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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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Kyrgyzstan

Kyrgyzstan Republic - US Consular Information Sheet
August 29, 2008
COUNTRY DESCRIPTION:
The Kyrgyz Republic, a mountainous country of five million people, is undergoing political and economic change. Tourist facilities are not highly deve
oped, and many of the goods and services taken for granted in other countries are not yet widely available. Read the Department of State Background Notes on the Kyrgyz Republic for additional information.

ENTRY/EXIT REQUIREMENTS: A passport and visa are required. American citizens can obtain a one-month single-entry, non-extendable tourist visa upon arrival at the “Manas” International Airport outside Bishkek for a $36 fee without invitation or sponsorship. Newly enacted legislation requires that all foreigners present in the Kyrgyz Republic for more than sixty days register with the Kyrgyz Department of Visa and Passport Control. Failure to do so may cause difficulties when exiting the country. Individuals traveling to Kyrgyzstan to perform religious work or work in affiliation with any religious organization in any capacity are required by Kyrgyz law to declare so on their visa applications. Failure to do so may lead to difficulties with local law enforcement as it is considered a violation of Kyrgyz law to engage in activities not matching the purpose of travel indicated on an individual’s visa. In general, travelers should apply for the correct category of visa for their purpose of travel. Travelers cannot obtain a tourist visa at land borders or other airports. American citizens visiting the Kyrgyz Republic are not required to register with the Office of Visas and Registration. The Embassy recommends that Americans traveling in the Kyrgyz Republic also obtain Kazakh visas, as commercial air travel out of the Kyrgyz Republic is limited and Americans may need to travel through Kazakhstan to return to the United States. For further information regarding entry/exit requirements, contact the Embassy of the Kyrgyz Republic at 2630 Massachusetts Avenue, NW, Washington, DC 20008, telephone: (202) 338-5141, fax: (202) 742 6501. Visit the Embassy of the Kyrgyz Republic web site at http://www.kgembassy.org/ for the most current visa information.

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

SAFETY AND SECURITY:
The Department of State urges U.S. citizens to avoid all travel to rural areas along the Kyrgyz-Uzbek and Kyrgyz-Tajik borders, and all areas to the south and west of the provincial capital of Osh. Security conditions in these parts of the southern Kyrgyz Republic differ from security conditions in the north, and the threat of violence against foreigners in the southern Kyrgyz Republic continues. Hostage-taking incidents involving foreigners occurred during the summers of 1999 and 2000, including one incident in the summer of 2000 involving American citizens. In 2007, there were reports of attempted “bride-kidnappings” in rural areas. While foreigners are not believed to be intentional targets, an American female was held against her will for several days in one reported incident. In 2006, suspected militants attacked a border post on the Kyrgyz-Tajik border, and ensuing skirmishes took place between the militants and Kyrgyz military forces throughout the southern Batken region. Land mines in Batken Oblast and near the Kyrgyz-Tajik border continue to be a concern. There are currently restrictions for U.S. Government employees traveling to areas of the Kyrgyz Republic south and west of Osh and in rural areas along the Kyrgyz-Uzbek border because of the volatile security situation in these areas.
Supporters of extremist groups such as the Islamic Movement of Uzbekistan (IMU), the Islamic Jihad Union (IJU), al-Qaeda, and the Eastern Turkistan Islamic Movement remain active in Central Asia. These groups have expressed anti-U.S. sentiments and may attempt to target U.S. Government or private interests in the region, including in the Kyrgyz Republic. Terrorist attacks involving the use of suicide bombers have previously taken place in neighboring Uzbekistan. Terrorists do not distinguish between official and civilian targets. Because of increased security at official U.S. facilities, terrorists are seeking softer civilian targets such as residential areas, clubs and restaurants, places of worship, hotels, schools, outdoor recreation events, resorts, beaches, maritime facilities, airports and aircraft.
In 2005-2007, there were several large-scale demonstrations and protests. Demonstrations in Bishkek have occurred in front of the Presidential Administration building (White House) and on Alatoo Square in the city center. The Embassy does not always have advance information regarding new demonstrations. Therefore, all Americans are reminded to remain vigilant and are urged to avoid the vicinity of all protests, because even protests that are intended to be peaceful can turn confrontational and possibly escalate into violence.
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 U.S. Embassy advises U.S. citizens to exercise caution in urban areas of the Kyrgyz Republic due to the high rate of violent crime against foreigners. Travelers arriving at Manas International Airport should arrange their transportation from the airport in advance. Foreign travelers have been the victims of extortion by airport taxi drivers, who appeared in some cases to be colluding with airport personnel to identify their victims. Travelers should not take public transportation or walk after dark, and should be extremely cautious in or near hotels, bars, parks and all places that attract an expatriate clientele. The Kyrgyz Republic has a high rate of violent crime due to unemployment and a large number of organized gangs. Muggings often occur after dark and can be quite violent, leaving the victim severely injured. Other common crimes include auto theft, mugging, and pick pocketing in crowded places such as markets, Internet cafes and on public transportation. U.S. citizens have been the victims of such crimes as rape, assault, kidnapping and robbery while in urban and rural parts of Kyrgyzstan, and there have been reports of U.S. citizens who were robbed by groups of young men who had followed them back to their residences from hotels and bars. Police officers rarely speak English and no victims’ assistance programs are available. Medical and psychiatric care for victims is limited.
Harassment and extortion by people who purport to be Kyrgyz police officers are common. According to Kyrgyz law, any person claiming to be a police officer must show identifying documents on demand. U.S. citizens should not act upon requests by people, whether in civilian dress or in police uniform, if they have no official identification. Also U.S. citizens should not get into cars with someone they do not know, even if the person claims to be a police officer.

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.

The local equivalent to the “911” emergency lines in Kyrgyzstan are: 101 for fire; 102 for police;
103 for first aid ambulance (state-funded); 151 (from landline), 0 312 684466 (from landline or cellphone); and 161 for rescue service (under the Ministry of emergency situations.)

See our information on Victims of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION: Medical services in the Kyrgyz Republic are extremely limited. Elderly travelers and those with existing health problems may be at risk due to inadequate medical facilities. The U.S. Embassy strongly recommends that travelers to the Kyrgyz Republic carry medical evacuation insurance in case of emergency. The Consular Section of the U.S. Embassy in Bishkek maintains a list of foreign-trained and local physicians who have agreed to give medical assistance to Americans. This list is available on the Embassy web site at http://bishkek.usembassy.gov.
Some HIV/AIDS entry restrictions exist for visitors to and foreign residents of Kyrgyzstan. There is no legal requirement for HIV/AIDS testing during the visa application or registration process. Kyrgyz law does state that if a foreign citizen refuses to submit to HIV/AIDS testing when requested while in Kyrgyzstan, that person could be deported. Please verify this information with the Embassy of Kyrgyzstan at http://www.kgembassy.org before you travel.

Tuberculosis is an increasingly serious health concern in Kyrgyzstan. For further information, please consult the CDC's Travel Notice on TB available at http://wwwn.cdc.gov/travel/yellowBookCh4-TB.aspx.

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

MEDICAL INSURANCE: The Department of State strongly urges Americans to consult with their medical insurance company prior to traveling abroad to confirm whether their policy applies overseas and whether it will cover emergency expenses such as a medical evacuation. 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 Kyrgyz Republic is provided for general reference only, and may not be totally accurate in a particular location or circumstance.
Most of the Kyrgyz Republic’s road infrastructure consists of two-lane roads, which are all in various states of disrepair, and are poorly marked and lit. Many local drivers tend to disobey fundamental traffic laws – such as stopping at red lights. As a result, driving can be very dangerous. Accidents involving severe injury and/or death are not uncommon.
Drivers must exercise particular caution to avoid uneven pavement, potholes and open drains and manholes. Night driving should be avoided, as roads are inadequately lit. In winter, roads are seldom plowed and ice and snow make the poor driving conditions even more hazardous. Pedestrians routinely walk in the road, often wearing dark clothes at night, necessitating even greater caution for drivers. Mountain roads in the Kyrgyz Republic are often narrow and treacherous, and may close without notice due to snow, ice or rockslides. Guardrails and barriers preventing falling rocks are often missing. The Kyrgyz Republic does not have a roadside assistance infrastructure. Towing companies do not exist. Although mechanics are available in cities there is little organized oversight or certification of their practices or abilities. Rest areas are infrequent and very primitive. Service stations are generally available in and near cities, but the fuel they provide may be adulterated or of poor quality.
The road between Almaty, Kazakhstan and Bishkek, Kyrgyz Republic, is especially treacherous at night or during poor weather. Americans and other travelers have been killed in traffic accidents on that road, and travel at night is not recommended.
Generally, speed limits are 60 km per hour in the cities and 90 km per hour in rural areas. Kyrgyz law mandates that all automobile passengers wear seat belts and that motorcycle riders wear helmets. International driving permits are recognized in the Kyrgyz Republic.

Drivers may face harassment by traffic police, who have been known to demand payment for arbitrary "fines" for purported infractions.

The Kyrgyz Republic has a "zero tolerance" policy for driving under the influence of alcohol.
Public transportation in the Kyrgyz Republic is limited to buses, taxis, and very few intercity trains. Travelers should be particularly careful when using public transportation. Buses tend to be very crowded and can be unsafe and unreliable. Taxis too can be dangerous. Due to the danger of theft or assault, travelers should avoid entering a cab that already contains passengers. Taxis are seldom metered, and travelers should negotiate a fare prior to entering a cab and be aware that cab drivers often try to charge foreigners a high fare. Drivers of vehicles that are not taxis are often willing to drive people for fares. However, U.S. citizens should avoid using any of these "private taxis" and unmarked taxis.

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 insert site here.
AVIATION SAFETY OVERSIGHT: As there is no direct commercial air service to the United States by carriers registered in the Kyrgyz Republic, the U.S. Federal Aviation Administration (FAA) has not assessed the Kyrgyz Republic’s Civil Aviation Authority for compliance with International Civil Aviation Organization (ICAO) aviation safety standards. For more information, travelers may visit the FAA’s web site at http://www.faa.gov/safety/programs_initiatives/oversight/iasa.
SPECIAL CIRCUMSTANCES:
Kyrgyz customs authorities may enforce strict regulations concerning temporary importation into or export from the Kyrgyz Republic of items such as antiquities or hunting trophies. It is advisable to contact the Embassy of the Kyrgyz Republic in Washington at 2630 Massachusetts Avenue, NW, Washington, DC 20008, telephone: (202) 338-5141, fax: (202) 742 6501 or at http://www.kgembassy.org/ for specific information regarding customs requirements.
The Kyrgyz Republic is a cash-only economy. The banking system is not well developed. ATMs are available, but the security of these machines remains untested. A hotel or bank may, on occasion, accept traveler’s checks or credit cards, but the fees can be as high as 20 percent for traveler’s checks.
U.S. citizens are encouraged to carry a copy of their U.S. passport with them at all times, so that, if questioned by local officials, proof of identity and citizenship are readily available.

In accordance with the Vienna Convention on Consular Relations and certain bilateral treaties, a consular officer from the U.S. Embassy must be given access to any U.S. citizen arrested in the Kyrgyz Republic. U.S. citizens who are arrested or detained should ask that the U.S. Embassy be contacted immediately. This is generally recognized, though there can be a sizeable delay in notification times depending on the local authorities’ interpretation of the case’s legal status.
The Kyrgyz Republic is an earthquake-prone country. 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.
Hunting and trekking are popular sports for locals and tourists in the Kyrgyz Republic; however, American citizens traveling to the Kyrgyz Republic should know that hunting in the Kyrgyz Republic without proper licenses is illegal. It is illegal to import or own firearms in the Kyrgyz Republic without a permit issued by the Kyrgyz government. Foreign hunters who do not have official permission to hunt or take trophies out of the country may face criminal and civil charges. Both hunting and trekking infrastructures are underdeveloped with limited services, especially in the high mountainous regions popular with trekkers and hunters. Avalanches and landslides are common in these mountainous regions, often cutting off villages for weeks at a time. These villages and hunting areas are in isolated, rugged, mountainous areas inaccessible by the limited rescue services available in the Kyrgyz Republic. Americans traveling to the Kyrgyz Republic to hunt or trek need to be aware of the risks involved. The Embassy recommends that all Americans register with the Embassy in Bishkek for the duration of their stay in the country.
Please see our Customs Information.

CRIMINAL PENALTIES: While in a foreign country, a U.S. citizen is subject to that country's laws and regulations, which sometimes differ significantly from those in the United States and may not afford the protections available to the individual under U.S. law. Penalties for breaking the law can be more severe than in the United States for similar offenses. Persons violating the Kyrgyz Republic’s laws, even unknowingly, may be expelled, arrested or imprisoned. Penalties for possession, use, or trafficking in illegal drugs in The Kyrgyz Republic 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 the Kyrgyz Republic 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 the Kyrgyz Republic. 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 Bishkek is located at 171 Prospect Mira, 720016 Bishkek, Kyrgyz Republic. The phone number is 996-312-551-241, fax: 996-517-777-202, and web site: http://bishkek.usembassy.gov
* * *
This replaces the Country Specific Information for the Kyrgyz Republic Dated January 8, 2008, to update sections on Country Description, Entry/Exit Requirements, Crime, Information for Victims of Crime, and Medical Facilities and Health Information.

Travel News Headlines WORLD NEWS

Date: Wed 9 Jan 2019
Source: AKIpress [abridged, edited]

A total of 722 cases of measles have been registered since the beginning of 2018 in Kyrgyzstan compared with one case in January through November 2017, the National Statistics Committee reports.

[Full story is available only by subscription.]
=====================
[HealthMap/ProMED-mail map:
Date: Wed 21 Nov 2018 14:26 KGT
Source: Kazakh Telegraph Agency (KazTAG] [edited]

KyrTAG [Kyrgyzstan Telegraph Agency] reports 2 people have been hospitalized in the Jalal-Abad region with anthrax assumption. "2 inhabitants of Suzak district have been hospitalized with anthrax assumption. The lab tests made in Jalal-Abad have shown a negative result, we sent the analysis to Osh for a repeated research," said Usen Zhorobayev, head of center of state sanitary-epidemiological surveillance of the Suzak district. In his words, the hospitalized men had been butchering a cow. The patients are in satisfactory condition
=============================
[To find Suzak in western Kyrgyzstan, go to:
<http://www.fallingrain.com/world/KG/03/Suzak.html>.

For a description of Jalal-Abad region, go to

Outbreaks in Jalal-Abad are an overflow of infection from the enzootic state of this disease in the adjoining Fergana Valley of Uzbekistan. Jalal-Abad is in western Kyrgyzstan at the head of the Fergana Valley. The Fergana Valley is rife with livestock anthrax. Without a coordinated vaccination-control program between the 2 countries in this region, we will continue to see outbreaks there. In spite of an initial negative test result, not uncommon with human cases, the authorities are assuming a greater probability of cutaneous anthrax based on the exposure history of these 2 farm workers. A pity they did not get their veterinary colleagues to test what was still available from this dead cow. - ProMED Mod.MHJ]

[HealthMap/ProMED-mail map of Kyrgyzstan:
Date: 27 Jun 2018
Source: Interax Kazakhstan [edited]

Nine people have been hospitalized with suspected anthrax infection in the Jalal-Abad region of southern Kyrgyzstan, Mamatzhan Miyanov, the coordinator of the healthcare ministry for the Jalal-Abad region, told Interfax on Wednesday [27 Jun 2018].
Date: Tue 13 Mar 2018
Source: XinHuaNet [edited]

A total of 14 people, including 4 children, were hospitalized after a mass botulism food poisoning outbreak in southern Kyrgyzstan, the Health Ministry said [Tue 13 Mar 2018]. It said 3 of them are in a serious condition. An epidemiological investigation has been conducted and all patients have received the botulinum antitoxin.

The first case of food poisoning in the city of Uzgen in the Osh region was reported on [Sun 11 Mar 2018]. According to preliminary data, the poisoning occurred due to eating homemade canned vegetable salad. A month earlier [February 2018], 17 people in southern Kyrgyzstan were hospitalized for the same reason; 2 of the 7 children affected died in that outbreak.
======================
[It is unclear if these clusters are related. Most clusters of botulism are associated with home prepared food. - ProMed Mod.LL]

[HealthMap/ProMED-mail map:
Date: Tue 5 Sep 2017 16:10
Source: Evening Bishjkek [in Russian, trans. ProMED Mod.NR, edited]

Currently in the at-Bashy district of Naryn region 3 recorded cases of anthrax infection are in the hospital, and 15 under the supervision of experts. Doctors say that the locals butchered the carcass of an animal, and 10 days later the 1st symptoms of this dangerous infection appeared on the skin of the wrist areas and forearms.

People have turned to professionals with complaints of ulcers. Then on [Wed 30 Aug 2017] 3 people were hospitalized in the Infectious Diseases Department. Tests confirmed the preliminary diagnosis. Doctors have checked all sick family members and friends, and currently they are under surveillance.

The incubation period of the infection is 10-14 days.[Actually it can be as short as 3 days and up to 60 days. - ProMED Mod.MHJ] At the end of this period, if there is no suspicion, patients are discharged from the hospital. "This disease is curable, it is treatable by conventional antibiotics. It's just included in the list of especially dangerous infections classifications of the World Health Organization. The main sources of infection are animals", - said the Director of the Republican center of Quarantine and Especially Dangerous Infections the Sabyrzhan of Abdykaimov.

It is likely that the meat of an infected animal got into the markets. According to some reports, some infectious contaminated products were located in the market town of Tokmak. Now multiple site checks are in hand by the Investigative Department. In addition, the market site and the territory around the cattle slaughter site have been quarantined, say doctors. And veterinary control has been initiated, along with the population being educated.

However, the situation is aggravated by the confused information from the sick individuals. They can't exactly tell where the infected meat was sent, said Abdykaimov. "One says that the meat is buried. Another says sold. Now this is in the hands of the investigating authorities and veterinary services. They don't say what happened: just stopped someone in a car; it was loaded, and they left. And where, on what car - they don't specify. The investigating authorities are handling this, but we in Public Health are doing our best to explain what should happen," - said Abdykaimov.  [Byline: Rodion Reshetov]
====================
[Comment by ProMED Mod.NP. In the territory of the Republic there are 1219 natural foci of anthrax. Concreted and enclosed only 1000 of them. Vaccination of cattle is held only periodically, delayed due to problems with funding and vaccine supplies, increasing the risk disease anthrax in both animals and humans. Annually in the territory of the Republic there are nearly 20 cases of anthrax in people. In this case, the situation is compounded by the fact that there is no accurate information on location of infected meat, which can lead to new cases of the disease. - ProMED Mod.NP]

[Public Health as it really is and not as shown on television. People get confused and, fearing legal action, may make up stories. My thanks to my colleague Natalia. It seems that circulation of the news in English is limited and widely available in Kyrgyz. - ProMED Mod.MHJ]

[A HealthMap/ProMED-mail map can be accessed at:
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Marshall Islands

Introduction
 
After almost four decades under US administration as the easternmost part of the UN Trust Territory of the Pacific Islands, the Mar
hall Islands attained independence in 1986 under a Compact of Free Association. Compensation claims continue as a result of US nuclear testing on some of the atolls between 1947 and 1962. The Marshall Islands hosts the US Army Kwajalein Atoll (USAKA) Reagan Missile Test Site, a key installation in the US missile defense network.
 
Geography
 
Located in the Oceania region its consists of two archipelagic island chains of 29 atolls, each made up of many small islets, and five single islands in the North Pacific Ocean, about half way between Hawaii and Australia
 
Climate
 
tropical; hot and humid; wet season May to November; islands border typhoon belt

Travel News Headlines WORLD NEWS

Date: Mon, 9 Mar 2020 00:51:21 +0100 (MET)

Majuro, Marshall Islands, March 8, 2020 (AFP) - The Marshall Islands has taken the radical step of banning all inbound air travellers for a two-week period in a bid to prevent the novel coronavirus reaching the Pacific island nation.   The emergency measure came into effect late Sunday and imposes "total suspension of air travellers coming into the Marshall Islands immediately" until March 22,  the country's health department said.    In addition, both air and sea arrivals from 10 countries -- including China, Japan, South Korea, Germany, France and Spain -- were barred with some exceptions to allow delivery of food and supplies.   The Marshalls, a group of islands and atolls about halfway between Australia and Hawaii, has also ordered cruise ships and yachts not to dock at its ports.

Health Secretary Jack Niedenthal said the air travel ban was designed to give the Marshalls time to establish isolation facilities and gear up healthcare staff for a possible local outbreak.   "We need more time to prepare," he told reporters Sunday.   The Marshalls, with a population of almost 80,000, welcomed about 6,800 international travellers in 2018, according to the most recent data from the UN World Tourism Organisation.   Small Pacific islands nations have so far had no confirmed cases of the virus, although there have been scares in the Marshalls, Fiji and Palau.

Samples from a possible case in Tonga are currently being examined by a New Zealand laboratory.   Niedenthal said last week that a lack of lab testing facilities in the islands was hampering the health response.   "If we know in a timely manner what we are dealing with here that would help us manage this situation much more effectively," he said.   The Marshalls last month barred international travel by government officials and elected leaders, with the only exception for patients referred for off-island medical treatment.   It has also "strongly advised" citizens and residents to postpone international travel until further notice.
Date: Fri, 29 Nov 2019 03:01:21 +0100 (MET)

Majuro, Marshall Islands, Nov 29, 2019 (AFP) - More than 200 people have been forced to flee their homes, after they were inundated by freak waves in the Marshall Islands capital Majuro.   Swells averaging five metres (16 feet) washed rocks and debris onto roads, temporarily cutting access to the international airport at the peak of the flooding on Wednesday.   The Red Cross set up evacuation centres at two schools, with local churches and Majuro's mosque also offering help to fleeing residents.

The Marshall Islands are one of the Pacific nations on the front line of climate change, causing increasingly intense weather phenomena and storm surges linked to rising seas.   Climate researcher Murray Ford said such factors may have played a role in this week's flooding but were not the main cause.   "The key driver of this current inundation appears to be a large swell which has arrived from a more northerly direction than the typical trade wind swell," he said.   "This particular event would be best described as a large swell, meeting a high, but not unusually high tide."   Disaster response officials were expected to complete a damage assessment on Friday.
8 Aug 2019

The Republic of the Marshall Islands declares dengue emergency, restricts travel. 1st case of DEN-3 confirmed on Ebeye Island; 21 cases probable.

HealthMap/ProMED-mail map of Marshall Islands:
Date: Mon, 28 May 2018 01:20:00 +0200

Majuro, Marshall Islands, May 27, 2018 (AFP) - Haze from the Kilauea volcano eruption in Hawaii blanketed the Marshall Islands 3,700 kilometres (2,300 miles) away on Sunday, as officials warned it would continue moving west.   The haze, a phenomenon known as "vog" or volcanic smog, "is spreading across Micronesia," the US National Weather Service based in Guam said.

The volcano on Hawaii's Big Island is now in its fourth week of eruptions.   Meteorologists advised residents on the Marshall Islands with respiratory problems to stay indoors while airlines and shipping companies were warned to be aware of "lower visibilities".

The Guam weather office said haze produced by Kilauea would spread farther westward and reach Kosrae, Pohnpei and possibly Chuuk in the Federated States of Micronesia over the next few days.   Kilauea is the world's most active volcano and one of five on Hawaii's Big Island.   It started erupting on May 3, prompting about 2,000 people to flee from their mountainside homes.   Scientists believe the volcanic activity may be a precursor to a major eruption similar to the one that shook the island in the mid-1920s.
Date: Fri 4 May 2018
Source: CDC. MMWR Morb Mortal Wkly Rep 2018; 67(17):504-5 [edited]

ref: Hofmeister MG, McCready JA, Link-Gelles R, et al. Notes from the field: Increase in hepatitis A virus infections -- Marshall Islands, 2016-2017. MMWR Morb Mortal Wkly Rep 2018; 67:504-5. doi: 10.15585/mmwr.mm6717a5
------------------------------------------------------------------------
In mid-September 2016, a case of hepatitis A virus (HAV) infection was reported to the Marshall Islands Ministry of Health and Human Services (MOHHS). On 4 Nov 2016, MOHHS received laboratory confirmation of 4 additional cases, prompting activation of an outbreak investigation by the MOHHS Exposure Prevention Information Network (EPINet) team and solicitation of technical assistance from the Pacific Island Health Officers' Association, the WHO, and CDC. CDC began participating in the investigation by providing technical assistance remotely at that time. CDC provided remote assistance throughout the course of the investigation. In April 2017, the CDC-affiliated coauthors traveled to the Marshall Islands to provide in-person technical assistance.

To characterize the outbreak, the MOHHS EPINet Team, with assistance from CDC, conducted an investigation through in-person interviews and medical chart abstractions. A probable HAV outbreak case was defined as an acute illness with onset of any signs or symptoms consistent with acute viral hepatitis (such as fever, anorexia, nausea, vomiting, diarrhoea, fatigue, dark urine, clay-colored stool, or abdominal pain) on or after 1 Sep 2016, and either jaundice or elevated serum aminotransferase levels; a confirmed case met the probable case definition and also had either a positive immunoglobulin M (IgM) antibody to HAV on laboratory testing or an epidemiologic link to a confirmed case.

>From September 2016 (epidemiologic week 37) through July 2017 (epidemiologic week 28), 194 outbreak-associated hepatitis A cases (168 confirmed and 26 probable) were reported by MOHHS (Figure [available at the source URL above. - ProMED Mod.LL]). Illness onset dates ranged from 12 Sep 2016 through 11 Jul 2017. The median age of infected persons was 8 years (range equal to 2-76 years), 57 percent of patients were male, 91 percent were Marshallese, and 11 percent were hospitalized. No deaths were reported. Persons younger than 25 years accounted for 90 percent of cases, and 92 percent of patients were residents of the capital, Majuro. The most commonly reported signs and symptoms were jaundice (92 percent), nausea (76 percent), anorexia (75 percent), and dark urine (68 percent). Clay-colored stool (10 percent) was less commonly reported.

Complete contact information was available for 102 (53 percent) patients. A total of 1143 contacts were identified, with a mean of 11 contacts identified per patient (range equal to 2-60). Among the identified contacts, 902 (79 percent) received post-exposure prophylaxis (PEP) with hepatitis A vaccine. Some contacts were identified outside the recommended PEP window of 14 days after exposure, and 14 contacts were infants who were too young to be vaccinated (1). 7 contacts refused vaccination.

The EPINet team disseminated public information about the outbreak and recommendations on hygiene and vaccination through radio shows, mass text messages, posters, and school presentations; developed standardized case reporting and interview tools; and expanded case finding through investigation of contacts. Hepatitis A vaccine is not currently included in the Marshall Islands routine childhood immunization schedule. Marshall Islands began immunization of contacts of patients with hepatitis A in January 2017 and then launched a comprehensive immunization campaign targeting school-aged children on Majuro in February 2017, which ultimately covered approximately 70 percent of the total kindergarten through 8th grade student population. Once the vaccine supply was replenished in April 2017, a 2nd immunization campaign was directed at high school students aged 14-19 years on Majuro. In total, approximately 12,500 doses of hepatitis A vaccine were administered to school-aged children and adult contacts of patients in response to the outbreak. No additional cases were reported as of 30 Aug 2017.

Before this outbreak, the last HAV outbreak in the Marshall Islands occurred approximately 25 years ago. Since then, approximately 5 hepatitis A cases per year have been reported (MOHHS, unpublished data, 2017). HAV infection is typically acquired through faecal-oral transmission, either from direct person-to-person contact or consumption of contaminated food or water. In this outbreak, transmission occurred primarily through direct person-to-person contact, and despite extensive measures, the initial source of HAV infection was not identified.

HAV infection occurs in 3 distinct epidemiologic patterns (high, intermediate, and low endemicity) associated with hygiene and sanitation, access to clean drinking water, household crowding, and socioeconomic conditions (2). As socioeconomic conditions and sanitation improve, areas transition from high to intermediate endemicity, which is associated with an increased incidence of symptomatic clinical disease and potential for outbreaks. Hepatitis A-related hospitalizations and mortality also increase as the age of infection shifts from early childhood, when disease is typically asymptomatic or mild, to adolescence and adulthood, when illness is more likely to be severe (2).

Before this outbreak, HAV was thought to be endemic in the Marshall Islands; however, this outbreak demonstrates that the country might be undergoing an epidemiologic transition toward intermediate endemicity (3). Health officials are evaluating the potential costs and benefits of incorporating routine hepatitis A vaccination in Marshall Islands as a means of reducing ongoing transmission and preventing outbreaks.

References
-----------------
1. Advisory Committee on Immunization Practices, CDC: Update: prevention of hepatitis A after exposure to hepatitis A virus and in international travelers. Updated recommendations of the Advisory Committee on Immunization Practices (ACIP).
MMWR Morb Mortal Wkly Rep 2007; 56(41): 1080-84; available at
2. Wasley A, Fiore A, Bell BP: Hepatitis A in the era of vaccination. Epidemiol Rev 2006; 28: 101-11; available at
3. Jacobsen KH: The global prevalence of hepatitis A virus infection and susceptibility: a systematic review. Geneva, Switzerland: World Health Organization; 2009; available at
===================
[This posting underscores the importance of the kind of epidemiologic pattern of HAV in an area and certainly suggests that this island nation has improved hygiene and sanitation to transition to intermediate endemicity where routine childhood HAV vaccination bears consideration. The current outbreaks in a variety of areas in the USA (including parts of Michigan, Utah, and Kentucky) affecting certain cohorts of adults (who were old enough not to be immunized as children) underscore immunization.

The Marshall Islands (<https://en.wikipedia.org/wiki/Marshall_Islands>), officially the Republic of the Marshall Islands, is an island country located near the equator in the Pacific Ocean, slightly west of the International Date Line. Geographically, the country is part of the larger island group of Micronesia. The country is spread out over 29 coral atolls, comprising 1156 individual islands and islets. Politically, the Marshall Islands is a presidential republic in free association with the United States, with the USA providing defense, subsidies, and access to USA-based agencies such as the Federal Communications Commission and the United States Postal Service. - ProMED Mod.LL]

[HealthMap/ProMED-mail map
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Seychelles

General:
************************************
This group of islands are situated off the eastern coast of Africa in the Indian Ocean. The main Island is Mahe and it has a population of under 100,000. The other two islands with significant popula
ions are Praslin and La Digue. Generally, tourist facilities are well developed throughout these main islands. Elsewhere facilities are poor. The islands enjoy an oceanic tropical climate with only mild variations throughout the year. Rainfall fluctuations do occur with more rainfall occurring between October to April each year.
Safety and Security:
***********************************
The majority of tourists visiting the Seychelles will have a very peaceful time and the rate of crime throughout the country is small. However, like many other destinations this situation is changing and there are increasing numbers of reports of petty crime - even on the more popular beaches. Generally it is unwise to leave valuables unattended while you bathe and walking around the main streets in Victoria after dark is not recommended especially for women. All money exchanges must be transacted with official designated dealers and a receipt obtained. Otherwise strict penalties may be enforced.
Health Facilities:
***********************************
The level of healthcare in the main tourists resorts is perfectly adequate for most situations but outside these regions the level of care is significantly less. On isolated islands doctors are often unavailable and it may take many hours before you could move to a better equipped location. Always make sure your travel and health insurance is up to date before you leave home.
Food & Water Facilities:
***********************************
The level of food and water preparation in the main tourist resorts is excellent but when travelling to isolated regions the standards drop considerably. Consuming foods cooked in local homes will be a significant risk in many circumstances and usually best avoided. However, well cooked fresh fish and other well prepared local delicacies should not present any particular difficulty. As always it is wise to avoid all under cooked bivalve shellfish such as oysters, mussels and clams. Unprepared cold foods like lettuce are also better left untasted and fruit which has been previously peeled will be potentially contaminated. If you peel it yourself it should be fine. Check the tap water smells of chlorine and if not, do not use it for drinking or even brushing your teeth.
Insect Bites and Malaria:
***********************************
No malaria risk occurs throughout the Seychelles so prophylaxis will not be required. This is excellent news but you should be aware that mosquitoes can still be a problem and so careful avoidance techniques are required - particularly between dusk and dawn. Dengue Fever has been found on the Islands through there has been no epidemic of the disease for some years.
The risk of Rabies:
***********************************
The Seychelles are rabies free but obviously care should still be taken to avoid any contact with warm-blooded animals such as dogs, cats and monkeys. With the difficulties in patrolling the extensive coastline of the Seychelles it is always possible that the disease will be introduced at some stage in the future.
Swimming:
***********************************
Take care to listen to local advice before swimming in the sea. Strong currents and various marine life may lead to a severely spoiled holiday. Never swim after a heavy meal or significant intake of alcohol and always swim in the company of others.
Sun Exposure:
***********************************
The strength of the sun in the Seychelles throughout the year is significant and this can cause both sunburn and serious dehydration. After a long haul flight it may be tempting to fall asleep beside the hotel pool but this may cause dreadful sunburn and can easily ruin a holiday. Children need to be watched carefully as they are more liable to the effects of the sun, particularly on any fair skinned child. Wearing a light good fitting t-shirt and Increasing their salt intake may be very beneficial.
Road Safety:
***********************************
In the Seychelles they drive on the left side of the road but outside the main tourist resorts the roads tend to be very narrow with often shear drops. Barriers are rare and accidents can easily occur. The speed limits are between 25 to 50 mph and both drivers and front seat passengers are required to wear safety belts at all times. There is an ambulance service on the islands of Mahe, Praslin and La Digue which is summonsed by ringing 999.
Local Laws and Customs:
***********************************
There are strict regulations regarding import and export of firearms, spear-fishing equipment, fruit and vegetables. When paying for your hotel expenses a credit card must be used in most circumstances. If you have cash you must provide a receipt showing how it was obtained. A casino receipt would be adequate if you have been lucky enough!
Vaccinations for the Seychelles:
******************************************
Unless you are entering the islands from tropical Africa there are no essential vaccines for entry or exit. However for your own personal health it is recommended that travellers are covered against the following diseases;
*
Poliomyelitis (childhood booster)
*
Tetanus (childhood booster)
*
Typhoid (food and water borne disease)
*
Hepatitis A (food and water borne disease)
For those undertaking a longer more rural trip other vaccines may need to be considered including Hepatitis B.
Summary:
***********************************
Generally most tourists who maintain the usual commonsense rules stay perfectly healthy while in the Seychelles. Just remember the different climate conditions to your home situation and take care with food and water consumption. Further information is available from the Tropical Medical Bureau.

Travel News Headlines WORLD NEWS

Date: Mon, 4 May 2020 17:53:05 +0200 (METDST)

Victoria, Seychelles, May 4, 2020 (AFP) - Life in the Seychelles began returning to normal on Monday as authorities relaxed confinement measures, with no new coronavirus cases recorded in almost a month and only 11 people infected in the island nation.

The archipelago went into lockdown on April 8, two days after the last case of the virus was recorded, shutting non-essential services and banning all movement aside from grocery shopping.   A few days later a nighttime curfew was added to the measures.   The restrictions were applied to Mahe, the main island as well as the second and third most-populated islands Praslin and La Digue.   On Monday most businesses were allowed to re-open and people were once again moving freely and going to work -- few of whom wore a mask.

Authorities have called on citizens to nevertheless maintain social distancing measures and remain vigilant.   "We have won the battle but we have not won the war. We must remain vigilant and prevent the spread of the virus in the Seychelles at all cost," said Public Health Commissioner Jude Gedeon.   Only three of the original patients remain ill.    Some restrictions will remain in place. Schools will not open until mid-May and bars and restaurants in June. Gatherings of more than four people are still banned.

The Indian Ocean archipelago of 115 islands is a paradise for luxury tourism, and welcomed more than 360,000 visitors in 2018 -- a figure four times its population.   The impact of the coronavirus pandemic on global tourism has hit the islands hard. The government banned cruise ships and shut its international airport when the first cases were announced on March 14.

The airport is due to re-open on June 1, although borders will remain closed to countries which still count active cases of the virus.    Authorities do not expect tourists to return until September.   The absence of tourists has led the Seychellois rupee to drop 30 percent to the US dollar and the euro in recent weeks.
Date: Thu, 20 Feb 2020 09:58:17 +0100 (MET)
By Nicolas DELAUNAY

Les Mamelles, Seychelles, Feb 20, 2020 (AFP) - On a plain suburban street in Seychelles, far from the idyllic coastline and luxury resorts pampering honeymooners and paradise-seekers, heroin addicts queue anxiously for their daily dose of methadone.   It is a scene few outsiders would associate with the tropical nirvana adrift in the Indian Ocean, and one rarely, if ever, glimpsed by tourists as they shuttle from the airport to five-star luxury on white-sand beaches.

But life for many Seychellois is far from picture perfect: the tiny archipelago nation is battling what officials say are the world's highest rates of heroin addiction.   Nearly 5,000 people are hooked, government figures show, equivalent to nearly 0 percent of the national workforce -- a statistic that has startled the government into action.

In comparison, 0.4 percent of the global population consumed opioids in 2016, half of them in Asia, according to a United Nations report that puts Seychelles among the top consumers alongside producing countries such as Afghanistan.   The Seychelles' heroin boom, which took off over the past decade, gripped young and old alike and cut across class lines.   Among those queueing in the town of Les Mamelles for methadone -- a substitute narcotic used to wean users off heroin -- are parents with young children, an old man leaning on a cane and a taxi driver between shifts.

Graham Moustache, a 29-year-old father of two, described how the arrival of affordable and high-quality heroin in Seychelles swept up his entire family.   "I have four brothers and two sisters, and we have all been heroin addicts at one point," he told AFP, tracing his fingers over the needle scars on his arms.   "I've been to prison twice," he said, adding his mother had turned him in as "she didn't know what to do any more".   "Sometimes, I didn't have enough to eat and I had to choose between eating and buying heroin. I chose heroin."

- Soaring addiction -
The rise of new trafficking routes through East Africa in the late 2000s, coupled with porous borders and relatively high purchasing power among Seychellois, flooded the paradisal islands with heroin.   The average salary in the archipelago is $420 (390) -- high compared to other African nations.   The World Bank considers the Seychelles the only high-income country on the continent, thanks to the growing tourism industry.    But around 40 percent of the population still lives in poverty.

By 2011, around 1,200 people were addicted, prompting a punitive crackdown.   "We did not make a difference between the victim and the trafficker," said Patrick Herminie, director of the state-run Agency for Drug Abuse Prevention and Rehabilitation (APDAR).   By 2017, addiction had risen four-fold, placing Seychelles among the world's most drug-dependent nations.   The government, realising its war on drugs had failed, changed tack and declared a public health emergency.   "The magnitude of the problem is simply because we reacted a bit late," Herminie said.

Money has poured into combating the scourge, with state funds for drug prevention and rehabilitation programmes soaring to 75 million Seychelles rupees ($5.5 million) in 2020 -- almost 10 times the 2016 budget.    APDAR, a specialist drug agency created in 2017 to tackle the problem, employs four times as many staff as the body that preceded it.   A state-run methadone programme has reached 2,500 people, with medical follow-ups helping to track their progress.    But the free availability of methadone has also prompted drug dealers to lower their prices.

Mobile clinics drive around offering methadone to addicts and providing free health checks and advice.    "I've been clean for more than a year. I found a job as a fisherman, and I can see my two kids," said Moustache proudly, as he queued at the white methadone van staffed with healthcare workers.   Others have struggled to stay the course.   "Methadone helps me a lot, but it's difficult not to take heroin at all," said Gisele Moumou, an emaciated 32-year-old addict, drawing ragged breaths and sweating as she waits for her small cup of methadone.

- Stopping the scourge  -
Schoolchildren are being taught about the damage done by drugs through awareness campaigns and billboards in classrooms.    But there is much work to be done, especially among children from families affected by drug use, says Noellie Gonthier from CARE, a local harm-reduction charity.   "Sometimes, four- or five-year-olds at school mimic injecting heroin," she said.   "Our challenge is to make them understand that what they consider normal -- because of their family context -- actually isn't at all."   On Mahe, a small, mountainous island with lush vegetation, most of the population lives near the water. Life is quiet here, without traffic, and the streets are mostly clean.

Poverty is largely hidden, concentrated in a few neighbourhoods behind faded walls or in the hills.   So why do so many Seychellois take drugs? The authorities admit they haven't quite figured it out, but say it appears that while poverty does not quite allow people to live well, it allows them enough money to buy drugs to forget their woes.   "The root of the cause, we're still working on it," said Herminie.   Early studies show that health and social problems associated with heroin use have declined since the government switched its response from punishment to prevention, officials say.

Crime has nearly halved and annual cases of new hepatitis C infections have fallen 60 percent.    Youth unemployment, meanwhile, has shrunk from 6.5 percent to 2.1 percent in recent years.   One recovering addict, a taxi driver who did not want to be named, offered a bleak assessment as he waited for his daily methadone in an empty car park in Les Mamelles.    "We're a small island in the middle of the ocean. What else is there to do here?" he said.
Date: Thu, 16 Jan 2020 02:59:31 +0100 (MET)
By Nicolas DELAUNAY

Cousin Island, Seychelles, Jan 16, 2020 (AFP) - Giant tortoises amble across Cousin Island as rare birds flit above.   The scene attests to a stunning success for BirdLife International, a conservation group that bought the tiny Seychelles isle in 1968 to save a songbird from extinction.   Thick vegetation smothers ruins that are the only reminder of the coconut and cinnamon plantations that covered the island when the group stepped in to protect the Seychelles Warbler.

Now teeming with flora and fauna and boasting white beaches, Cousin Island is firmly on the tourist map, with managers scrambling to contain visitor numbers and soften their negative environmental impact.    More than 16,000 people visited the island in 2018, compared with 12,000 a decade earlier.   "Tourism is important for Cousin. That's what allows us to finance the conservation projects we run here.    "But 16,000 tourists... that was too much," said Nirmal Shah, director of Nature Seychelles, which is charged with running the special reserve.

Before the island was in private hands, the population of Seychelles Warblers was thought to have shrunk to just 26, barely hanging on in a mangrove swamp after much of their native habitat had been destroyed.    Now, they number more than 3,000 and the greenish-brown bird has been reintroduced to four other islands in the archipelago.   The former plantations have transformed into native forests, teeming with lizards, hermit crabs and seabirds, and the island is the most important nesting site for hawksbill turtles in the western Indian Ocean.   The International Union for Conservation of Nature (IUCN) waxes lyrical about the "unique biodiversity and conservation achievements" of Cousin, "the first island purchased for species conservation", a model since replicated around the world.

- Nature first -
Tourists have been allowed onto the island since 1972, but the message is clear: nature comes first.   In a well-oiled routine, every morning a handful of luxury sailboats and small motorboats anchor off the island, where their occupants wait for Nature Seychelles to skipper them ashore on their boats.   "Tourist boats cannot land directly on the island, the biohazard risk is too big," Shah said.   "Non-indigenous animals who may accidently be on board could come to the island and threaten its (ecological) balance."   Too many tourists can also upset this balance.

Nature Seychelles in July increased the price of visits from 33 to 40 euros ($36 to $44) and removed a free pass for children under 15, resulting in a welcome 10-percent reduction in visitor numbers.   "Something had to be done, there was too much pressure on the environment," said Dailus Laurence, the chief warden of the island.   "When there are too many tourists it can bother nesting birds and turtles who want to come and lay their eggs on the island."

One guide said that some tourists, bothered by the island's ubiquitous mosquitos, would "leave the paths, move away from the group and walk where they are not supposed to", putting fragile habitats at risk.   Shah said that if they wanted to increase the number of tourists, it would require hiring more wardens and guides who live on the island, which would also have a negative impact on nature.   "Our absolute priority is nature, and it comes before tourists. If we have to take more steps to protect it and reduce the number of tourists, we will," he said.
Date: Mon, 30 Dec 2019 08:31:15 +0100 (MET)

Victoria, Seychelles, Dec 30, 2019 (AFP) - A French tourist was seriously injured after being attacked by a shark while swimming in the Seychelles, a popular tourist destination, the French ambassador said Monday.   The attack on the 45-year-old woman took place Sunday night off the island of Praslin, the second-largest in the picturesque archipelago famed for its pristine beaches.    The victim was injured in one arm and was transported to a hospital.    "She underwent an operation last night and her life is not in danger," Ambassador Dominique Mas told AFP.    The attack comes during the high tourist season for the Seychelles, an archipelago of 115 islands located off the coast of East Africa in the Indian Ocean.

Such incidents are rare in the Seychelles, though two tourists -- one French and one British -- were killed in shark attacks off Praslin in August 2011.    Officials said Praslin's relatively cool waters could attract sharks during breeding.     The Seychelles Maritime Safety Administration (SMSA) cordoned off the area where Sunday's attack occurred to search for the shark.    The SMSA also imposed a temporary ban on swimming in the area.
18th Oct 2017
http://www.who.int/mediacentre/news/releases/2017/seychelles-plague-negative/en/ 

Samples from patients in Seychelles suspected to be ill with pneumonic plague tested negative at a World Health Organization (WHO) partner laboratory in Paris, France on Tuesday (17 October).
 
The ten samples were shipped by the Seychelles Ministry of Health and WHO to the collaborating centre for Yersinia at the Institut Pasteur to confirm the status of several suspected and one probable case – a 34-year-old Seychelles national who had returned from Madagascar with plague-like symptoms.

WHO is working with the Seychelles health authorities to reduce the risk of plague spreading from neighbouring Madagascar, which faces an unprecedented outbreak that has killed more than 70 people since August. No plague cases have been confirmed in the Seychelles.
Alongside support for laboratory testing, WHO has deployed experts and medical supplies to the 115-island country. The Organization is also providing guidance for the tracing and treatment of contacts of people who are suspected to have been infected.

“We are working with health authorities to reduce the risk of the spread of plague in the Seychelles by improving surveillance and preparedness,” said Dr. Ibrahima Soce Fall, WHO Regional Emergencies Director for the Africa region.

WHO is advising the Government of Seychelles on the implementation of public health measures that are in line with the WHO International Health Regulations, such as enhanced surveillance, isolation and treatment of suspect cases, contact tracing and prophylactic treatment of potential contacts.

WHO currently assesses the risk of spread of plague in the Seychelles to be low.
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World Travel News Headlines

Date: Mon, 1 Jun 2020 10:23:53 +0200 (METDST)

Yerevan, June 1, 2020 (AFP) - Armenian Prime Minister Nikol Pashinyan and his family have tested positive for the coronavirus, he said Monday, as the rate of new infections soared in the Caucasus nation.   "My coronavirus test was positive yesterday," Pashinyan said in a self-recorded video message on Facebook, adding that his family were also infected.   He said he had no "viable symptoms" of the virus and would be working from home.   The prime minister and his wife Anna Hakobyan, who is a journalist, have four children.   The ex-Soviet republic of some three million has so far reported 9,492 cases of the coronavirus and 139 deaths.

Coronavirus patients have overwhelmed Armenia's hospitals and last week health officials said that intensive care treatment could be soon restricted to patients with the best chance of survival.   Pashinyan's announcement came nearly one month after Armenia on May 4 lifted a state of emergency imposed in March to slow the spread of the coronavirus.

The prime minister acknowledged his government had failed to enforce anti-virus measures and there had been widespread quarantine violations.   Pashinyan was elected prime minister in the wake of mass popular protests he led two years ago against veteran leader Serzh Sarkisian and his Republican Party.   He has since led a relentless crusade against graft and initiated sweeping judicial reforms.
Date: Mon, 1 Jun 2020 09:17:15 +0200 (METDST)

San Salvador, June 1, 2020 (AFP) - Tropical Storm Amanda triggered flash floods, landslides and power outages as it barrelled through El Salvador and Guatemala Sunday, killing 14 people, authorities said, warning of further heavy rain to come.   El Salvador President Nayib Bukele declared a 15-day state of emergency to cope with the effects of the storm, which he estimated to have caused $200 million in damage, but which weakened later in the day as it moved into Guatemala.

Amanda, the first named storm of the season in the Pacific, unleashed torrents of floodwater that tossed vehicles around like toys and damaged about 200 homes, the head of the Civil Protection Service William Hernandez said.   The fatalities were all recorded in El Salvador, Interior Minister Mario Duran said, warning that the death toll could rise.   One person is still missing, senior government official Carolina Recinos added.   "We are experiencing an unprecedented situation: one top-level emergency on top of another serious one," San Salvador mayor Ernesto Muyshondt said, referring to the coronavirus pandemic.

He added that half of those killed died in the capital, and that 4,200 people had sought refuge in government-run shelters after losing their homes or being forced to leave because they were in high-risk areas.   In some flooded areas, soldiers worked alongside emergency personnel to rescue people.   "We lost everything, we've been left with nowhere to live," said Isidro Gomez, a resident of hard-hit southeastern San Salvador, after a nearby river overflowed and destroyed his home.

Another victim, Mariano Ramos, said that at dawn residents of his San Salvador neighborhood were slammed by an avalanche of mud and water. An elderly man died in the area, officials said.   El Salvador's environment ministry warned residents of the "high probability" of multiple landslides that could damage buildings and injure or kill people.

Nearly 90 percent of El Salvador's 6.6 million people are considered vulnerable to flooding and landslides due to its geography.   In neighboring Guatemala, officials said roads had been blocked by at least five landslides and some flooding was reported, but no evacuations were underway.   Even though Amanda weakened to tropical depression status, Guatemalan officials warned that heavy rain would continue, with swollen rivers and possible "landslides affecting highways ... and flooding in coastal areas."
Date: Mon, 1 Jun 2020 06:55:18 +0200 (METDST)

Lima, June 1, 2020 (AFP) - Peru on Sunday reported 8,800 new COVID-19 infections, setting a new daily record for a country that already has the second highest number of novel coronavirus cases in Latin America after Brazil.   The death toll is now at 4,506, the third highest in the region -- itself the new hotspot of the deadly disease -- after Brazil and Mexico, with President Martin Vizcarra warning the country is only halfway through the crisis.

Infections have jumped in Peru despite a months-long mandatory lockdown and a nigh time curfew and the government ordering international borders to be closed.   The spike is concentrated around the capital Lima, where one third of the population lives, and put tremendous strain on Peru's economy and healthcare system.   Four out of every ten Peruvians lost their source of income when the lockdown began, according to one study, and last week Peru secured a two-year, $11 billion credit line from the International Monetary Fund.

- 'Tremendous challenge' in Chile -
Neighbouring Chile on Sunday reported 57 more fatalities in the past 24 hours, a new record that brings the country's COVID-19 death toll to 1,054.   "We are facing the largest pandemic of the past 100 years," said Deputy Health Minister Paula Daza, as she announced the latest figures.    "It is a tremendous challenge; we are living very difficult times in our country."

In Santiago, where the 80 percent of the virus cases were reported, 96 percent of the emergency room beds were taken, officials said.   Officials reported a sharp increase in cases over the past two weeks.   In early May the government of President Sebastian Pinera said that the number of virus cases had hit a plateau, and lockdown restrictions would be loosened.
Date: Mon, 1 Jun 2020 03:38:38 +0200 (METDST)
By Anna SMOLCHENKO

Moscow, June 1, 2020 (AFP) - Shopping malls and parks are set to reopen in Moscow on Monday as the Russian capital eases coronavirus restrictions despite having the world's third-largest caseload.   The relaxation of the confinement orders in Moscow, the epicentre of Russia's outbreak with a population of more than 12 million, comes after President Vladimir Putin announced the epidemic had passed its peak in the country.

Under lockdown since March 30, residents of Europe's most populous city were until now only allowed to leave their homes for brief trips to shop, walk dogs or travel to essential jobs with a permit.   While Muscovites welcomed the opportunity to return to parks and malls after weeks of being cooped up at home, many ridiculed the Moscow mayor's "experiment" aimed at regulating people's walks and exercise.

As a two-week test measure, Sergei Sobyanin said residents of Moscow will be allowed to take walks according to a staggered schedule based on their home address.   "Regular walks are allowed between 9am and 9pm but no more than three times a week -- twice on weekdays and once on a weekend," said Sobyanin on his blog, adding that a detailed schedule would be released separately.   People can jog or exercise between 5am and 9am but must wear masks, according to the new rules.   Sobyanin said he feared that without limits on walking, people would throng the streets in scenes reminiscent of May Day outpourings in Soviet times.

- 'Sheer lunacy' -
The new regulations unleashed a flood of mockery on social media, with political commentator Alexander Golts calling them "sheer lunacy".   Critics quipped that life in Moscow was beginning to imitate dystopian fiction such as the novels of Aldous Huxley and Yevgeny Zamyatin.

Popular comedian Maxim Galkin, who has nearly eight million followers on Instagram, released a sketch in which Putin and Sobyanin discuss a "breathing schedule" for Moscow residents.   The five-minute parody has been viewed nearly six million times over the past few days.   When the restrictions are relaxed, dry-cleaners, laundry services and repair workshops will be allowed to reopen, while restaurants, cafes and cinemas will remain closed for now.

Moscow authorities also said that no mass gatherings would be allowed during the city-wide quarantine that will remain in place until at least June 14.   On Thursday authorities sentenced prominent reporter and activist Ilya Azar to 15 days in jail for staging a lone protest in central Moscow.   Dozens of his supporters have also been briefly detained over the past few days.   Rights organisations including Amnesty International and the Council of Europe have warned Moscow against using the coronavirus lockdown as a pretext to muzzle activists.

Many critics have also questioned the move to lift the restrictions as Russia reported more than 9,000 new infections on Sunday.   With more than 405,000 confirmed infections and over 4,600 deaths, the country has the world's third-largest caseload after the United States and Brazil.   Analysts say Putin is keen to open up the Russian economy and has recently ordered a World War II victory parade postponed by the contagion to be held on June 24.   The 67-year-old leader is also widely expected to announce a new date for a vote on constitutional reforms that could pave the way for him to potentially stay in power until 2036.
Date: Sun, 31 May 2020 11:16:20 +0200 (METDST)

Mogadishu, May 31, 2020 (AFP) - At least 10 people died and 12 were wounded when an explosive device ripped through a minibus outside the Somali capital Mogadishu on Sunday, the government said.   The deadly explosion occurred near Lafole village along the Afgoye-Mogadishu where the passenger bus was travelling early in the day.   "At least 10 civilians were killed in an explosion at Lafole area this morning, those who died were all civilians," the information ministry said in a statement, adding that the victims were on their way to a funeral.

Witnesses said the minibus was completely destroyed, and described an horrific scene with everyone on board either dead or wounded and many bodies ripped apart or burned beyond recognition.   "This was a horrible incident this morning, the explosive device went off as the bus was passing by the area and destroyed it completely," said Daud Doyow, a witness.   "Bodies of civilians were strewn in pieces and most of the people died," he added.   "There were more than 20 people on board and 10 of them were confirmed dead while the rest are seriously wounded and taken to hospital, this is a horrible scene here," said another witness, Abdirisak Adan.   No group immediately claimed responsibility for the bombing, but Somalia's al Qaeda-aligned Shabaab group carries out regular attacks in and around the capital, often killing civilians.
Date: Wed, 27 May 2020 17:58:12 +0200 (METDST)

Nairobi, May 27, 2020 (AFP) - Kenya said Wednesday it had documented a record 123 cases of coronavirus in the past 24 hours, a "staggering" figure although one also explained in part by wider testing.   "Today, I come to you with sombre news," Health Minister Mutahi Kagwe said.   "Our figures today are staggering. Out of the 3,077 samples tested, we have 123 positive cases. For the first time we have hit a triple digit.    "This is the highest number of positive cases we have ever recorded in a single day since we recorded the first case on March 13."

A total of 1,471 cases of COVID-19 have been recorded in Kenya since the start of the epidemic. Of these, 55 have been fatal.   The tally of infections has doubled since mid-May but the country has also tripled its number of daily tests, from less than 1,000 to nearly 3,000, which has helped unearth more cases.

Kagwe sounded a warning about the vulnerability of crowded slums in the capital Nairobi, which leads the list of new cases followed by the port city of Mombasa.   "There is a raging number of infections in these areas," he said, adding: "No-one should have a false sense of security about their immunity to COVID-19."   Among its anti-coronavirus measures, Kenya has a national 7pm-5am curfew, which is currently in force until June 6, and has a ban on entering or exiting the cities of Nairobi, Mombasa, Kilifi, Kwale and Mandera.
Date: Wed, 27 May 2020 16:38:21 +0200 (METDST)

Nicosia, May 27, 2020 (AFP) - Cyprus hopes to attract tourists after its coronavirus lockdown by paying the medical costs of anyone who tests positive for COVID-19 while holidaying on the island, officials said Wednesday.   The plan was outlined in a letter to tour operators and airlines detailing the measures Cyprus is taking to ensure the safety of its tourism sector.   The letter was made public Wednesday and signed by the ministers of foreign affairs, transport, and tourism.

The Mediterranean island is marketing itself as a safe holiday destination during the global pandemic.   The Republic of Cyprus has reported 939 novel coronavirus cases and only 17 deaths.   The government said it is "committed to taking care of all travellers who test positive during their stay, as well as their families and close contacts".   It pledged to cover accommodation, dining and medical care if a tourist falls ill with the virus.   The "traveller will only need to bear the cost of their airport transfer and repatriation flight," it said.

- 'Quarantine hotels' -
A 100-bed hospital will be available exclusively for tourists who test positive, with more beds available "at very short notice if required".   An additional 112 beds in intensive care units with 200 respirators will be reserved for critically ill patients.   Designated "quarantine hotels" will have 500 rooms available for family members and close contacts of patients.

Other hotels on the island will be allowed to remain open if a guest tests positive, but their room will "undergo a deep clean".   Authorities have forecast a 70 percent decline in tourist arrivals in 2020.    Tourism earned Cyprus EUR2.68 billion ($2.94 bn) in 2019 -- about 15 percent of gross domestic product -- down one percent from the previous year, which was bolstered by a record 3.97 million arrivals.   Cyprus plans to reopen its airports on June 9 to arrivals from 13 countries considered low risk.   These include Israel, Greece, Germany, Austria and Malta but the island's two biggest markets Britain and Russia are not on the approved list.

hose arriving between June 9-19 will need to provide a health certificate proving they do not have the virus.   That requirement will be dropped from June 20, when another six countries will be added to the approved list, including Switzerland and Poland.   Cyprus says it will update the list of approved countries on a weekly basis based on scientific advice.

Officials will administer temperature checks and free random testing of arrivals.   Having tested over 10 percent of its population, Cyprus says it has one of the lowest coronavirus infection rates in Europe.   "Very few countries worldwide, especially in the Mediterranean, can boast about such statistics," the letter said.
Date: Wed, 27 May 2020 14:45:11 +0200 (METDST)

Stockholm, May 27, 2020 (AFP) - Airline SAS said Wednesday it would resume flights on several domestic and international routes in June, over two months after the operator grounded most of its fleet over the new coronavirus' impact on travel.   "This primarily includes domestic flights within and between the Scandinavian countries, but flights to New York, Chicago and Amsterdam from Copenhagen are also set to resume," SAS said in a statement.

The Scandinavian airline announced in mid-March it was halting most of its traffic and furloughing around 90 percent of its staff.   In late April the airline, whose two largest shareholders are the Swedish and Danish states, announced it was laying off about 5,000 people, representing 40 percent of the company's workforce.

In early May the company secured a state-guaranteed credit line of 3.3 billion Swedish kronor ($344 million or 313 million euros) to help it navigate the impact of the new coronavirus.   Even with the resumption of some flights, the airline continues to operate at a reduced capacity, but the added routes means an effective doubling of the aircraft in use from 15 to 30, according to SAS.   Finnair, of Nordic neighbour Finland, announced early last week it would start resuming its long-haul flight to Asia in July.
Date: Wed, 27 May 2020 14:25:21 +0200 (METDST)

Yerevan, May 27, 2020 (AFP) - Virus cases have overwhelmed Armenia's hospitals, officials said Wednesday, raising the prospect that intensive care treatment could be restricted to patients with the best chance of survival.   The tiny Caucasus nation of some three million has so far reported 7,774 coronavirus cases and 98 deaths.   At a cabinet meeting on Wednesday, Prime Minister Nikol Pashinyan said "the situation with the coronavirus pandemic is very severe in Armenia."

Health ministry spokeswoman Alina Nikoghosyan told AFP: "if the current situation persists, in the coming days, intensive care will only be available for the patients with the best survival chances."   Health Minister Arsen Torosyan said Sunday that out of the country's 186 intensive care beds for coronavirus patients, only 32 remained empty and would soon be filled.

The prime minister called for stricter enforcement of measures aimed at containing the outbreak such as the wearing of face masks in public spaces.   This comes after the country lifted a state of emergency on May 4 which it had declared in March because of the pandemic.   Pashinyan said his government had failed to enforce anti-virus measures and there had been widespread quarantine violations.   "Our mistake was that we put too much trust in our citizens' sense of responsibility," he said.

Deputy Prime Minister Tigran Avinyan said he did not rule out that the government could have to impose a fresh nationwide lockdown.   Analysts have criticised the government's handling of the crisis, saying a decision to close borders was taken too late and officials sent the public "confusing messages."   "Officials were calling for the wearing of face masks, but they themselves didn't wear them until recently," said analyst Tatul Hakobyan.
Date: Wed, 27 May 2020 09:53:01 +0200 (METDST)

New Delhi, May 27, 2020 (AFP) - India is wilting under a heatwave, with the temperature in places reaching 50 degrees Celsius (122 degrees Fahrenheit) and the capital enduring its hottest May day in nearly two decades.   The hot spell is projected to scorch northern India for several more days, the Meteorological Department said late Tuesday, "with severe heat wave conditions in isolated pockets".   As global temperatures rise, heatwaves are a regular menace in the country -- particularly in May and June. Last year dozens of people died.

Met officials said Churu in the northern state of Rajasthan was the hottest place on record on Tuesday, at 50 Celsius, while parts of Punjab, Haryana and Uttar Pradesh sweltered in the high 40s.   Parts of the capital, New Delhi, recorded the hottest May day in 18 years with the mercury hitting 47.6 Celsius.   No deaths have been reported so far this year, but last year the government said the heat had killed 3,500 people since 2015. There have been fewer
fatalities in recent years.

The country of 1.3 billion people suffers from severe water shortages with tens of millions lacking running water -- to say nothing of air conditioning.   Parts of Delhi and elsewhere regularly see scuffles when tankers arrive to deliver water. Last year Chennai made international headlines when the southern city ran out of water entirely.   The heatwave adds to problems the country already has dealing with the spread of coronavirus.   India now has the 10th highest number of coronavirus cases globally, climbing above 150,000 on Wednesday with almost 4,500 deaths.

Last week cyclone Amphan killed more than 100 people as it ravaged in eastern India and Bangladesh, flattening villages, destroying farms and leaving millions without power.   Huge swarms of desert locusts, meanwhile, have destroyed nearly 50,000 hectares (125,000 acres) of crops across western and central India, and may enter Delhi in coming days.   The north-eastern states of Assam and Meghalaya are also currently experiencing floods, with more heavy rainfall forecast in the coming days.