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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: Thu, 3 Oct 2019 16:35:31 +0200 (METDST)

Brazzaville, Oct 3, 2019 (AFP) - The Republic of Congo on Thursday launched a campaign to distribute anti-malaria bed nets to more than 90 percent of the nation's households.   More than three million insecticide-treated nets will be distributed over the five-day operation, initiated by Prime Minister Clement Mouamba in the capital Brazzaville.

The cost of the operation, put at 12 million euros ($13.39 million), is being met by the Global Fund to Fight AIDS, Tuberculosis and Malaria.   Health Minister Jacqueline Lydia Mikolo said malaria was the prime cause of death among children aged under five, and the disease was a major cause of absence from school.   Insecticide-treated nets are a time-honoured but highly effective way of preventing transmission of the mosquito-borne malarial parasite.   The last major net distribution in the Republic of Congo was 2012.
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>]
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: Fri, 9 Aug 2019 23:12:50 +0200 (METDST)

Luxembourg, Aug 9, 2019 (AFP) - A huge tornado ripped across southwest Luxembourg on Friday leaving at least seven people injured, authorities said, as images posted on social media showed the powerful twister whipping roofs and other debris into the air.   With winds reaching 128 kilometres per hour (80 miles per hour), according to the meteorological office, the tornado smashed through towns near the borders with Belgium and France on Friday evening.   Footage posted on social media showed the swirling winds towering above homes and roads and tearing up roofs and tree branches high into the air.

The Luxembourg government, which released the toll, has set up a crisis unit.     Around 100 homes have been damaged, Pierre Mellina, mayor of the town of Petange, told RTL media.   Other images broadcast showed roads blocked and vehicles damaged.    The local fire service said the electricity had been cut to certain areas "preventatively".     As the tornado entered France late Friday it damaged homes in the Meurthe-et-Moselle region, but there were no reports of injuries, according to local authorities.
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.
More ...

Faroe Islands

http://en.wikipedia.org/wiki/Faroe_Islands
=========================
The early history of the Faroe Islands is not very clear. According to Færeyinga Saga emigrants who left Norway to escape the tyranny of Harald I of Norway settled in the isla
ds about the beginning of the 9th century. There is also evidence that Irish monks settled the islands, introducing sheep in the process. Early in the 11th century Sigmund, whose family had flourished in the southern islands but had been almost exterminated by invaders from the northern islands, was sent from Norway, from which he had escaped, to take possession of the islands for Olaf Tryggvason, king of Norway. He introduced Christianity and, though he was subsequently murdered, Norwegian supremacy was upheld. Norwegian control of the islands continued until 1380, when Norway entered into a union with Denmark, which gradually evolved into the double monarchy Denmark/Norway. The reformation reached the Faroes in 1538. When Norway was taken away from Denmark at the Treaty of Kiel in 1814, Denmark retained possession of the Faroe Islands.
The monopoly trade over the Faroe Islands was abolished in 1856. Since then, the country developed towards a modern fishery nation with its own fleet. The national awakening since 1888 was first based on a struggle for the Faroese language, and thus more culturally oriented, but after 1906 was more and more politically oriented after the foundation of the political parties of the Faroe Islands.
On April 12, 1940, the Faroes were invaded and occupied by British troops. The move followed the invasion of Denmark by Nazi Germany and had the objective of strengthening British control of the North Atlantic (see Second Battle of the Atlantic). In 1942–43 the British Royal Engineers built the only airport in the Faroes, the Vágar Airport. Control of the islands reverted to Denmark following the war, but in 1948 a home rule regime was implemented granting a high degree of local autonomy. The Faroes declined to join Denmark in entering the European Community (now European Union) in 1973. The islands experienced considerable economic difficulties following the collapse of the fishing industry in the early 1990s, but have since made efforts to diversify the economy. Support for independence has grown and is the objective of the government.
================
Denmark, Greenland and the Faeroe Islands US Consular Information Sheet
August 15, 2006
COUNTRY DESCRIPTION: Denmark is a highly developed stable democracy with a modern economy. Greenland is a self-governing dependency of Denmark. The Faroe Islands are a self-governing overseas administrative division of Denmark. Read the Department of State Background Notes on Denmark for additional information.

ENTRY REQUIREMENTS: Passport and visa regulations are similar for Denmark, Greenland, and the Faroes. A valid passport is required. U.S. citizen tourist and business travelers do not need visas for visits of up to 90 days. That period begins when entering any of the following countries which are parties to the Schengen agreement: Austria, Belgium, Denmark, Finland, France, Germany, Greece, Iceland, Italy, Luxembourg, The Netherlands, Norway, Portugal, Spain, and Sweden. See our Foreign Entry Requirements brochure for more information on Denmark and other countries. Contact the Royal Danish Embassy at 3200 Whitehaven Street, N.W. Washington, DC 20008, telephone (202) 234-4300 or visit its website at for the most current visa information.

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

Find more information about Entry and Exit Requirements pertaining to dual nationality and the prevention of international child abduction .
SAFETY AND SECURITY: Denmark remains largely free of terrorist incidents, however the country shares, with the rest of Western Europe, an increased threat of Islamic terrorism. Like other countries in the Schengen area, Denmark's open borders with its Western European neighbors allow the possibility of terrorist groups entering and exiting the country with anonymity. Americans are reminded to remain vigilant with regard to their personal security and to exercise caution.

Public demonstrations occasionally occur in Copenhagen and other Danish cities and are generally peaceful events. Prior police approval is required for public demonstrations, and police oversight is routinely provided to ensure adequate security for participants and passers-by. Nonetheless, as with any large crowd comprised of diverse groups, 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's web site , where the current Worldwide Caution Public Announcement , Travel Warnings, and Public Announcements can be found.

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

The Department of State urges American citizens to take responsibility for their own personal security while traveling overseas. For general information about appropriate measures travelers can take to protect themselves in an overseas environment, see the Department of State's pamphlet A Safe Trip Abroad .
CRIME: Denmark, Greenland, and the Faroes all have very low violent crime rates, however, non-violent crimes of opportunity have slightly increased over the last few years, especially in Copenhagen and other major Danish cities, where tourists can become targets for pickpockets and sophisticated thieves. Criminals frequent airports, train stations, and cruise ship quays to take advantage of weary, luggage-burdened travelers. Thieves also operate at popular tourist attractions, shopping streets, and restaurants. In hotel lobbies and breakfast areas, thieves take advantage of even a brief lapse in attention to snatch jackets, purses, and backpacks. Women's purses placed either on the backs of chairs or on the floor are typical targets for thieves. Car and home break-ins are also on the rise.

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

Denmark has a program to provide financial compensation to victims who suffer serious criminal injuries. According to existing regulations, the victim must report the incident to the police within 24 hours. Danish police routinely inform victims of serious crime of their rights to seek compensation. The relevant forms can be obtained from the police or the Danish Victims' Compensation Board: Civilstyrelsen, Erstatningsnaevnet, Gyldenløvesgade 11, 1600 Copenhagen V, TEL: (45) 33-92- 3334; FAX: (45) 39-20-45-05; www.erstatningsnaevnet.dk ; Email: erstatningsnaevnet@erstatningsnaevnet.dk . Claim processing time is a minimum of 4 weeks. There is no maximum award limit.

See our information for Victims of Crime .
MEDICAL FACILITIES AND HEALTH INFORMATION: Excellent medical facilities are widely available in Denmark. In Greenland and the Faroe Islands, medical facilities are limited and evacuation is required for serious illness or injury. Although emergency medical treatment is free of charge, the patient is charged for follow-up care.

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 (CDC) hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747) or via the CDC's website at . 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 .

MEDICAL INSURANCE: The Department 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 Denmark is provided for general reference only, and may not be totally accurate in a particular location or circumstance.

A valid U.S. driver's license may be used while visiting Denmark, but the driver must be at least 18 years old. Driving in Denmark is on the right side of the road. Road signs use standard international symbols. Many urban streets have traffic lanes reserved for public transport only. Unless otherwise noted on traffic signs, the speed limit is 50 km/h in urban areas, 80 km/h on open roads, and 130 km/h on expressways.

Use of seat belts is mandatory for drivers and all passengers. Children under three years of age must be secured with approved safety equipment appropriate to the child's age, size, and weight. Children from three to six years of age may use approved child or booster seats instead of seat belts.

Driving under the influence of alcohol or drugs is considered a very serious offense. The rules are stringently enforced, and violations can result in stiff fines and possible jail sentences.

Copenhagen, the capital and largest city in Denmark, has an extensive and efficient public transportation system. Trains and buses connect Copenhagen with other major cities in Denmark and to Norway, Sweden, and Germany. Bicycles are also a common mode of transportation in Denmark. Passengers exiting public or tourist buses, as well as tourists driving rental cars, should watch for bicycles on their designated paths, which are usually located between the pedestrian sidewalks and the traffic lanes.

Danish expressways, highways, and secondary roads are of high quality and connect all areas of the country. It is possible to drive from the northern tip of Denmark to the German border in the south in just four hours. Greenland has no established road system, and domestic travel is performed by foot, boat, or by air. The majority of the Faroe Islands are connected by bridges or serviced by boat. Although the largest islands have roads, most domestic travel is done on foot, horseback, boat, or by air.

The emergency telephone number for police/fire/ambulance in Denmark and the Faroe Islands is 112. In Greenland contact the local police.

Please refer to our Road Safety page for more information. Visit the website of the country's national tourist office and national authority responsible for road safety at . See also additional information on driving in Denmark at .

AVIATION SAFETY OVERSIGHT: The U.S. Federal Aviation Administration (FAA) has assessed the government of Denmark's Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for the oversight of Denmark's air carrier operations. This rating applies to Greenland and the Faroe Islands as well. For more information, travelers may visit the FAA's Internet website at www.faa.gov/safety/programs_initiatives/oversight/iasa .

SPECIAL CIRCUMSTANCES: The official unit of currency in Denmark is the Danish krone. ATM machines are widely available throughout Denmark. Please see our information on customs regulations .

For information concerning the importation of pets into Denmark, please visit the following website:
.
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 protection 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 Denmark's laws, even unknowingly, may be expelled, arrested, or imprisoned. Penalties for possession, use, or trafficking in illegal drugs in Denmark 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 website.

REGISTRATION/EMBASSY LOCATION: Americans living or traveling in Denmark are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department's travel registration website , and to obtain updated information on travel and security within Denmark. 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 is located at Dag Hammarskjolds Alle 24; 2100 Copenhagen, telephone: (45) 33-41-71-00; Embassy fax: (45) 35-43-02-23; Consular Section fax: (45) 35-38-96-16; After-hours emergency telephone: (45) 35-55-92-70. Information is also available via the U.S. Embassy's website at http://www.usembassy.dk. The United States has no consular presence in Greenland or the Faroe Islands.
* * *
This replaces the Consular Information Sheet dated February 10, 2006, to update the section on Entry Requirements and Traffic Safety and Road Conditions.

Travel News Headlines WORLD NEWS

Date: Thu, 14 Nov 2019 12:51:34 +0100 (MET)

Copenhagen, Nov 14, 2019 (AFP) - Authorities in the Faroe Islands have announced the archipelago in the North Atlantic will be "closed for maintenance" for two days in April when tourists won't be welcome, instead opening the doors to volunteer caretakers.   In practice, the self-governing Danish islands will keep hotels open and international flights running, but popular tourist sites will be temporarily closed on April 16 and 17 next year.   The event is a continuation of a pilot project run in the spring of 2019, when 100 volunteers from 25 countries were invited to the islands.

Registrations for eager volunteers opened on Wednesday at 1500 GMT and were to remain open for 24 hours, the Faroese tourism office said on its website.   One hundred people will then be randomly selected to be part of the maintenance crew, who will be offered housing and food during their stay although they will still need to pay for their own plane tickets.   "The fragile natural environment in some popular tourist locations has felt the effects of an increase of visitors," the head of the tourism office, Guri Hojgaard, told AFP in March shortly after the pilot project was launched.   "These areas need a helping hand to ensure they remain pristine".

For the first edition of the event they received about 3,500 applications and the selected volunteers helped with projects like creating walking paths, constructing viewpoints to help preserve nature and protect birdlife sanctuaries and re-building rock cairns.   A popular destination for its fascinating landscapes with 30-metre cliffs, the archipelago covers 1,400 square kilometres (540 square miles) and has 50,000 inhabitants and 80,000 sheep spread over 18 islands.   In 2018, 110,000 tourists visited the Faroe Islands and the number of tourists has increased by about 10 percent annually for the past five years.    According to Hojgaard, the "closed for maintenance, open for voluntourism" weekend can "contribute to the international discussion about overtourism by showing that tourists can actually be a part of the solution."
Date: Fri, 25 Nov 2011 12:19:28 +0100 (MET)

COPENHAGEN, Nov 25, 2011 (AFP) - A hurricane packing winds of almost 200 kilometres (125 miles) an hour tore through the Faroe Islands overnight, causing major damage and evacuations but no deaths, police said Friday.  "There was a hurricane... a lot of material damage has been reported but no deaths so far," said Rani Wardum, a police officer in Torshavn, the capital of the North Atlantic archipelago. "Winds reach up to 55 metres per second," or 198 kilometres per hour, in some places, meteorologist Mogens Roenebek of the Danish Meteorological Institute told AFP.

The Faroe Islands, an autonomous Danish province, are home to around 48,000 people. The extent of the damage was not immediately known. "Many roofs were blown off and we had to evacuate a retirement home. The seniors were moved into a hospital," Wardum said.

Some residents were also evacuated from their homes during the night and a number of boats came loose from their moorings and ended up on land, he added. "The winds are still raging, but it was particularly violent last night and overnight," Wardum said, noting that the southern coastal regions of the Faroes Islands were hardest hit. The storm was heading towards the west coast of Norway on Friday, with strong winds and heavy seas, according to Roenebek.
Date: Thu, 6 May 2010 16:55:58 +0200 (METDST)

REYKJAVIK, May 6, 2010 (AFP) - The quantity of ash spewed by Iceland's Eyjafjoell volcano increased overnight and the higher ash cloud could make it to the Faroe Islands Friday, Icelandic authorities said Thursday.   "Ash production did increase last night and the ash plume is going higher now than the last couple of days," Agust Gunnar Gylfason, who monitors the eruption's progress at Iceland's Civil Protection Department, told AFP.

The ash cloud "might reach the Faroe Islands around midnight (GMT Thursday) under 20,000 feet (6,000 meters)" and continue on south towards Ireland on Friday, he added.   "The plume went up to 30,000 feet (9,000 meters) for some time last night, and again this morning, due to an increase in explosive activity, but otherwise it's been around 18,000 and 20,000 feet" high, he said.

At the strongest period of the eruption, Eyjafjoell sent a plume around 30,000 feet into the air, but scientists have stressed that the height of the plume does not necessarily reflect a particular quantity of ash.   On Tuesday, the plume contained about only 10 percent of the ash it held at the beginning of the eruption.   European airspace and airports across the continent were open on Thursday, but intergovernmental air traffic controller Eurocontrol said the ash cloud could mean transatlantic flights might need to be re-routed.

Airspace above Ireland, Northern Ireland and Scotland was partly shut Wednesday for the second time in two days, causing the cancellation of hundreds of flights.   The fresh disruption came after Europe's skies were closed for up to a week last month by the eruption of the Eyjafjoell volcano. It was the biggest aerial shutdown in Europe since World War II, with more than 100,000 flights cancelled and eight million passengers affected.
More ...

Malaysia

General
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Malaysia consists of two separate components; peninsular Malaysia (which is situated between Thailand and Singapore) and Borneo (which has the states of Sabah and Sarawak.) The total population is o
er 20 million and it has a very diverse cosmopolitan culture. Bahasa Malaysia is the official language though English is very widely spoken. The entire country has an equatorial climate with rainfall throughout most of the year. However there are two distinct rainy seasons – March to May and September to November. The costal regions may also experience monsoon conditions. Info: http://www.visitmalaysia.com
Safety & Security
**************************************
Violent crime against tourists is rare though petty incidents like bag snatching, burglaries and car break-in crimes are increasing. It is wise to take special care of your personal belongings when walking through some of the crowded market places or along the curb. Credit card fraud is becoming a serious problem so don’t let your card out of your sight at any time. Travelling out from the main tourist destinations on Borneo may lead to a higher risk of personal danger. Kidnapping from Pandanan Island and Sipadan (both diving resorts) show how there is a need for increased vigilance when visiting parts of coastal Sabah near to the islands. Drug offences of any kind are treated very seriously in Malaysia and may result in disruption of travel plans or imprisonment. Never carry drugs for another individual unless you are certain that there is no risk involved whatsoever.
Climate
**************************************
All over Malaysia the climate tends to be very humid though this can vary from location to location and throughout the year. Being so close to the equator, the sun is strong and proper care against sun burn must be constantly taken. Dehydration and loss of salt through perspiration are two other common problems for the unprepared traveller. Drink plenty of fluids and replace your salt loss. Make sure you pack clothing suitable for a warm humid climate.
Long Haul Flight & Jet Lag
**************************************
On the plane make sure you exercise your calf muscles and drink plenty of fluids. Female travellers on the contraceptive pill should be aware of the higher risk of venous clotting. After your long haul flight it is essential to allow your body catch up and so try to ensure that you have sufficient time to rest on the first day after arrival. (Make sure you don’t fall asleep beside the pool after arrival and then awaken with sunburn.)
Food & Water
**************************************
Generally the level of food hygiene throughout the country is high. Nevertheless avoidance of bivalve shellfish meals is a wise precaution. Food from street vendors should also be treated with suspicion though unpeeled fresh fruit or various well-cooked foods should be fine. Adding ice to your drinks is probably unnecessary and potentially harmful and should be avoided. The menus will usually be in English so that should make meal selection somewhat easier!
Mosquitoes
**************************************
Due to the constant humid climate mosquitoes tend to be present throughout the year. In Malaysia there are a number of diseases transmitted by mosquitoes and so care to avoid their bite is to be encouraged at all times. The three most significant diseases transmitted by mosquitoes are Malaria, Dengue Fever and Japanese B Encephalitis. In the case of Dengue Fever the mosquito responsible tends to prefer to live in the towns and cities throughout both Borneo and Peninsular Malaysia. This mosquito usually bites during the day-light hours. The transmission of Japanese B is usually in the rural regions of the country seldom visited by tourists. Most cases occur in Sarawak. Both of these viral diseases can be very serious and even life threatening and so avoidance of mosquito bites is essential.
Malaria Risk
**************************************
The risk of malaria for most tourists visiting Peninsular Malaysia is extremely small. There is insignificant risk in Kuala Lumpur, Penang etc and so many tourists opt not to use prophylaxis. However in Sarawak and Sabah the risk of malaria is present throughout the year. Even in these regions the risk is mainly off the coastal plains and towards the border areas. Generally prophylaxis is recommended for those visiting Sabah or Sarawak.
Water Sports in Malaysia
**************************************
Many tourists will undertake some water sports while in Malaysia and so make sure your insurance policy will cover this eventuality. Before you agree a contract with a provider check that their equipment appears to be well maintained and that they have good safety instructions. If you are unsure do not take part. Never swim alone or after a heavy meal (or excess alcohol intake) and always listen to local advice regarding sea currents etc.
Vaccinations for Malaysia
**************************************
Travelling directly from Ireland there are no vaccines which are essential for entry into Malaysia. However for most tourists the following vaccines are recommended for personal protection.
*
Poliomyelitis (childhood booster)
*
Tetanus (childhood booster)
*
Typhoid (food & water borne disease)
*
Hepatitis A (food & water borne disease)
For those undertaking a more adventurous trip further vaccines may need to be considered such as Hepatitis B, Rabies, Japanese B Encephalitis and Meningitis. The need for Malaria prophylaxis will depend on your proposed itinerary.
Summary:
**************************************
Malaysia is becoming a more common destination for holidays and also as a stop-off for those travelling on to Australia. With commonsense and care you should be able to have a very enjoyable safe time. If you do develop any unusual health problem after your trip (skin rash, bowel disturbance, influenza symptoms etc) make sure you attend for urgent medical attention.

Travel News Headlines WORLD NEWS

Date: Thu 3 Oct 2019
Source: European Centre for Disease Prevention and Control (ECDC) News & events [edited]

[Authorities in] Denmark has reported a travel-related case of malaria caused by _Plasmodium cynomolgi_ in a Danish traveller returning from a visit to forested areas in peninsular Malaysia and Thailand during August-September 2018.

_P. cynomolgi_ is a parasite causing disease among macaque monkeys across Southeast Asia but rarely infects humans.

The traveller was admitted to hospital with the suspicion of malaria. Routine initial tests for malaria (rapid diagnostic test and microscopy) and more in-depth tests (malaria-specific loop-mediated isothermal amplification test and Sanger sequencing) were required to diagnose malaria caused by _P. cynomolgi_. After receiving treatment, symptoms resolved on the 2nd day and the patient recovered fully.

ECDC wants to raise awareness about the possibility of more human cases due to the presence of _P. cynomolgi_ in macaques across Southeast Asia and the volume of tourists visiting these areas, including national parks. Since the diagnosis is challenging, advanced detection and identification techniques should be performed when all other tests show negative results.

Travellers to the region are advised to apply preventive measures against malaria such as taking chemoprophylaxis and using mosquito nets and insect repellents, wearing long sleeved shirts and trousers, and sleeping in air-conditioned rooms.
=====================
[It is well known that _P. cynomolgi_ can be transmitted from monkeys to humans just as it is seen for _P. knowlesi_ (Eyles DE, Coatney GR, Getz ME. _Vivax_-type malaria parasite of macaques transmissible to man. Science. 1960; 131: 1812-3; Coatney GR et al. Transmission of the M strain of _Plasmodium cynomolgi_ to man. Am J Trop Med Hyg. 1961; 10: 673-8). Thus, it is not surprising that _P. cynomolgi_ is seen in humans visiting areas where the simian host is abundant and the _Anopheles_ vectors are present, as is the case for _P. knowlesi_. As far as we know, neither _P. cynomolgi_ nor _P. knowlesi_ can be transmitted between humans. - ProMED Mod.EP]

[HealthMap/ProMED-mail maps:
Date: Tue, 17 Sep 2019 15:38:37 +0200 (METDST)

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

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

Orangutans have been particularly vulnerable to commercial land clearances and have seen their natural habitat shrink dramatically in the last few decades.   The population of orangutan in Borneo has plummeted from about 288,500 in 1973 to about 100,000 today, according to the International Union for Conservation of Nature.   The toxic smoke caused by the forest fires is an annual problem for Indonesia and its neighbours, but has been worsened this year by particularly dry weather.   On Borneo island, which Indonesia shares with Malaysia and Brunei, pollution levels were "hazardous", according to environment ministry data.   Hundreds of schools across Indonesia and Malaysia were shut.
Date: Mon, 9 Sep 2019 11:49:46 +0200 (METDST)

Kuala Lumpur, Sept 9, 2019 (AFP) - Malaysia prepared to seed clouds after air quality in parts of the country reached unhealthy levels due to smog from forest fires in neighbouring Indonesia, an official said Monday.   Smog regularly blankets parts of Southeast Asia during the dry season when burning is used to clear Indonesian land for palm oil, paper plantations and other crops, sparking ire from regional neighbours.   In the latest outbreak, parts of Malaysia's eastern state of Sarawak on Borneo island have been blanketed over the past few days.

The pollutant index in some places has reached "very unhealthy levels", said Gary Theseira, special functions officer with the environment ministry.   "It is extremely severe in Kuching," Theseira told AFP, referring to a city of half a million people.   He said Malaysia is prepared to carry out cloud seeding to induce rain in an effort to ease the smog.   "The moment the cloud situation is right, the chemicals will be loaded and the aircraft will take off and proceed with the seeding," he said.

Some countries conduct seeding during prolonged dry spells to induce rain and clear the air by releasing certain chemicals into the clouds, although some experts have questioned its efficacy.   Boo Siang Voon, a 47 year-old engineer in Kuching described the skies as "hazy, hot with smoky smell".   "This year the smog is getting worse. Residents are using face masks. We should not pay the price of our health for the open burning. We want a solution," he told AFP.   The Malaysian capital Kuala Lumpur and neighbouring Singapore were also experiencing hazy conditions on Monday, with the air laced with the smell of burning foliage, although the pollutant index remained at moderate levels.   Some Kuala Lumpur residents complained about eye and throat irritation.

Malaysia's meteorological department Sunday warned that hot conditions will prevail for another week, and the monsoon season is only expected to arrive at the end of September or early October.   The ministry of science, technology and innovation on Friday said it would lodge a complaint with Indonesia for the haze and called for quick action to be taken to put out the fires.   Indonesian authorities have deployed thousands of extra personnel since last month to prevent a repeat of the 2015 fires, which were the worst for two decades and choked the region in haze for weeks.   Under pressure from neighbours, Indonesian leader Joko Widodo last month warned that officials would be sacked if they failed to stamp out forest fires.
Date: Tue 16 Jul 2019 3:34 PM MYT
Source: The Star [abridged, edited]

The Japanese encephalitis (JE) virus has been detected in Tambunan [Sabah], about 100 km (62 mi) from [the state capital, Kota Kinabalu], says the state agriculture and food industries minister Datuk Junz Wong on [Tue 16 Jul 2019]. He said Health Department officials in Sabah had detected the virus in a pig farm in Kampung Lubang, Tambunan on [11 Jul 2019].

On being informed, the Department of Veterinary Services started inspection at all 7 pig farms within the vicinity. "My officers are still on the ground and taking samples from the pigs in the area."

Wong's confirmation came after an internal memo from the Veterinary Department informing the department that health officials had found a [presumably human] case of JE in Tambunan.

There is no cure for JE, but vaccinations [for people] are encouraged by health officials as they provide a form of protection. JE is a type of viral brain infection that can affect both humans and animals. It can be passed on to humans by infected animals through the bite of an infected culex mosquito.

An infected person develops inflammation of the brain (encephalitis) and suffers symptoms such as sudden onset of headache, high fever, neck stiffness, convulsions and muscle weakness, and might even fall into a coma.

Last month [June 2019], the Sarawak Health Department urged public to be cautious after confirming 5 JE cases in the state.  [byline: Muguntan Vanar]
===================
[JE virus is endemic in Malaysia's Borneo, including Sabah and its neighbouring state, Sarawak. Pigs are susceptible to JE virus infection, develop high viremias that serve as infectious blood meals for culex vector mosquitoes. The report above does not indicate which tests were done to determine JE virus infection in the pigs, whether by virus isolation, PCR demonstration of JE virus genomic segments or development of antibodies. Pregnant sows may have transplacental infection of their foetal piglets with teratogenic effects. Piglets and very young pigs may develop encephalitis when infected by JE virus. Infected adult male pigs may develop orchitis with a loss of libido and reduced fertility. Since pigs are JE virus amplifying hosts, people in the areas where pigs are infected should be especially careful to avoid mosquito bites. Vaccination may be the best measure for avoiding JE. - ProMED Mod.TY]

[Maps of Malaysia:
Date: Mon 15 Jul 2019
Source: Outbreak News Today [edited]

Health officials in Malaysia are investigating a malaria cluster in Kuala Lipis, Pahang state. On [Thu 11 Jul 2019], 4 confirmed cases of malaria were reported to Kuala Lipis District Health Office (PKD) from Betau Health Clinic. All cases involve Orang Asli children aged 4-10 from 2 villages, 2 cases [each] from Kampung Pagar and Kampung Serdang. All cases have been taken to the Kuala Lipis Hospital ward and given treatment.

Kuala Lipis has not reported a malaria case for the past 8 years; the last case was reported in 2011.

The Pahang State Health Department has activated the epidemic room on [12 Jul 2019] and control activities and case detection (active case detection) conducted by Kuala Lipis PKD Team in Kampung Pagar and Kampung Serdang. A total of 393 blood slides have been taken from residents in both villages for microscopic testing. [Based on] initial examination of the slides, PKD found 11 more malaria infections in Kampung Serdang.

>From [11-15 Jul 2019], there have been 15 cases reported from these 2 villages. All cases have been diagnosed with _Plasmodium vivax_, hospitalized for treatment and are in a stable condition.

PKD has also carried out malaria control activities by conducting indoor residual spraying and distribution of mosquito nets in the affected locality. At this point, the PKD team is in the process of tracking cases and vector control activities.

Residents in the locality have been given health education to take preventive measures by wearing clothing that covers the limbs and using repellents to prevent mosquito bites. In addition, residents are advised to sleep in the mosquito nets and avoid activities that take place in or near the forest area at night.

The Ministry of Health is monitoring the occurrence of this malaria case cluster, and the collaboration of the public is very much needed to ensure that the incidence of malaria can be controlled.
=====================
[Along with China and the Republic of Korea, Malaysia is one of the 3 countries of the WHO Western Pacific Region, and it's also among 21 countries in total across the globe identified by WHO in 2016 as having the potential to eliminate malaria by 2020. The selection was based on an analysis that looked at the likelihood of elimination across key criteria. Reaching malaria-free status is a critically important public health and sustainable development goal. It is also a core objective of the WHO Global Technical Strategy for Malaria 2016-2030, which calls for the elimination of malaria in at least 10 countries by the year 2020.

It is also worth noting that the dominant local human malaria species in Malaysia is _Plasmodium vivax_ (69%) with 33 areas (foci) with active malaria transmission; the populations at greater risk are labourers, including foreign workers, in agriculture, farming, and forestry sectors in East Malaysia. There are 8666 people at risk of malaria in these areas.

As "an important aspect of the disease in the country is the presence of _P. knowlesi_ malaria, a parasite normally found in monkeys, and now accounting for the majority of local cases", the 3 main activities to keep Malaysia on the course of malaria elimination by 2020 are as follows:
- increase surveillance of _P. knowlesi_ zoonotic infections and strengthen elimination efforts;
- intensify surveillance activities to address the threat of malaria importation and better target foreign and migrant workers engaged in activities such as agriculture, forestry, and mining; and
- continue to invest in its national malaria strategy to ensure the financing of programmes targeting elimination and prevention of reintroduction. (<https://apps.who.int/iris/bitstream/handle/10665/273633/WHO-CDS-GMP-2018.13-eng.pdf>)

The resurgence of _P. vivax_ among this specific group of people (aged 4-10 years old) is worrisome, and further investigation will elucidate the specific contextual situation to support the national effort to eliminate malaria by 2020. - ProMED Mod.ST]

[_Plasmodium vivax_ are seen in 2 isoforms, one with a long incubation time of up to 8 months (White NJ. The rise and fall of long-latency _Plasmodium vivax_. Trans R Soc Trop Med Hyg. 2019 Apr 1; 113(4):  163-168. doi: 10.1093/trstmh/trz002.  <https://www.ncbi.nlm.nih.gov/pubmed/30809676>).

Outbreaks like this one is common in areas where there is a transmission potential due to the presence of anopheles mosquitoes, and a limited local transmission is started from an introduced case, usually an asymptomatic carrier from an endemic area. It is important to know which isoform is found in this outbreak to understand the transmission dynamics and when it was introduced. Thus, genotyping should be performed. - ProMED Mod.EP]

[HealthMap/ProMED-mail map of Pahang, Malaysia:
More ...

World Travel News Headlines

Date: Wed 4 Dec 2019
Source: Samaa News [edited]

The number of polio cases reported in Sindh this year [2019] has gone up to 14 as the Emergency Operation Centre [EOC] for Polio has confirmed a new case.

A 9-month-old boy from Larkana has contracted polio. According to EOC officials, the polio case surfaced in Larkana's UC Karani on [9 Nov 2019].

According to his parents, the child received 4 doses of the oral polio vaccine during a campaign and 3 doses during routine vaccination.

Officials say the poliovirus in the environment in Karachi and other parts of Sindh must be dealt with.
Date: Tue 3 Dec 2019
Source: Animals Health, Espana [in Spanish, machine trans. edited]

A total of 9 people have been treated in Health Centers of La Rioja for an outbreak of Q fever, and 3 of them have been admitted, according to various local media. This disease is a zoonosis that is transmitted by inhalation of the bacteria present in infected animals.

In addition, 3 citizens of the Basque Country, specifically from Biscay, are also admitted with Q fever, and a 4th person is waiting for bacteriological results. The patients would have acquired the disease after a visit to La Rioja, where they would have been infected by having contact with infected animals. They spent a weekend in La Rioja, and all of them, during a rural stay, maintained direct contact with newborn goats.

The spread of Q fever does not occur from person to person but only occurs through direct contact with sick animals. Therefore, the disease, caused by the bacterium _Coxiella burnetii_, has implications for animal health, especially for livestock, and infections can also be caused by the inhalation of bacterial spores that can be transported long distances by dust and wind.

Acute cases of Q fever are often mild, with symptoms similar to those of the flu, and can be treated with antimicrobials. However, chronic cases can cause dangerous infections in the heart and blood vessels and have a poor prognosis.

Recently, the Valencian Ministry of Health reported the existence of another outbreak of Q fever in Villajoyosa (Alicante), with 6 cases declared, all of them now in good health.
=====================
[Q fever is due to _Coxiella burnetii_, an obligate intracellular rickettsia-like bacterial pathogen. It is highly resistant to drying and heat, which enables the bacteria to survive for long periods in the environment. Its survival is attributed to a small cell variant of the organism that is part of its biphasic developmental cycle.

Q fever is a zoonosis. Although it has a wide and diverse host range, in animals this organism is primarily known as a cause of reproductive losses in domesticated ruminants. Clinical cases seem to be most significant in sheep and goats, with sporadic losses and occasional outbreaks that may affect up to 50-90% of the herd. Infected animals can be difficult to recognize: nonpregnant animals do not seem to have any obvious clinical signs, and seropositivity is not always correlated with shedding of the bacteria. The organism is shed in urine, feces, milk, and especially birthing products; intermittent high-level shedding occurs at the time of parturition, with millions of bacteria being released per gram of placenta.

Humans usually become infected by inhaling aerosolized organisms,often when they are exposed to an animal that had aborted but also if birth was at term and seemed normal. Acute symptoms of a flu-like illness usually develop within 2-3 weeks of exposure, although as many as half of humans infected with _C. burnetii_ do not show symptoms (<http://www.cdc.gov/qfever/symptoms/index.html>). Although most persons with acute Q fever infection recover, others may experience serious illness with complications that may include pneumonia, granulomatous hepatitis, endocarditis (especially in patients with previous cardiac valvulopathy), myocarditis, and central nervous system involvement. Pregnant women who are infected may be at risk for pre-term delivery or miscarriage.

Q fever is frequently an occupationally acquired illness; people most at risk include workers from the meat and livestock industries, shearers, veterinarians, laboratory personnel performing _C. burnetii_ cultures, as well as the general population in close proximity to infected animals in stockyards, feedlots, processing plants, or farms. - ProMED Mod.LL]

[HealthMap/ProMED map available at:
Date: Mon 11 Nov 2019 2:15 PM EST
Source: Northern News [abridged, edited]

The Timiskaming Health Unit is investigating 7 cases of whooping cough (pertussis), with exposures at Ecole Catholique Sainte-Croix, Ecole Catholique St-Michel, and Ecole Secondaire Catholique Sainte-Marie. Public Health Nurses are contacting parents and guardians of students who have the highest risk of exposure.

Check with your health care provider or the Timiskaming Health Unit to ensure you and your family are up to date on your whooping cough (pertussis) vaccination. The vaccine is free in Canada and part of the routine immunization schedule for infants, children, and teenagers. The vaccine is given at 2, 4, 6, and 18 months of age. A booster dose is needed between 4 and 6 years of age and again at 14-16 years of age. Immunity decreases over time, therefore one booster dose of vaccine is recommended for adults. You may review your immunization record online at (<http://timiskaminghu.com/281/Immunization>).

Pregnant or immunocompromised individuals should follow-up with their healthcare provider to confirm their history of vaccination against whooping cough (pertussis). A booster of the pertussis vaccine is recommended for all pregnant women in their 3rd trimester.

If you develop symptoms of whooping cough in the next 21 days, please follow-up with your healthcare provider and notify the Timiskaming Health Unit. For further information or if you have any comments or concerns, please call the Timiskaming Health Unit at 705-647-4305 or toll free at 1-866-747-4305.
====================
[Timiskaming, with a population of 32 251 residents in 2016, is a district in north-eastern part of the Canadian province of Ontario, just west of the similarly-named Temiscamingue county in Quebec  (<https://en.wikipedia.org/wiki/Timiskaming_District>).

A map showing the location of Timiskaming can be found at

[HealthMap/ProMED-mail map of Ontario, Canada:
5th December 2019
World Health Organisation

Measles vaccination drive launched, North Kivu targets 2.2 million children 
 
https://www.afro.who.int/news/measles-vaccination-drive-launched-north-kivu-targets-22-million-children

Kinshasa, 5 December 2019 – Around 2.2 million children are to be vaccinated against measles in North Kivu, the Democratic Republic of the Congo (DRC), where efforts are underway to curb the world’s second-worst Ebola outbreak amid persistent insecurity.

The DRC is also currently experiencing the world’s largest and most severe measles epidemic, affecting all its 26 provinces. Since the start of 2019, more than 250 000 suspected cases and over 5000 deaths mostly among children under 5 years, have been recorded.

This drive closes the second phase of a preventive vaccination campaign and will be followed by a third and final phase planned in 10 remaining provinces: Bas Uélé, Equateur, Haut Katanga, Haut Lomami, Haut Uélé, Kasai Oriental, Lualaba, Maniema, Mongala and Tshuapa.

This mass follow-up campaign will ultimately reach 18.9 million children across the country by the end of the year, particularly targeting those who may have been missed by routine immunization.

“While the Ebola outbreak in the DRC has won the world’s attention and progress is being made in saving lives, we must not forget the other urgent health needs the country faces,” said Dr Matshidiso Moeti, WHO Regional Director for Africa. “This new vaccination campaign aims to protect children in North Kivu, as well as other parts of the country from a disease that is easily preventable with a vaccine.”

Low immunization rates and high levels of malnutrition have contributed to the measles epidemic and associated high rates of mortality.

In North Kivu, the measles vaccination is being carried out under a challenging context, with high insecurity particularly around Beni town and Masisi territory.

“In the context of North Kivu, where the population is highly mobile, it is imperative that we reach out to travellers and ensure that their children are also covered. Every child should receive his or her vaccine so that they are well protected and can grow up healthy,” said Dr Deo Nshimirimana, WHO acting Representative in the DRC.

The five-day campaign is being implemented by the Ministry of Health with the support of WHO and partners and is fully funded by Gavi, the Vaccine Alliance. WHO staff are assisting the health ministry’s national and field coordination efforts, case management, epidemiological surveillance and deployment of a post campaign survey.

“Sadly, measles has claimed more Congolese lives this year than Ebola. We must do better at protecting the most vulnerable, who are often also the hardest to reach. This campaign is an important step in that direction,” said Thabani Maphosa, Managing Director of Country Programmes for Gavi. “For maximum impact, campaigns must be combined with the strengthening of routine immunization and health systems.” 

Strengthening routine immunization, measles case-based surveillance and case management will contribute to ending the current outbreak and eliminating measles as a public health threat in the DRC.  

Lack of funding has hampered efforts for reactive campaigns. To date, US$ 27.5 million have been mobilized; however, another estimated US$ 4.8 million are needed to complete the vaccination campaign and response and to strengthen other elements of response such as disease surveillance, case management and communication.
Date: Thu, 5 Dec 2019 09:54:04 +0100 (MET)
By Joseph Schmid

Paris, Dec 5, 2019 (AFP) - A nationwide strike shut down public transport, schools and other services across France on Thursday as unions kicked off an open-ended strike against President Emmanuel Macron's plans for a "universal" pension system they say will force millions of people to work longer.

Parents scrambled to organise daycare as teachers walked off the job or were unable to get to work, and many employees were working from home or forced to take the day off as trains, metros and buses were cancelled.   Union leaders have vowed to keep up their protest unless Macron drops the pension overhaul, the latest move in the centrist president's push to reform wide swathes of the French economy.   "The idea of social concertation that Macron says is so important in fact doesn't exist," the head of the CGT union, Philippe Martinez, said on BFM television Thursday.

Around 90 percent of high-speed TGV trains as well as regional lines were cancelled, and Air France has axed 30 percent of domestic flights and 15 percent of short-haul international routes.   In Paris, 11 of the 16 metro lines were shut down and others had just bare-bones service during the morning rush hour, and the Eiffel Tower turned away tourists because of the strike.   "There are not enough employees to open the monument in secure conditions," the tower's operator said in a statement.

The strike -- which is open-ended and could last several days -- has drawn comparisons with the showdown between government and unions over pensions in November-December 1995, when the country was paralysed for around three weeks.   Unions won that battle, and are banking on widespread support from both public and private-sector workers against Macron's reform.   The government has yet to unveil the details of the project, but officials have conceded that people will have to work longer for the system to remain financial viable.

- Outcome uncertain -
The strikes will be a major test of whether Macron, a former investment banker who came to power on the back of a promise to transform France, has the political strength to push through one of his key campaign pledges.   He has already succeeded in controversial labour and tax reforms aimed at encouraging hiring, as well as an overhaul of the state rail operator SNCF, long seen as an untouchable union bastion.

He has also largely seen off the "yellow vest" protests against declining living standards that erupted a year ago, but that anger could feed into the latest protest.   "The moment of truth for Macron," the Le Monde daily wrote in Thursday's edition. "The next days are a decisive test for the head of state."   The SNCF said international lines including the Eurostar and Thalys services were severely disrupted, and Education Minister Jean-Michel Blanquer said Wednesday that he expected just three in 10 schools would be able to open.

- 'Special regimes' -
The strike is the latest in a series of protests against Macron this year by the "yellow vests" as well as police, firefighters, teachers, hospital workers and lawyers.   Macron wants to implement a "universal" retirement system that would do away with 42 "special regimes" for sectors ranging from rail and energy workers to lawyers and Paris Opera employees, which often grant workers higher pensions or early retirement.

But unions say the changes would effectively require millions of private-sector workers to work beyond the legal retirement age of 62 if they want to receive the full pension they have been promised.   Prime Minister Edouard Philippe, who has acknowledged French workers will gradually have to work longer, is set to unveil details of the reform on December 12.

Interior Minister Christophe Castaner said Wednesday that some 250 demonstrations are expected nationwide, warning that a radical fringe of protesters could cause trouble.   Paris police chief Didier Lallement said around 6,000 members of the security forces would be deployed in the capital alone, with 180 motorbikes used to respond fast to any rioting.   Two major demonstrations are planned for Paris that will converge on the Place de la Nation, with officials ordering Paris businesses along the routes to close on Thursday.   British low-cost carrier EasyJet has cancelled 223 domestic and short-haul international flights and warned others risk being delayed.
Date: Thu, 5 Dec 2019 08:13:04 +0100 (MET)
By Sofia CHRISTENSEN

Johannesburg, Dec 5, 2019 (AFP) - South African Airways was placed under a state-led rescue plan on Thursday as part of a massive restructuring following a costly week-long strike last month.   Thousands of South African Airways (SAA) staff walked out on November 15 after the cash-strapped airline failed to meet a string of demands, including higher wages and job in-sourcing.   The strike was called off the following week after SAA management and unions eventually clinched a deal.

But the walkout dealt a severe blow to the debt-ridden airline, which has failed to make a profit since 2011 and survives on government bailouts.   "The Board of SAA has adopted a resolution to place the company into business rescue," said a statement by South Africa's Public Enterprises Minister Pravin Gordhan, adding that the decision was also supported by the government.   "It must be clear that this is not a bailout," said Gordhan. "This is the provision of financial assistance in order to facilitate a radical restructure of the airline."   South Africa is struggling to get state-owned companies back on track after nine years of corruption and mismanagement under former president Jacob Zuma.

- Costly strike -
Its national airline -- which employs more than 5,000 workers and is Africa's second largest airline after Ethiopian Airlines -- had been losing 52 million rand ($3.5 million) a day during the strike.   SAA's board said the business rescue, scheduled to start immediately, was decided after consultations with shareholders and the public enterprises department "to find a solution to our company's well-documented financial challenges".   "The considered and unanimous conclusion has been to place the company into business rescue in order to create a better return for the company's creditors and shareholders," said the SAA board of directors in a statement.

Business practitioners were set to be appointed "in the near future" to oversee the process, they added.   Unions did not immediately respond to AFP's requests for comment.   They have agreed to a 5.9-percent wage increase backdated to April, but which would only start to be paid out next March depending on funding.   SAA had initially refused any pay rise.    The cash-strapped airline needs two billion rand ($136 million) to fund operations through the end of March.   "SAA understand that this decision presents many challenges and uncertainties for its staff," said the board.   "The company will engage in targeted communication and support for all its employee groups at this difficult time."
Date: Thu, 5 Dec 2019 07:01:49 +0100 (MET)

Manila, Dec 5, 2019 (AFP) - The number of people killed by Typhoon Kammuri's pounding of the Philippines this week has hit 13, officials said Thursday, as authorities confirmed reports of storm-related deaths.   Kammuri's fierce winds toppled trees and flattened flimsy homes across a swathe of the nation's north on Tuesday, and forced a rare 12-hour shutdown of Manila's international airport.   Authorities said on Wednesday one person had drowned while three died after being hit by trees and flying objects.

Disaster officials did not offer details on how the other victims died, but local police reports indicated some may have drowned or been crushed by trees.   Mark Timbal, spokesman for the national disaster agency, said no new bodies have been found but the death toll could rise as reports on the ground are verified.    "There is the possibility of an increase in the number, but we are hoping against it," Timbal told AFP.    Hundreds of thousands of people living in exposed or low-lying areas were evacuated from their homes before Kammuri made landfall late Monday, which authorities said had saved lives.

Still the storm damaged 135 schools and destroyed nearly 1,200 homes, with crop damage in the hardest hit areas estimated to reach nearly $16 million.   The Philippines is hit by an average of 20 storms and typhoons each year, killing hundreds and putting people in disaster-prone areas in a state of constant poverty.    President Rodrigo Duterte is scheduled to visit on Thursday the Bicol region, a peninsula south of Manila which was hit hard by the typhoon.     Ninoy Aquino International Airport was closed half of Tuesday as a precaution, affecting over 500 flights, while roughly half the day's programme at the Southeast Asian Games, hosted by Manila and nearby cities, had to be postponed.
Date: Thu, 5 Dec 2019 05:14:37 +0100 (MET)

Bogota, Dec 5, 2019 (AFP) - Thousands of protesters took part in anti-government demonstrations in Colombia's capital Bogota and other cities Wednesday during the country's third general strike in two weeks.   Strike leaders say they intend to maintain pressure on right-wing President Ivan Duque's government, after brushing aside his appeals to cancel the strike on the grounds its effects were crippling the economy.   But crowds were smaller than previous demonstrations as protests took place for a 14th consecutive day.   Some roads were blocked in the capital and in the northeastern city of Cali, but many businesses remained open.   Around 250,000 people took part in the first demonstration against Duque's 15-month-old government on November 21, when the initial general strike brought the country to a standstill.

Interior Minister Nancy Patricia Gutierrez estimated that 40,000 people took part in demonstrations across the country on Wednesday, but organizers said the number of participants was much higher.   "The Colombian people have woken up!" shouted Paola Jiminez, a 41-year-old lawyer taking part in a pot-banging "cacerolazo" demonstration in Bogota.   "Colombians are finding it more and more difficult financially," she said.   A student taking part in one of several peaceful protests in Bogota, who gave his name as Nicolas, held up a banner saying: "The state lies more than my ex."

Police were deployed in nearby streets, but there were no confrontations of the kind that have marred some protests over the last two weeks, during which four people died. Some 500 have been injured.   On Tuesday, the Colombian National Strike Committee -- comprising unions, students and teacher organizations, indigenous groups and the opposition -- met directly with Duque's advisors for the first time, but reached no agreement.    Another meeting was scheduled for Thursday.

Under fire for his economic policies and corruption in the country, Duque launched a national dialogue with mayors and other officials 10 days ago.   The strike committee has presented Duque with a list of 13 demands, including the withdrawal of his proposed tax reforms, and full compliance with the 2016 peace deal with FARC guerrillas.   Among them is a call to dismantle the feared ESMAD riot police, widely criticized for its heavy handed response to protesters.   Duque has yielded to some of the demands on tax reform, announcing the return of Value Added Tax to the poorest 20 percent of the population and benefits for companies that hire young people.
Date: Thu, 5 Dec 2019 00:51:07 +0100 (MET)
By Neil SANDS

Wellington, Dec 4, 2019 (AFP) - Samoa entered a two-day lockdown Thursday as authorities launched an unprecedented mass vaccination campaign to contain a deadly measles outbreak that has devastated the Pacific island nation.   Officials ordered all businesses and non-essential government services to close, shut down inter-island ferry services and told private cars to keep off the roads.

Residents were advised to stay in their homes and display a red flag if they were not yet immunised as hundreds of vaccination teams fanned out across the nation of 200,000 in the early hours of the morning.   The operation, carried out under emergency powers invoked as the epidemic took hold last month, is a desperate bid to halt an inexorably rising death toll that reached 62 on Thursday, most of them young children.   "I've seen mass mobilisation campaigns before, but not over an entire country like this," UNICEF's Pacific island chief Sheldon Yett told AFP.   "That's what we're doing right now. This entire country is being vaccinated."

Immunisation rates in Samoa were about 30 percent before the outbreak and have risen to more than 55 percent since a compulsory mass vaccination campaign began a fortnight ago.   Yett said the aim of this week's two-day drive was to push the rate above 90 percent, which should help curb the current outbreak and stop future epidemics.   He said the normally busy streets of the capital Apia were almost deserted early Thursday.   "It's very, very quiet out here. I can just hear a few barking dogs. The streets are empty. There are no cars," he said.   "People are staying at home waiting for the vaccination campaign. The teams are getting their supplies together and getting ready to go out."   Even Prime Minister Tuilaepa Sailele Malielegaoi's residence had a red flag fluttering outside it, with the leader saying his nephew had recently arrived from Australia and needed a measles shot.

Malielegaoi said he was angered by anecdotal reports that some parents were encouraging their children to hide from the vaccination teams to avoid the mandatory immunisation injection.    "The message is that we have vaccinated a lot of people and they are OK," he told reporters.   "The only cure for this is vaccination... having your children vaccinated is the only way."   Children are the most vulnerable to measles, which typically causes a rash and fever but can also lead to brain damage and death.

The latest figures show that 54 of the 62 dead were aged four or less and infants account for most of the 4,217 cases recorded since the outbreak began in mid-October.   There have also been measles epidemics in neighbouring Fiji and Tonga, but higher immunisation rates mean they have been more easily contained, with no fatalities.
Date: Wed, 4 Dec 2019 22:05:06 +0100 (MET)

Goma, DR Congo, Dec 4, 2019 (AFP) - Doctors Without Borders (MSF) said Wednesday it was pulling its non-local staff from an eastern region of Democratic Republic of Congo after it said an armed group tried to enter its compound.    The NGO becomes the latest aid agency to withdraw its staff from the Biakato region after an unclaimed attack last week saw three Ebola workers killed at an accommodation camp in Biakato Mines in Ituri province, causing the World Health Organization to withdraw its staff from the area.     MSF and an Ebola Treatment Centre (ETC), which is treating two people with confirmed cases of Ebola and nine suspected cases, decided to stay in the Biakato region despite last week's incident.

The NGO said that on Tuesday night a group wielding machetes and sticks broke into the Biakato Health Centre, which houses the ETC, but did not cause any casualties and did not enter the Ebola facility.   A separate group with the same weapons then tried but failed to enter the MSF facility in Biakato Mines. The NGO said they threw stones but did not do any damage.   "Due to a deterioration in the security situation, MSF made the difficult decision to withdraw all non-local staff from the Biakato region," MSF said in a statement.    According to local authorities, the attackers from last week's incident are likely to be members of the Mayi-Mayi militia group.

The Democratic Republic of Congo is undergoing its 10th Ebola epidemic, which is the second deadliest on record.    An outbreak of the much-feared haemorrhagic virus has killed 2,206 people mainly in North Kivu and neighbouring Ituri, according to the latest official figures.   Insecurity has complicated the epidemic from the outset, compounding resistance within communities to preventive measures, care facilities and safe burials.   On November 4, the authorities said more than 300 attacks on Ebola health workers had been recorded since the start of the year, leaving six dead and 70 wounded, some of them patients.