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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 ...

Liberia

Liberia - US Consular Information Sheet
February 21, 2008
COUNTRY DESCRIPTION: Liberia is a country in West Africa that suffered from years of instability and conflict from 1990 - 2003, with attendant destruction of buildings, roads, and infras
ructure and public institutions.
A comprehensive peace accord ended the conflict in August 2003 and a United Nations peacekeeping force (UNMIL) was deployed to facilitate disarmament and demobilization, help arrange democratic elections and provide for security of the country.
In late 2005, Liberians went to the polls and elected Ellen Johnson Sirleaf as president.
The new government was inaugurated in January 2006, and has made tremendous progress towards restoring security and stability to the country.

Despite nearly four years of peace and a renewal of economic growth, Liberia is still one of the poorest countries in the world and many basic services (public power, water and sewage, land line phones) are either limited or unavailable.
Facilities for foreign visitors are adequate in the capital, Monrovia, but virtually non-existent in the rest of the country.
The official language of Liberia is English.
Read the Department of State Background Notes on Liberia for additional information.

ENTRY/EXIT REQUIREMENTS:
A passport and a visa are required for entry, as is evidence of a yellow fever vaccination and a physician's letter attesting to absence of communicable diseases.
Visa applicants may also be asked to provide evidence of health insurance.
Immigration officials no longer issue visas at the airport.
Persons arriving without a visa may be deported immediately, without leaving the airport.
Persons arriving from the United States must obtain a Liberian visa before traveling.
There is a US $25 airport tax on departing passengers, although this is usually collected as part of the ticket price.
For the latest information on entry requirements, visa fees and airport tax for Liberia, contact the Embassy of the Republic of Liberia, 5201 16th Street NW, Washington, DC 20011, tel. (202) 723-0437, web site www.embassyofliberia.org.
Overseas, inquiries should be made at the nearest Liberian embassy or consulate.

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

SAFETY AND SECURITY:
The Department of State urges U.S. citizens to plan proposed travel to Liberia carefully and to exercise caution when traveling in Liberia.
Neither public transport nor taxis are available at the international airport, which is located 40 miles outside of Monrovia; therefore, before traveling to Liberia, Americans are urged to make arrangements for transportation from the international airport into the city center.
Americans traveling to Liberia are also urged to ensure that they have confirmed reservations at a reputable hotel, as rooms can be scarce and difficult to find without advance plans.

Americans who travel to or reside in Liberia should realize that Liberia's police force is in the process of being rebuilt.
There is a UN Mission in Liberia (UNMIL), but its mandate is to ensure political stability in Liberia.
Americans who travel around Liberia must realize that the role of UN Police (UNPOL) officers is to serve as advisors to the Liberia National Police. Accordingly, they do not have the authority to arrest or detain, and they are unarmed.
The Liberia National Police, for its part, has a limited presence in Monrovia, and even less of a presence outside of Monrovia.
In addition, police officers can be a source of problems for visitors as well as a source of aid or assistance.
Although problems with corruption have improved, travelers may be detained by police officers who solicit bribes.
Americans are encouraged to carry a photocopy of their passports with them at all times so that, if questioned by local officials, proof of identity and U.S. citizenship is readily available.
If detained or arrested, U.S. citizens should always ask to be allowed to contact the U.S. Embassy.

U.S. citizens in Liberia should be aware of their surroundings at all times and use caution when moving around, especially at night.
The U.S. Embassy recommends that American citizens observe a suggested curfew of 2:00 a.m. – 6:00 a.m.
Travel outside of Monrovia after dark is strongly discouraged as roads are in poor condition and thus dangerous to navigate at night.
U.S. citizens should avoid crowds, political rallies, and street demonstrations and maintain security awareness at all times.
For the latest security information, Americans traveling abroad should regularly monitor the Department’s Internet web site, where the current Worldwide Caution Public Announcement, 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., 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).

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:
Crime in Liberia is rated high and is exacerbated by the high rate of unemployment.
Theft, assault, sexual crimes, and murder are problems, and they occur more frequently after dark.
Foreigners, including U.S. citizens, have been targets of street crime, robbery, and sexual assault.
Women have been attacked on deserted beaches.
Residential armed break-ins occur.
The police are ill equipped and largely incapable of providing effective protection or investigation.
Criminal activity is reported in both urban and rural areas.

Perpetrators of business fraud often target foreigners, including Americans.
Formerly associated with Nigeria, these fraud schemes are now prevalent throughout western Africa, including Liberia, and pose a danger of both financial loss and physical harm.
An increasing number of American citizens have been the targets of such scams.
The best way to avoid becoming a victim of fraud is common sense – if it looks too good to be true, it probably is.
Any unsolicited business proposal originating in Liberia should be carefully checked before committing any funds, providing any goods or services, or undertaking any travel.
There is also an increase in Liberian/American Internet relationships, where there are eventual requests for financial assistance under fraudulent pretenses.
For additional information, please see the Department of State's Bureau of Consular Affairs brochure International Financial Scams.

Petty corruption is rampant; poorly paid government officials are not immune from the temptation to collect fees for doing their job.
The result is that travelers may be asked for bribes and inconvenienced for not paying them.

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:
Hospitals and medical facilities in Liberia are very poorly equipped and are incapable of providing many services.
Emergency services comparable to those in the U.S. or Europe are non-existent, and the blood supply is unreliable and unsafe for transfusion.
Americans with serious medical problems travel or are medically evacuated to the United States, Europe or South Africa.
Medicines are scarce, often beyond expiration dates, and generally unavailable in most areas.
As there is neither an effective garbage removal service nor a functioning sewer system, the level of sanitation throughout urban areas is very poor, which increases the potential for disease.
Upper respiratory infections and diarrhea are common, as well as the more serious diseases, typhoid and malaria.
All travelers to Liberia must be vaccinated against yellow fever and should carry a supply of all prescription medication, plus anti-malaria medication, adequate for their entire stay.
A typhoid vaccination is also recommended.

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.
For travel to Liberia, obtaining separate medical evacuation insurance before arriving in Liberia is strongly recommended.
Please see our information on medical insurance overseas.
SWIMMING HAZARD:
Liberia has many excellent beaches along the Atlantic coastline that tourist and those who live in the country enjoy throughout the year, however American citizens should be aware of the threat of dangerous rip currents better known as rip tides.
These strong currents can occur anywhere on the coast given the right surf conditions.
The Liberia Weather Service does not provide information on where and when these tides form and there are no lifeguards posted on beaches.
American citizens who plan to swim in the Atlantic should read from various sources e about the dangers of rip currents and how to navigate if you find yourself in such a situation; or better still do not swim if you are unfamiliar with swimming in water where very strong rip currents occur.

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 Liberia is provided for general reference only, and may not be totally accurate in a particular location or circumstance.

Road travel in Liberia can be hazardous.
Potholes and poor road surfaces are common, making safe driving extremely challenging.
Cars, trucks, and taxis are often overloaded with people and goods and make frequent stops without signaling.
Drivers overtake on the right as well as the left.
Many vehicles operate with threadbare tires, and blowouts are frequent.
Public taxis are poorly maintained and usually overloaded.
Intersections must be approached with caution.
The absence of public streetlights makes pedestrians walking in the city streets and those walking on country roads difficult to see at night.
Drivers and pedestrians are cautioned that high-speed car convoys carrying government officials require all other vehicles to pull off the road until they have passed.

Travelers should expect delays at UNMIL security checkpoints, as well as time-consuming detours around the many bridges and roads damaged by war, neglect, or the heavy annual rains, which occur from May to November.
Travelers can expect strict enforcement of border controls by Liberian, Ivorian, Sierra Leonean, and Guinean authorities.
At times border crossings to neighboring countries are closed.

Please refer to our Road Safety page for more information.

AVIATION SAFETY OVERSIGHT: As there is no direct commercial air service between the United States and Liberia, the U.S. Federal Aviation Administration (FAA) has not assessed Liberia’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:
Lodging, fuel, transportation, and telephone services are unevenly available in Liberia, and are nonexistent or severely limited in rural areas.
Neither water nor electricity is commercially available in Liberia, including the capital of Monrovia.
Most hotels have utilities available, but not always on a 24-hour basis.
There is no working landline telephone system in Liberia.
Several cell phone companies provide service in Monrovia and some areas outside the capital.
US cellular phones do not always work in Liberia and it is advisable to rent or purchase a local cellular phone.
The postal system is slow and unreliable.
Commercial air courier service is available through UPS, Federal Express (FedEx), and other companies.

The U.S. dollar is readily accepted in Liberia, and there is no limit on the amount of foreign currency that can be transported into and out of the country, provided one follows the specific regulations on how such transfers must be done.
Sums in excess of US $10,000 must be reported at the port of entry and no more than US $7,500 in foreign currency banknotes can be moved out of the country at one time.
Larger sums must be transferred via bank drafts or other financial instruments; persons without a Liberian bank account are limited to two outgoing US $5,000 over-the-counter cash wire transfers per month.
Wire transfers are not widely used and are subject to substantial fees.
ATMs are unavailable and Traveler's checks and credit/debit cards are not accepted anywhere in Liberia.

Photographing military installations, air and seaports, and important government buildings is prohibited.
Visitors should not take photographs of sites or activities that might be considered sensitive, or police are liable to confiscate the camera.

Please see our information on 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 Liberian law, even unknowingly, may be expelled, arrested, or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in Liberia are severe, and convicted offenders can expect long jail sentences and heavy fines.
The U.S. Embassy does not always receive timely notification of the arrest of U.S. citizens by Liberian authorities.
If arrested, U.S. citizens should ask to be allowed to contact the U.S. Embassy (see the Registration/Embassy Location section below).
Americans should carry a photocopy of their U.S. passport with them at all times.
The consular section of the U.S. Embassy cannot give legal assistance but can provide a list of Liberian attorneys if one is required.
Engaging in sexual conduct with children or using or disseminating child pornography in a foreign country is a crime, prosecutable in the United States.
Please see our information on Criminal Penalties.

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

REGISTRATION / EMBASSY LOCATION:
Americans living or traveling in Liberia 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 Liberia.
Americans without Internet access may register directly with the nearest U.S. Embassy or Consulate.
By registering, American citizens make it easier for the Embassy or Consulate to contact them in case of emergency.
The U.S. Embassy is located at 111 United Nations Drive, Mamba Point, Monrovia; telephone 231-77-054-826; fax 231-77-010-370; web site http://monrovia.usembassy.gov.
U.S. citizens who wish to write to the U.S. Embassy in Monrovia may address letters to the Consular Section, 8800 Monrovia Place, U.S. Department of State, Washington, D.C. 20521-8800, or send emails to ConsularMonrovia@state.gov.
*

*

*
This replaces the Consular Information Sheet on Liberia dated June 15, 2007 to include a caution on swimming at local beaches.

Travel News Headlines WORLD NEWS

Date: Tue 23 Oct 2018
Source: The Bush Chicken [edited]

The director for immunization at the Ministry of Health says there are currently 29 reported measles cases in Grand Gedeh, with 7 of those cases confirmed.

Director for immunization at the Health Ministry Adolphus T. Clarke said reports of the outbreak in Tchien district 1st emerged on [Wed 17 Oct 2018]. Speaking to The Bush Chicken in an exclusive interview, Clarke said out of the 29 cases reported, health officials in the area realized that 11 children under 5 years of age were affected by the disease. The other children were older than 5.

"The 29 cases identified were managed at the Martha Tubman Memorial Hospital in Zwedru, and the affected children fully recovered with no death reported."

With support from the Ministry of Health, Clarke said the county responded quickly with vaccinations. "The exercise has concluded, and health officials were able to reach a total of 1551 children not less than 5 years," he said. "So I can say that the county responded swiftly to the outbreak of the disease and recorded zero deaths."

However, things did not go smoothly. Due to the poor road conditions in the south-eastern region, Clarke said some health officials who left Monrovia with vaccinations for Grand Gedeh endured difficulties during the journey. "Others had to travel through neighbouring Ivory Coast to reach the country," he said.

The director indicated that, due to the challenge in attaining high vaccination coverage, health authorities in the country knew that, at some point in time, there would be sporadic outbreaks of the disease in the county.

Clarke said the current outbreak was not severe, because the ministry has dealt with sporadic outbreaks of measles in the past. He noted that health officials in Grand Gedeh have now been encouraged to carry out vaccination campaigns in affected and nearby communities as the dry season approaches.

"We have encouraged mothers to make use of the health facilities in the county and ensure that their children are vaccinated against all the diseases the ministry is preventing," Clarke said.  [Byline: Zeze Ballah]
Date: Thu 27 Sep 2018
Source: Front Page Africa [edited]

The National Public Health Institute of Liberia (NPHIL) in collaboration with the Ministry of Health (MoH) and partners is investigating a suspected case of yellow fever in Grand Kru County.

According to a release issued in Monrovia, the suspected case is a 2-year-old female from Farina Town, Barclayville Health District. There has been no death or new cases reported. The suspected case has been managed and is in good health.

A blood specimen has been collected and sent to the National Public Health Reference Laboratory (NPHRL) for confirmation. According to the release, health authorities in the county are conducting an active case search, risk assessment, and planning for a possible reactive vaccination exercise, pending the laboratory result.

Since January 2018, this is the 2nd reported suspected case from Grand Kru County. The 1st was a 29-year-old female from Dorbor District.

There have been no confirmed cases of yellow fever in the country since the 2009 nationwide preventive vaccination campaign. The release also noted that a total of 94 suspected cases of yellow fever have been recorded across the country since the beginning of 2018.

Yellow fever is an acute viral haemorrhagic disease transmitted by infected mosquitoes. The symptoms include fever, headache, jaundice, muscle pain, nausea, vomiting, and fatigue. Communities have been advised to report unexplained deaths for safe and dignified burials as measures to prevent infection. Community engagement and response activities have been intensified in the area.

Meanwhile, the public is advised to take the following public-health measures:
- Keep your environment clean
- Visit a health facility immediately when you feel the symptoms of yellow fever
- Continue sleeping under treated bed nets

Yellow fever is not transmitted through body touch or body fluids.
=====================
[Yellow fever (YF) cases have occurred sporadically in Liberia, although the last YF ProMED-mail post was in 2009. The 94 suspected YF cases this year (2018), including the most recent one above, is a cause for serious concern. It is important to have a timely laboratory diagnosis and well-developed contingency plans should YF be confirmed. YF can quickly spread if a significant proportion of the human population is unvaccinated and the vector mosquitoes are abundant. The above report does not indicate the number of unvaccinated individuals nor the status of the vector mosquito population. - ProMED Mod.TY]

[HealthMap/ProMED-mail map:
Grand Kru County, Liberia: <http://healthmap.org/promed/p/32407>]
Date: Fri 6 Jul 2018, 5:00 PM
Source: WHO Weekly Bulletin on Outbreaks and Other Emergencies [edited]

Event Description
-----------------
Liberia has continued to experience sporadic cases of Lassa fever since the beginning of 2018. In week 25 (week ending 26 Jun 2018), 2 new confirmed Lassa fever cases were reported in Nimba County, the only county with active transmission currently. Nimba County has reported 5 confirmed Lassa fever cases since [12 May 2018]. In the latest event (the 2 confirmed cases in week 25), the 1st case-patient, a 59-year- old male from Gbehlay Geh district, fell ill on [4 Jun 2018] and was treated with antimalarials and antibiotics at a local clinic. On [20 Jun 2018], the case-patient presented to a public hospital with fever and other constitutional symptoms, and had bleeding from a venepuncture site.

On [21 Jun 2018], a blood specimen was collected and sent to the National Public Health Reference Laboratory (NPHRL). The test result released on [26 Jun 2018] was positive for Lassa fever virus infection. The 2nd case-patient, a 41-year-old female, is the wife of the first case-patient (described above). She developed illness on [17 Jun 2018] and was admitted to the same hospital on [20 June 2018] with fever and other constitutional symptoms. Being a known contact, a blood specimen was collected on [21 Jun 2018] and the test result released on [26 Jun 2018] was positive for Lassa fever. The 2 case-patients are admitted under barrier nursing and ribavirin treatment initiated. A total of 26 contacts, including 13 health workers, have been line listed and are being followed up.

Between [1 Jan 2018] and [27 Jun 2018], a total of 130 suspected Lassa fever cases, including 33 deaths, were reported. Of these, 20 cases were laboratory confirmed, 103 were discarded (after testing negative), and 7 cases were not tested due to inadequate specimens. Of the 20 confirmed cases, 14 have died, giving a case fatality rate of 70 percent. Females make up 60 percent (12) of the confirmed cases. The age range for the confirmed cases is 1 to 65 years old, with a median of 32.5 years. The confirmed cases are from 5 counties, namely (Nimba (9), Bong (4), Montserrado (3), Margibi (2), and Grand Bassa (2).

Public Health Actions
---------------------
- The Ministry of Health and the National Public Health Institute of Liberia (NPHIL) are coordinating response activities to the Lassa fever outbreak, with support from WHO, CDC and other partners. The national epidemic preparedness and response committee (NEPRC), under the leadership of NPHIL, have been meeting weekly to review the Lassa fever outbreak situation and provide technical support to sub-national level, with technical support from WHO, and US-CDC; 15 WHO field offices are providing technical and operational support to the response.
- Active surveillance, including case search, case investigation and contact tracing are ongoing in the affected districts. A specimen transport system using couriers is available at designated points across the country to transport specimens to the NPHRL for testing.
- The Ganta United Methodist Hospital has been designated as a treatment centre, and equipped with ribavirin and other medical supplies for case management. Orientation of healthcare workers on case management protocol is ongoing.
- Healthcare workers in the country are being trained on Lassa fever case management and infection prevention and control (IPC) measures by NPHIL and MOH, with support from WHO.
- Health workers' exposure risk assessment is planned to be conducted in the clinic or hospital where the confirmed cases sought care.
- Community engagement activities are ongoing in the affected communities, including home visits and providing information on environmental cleanliness.

Situation Interpretation
------------------------
Sporadic Lassa fever cases continue to occur in certain parts of Liberia where the disease is known to be endemic. Bong, Grand Bassa, Margibi, and Nimba are among the counties that report cases annually. In 2017, a total of 30 confirmed cases were reported from 7 counties. The reason for these sporadic cases is known: the constant interaction of rats (the vector for Lassa fever virus) and people in unsanitary conditions. The national authorities and partners need to prioritize measures mitigating this exposure risk factor by improving vector and environmental management components of the response. This goes along with effective social mobilization and community engagement strategies, targeting vector control and environmental management in the communities. There is also a need to enhance capacity at the subnational levels for early case detection, case investigation, appropriate case management and its associated IPC [infection prevention and control] measures aimed at averting infection among health workers.
========================
[The number of Lassa fever cases in Liberia continues to slowly increase. Between 1 Jan 2018 and 27 Jun 2018, 20 cases were laboratory confirmed, up from 18 cases on 1 Jun 2018. Apparently, all these Lassa fever virus infections were acquired by contact with infected rodents or their excretions. Lassa fever virus can be acquired from infected rodents or patients in the hospital but in the above report, there is no mention of Lassa fever virus nosocomial transmission. Transmission can occur in health facilities when personal protective equipment is not employed and barrier-nursing practices are not adequate to protect staff from blood and secretions of infected patients. The hospitals attending the patients mentioned above do have barrier measures in place.

As mentioned in previous posts, Lassa fever virus transmission to humans occur when people are in contact with the reservoir rodent host, the multimammate mouse (_Mastomys natalensis_ and _M. erythroleucus_) and the African wood mouse (_Hylomycus pamfi_) or their excreta, as was likely the situation in these cases. Rodent control has to be undertaken at the village level with individual households employing the preventive measures listed above. This requires an extensive and continuous public education effort.

Images of the _Mastomys natalensis_ mouse, the rodent reservoir of Lassa fever virus, can be seen at
_M. erythroleucus_ and _Hylomycus pamfi_ at:

[Maps of Liberia can be accessed at:
Date: Fri 15 Jun 2018
Source: WHO Regional Office for Africa, Health Information and Risk Assessment [edited]

Weekly bulletin on outbreaks and other emergencies week 24: [11-17 Jun 2018; data as of 15 Jun 2018]
----------------------------------------------------------------------
Liberia: 2930 cases, 14 deaths, 0.5 percent CFR

Event description
-----------------
Liberia has been experiencing recurrent measles outbreaks since the beginning of 2018. In week 23 (week ending 10 Jun 2018), a total of 61 new suspected measles cases (with no deaths) were reported from 13 out of the 15 counties in the country, compared to 72 new cases reported in week 22 [week ending 3 Jun 2018]. 23 blood specimens collected from the suspected cases have been shipped to the National Reference Laboratory, while 20 of the case-patients had epidemiological links to confirmed cases. During the reporting week, 14 out of 92 health districts (in 5 counties) attained measles epidemic threshold of 3 laboratory confirmed cases. The 5 counties are Grand Bassa, Margibi, Maryland, Montserrado, and Nimba.

Between week 1 and week 23 of 2018 [1 Jan-10 Jun 2018], a total of 3086 suspected measles cases were reported. Of these, 177 were laboratory confirmed, 1762 had epidemiological links to confirmed cases, 562 were clinically compatible, 156 were discarded (after testing negative), and test results for 429 cases were pending. Of the 2930 confirmed, epidemiologically linked, clinically compatible, and suspected cases, 14 have died, giving a case fatality rate of 0.5 percent in this group; 558 (19 percent) were vaccinated, 334 (11 percent) were not vaccinated and 2 038 (70 percent) had unknown vaccination status. About 39 percent of the affected people are 4 years of age and below, 25 percent are between 5 and 9 years and 36 percent are 10 years and above.

Public health actions
---------------------
The Ministry of Health Expanded Program on Immunization and the National Public Health Institute of Liberia (NPHIL) are coordinating response activities to the measles outbreak, with support from WHO, UNICEF, and other partners. The national epidemic preparedness and response committee (NEPRC), under the leadership of NPHIL and with technical support from WHO, UNICEF, US-CDC and other agencies, have been meeting weekly to review the measles outbreak situation and provide technical support to sub-national level. WHO has deployed the Polio STOP team in the 15 counties to support sub-national level response.

A nation-wide measles immunization campaign has been conducted across the country in 3 phases since 15 Feb 2018, targeting a total of 654 803 children aged 6-59 months. Preliminary data indicates that 97 percent (63 350) of the targeted populations were vaccinated across the country.

Active search for measles cases continues throughout the country and has been reinforced in districts and communities with sustained outbreaks. Epidemic threshold is monitored weekly across the country through routine data collection and analysis.

All measles cases are being provided with symptomatic management along with a high dose of vitamin A.

The National Public Health Reference Laboratory has been testing samples reported across the country, by serology (IgM detection), and routinely releasing test results.

Communities have been provided with education to seek early care for measles cases at the nearest health facility. Communities have also mobilized through town criers, radio messaging, and posters to ensure high coverage of the immunization campaign among targeted age group.

Situation interpretation
------------------------
Liberia has been experiencing recurrent measles outbreaks since the beginning of the year [2018]. The reason for these outbreaks is known: the accumulation of a large number of susceptible populations over the years due to suboptimal immunization coverage. It is concerning that measles incidence cases are occurring in spite of the 3 phases of mass immunization campaigns conducted since February 2018, with seemingly high administrative coverage. The national authorities and partners need to drastically and speedily reduce the number of susceptible individuals in the most affected age-groups, maintain the build-up of vulnerable individuals at very low levels by immunising a large proportion (over 95 percent) of each new birth cohort and implement additional vaccination activities to periodically protect susceptible individuals who have accumulated.

With the well-developed immunization programme, structures, and systems, such measles outbreaks should be predicted and adequate preparedness measures put in place. Additionally, each measles outbreak should be followed by thorough evaluation of the cause of the outbreak, the surveillance system for early outbreak detection, the preparedness measures preceding the outbreak and the management of the outbreak, and an overall review of immunization programme goals and operations.
==========================
[A map showing the geographical distribution of measles cases in Liberia, week 1-23, 2018 can be seen at the source URL above. - ProMED Sr.Tech.Ed.MJ]

[HealthMap/ProMED-mail map of Liberia:
Date: Wed 13 Jun 2018
Source: Daily Observer [edited]

The National Public Health Institute of Liberia (NPHIL) in collaboration with the Ministry of Health (MoH) has responded to the Lassa fever outbreak in the country.  According to a release issued in Monrovia, cases of Lassa fever are on the increase in the Lassa belt (Bong, Nimba, and Grand Bassa Counties).

In the country, 4 new confirmed cases have been reported: from Bong (2), Grand Bassa (1) and Nimba (1) since the last outbreak in May 2018. A blood specimen was collected and tested positive for Lassa fever on 4-7 Jun 2018 at the National Public Health Reference Laboratory (NPHRL). The recent case from Nimba County was confirmed by the NPHRL on 7 Jun [2018].

A total of 128 contacts, including 59 healthcare workers, have been line-listed and are being followed up. One case is currently undergoing treatment at Phebe Hospital in Gbarnga Bong County, while one has been discharged; 2 deaths have been reported in this recent outbreak.

Since the beginning of January 2018, a total of 112 suspected cases have been reported across the country, of which 18 have been confirmed positive by RT-PCR (Nimba-7, Montserrado-3, Bong-4, Margibi-2, and Grand Bassa-2. The case fatality rate among confirmed cases is 72.2 percent (13/18). The high death rate is alarming to NPHIL, which has launched an in-depth investigation.

The release also discloses that although Lassa fever is not new to Liberia, it is a deadly viral disease that requires urgent attention. The disease is spread by rodents (rats) through close contact with affected persons [or contaminated environments - ProMED Mod.TY].

People are advised to keep their environment clean: cover dishes to prevent rats from defecating or urinating on them; cover food in tightly closed containers to prevent rats from playing in food or drinking water; do not eat rats because you can get the sickness by coming into contact with their blood, urine or feces, and do not dry food in open places where rats can reach.

Other preventive measures are to avoid body contact with affected persons and endemic zones; visit a health facility immediately when you feel sick.

Meanwhile, NPHIL, MOH, and partners have appealed to the general public to take the necessary preventive measures, and to kindly report cases of fever to the nearest health facility.

"We continue to improve our rapid response at the county, district and community levels through the County Emergency Operation Centers, and to provide technical, financial and logistical support to the outbreaks, the release concluded.
=====================
[The number of confirmed Lassa fever cases in Liberia has increased somewhat since 1 Jun 2018, from 13 to 18 cases.

Lassa fever virus can be acquired from infected rodents or patients in the hospital. In the above report, there is no mention of Lassa fever virus nosocomial transmission. The situation where these people acquired Lassa fever virus is not indicated in these cases.

Virus transmission to humans occurs when people are in contact with the reservoir rodent host, the multimammate mouse (_Mastomys natalensis_ and _M. erythroleucus_) and the African wood mouse (_Hylomycus pamfi_) or their excreta, as was likely the situation in these cases. Rodent control has to be undertaken at the village level with individual households employing the preventive measures listed above. This requires an extensive and continuous public education effort. Transmission can occur in health facilities when personal protective equipment is not employed and barrier-nursing practices are not adequate to protect staff from blood and secretions of infected patients.

Images of the _Mastomys natalensis_ mouse, the rodent reservoir of Lassa fever virus, can be seen at
<https://www.inaturalist.org/taxa/45326-Mastomys-natalensis> and _M. erythroleucus_ and _Hylomycus pamfi_ at:

[Maps of Liberia can be accessed at:
More ...

World Travel News Headlines

Date: Tue, 19 Mar 2019 12:35:15 +0100
Watamu, Kenya, March 19, 2019 (AFP) - If you live in a country with venomous snakes, or are travelling to one, here are a few tips to avoid being bitten.

- Do not provoke -

Snakes usually will not attack unless they feel threatened. In the bush, wear sturdy leather shoes and stomp heavily when walking, striking with a stick on the ground in front of you to warn any reptiles you are coming -- they will most likely just slither away.
Most strikes occur when snakes feel cornered or under threat, or when people accidentally step on them.

- Be alert and prepared -

Outside, have a good look around you for snakes that may hang from tree branches or swim in water, and be careful when turning over rocks or other objects. And remember: snakes are evolved to be well-camouflaged in their environment, whether it be the desert, forest or bush.
Thick, protective gloves are recommended for gardening and farming.
Carry a lamp at night.
Birds can help too: Many species possess an alarm cry to alert others of hidden danger.
Inside, check your bed and dark corners -- snakes can enter homes in pursuit of prey, heat or water.
The neater your home, the more likely you will spot an out-of-place snake. A mosquito net around your bed can be an effective snake repellent.

- Once bitten -
If you or someone else is bitten, try and remember the colour and shape of the snake, and seek immediately medical care at a clinic or hospital.
Remove any bracelets, rings or watches that may hamper blood flow in case of swelling.
Do NOT try and catch the snake, apply a tourniquet, cut the wound, suck out the venom, or drink alcohol or coffee.
Also do not seek to inject your own antivenom, which can induce a violent allergic reaction and needs to be administered in a professional environment with adrenaline and oxygen on hand.

Sources: Doctors Without Borders, Centers for Disease Control and Prevention, Health Action International, Bio-Ken research centre.

Date: Tue, 19 Mar 2019 08:06:51 +0100

Sentani, Indonesia, March 19, 2019 (AFP) - At least 89 people are known to have died after flash floods and landslides tore through Indonesia's Papua region, with the toll expected to rise further as rescuers hunt for dozens still missing, the national disaster agency said Tuesday.   Scores have also been injured in the disaster, triggered by torrential rain on Saturday, with some 6,800 people evacuated to temporary shelters.   The military has taken up the grim task of putting mud-caked corpses into body bags, with the search hampered by mountains of debris including rocks and fallen trees.

Seventy-four people remain unaccounted for, while around 150 suffered broken bones, cuts and other injuries.   "Many people are choosing to stay at shelters because they're still traumatised and scared of more flash floods, so some evacuation centres are packed," said national disaster agency spokesman Sutopo Purwo Nugroho.

The government has issued a 14-day state of emergency in Papua, which shares a border with independent Papua New Guinea on an island just north of Australia.   Flooding is common in Indonesia, especially during the rainy season which runs from October to April.   In January, floods and landslides killed at least 70 people on Sulawesi island, while earlier this month hundreds in West Java province were forced to evacuate when torrential rains triggered severe flooding.

Meanwhile, three people were killed -- including two Malaysian tourists -- and some 182 were injured after an earthquake Sunday triggered a landslide on the Indonesian tourist island of Lombok, next to Bali.   Lombok was rocked by several earthquakes last summer, killing more than 500 people and leaving over 150,000 homeless.

Last September, the country was hit by an earthquake and tsunami in Palu on Sulawesi island which killed around 2,200 people.    The Southeast Asian archipelago of some 17,000 islands is one of the most disaster-prone nations on Earth, straddling the Pacific Ring of Fire, where tectonic plates collide. Earthquakes and volcanic eruptions are common.
Date: Mon, 18 Mar 2019 23:35:47 +0100
By Nova SAFO

Chicago, March 18, 2019 (AFP) - The US Midwest struggled Monday with historic flooding that claimed at least three lives, displaced residents and damaged hundreds of homes and businesses.    Swollen waters hit much of Nebraska, as well as parts of Iowa, Wisconsin, and South Dakota, after a major storm last week dumped snow and rain, even as melting snow was already raising the levels of area waterways.   Neighboring states could also be affected as floodwaters drain, officials said.    President Donald Trump on Monday described the floods as "devastating" and said the White House would remain in close contact with state officials.    "Our prayers are with the great people of South Dakota," he said in one tweet.    In another aimed at Iowa residents, he said: "We support you and thank all of the first responders working long hours to help the great people of Iowa!"

- 'Historic' flooding -
The National Weather Service (NWS) described the flooding as "major" and "historic," forecasting that it would continue across large sections of the middle of the country.    "Flood Warnings and Advisories are scattered throughout the Plains, Mississippi Valley, and western parts of the Ohio Valley region, with a focus in Nebraska and western Iowa," the NWS said in an advisory.    "Farther west and north, areal flooding is also possible in the Northwest and Northern Plains as snowmelt continues over frozen ground."   The early damage assessment total for the state of Nebraska was more than $260 million, according to emergency management officials.

Record flooding was reported in 17 locations in the state and 10 American Red Cross shelters were operating for displaced residents.    At its highest point, the Missouri River was expected to crest at 47.5 feet (14.5 meters), beating its 2011 record by more than one foot.    "Comparisons to 2011 were inevitable," the NWS office in Iowa tweeted, "but these floods have resulted in many more rescues and widespread damage in eastern Nebraska and western Iowa."   Failing levees were blamed for flooding in numerous communities -- damaging homes and businesses.    The US Army Corps of Engineers, which maintains federal levee systems, said a majority were compromised along an approximately 100-mile portion of the Missouri River in southeast Nebraska.

- Military base under water -
Hundreds of people were rescued in Nebraska, where 54 cities issued emergency declarations, as did four Native American tribal areas.    Fremont, a city of more than 25,000, was surrounded by floodwaters over the weekend and cut off from aid.    It finally received food and other emergency supplies Sunday after crews managed to clear debris and mud from a road, officials said.    Three dozen Iowa counties were under states of emergency.    Roads were closed throughout Wisconsin and more than 200 people were evacuated, according to officials.

A third of Offutt Air Force Base in Nebraska was overcome with floodwater, and was not expected to be dry again until Thursday.   "It's important to understand that this is going to take weeks and months to recover so this will be a prolonged effort," one of the base's leaders, Kevin Humphrey, said in a statement.    Three people were reported killed.   A Nebraska farmer died Thursday, during the height of the storm, trying to rescue a motorist stranded by floodwaters, the Omaha World-Herald reported.    On the same day, 80-year-old Betty Hamernik died after being trapped by floodwaters in her home in rural Columbus, Nebraska, according to the newspaper.    Aleido Rojas Galan, 55, was killed Friday in Iowa when his vehicle was swept away by floodwaters, TV station KETV said.
Date: Mon, 18 Mar 2019 16:57:59 +0100

Kiev, March 18, 2019 (AFP) - Eleven people have died and more than 30,000 have been infected this year in a major measles outbreak in Ukraine, the European country worst hit by the disease, Kiev said Monday.  The latest victim was a nine-year-old girl who died from complications Saturday after contracting the highly infectious disease, the health ministry said.

Some 30,500 people, including 17,000 children, have been infected so this year.   Authorities said shortages of vaccine in previous years and anti-vaccination sentiment, often driven by online campaigns spreading false information about the alleged risks, were the main reasons behind the outbreak.

The World Health Organization (WHO) recommends a 95-percent vaccination rate to prevent mass hospitalisations and fatalities.   But in Ukraine, just 42 percent of one-year-olds had been vaccinated as of end-2016, according to the United Nations children's agency UNICEF.   Measles cases more than tripled across Europe in 2018, with Ukraine accounting for most of the gain.

Europe as a whole saw nearly 83,000 cases last year, according to WHO figures.  The Ukrainian government reported 54,000 cases in 2018. There were 16 deaths nationwide.  In 2019, the authorities launched a special campaign including sending mobile vaccination teams to rural schools in two western regions particularly hard hit in the outbreak.   Measles is characterised by high fever and a reddish rash. It usually triggers only mild symptoms but remains one of the leading causes of death among young children globally.
Date: Sun, 17 Mar 2019 16:19:02 +0100

Paris, March 17, 2019 (AFP) - Eurostar trains from Paris to London were hit by cancellations and "severe delays" on Sunday as French customs officers staged work-to-rule industrial action.     The customs officers are demanding higher pay and better working conditions while seeking to demonstrate what might happen if full border controls are put in place once Britain leaves the European Union.

Paris-to-London trains were experiencing "severe delays and lengthy queues for our services," Eurostar said on its website. "We strongly recommend that you do not travel today."   Four trains had been cancelled by lunchtime on Sunday, with another three on Monday and one on Tuesday.   Sunday's work-to-rule was just the latest in a string of strike actions by the French customs officers.

Work-to-rule strikes began in early March, in the Channel ports of Dunkirk and Calais, northern France, leading to long delays for trucks waiting to cross to Britain.   The customs workers want better pay but also more staff to cope with British travellers who will no longer have European passports once the UK leaves the European Union.

Brexit is due to happen on March 29 but looks increasingly likely to be delayed as the British parliament is yet to agree on a divorce plan.   On Wednesday French unions representing the around 17,000 customs workers rejected a government offer of a 14 million euro ($15.8 million) payroll boost, saying it was insufficient.
Date: Sun, 17 Mar 2019 16:15:35 +0100

Mataram, Indonesia, March 17, 2019 (AFP) - At least two people were killed and dozens injured Sunday after an earthquake on the Indonesian tourist island of Lombok triggered a landslide, officials said.    The 5.5-magnitude quake is thought to have caused the landslide at the Tiu Kelep waterfall in the north of the island.   "Two people died in the landslide in the Tiu Kelep waterfall after the earthquake, one of them is a Malaysian," a disaster agency spokesman told AFP.   At least 44 people were injured in the earthquake, according to the agency, including eight Malaysians, while more than 30 houses were destroyed and about 500 others slightly damaged.

Indonesia is one of the most disaster-prone nations on Earth due to its position straddling the so-called Pacific Ring of Fire, where tectonic plates collide.   Lombok was rocked by several earthquakes last summer, killing more than 500 people and leaving over 150,000 homeless.   Last September, the country was hit by an earthquake and tsunami in Palu on Sulawesi island which killed around 2,200 people.
Date: Fri 15 Mar 2019
Source: Prothom Alo [edited]

The 3 members of a family from Baliadangi upazila's [2nd-lowest tier of regional administration] Ujarmoni village in Thakurgaon [district] are suspected to have been infected with the deadly Nipah virus, reports United News of Bangladesh [apparently later confirmed as Nipah virus; see below. - ProMED Mod.TY].

The victims include a 28 year old mother; her son, aged 8; and her daughter, aged 4. They were taken to Rangpur Medical College Hospital on Thursday [14 Mar 2019], said ABM Maniruzzaman, the resident medical officer of Baliadangi Upazila Health Complex. He said the victims had been suffering from fever for the last 3 days. They also reported headache and vomiting. The trio was 1st taken to Thakurgaon Modern Sadar Hospital and later shifted to RMCH.

Nipah virus is transmitted from animals to humans and can also be transmitted through contaminated food or directly between people, according to the World Health Organisation. There is no vaccine for the virus, which is spread through body fluids and can cause inflammation of the brain.

The mother's husband said his wife and children fell sick after eating jujube [fruit of the _Ziziphus jujuba_ bush] on Wednesday night [13 Mar 2019].

Thakurgaon civil surgeon Abu Mohammad Khairul Kabir said their blood samples had been collected for testing. A medical team from the Institute of Epidemiology, Disease Control and Research is scheduled to visit RMCH.

In February [2019], 5 members of a family died mysteriously in Baliadanga upazila. It is unclear what caused their deaths [Nipah virus is suspected]. In 2001, Nipah virus was identified as the causative agent in an outbreak of human disease occurring in Bangladesh. Genetic sequencing confirmed this virus as Nipah virus, according to the Centre for Disease Control and Prevention.
======================
[This is the 2nd family in Bangladesh to have been infected by Nipah virus this year [2019]. Nipah virus infections occur sporadically in Bangladesh. As noted in the previous comment (ProMED-mail archive no. http://promedmail.org/post/20150204.3143251), "Giant fruit bats or flying foxes (_Pteropus_ of several species) are reservoirs of Nipah virus, and . . . they contaminate date palm sap or the fruit. [The above report suggests that the family may have eaten contaminated jujube fruit]. This is the season for cases of Nipah virus infection to occur. The transmission season is usually January to April."

"It is unfortunate that the public awareness efforts have not prevented these cases from occurring. Perhaps because cases are sporadic and geographically scattered there is little public perception of risk of infection and serious disease. Until effective public education to prevent infection by avoiding eating contaminated fruit or date palm sap is implemented, sporadic cases will continue to occur."

An image of a _Pteropus_ fruit bat can be found at

[HealthMap/ProMED-mail maps:
Rangpur Division, Bangladesh: <http://healthmap.org/promed/p/16030>]
Date: Fri 15 Mar 2019
Source: Le Journal de Mayotte [in French, trans. ProMED B, edited]

The circulation of Rift Valley fever (RVF) continues in Mayotte. An animal disease of viral origin, Rift Valley fever mainly affects domestic ruminants (cattle, sheep, goats), causing abortions and high mortality in young animals. It can be transmitted from the infected animal to humans.

In total, since the beginning of the epidemic (end of November [2018]),
- samples taken by veterinarians from sick animals or during abortions led to the identification of 8 new outbreaks this week [week of Mon 11 Mar 2019], for a total of 60 cases in animals (including 49 cattle). Animal foci are located mainly in the centre and north west of the island;
- a total of 101 human cases of RVF have been reported to the platform/cell watch and health emergencies of the ARS OI (CVAGS) of Mayotte by the CHM laboratory. Of those who could be interviewed, almost 80% report having been in contact with animals;
- since the beginning of the health alert, human cases have been located mainly in the centre and north west of the island, with nearly 60% of cases in Chiconi and Tsingoni.

Since 25 Feb 2019, the weekly number of new human cases has been on the decrease.  [byline: Anne Perzo]
========================
[This Rift Valley fever (RVF) outbreak has been going on since November 2018. The number of human cases of RVF has increased from 82 to 101 in about 2 weeks. However, it is good to learn that the number of new human cases is decreasing. The above report implies that the human infections are the result of contact with infected animals or their products, with fewer from virus transmission by mosquito vectors. The cattle cases certainly are the result of mosquito transmission.

Because RVF virus can be transovarially transmitted in populations of aedes mosquito vectors, and those resulting eggs can persist for a long period of time in nature, cases can occur periodically when the virus-containing eggs hatch, and infected adult females emerge from them. There is a risk that RVF will reappear on the island after the current outbreak has ended.

Recent studies have shown that RVF virus may severely injure human foetuses if contracted by mothers during pregnancy. There is no indication of whether any of the 101 RVF virus-infected people were pregnant. Abortions in infected livestock are common. There is no vaccine available for human use, but there is for livestock. There is no mention of whether the livestock populations in the area have been vaccinated.

The clinical findings related to the above human cases are not mentioned. In an earlier comment, ProMED noted that: "The most common complication associated with RVF is inflammation of the retina. As a result, approximately 1-10% of affected patients may have some permanent vision loss. Approximately 1% of humans that become infected with RVF virus die of the disease." - ProMED

[ealthMap/ProMED-mail map of Region d'outre-mer de Mayotte, France:
Date: Thu 14 Mar 2019
Source: Outbreak News Today [edited]

Tasmania health officials are advising people who live on the east coast, or plan on travelling there, to ensure they protect themselves against mosquitoes following a number of cases of Barmah Forest virus. To date, 5 confirmed cases of the mosquito borne disease have been reported, with 2 additional cases being investigated. Officials note that these cases represent the 1st time the officials have been able to confirm the virus was contracted in Tasmania.

Public Health Services has partnered with University of Tasmania to conduct mosquito trapping in an attempt to learn more about this outbreak. PHS and UTAS staff will volunteer their time this weekend [16-17 Mar 2019] to set a number of traps on the East Coast. The trapping will attempt to confirm the presence of mosquito species known to carry the virus, and also to hopefully trap a mosquito carrying the virus for further research.

Barmah Forest virus is spread by the bite of an infected mosquito. It is related to Ross River virus. Barmah Forest virus is relatively common in mainland states but has not been thought to be present in Tasmania until recently.

Many people may be asymptomatic. If symptoms are present, they can manifest as fever, headache, aches and pains in muscles and joints, tiredness, rash, and swollen or stiff joints. Symptoms usually develop 3-21 days after being bitten by an infected mosquito. Most people recover completely in a few weeks.

Preventing insect bites will also protect against other mosquito borne diseases, such as Ross River virus, and tickborne diseases, such as Flinders Island spotted fever.

To protect against mosquitoes and ticks,
- avoid mosquito-infested areas when possible;
- cover up with a loose-fitting, long-sleeved shirt and long pants when outside;
- apply mosquito repellent to exposed skin;
- take special care during peak mosquito-biting hours, especially around dawn and dusk, and when outdoors or camping; and
- remove potential mosquito-breeding sites from around the home and screen windows and doors.
=======================
[Clearly, Barmah Forest virus (BFV) is currently being transmitted in Tasmania, reportedly for the 1st time. Interestingly, Dr Steve Berger's comment (Barmah Forest virus - Australia (02): (TS) comment http://promedmail.org/post/20190310.6360212) indicated that 19 cases of BFV infections have been reported in Tasmania from 1999-2018, suggesting that these infections were acquired in other Australian states. The previously ProMED-mail-posted cases of BFV infections have been in Queensland state. It will be interesting to learn which mosquito species are transmitting the virus in Tasmania. The Tasmania Public Health Services' advice to prevent mosquito bites should be taken seriously. - ProMED Mod.TY]

[HealthMap/ProMED-mail map of Tasmania, Australia:
Date: Fri, 15 Mar 2019 19:08:37 +0100
By Joaquim Nhamirre

Maputo, March 15, 2019 (AFP) - Tropical cyclone Idai battered Mozambican coastal city Beira Friday, leaving half a million people virtually cut off after power lines crashed, airport shut and roads were swamped by flooding that killed 66 people nationwide.   "There is no communication with Beira. Houses and trees were destroyed and pylons downed," an official at the National Institute of Disaster Management (NIDM) told AFP.   Authorities had to close Beira international airport after the air traffic control tower, the navigation systems and the runways were damaged by the storm.   "Unfortunately there is extreme havoc," said the official.   "Some runway lights were damaged, the navigation system is damaged, the control tower antennas and the control tower itself are all damaged.    "The runway is full of obstacles and parked aircrafts are damaged."

Late on Wednesday, the national carrier LAM cancelled all flights to Beira and Quelimane, which is also on the coast, as well as to Chomoio, which is inland.    Power utility Electricidade de Mocambique said in a statement that the provinces of Manica, Sofala and parts of Inhambane have been without power since Thursday.   Officials did not report any confirmed deaths, but local Beira station STV reported a child had died in Manica province west of the city, apparently the victim of a falling roof.   "There was no tsunami-type storm but Beira and Chinde (400 kilometres, 250 miles northeast of Beira on the coast) were badly hit," added the NIDM official.

Another official, Pedro Armando Alberto Virgula, in Chinde, said a hospital, police station and seven schools there lost their roofs and four houses were destroyed.   Virgula added that efforts were under way to assess the damage caused after Idai made landfall late on Thursday.   Local officials said that this week's heavy rains claimed 66 lives, injured 111 people and displaced 17,000 people.   The World Food Programme (WFP) said it would move 20 tonnes of emergency food aid to the affected areas.   The UN Office for the Coordination of Humanitarian Affairs (OCHA) had warned that the storm could pack winds of up to 190 kilometres per hour (118 miles per hour).

- 'Devastation' -
At least 126 people were killed by the downpour that has struck parts of Mozambique, Malawi and South Africa over the past week, officials said.   Heavy rains in neighbouring Malawi have affected almost a million people and claimed 56 lives, according to the latest government toll.   Authorities there have opened emergency relief camps where malaria and shortages of supplies have led to dire conditions, according to AFP correspondents.

Malawian President Peter Mutharika this week declared a natural disaster.   Mozambique's weather service has warned that heavy rain will continue to batter Beira and surrounding areas until Sunday.   The UN warned of damage to crops, "including about 168,000 hectares (415,000 acres) of crops already impacted by flooding in early March, which will undermine food security and nutrition".   Mozambique and Malawi, two of the poorest countries in the world, are prone to deadly flooding during the rainy season and chronic drought during the dry season.   In neighbouring Zimbabwe, weather services have warned that violent thunderstorms, lightning and strong winds will be experienced in the eastern regions of the country.