzaville, and several in Pointe Noire, accept major credit cards, but prefer payment in cash. Prices are usually quoted in CFA or Euros. Other businesses do not normally accept credit cards. Personal checks drawn on foreign accounts are not accepted. Western Union has offices in Brazzaville and Pointe Noire, and one bank in Brazzaville has an ATM.
Airport police and customs officials routinely inspect incoming and outgoing luggage, even for internal travel. For a complete list of prohibited items, please contact the nearest Congolese embassy or consulate. Please see our Customs Information.
Local security forces in areas outside Brazzaville and Pointe Noire may detain foreigners to solicit bribes. Detention of U.S. citizens, particularly in remote areas, may not always be promptly reported to the U.S. Government by Congolese authorities. U.S. citizens are encouraged to carry a copy of their passports with them at all times so that, if questioned by local officials, proof of identity and U.S. citizenship is readily available. If detained or arrested, U.S. citizens should always ask to be allowed to contact the U.S. Embassy. Please see the Registration/Embassy Location section below.
In general there are no restrictions on photography; however photographs of government buildings or military installations, port facilities or the airport should not be taken. When photographing human beings in remote areas where populations adhere to traditional beliefs, it is best to request permission first. If permission is refused, the photo should not be taken.
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 Republic of the Congo’s laws, even unknowingly, may be expelled, arrested or imprisoned. Penalties for possession, use, or trafficking in illegal drugs in Republic of the Congo are severe, and convicted offenders can expect long jail sentences and heavy fines. Engaging in sexual conduct with children or using or disseminating child pornography in a foreign country is a crime, prosecutable in the United States. Please see our information on Criminal Penalties.

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

REGISTRATION / EMBASSY LOCATION:
Americans living or traveling in Republic of the Congo are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department’s travel registration web site so that they can obtain updated information on travel and security within Republic of the Congo. Americans withoutInternet access may register directly with the nearest U.S. Embassy or Consulate. By registering, American citizens make it easier for the Embassy or Consulate to contact them in case of emergency.

The U.S. Embassy in Brazzaville has interim offices located in the B.D.E.A.C Building, 4th Floor, Place du Gouvernement, Plateau de Centre Ville, Brazzaville. The web site is http://brazzaville.usembassy.gov. The telephone number during regular business hours (7:30 am until 4:30 pm, Monday through Friday) is 242-81-14-81; email is Consular.Brazzaville@state.gov. For after-hours emergencies, call the U.S. Embassy in Kinshasa (see below).

The U.S. Embassy in Kinshasa, Democratic Republic of the Congo (DRC) is located at 310 Avenue des Aviateurs, Gombe; tel. 243-(0)81-225-5872 (do not dial the zero when calling from abroad into the DRC). Entrance to the Consular Section of the U.S. Embassy in Kinshasa is on Avenue Dumi, opposite Ste. Anne residence. The Consular Section of the Embassy in Kinshasa may be reached at cellular tel. 243-(0)81-884-4609, 243-(0)81-884-6859 or 243-(0)81-225-5872; fax 243-(0)81-301-0560. For after-hours emergencies, use 243-81-225-5872. (Cellular phones are the norm, as other telephone service is often unreliable).
* * *
This replaces the Country Specific Information for Republic of the Congo dated August 20, 2008 to update the section on Safety and Security.

Travel News Headlines WORLD NEWS

Date: Wed 26 Sep 2018
Source: WHO Relief Web [edited]

The Republic of Congo, in collaboration with the World Health Organization (WHO) and partners, started today [26 Sep 2018] a vaccination campaign to control the spread of yellow fever in the port city of Pointe Noire and surrounding areas. More than one million people from 9 months of age are expected to be vaccinated in this 6-day campaign.

The vaccination campaign uses doses from the global emergency yellow fever vaccine stockpile managed by the International Coordination Group on Vaccine Provision (ICG) and funded by Gavi, the Vaccine Alliance. The ICG coordinates the timely and equitable provision of vaccines during outbreaks and maintains an emergency stockpile of 6 million doses of yellow fever vaccine, which is continually replenished. Gavi will also cover operational costs for this campaign.

The immunization drive is a response to a laboratory-confirmed yellow fever case, which tested positive on 21 Aug 2018, after the person visited a rural area. Since then, no other case has been confirmed in the country, but more than 200 suspected cases have been reported since the beginning of the year [2018], with most of these notified by the health authority in Pointe Noire. It is possible that there are also undetected cases, as a large proportion of the Pointe Noire population seeks care in the private system; therefore, the national surveillance system may not be receiving notification.

Yellow fever is an acute viral haemorrhagic disease transmitted by infected mosquitoes that can be deadly but is prevented by an extremely effective vaccine. Urban outbreaks are of particular concern, and Pointe Noire is the country's economic capital, with a population of more than one million people. After declining for many years, yellow fever outbreaks are on the rise globally. The ease and speed of population movements, rapid urbanization and a resurgence of mosquitoes because of global warming have significantly increased the risk of urban outbreaks with international spread.

"Yellow fever has re-emerged as a public health threat in recent years in the African region," said Dr. Ibrahima Soce Fall, WHO's Emergencies Director for Africa. "However, the vaccine is safe and provides life-long immunity. This reactive vaccination campaign is focusing on people who are most at risk and will set up a firewall which will prevent the virus from spreading further."

The neighbouring Democratic Republic of the Congo has shown solidarity with the Republic of Congo by lending more than 700 000 syringes for the vaccination campaign while Pointe Noire health authorities wait for syringes to arrive from the international stockpile next month [October 2018].

The response to this outbreak is part of a comprehensive strategy to eliminate yellow fever epidemics (EYE) globally by 2026. WHO, UNICEF, Gavi, and more than 50 partners are supporting the Government of Congo and 39 other high-risk countries to assess epidemic risk, roll out vaccination campaigns, engage with communities and deliver other response activities, including surveillance and laboratory diagnosis.

Nationwide preventive actions are also needed to ensure the protection of the entire population at risk. Rapid outbreak detection and response and long-term prevention are integral to a sustained control of yellow fever. As part of the EYE Strategy, more than 4 million additional people are expected to be vaccinated in preventive mass campaigns in the Republic of Congo over the few next years.
=====================
[It is encouraging to see that components of a large yellow fever (YF) vaccination campaign have come together to start the effort 2 days ago [26 Sep 2018]. Although there is only one confirmed YF case, considering the 200 suspected cases and the risk of rapid YF virus spread in Pointe Noir, a city with a dense and susceptible human population and abundant mosquito vectors, the vaccination campaign is prudent. A recent report indicated that entomological surveys in the affected area have revealed high densities of mosquito vectors (_Aedes aegypti_) responsible for urban YF transmission, signaling the potential for human-to-human transmission via _Aedes aegypti_ and rapid amplification. Larval sites have been found around the homes of suspected cases, and this situation could worsen with the arrival of the rainy season. WHO is supporting the Ministry of Health and Population in implementing targeted vector control activities for adult mosquitoes and larvae within a 200-metre [660-foot] perimeter of areas where the confirmed case-patient lives and works. YF outbreaks under conditions like these can spread rapidly and get out of control, as occurred in Angola with spillover into the Democratic Republic of the Congo. - ProMED Mod.TY]

[HealthMap/ProMED map available at:
Republic of Congo: <http://healthmap.org/promed/p/166>]
Date: Tue 25 Sep 2018
Source: Africa News [edited]
<http://www.africanews.com/2018/09/25/congo-to-launch-immunization-against-yellow-fever-outbreak-the-morning-call/>

On Thursday [27 Sep 2018], the government of the Republic of Congo will begin what it calls a robust and coordinated response against the yellow fever outbreak recorded in some parts of the country. The planned response follows the health ministry's warning last month [August 2018] of "an emerging event of epidemic proportions." According to the head of the government's epidemics unit, Lambert Kitembo, 186 suspected cases of yellow fever have been detected this year [2018], many of which were reported in the western commercial hub of Pointe Noire. [Byline: Jerry Bambi]
===================
[The numbers of reported yellow fever cases in the Republic of the Congo (RC) is growing, especially in the Pointe-Noire area. Pointe-Noire is a port city and oil industry hub with an international airport and links to other large cities. A previous report indicated that a retrospective search in 16 health centre registers in Pointe-Noire found 69 additional suspected cases during 2018 that meet the clinical case definition for yellow fever; 56 of the suspected cases were already recorded in the national surveillance system. Of these, 2 of the suspected cases reported staying in Angola.

The above report indicates that there are now 186 suspected cases. A recent WHO risk assessment reported that the overall public health risk at the national level is high due to the confirmation of a yellow fever case in the densely populated urban city of Pointe Noire (‎1.2 million inhabitants), with suboptimal immunization coverage in the affected community and the potential risk of spread within the Congo, especially to the capital city of Brazzaville.

The Ministry of Health and Population (MoHP) declared a yellow fever outbreak in Pointe Noire on 22 Aug 2018, and the national committee for outbreak management was promptly activated. WHO was notified on 23 Aug 2018, in line with the International Health Regulations (IHR 2005). A recent report indicated that entomological surveys in the affected area have revealed high densities of mosquito vectors (_Aedes aegypti_) responsible for urban yellow fever transmission, signalling the potential for human-to-human transmission and rapid amplification. Larval sites have been found around the homes of suspected cases, and this situation could worsen with the arrival of the rainy season.

WHO is supporting the MoHP in implementing targeted vector control activities for adult mosquitoes and larvae within a 200-metre [660 foot] perimeter of areas where the confirmed case-patient lives and works. It is difficult to assess the risk of an ongoing outbreak without knowing the proportion of the unvaccinated population in the areas where the cases occurred. One hopes that the planned vigorous vaccination campaign will be initiated as planned this week. Yellow fever outbreaks can quickly get out of hand, as occurred in Angola and the DRC in 2016-2017.

Frequent movement of individuals across borders of neighbouring countries and beyond underscores the need for prompt action to prevent spread. - ProMED Mod.TY]

[HealthMap/ProMED map available at: Republic of Congo: <http://healthmap.org/promed/p/166>]
Disease outbreak news
7 September 2018

Event Description
On 5 July 2018, a 20-year-old male living in Bissongo, Republic of the Congo, visited Bissongo health centre in the Loandjili District of Pointe-Noire City, with a fever he had developed the previous day. On 9 July, due to the onset of jaundice and persistent fever, he returned to the same health facility. The patient did not have a history of yellow fever vaccination or haemorrhagic symptoms. The patient had previously travelled to Ngoyo and Tchiamba Nzassi districts two weeks prior to symptom onset; Tchiamba Nzassi is a rural district in Pointe-Noire located along the border with Angola.

He was admitted to the health facility and received antimalarial and antibiotic treatments. As yellow fever was also suspected as a differential diagnosis, a blood sample was collected on 10 July and sent to Institut National de Recherche Biomédicale (INRB) in Kinshasa, Democratic Republic of the Congo, for testing; on 26 July, the sample tested positive for yellow fever by serology. On 30 July, INRB sent a sample to Institut Pasteur de Dakar for confirmation; on 21 August, the sample tested positive for yellow fever by seroneutralization with a high titre.

Following the confirmation of yellow fever, an investigation was conducted in the affected area. A retrospective search in 16 health centre registers in Pointe-Noire found 69 additional suspected cases during 2018 which meet the clinical case definition for yellow fever; 56 of the suspected cases were already recorded in the national surveillance system. Two of the suspected cases reported staying in Angola. Samples were collected from 43 of these cases and sent to INRB; all samples tested negative for yellow fever. Entomological surveys in the affected area have revealed high densities of mosquito vectors (Aedes aegypti) responsible for urban yellow fever transmission, signalling the potential for human-to-human transmission and rapid amplification. Larval sites have been found around the homes of suspected cases, and this situation could worsen with the arrival of the rainy season.

Public health response

The Ministry of Health and Population (MoHP) declared a yellow fever outbreak in Pointe-Noire on 22 August 2018 and the national committee for outbreak management was promptly activated. WHO was notified on 23 August 2018 in line with the International Health Regulations (IHR 2005).

WHO is supporting the country in the preparation of an emergency response plan and an International Coordinating Group (ICG) request for supplies for a reactive mass vaccination campaign targeting the Pointe-Noire area, which has a population of approximately one million people. WHO is also supporting resource mobilization activities, as the country is not eligible for Gavi support.

WHO is supporting the MoHP in implementing targeted vector control activities for adult mosquitoes and larvae within a 200-metre perimeter of areas where the confirmed case-patient lives and works. WHO is also providing technical support to strengthen surveillance at points of entry, case management, and public awareness, as well as recommending the use of mosquito nets during the day time.

WHO risk assessment

The overall public health risk at the national level is high due to the confirmation of a yellow fever case in a densely populated urban city of Pointe-Noire (‎1.2 million inhabitants), with suboptimal immunization coverage in the affected community and the potential risk of spread within the Congo, especially to the capital city of Brazzaville. Entomological surveys in the affected area revealed high densities of Aedes aegypti, responsible for urban transmission of yellow fever, signalling the potential for rapid amplification. The approaching rainy season may potentially increase this risk. Thus, the risk of an urban epidemic needs to be mitigated urgently, although there is no indication of active urban transmission according to the information available.

The risk at the regional level is considered to be moderate due to the lack of information to describe the scope and the dynamics of the outbreak, as well as because of cross-border movements, particularly between to and from Gabon and Cabinda in Angola. Pointe-Noire is a port city and oil industry hub with an international airport and links to other large cities. Angola and the Democratic Republic of the Congo have recently conducted mass preventive and reactive yellow fever vaccination campaigns, respectively. However, population immunity levels in the Democratic Republic of the Congo are low in the zones not targeted by the 2016 reactive campaigns, such as the areas neighbouring Pointe-Noire. No other yellow fever cases related to the outbreak in Pointe-Noire have been reported outside the country at this stage.

The risk at the global level is considered low. Risks need to be closely monitored and regularly reassessed.

WHO Recommendations

Vaccination is the primary means for prevention and control of yellow fever. In urban centres, targeted vector control measures are also helpful to interrupt transmission. WHO and partners will continue to support local authorities to implement these interventions to control the current outbreak.

WHO recommends vaccination against yellow fever for all international travellers above nine months of age going to the Republic of the Congo, as there is evidence of yellow fever virus transmission. The Republic of the Congo also requires a yellow fever vaccination certificate for all travellers aged 9 months or older . Yellow fever vaccination is safe, highly effective and provides life-long protection. In accordance with the IHR (2005), the validity of the international certificate of vaccination against yellow fever extends to the life of the person vaccinated. A booster dose of yellow fever vaccine cannot be required of international travellers as a condition of entry.

WHO encourages its Member States to take all actions necessary to keep travellers well informed of risks and preventive measures including vaccination. Travellers should also be made aware of yellow fever symptoms and signs and instructed to rapidly seek medical advice when presenting with these. Viraemic returning travellers may pose a risk for the establishment of local cycles of yellow fever transmission in areas where the competent vector is present.

WHO advises against the application of any restrictions on travel or trade to the Republic of the Congo in relation to this outbreak, based on the information currently available.
Date: Fri 31 Aug 2018
Source: Business Insider [edited]

Congo Republic will launch a country-wide vaccination campaign to control an outbreak of yellow fever near the border with the Angolan enclave of Cabinda, the health ministry said on Friday [31 Aug 2018].

Earlier this week, the authorities said over 180 suspected cases and one confirmed case of the sometimes deadly mosquito-borne virus had been identified this year [2018], many in the western commercial hub of Pointe Noire.

"Congo (Republic) declared a yellow fever epidemic at Pointe Noire on 24 Aug [2018]," the ministry said in a statement.

In response, it said: "The Health and Population Ministry will organize, in collaboration with partners, a national vaccination campaign." It did not specify when the campaign would begin. The vaccinations will be free of charge. Only children under 9 months, pregnant women and mothers breastfeeding infants under 6 months will not be vaccinated, the statement added.

No deaths have yet been reported in the outbreak.

The disease causes fever, body aches and nausea and can quickly spread in areas with large unvaccinated populations.

A major outbreak in 2016 in Angola and Democratic Republic of Congo killed more than 400 people and was believed to have infected thousands more before it was brought under control through an extensive vaccination campaign.  [Byline: Alessandra Prentice]
======================
[The case numbers and locations are essentially the same as reported in the earlier ProMED-mail post, with no increase in the numbers of suspected cases. A country-wide vaccination campaign is planned in response to these cases. As noted in previous posts, this outbreak is fairly widely distributed geographically across 5 health districts. The dates on which these suspected cases were diagnosed are not given, so we do not have a picture of the timeframe of this outbreak. None of these cases resulted in deaths.

It is difficult to assess the risk of an ongoing outbreak without knowing the proportion of the unvaccinated population in the areas where the cases occurred. One hopes that the planned vigorous vaccination campaign will be initiated as soon as possible. Yellow fever outbreaks can quickly get out of hand, as occurred in Angola and the Democratic Republic of the Congo in 2016-2017. - ProMED Mod.TY]

[HealthMap/ProMED map available at:
Republic of Congo: <http://healthmap.org/promed/p/166>]
Date: Tue 28 Aug 2018
Source: Reuters [edited]

Congo Republic has confirmed a case of yellow fever near the border with an Angolan enclave, the health ministry said on Tuesday [28 Aug 2018], and has warned of "an emerging event of epidemic proportions."

In all, 186 suspected cases have been detected this year [2018], many of which were in the western commercial hub of Pointe Noire, the head of the government's epidemics unit, Lambert Kitembo told Reuters.

He said 8 blood samples were sent to Democratic Republic of Congo (DRC) for testing last month [July 2018], one of which came back positive. It was then officially confirmed last week at a laboratory in Senegal.

The sometimes deadly mosquito-borne virus causes fever, body aches and nausea and can quickly spread in areas with large unvaccinated populations.

A major outbreak in 2016 in Angola and the DRC killed more than 400 people and was believed to have infected thousands more before it was brought under control through an extensive vaccination campaign.

The confirmed victim in the case of yellow fever in Congo Republic had traveled in Tchiamba Nzassi district, which lies along the border with the Angolan enclave of Cabinda, 2 weeks prior to the onset of his symptoms, the World Health Organization (WHO) said in a weekly report.

No deaths have been reported, but the situation is being taken seriously by health officials, Kitembo said. He did not say whether authorities had plans to test other blood samples.

"Congo, in general, and the departments of Pointe Noire and Koulou in particular are experiencing since the start of 2018 an emerging event of epidemic proportions," the health ministry said in a statement dated last week.

The WHO said that the confirmed case was detected early last month [July 2018] at a health centre in Pointe Noire, where the patient with fever and jaundice was admitted for treatment.
======================
[The number of suspected cases has gone up from 70 yesterday [27 Aug 2018] to 186 mentioned above. There is now one laboratory confirmation. As noted in the previous post, this outbreak is fairly widely distributed geographically across 5 health districts. The dates on which these suspected cases were diagnosed are not given, so we do not have a picture of the time frame of this outbreak. None of these cases resulted in deaths.

It is difficult to assess the risk of an ongoing outbreak without knowing the proportion of the unvaccinated population in the areas where the cases occurred. One hopes that a vigorous vaccination campaign will be initiated as soon as possible. Yellow fever outbreaks can quickly get out of hand, as occurred in Angola and the Democratic Republic of the Congo in 2016-2017. - ProMED Mod.TY]

[HealthMap/ProMED map available at:
Republic of Congo: <http://healthmap.org/promed/p/166>]
More ...

Luxembourg

Luxembourg - US Consular Information Sheet
October 03, 2008
COUNTRY DESCRIPTION:
Luxembourg is a highly developed, stable constitutional monarchy and parliamentary democracy. Tourist facilities are widely available.
Read the Departmen
of State Background Notes on Luxembourg for additional information.

ENTRY/EXIT REQUIREMENTS: A passport is required. Luxembourg is a party to the Schengen agreement. As such, U.S. citizens may enter Luxembourg for up to 90 days for tourist or business purposes without a visa. The passport should be valid for at least three months beyond the period of stay. Sufficient funds and a return airline ticket are required. For further details about travel into and within Schengen countries, please see our fact sheet. No immunization is necessary. For further information concerning entry requirements for Luxembourg, travelers may contact the Embassy of Luxembourg at 2200 Massachusetts Avenue NW, Washington, DC 20008, phone: (202) 265-4171 or 4172, or the Luxembourg Consulate General in New York, phone: (212) 888-6664 or in San Francisco, phone: (415) 788-0816. Visit the Embassy of Luxembourg web site at http://www.luxembourg-usa.org for the most current visa information.

Find more information about Entry and Exit Requirements pertaining to dual nationality and the prevention of international child abduction. Please refer to our Customs Information to learn more about customs regulations.

SAFETY AND SECURITY:
Terrorist incidents are rare in Luxembourg. However, like other countries in the Schengen area, Luxembourg’s open borders with its Western European neighbors could allow the possibility of terrorist groups to enter/exit the country unnoticed.

Prior police approval is required for public demonstrations in Luxembourg, and police oversight is routinely provided to ensure adequate security for participants and passers-by. Nonetheless, situations may develop which could pose a threat to public safety. U.S. citizens are advised to avoid areas where public demonstrations are taking place.

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

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

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

CRIME: The crime rate in Luxembourg is moderate compared to other European countries. The predominant form of crime in Luxembourg is non-violent theft of valuables through the snatching of purses/bags or more sophisticated breaking and entering of unoccupied homes. Travelers should take common-sense precautions while in Luxembourg. In particular, travelers should be especially cautious in public areas, the airport and train terminals, where pickpockets can be a problem. Luxembourg has many public parks that are safe during the daylight hours, though the volume of low-level drug vending has increased in some of the city parks. Tourists should avoid these parks after dark due to the higher risk at night. During the summer season, Americans should be particularly alert to purse snatchings and confidence scams against tourists. Incidents of petty crime spike during the annual “Schueberfoire”, a traveling fun fair that visits the country every year for 3 weeks in the summer.

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 in finding appropriate medical care, contacting family members or friends and explaining 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. Luxembourg judicial authorities provide information, legal advice and psychological counseling at no charge to victims of crime (adults and children). Address: Service d’aide aux victimes, Parquet General, Galerie Kons, 24-26, place de la Gare, L-1616 Luxembourg. Phone: (352) 475821, extension 625, 627 or 628 Monday-Friday 8am-12pm and 2pm-6pm, in an emergency call (352) 621326595 Monday-Friday 8am-7pm.

The local equivalent to the “911” emergency line in Luxembourg is: 113
See our information on Victims of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION: Medical facilities are widely available. In an emergency, dial 112 for an ambulance or in case of fire; dial 113 for the police. Hospitals in Luxembourg operate on a 24-hour rotation system. The on-call emergency room can be determined by calling 112. Patients may self-refer to any clinic Monday-Friday between 8am-5pm. In Luxembourg City, three major hospitals offer comprehensive general medical and surgical treatment, as well as specialized care in orthopedics, cardiology and psychiatry. In addition, there are two pediatric clinics and two obstetric clinics in Luxembourg City. Hospitals also exist in the south of the country (Esch-sur-Alzette) and in the north (Wiltz). For more specialized care, including major burns, transfer to a regional burn center in Belgium or France is necessary.

Most drugstores are located in the city of Luxembourg but can also be found throughout the country in all major communes. Drugstores operate on a 24-hour rotation system for after-hours services, including emergency prescriptions. The on-call pharmacy is listed daily in the local newspaper or can be determined by calling 112. A doctor's prescription is sometimes necessary for drugs that are sold over the counter in the United States.

The U.S. Department of State is unaware of any HIV/AIDS entry restrictions for visitors to or foreign residents of Luxembourg.
Information on vaccinations and other health precautions, such as safe food and water precautions and insect bite protection, may be obtained from the Centers for Disease Control and Prevention’s hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747) or via the CDC’s web site at http://wwwn.cdc.gov/travel/default.aspx. For information about outbreaks of infectious diseases abroad consult the World Health Organization’s (WHO) web site at http://www.who.int/en. Further health information for travelers is available at http://www.who.int/ith/en/
MEDICAL INSURANCE: The Department of State strongly urges Americans to consult with their medical insurance company prior to traveling abroad to confirm whether their policy applies overseas and whether it will cover emergency expenses such as a medical evacuation. Please see our information on medical insurance overseas.

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

Luxembourg has a modern, well-maintained system of highways and secondary roads. Road signs and markings are clear and, as applicable, worded in French. Streets in the city, construction sites and crossroads are well illuminated at night. On highways, a digital alert system warns drivers of incidents or detours. Roads towards and out of Luxembourg City are congested during the morning and evening rush hour. Visitors should drive defensively in high-volume commuter traffic. During the fall and winter, fog and ice can cause sudden slowdowns on highways and secondary roads.

In case of a car accident involving injury or dispute, it is advisable for a foreigner to call the police at 113. The police will make an official assessment of the accident’s circumstances that can consequently be used if further legal action becomes necessary.

The daily mix of drivers from Luxembourg and its three neighboring countries results in a variety of driving practices and courtesies. While most drivers respect speed limits, traffic signals, and rules, others do not. Vehicle maintenance for cars registered in Luxembourg is controlled by the mandatory yearly car inspection; police can perform random road checks at any time. The possibility of encountering an intoxicated driver increases on weekends, especially during the late evening hours. Driving while intoxicated may result in penalties including imprisonment from 8 days up to two years plus a fine of 251 to 5000 Euros (approximately US$300 to US$6,000).

Public transportation throughout the country, including bus services and taxis, is highly developed and is considered very safe.

Emergency road services in Luxembourg are excellent. For breakdown and towing service call the ACL (Automobile Club Luxembourg) at 26000, www.acl.lu. In case of an accident, call 112 for a medical emergency and 113 for the police.

Please refer to our Road Safety page for more information. Visit the web site of Luxembourg’s national tourist office at www.ont.lu and national authority responsible for road safety at www.police.public.lu
AVIATION SAFETY OVERSIGHT: The U.S. Federal Aviation Administration (FAA) has assessed the Government ofLuxembourg’s Civil Aviation Authorityas being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for oversight of Luxembourg’s air carrier operations. For more information, travelers may visit the FAA’s web site at http://www.faa.gov/safety/programs_initiatives/oversight/iasa.

SPECIAL CIRCUMSTANCES: Luxembourgcustoms authorities may enforce strict regulations concerning temporary importation into or export from Luxembourg of items such as live animals, plants, endangered species, medication (except for personal use), firearms and ammunition, cultural artifacts, alcoholic beverages and tobacco products. It is advisable to contact the Embassy of Luxembourg in Washington or one of Luxembourg’s consulates in the United States for specific information regarding customs requirements. The amount of imported currency is not limited. The euro is the official currency in Luxembourg. Please see our information on customs regulations.

Luxembourg does not yet allow dual nationality. When obtaining Luxembourg nationality either through option or naturalization, the former nationality must be renounced.

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 Luxembourg’s laws, even unknowingly, may be expelled, arrested or imprisoned. Penalties for possession, use, or trafficking in illegal drugs in Luxembourg 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.

REGISTRATION / EMBASSY LOCATION:
Americans living or traveling in Luxembourg are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department’s travel registration web site, https://travelregistration.state.gov, and to obtain updated information on travel and security within Luxembourg. Americans withoutInternet access may register directly with the nearest U.S. Embassy or Consulate. By registering, American citizens make it easier for the Embassy or Consulate to contact them in case of emergency. The U.S. Embassy is located at 22, Blvd Emmanuel Servais, L-2535 Luxembourg City, phone: (352) 46 01 23 (available 24/7), fax: (352) 46 14 01. Consular Section phone: (352) 46 01 23 -22 13, Consular Section fax: (352) 46 19 39, email: LuxembourgConsular@state.gov.

The U.S. Embassy’s web page is http://luxembourg.usembassy.gov
* * *
This replaces the Consular Information Sheet dated March 17, 2008 to update the sections on Entry/Exit Requirements, Safety and Security, Crime, and Medical Facilities and Health Information.

Travel News Headlines WORLD NEWS

Date: 28 May 2018
Source: Food Navigator [edited]
<https://www.foodnavigator.com/Article/2018/05/28/Tuna-linked-to-foodborne-outbreak-in-Luxembourg>

Five people were sickened in Luxembourg last month [April 2018] by sashimi tuna fillets from the Netherlands, with raw material from Sri Lanka. Cactus, a supermarket in the country, recalled 2 tuna products and informed authorities following the suspicion of histamine. L'Administration des Services Vatarinaires (ASV) told us that initially 2 people fell sick, and investigations revealed 3 more illnesses.

The link was made as all people with symptoms had eaten tuna from the same Cactus store. High levels of histamine in fish may cause an allergic reaction after consumption. In the product, histamine can be detected and quantified by laboratory analysis, and in people, it is mainly based on symptoms.

ASV said such poisoning is rare but sporadic and unpredictable, which makes it difficult to exclude future outbreaks. Filet de Thon sashimi and brochettes de poisson mixte nature et marinées were sold in bulk or packaged trays between 12 and 14 Apr 2018 with expiry dates of 14, 15 or 16 Apr 2018. Products were distributed in Luxembourg in Cactus stores. ASV analysed some of the remaining tuna from the same batch sold in the store that customers complained about and from another Cactus store from the same lot, and analyses were mostly compliant. The agency said the presence of histamine was not due to poor quality, but concentration at high levels was limited to a specific location of the tuna. It added that previous analysis on the supplier confirmed the compliance of tuna delivered to Cactus.

There is no connection between the Luxembourg outbreak and the EU investigation involving 11 countries of tuna intended for canning being sold as fresh. Europol, Interpol, and the EU Food Fraud Network discovered that Spain, Italy, France, Germany, Portugal, Netherlands, UK, Hungary, Liechtenstein, Norway, and Switzerland were involved. More than 51 tons of tuna was seized.

Tuna for canning was illegally treated with vegetable extracts containing a high concentration of nitrites to alter colour and to give the impression of freshness. This can represent a risk to health, as modification of colour can mask spoilage, allowing development of biological amines (histamine) responsible for scombroid syndrome. In 2017, more than 150 people in Spain were affected after consuming illegally treated tuna. Spain and France are continuing to investigate tuna destined for canning and sold as fresh and the illegal use of additives. [Byline: Joseph James Whitworth]
========================
[There seem to be 2 situations at play here. One is the scromboid poisoning from tuna, the 2nd is a high concentrations of nitrates, possibly masking spoilage allowing the development of biological amines (histamine) responsible for scrombroid syndrome. While these appear to be 2 situations, the result is the same: scrombroid syndrome.

Two good reviews on the subject can be found at:

1. Taylor SL, Stratton JE and Nordlee JA: Histamine poisoning (scombroid fish poisoning): an allergy-like intoxication. J Toxicol Clin Toxicol. 1989;27(4-5):225-40.
Abstract
-------------------------------
"Histamine poisoning results from the consumption of foods, typically certain types of fish and cheeses that contain unusually high levels of histamine. Spoiled fish of the families, Scombridae and Scomberesocidae (e.g. tuna, mackerel, bonito), are commonly implicated in incidents of histamine poisoning, which leads to the common usage of the term, "scombroid fish poisoning", to describe this illness. However, certain non-scombroid fish, most notably mahi-mahi, bluefish, and sardines, when spoiled are also commonly implicated in histamine poisoning.

Also, on rare occasions cheeses, especially Swiss cheese, can be implicated in histamine poisoning. The symptoms of histamine poisoning generally resemble the symptoms encountered with IgE-mediated food allergies. The symptoms include nausea, vomiting, diarrhoea, an oral burning sensation or peppery taste, hives, itching, red rash, and hypotension.

The onset of the symptoms usually occurs within a few minutes after ingestion of the implicated food, and the duration of symptoms ranges from a few hours to 24 h. Antihistamines can be used effectively to treat this intoxication. Histamine is formed in foods by certain bacteria that are able to decarboxylate the amino acid, histidine. However, foods containing unusually high levels of histamine may not appear to be outwardly spoiled.

Foods with histamine concentrations exceeding 50 mg per 100 g of food are generally considered to be hazardous. Histamine formation in fish can be prevented by proper handling and refrigerated storage while the control of histamine formation in cheese seems dependent on insuring that histamine-producing bacteria are not present in significant numbers in the raw milk."

2. Hungerford JM: Scombroid poisoning: a review. Toxicon. 2010;56(2):231-43. doi: 10.1016/j.toxicon.2010.02.006.
Abstract
-----------------------------
"Scombroid poisoning, also called histamine fish poisoning, is an allergy-like form of food poisoning that continues to be a major problem in seafood safety. The exact role of histamine in scombroid poisoning is not straightforward. Deviations from the expected dose-response have led to the advancement of various possible mechanisms of toxicity, none of them proven. Histamine action levels are used in regulation until more is known about the mechanism of scombroid poisoning. Scombroid poisoning and histamine are correlated but complicated. Victims of scombroid poisoning respond well to antihistamines, and chemical analyses of fish implicated in scombroid poisoning generally reveal elevated levels of histamine.

Scombroid poisoning is unique among the seafood toxins since it results from product mishandling rather than contamination from other trophic levels. Inadequate cooling following harvest promotes bacterial histamine production and can result in outbreaks of scombroid poisoning. Fish with high levels of free histidine, the enzyme substrate converted to histamine by bacterial histidine decarboxylase, are those most often implicated in scombroid poisoning. Laboratory methods and screening methods for detecting histamine are available in abundance but need to be compared and validated to harmonize testing.

Successful field testing, including dockside or on-board testing needed to augment HACCP efforts will have to integrate rapid and simplified detection methods with simplified and rapid sampling and extraction. Otherwise, time-consuming sample preparation reduces the impact of gains in detection speed on the overall analysis time." Thanks to my ProMED colleague Mod.LL for portions of this comment. - ProMED Mod.TG]

[HealthMap/ProMED-mail map: Luxembourg: <http://healthmap.org/promed/p/103>]
Date: Mon, 20 Oct 2014 11:14:02 +0200 (METDST)
by Bryan McManus

LUXEMBOURG, Oct 20, 2014 (AFP) - European Union foreign ministers thrashed out measures to help halt Ebola's deadly spread on Monday, as Nigeria -- Africa's most populous country -- was expected to be declared free of the disease.   The meeting in Luxembourg underlined the heightened concern in Europe about the virus.

A Spanish nurse who was the first case of transmission outside Africa has been shown by tests to apparently be finally clear of her Ebola infection.   A civilian EU mission was one of the options being discussed by the EU ministers to aid the worst affected countries of Liberia, Sierra Leone and Guinea, as diplomats talked of a "tipping point" in the crisis, which has claimed more than 4,500 lives so far.   Liberian President Ellen Johnson Sirleaf warned Sunday that a generation of Africans were at risk of "being lost to economic catastrophe" because of the crisis.

The "time for talking or theorising is over," she said in an open letter published by the BBC. "This fight requires a commitment from every nation that has the capacity to help -- whether that is with emergency funds, medical supplies or clinical expertise."   The EU foreign ministers will look closely at current efforts and what more needs to be done, not least in getting more skilled staff on the ground in Africa.

One proposal is to reassure medical workers on the Ebola frontline that they will get the back-up and, crucially, Western-level care if they fall sick with a disease for which there is no vaccine nor marketed cure.  Another priority was to ensure that the scattered cases reported so far in the United States and Europe are quickly contained, to prevent Ebola getting a foothold outside of west Africa.   "This is a serious and significant problem that we should not underestimate. It's not a problem that will stay in one part of the globe," EU foreign affairs chief Catherine Ashton told reporters on the way into the meeting in Luxembourg.

German Foreign Minister Frank-Walter Steinmeier said the bloc should consider setting up "a civilian EU mission" to west Africa, which would serve as a platform for sending medical staff.   Another diplomat said there were plans for three nations to spearhead global aid to the worst-hit countries: the United States for Liberia, Britain for Sierra Leone and France for Guinea.

A global UN appeal for nearly $1 billion (780 billion euros) has so far fallen short, with only $386 million given by governments and agencies, and a further $226 million promised.   "This is a major health crisis. We have only a short time to get on top of it," British Foreign Secretary Philip Hammond said.   "The only way to stop its spread is to make sure people are isolated and treated earlier."

- Spanish nurse tests negative -
The Spanish authorities said Sunday that Teresa Romero, a nurse hospitalised on October 6, had now tested negative but must take a second test before she can be declared free of Ebola.   Romero fell ill after caring for two Ebola patients who died of Ebola at Madrid's Carlos III hospital, in the first known case of transmission outside Africa.   "I am very happy because we can say Teresa beat the disease," Romero's husband Javier Limon said. 

In Nigeria, Africa's most populous nation, authorities are expected to declare the country free of the disease on Monday after 42 days without any new case.   The Nigeria cases sparked huge alarm amid fears the highly contagious Ebola virus would spread quickly in its teeming cities, making the apparent success in containment even more significant.   US President Barack Obama has cautioned about the danger of panic in Western countries following a series of false alarms in America in the wake of two nurses at a Texas hospital falling ill after treating a Liberian patient who died.

France and Belgium have joined the United States, Britain and Canada in screening air passengers from Ebola-hit countries.   For the moment, however, they have no plans to halt flights, fearing it would be counter-productive as travellers would seek other means of going abroad and possibly hide any exposure, making it harder to monitor and control the virus's spread.
Date: Thu 24 Jul 2014
Source: Luxemburger Wort [edited]

A pesto pasta salad has been officially blamed for a food poisoning outbreak at a horse-riding event in Roeser [Luxembourg District]. The conclusion was drawn by Luxembourg's Health Ministry following an investigation into the foodborne infection, which spread among people who ate from the buffet of a VIP area at the event from 12 to 13 Jun 2014.

Analysis of the stools of 10 people admitted to emergency services were found to contain _Staphylococcus aureus_ bacteria. The bacterium can grow on food which is not refrigerated and, in sufficient concentrations, causes acute abdominal cramps, vomiting, nausea and diarrhoea in humans. Food hygiene inspections of the caterers who prepared the buffet showed minor deficiencies in procedures for producing and storing food at the event.

Initially, the smoked salmon was blamed for the food poisoning outbreak. But the investigation found that among those who fell ill, 82 per cent reported having eaten the pesto pasta salad. At the time of the investigation, however, no sample of the actual food served was available for testing.
======================
[Classical food poisoning due to _Staphylococcus aureus_ presents with a short incubation period of 4-6 hours as acute nausea and vomiting usually without fever or diarrhoea. The illness generally lasts less than 24 hours.

The following information regarding this entity is extracted from the US Food and Drug Administration's Bad Bug Book at

"In the diagnosis of staphylococcal foodborne illness, proper interviews with the victims and the gathering and analysing of epidemiological data, are essential. Incriminated foods should be collected and examined for staphylococci. The presence of relatively large numbers of enterotoxigenic staphylococci is good circumstantial evidence that the food contains toxin. The most conclusive test is the linking of an illness with a specific food, or, in cases where multiple vehicles exist, the detection of the toxin in the food sample(s).

"In cases where the food may have been treated to kill the staphylococci, as in pasteurization or heating, direct microscopic observation of the food may be an aid in the diagnosis. A number of serological methods for determining the enterotoxigenicity of _S. aureus_ isolated from foods, as well as methods for the separation and detection of toxins in foods, have been developed, and used successfully, to aid in the diagnosis of the illness. Phage typing may also be useful when viable staphylococci can be isolated from the incriminated food, from victims, and from suspected carriers, such as food handlers.

"A toxin dose of less than 1.0 microgram in contaminated food will produce symptoms of staphylococcal intoxication. This toxin level is reached when _S. aureus_ populations exceed 100 000 per gram.

"Foods that are frequently incriminated in staphylococcal food poisoning include meat and meat products; poultry and egg products; salads such as egg, tuna, chicken, potato, and macaroni; bakery products such as cream-filled pastries, cream pies, and chocolate éclairs; sandwich fillings; and milk and dairy products. Foods that require considerable handling during preparation, and that are kept at slightly elevated temperatures after preparation, are frequently involved in staphylococcal food poisoning." - ProMed Mod.LL]

[A HealthMap/ProMED-mail map can be accessed at:
Date: Fri, 8 Feb 2013 19:50:23 +0100 (MET)

CAPELLEN, Luxembourg, Feb 08, 2013 (AFP) - Horsemeat discovered in lasagne meals sold in Britain was of French origin and was falsely labelled beef, according to health authorities in Luxembourg where the dishes were prepared.   Luxembourg company Tavola, which makes the products for the Findus brand, imported the meat from France but it was "fraudulently labelled" as beef, the country's director of veterinary services Felix Wildschutz told AFP.   "It was clearly fraudulently labelled since we sold (Tavola) horsemeat that should have been beef," Wildschutz said.    "We were not able to ascertain the country of origin from the labelling, which should be very precise. It was only marked as originating from the European Community but that is insufficient," he added.   Wildschutz declined to give the name of the supplier but said that Luxembourg had asked French authorities to launch an inquiry.   He said no action had been taken against Tavola, who had blocked "the rest of the incriminating meat" and recalled meals from stores.
Date: Wed 19 Sep 2012
From: Marcella Mori <Marcella.Mori@coda-cerva.be> [edited]

On Mon 20 Aug 2012, the Veterinary and Agrochemical Research Centre in Brussels (CODA-CERVA) was contacted by the official Health Inspectorate (Control of infectious diseases) of the Walloon region to investigate an outbreak of leptospirosis in boys attending a scout camp. The camp was located on the banks of the Semois River, in the province of Luxembourg. 10 out of 25 boys participating developed clinical symptoms. The diagnosis of leptospirosis was confirmed by the microscopic agglutination test (MAT) in the 3 boys that were hospitalized.

Contamination from an infected wildlife reservoir was immediately suspected because boy-scouts deemed to have played with a rat, most probably a muskrat considering the dimensions (information is scarce due to the discomfort of the patients). On site investigations were conducted by CODA-CERVA in association with the environmental unit of the Walloon region to collect water samples and muskrats. Animals were captured from 2 nests in the vicinity of the scout camp.

Pathogenic _Leptospira_ spp. was found in the liver and kidney of these animals and antibodies against _Leptospira_ were demonstrated by MAT in the body fluids. Water samples were negative, which could be explained by the absence of stagnant water. The definitive link between the human infections and the infected animals requires further investigations.

Leptospirosis is a pandemic zoonosis and may affect various species, including domestic animals and humans. The natural hosts are wild animals particularly rats where the pathogenicity is not manifested but whose role is expressed as carriers. Those animals are important determinants for leptospirosis and their control can positively impact the wellness at veterinary and public health levels.

In Belgium, leptospirosis is present in domestic animals (particularly dogs and horses) but it is infrequent in humans. The human cases are the result of direct contact with animal reservoirs or contaminated water sources in Belgium or result from recreational activities in (sub)tropical regions.

Combination of both climate change and increased uncontrolled water sports is certainly playing a role in driving favorable conditions for leptospirosis spreading worldwide. Under beneficial weather conditions the rodent population is growing fast. These premises suggest rodent surveillance programs to complement the control of leptospirosis, particularly in regions with opportunities for water sports and recreation.
-------------------------------
Dr Marcella Mori
Dr David Fretin
Belgian Reference Laboratory for Leptospirosis in animals
CODA-CERVA, Brussels

Dr Sylvia Depoorter
Pediatrics Department in AZ-Sint Jan, Brugge

Dr Marjan Van Esbroeck
Belgian Reference Laboratory for Leptospirosis in humans
Institute of Tropical Medicine, Antwerp

Dr Carole Schirvel
Directeur Generale de la Sante,
Direction Surveillance et Protection de la Sante
Federation Wallonie-Bruxelles
Belgium
================
[ProMED very much appreciates this outbreak report direct from the Belgium authorities. It serves as a warning to people who operate campsites that may be contaminated with bat guano in any country. - ProMed Mod.JW]

[Leptospirosis is a zoonotic spirochetal infection that is distributed throughout the world in warm climates and is transmitted to humans by direct contact of abraded skin or mucous membranes with the urine of infected animals or by contact with wet soil, vegetation, or water that has been contaminated with infected animal urine. These animals are mostly asymptomatic, but chronically infected with one of the several hundred serovars of pathogenic _Leptospira_. Different leptospiral serovars are prevalent in particular geographical regions. In carrier animals with chronic renal infections, leptospiruria persists for long periods or for life. _Leptospira_ bacteria shed in urine may survive in water or moist soil for weeks to months. Many species of wild and domestic animals (including dogs, cattle, swine, and especially rodents) are susceptible to chronic urinary infection with pathogenic leptospira. Outbreaks of leptospirosis frequently follow heavy rainfall, flooding with fresh water, and increasing rodent numbers.

Leptospirosis is an occupational hazard for people who work outdoors or with animals -- for example, farmers, sewer workers, veterinarians, dairy farmers, rice and sugarcane field workers, and military personnel. It is a recreational hazard for those who participate in outdoor water sports such as swimming, rowing, or whitewater rafting in contaminated lakes and rivers.

Because of the relatively nonspecific nature of the clinical presentation of leptospirosis, its diagnosis cannot be made confidently without laboratory confirmation. The United States Centers for Disease Control and Prevention can provide _Leptospira_ Dip-S-Tick (DST) IgM dot-ELISA test kits (PanBio Integrated Diagnostics) to local laboratories for serological testing of suspected leptospirosis cases in support of the response to a disaster. The DST is suitable for in-the-field testing of suspected patients. Confirmatory testing uses the microscopic agglutination test (MAT).

The muskrat, the apparent wildlife reservoir for this leptospirosis outbreak in Belgian boy scouts, is a medium-sized semiaquatic rodent (<http://en.wikipedia.org/wiki/Muskrat>).

Belgium is a federal state with 3 regions: the Brussels-Capital Region, the Dutch-speaking region of Flanders in the north, and the landlocked French-speaking region of Wallonia in the south (for a map showing these 3 regions of Belgium, see <http://ssy.org.uk/wp-content/uploads/2010/04/belgium.gif>.) Wallonia consists of the provinces of Walloon Brabant, Hainaut, Liege, Luxembourg, and Namur (<http://www.yurtdisiegitimim.net/sites/default/files/belgium_regions_map.jpg>). The source of the Semois River, where this leptospirosis outbreak occurred, is in the province of Luxembourg, close to the border with the Grand Duchy of Luxembourg; it flows westerly to France and joins the Meuse River (<http://en.wikipedia.org/wiki/Semois>). For a map of Semois River see <http://en.wikipedia.org/wiki/File:KaartSemois.jpg>.

The HealthMap/ProMED-mail interactive map of Belgium is available at
<http://healthmap.org/r/3wCR>. - ProMed Mod.ML]

[Muskrat photo at:
More ...

Belize

Belize US Consular Information Sheet
November 05, 2008
COUNTRY DESCRIPTION:
Belize is a developing country.
Tourism facilities vary in quality, from a limited number of business class hotels in Belize City and resorts on the cayes to
range of ecotourism lodges and very basic accommodations in the countryside.
Crime is a growing concern. Read the Department of State Background Notes on Belize for additional information.

ENTRY/EXIT REQUIREMENTS :
All U.S. citizens must have a U.S. passport valid for the duration of their visit to Belize.
U.S. citizens do not need visas for tourist visits of up to thirty days, but they must have onward or return air tickets and proof of sufficient funds to maintain themselves while in Belize.
Visitors for purposes other than tourism, or who wish to stay longer than 30 days, must obtain visas from the government of Belize.
All tourists and non-Belizean nationalities are required to pay an exit fee of U.S. $35 (payable in U.S. dollars only) when leaving Belize. Additional information on entry and customs requirements may be obtained from the Embassy of Belize at 2535 Massachusetts Avenue NW, Washington, DC
20008, Tel. (202) 332-9636 or at their web site:
http://www.embassyofbelize.org.

Information is also available at the Belizean Consular offices in Miami, and Los Angeles, or at the Belizean Mission to the UN in New York.
Visit the Embassy of Belize web site at http://belize.usembassy.gov for the most current visa information.

Information about dual nationality or the prevention of international child abduction can be found on our web site.
For further information about customs regulations, please read our Customs Information sheet.
SAFETY AND SECURITY:
Visitors should exercise caution and good judgment when visiting Belize.
Crime can be a serious problem (see Crime), particularly in Belize City and remote areas.
Road accidents are common (see Traffic Safety and Road Conditions) and traffic fatalities have included Americans.
Public buses and taxis are frequently in poor condition and lack safety equipment.
Medical care is limited and emergency response services such as ambulances or paramedics may be either unavailable or limited in capability or equipment (See Medical Facilities and Health Information).

Boats serving the public, especially water taxis, often do not carry sufficient safety equipment, may carry an excess number of passengers and may sail in inclement weather.
Rental diving equipment may not always be properly maintained or inspected, and some local dive masters fail to consider the skill levels of individual tourists when organizing dives to some of Belize’s more challenging sites. Deaths and serious mishaps have occurred as a result of negligent diving tour operators and the lack of strict enforcement of tour regulations. The Embassy strongly recommends that anyone interested in scuba diving and snorkeling while in Belize check the references, licenses and equipment of tour operators before agreeing to or paying for a tour.
Both tour guides and boat captains are now required to be licensed by the Government of Belize. Safety precautions and emergency response capabilities may not be up to U.S. standards.

Following a fatal accident at the Cave Branch Archeological Park in September 2008, the Belize Tourism Board (BTB) is implementing new regulations, effective and legally enforced beginning October 15, 2008, to improve safety at cave tubing attractions.
Those policies will include an enhanced, mandatory guest-to-guide ratio of eight-to-one for all operating cave tubing tour companies in Belize.
Additional signage will be posted in each cave tubing excursion site, informing participants of park rules and current water conditions and/or warnings.
Mandatory specialty training for each cave tubing guide will continue and include education on new regulations.

Helmets will also be required for each cave tubing participant starting January 1, 2009.
Furthermore, the National Institute of Culture and History (NICH), which manages the Cave Branch Archeological Park, will be installing additional monitoring equipment for cave tubing excursions which measure currents and other factors needing to be taken into considerations to ensure participant safety,

Cave tubing participants are urged to exercise due caution and their own best judgment regarding safety and river conditions at the time of their tour, particularly during the rainy/hurricane season from June 1 through November 30.
Rainfall upstream from tour sites, sometimes miles away, can cause rapid changes in current strength and water level conditions without notice.

The border between Belize and Guatemala is in dispute, but the dispute thus far has not affected travel between the two countries.
There have not been any terrorist activities in Belize.

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

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

The Department of State urges American citizens to take responsibility for their own personal security while traveling overseas.
For general information about appropriate measures travelers can take to protect themselves in an overseas environment, see the Department of State’s pamphlet A Safe Trip Abroad .
CRIME:
The incidence of crime, including violent crimes such as armed robbery, shooting, stabbing, murder, and rape, is on the rise.
The Embassy has noted an increase in recent years in reports of crimes against tourists at resorts and on the roadways and river ways.
The incidence of crimes such as theft, burglary, purse snatching and pick pocketing rises around the winter holidays and spring break.
Several victims who resisted when confronted by criminals have received serious personal injuries, including gunshot wounds.
Although the majority of reported incidents are in Belize City, crime occurs in all districts including tourist spots such as San Pedro, Caye Caulker, and Placencia.

Sexual harassment and/or assault of females traveling alone or in small groups have occurred this past year.
Several American travelers have been the victims of sexual assaults in recent years. One of these occurred after the victim accepted a lift from an acquaintance, while others have occurred during armed robberies in resort areas.
One of these assaults has resulted in the death of the victim.

The Embassy recommends that visitors travel in groups and only in daylight hours, stay off the streets after dark, in urban and rural areas, and avoid wearing jewelry, or carrying valuable or expensive items.
As a general rule, valuables should not be left unattended, including in hotel rooms and on the beach.
Care should be taken when carrying high value items such as cameras, or when wearing expensive jewelry on the street.
Women’s handbags should be zipped and held close to the body.
Men should carry wallets in their front pants pocket.
Large amounts of cash should always be handled discreetly.

If traveling by taxi, use only vehicles with green license plates, do not get in a taxi that is occupied by more than the driver, and do not let the driver pick up additional fares.

Armed robberies of American tourist groups occurred during the summer of 2006 in the Mountain Pine Ridge and Caracol regions of the western district of Belize.
Due to increased police patrols, coordinated tours among resort security managers, and the arrest of two of the "highway bandits," there have not been any additional robberies since June, 2006. In the past, criminals have targeted popular Mayan archeological sites in that region.
Visitors should travel in groups and should stick to the main plazas and tourist sites.
Although there are armed guards posted at some of the archeological sites, armed criminals have been known to prey on persons walking from one site to another.
Victims who resist when confronted by these armed assailants frequently suffer personal injury.

Travel on rural roads, especially at night, increases the risk of encountering criminal activities.
Widespread narcotics and alien smuggling activities can make remote areas especially dangerous.
Though there is no evidence that Americans in particular are targeted, criminals look for every opportunity to attack, so all travelers should be vigilant.

Rather than traveling alone, use a reputable tour organization.
It is best to stay in groups, travel in a caravan consisting of two or more vehicles, and stay on the main roads.
Ensure that someone not traveling with you is aware of your itinerary.
Travelers should resist the temptation to stay in budget hotels, which are generally more susceptible to crime, and stay in the main tourist destinations.
Do not explore back roads or isolated paths near tourist sites.
And remember always to pay close attention to your surroundings.

Americans visiting the Belize-Guatemala border area should consider carefully their security situation and should travel only during daylight hours. Vehicles should be in good operating condition, adequately fueled, and carry communications equipment.
Persons traveling into Guatemala from Belize should check the Country Specific Information for Guatemala and the U.S. Embassy web site at http://guatemala.usembassy.gov for the latest information about crime and security in Guatemala.

A lack of resources and training impedes the ability of the police to investigate crimes effectively and to apprehend serious offenders. As a result, a number of crimes against Americans in Belize remain unresolved.
Nonetheless, victims of crime should report immediately to the police all incidents of assault, robbery, theft or other crimes as well as notifying the U.S. Embassy in Belmopan, telephone 822-4011(after hours and weekends 610-5030).
Tourists may contact the Belizean tourist police unit in addition to the main police office for assistance.

In addition to reporting crimes to local police, American citizens should report all criminal incidents to the U.S. Embassy in Belmopan, telephone 822-4011 (after hours and weekends 610-5030).
The embassy staff can assist an American with finding appropriate medical care, contacting family members or friends, and having funds transferred, as well as in determining whether any assistance is available from the victim’s home state.
Although the investigation and prosecution of the crime is solely the responsibility of local authorities, consular officers can help explain the local criminal justice process and assist in finding an attorney if needed.

Drug use is common in some tourist areas.
American citizens should avoid buying, selling, holding, or taking illegal drugs under any circumstances.
Penalties for possession of drugs or drug paraphernalia are generally more severe than in the U.S.

In many countries around the world, counterfeit and pirated goods are widely available.
Transactions involving such products may be illegal under local law.
In addition, bringing them back to the United States may result in forfeitures and/or fines.
More information on this serious problem is available at http://www.cybercrime.gov.

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 care for minor conditions is generally available in urban areas.
Trauma or advanced medical care is limited even in Belize City; it is extremely limited or unavailable in rural areas.
Serious injuries or illnesses often necessitate evacuation to another country.
The Government of Belize reported an outbreak of dengue fever in April, May and June of 2005.

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

MEDICAL INSURANCE:
The Department of State strongly urges Americans to consult with their medical insurance company prior to traveling abroad to confirm whether their policy applies overseas and whether it will cover emergency expenses such as a medical evacuation.
Please see our information on medical insurance overseas .
TRAFFIC SAFETY AND ROAD CONDITIONS:
While in a foreign country, U.S. citizens may encounter road conditions that differ significantly from those in the United States.
The information below concerning Belize is provided for general reference only, and may not be totally accurate in a particular location or circumstance.

Valid U.S. driver's licenses and international driving permits are accepted in Belize for a period of three months after entry.
Driving is on the right-hand side of the road.
Buses and private vehicles are the main mode of transportation in Belize; no trains operate in the country.
Roadside assistance can be difficult to summon, as there are very few public telephones along the road and emergency telephone numbers do not always function properly.
The Belizean Department of Transportation is responsible for road safety.

Roads in Belize vary from two-lane paved roads to dirt tracks.
The few paved roads are high-crowned roads, which can contribute to cars overturning, and have few markings or reflectors.
Even in urban areas, few streets have lane markings, leading many motorists to create as many lanes as possible in any given stretch of street or road.
Bridges on the major highways are often only single lanes.
The Manatee Road, leading from the Western Highway to Dangriga, is unpaved, easily flooded after storms and without services.
The Southern Highway from Dangriga to Punta Gorda is mostly completed and in good condition, except for a short portion that is under construction.
Service stations are plentiful along the major roads, although there are some significant gaps in the rural areas.

During Tropical Storm Alma/Arthur in May-June 2008, the Southern Highway bridge over the Sittee River, north of Kendall, Stann Creek District, was destroyed.
In the interim, a temporary causeway has been constructed pending permanent replacement of the Kendall bridge but at times the causeway may not be passable due to conditions on the Sittee River.
The causeway itself has had to be replaced several times following major rainfall and flooding.

Poor road and/or vehicle maintenance causes many fatal accidents on Belizean roads.
Speed limits are 55 miles per hour on most highways and 25 miles per hour on most other roads, but they are seldom obeyed or even posted.
Many vehicles on the road do not have functioning safety equipment such as turn signals, flashers, or brake lights.
Seatbelts for drivers and front-seat passengers are mandatory, but child car seats are not required.
Driving while intoxicated is punishable by a fine; if an alcohol-related accident results in a fatality, the driver may face manslaughter charges. Moreover, Americans can and have been imprisoned in Belize for accidents, even where alcohol is not involved.

Unusual local traffic customs include: pulling to the right before making a left turn; passing on the right of someone who is signaling a right-hand turn; stopping in the middle of the road to talk to someone while blocking traffic; carrying passengers, including small children, in the open beds of trucks; and tailgating at high speeds.

Bicycles are numerous and constitute a traffic hazard at all times.
Bicyclists often ride against traffic and do not obey even basic traffic laws such as red lights or stop signs.
Few bicycles have lights at night. It is common to see bicyclists carrying heavy loads or passengers, including balancing small children on their laps or across the handlebars.
The driver of a vehicle that strikes a bicyclist or pedestrian is almost always considered to be at fault, regardless of circumstances.
Americans who have struck cyclists in Belize have faced significant financial penalty or even prison time.

Driving at night is not recommended, due to poor signage and road markings, a tendency not to dim the lights when approaching other vehicles, and drunk driving.
Pedestrians, motorcyclists and bicyclists without lights, reflectors, or reflective clothing also constitute a very serious after-dark hazard.
Local wildlife and cattle also are road hazards in rural areas.
For safety reasons, travelers should not stop to offer assistance to others whose vehicles apparently have broken down.

Please refer to our Road Safety page for more information.

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

SPECIAL CIRCUMSTANCES:
Belize is vulnerable to tropical storms, especially from June 1 until November 30 of each year. General information on weather conditions may be obtained from the National Hurricane Center at http://www.nhc.noaa.gov.

It is not possible to access most U.S. bank accounts through automated teller machines (ATMs) in Belize.
However, travelers can usually obtain cash advances from local banks, Monday through Friday, using major international credit cards.

Special Notice for Dual Nationals:
A person who is a citizen of both the U.S. and Belize is able to enter Belize with only a Belizean passport; such a dual national should be aware, however, that he/she must have a U.S. passport in order to board a flight to the U.S. from Belize, and that average processing time for a passport at the U.S. Embassy in Belize is approximately 10 working days.

Belize customs authorities may enforce strict regulations concerning temporary importation into or export from Belize of firearms.
It is advisable to contact the Embassy of Belize in Washington or one of Belize’s Consulates in the U.S. for specific information regarding customs requirements.
Please see our Customs Information.
CRIMINAL PENALTIES:
While in a foreign country, a U.S. citizen is subject to that country's laws and regulations, which sometimes differ significantly from those in the United States and may not afford the protections available to the individual under U.S. law.
Penalties for breaking the law can be more severe than in the United States for similar offenses.
Persons violating Belize laws, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in Belize 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.
Belize has strict laws making possession of a firearm or ammunition illegal unless a valid permit is obtained.
Penalties for firearms violations are severe.
Please see our information on Criminal Penalties.

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

REGISTRATION / EMBASSY LOCATION:
Americans living or traveling in Belize are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department’s travel registration web site in order to obtain updated information on travel and security within Belize.
Americans withoutInternet access may register directly with the nearest U.S. Embassy or Consulate.
By registering, American citizens make it easier for the Embassy or Consulate to contact them in case of emergency.
The U.S. Embassy is located in the capital city of Belmopan, approximately 50 miles west of Belize City.
The U.S. Embassy is on Floral Park Road, Belmopan, Cayo District, and the telephone number is 822-4011.
The American Citizen Services section fax number is 822-4050.
In the event of an after hours emergency, the embassy duty officer may be reached at 610-5030. The Embassy is open from 8:00 a.m. to 5:00 p.m., Monday through Friday, except for the 12:00 noon to 1:00 p.m. lunch hour, and on U.S. and Belizean holidays.
The Embassy web site is http://belize.usembassy.gov/; the e-mail address is embbelize@state.gov

Travel News Headlines WORLD NEWS

Date: Wed 2 May 2018, 3:30 PM CST.
Source: Breaking Belize News [edited]

Ministry of Health staff from the Western Health Region are currently in Benque Viejo and surrounding areas monitoring a developing situation due to confirmed cases of hepatitis A in Arenal and Benque. According to a statement from the Ministry, there have been 3 confirmed cases in Benque Viejo and 11 suspected cases in Arenal.

Part of the plan includes sensitization of school staff and students about hepatitis A, its transmission and risk factors. Food handlers in Benque and Arenal will also be visited and informed of the risks of hepatitis A and the importance of following established protocols.

The relevant departments in health have been made aware and are working closely with the region to minimize ongoing cases including a sensitization session on the local radio station in Benque.
===================
[No information is given about the age of those affected. In much of the developing world where hepatitis A is quite endemic, the population is almost all seropositive for HAV by the age of 10. I would wonder if the infection was confirmed by a specific IgM anti-HAV antibody. - ProMED Mod.LL]

[HealthMap/ProMED-mail map:
Cayo District, Belize: <http://healthmap.org/promed/p/6149>]
Date: Mon 8 Oct 2017
Source: Outbreak News Today [edited]

The summer of 2017 appears to be "pink eye", or conjunctivitis season in the Americas with a number of countries in Central and South America and the Caribbean reporting increases of the eye infection.

Now joining the Bahamas, Brazil, Costa Rica, Dominica, the Dominican Republic, Guadeloupe, Martinique, Mexico, Panama, Saint Lucia, Saint Martin, Suriname, and the Turks and Caicos Islands is Belize where health officials report an increase in the number of reported conjunctivitis cases, particularly in the northern and central health regions.

The Belize Health Ministry says the symptoms of pink eye include:
- redness in the white of the eye or inner eyelid;
- watery eyes;
- thick yellow discharge that crusts over the eyelashes, especially after sleep; and
- itchy eyes, blurred vision and increased sensitivity to light

They offer the following measures to prevent the spread of this contagious infection:
- wash your hands often with soap and warm water. Wash them especially before and after cleaning, or applying eye drops or ointment to your infected eye;
- avoid touching or rubbing your eyes. This can worsen the condition or spread the infection;
- with clean hands, wash any discharge from around your eye(s) several times a day using a clean wet washcloth. Wash the used washcloth with hot water and soap, and then wash your hands again with soap and warm water;
- wash pillowcases, sheets, washcloths, and towels often with hot water and soap; wash your hands after handling such items;
- do not wear contact lenses until your eye doctor says it's okay to start wearing them again;
- do not share personal items such as pillows, washcloths, towels, eye drops, eye and face makeup, makeup brushes, contact lenses and contact lens containers, or eyeglasses;
- avoid shaking hands with others;
- persons suffering pink eye should stay away from work, school and public places until the infection clears.  [Byline: Robert Herriman]
==================
[Viral conjunctivitis, also called pinkeye, is a common, self-limiting condition that is typically caused by adenovirus. Other viruses that can be responsible for conjunctival infection include herpes simplex virus (HSV), varicella-zoster virus (VZV), picornavirus (enterovirus 70, Coxsackie A24), poxvirus (molluscum contagiosum, vaccinia), and human immunodeficiency virus (HIV) (<http://emedicine.medscape.com/article/1191370-overview>). But bacteria and allergens also can cause conjunctivitis.

There is no known specific treatment for this disease, and containment includes increased attention to hygiene.

According to <https://www.garda.com/crisis24/news-alerts/73151/belize-conjunctivitis-outbreak>, in the [3 weeks leading up to 26 Sep 2017], 1108 cases have been reported [in Belize] in what government officials are calling the worst such outbreak since 2005. Cases have been reported in Belize City, Corozal, Cayo, Chetumal, and Orange Walk, among other places.

See ProMED Conjunctivitis - Americas (10): Panama, Grenada, Mexico http://promedmail.org/post/20170929.5348507 for further discussion regarding the conjunctivitis outbreak in the Americas.

A HealthMap/ProMED-mail map of Belize can be found at
Date: Sat 26 Aug 2017
Source: Amandala [edited]
<http://amandala.com.bz/news/ciguatera-poisoning-linked-turneffe-barracudas/>

Each year, between 10,000 and 50,000 people who live in or visit tropical and subtropical areas suffer from Ciguatera Fish Poisoning (CFP), which is said to be one of the most frequently reported seafood-toxin illness in the world. Ciguatera poisoning, which causes symptoms such as tingling and numbness in fingers and toes, around lips, tongue, mouth and throat; nausea, vomiting, diarrhoea and/or abdominal cramps; joint pains and headache; and breathing difficulty, has also been reported in Belize, and over the past 4 days, 2 alerts have been issued by the Ministry of Health in Belize, following reports of cases cropping up, which have been linked to the consumption of barracuda fish. In the 1st alert, issued on [Fri 18 Aug 2017], the Ministry of Health reported that "suspected fish poisoning (Ciguatera poisoning) was detected in people that had eaten fish bought from a fish vendor in Ladyville, Belize District."

In the 2nd alert, issued on [Tue 23 Aug 2017], the Ministry said that 2 further cases of suspected Ciguatera poisoning, linked to the consumption of the large predatory fish, had been identified. "Investigations conducted so far reveal that the barracuda fish from the Turneffe Islands area has been the sole carrier of the ciguaxtoin or poison," the alert said. It warned that toxic fish does not have any odor or taste and cooking and freezing does not eliminate the toxin. According to the US Center for Disease Control and Prevention (CDC), ciguatera fish poisoning (or ciguatera) is an illness caused by eating fish that contain toxins produced by a marine microalgae called _Gambierdiscus toxicus_, associated with corals.

Whereas the barracuda is believed to be the culprit for the most recent bouts of illness caused by the toxin, other fish may also carry the toxin, including coral trout, red snapper, donu, parrot fish, grouper, Spanish mackerel, red emperor, wrasse, reef cod, sturgeon fish, trevally and moray eel. The CDC also lists blackfin snapper, cubera snapper, dog snapper, greater amberjack, hogfish, horse-eye jack, and king mackerel among the fish which have been known to carry ciguatoxins. "Anyone who consumes fish contaminated with the ciguatera toxin will become ill," the Ministry's alert said, adding that, "The gastrointestinal or stomach symptoms normally appear within 24 hours of exposure and those of the nervous system can appear 1 to 2 days later."

Although some symptoms may last only a few days, in some cases, the toxin can continue to affect those who ingest it for months. The CDC says people who have ciguatera may find that cold things feel hot and hot things feel cold. The Belize Ministry of Health has shared some guidelines for reducing the risk of CFP.

It advises the following:
- Avoid eating larger reef fish that have a greater likelihood of carrying ciguatoxins, especially the barracuda.
- Limit the weight of a fish to less than 11 pounds, as ciguatera fish poisoning occurs more frequently in larger fish.
- Eat other types of fish not listed above.
- Avoid eating the head, roe or fish egg, liver, or other organs of the fish, as it is where the highest level of toxin is present. [Byline: Adele Ramos]
=========================
[A recent open access review of ciguatera fish poisoning (CFP) has been published in Marine Drugs: Friedman MA , Fernandez M, Backer LC, et al: An updated review of Ciguatera Fish Poisoning: Clinical, epidemiological, environmental, and public health management. Mar Drugs 2017, 15(3): pii: E72; doi:10.3390/md15030072; available at: <http://www.mdpi.com/1660-3397/15/3/72/htm.

The publication does not say that the intoxication occurs related to fish from European waters. The description of the acute illness with the citations intact (the citations can be found at the original URL) has been extracted below: "CFP is characterized by gastrointestinal, neurological, and cardiovascular symptoms. In addition, after the initial or acute illness, neuropsychological symptoms may be reported.

Clinical features can vary depending on elapsed time since eating the toxic meal, and whether the geographic source of the implicated fish was the Caribbean Sea, Pacific, or Indian Ocean [17,36,52-58]. Gastrointestinal symptoms and signs usually begin within 6-12 hours of fish consumption and resolve spontaneously within 1-4 days.

Gastrointestinal symptoms may include nausea, vomiting, abdominal pain, and diarrhoea. The neurologic symptoms usually present within the 1st 2 days of illness. They often become prominent after the gastrointestinal symptoms (particularly in CFP events from Caribbean fish), although they may present concurrently with gastrointestinal symptoms (K Schrank, written communication, April 2016) [59].

The neurologic symptoms vary among patients and include paresthesias (that is, numbness or tingling) in the hands and feet or oral region, metallic taste, sensation of loose teeth, generalized pruritus (itching), myalgia (muscle pain), arthralgia (joint pain), headache, and dizziness. A distinctive neurologic symptom is cold allodynia, sometimes referred to as "hot-cold reversal," an alteration of temperature perception in which touching cold surfaces produces a burning sensation or a dysesthesia (that is, unpleasant, abnormal sensation) [60]. One study revealed that intra-cutaneous injection of CTX in humans elicited this sensation [61].

Cold allodynia is considered pathognomonic of CFP, although not all patients report experiencing it and it can be seen with other human seafood poisoning syndromes (such as neurotoxic shellfish poisoning). Less commonly, severe central nervous system symptoms, such as coma or hallucinations, have been reported [54,62,63].

Neuropsychological symptoms, which often become apparent in the days or weeks after the initial or acute illness, include subjectively reported cognitive complaints such as confusion, reduced memory, and difficulty concentrating [64-67], depression or irritability [64,65,68], and anxiety [65]. Fatigue or malaise have been reported and may be debilitating [6,62,69,70].

Cardiac symptoms and signs may manifest, generally in the early stage of the illness. When present, they usually occur in combination with gastrointestinal and/or neurologic signs and symptoms [71,72]. Cardiac signs often include hypotension and bradycardia which may necessitate emergency medical care." - ProMED Mod.LL]

[A HealthMap/ProMED-mail map can be accessed at: <http://healthmap.org/promed/p/19>.]
Date: Thu 2 Feb 2017 10:41 AM CST
Source: Breaking Belize News [edited]

Yesterday [1 Feb 2017] the Belize Agricultural Health Authority (BAHA) announced that bovine rabies has been confirmed in 3 districts in Belize: Orange Walk, Cayo, and Toledo.

Bovine rabies is a specific type of rabies that affects cattle; however, it can be transmitted to humans and as a result, farmers are advised by BAHA to vaccinate their livestock as well as sheep, cattle and horses.

Bovine rabies is a fatal disease that can be prevented through vaccination of animals.

Affected animals will show aggressive behavior and may salivate more than normal.

If [bovine] rabies is suspected in your district, please contact BAHA immediately at phone number 822-0818.
===================
[Rabies is a viral infection caused by viruses belonging to the Lyssavirus genus. It is a zoonosis -- an animal disease that can spread to humans -- transmitted through saliva from bites, and even scratches of infected animals.

In Belize, as urban rabies is well controlled, most cases of rabies occur as bovine paralytic rabies transmitted by the vampire bat. Rabies in cattle has been reported in all 6 districts. According to the OIE vaccinating 70 percent of dogs allows rabies to be eradicated from a given endemic area.

Generally in Belize the rabies is of vampire bat origin. Cases of human rabies, including deaths, have been reported in Belize. There, several strains of the rabid virus circulate in the vampire bat, _Desmodus rotundus_.

The hairy-legged vampire bat, _Diphylla ecaudata_, is naturally infected by rabies virus (same variant as one infecting _D. rotundus_), so this vampire species is definitely a source for rabies cases in humans.

This vampire species ranges from Southern Tamaulipas (Mexico) to Colombia, Venezuela, Ecuador, Peru, Bolivia, Belize, and Brazil (except the central Amazon basin); a single vagrant individual has also been reported from Southern Texas, USA. (For a picture go to  <https://naturalhistory.si.edu/mna/images/images/831032911523015.jpg>).

Predators and parasites can be plastic when it comes to selecting their preys/hosts, and this confers to them the ability to adapt to environmental changes, and a phenomenon of special interest for public health, as it is associated with the link between human-driven change and emerging diseases.

Notifications of suspect rabies cases are investigated by BAHA, the MoH and the Ministry of Agriculture (MNRA) at no cost to the animal owner. A history of the animal determines the steps to be taken, I.e., whether it is isolated and kept for observation or euthanatized and the brain sent to the veterinary services laboratory in Panama. The MoH will determine human exposure to the virus. If warranted (bite, scratch, saliva) a post exposure regimen will be initiated which consists of 5 vaccines. Laboratory-confirmed cases in cattle trigger control response which includes vaccination of herd, vaccination of susceptible animals in protection zone and vampire bat control at farm and roosts (caves).

If you believe your animal, regardless of whether it is bovine, dog or other animal has rabies or is acting differently than normal, please call your veterinarian. Remember that thinking a bovine is choking and putting your hand in the mouth to remove the blockage may expose you to rabies.

Portions of this comment were extracted from

[Maps of Belize can be seen at
<http://healthmap.org/promed/p/19>. - ProMED Sr.Tech.Ed.MJ]
Date: Thu, 4 Aug 2016 08:41:33 +0200
By Henry MORALES

Puerto Barrios, Guatemala, Aug 4, 2016 (AFP) - A hurricane packing 130 kilometre (80 mile) per hour winds and heavy rain made landfall in Central America near Belize's capital, where officials warned of likely flooding and damage to homes Thursday.   Hurricane Earl swept in from the Caribbean to strike just south of Belize City, population 60,000, around midnight Wednesday (0600 GMT Thursday), according to the US National Hurricane Center (NHC).

Along the way, it had gathered strength and dumped rain on northern Honduras as it brushed past at sea.     The hurricane's heavy rains "could cause flash floods and mudslides especially over higher terrain," Belize's National Emergency Management Organization said in a bulletin just before it arrived.   "For coastal areas, there is also a risk for flooding, especially in low-lying areas."   Nearby Guatemala, Honduras and southern Mexico also issued alerts. Airports in the area were closed.

- Evacuations -
Earl was expected to weaken as it continued west from Belize City, farther inland, toward northern Guatemala and southeastern Mexico.   The Mexican authorities took no chances, evacuating 300 families living close to a river along the border with Belize in the southeastern state of Quinta Roo for fear of flooding.   More than 750 shelters were readied in the state in preparation for expected high winds and fierce gusts.

Other southern Mexican states likely to be affected were Campeche, Tabasco and Yucatan.   In the northern Guatemala town of Puerto Barrios, a military commander, Colonel Nelson Tun, told AFP that "patrols in vulnerable areas" were being carried out.   "We have identified high areas to where the population can evacuate before possible flooding," he said.

Guatemala in particular is prone to rainy season flooding and mudslides that often prove fatal.   Guatemala's population, at 16 million, is much bigger than the 330,000 in Belize, Central America's only English speaking country.   Guatemala's president, Jimmy Morales, late Wednesday offered Belize humanitarian aid and shelters along the border if needed.   That gesture was significant after months of tensions between the two countries following a shooting death of a Guatemalan boy by a Belizean border patrol in April.

- Category 1 hurricane -
The fifth named tropical storm of the 2016 season, Earl strengthened to a Category 1 hurricane on Wednesday, according to the NHC. Winds initially measured at 120 kilometers per hour picked up just before landfall.   Category 1, the lowest of five grades on the hurricane scale, is described as having dangerous winds of between 119 and 153 kilometers per hour that can rip off roofs, bring down trees and cause extensive damage to power lines.   Belizean public and private sector workers were permitted to go to their homes Wednesday to secure property.   Officials warned that people living on the ground floor "will experience flooding" and some older wooden buildings would likely be destroyed.   The authorities have opened 29 shelters.
More ...

World Travel News Headlines

Date: Tue, 16 Jul 2019 10:44:51 +0200

Zagreb, July 16, 2019 (AFP) - Some 10,000 tourists were evacuated from a popular party beach on a Croatian island after a forest fire erupted early Tuesday, police said.

Police ordered visitors to night clubs on Zrce beach on the northern island of Pag to leave after the blaze erupted in a pine forest at around 1:00 am (2300 GMT Monday), a police statement said.   No one was injured in the fire which was brought under control, the mayor of the nearby town of Novalja, Ante Dabo, told national radio.  The cause was not immediately known.   Three firefighting planes were rushed to the scene to help extinguish the blaze which spread to a local road that had to be closed.

The island of Pag and its Zrce beach are popular with young tourists, notably British, who party there.  Tourism is a pillar of Croatia's economy, with visitors flocking to hundreds of islands and islets along its stunning Adriatic coast.   Last year the country of 4.2 million people welcomed more than 19 million tourists.
Date: Mon, 15 Jul 2019 01:09:24 +0200

Kinshasa, July 14, 2019 (AFP) - The first case of Ebola has been confirmed in Goma, now the biggest city to have been affected by the disease since its outbreak in eastern DR Congo last August, the health ministry said on Sunday.  A sick man had arrived in Goma early Sunday by bus with 18 other passengers and the driver from Butembo, one of the main towns touched by Ebola in Nord-Kivu province.

The man was tested  "and the results of the laboratory test confirmed that he was positive for Ebola," the ministry said in a statement.   It added that his trip began on Friday after "the first symptoms appeared on July 9 (Tuesday)".   "Given that the patient was quickly identified, as well as all the passengers on the bus from Butembo, the risk of the disease spreading in the city of Goma is low," the ministry said.    The passengers and the bus driver will begin getting vaccinations on Monday, it added.

The Ebola outbreak in eastern Democratic Republic of Congo has so far killed 1,655 people and 694 have been cured, according to a health ministry bulletin on Saturday.  And 160,239 people have been vaccinated, it added.  But efforts to tackle the crisis have been hampered both by militia attacks on treatment centres, in which some staff have been killed, and by the hostility of some local people to the medical teams.
Date: Sun, 14 Jul 2019 13:37:24 +0200

Pamplona, Spain, July 14, 2019 (AFP) - Three men were gored Sunday during the eighth and final bull run of Spain's San Fermin festival, bringing to eight the total number of daredevils injured during this year's fiesta.   Among those who were hospitalised this year after being injured by a bull's horns was an American who was wounded in the neck while taking a selfie.    In the last run, two Australians aged 27 and 30 as well as well as a 25-year-old Spaniard from Madrid were gored by the half-tonne fighting bull, "Rabonero", regional health authorities said.

The three men suffered injuries to the armpit, arm and leg from the bull's horns. Another two men were taken to hospital with bruises.   During Sunday's run in the northern city of Pamplona, Rabonero, the heaviest of the six bulls used in the event, became separated from the pack moments into the run and began charging people in its way.   Isolated bulls are more likely to get disoriented and start charging at people.

The bulls from the Miura ranch in the southwestern province of Seville completed the 848.6-metre (928-yard) course from a holding pen to the city bull ring in two minutes and 45 seconds.   Each morning from July 7 to 14, hundreds of daredevils, many wearing traditional white shirts with red scarves tied around their necks, tested their bravery by running ahead of a pack of bulls through the course set up in the narrow, winding streets of the medieval city.

- Like getting hit by a truck -
The bulls face almost certain death in afternoon bullfights, and earlier this month animal rights activists staged a "die-in" protest in the streets of the city to protest the tradition.   At the end of the festival's first run, a bull ran over and sunk one of its horns deep in the neck of a 46-year-old  American from San Francisco, Jaime Alvarez, narrowly missing key arteries.    He was injured as he was trying to take a video-selfie with his mobile phone.   "It was like a truck or car just hitting me in the side of the head. I put my hand on my neck and I saw blood," he told US television from a Pamplona hospital.   His wife had asked him not to take part in the bull run, he added.    He was released from hospital two days later.

Another 23-year-old American from Kentucky and 40-year-old Spaniard were also gored that day.   In addition to the eight men who were gored, another 27 people were taken to hospital for broken bones and bruises suffered during the bull runs.   About 500 more people were treated at the scene for more minor injuries, according to the Red Cross.   The festival dates back to medieval times and was immortalised in Nobel Prize-winning author Ernest Hemingway's 1926 novel "The Sun Also Rises".   It claims scores of casualties every year although last year just two men were gored.

Although the runs are over, the festival's closing ceremony takes place at midnight Sunday.   People from around the world flock to the city of 200,000 residents to test their bravery and enjoy the festival's mix of round-the-clock parties, religious processions and concerts.   Sixteen people have been killed in the bull runs since records started in 1911.   The last death was in 2009 when a bull gored a 27-year-old Spaniard in the neck, heart and lungs.
Date: Sun, 14 Jul 2019 12:47:38 +0200

Labuha, Indonesia, July 14, 2019 (AFP) - A major 7.3-magnitude earthquake hit the remote Maluku islands in eastern Indonesia Sunday, sending panicked residents running into the streets, but no tsunami warning was issued.   The shallow quake struck about 165 kilometres (100 miles) south-southwest of the town of Ternate in North Maluku province at 6:28 pm (0928 GMT), according to the US Geological Survey.
 
"The earthquake was quite strong, sending residents to flee outside. They are panicking and many are now waiting on the roadside," said local disaster mitigation official Mansur, who like many Indonesians goes by one name.   Officials were assessing the situation but there were no immediate reports of casualties, he told AFP.

In the town of Labuha, one of the closest to the epicentre, panicked residents took to motorcycles in a bid to flee to higher ground, according to an AFP photographer in town when the earthquake hit.   Local disaster official Ihsan Subur told Metro TV that no damage or casualties had been reported there so far, but residents took to the streets and many evacuated to higher ground.   "Electricity went of during the earthquake, but now it's back to normal," ubur said, adding that at least seven big aftershocks were felt after the initial quake.

The province was also hit by a 6.9-magnitude tremor last week.   Indonesia experiences frequent seismic and volcanic activity due to its position on the Pacific "Ring of Fire", where tectonic plates collide.   Last year, a 7.5-magnitude quake and a subsequent tsunami in Palu on Sulawesi island killed more than 2,200 people, with another thousand declared missing.   On December 26, 2004, a devastating 9.1-magnitude earthquake struck off the coast of Sumatra and triggered a tsunami that killed 220,000 across the Indian Ocean region, including around 170,000 in Indonesia.
Date: Sun, 14 Jul 2019 09:02:36 +0200

Sydney, July 14, 2019 (AFP) - A strong 6.6-magnitude earthquake struck off northwest Australia Sunday, shaking buildings over a wide area but causing no immediate reports of damage or injuries.   The shallow quake hit early Sunday afternoon 10 kilometres under the Indian Ocean 203 kilometres (126 miles) west of the West Australian beach resort of Broome, the US Geological Survey said. No tsunami alert was issued.   Sergeant Neil Gordon of the Broome police department said the quake rattled the city for more than a minute.   "The building here was shaking for about a minute and a half ... a steady shaking for that period of time," he told AFP by telephone.   He added that there had been "no reports of any injuries or any damage throughout the district," following the tremor.   The national broadcaster ABC said there were some reports of minor damage from the quake, and no injuries.   Australian media said the tremor was felt across a long stretch of the northwestern coast of Australia, from the West Australian capital of Perth and the mining centres of Karatha and Port Hedland to the south and as far as Darwin to the north.

Thursday 11th July 2019
https://www.who.int/csr/don/11-july-2019-ebola-drc/en/

The outbreak of Ebola virus disease (EVD) in North Kivu and Ituri provinces, Democratic Republic of the Congo continues this past week with a similar transmission intensity to the previous week. While the number of new cases continues to ease in former hotspots, such as Butembo, Katwa and Mandima health zones, there has been an increase in cases in Beni, and a high incidence of cases continues in parts of Mabalako Health Zone. In addition to these re-emerging hotspots, there are a large number of people with confirmed and probable infections moving to other health zones, with the greatest number coming from Beni Health Zone. The movement of cases causes the outbreak to spread to new health zones and re-emerge in health zones with previously controlled infections. Overall, this underscores the importance of robust mechanisms for listing and following up contacts and understanding the motivations for peoples’ decisions to move.

After the first reported case in the Ariwara Health Zone on 30 June, no new cases have been observed in that health zone. A response team deployed to that zone continues to identify contacts, engage the community, and vaccinate individuals at risk. Response personnel from the bordering countries of Uganda and South Sudan continue to support operational readiness activities. Resources are being dedicated to monitoring the Uganda-Democratic Republic of the Congo border in that area.

In the 21 days from 19 June through 9 July 2019, 72 health areas within 22 health zones reported new cases, representing 11% of the 664 health areas within North Kivu and Ituri provinces (Figure 2). During this period, a total of 247 confirmed cases were reported, the majority of which were from the health zones of Beni (41%, n=101), Mabalako (19%, n=48), Lubero (6%, n=16), and Mandima (5%, n=13). As of 09 July 2019, a total of 2437 EVD cases, including 2343 confirmed and 94 probable cases, were reported (Table 1). A total of 1646 deaths were reported (overall case fatality ratio 68%), including 1552 deaths among confirmed cases. Of the 2437 confirmed and probable cases with known age and sex, 57% (1384) were female, and 29% (704) were children aged less than 18 years.

Cases continue to increase among health workers, with the cumulative number infected rising to 132 (5% of total cases). Of the 128 health workers with information available, the greatest proportion is among health workers at health posts [poste de santé] (20%, n = 26) and private health facilities (35%, n = 45). The majority (68%, n = 87) of health worker infections were among nurses.

No new EVD cases or deaths have been reported in the Republic of Uganda since the previous EVD Disease Outbreak News publication on 13 June 2019. As of 3 July, 108 contacts exposed to those cases were identified, and they all completed the 21-day follow-up period. All contacts were asymptomatic. Arua district, located in the north-western part of Uganda near the Uganda-Democratic Republic of the Congo border, is currently stepping up its response readiness to prevent imported cases of Ebola following the case that died on 30 June 2019 in Ariwara Health Zone in neighbouring Democratic Republic of the Congo, located 8 kilometres from the Uganda border. This case is known to have over 200 contacts, some of whom are in the communities bordering the Arua district. As of 9 July 2019, two suspected cases in the Arua district were reported and both tested negative. As of 9 July 2019, the cumulative number of individuals vaccinated in Arua district is 811 out of 1092 targeted front line and healthcare workers.

More information here: https://www.who.int/csr/don/11-july-2019-ebola-drc/en/

Date: Sat, 13 Jul 2019 10:41:55 +0200

Kuala Lumpur, July 13, 2019 (AFP) - Flash floods killed a Dutch tourist in a popular cave located in the rugged Mulu National Park on Malaysia's Borneo island, an official said Saturday, as a search continues for a missing guide.    Local fire and rescue chief Law Poh Kiong identified the dead man as 66-year-old Peter Hans Hovenkamp from Utrecht in the central Netherlands.     "He died due to drowning following flash floods in the caves. His body was found in a river inside the cave and was taken to the Miri public hospital for a post-mortem on Saturday," he told AFP.   Law said a search-and-rescue operation involving 16 officers had been launched to locate 20-year local tour guide Roviezal Robin.   Eight other tourists in the same group "almost become victims" but fled to higher ground and escaped from being washed into the river, Law added.

Hovenkamp was reported missing on Friday while the group was touring the popular "Deer Cave", home to an estimated three million bats which form amazing patterns in the sky when they leave each dusk.   Mulu park, located in the remote Borneo jungle of Sarawak state and famous for its caves, cliffs and gorges, is a UNESCO world heritage site.   It sees thousands of visitors annually, particularly for its cooling rains during the summer months.    Law described the death as "a freak tragedy."
Date: Sat, 13 Jul 2019 09:52:36 +0200

Kathmandu, July 13, 2019 (AFP) - Floods and landslides triggered by torrential monsoon rains have killed at least 40 people across South Asia in the last two days, officials said Saturday.   The monsoon, which lasts from June to September, causes widespread death and destruction across South Asia each year.   In Nepal, 27 people have died in floods and landslides after heavy rains hit the country's eastern region and the southern plains.

Bishwaraj Pokharel, spokesperson for Nepal Police, added that another 11 people were injured and 15 others reported missing.    Three of the victims were killed when a wall collapsed in the capital Kathmandu.   "Our first priority is life saving rescue and all our resources have been deployed," Home Ministry official Umakanta Adhikari told AFP.

Police used boats to bring people to safety as rivers swelled, inundating their settlements, while parents were seen wading across chest-high waters carrying children on their shoulders.    Nepal's weather department issued a high alert for the southern Sapta Koshi river on Saturday and sent SMS warnings to people in the area.

In neighbouring India 11 deaths have been recorded in the north-eastern states of Assam and Arunachal Pradesh, officials said Friday.  Monsoon floods have inundated 21 districts in Assam, affecting thousands, officials said Friday.

In Bangladesh aid groups were providing rations to Rohingya refugees in the southeast of the country with the UN World Food Programme saying Friday that two people including a child had died.   Last year, more than 1,200 people were been killed across South Asia in monsoon storms with India's Kerala suffering its worst floods in nearly 100 years.
Date: Fri, 12 Jul 2019 16:00:57 +0200

Chennai, India, July 12, 2019 (AFP) - A special 50-wagon train carrying 2.5 million litres of water arrived in the Indian city of Chennai Friday, as the southern hub reels under one of its worst shortages in decades.    The wagons were hauled by a special locomotive, decorated with flowers and with a "Drinking Water for Chennai" banner on its front.   Four special trains a day have been called up to bring water to Chennai -- India's sixth most populous city -- from Vellore, some 80 miles (125 kilometres) away, to help battle the drought.    The first consignment will be taken to a water treatment centre, and then distributed in trucks to different parts of the metropolis on Saturday.   Chennai has seen only a fraction of the rain it usually receives during June and July.   The city of 4.9 million people also needed trains to bring water in when it suffered a similar crisis in 2001.

The bustling capital of Tamil Nadu state normally requires at least 825 million litres of water a day, but authorities are currently only able to supply 60 percent of that.   With temperatures regularly hitting 40 degrees Celsius (104 Fahrenheit), reservoirs have run dry and other water sources are dwindling further each day.   The Chennai metro has turned off its air conditioning, farmers have been forced to stop watering their crops, and offices have asked staff to work from home.   The city's economy has also taken a hit as some hotels and restaurants shut shop temporarily, and there have been reports of fights breaking out as people queue for water. 
Date: Fri, 12 Jul 2019 11:42:26 +0200

Sydney, July 12, 2019 (AFP) - A looming ban on climbing Australia's Uluru rock, intended to protect the sacred site from damage, has instead triggered a damaging influx of visitors, tourism operators said Friday.    Clambering up the giant red monolith, also known as Ayers Rock, will be prohibited from October -- in line with the wishes of the traditional Aboriginal owners of the land, the Anangu.   But a rush to beat the ban has led to a sharp increase in tourists and is causing its own problems for the World Heritage Uluru-Kata Tjuta National Park.   Families arriving in campers vans and RVs are a particular problem, chief executive of Tourism Central Australia Stephen Schwer told AFP.   "We have got so much of one particular market coming, we don't have enough infrastructure to handle the number of drive travellers."

While most visitors are doing the right thing, camping venues in the area are at capacity with advance bookings, leaving many less organised arrivals to set up illegally.   "People don't realise when they go off the road they are actually trespassing on pastoral land, or Aboriginal land, or protected land," Schwer said.   "We are getting people that are leaving their rubbish behind and lighting fires," he added.   "Sadly, people are also emptying their toilet waste out of their vans on what they think is unpopulated land, but is actually private land."   In the 12 months to June 2019, more than 395,000 people visited the Uluru-Kata National Park, according to Parks Australia, about 20 percent more than the previous year.   Yet just 13 percent of those who visited also climbed the rock, the government agency said.    Tourism operators say that Australian and Japanese tourists most commonly seek to climb Uluru.

The Aboriginal connection to the site dates back tens of thousands of years and it has great spiritual and cultural significance to them.   "Since the hand back of Uluru and Kata Tjuta to traditional owners in 1985, visitors have been encouraged to develop an understanding and respect for Anangu and their culture," a spokesperson for Parks Australia said.     "This is reflected in the 'please don't climb' message," they added.   Lyndee Severin from Curtin Springs station and roadhouse, one of just a few camping venues within 100 kilometres of Uluru, said "the vast majority of people are doing the right thing" but hundreds were setting up illegally by the side of the road or down a bush track.   "So we have some people that think that the rules don't apply to them," she told AFP.