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Anguilla

Anguilla US Consular Information Sheet
March 03, 2009
COUNTRY DESCRIPTION: Anguilla is a British overseas territory in the Caribbean, part of the British West Indies. It is a small but rapidly developing island with particularly well-developed
ourist facilities.

ENTRY/EXIT REQUIREMENTS:
The Intelligence Reform and Terrorism Prevention Act of 2004 requires all travelers to and from the Caribbean, Bermuda, Panama, Mexico and Canada to have a valid passport to enter or re-enter the United States. U.S. citizens must have a valid U.S. passport if traveling by air, including to and from Mexico.
If traveling by sea, U.S. citizens can use a passport or passport card. We strongly encourage all American citizen travelers to apply for a U.S. passport or passport card 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.

In addition to a valid passport, U.S. citizens need onward or return tickets, and sufficient funds for their stay.
A departure tax is charged at the airport or ferry dock when leaving. For further information, travelers may contact the British Embassy, 19 Observatory Circle NW, Washington, DC
20008; telephone (202) 588-7800; or the nearest consulate of the United Kingdom in Atlanta, Boston, Chicago, Dallas, Los Angeles, New York, Denver, Houston, Miami, Orlando, Seattle, or San Francisco. Visit the British Embassy web site 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:
For the latest security information, Americans traveling abroad should regularly monitor the Department of State, Bureau of Consular Affairs’ web site, where the current Travel Warnings and Travel Alerts, as well as the Worldwide Caution, can be found.

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

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

CRIME:
While Anguilla's crime rate is relatively low, both petty and violent crimes
do occur. Travelers should take common-sense precautions to ensure their personal security, such as avoiding carrying large amounts of cash or displaying expensive jewelry. Travelers should not leave valuables unattended in hotel rooms or on the beach. They should use hotel safety deposit facilities to safeguard valuables and travel documents. Similarly, they should keep their lodgings locked at all times, whether they are present or away, and should not leave valuables in their vehicles, even when locked.

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 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 emergency line in Anguilla is 911.
See our information on Victims of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION:
There is only one hospital, Princess Alexandra Hospital (telephone: 264-497-2551), and a handful of clinics on Anguilla, so medical facilities are limited.
Serious problems requiring extensive care or major surgery may require evacuation to the United States, often at considerable expense.

There are no formal, documented HIV/AIDS entry restrictions for visitors to and foreign residents of Anguilla, but there have been anecdotal reports of exclusion.
Please verify this information with the British Embassy before you travel.

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

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

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

Unlike the U.S., traffic in Anguilla moves on the left. The few roads on the island are generally poorly paved and narrow. While traffic generally moves at a slow pace, with the increasing number of young drivers in Anguilla, there are occasional severe accidents caused by excessive speed. Although emergency services, including tow truck service, are limited and inconsistent, local residents are often willing to provide roadside assistance. For police, fire, or ambulance service dial 911.

Please refer to our Road Safety page for more information.
Visit the Government of Anguilla web site for further road safety information.

AVIATION SAFETY OVERSIGHT:
Civil aviation operations in Anguilla fall under the jurisdiction of British authorities. The U.S. Federal Aviation Administration (FAA) has assessed the Government of the United Kingdom’s Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for oversight of Anguilla’s air carrier operations.
For more information, travelers may visit the FAA web site.

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 Anguilla laws, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in Anguilla 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 Anguilla are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department's travel registration web site and to obtain updated information on travel and security within Anguilla. 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 with consular responsibility over Anguilla is located in Bridgetown, Barbados in the Wildey Business Park in suburban Wildey, southeast 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.
Visit the U.S. Embassy Bridgetown online for more information.
Hours of operation are 8:30 a.m. – 4:30 p.m. Monday through Friday, except Barbadian and U.S. holidays.
* * *
This replaces the Country Specific Information for Anguilla dated April 2, 2008, to update sections on Country Description, Entry/Exit Requirements, Information for Victims of Crime, and Medical Facilities and Health Information.

Travel News Headlines WORLD NEWS

Date: Sat, 9 Sep 2017 19:31:32 +0200

Paris, Sept 9, 2017 (AFP) - France's meteorological agency on Saturday issued its highest warning for the Caribbean islands of St Martin and St Barts as Hurricane Jose bore down, three days after they were hit by Hurricane Irma.   The alert warned of a "dangerous event of exceptional intensity," with winds that could reach 120 kilometres (75 miles) per hour, and strong rains and high waves.

St Barts is a French overseas territory, as is the French part of St Martin, which is divided between France and the Netherlands.   Twelve people were killed on the two islands by Hurricane Irma, thousands of buildings were flattened and the authorities are struggling to control looting.   The French state-owned reinsurer CCR on Saturday estimated the damage at 1.2 billion euros ($1.4 billion).   Irma is now heading for Florida, where a total of 6.3 million people have been ordered to evacuate, according to state authorities.
Date: Tue 29 Apr 2014
Source: National Institute for Public Health and the Environment [edited]

1 Oct 2013-29 Apr 2014 (week 18) St Maarten - Since the last report (week 15 [17?]) 52 new cases have been confirmed among St Maarten residents. Up to 29 Apr 2014, now a total of 343 confirmed cases have been reported. One of these confirmed cases was hospitalized.

The median age of the confirmed patients was 44 years, range 4-92 years. Of those cases for which gender was available, 201 were female and 130 were male.

- On 6 Dec 2013, the 1st indigenous chikungunya [virus infection] case of St Maarten was reported. Retrospectively, the 1st patient with suspected complaints was reported in mid-October 2013 in St Martin.
------------------------------------
Communicated by:
Roland Hubner
Superior Health Council
Brussels
Belgium
=====================
[The report also has graphs showing case numbers over time.

Maps of St Martin/St Maarten can be accessed at
Date: 5-11 May 2014
Source: Institut de Veille Sanitaire (French Institute for Public Health Surveillance, InVS) [edited]

Cases since the beginning of the outbreak in December 2013:
- St Martin: (susp) 3240 cases; deaths 3; stable.
- St Barthelemy: (susp) 500 cases; stable.
- Martinique: (susp) 24 180; deaths 3; increasing.
- Guadeloupe: (susp) 13 600 cases; deaths 1; increasing.
- French Guiana: (susp) not available; (probable or confirmed) 122 cases with 83 locally acquired; increasing, with a new cluster in Kourou and 2 near Cayenne.
======================
[The 16 May 2014 report from Guyaweb (<http://www.guyaweb.com/actualites/news/sciences-et-environnement/le-chik-revient-kourou-setend-cayenne-desormais-saint-laurent/>) states that there are 2 new cases in Saint-Laurent-du-Maroni, overlooking the Suriname River, of which one is certainly autochthonous, and a new focal point occurred in Kourou with 4 cases.

Maps of the area can be seen at
and <http://healthmap.org/promed/p/35574>. - ProMed Mod.TY]
Date: 7-13 Apr 2014
Source: INVS Point Sanitaire No. 14 [in French, trans. ProMed Mod.TY, edited]

Cases since the beginning of the outbreak in December, 2013:
- St. Martin: (susp.) 2980 cases, (probable and conf.) 793 cases; Deaths 3; Decreasing.
- Saint Barthelemy: (susp.) 460 cases, (probable or confirmed) 135 cases; Decreasing.
- Martinique: (susp.) 16 000, (probable or confirmed) 1473 cases; Deaths 2; Increasing.
- Guadeloupe: (susp.) 4710 cases, (probable or confirmed) 1261 cases; Deaths 1; In epidemic status.
- French Guiana: (susp.) 7 cases with 4 locally acquired, (probable or confirmed) 39 cases with 26 locally acquired) 30 cases; (imported) 16 cases; Moderate to increasing; Half of probable and confirmed cases are located in Kourou; however indigenous cases have also been recorded from the Cayenne Matoury, Remire and Macouria communities.
=================
[Maps showing case distributions on each island can be accessed at the above URL. - ProMed Mod.TY]
Date: Thu 27 Mar 2014
Source: The Daily Herald [edited]

As St. Maarten continues to take measures to combat the spread of the chikungunya virus, the number of cases continues to climb.

Health Minister Cornelius de Weever announced on Wednesday [26 Mar 2014], that the total number of confirmed chikungunya cases thus far stood at 224.

De Weever also announced that government will be signing a Memorandum of Understanding (MOU) with French St. Martin as a means of collectively responding to the mosquito threat that puts the population at risk. He said both sides have been working closely together to address the dengue and chikungunya threats.

The MOU will cover, amongst other things, a regular exchange of epidemiological information on vector-borne diseases and collectively publishing and representing data collected under the agreement.

The need for collective information campaigns and enhancement of the mosquito vector-control programme will also be included in the MOU. The MOU also describes the need for planning execution and evaluation of collective responses to the chikungunya threat.
=========================
[The increase in the number of chikungunya virus infections over the past week in St. Maarten is of concern, rising from 123 cases to 224 cases. This number is confirmed in another report that also indicates that there are an additional 325 suspected cases (<http://www.rivm.nl/dsresource?type=pdf&disposition=inline&objectid=rivmp:239786>).  - ProMed Mod.TY]

[A HealthMap/ProMED-mail map can be accessed at:
<http://healthmap.org/promed/p/35574>.]
More ...

Fiji

Fiji - US Consular Information Sheet
October 24, 2008
COUNTRY DESCRIPTION:
Fiji is a South Pacific island nation consisting of over 350 islands and islets, of which approximately 100 are inhabited. The capital is Suva. On December 5, 2006,
in the fourth coup since 1987, the Commander of Fiji’s military force deposed the lawfully elected government of Fiji. There is currently an unelected interim government in place established by the military. The coup has had a negative effect on Fiji’s economy. Tourist facilities are available. The Fiji Visitors Bureau, which has a wide range of information of interest to travelers, can be contacted via the Internet at http://www.bulafiji.com/. Read the Department of State Background Notes on Fiji for additional information.
ENTRY/EXIT REQUIREMENTS: A passport valid for at least three months beyond the intended date of departure from Fiji, proof of sufficient funds and an onward/return ticket are required for entry to Fiji. A visa is not required for tourist stays up to four months. Yachts wishing to call at the Lau group of islands need special permission granted at the first port of entry into Fiji. For further information on entry/exit requirements, travelers may contact the Embassy of the Republic of Fiji, 2233 Wisconsin Avenue NW, No. 240, Washington, DC 20007; telephone (202) 337-8320, or the Fiji Mission to the United Nations in New York. This is particularly important for travelers planning to enter Fiji by sailing vessel.

Information about dual nationality and the prevention of international child abduction can be found on our web site. For further information about customs regulations, please read our Customs Information.
SAFETY AND SECURITY:
While a state of emergency is no longer in effect, some basic rights remain uncertain. The independence of Fiji’s law enforcement and judicial systems appears compromised, putting into question protections ordinarily afforded by the rule of law. The Department of State continues to warn U.S. citizens to carefully consider the risks of travel to the Republic of Fiji at this time. While Fiji’s country situation appears calm on the surface, political, economic, and security uncertainties continue. It is possible that the security situation, especially in Suva, could deteriorate rapidly. American citizens in Fiji should remain vigilant, particularly in public places and near military activities in the greater Suva area, and should avoid demonstrations and large crowds. Even demonstrations intended to be peaceful could turn confrontational and escalate into violence unexpectedly.
For the latest security information, Americans traveling abroad should regularly monitor the Department of State, Bureau of Consular Affair’s web site at http://travel.state.gov, where the current Travel Warnings and Travel Alerts, including the Worldwide Caution, can be found.
Up-to-date information on 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: Urban areas experience a higher incidence of crime than do other areas. Travelers should protect their valuables and be aware that theft from hotel rooms and purse snatching or pick-pocketing are the most common crimes against tourists. Offenses against persons do occur, and visitors should remain attentive to their personal safety. Tourists should be cautious about sharing too much personal information about their country of origin or lodging. Americans not familiar with their environs should ask hotel staff about areas to avoid at night. Visitors are advised not to walk alone after dark and not to walk alone in isolated areas at any time. Due to crime directed against taxi drivers, travelers should not allow taxis to pick up other passengers while en route and should not enter a taxi that already carries other passengers.
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 U.S. Embassy in Suva, Fiji at (679) 331-4466 (ask for American Citizen Services). 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 line in Fiji is 911.

See our information on Victims of Crime.
MEDICAL FACILITIES AND HEALTH INFORMATION: Health-care facilities in Fiji are adequate for routine medical problems. Emergency response is extremely limited, and the few ambulances available are poorly equipped and staffed. Two major hospitals, the Lautoka Hospital in the western city of Lautoka, and the Colonial War Memorial Hospital in Suva, provide limited emergency and outpatient services. A private hospital in Suva provides Western-style medical care, and maintains the Fiji Recompression Chamber for the benefit of scuba divers. Other hospitals and clinics provide only a limited range of health services. Medical emergencies may be referred to Australia, New Zealand, or the United States. Serious medical problems requiring hospitalization and/or medical evacuation to the United States or elsewhere can cost thousands of dollars. Doctors and hospitals expect immediate cash payment for health services.
Fiji may impose HIV/AIDS travel restrictions on some visa applicants for work permits. Applicants must obtain a medical clearance, and the work permit committee will make the decision to grant the permit on a case-by-case basis. Before traveling, please inquire directly with the Embassy of the Republic of Fiji, 2233 Wisconsin Avenue NW, No. 240, Washington, DC 20007; telephone (202) 337-8320, or the Fiji Mission to the United Nations in New York.

Fiji is currently experiencing an increased number of Dengue fever cases, with almost 1,000 cases confirmed (but no deaths) since September 1, 2008. Dengue fever is a common disease caused by a virus that humans get by being bitten by infected mosquitoes (usually Aedes aegypti). For more information about Dengue fever, see the CDC website below.

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 if it will cover emergency expenses such as a medical evacuation. Please see our information on medical insurance overseas.

TRAFFIC SAFETY AND ROAD CONDITIONS: While in a foreign country, U.S. citizens may encounter road conditions that differ significantly from those in the United States. The information below concerning Fiji is provided for general reference only, and it may not be totally accurate in a particular location or circumstance.
Traffic moves on the left in Fiji. While most roads in urban areas are paved, they are poorly maintained. Roads outside the city are usually not paved. In the city, driving after dark requires heightened attentiveness; outside the city, it is discouraged, except in emergency or exceptional circumstances. Stray animals, unwary pedestrians, and potholes make driving dangerous and particularly hazardous at night.
Please refer to our Road Safety page for more information. Visit the web site of Fiji’s national tourist office and national authority responsible for road safety at http://www.bulafiji.com
AVIATION SAFETY OVERSIGHT: The U.S. Federal Aviation Administration (FAA) has assessed the Government of Fiji’s Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for oversight of Fiji's air carrier operations. For further information, travelers may visit the FAA’s web site at http://www.faa.gov/safety/programs_initiatives/oversight/iasa
SPECIAL CIRCUMSTANCES:
Water Sports: Many visitors to Fiji participate in water sports, including scuba diving, snorkeling, surfing, and operating jet-skis. The Embassy strongly recommends that anyone interested in scuba diving and snorkeling while in Fiji check the references, licenses, and equipment of tour operators before agreeing to or paying for a tour. Visitors should rent equipment only from reputable operators and should insist on sufficient training before using the equipment. Rental diving equipment may not always be properly maintained or inspected, and some local dive masters may fail to consider the skill levels of individual tourists when organizing dives. Deaths and serious mishaps have occurred in the past as a result of lack of attention to basic safety measures during diving and snorkeling trips. Surfing on Fiji’s numerous reef breaks can be highly dangerous. Safety precautions and emergency response capabilities may not be up to U.S. standards. Fiji has only one decompression chamber, which is located in Suva, far from most resorts.

Trekking: Terrain in the Fiji islands can be hazardous. Please consult with local guides and/or your place of lodging before undertaking a trek. Americans are also advised to hike with a companion and not to stray from marked or well-worn paths.
Customs: Fiji's customs authorities may enforce strict regulations concerning temporary importation into, or export from, Fiji of items such as alcohol or tobacco products. It is advisable to contact the Embassy of Fiji in Washington, DC at (202) 337-8320 for specific information regarding customs requirements. Importation of animals is strictly controlled. Pets may be imported only from designated, rabies-free locales. Those wishing to bring pets to Fiji should contact the Ministry of Agriculture in Suva as much as six months in advance for particulars.

Purchase of Real Estate: U.S. citizens should be aware of the risks inherent in purchasing real estate in Fiji, and should exercise caution before entering into any form of commitment to invest in property there. Investors must recognize the need to obtain authoritative information and to hire competent Fijian legal counsel when contemplating any real estate investment. Fijian law and practices regarding real estate differ substantially from those in the United States.
Notification of Arrest: U.S. citizens are encouraged to carry a copy of their U.S. passports with them at all times so, that if questioned by local officials, proof of identity and U.S. citizenship are readily available. According to Fijian law, a criminal detainee may be held for a maximum of 48 hours before being charged. Police authorities normally advise the U.S. Embassy of the detention or arrest of a U.S. citizen within 24 hours of the incident. Nevertheless, U.S. citizens who are detained are encouraged to request that a consular officer at the U.S. Embassy in Suva be notified.
Natural Disasters: Fiji is located in an area of high seismic activity. Although the probability of a major earthquake occurring during a particular trip is remote, earthquakes can and do occur. The cyclone season is November through April. The Fiji Meteorological Service maintains a Tropical Cyclone Warning Center (TCWC) in Nadi serving the Southwest Pacific Region. General information regarding disaster preparedness is available via the Bureau of Consular Affairs' web site, and from the U.S. Federal Emergency Management Agency (FEMA) home page at http://www.fema.gov/
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 those in the United States for similar offenses. Persons violating Fijian laws, even unknowingly, may be expelled, arrested or imprisoned. Penalties for possession of, use of, or trafficking in illegal drugs in Fiji are strict, and convicted offenders can expect jail sentences and heavy fines. Please see our information on Criminal Penalties.

CHILDREN'S ISSUES: For information see our Office of Children’s Issues web pages on international adoption and international parental child abduction.
REGISTRATION / EMBASSY LOCATION: Americans living or traveling in Fiji are encouraged to register with the U.S. Embassy in Suva through the State Department's travel registration web site, and to obtain updated information on travel and security within Fiji. Americans without Internet access may register directly with the nearest U.S. embassy or consulate. By registering, American citizens make it easier for the U.S. embassy or consulate to contact them in case of emergency. The U.S. Embassy is located at 31 Loftus Street in Fiji’s capital city of Suva. The telephone number is (679) 331-4466; the fax number is (679) 330-2267. Information may also be obtained by visiting the U.S. Embassy’s home page at http://suva.usembassy.gov/information_for_travelers.html
* * *
This replaces the Country Specific Information dated February 5, 2008, to update the sections on Information for Victims of Crime, and Medical Facilities and Health Information.

Travel News Headlines WORLD NEWS

Date: Tue 29 Jan 2019
Source: FBC [edited]

Four people have died from leptospirosis in the Central Division [Fiji] so far this year [2019]. This has resulted in the Ministry of Health declaring an outbreak in the division.

There have been 69 cases of leptospirosis in the Central Division from 1 Jan [2019], with 18 people requiring admission to the CWM Hospital. A majority of the cases are between the age groups of 1-19 and 20-29.

Leptospirosis is a disease caused by bacteria that affect both humans and animals. Humans get leptospirosis through contact with the urine of infected animals. This often happens through contact with mud, water, or food contaminated with the urine of infected animals. The ministry says that people who work with animals, especially farmers, are at higher risk of getting this disease; however, the current outbreak in the Central Division is also affecting people who do non-animal related work. It says recent heavy rain and flooding are likely to have contributed to the increase in cases.

Symptoms of leptospirosis include high fever, chills, headache, muscle aches, nausea/vomiting, jaundice (yellow skin and/or eyes), red eyes, abdominal pain, diarrhoea, cough, shortness of breath and rash. Without treatment, the disease can lead to kidney damage, meningitis, liver failure, respiratory distress, and even death. Early treatment with antibiotics administered by a doctor is the key to preventing complications and deaths.  [Byline: Ritika Pratap]
=======================
[For a discussion of leptospirosis, please see the moderator's comments in ProMED-mail: Leptospirosis - Fiji: flood-related http://promedmail.org/post/20160421.4175079.

Fiji is an island nation in Melanesia in the South Pacific Ocean about 2000 km (1300 miles) northeast of New Zealand's North Island (<http://en.wikipedia.org/wiki/Fiji>). Fiji is divided into 4 major divisions: Central, Eastern, Northern, and Western.

For a map of Fiji's divisions, see

Fiji's wet season is from November to April, with the heaviest rains falling between December and mid-April

[HealthMap/ProMED map available at:
Date: Fri 7 Dec 2018
Source: The Fiji Times [edited]

A typhoid outbreak has been identified in the Naitasiri subdivision. This was confirmed by the Minister for Health, Dr. Ifereimi Waqainabete, who said there are 31 confirmed cases of typhoid and 14 suspected cases.

He said the Naitasiri medical team continued to make daily visits, implementing public health awareness and public health interventions in these villages. He added that families have been educated on safe food preparation, food handling and proper hygiene practices.

The minister strongly urged the general public to postpone nonessential travel to the outbreak-affected areas and take extra precaution during the holiday season.
======================
[Typhoid fever, so-called enteric fever caused by _Salmonella enterica_ serotype Typhi, has a totally different presentation from that of the more common kinds of salmonellosis. Epidemiologically, usually spread by contaminated food or water, typhoid is not a zoonosis like the more commonly seen types of salmonellosis. Clinically, vomiting and diarrhoea are typically absent; indeed, constipation is frequently reported. As it is a systemic illness, blood cultures are at least as likely to be positive as stool in enteric fever, particularly early in the course of the infection, and bone marrow cultures may be the most sensitive.

The symptoms of classical typhoid fever typically include fever, anorexia, lethargy, malaise, dull continuous headache, non-productive cough, vague abdominal pain, and constipation. Despite the (often high) fever, the pulse is often only slightly elevated. During the 2nd week of the illness, there is protracted fever and mental dullness, classically called coma vigil. Diarrhoea may develop but usually does not. Many patients develop hepatosplenomegaly (both liver and spleen enlarged). After the 1st week or so, many cases develop a maculopapular rash on the upper abdomen. These lesions ("rose spots") are about 2 cm (0.78 inch) in diameter and blanch on pressure. They persist for 2 to 4 days and may come and go. Mild and atypical infections are common.

The word typhoid (as in typhus-like) reflects the similarity of the louse-borne rickettsial disease epidemic typhus and that of typhoid fever; in fact, in some areas, typhoid fever is still referred to as abdominal typhus.

Naitasiri is one of the 14 provinces of Fiji and one of 8 located on Viti Levu, Fiji's largest island. - ProMED Mod.LL]

[HealthMap/ProMED-mail map:
Date: Mon, 19 Nov 2018 00:23:21 +0100

Suva, Fiji, Nov 18, 2018 (AFP) - A 6.7-magnitude earthquake struck off the coast of Fiji Monday, the United States Geological Survey said, but it was too deep to cause any damage.   It was centred 534 kilometres (331 miles) deep and 283 kilometres east of the capital Suva where residents said they did not notice any shaking.   The Pacific Tsunami Warning Center said there was no tsunami threat from the tremor which occurred at 9:25 am (2025 GMT Sunday).   The area is prone to deep undersea earthquakes and was hit with a 7.8-magnitude tremor two months ago.   Fiji sits within the "Ring of Fire", a zone of tectonic activity around the Pacific that is subject to frequent earthquakes and volcanic eruptions.
Date: Fri, 19 Oct 2018 09:13:14 +0200

Wellington, Oct 19, 2018 (AFP) - As Prince Harry and his expectant wife Meghan prepare to tour Fiji and Tonga next week, the World Health Organisation (WHO) has declared the risk of contracting Zika virus in the Pacific nations is low.   The British royals, currently in Australia, arranged their trip before Meghan's pregnancy was known, sparking fears she and her unborn baby could be vulnerable in the island nations, where Zika is officially listed as a risk.

But WHO said the most recent case of the mosquito-borne virus in Fiji was in 2017 and there had been no recorded cases in Tonga since 2016.   "At the moment, there is really no evidence of a Zika virus outbreak in Fiji," Dr Angela Merianos, a Suva-based communicable diseases specialist with WHO told AFP.   She said the situation was similar in Tonga, adding: "Overall, the risk is low and there lots of things that you can do to decrease that risk even further."

Merianos said all travellers should follow "common sense" precautions to avoid mosquitos, which can carry dengue fever and chikungunya, as well as Zika.   These include wearing insect repellent, using mosquito screens and staying indoors where possible.   "Zika of course is a particular concern for pregnant women and women of reproductive age," she said.   "People should be wearing protective clothing, preferably light coloured, that covers most of the body."   Kensington Palace said after Meghan's pregnancy was publicly announced that the royals had decided to proceed with the trip after seeking advice from doctors about the Zika virus.

Zika normally causes a mild fever that lasts less than a week but if a pregnant woman is infected the baby can develop microcephaly, a smaller than normal head size, and other congenital defects.   Public Health England lists both Fiji and Tonga as moderate risk of Zika.   The British health department's advice for travellers on Fiji states: "Pregnant women should consider postponing non-essential travel until after the pregnancy."   Harry and Meghan will arrive in Fiji next Tuesday, travelling on to Tonga on Thursday.
Date: Thu, 6 Sep 2018 19:42:22 +0200

Hong Kong, Sept 6, 2018 (AFP) - A major 7.8 magnitude quake struck off the Fiji coast early Friday, the United States Geological Survey said, but no tsunami threat was issued.   The epicentre of the tremor was 102 kilometres (63 miles) southeast of the capital Suva.    The Pacific Tsunami Warning Center said there was no tsunami threat because the quake was too deep.    It hit 609 kilometres (378 miles) underground.    The USGS said only "light" shaking would have been felt across the Pacific Ocean archipelago ocean.   Fiji sits within the "Ring of Fire", a zone of tectonic activity around the Pacific that is subject to frequent earthquakes and volcanic eruptions.
More ...

World Travel News Headlines

Date: Mon, 25 Mar 2019 11:52:43 +0100

Sanaa, March 25, 2019 (AFP) - Nearly 110,000 suspected cases of cholera have been reported in war-hit Yemen since the beginning of January, including 190 related deaths, the UN said on Monday.   The UN office for humanitarian affairs (OCHA) said children under the age of five make up nearly a third of 108,889 cases which were reported between January 1 and March 17.

OCHA said the spike, which comes two years after Yemen suffered its worst cholera outbreak, was concentrated in six governorates including in the Red Sea port of Hodeida and the Sanaa province home to the capital.   Early rains could be blamed for the recent increase in suspected cholera cases, it said.   "The situation is exacerbated by poor maintenance of sewage disposal systems in many of the affected districts, the use of contaminated water for irrigation, and population movements," OCHA added.   The waterborne disease is endemic to Yemen, which witnessed the worst cholera outbreak in its modern history in 2017.

More than one million suspected cases were reported within an eight-month period that year. More than 2,500 people died of the infection between April and December 2017.    Yemen's brutal conflict, which pits Iran-linked rebels against a regional pro-government alliance led by Saudi Arabia, has left some 10,000 people dead since 2015 and pushed millions to the brink of famine.    The war has created the perfect environment for cholera to thrive, as civilians across the country lack access to clean water and health care.
Date: Wed 20 Mar 2019
Source: Outbreak News Today [edited]

Swedish public health authorities, Folkhalsomyndigheten, is reporting an outbreak of psittacosis, or parrot disease, since November 2018. According to officials, some 60 cases have been reported from the regions of Vastra Gotaland, Kalmar, Jonkoping, and Skane. This is the highest number of cases reported in one winter in 2 decades.

Those who have now fallen ill have mainly come into contact with bird droppings from wild birds, for example through the handling of bird tables and other outdoor activities. A smaller number are believed to have been infected by domestic birds (parrots) in cages. The most common way someone gets infected with the bacteria that cause psittacosis (_Chlamydia psittaci_) is by breathing in dust containing dried secretions (e.g., droppings, respiratory) from infected birds. It is rare for psittacosis to spread from person to person.

In general, psittacosis causes mild illness in people. The most common symptoms include fever and chills, headache, muscle aches, and dry cough. Psittacosis can also cause pneumonia (a lung infection) that may require treatment or care in a hospital. Rarely, psittacosis can result in death. Most people begin developing signs and symptoms of psittacosis within 5-14 days after exposure to the bacteria (_C. psittaci_). Occasionally, people report the start of symptoms after more than 14 days.
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[The news report above attributes the increase in number of human cases of psittacosis in Sweden since Nov 2018 mainly to contact with wild bird droppings, for example through the handling of bird tables and other outdoor activities. Outbreaks of avian chlamydiosis, due to _Chlamydia psittaci_ or the other Chlamydia species, have been reported occasionally in wild birds including shorebirds, waterfowl, and migratory birds, especially in birds under stress (<http://www.cfsph.iastate.edu/Factsheets/pdfs/psittacosis.pdf>).

An outbreak in Australia was probably caused by organisms carried in wild birds and spread when organisms in bird droppings became aerosolized during activities such as lawn mowing (<https://www.ncbi.nlm.nih.gov/pubmed/15757553>). An increase in psittacosis cases in Sweden in the winter of 2013 was also linked to wild birds, apparently through exposure to wild bird droppings; most cases were associated with tending bird feeders (<https://www.ncbi.nlm.nih.gov/pubmed/23725809>; also see ProMED-mail post Psittacosis - Sweden (02): wild bird http://promedmail.org/post/20130509.1701695).

Vastra Gotaland, Kalmar, Jonkoping, and Skane are counties located in southern Sweden. A map of Swedish counties can be found at <https://fotw.info/flags/se(.html>. - ProMED Mod.ML]

[HealthMap/ProMED-mail map:
Date: Wed 20 Mar 2019
Source: PNA [edited]

A public elementary school in Tubungan town, Iloilo has recorded a total of 36 chickenpox cases from 15 Jan to 3 Mar [2019], the Provincial Health Office (PHO) said. In an interview on Wednesday [20 Mar 2019], Dr. Patricia Grace Trabado, PHO head, said the cases were observed as patients who sought treatment at the rural health units (RHU) and private clinics in Tubungan.

All the cases were recorded in Cadabdab Elementary School, with 21 male and 15 female students affected. Trabado said affected pupils might still be attending school even though they were infected, which resulted in its transmission.

She emphasized that the spread of the infection might have been prevented if the children were advised not to attend school with the onset of infection. "If a child is showing chickenpox symptoms, especially when he or she was previously exposed to an affected person, then the pupil will be advised to stay at home," she said.

Trabado said the source of the infection came from the 1st patient working in Iloilo City but lives in Tubungan town. "The patient might have a family member that attends school in Cadabdab. From there, we see where the infection originated," she said. Trabado, however, did not give figures of the disease other than that from the school.

The RHUs and private clinics were able to monitor and manage the cases, Trabado said. All the student patients were discharged, given medication, and let the viral infection take its course. "And eventually, the patients recovered," she said. However, Trabado warns that a child with chickenpox can get secondary infection when he or she scratches the blisters, creating skin lesions.

She added that cases of chickenpox and mumps are mostly observed during the summer season. Trabado said patients with chickenpox experience fever and headache in the first 1 or 2 days before the itchy blister rash appears.  [Byline: Gail Momblan]
======================
[HealthMap/ProMED-mail map:
Date: Wed 20 Mar 2019
Source: USDA Animal and Plant Health Inspection Services [edited]
<https://content.govdelivery.com/accounts/USDAAPHIS/bulletins/23806a5>

The US Department of Agriculture's (USDA) under secretary for marketing and regulatory programs, Greg Ibach, is alerting international travellers of a deadly swine disease they could unknowingly bring back into the United States on their clothes, shoes, or hands.

African swine fever (ASF) is a highly contagious and deadly disease affecting both domestic and feral (wild) pigs. It does not affect human health and cannot be transmitted from pigs to humans. Recent spread of the disease to new countries in Asia and Europe has triggered a series of actions by USDA, state agriculture departments, and the pork industry to bolster protections against ASF in the United States and keep ASF out of North America.

"ASF has never been detected in the United States," said Ibach, "but an outbreak here would not only affect the pork industry, but also have major impacts on trade and raise food prices for consumers. We are asking international travellers to help prevent the spread of ASF to the United States by understanding what products can be brought back into the United States and declaring any agricultural items in their baggage."

The USDA's Animal Plant and Health Inspection Service's (APHIS) new traveller website provides updated information about potentially harmful pests and diseases that can hitchhike on food or other agricultural products. When returning to the United States, travellers are reminded to declare food items and animal products in their luggage. Failure to declare items may result in serious penalties.

"USDA and US Customs and Border Protection (CBP) recognize the crucial work of detector dog teams at US ports of entry." said Ibach. "While travellers' declarations of any food products brought with them to the United States is a critical step to protecting US agriculture, the dogs and secondary agricultural inspections provide another line of defence to keep ASF out of the country."

Travellers will also see some changes at airports as USDA works with CBP to increase screenings of passenger baggage. This includes training and adding 60 additional beagle teams for a total of 179 teams working at key US commercial, sea, and air ports and ensuring travellers who pose an ASF risk receive secondary agricultural inspection. USDA is also coordinating with CBP to expand arrival screenings, including checking cargo for illegal pork and pork products.

Anyone who visits a farm in an ASF-affected country should take specific precautions before returning to the United States. Follow the farm's biosecurity protocols and wear site specific footwear and coveralls or clothing. Thoroughly clean and disinfect or dispose of clothes and footwear worn on the farm before returning, and declare the farm visit to CBP when re-entering the United States. Travelers should not visit farms or any other locations with pigs -- including livestock markets, zoos, circuses, and pet stores with pot-bellied pigs -- for at least 5 days after returning.

More information on ASF, partner resources, and additional resources for travellers are available on the APHIS ASF webpage
and in this infographic
======================
[This disease would be extremely serious for the US, and likely for all of North America. The warning is appropriate for travellers to be more alert to situations that could ultimately have horrible outcomes. - ProMED Mod.TG]

[HealthMap/ProMED-mail map:
Date: Wed 20 Mar 2019
Source: ReliefWeb [edited]

The Federal Ministry of Health, in collaboration with the World Health Organization (WHO), Gavi, the Vaccine Alliance, and UNICEF, has launched a large-scale mass vaccination campaign in Sudan to vaccinate more than 8.3 million people 9 months to 60 years of age against yellow fever in the states of Blue Nile, Gezira and Sennar during 10-29 Mar 2019.

The campaign represents a crucial step in protecting a large portion of the population and reducing the risk of severe and deadly yellow fever outbreaks in the country. It is the 3rd and final drive thatSudan is undertaking to protect populations at risk and prevent yellow fever epidemics, pending the implementation of infant immunization as routine practice.

The campaign forms a critical part of Sudan's ongoing work to protect all populations against yellow fever epidemics, in alignment with the global Eliminate Yellow fever Epidemics (EYE) Strategy. The country plans to complement these yellow fever mass campaigns and ensure long-term protection through the introduction of yellow fever vaccination into routine immunization in the coming months.

"We acknowledge the commitment of the health authorities in Sudan to avail cash and fuel during this economic crisis to ensure that their people, especially children, are protected with a quality vaccine which will contribute to health security and making the world safer," said Dr. Naeema Al-Gasseer, WHO Representative in Sudan.

"Yellow fever vaccination is the most important tool we have to prevent yellow fever outbreaks. The vaccine will be freely available to any eligible person and will provide life-long protection against the disease. While protecting yourself against mosquito bites is important to reduce the risk of many diseases, only vaccination can eliminate the risk of yellow fever outbreaks," she added.

Yellow fever is a viral disease that is transmitted by certain types of mosquito. Infection can cause fatal illness, including jaundice, and death, and can spread rapidly, locally and internationally, especially in urban areas. However, the disease can be prevented by a single dose of a highly effective and safe vaccine. This campaign aims to boost protection in the general population and will target all eligible people.

Sudan is at high risk for the spread of yellow fever due to a combination of climate and ecological factors, and because there are still areas of low population immunity. Recent years have seen global changes in the epidemiology of yellow fever, with outbreaks occurring in areas that were not previously assessed as being at high risk.

"We are observing a changing nature in yellow fever disease dynamics. It is very important that every eligible person in this campaign receives the vaccine to protect themselves, their families and their communities," said Professor Dr. Babkir Kabaloo, Undersecretary of the Federal Ministry of Health.

"The current campaign represents one of the final phases in the Ministry's efforts to protect the entire nation against yellow fever outbreaks. This campaign will cover Blue Nile, Gezira, and Sennar states. In the coming months, the remaining states of Khartoum, Northern and River Nile will also be covered, completing the protection of the entire Sudanese population," he added.

Sudan's health authorities and partners are working to introduce yellow fever vaccine in the national immunization schedule in the near future. This will help ensure the protection of the whole population and generations to come against this fatal but preventable disease.
=====================
[It is good to see this ambitious yellow fever (YF) vaccination campaign drawing to a close. Incorporating YF vaccine into routine childhood vaccination schedules is prudent and if successful will eliminate the need for intensive, country-wide campaigns to deal with outbreaks. YF is no stranger to Sudan. Between 3 Oct and 24 Nov 2013, a total of 44 confirmed cases of YF were reported, including 14 deaths. A total of 12 localities in West and South Kordofan were affected by that outbreak. There was a large YF outbreak in the Darfur state in 2012-2013. In 2012, the World Health Organisation (WHO) said that more than 840 people were infected with YF in Darfur and that the epidemic affected 35 of 64 localities in the region since September 2012. The total recorded cases of YF in Greater Darfur hit 849 with a 20% death toll during an epidemic in 2012 (see WHO Disease Outbreak News <http://who.int/csr/don/2012_12_03/en> as reported by ProMED post http://promedmail.org/post/20130125.1513849, as noted at the time by Mod.JW). Mounting campaigns in the face of these types of outbreaks is inefficient, logistically difficult, and costly -- financially and in terms of human lives. - ProMED Mod.TY]

[HealthMap/ProMED-mail map:
Date: Thu 21 Mar 2019
Source: SBS News, Australian Associated Press (AAP) report [edited]

An egg recall has been announced following the discovery of a _Salmonella_ outbreak at a Victorian egg farm. The scare has prompted a recall of some brands of eggs from outlets in 4 states.

To date, 5 cases of _Salmonella [enterica_ serotype] Enteritidis have been linked to eggs produced by Victoria's Bridgewater Poultry, the state's health department said on [Thu 21 Mar 2019]. The company's free-range and barn-laid eggs are packaged as Woolworths brand, Victorian Fresh, and Loddon Valley, with best-before dates ranging from [20 Mar to 29 Apr 2019]. They are on shelves in Victoria, New South Wales, Tasmania, and South Australia. All other eggs are safe to eat, Chief Health Officer Brett Sutton said.

"It is important to know that not all eggs are affected, but any eggs carrying the listed brands should return them to the point of sale for a full refund. Alternatively, they can be discarded by throwing them into the garbage, not the garden or compost. "These eggs should not be given to pets or livestock."

Vulnerable people, including the elderly, are urged to avoid eating raw egg products.

Eggs of concern:
- Woolworths 12 Cage Free Eggs 700 g
- Victorian Fresh Barn Laid Eggs 600 g
- Victorian Fresh Barn Laid Eggs 700 g
- Victorian Fresh Barn Laid Eggs 800 g
- Loddon Valley Barn Laid 600 g (Victoria and South Australia only)
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[Salmonellosis is often thought to be associated with cracked eggs or eggs dirty with faecal matter, a problem controlled by cleaning procedures implemented in the egg industry. It is clearly the case, however, that most of the salmonellosis outbreaks linked to eggs were associated with uncracked, disinfected grade A eggs, or foods containing such eggs. The undamaged eggs become contaminated during ovulation, and thus were contaminated with the bacteria before the egg shell was formed. To avoid this, uncooked eggs should only be used as an ingredient, if pasteurized. - ProMED Mod.LL]

[Maps of Australia:
Date: Wed 20 Mar 2019 3:50 PM EDT
Source: The Day [edited]

Groton [New London county] public health officials are reminding residents to refrain from feeding or approaching wild or stray animals after a dog found in the area of Midway Oval tested positive for rabies [Wed 20 Mar 2019].

Rabies is a deadly disease caused by a virus that can infect all warm-blooded animals, including people, the Ledge Light Health District said in an alert sent to media outlets.

The disease mostly is spread by wild animals, but stray cats and dogs may also become infected and spread the virus, the district's alert said. The rabies virus lives in the saliva and brain tissue of infected animals, and the disease can be spread by scratches from infected animals or when infected saliva comes into contact with open wounds, breaks in the skin or mucous membranes, including the eyes, nose and mouth.

For more information, contact Ledge Light Health District at (860) 448-4882, extension 1311, or the animal control officer at (860) 441-6709.
======================
[HealthMap/ProMED-mail map of Connecticut, United States:
Connecticut county map:

Please keep your animals up-to-date on their rabies vaccine. It is for their protection and for your protection.

Regarding the 1st article, it sounds like South Carolina could consider using some oral rabies vaccine bait for some of their wild animals.

Unfortunately, wild animals may attack even when you are unaware of their presence.

Animals may be either unusually friendly and timid (dumb rabies) or aggressive and vicious (furious rabies). These are 2 presentations of the same disease but we should be aware of both forms and teach both forms to our children. - ProMED Mod.TG]
Date: Wed 20 Mar 2019
Source: Aiken Standard [edited]

[One person] in Aiken county may have been exposed to rabies following an unfriendly encounter with a wild raccoon, according to the South Carolina Department of Health and Environmental Control [DHEC].

According to a DHEC press release, the victim was on the North Augusta Greeneway Walking Trail on 16 Mar 2019 when they were bitten by a raccoon. The raccoon was later submitted to DHEC and tested positive for rabies. [Apparently the DHEC knows there is a victim so their earlier statement of "may have been exposed" seems a bit odd. - ProMED Mod.TG]

The victim who was bitten has since been referred to their health care provider. The raccoon on the Greeneway trail was the 3rd animal diagnosed with rabies in Aiken county this year [2019]. Statewide, there have been 32 confirmed cases of rabies in 2019. Coyotes, foxes, and skunks are also common carriers of the virus. Although it is extremely rare in people, rabies can be spread to humans and can also claim the lives of pets. The virus causes hallucinations, hydrophobia (fear of water), aggression, and death in its final stages.

Rabies is normally spread through bites but can also be spread when open wounds or areas like the eyes, nose, or mouth come into contact with saliva or blood of an infected animal. Infected areas should be washed with soap and water and medical attention should be sought immediately.  If a wild animal is foaming at the mouth and shows a lack of motor control (stumbling, staggering, or bumping into things) it may have rabies. Rabid animals are often very aggressive and do not fear people or other animals. [This behaviour may describe raccoons with distemper, but although they are not usually aggressive with distemper, they can be. The point is, when an animal is not acting normally it is time to move on and leave it alone and report it to the authorities in your area. - ProMED Mod.TG]

"To reduce the risk of getting rabies, always give wild and stray animals their space," said David Vaughan, Director of DHEC's Onsite Wastewater, Rabies Prevention, and Enforcement Division. "If you see an animal in need, avoid touching it and contact someone trained in handling animals, such as your local animal control officer or wildlife rehabilitator."

DHEC also stresses the importance of keeping pets up to date on their rabies shots to prevent the spread of the disease. For more information, call DHEC's Environmental Affairs Aiken office at 803-642-1637 during normal business hours on weekdays.  [Byline: Kristina Rackley]
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[HealthMap/ProMED-mail map of South Carolina, United States:
South Carolina county map:
Date: Thu, 21 Mar 2019 16:10:28 +0100

Kinshasa, March 21, 2019 (AFP) - A six-month-old baby in the eastern DR Congo city of Bunia has died of Ebola, becoming the first fatality of the disease in a provincial capital, the heath ministry said Thursday.   Bunia, which has a population of 300,000, is the capital of Ituri province, which along with neighbouring North Kivu province has been battling an epidemic of Ebola since last August.

The baby is among 610 fatalities out of 980 recorded cases, the ministry said in a statement.   "The parents are apparently in good health," it said.   "Extensive investigations are underway and will include, among other things, analysis of the maternal milk to identify the source of contamination."   The ministry added that it had also registered 97 new cases in the previous three weeks.   This increase "was expected" given the impact of an attack on two Ebola treatment centres by armed groups in the troubled region, it said.
Date: Thu, 21 Mar 2019 22:32:17 +0100

Blantyre, Malawi, March 21, 2019 (AFP) - Heavy rains could cause a dam in southern Malawi to give way if there is no let-up, authorities said Thursday, urging local residents to take shelter.   The warning came after cyclone Idai battered neighbouring Mozambique last Friday killing 242 people    Hurricane-force winds and rains have also ravaged hit eastern Zimbabwe where over 100 have died.

In Malawi, the storm has affected nearly a million people with over 80,000 displaced, according to the WHO.   The Chagwa dam "has had one of its major embankments eroded due to heavy rains," the interior security ministry said in a statement. "(It) is likely to burst in the event of heavy and incessant rains."   The statement advised local residents in the southern African country to evacuate "in case of an emergency".