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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 ...

Paraguay

Paraguay - US Consular Information Sheet
September 15, 2008
COUNTRY DESCRIPTION:
Paraguay is a constitutional democracy with a developing economy.
Tourist facilities are adequate in the capital city of Asuncion, but they vary greatly
n quality and prices.
Travelers outside Asuncion should consider seeking travel agency assistance, as satisfactory or adequate tourist facilities are very limited in other major cities and almost nonexistent in remote areas.
Read the Department of State Background Notes on Paraguay for additional information.
ENTRY/EXIT REQUIREMENTS:
A passport and visa are required.
U.S. citizens traveling to Paraguay must submit completed visa applications in person or by secure messenger to the Paraguayan Embassy or one of the consulates and pay a fee.
Paraguay issues visas for one-entry or multiple entries up to the validity of the U.S. passport.
Applicants under 18 years of age traveling alone must appear with both of their parents or a legal guardian.
In case of a guardian, an original and one copy of proof of legal guardianship are required.
A document of authorization from parents/guardian will be accepted only if it is notarized and certified by the county clerk.
Travelers entering or departing Paraguay with regular U.S. passports will be fingerprinted.
Some airlines include the Paraguayan airport departure tax in the price of the airline ticket.
It is recommended that you check with the airline in order to determine whether or not the departure tax has been included.
If the tax is not included in the airline ticket then payment would be required upon departure in either U.S. or local currency (no credit cards or checks accepted). Visit the Embassy of Paraguay web site at http://www.embaparusa.gov.py 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:
As stated in the Department of State's latest Worldwide Caution, U.S. citizens overseas may be targeted by extremist groups and should maintain a high level of vigilance.
The U.S. Embassy is not aware of any specific terrorist threat to Americans in Paraguay.
Individuals and organizations providing financial support to extremist groups operate in Ciudad del Este and along the tri-border area between Paraguay, Brazil and Argentina.
Small armed groups have also been reported to be operating in the San Pedro and Concepcion Departments.
Drug trafficking remains a serious concern in the Department of Amambay.
Because of concerns about the lack of security in border areas, the U.S. Embassy in Asuncion requires U.S. Government personnel and their family members to provide advance notice and a travel itinerary when traveling to Ciudad del Este or Pedro Juan Caballero.
As a general precaution, the Embassy also counsels its employees traveling outside the capital to provide an itinerary including dates, contact names, and telephone numbers where the employee may be reached.

Since January 2007, there have been numerous kidnapping incidents mainly in the Alto Parana department.
Targets have been members of the Paraguayan business community or their family members.
It is believed that the individuals responsible for the kidnappings are financially motivated and have pre-selected their targets based on the victims’ wealth.

U.S. citizens should avoid large gatherings or any other event where crowds have congregated to demonstrate or protest.
Such activities have resulted in intermittent road closures including major routes traveled by tourists and residents.
While generally nonviolent, demonstrations and/or roadblocks have turned violent in the past.
Areas where such closures and barricades exist should be avoided.
U.S. citizens who encounter demonstrations and/or roadblocks should not attempt to continue the planned travel or to confront those at the roadblock.
Instead, they should avoid areas where individuals are demonstrating and in case of roadblock, wait for the road to reopen or return to the origin of their trip.
Uniformed police often conduct roving checks of vehicles and passengers.

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

Up-to-date information on safety and security can also be obtained by calling 1-888-407-4747 toll free in the United States and Canada, or for callers outside the United States and Canada, a regular toll-line at 1-202-501-4444.
These numbers are available from 8:00 a.m. to 8:00 p.m. Eastern Time, Monday through Friday (except U.S. federal holidays).
The Department of State urges American citizens to take responsibility for their own personal security while traveling overseas.
For general information about appropriate measures travelers can take to protect themselves in an overseas environment, see the Department of State’s pamphlet A Safe Trip Abroad.

CRIME:
Crime has increased in recent years with criminals often targeting those thought to be wealthy.
Although most crime is nonviolent, there has been an increase in the use of weapons and there have been incidents where extreme violence has been used.
U.S. citizens have on occasion been the victims of assaults, kidnappings, robberies, and rapes.
Local authorities frequently lack the training and resources to solve these cases.
Under these circumstances, U.S. citizens traveling to or residing in Paraguay should be aware of their surroundings and security at all times.
They should take common sense precautions including refraining from displaying expensive-looking cameras and jewelry, large amounts of money, or other valuable items.
Resistance to armed assailants has often aggravated the situation and therefore is not advised.

Armed robbery, carjackings, car theft, and home invasions are a problem in both urban and rural areas.
Street crime, including pick pocketing and mugging, is prevalent in cities.
The number of pick pocketing incidents and armed assaults is also increasing on public buses and in the downtown area of Asunción.
As many incidents on public buses involve individuals snatching valuables, passengers should not wear expensive-looking jewelry or display other flashy items.
There have been incidents of pilferage from checked baggage at both airports and bus terminals.
Travelers have found it prudent to hide valuables on their person or in carry-on luggage.
Unauthorized ticket vendors also reportedly operate at the Asuncion bus terminal, badgering travelers into buying tickets for substandard or non-existent services.

In many countries around the world, counterfeit and pirated goods are widely available.
Transactions involving such products may be illegal under local law.
In addition, bringing them back to the United States may result in forfeitures and/or fines.
More information on this serious problem is available at http://www.cybercrime.gov/18usc2320.htm
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 are 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.

Below are the local equivalent phone numbers to the “911” emergency line in Paraguay.
In Asuncion, the following phone numbers exist for roadside/ambulance assistance:
Emergency Services, including police and ambulances:
911.
Fire Department, including rescue of accident victims: 131, 132.
See our information on Victims of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION:
Adequate medical facilities, prescription and over-the-counter medicine, supplies, and services are available only in Asuncion.
Elsewhere, these are limited and may not exist.

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.
The U.S. Department of State is unaware of any HIV/AIDS entry restrictions for visitors to Paraguay or foreign residents of the country.

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

U.S. citizens have been injured and killed in traffic accidents.
Only minimal standards must be met to obtain a Paraguayan driver's license, and driver education prior to licensing is not common.
Drivers throughout Paraguay routinely ignore traffic regulations.
No vehicle insurance is required, and many Paraguayans drive without any insurance coverage.
Persons who drive in Paraguay should be prepared to drive defensively and with their own insurance in both urban and rural areas.

Public transportation is readily available for urban and inter-city travel.
Buses vary in maintenance conditions and may not meet U.S. safety standards.
Armed robberies and pick pocketing occur on buses in cities and rural areas, sometimes with the apparent collusion of the bus driver.
Taxis are available and may be called using telephone numbers listed in the newspapers.
No passenger train service exists.
Bicycle travel may not be safe due to traffic and other road hazards.
Most urban streets consist of cobblestones over dirt.
Some roads in Asuncion and other large cities are paved.
However, these roads frequently develop potholes that often remain unrepaired.
Nearly all rural roads are unpaved, and during rainy periods and the rainy season (November-March/April), they may be impassable.
Road signs indicating hazards, such as sharp curves or major intersections, are lacking in many areas.

Driving or traveling at night is not advisable outside Asuncion because pedestrians, animals, or vehicles without proper lights are often on the roads.
In addition, assaults and other crimes against motorists traveling at night have occurred.
Extra precautions should be exercised along infrequently traveled portions of the rural roads.

Intercity highway maintenance is not equal to U.S. standards.
The privately maintained toll road between Caaguazu and Ciudad del Este and the routes between Asuncion and Encarnacion and Asuncion and Pedro Juan Caballero are in good condition.
Most other intercity routes are in good to fair condition, with brief stretches in poor condition.
The Trans-Chaco route is in fair condition except for the portion between Mariscal Estigarribia and the Bolivian border, which is unpaved and at times impassable.

The Touring and Automobile Club provides some roadside assistance to its members.
The Club may be contacted in Asuncion by visiting its offices at 25 de Mayo near Brazil, First Floor, or telephoning 210-550, 210-551, 210-552, 210-553, Monday through Friday from 8:00 a.m. to 5:00 p.m., or Saturday from 8:00 a.m. to noon, except for Paraguayan holidays.
The Touring Club also has offices in Ciudad del Este (tel. 061-512-340), Coronel Oviedo (tel. 0521-203-350), Encarnación (tel. 071-202-203), San Ignacio Misiones (tel. 082-232-080), Caaguazu Campo 9 ( tel. 0528-222-211), Santani (tel. 043-20-314), Pozo Colorado (cell phone. 0981-939-611, Villa Florida (tel. 083-240-205) and Ybyyau (tel. 039-210-206).
Towing services are scarce outside urban areas.
Twenty-four-hour tow truck services from Asuncion may be contacted by telephoning (021) 224-366, (021) 208-400, (cellular service provider) Tigo by dialing *822 or 0971-951-930.
For an extra fee, these companies may provide service outside Asuncion, but they typically demand immediate payment and may not accept credit cards.

Please refer to our Road Safety page for more information.
Visit the website of Paraguay’s national tourist office and national authority responsible for road safety at http://www.senatur.gov.py and http://www.mopc.gov.py/
AVIATION SAFETY OVERSIGHT: The U.S. Federal Aviation Administration (FAA) has assessed the Government of Paraguay’s Civil Aviation Authority as not being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for the oversight of Paraguay’s air carrier operations.
For more information, travelers may visit the FAA’s web site at http://www.faa.gov/safety/programs%5Finitiatives/oversight/iasa/
SPECIAL CIRCUMSTANCES: Paraguay’s customs authority may enforce strict regulations concerning temporary importation into or export from Paraguay of items such as firearms, medications, toys resembling weapons, or protected species.
It is advisable to contact the Paraguayan Embassy in Washington, D.C., or one of Paraguay's consulates in the United States for specific information regarding customs requirements.

Paraguay does not recognize dual Paraguayan nationality for American citizens.
Under Article 150 of the Paraguayan Constitution, naturalized Paraguayans lose their nationality by virtue of a court ruling based on unjustified absence from the Republic for more than three years, or by voluntary adoption of another nationality.
Please see our Customs Information.

CRIMINAL PENALTIES:
While in a foreign country, a U.S. citizen is subject to that country's laws and regulations, which sometimes differ significantly from those in the United States and may not afford the protections available to the individual under U.S. law.
Penalties for breaking the law can be more severe than in the United States for similar offenses.
Persons violating Paraguay’s laws, even unknowingly, may be expelled, arrested, or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in Paraguay 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 residing or traveling in Paraguay 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 Paraguay.
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 1776 Mariscal Lopez Avenue, Asuncion; telephone (011-595-21) 213-715, fax (011-595-21) 213-728; Internet: http://paraguay.usembassy.gov, email: paraguayconsular@state.gov.
The Consular Section is open for U.S. citizen services, including registration, Monday through Thursday from 1:00 p.m. to 4:30 p.m. and Fridays from 7:30 a.m. to 10:30 a.m., except for U.S. and Paraguayan holidays; telephone (011-595-21) 213-715, fax (011-595-21) 228-603.

Travel News Headlines WORLD NEWS

Date: Tue, 28 May 2019 03:40:13 +0200
By Hugo OLAZAR

Nanawa, Paraguay, May 28, 2019 (AFP) - Like 70,000 people living close to the broken banks of the Paraguay River, where the water level has risen seven meters (23 feet) in some places, Graciela Acosta has had to pack up her belongings and evacuate.   Piled up on a canoe are the 39-year-old housewife's bed, wardrobe, bedside table and her dog Pirulin.

Acosta is getting ready to cross the border into Argentina with her daughter to seek refuge in a reception center in the neighboring town of Clorinda.   "I've had enough! It's the third time that I've had to move everything because of the floods," said Acosta.   "I pray to God that it ends. Every time. it costs a lot of money."   However, there's no chance of Acosta leaving her home in Nanawa, a town of just 6,000 people that borders Argentina to the west and faces the capital Asuncion to the east across the Paraguay River, for good.   "As soon as the water level drops, I'll go home," she said.

- 'Greater impact' -
In Nanawa, only around 500 people were able to avoid evacuation, due to living in homes with upper floors above the flood levels.   They're used to this as the Paraguay River, one of the largest in the Americas, breaks its banks and causes havoc in the poorest Nanawa neighborhoods built on the flood plain.   The river's brown waters rise almost to the height of street signs: in some areas, there is up to one or two meters of water covering roads.

Paraguayans have seen worse, though, back in 1983, according to the assistant director of the country's meteorology and hydrology service, Nelson Perez.   "It's not the Paraguay River's worst flood, but the impact is greater because more people live close to the river," said Perez.   "These are the worst floods I've seen," said Ruben Acosta, 55, who peddles his moving services by canoe.   It's a far cry from January and February, when the river's level was so low that navigating it became difficult.   "It rained a lot in March, three times more than usual, and it also rained a lot in April and May," said Perez, who pointed to deforestation as an added problem.

- 'It's like being in Venice' -
Wading through water up to his chest, Rigoberto Nunez leaves a cemetery carrying a chandelier, a vase, some crucifixes and family portraits, all plucked from the family vault.   "I prefer to take them away to be safe," says the 47-year-old traveling salesman.    The town is without electricity or police and inhabitants are afraid of looters.   Nunez is heading to a reception center provided by Argentine authorities in a Clorinda slum where he's already stashed his furniture.   Enrique Cardozo's workshop has already been ravaged by the floods.   "I've lost my sofa, the cupboard, I had nowhere to put them," said the 51-year-old father of four.

The family has moved into the first floor of their house, which is just 15 meters from the river.   "It rained non-stop for a week. One day, the water rose one meter. It was impressive, we couldn't save everything," said Cardozo.   "There's nowhere you can put your feet on the ground. It's like being in Venice, we move about by Gondola!"

On the other side of the river, Asuncion has not been spared as several areas have also had to be evacuated.   In the Sajonia residential zone, inhabitants and shopkeepers have seen their sidewalks lined with sandbags, to keep back the floodwaters.   According to Perez, though, the problems -- and waters -- will soon subside.   The water level rose only slightly on Monday, and will continue to do so for a few more days before it drains away during the first half of June, he said.
Date: Mon, 27 May 2019 12:07:58 +0200

Asuncion, May 27, 2019 (AFP) - Heavy flooding in Paraguay has displaced 70,000 families and is threatening to further inundate the capital Asuncion in the coming weeks, the country's weather bureau said.   Water levels on the Paraguay River are rising at a rate of 4-5 centimetres (1.5-2 inches) every day and is only 46 cm (18 in) below a "disaster" level, according to official data from the Department of Meteorology and Hydrology (DMH).

Crossing that threshold would "have a very strong impact" because of the number of Asuncion residents who have moved into the city's floodplain, said DMH deputy director Nelson Perez on Sunday.   The city's water service infrastructure was clogged with garbage which was exacerbating the floods, Perez added. 

Unusually heavy downpours over May, including two days which together exceeded Asuncion's average monthly rainfall, have exacerbated the flooding, said DMH meteorologist Eduardo Mingo.    Some 40,000 people in Asuncion have already been affected by the floods, official data reported.   A further 10,000 people have been displaced in the southern town of Pilar on the Argentinian border.   The government has mobilized armed forces to help displaced residents relocate to shelters, but hundreds of families have opted to stay behind in their inundated homes.
Date: Thu, 4 Apr 2019 03:06:45 +0200

Asuncion, April 4, 2019 (AFP) - More than 20,000 families across Paraguay have been affected by severe flooding from two weeks of heavy rain that caused the country's main river to burst its banks, a senior official said Wednesday as an emergency was declared in the capital.   National Emergency Minister Joaquin Roa made the announcement as forecasters said the precipitation would continue for the rest of the week.   The Paraguay River, which runs some 1,000 kilometres north to south and splits the country in two, is expected to continue overflowing.

A 90-day emergency was declared in Asuncion on Wednesday due to the flooding. Hardest-hit are some 5,000 families living in the Banado Sur working-class neighbourhood on the city outskirts.   The people affected by flooding "need sheet metal roofing, wood, and all types of help," a municipal official told AFP.   The Paraguay River flows past Asuncion and eventually merges into the Parana River in Argentina.   "We did not expect it to swell so quickly," said Pablo Ramirez, a resident of Banado Sur, a neighbourhood in the capital, dismayed after returning to his home after he left it one month ago due to flooding.

Ramirez, who relies on crutches to get around following a car accident, said that he will not leave home this time. The flooding "will go by quickly," he said optimistically.   Pedro Velasco, the leading neighbourhood Catholic priest, said that one week ago they warned emergency officials that the river was about to overflow and asked for trucks to deliver aid and help evacuate people.   "They didn't move until Monday, but by then it was already too late and they couldn't come in" because of the flooding, Velasco said.   Roa said that his office will deliver 400,000 of food in the next days in coordination with the Paraguayan military.
Date: Thu 28 Feb 2019
Source: Hoy [in Spanish trans. Mod.TY, edited]

Patients who present with febrile symptoms and who reside in the area where the 1st positive case was reported positive request tests for hantavirus [infection]. Until now there are 5 cases, 3 were positive in initial laboratory tests and 2 are suspect cases that will be tested outside [the country] because the Central Laboratory does not do confirmatory tests.

The febrile cases of residents in Capiata [Central department], the area where the 1st cases of hantavirus occurred, are adding up and now Health Surveillance has reported 2 more suspected cases, all children between 2 and 7 years old living in the same city; community intervention continues in search of possible cases.

The 1st cases confirmed in a private laboratory remain hospitalized in intensive care and the others who have improved are now receiving ambulatory treatment, stated Dr Sandra Irala of Health Surveillance.

"The clinical picture of hantavirus [infection] is that of a patient with a temperature above 38 deg C [100.4 deg F] and respiratory difficulty is another characteristic in the endemic area such as that of Chaco. In the non-endemic area [hantavirus infection] is suspected if the patient presents with fever and other possible causes are eliminated," the doctor indicated in a press conference.

The rodents that transmit the hantavirus do not inhabit urban areas and the way in which the disease [virus] is acquired is through contact with excreta and other secretions such as saliva and urine of these [infected] rodents.

Irala pointed out that the cases that are initially positive should have a cross-section of studies for final confirmation, so the samples were sent to Argentina, where there is a reference laboratory for the detection of this type of virus.

The person acquires the virus by inhaling air contaminated with the virus that is transported through dust particles, which is why it is recommended before cleaning, especially of storage buildings, to open doors and windows to ventilate the environment and moisten the soil to before proceeding with the sweeping.

The possibility of acquiring a hantavirus [infection] is if you have a history of having visited the Chaco area or if you were in a country that registers outbreaks of hantavirus, such as southern Argentina.

The disease has a 30% mortality rate and in Paraguay every year about 20 cases are registered, all in the Chaco region.

Alerting symptoms
-----------------
The symptoms of hantavirus [infection] are similar to other infectious diseases and include fever, headache, and gastrointestinal problems and, according to the development and the seriousness of the case, the patient may present with respiratory manifestations.

Before the appearance of any of these or other symptoms [the Ministry of Health] urges the public to go to the nearest health service to make the appropriate diagnosis and appropriate treatment. Under no circumstances should self-medication be used as this could aggravate the picture and obstruct the actual diagnosis of the disease.
=====================
[The active surveillance efforts in the neighborhood of the initial case has detected more patients now with a total 3 confirmed and 2 suspected. The tests used in the private laboratory to determine that 3 cases as confirmed are not indicated, nor if samples of these 3 cases were sent to the reference laboratory in Argentina for confirmation.

Most of the previous cases of hantavirus infection in Paraguay have been diagnosed in Boqueron department in the north western part of the country. This is the 1st report of hantavirus infections in the Central department of Paraguay. The possible hantavirus involved in this suspected case is not stated. A 2011 report indicated that Leguna Negra hantavirus was responsible for hantavirus pulmonary syndrome (HPS) cases in Presidente Hayes department. In addition to Laguna Negra virus (rodent host _Calomys laucha_), other hantaviruses that can cause HPS and are found in Paraguay (and their rodent hosts) include Juquitiba (_Akodon cursor_), Ape Aime-Itapua (_Akodon montensis_), Araucaria (_A. montensis_, _Oligoryzomys nigripes_), Jabora and Jabora-like (_A. montensis_), Alto Paraguay (_Holochilus chararius_), and Lechiguanas (_Oligoryzomys nigripes_). - ProMED Mod.TY]

[Maps of Paraguay:
Date: Tue 12 Jun 2018
Source: WHO, Malaria [edited]

- What were the key elements to Paraguay's malaria elimination success that helped the country reach zero indigenous cases of the disease?
Paraguay is the 1st country in the Americas since Cuba in 1973 to be certified malaria-free, representing a significant public health achievement not only for Paraguay but for the Americas as a whole. Achieving elimination in Paraguay required substantial levels of political commitment and leadership, as well as sustained investments in its national malaria programme over a period spanning more than 50 years. Notable aspects of its approach include:

Rapid and targeted response
---------------------------
With free universal health services in Paraguay and a strong malaria surveillance system, malaria cases were detected early, investigated promptly, and classified correctly.

Dedicated elimination strategy
------------------------------
After reporting its last case of malaria in 2011, Paraguay launched a 5-year plan to consolidate the gains, prevent re-establishment of transmission, and prepare for elimination certification. Activities centred on strengthening epidemiological surveillance, robust case management, and a public information campaign on the diagnosis, treatment, and prevention of malaria to promote behaviour change among populations in at-risk areas.

Integration
-----------
During 2015 and 2016, as part of a broader health reform, malaria surveillance, diagnosis, and treatment activities were integrated within Paraguay's general health services, with the aim of expanding health coverage to at-risk populations and preventing re-establishment.

Strengthening surveillance skills
---------------------------------
A 3-year initiative to hone the skills of front-line health workers in the country's 18 health regions was launched in 2016 to keep the malaria surveillance system sustainable over the long term. Supported by The Global Fund to Fight AIDS, Tuberculosis and Malaria, the project addresses disease prevention, identification of suspected cases, accurate diagnosis and prompt treatment to respond to the on-going threat of malaria importation from endemic countries in the region and Africa.

- How has Paraguay managed to stay malaria-free since 2012? What are the systems in place that made this possible and how long will the country keep those systems operational?
As part of the WHO elimination certification process, countries must demonstrate that they have the capacity to prevent the re-establishment of malaria transmission. The availability of free universal health services in Paraguay and a strong malaria surveillance system ensure imported cases of malaria are detected and responded to in a timely manner to prevent local transmission.

The inclusion of the national malaria programme within the National Malaria Eradication Service (SENEPA, in the Spanish acronym), the institution within the ministry of health responsible for the control of vector-borne diseases, helps guarantee the programme's future existence.

Further, congressional legislation provides predictable and long-term financing for the national malaria programme: by law, 1.5 percent of annual income from Paraguay's social security programme is allocated to SENEPA. Together, these elements ensure that efforts to prevent the re-establishment of malaria transmission can be sustained in the decades to come.

- What are the benefits of malaria elimination for Paraguay?
Eliminating malaria in Paraguay means that no one will fall ill or die from local transmission of the disease, bringing about tangible health benefits at the individual and community levels, as well as broader socio-economic outcomes.

- What role did national leadership, political will, civil society and international partners play in Paraguay's success?
Eliminating malaria is a collective effort, requiring the sustained engagement of many partners at the national, regional and global levels. However, achieving elimination is a country-driven process. For elimination efforts to succeed, government stewardship is essential, together with the engagement and participation of affected communities.

- Does Paraguay coordinate cross-border surveillance activities to prevent importation of malaria cases and do they provide antimalarial treatment to visitors and migrants?
Paraguay provides free treatment to all citizens, visitors, and migrants, regardless of their nationality or residency status. The national malaria programme has identified 3 populations at greatest risk: the military, Brazilian students attending universities in Paraguay, and Paraguayans travelling to Africa. Targeted interventions include strengthening passive detection systems, promotion of health education, and providing prophylaxis to travellers heading to and returning from malaria-endemic regions in Africa.

To step up cross-border collaboration, the Pan American Health Organization (PAHO) funded a project focused on strengthening entomological surveillance and control of vector-borne diseases in the 'triple border' area of Argentina, Brazil, and Paraguay. A key outcome of the project, which ran from 2010 to 2012, was the development of an _Anopheles_ mosquito range map, a tool that shows the geographic distribution of malaria-carrying mosquitoes.

- What are the lessons learned from Paraguay's experience that can be applied in other countries looking to eliminate malaria?
Paraguay provides universal free health services to all, one of the critical elements that helps drive a country towards malaria elimination. Sustained political commitment and robust financial support are further keys to success. Continued surveillance of suspected cases, targeted community engagement and education, as well as strengthening skills of front-line health workers, are recommended strategies that WHO encourages countries to adopt as part of their national malaria elimination programmes.
 
- Is Paraguay replicating its elimination strategy with other infectious and mosquito-borne diseases?
Paraguay has an integrated approach to entomological surveillance activities, taking into account several vector-borne diseases including dengue, leishmaniasis, and Zika virus. Integration of malaria surveillance into the general health system had been a challenging task in Paraguay, but the lessons and experiences learned from other vector-borne diseases have contributed to the smooth integration and transition of the malaria programme. At the same time, the approach used to eliminate malaria is now being applied to eliminate Chagas disease and schistosomiasis.
======================
[ProMED congratulates Paraguay for this important public health achievement. It is important to demonstrate that malaria eradication is possible, and the achievement could be an inspiration for the countries in southeast Asia experiencing a decline in artemisinin susceptibility. - ProMED Mod.EP]

[HealthMap/ProMED-mail map of Paraguay:
More ...

Myanmar (Burma)

Myanmar (Burma) US Consular Information Sheet
October 09, 2008
COUNTRY DESCRIPTION:
Burma (Myanmar) is an underdeveloped agrarian country ruled by an authoritarian military regime.
The country's government suppresses all expression of
opposition to its rule.

After a long period of isolation, Burma has started to encourage tourism.
Foreigners can expect to pay several times more than locals do for accommodations, domestic airfares, and entry to tourist sites.
Tourist facilities in Rangoon, Bagan, Ngapali Beach, Inle Lake, and Mandalay are superior to tourist facilities in other parts of the country, where they are limited.
Please note that visitors should travel with sufficient cash to cover their expenses for the duration of their visit.
Traveler’s checks and credit cards are not accepted anywhere, and ATM machines are nonexistent in Burma.
(See "Currency" and “U.S. Treasury Sanctions" below.)
Read the Department of State's Background Notes on Burma for additional information.
ENTRY/EXIT REQUIREMENTS: The Government of Burma strictly controls travel to, from, and within Burma.
Since October 1, 2006, Burmese authorities have often prohibited entry or exit at most land border crossings, unless the traveler is part of a package tour group that has received prior permission from the Burmese authorities.
A passport and visa are required for entry into Burma.
Travelers are required to show their passports with a valid visa at all airports, train stations, and hotels.
Security checkpoints are common outside of tourist areas.

Burmese authorities rarely issue visas to persons with occupations they deem “sensitive,” including journalists.
Many journalists and writers traveling to Burma on tourist visas have been denied entry.
Journalists -- and tourists mistaken for journalists -- have been harassed.
Some journalists have had film and notes confiscated upon leaving the country.
In an effort to prevent international child abduction, many governments have initiated procedures at entry/exit points.
These often include requiring documentary evidence of relationship and permission for the child's travel from the absent parent(s) or legal guardian. Having such documentation on hand, even if not required, may facilitate entry/departure.
Information about entry requirements as well as other information may be obtained from the Burmese Embassy (Embassy of the Union of Myanmar) at http://www.mewashingtondc.com/,
2300 S Street NW, Washington, DC
20008, telephone 202-332-4350 or the Permanent Burma Mission (Mission of Myanmar) to the U.N. 10 East 77th St., New York, NY 10021, (212-535-1311) 212-744-1271, fax 212-744-1290.

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: U.S. citizens traveling in Burma should exercise caution, register with the U.S. Embassy and check in for an update on the current security situation.
U.S. citizens are encouraged to carry their U.S. passports or photocopies of passport data and visa pages at all times so that if questioned by Burmese officials, they will have proof of U.S. citizenship readily available.

In September 2007, the Burmese Government brutally cracked down on peaceful demonstrators, using gunfire, rubber bullets, batons, and tear gas against them and those observing in the vicinity.
The authorities killed at least 30 people during the crackdown and arrested more than 3,000.
On September 27, 2007, security forces shot and killed a Japanese journalist in the Sule Pagoda downtown area during a demonstration. The Burmese Government has a standing law, which is sporadically enforced, that bans all gatherings of more than five people.

On May 7, 2005, three large bombs simultaneously exploded in Rangoon at two crowded shopping areas frequented by foreigners and at an international trade center, killing at least 20 people and wounding several hundred.
On April 26, 2005, an explosive device detonated at a busy market in Mandalay, killing at least three people.
Although other smaller-scale bombings have occurred in Burma in recent years, including in early 2007 and early 2008, the 2005 bombings were more sophisticated and specifically targeted more highly trafficked areas than those used in other bombings.
However, there is no indication that these attacks targeted American citizens or U.S. interests.
The perpetrators of these bombings have not been identified.

In light of these incidents and the possibility of recurring political unrest, Americans in Burma should exercise caution in public places and be alert to their surroundings.
Furthermore, Americans in Burma should avoid crowded public places, such as large public gatherings, demonstrations, and any area cordoned off by security forces.
The Embassy also advises U.S. citizens not to photograph or videotape the military or police, because doing so could be interpreted as provocative.
Burma experienced major political unrest in 1988 when the military regime jailed as well as killed thousands of Burmese democracy activists.
In 1990, the military government refused to recognize the results of an election that the opposition won overwhelmingly.
Major demonstrations by opposition activists occurred in 1996 and 1998.
In May 2003, individuals affiliated with the Burmese regime attacked a convoy carrying opposition leader Aung San Suu Kyi in Sagaing Division; dozens were killed or injured.

Ethnic rebellions still smolder in regions along Burma’s borders with Thailand, China, India, and Bangladesh, and anti-personnel landmines along border areas pose an additional danger. Occasional fighting between government forces and various rebel groups has occurred in Chin State and Sagaing Division near India and along the Thai-Burma border area in Burma's Shan, Mon, Kayah (Karenni), and Karen states.
From time to time, the Governments of Burma and Thailand have closed the border between the two nations on short notice.
In January 2005, regional governments announced a major regional law enforcement initiative aimed at dismantling the operations of Southeast Asia's largest narcotics trafficking organization, the United Wa State Army.
At that time, the Burmese Government stated that it could not guarantee the safety of foreign officials or personnel from non-governmental organizations traveling or working in Wa Special Region 2 (northeastern Shan State).

U.S. citizens have been detained, arrested, tried, and deported for, among other activities, distributing pro-democracy literature and visiting the homes and offices of Burmese pro-democracy leaders.
Taking photographs of anything that could be perceived as being of military or security interest may also result in problems with authorities.
Burmese authorities have warned U.S. Embassy officials that those who engage in similar activities in the future will be jailed rather than deported.
For the latest security information, Americans traveling abroad should regularly monitor the Department of State, Bureau of Consular Affairs’ web site at http://travel.state.gov, where the current Travel Warnings and Travel Alerts, as well as the Worldwide Caution, can be found.

Up–to-date information on safety and security can also be obtained by calling 1-888-407-4747 toll-free in the U.S. and Canada, or for callers outside the U.S. and Canada, a regular toll line at 1-202-501-4444.
These numbers are available from 8:00 a.m. - 8:00 p.m. Eastern Time, Monday through Friday (except for 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 rates in Burma, especially toward foreigners, are lower than those of many other countries in the region.
Nevertheless, due in part to the poor economic situation in Burma, the crime rate has been increasing.
Violent crime against foreigners is rare.
INFORMATION FOR VICTIMS OF CRIME:
The loss or theft abroad of a U.S. passport should be reported immediately to the local police and the nearest U.S. embassy or consulate.
If you are the victim of a crime while overseas, in addition to reporting to local police, please contact the nearest U.S. embassy or consulate for assistance.
The embassy/consulate staff can, for example, assist you to find appropriate medical care, to contact family members or friends and explain how funds could be transferred.
Although the investigation and prosecution of the crime is solely the responsibility of local authorities, consular officers can help you to understand the local criminal justice process and to find an attorney if needed.

See our information on Victims of Crime.
MEDICAL FACILITIES AND HEALTH INFORMATION: Medical facilities in Burma are inadequate for even routine medical care.
There are few trained medical personnel.
Most foreign drugs on sale have been smuggled into the country, and many are counterfeit or adulterated and thus unsafe to use.
Travelers should bring adequate supplies of their medications for the duration of their stay in Burma.
HIV/AIDS is widespread among high-risk populations, such as prostitutes and illegal drug users.
Malaria, tuberculosis, hepatitis, and other infectious diseases are endemic in most parts of the country.

In early 2006 and throughout 2007, brief avian influenza outbreaks resulted in the death of domestic poultry and some wild birds. In December 2007, the World Health Organization and Burmese Ministry of Health confirmed Burma’s first case of human infection with the H5N1 avian influenza virus.
The young girl infected with the virus during a poultry outbreak in eastern Shan State in late November responded well to treatment and fully recovered.
Travelers to Burma and other South Asian countries affected by avian influenza are cautioned to avoid poultry farms, contact with animals in live food markets, and any other surfaces that appear to be contaminated with feces from poultry or other animals.
Current information about avian influenza A (H5N1) and pandemic influenza can be found via the Centers for Disease Control and Prevention’s (CDC) web site at http://www.cdc.gov/flu/avian/ or at AvianFlu.gov.
For additional information on avian influenza as it affects American citizens residing abroad, see the U.S. Department of State’s Avian Influenza Fact Sheet.

Tuberculosis is an increasingly serious health concern in Burma.
For further information, please consult the CDC's Travel Notice on TB at http://wwwn.cdc.gov/travel/yellowBookCh4-TB.aspx.
The U.S. Department of State is unaware of any HIV/AIDS entry restrictions for visitors to or foreign residents of Burma.
Information on vaccinations and other health precautions, such as safe food and water precautions and insect bite protection, may be obtained from the Centers for Disease Control and Prevention's (CDC) hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747) or via the CDC's web site at http://wwwn.cdc.gov/travel/default.aspx.
For information about outbreaks of infectious diseases abroad and other health information, consult the World Health Organization's (WHO) web site at http://www.who.int/en/.
Further health information for travelers is available at http://www.who.int/ith/en
MEDICAL INSURANCE: The Department of State strongly urges Americans to consult with their medical insurance company prior to traveling abroad to confirm whether their policy applies overseas and whether it will cover emergency expenses such as a medical evacuation. Please see our information on medical insurance overseas.
TRAFFIC SAFETY AND ROAD CONDITIONS: While in a foreign country, U.S. citizens may encounter road conditions that differ significantly from those in the United States.
The information below concerning Burma is provided for general reference only, and may not be accurate in a particular location or circumstance.
Rangoon's main roads are generally in poor condition.
Traffic in the capital is increasing rapidly, but heavy congestion is still uncommon.
Some roads are in serious disrepair.
Slow-moving vehicles, bicycles, animals, and heavy pedestrian traffic create numerous hazards for drivers on Rangoon's streets.
Drivers must remain extremely alert to avoid hitting pedestrians.
Most roads outside of Rangoon consist of one to two lanes and are potholed, often unpaved, and unlit at night.
Many of the truck drivers traversing from China to Rangoon are believed to drive under the influence of methamphetamines and other stimulants.
Drunken and/or drugged drivers are also common on the roads during the four-day Buddhist water festival in mid-April.
Driving at night is particularly dangerous.
Few, if any, streets are adequately lit.
Most Burmese drivers do not turn on their headlights until the sky is completely dark; many do not use headlights at all.
Many bicyclists use no lights or reflectors.

Vehicular traffic moves on the right side, as in the United States; however, a majority of vehicles have the steering wheel positioned on the right.
The “right of way” concept is generally respected, but military convoys and motorcades always have precedence.
Most vehicle accidents are settled between the parties on site, with the party at fault paying the damages.
In the event of an accident with a pedestrian, the driver is always considered to be at fault and subject to fines or arrest, regardless of the circumstances. Accidents that require an investigation are concluded quickly and rarely result in criminal prosecution.
There is no roadside assistance, and ambulances are not available.
Vehicles generally do not have seat belts.
Child car seats are also not available.

Please refer to our Road Safety page for more information.
AVIATION SAFETY OVERSIGHT: As there is no direct commercial air service to the United States by carriers registered in Burma, the U.S. Federal Aviation Administration (FAA) has not assessed Burma’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.
The U.S. Embassy in Rangoon has advised its employees to avoid travel on state-owned Myanmar Airways, as well as on Air Bagan, whenever possible due to serious concerns about the airlines’ ability to maintain their airplanes.
(Myanmar Airways International [MAI] is a different carrier that operates flights between Bangkok and Rangoon.)

SPECIAL CIRCUMSTANCES:
Foreigner Travel within Burma:
Burmese authorities require that hotels and guesthouses furnish information about the identities and activities of their foreign guests.
Burmese who interact with foreigners may be compelled to report on those interactions to the Burmese authorities.
Security personnel may at times place foreign visitors under surveillance, and travelers must assume their actions, such as meeting with Burmese citizens, particularly in hotel lobbies and rooms, are being closely monitored.
Travelers must assume that telephones and fax machines may be monitored, and personal possessions in hotel rooms may be searched.

Travelers are not generally required to obtain advance permission to travel to the main tourist areas of Mandalay and the surrounding area, Bagan, Inle Lake, Ngapali, and other beach resorts.
However, some tourists traveling to places where permission is not expressly required have reported delays due to questioning by local security personnel.
Additionally, the military regime restricts access to some areas of the country on an ad hoc basis, and in 2005 stated it could not guarantee the safety of foreigners traveling in eastern Shan State, specifically in Wa territory, also known as Special Region 2.
Individuals planning to travel in Burma should check with Burmese tourism authorities to see whether travel to specific destinations is permitted.
Even if the Burmese authorities allow travel to specific destinations in Burma, it may not be safe to travel in those areas.

Irrawaddy Delta Region: On May 2, 2008, Cyclone Nargis devastated Burma’s Irrawaddy Delta region and surrounding areas, killing over 130,000 people.
The Delta region is still without many basic necessities, and the risk of outbreaks of disease remains high.
The United Nations, ASEAN, and others in the international community, including the United States, provided international relief assistance to meet both immediate and long-term needs.
The Burmese Government has restricted access to this area for people other than relief workers it has authorized.
American citizens should defer nonessential travel to the Irrawaddy Delta region.

The environment in Rangoon, Burma’s most populous city, and other areas outside of the Irrawaddy Delta has gradually improved.
Electrical power and water supply have been restored in most areas and markets are now operating normally.

Customs Regulations:
Customs regulations in Burma are restrictive and strictly enforced.
Customs authorities closely search travelers’ luggage upon arrival and departure from Burma.
It is illegal to enter or exit Burma with items such as firearms, religious materials, antiquities, medications, business equipment, currency, gems, and ivory.
On several occasions in the past two decades, foreigners have been detained, searched, and imprisoned for attempting to take restricted items out of the country.

Customs officials also strictly limit what is brought into the country, including bans on pornography and political material or literature critical of the regime or supportive of the opposition.
Travelers have also reported problems bringing in high-tech electronic devices and equipment, ranging from toys to computers.
The military regime has never provided a complete listing of prohibited import items.
For information on restricted items for import into Burma and specific customs’ requirements, it is best to consult the nearest Burmese Embassy (Embassy of the Union of Myanmar) or in Washington DC located at 2300 S Street NW, Washington DC 20008, tel..: 202-332-4350.
You may also contact Burma’s Mission in New York located at 10 E. 77th Street, New York, NY
10021, tel. 202-535-1310, or 212-535-1311, fax 212-744-1290
In many countries around the world, counterfeit and pirated goods are widely available.
Transactions involving such products are illegal, and bringing them back to the United States may result in forfeitures and/or fines.
Please see our information on Customs Regulations.

Computers, Internet, and E-Mail: The military regime carefully controls and monitors all internet use in Burma and restricts internet access through software-based censorship that limits the materials individuals can access on line.
The government has allowed several cyber cafes to open, but access to the Internet is very expensive, and access to most “free” international e-mail services such as Hotmail and Yahoo is prohibited.
Currently, Gmail (Google mail) accounts can be accessed in Burma, and many locals and resident expatriates use it.
It is illegal to own an unregistered modem in Burma.
Tourists may bring one laptop computer per person into Burma and must declare it upon arrival.
Limited e-mail service is available at some large hotels.
All e-mails are read by military intelligence.
It is very expensive to send photographs via e-mail.
One foreign visitor was presented a bill for $2,000 after transmitting one photograph via a major hotel's e-mail system.
During September and October 2007, the military government disconnected all Internet access across the country for extended periods of time.

Consular Notification and Access: U.S. consular officers do not always receive timely notification of the detention, arrest, or deportation of U.S. citizens.
In addition, Burmese authorities have on occasion refused to give Embassy consular officers access to arrested or detained U.S. citizens.
U.S. citizens who are arrested or detained should request immediate contact with the U.S. Embassy.
U.S. citizens are encouraged to carry their U.S. passports with them at all times, so that if questioned by local officials, they have proof of identity and U.S. citizenship readily available.

Should an emergency arise involving the detention of a U.S. citizen, especially outside of Rangoon, it may be difficult for U.S. Embassy personnel to assist quickly, because travel inside Burma can be slow and difficult.
The Burmese authorities do not routinely notify the U.S. Embassy of the arrest of American citizens, and the Burmese Government has obstructed regular access by consular officers to American citizen detainees.

Photography: Photographing military installations or people in uniform is prohibited by Burmese authorities and could lead to arrest or the confiscation of cameras and film.
It is advisable to avoid photographing anything that could be perceived by the Burmese authorities as being of military or security interest—such as bridges, airfields, government buildings or government vehicles.

Telephone Services: Telephone services are poor in Rangoon and other major cities and non-existent in many areas.
Calling the United States from Burma is difficult and extremely expensive.

Currency: Executive Order 13310, signed by President Bush on July 28, 2003 imposed a ban on the exportation of financial services to Burma.
Travelers’ checks, credit cards, and ATM cards can rarely, if ever, be used.
Although moneychangers sometimes approach travelers with an offer to change dollars into Burmese kyat at the market rate, it is illegal to exchange currency except at authorized locations such as the airport, banks and government stores.
It is also illegal for Burmese to have possession of foreign currency without a permit.
Foreigners are required to use U.S. dollars, other hard currency, or Foreign Exchange Certificates (FEC) for the payment of plane tickets, train tickets and most hotels.
Burmese kyats are accepted for nearly all other transactions.

In recent months, U.S. financial institutions have increased scrutiny of on-line financial transactions taking place on Burmese internet providers.
The result has been that bank accounts of some American citizens working or traveling in Burma have been frozen.
To avoid this potential problem, customers of U.S. banks may wish to avoid on-line banking while using a Burmese Internet Service Provider (ISP).
Those who believe their accounts have been subject to similar restrictions in error are asked to contact the Consular Section of U.S. Embassy Rangoon.

U.S. Treasury Sanctions: As of August 27, 2003, U.S. Treasury sanctions ban the import of almost all goods from Burma into the United States.
This ban includes Burmese-origin products such as gifts, souvenirs, and items for personal use, even if carried in personal luggage.
These sanctions are part of a much larger U.S. sanctions regime for Burma, which includes a ban on new U.S. investment among other measures.
For specific information, contact the U.S. Department of the Treasury, Office of Foreign Assets Control (OFAC) home page at http://www.treas.gov/offices/enforcement/ofac/ via OFAC's Info-by-Fax service at 202-622-0077 or by phone toll-free at 1-800-540-6322.
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 Burmese laws, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession of, use of, or trafficking in illegal drugs in Burma are strict, and convicted offenders can expect jail sentences and heavy fines.

Some foreigners have been denied even minimal rights in criminal proceedings in Burma, especially when suspected of engaging in political activity of any type.
This includes, but is not limited to, denial of access to an attorney, denial of access to court records, and denial of family and consular visits.
The criminal justice system is controlled by the military junta, which orders maximum sentences for most offenses.
Engaging in sexual conduct with children, using or disseminating child pornography in a foreign country is a crime prosecutable in the United States.
See our section on Criminal Penalties for more information.
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 Burma are encouraged to register with the Embassy through the State Department's travel registration web site and to obtain updated information on travel and security within Burma.
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 110 University Ave., Kamayut Township, Rangoon.
The Consular Section telephone number is (95-1) 536-509, ext. 4240; email consularrangoo@state.gov. Travelers may visit the U.S. Embassy web site at http://burma.usembassy.gov/.
The after-hours emergency number is 09-512-4330, or (95-1) 536-509, ext. 4014.
The Consular Section is open from 8:00 am to 4:30 p.m., with non-emergency American Citizen Services from 2:00 to 3:30 pm, Monday through Friday except on U.S. and Burmese holidays.
*
*
*
*
*
This replaces the Consular Information Sheet dated March 19 to update the sections on Safety and Security, Medical Facilities and Health Information, Special Circumstances, and Criminal Penalties.

Travel News Headlines WORLD NEWS

Date: Tue, 7 Jan 2020 14:53:47 +0100 (MET)

Yangon, Jan 7, 2020 (AFP) - Four children were killed and five injured alongside their teacher as an explosion hit while they collected firewood in an area of Myanmar's Rakhine state beset by fighting between the military and Arakan Army (AA) rebels.   It was not immediately clear what caused the blast or who was behind it.   The conflict has seen scores of civilians killed, hundreds wounded and some 100,000 displaced in the past year as the AA fights for more autonomy for ethnic Rakhine Buddhists.

The attack happened Tuesday morning in Htaikhtoo Pauk village in Buthidaung township, deputy administrator Hla Shwe told AFP.   Local media posted a graphic video on Facebook showing people retrieving the victims' bodies and carrying the bloodied injured away as distressed crowds gathered.   "They were looking for firewood on the mountainside," Hla Shwe said by phone, adding the wounded had been taken to nearby hospitals in Buthidaung and Maungdaw.   He declined to say who he thought had been behind the attack.

Military spokesman Zaw Min Tun confirmed the incident and number of victims, accusing the AA of planting a landmine.   The rebels could not be reached for comment but one local village leader, who asked not to be named, told AFP the number of casualties and lack of blast crater made him doubt it had been a mine.   "Some people say a mine explosion, some say this was from heavy shelling."   The rebels have carried out a series of brazen kidnappings, bombings and raids against the military and local officials in recent months.   The army has hit back hard, deploying thousands of soldiers to the conflict-ridden region.
Date: Wed, 27 Nov 2019 10:44:40 +0100 (MET)

Yangon, Nov 27, 2019 (AFP) - A German tourist was killed and an Argentine woman injured in a landmine explosion in Myanmar, local police said Wednesday, days after the country was shamed over its continuing use of the weapons.   The accident happened near the town of Hsipaw, a popular hiking spot for backpackers who often ride the scenic route by train from Mandalay to reach the mountains.

Tim Geibler, 40, died on Tuesday afternoon near the villages of Pan Nayung and Kwun Haung, a local police officer told AFP, on condition of anonymity.   "Tourists are not permitted to go to that area," he said, adding that a 39-year-old Argentine woman was also slightly injured in the blast.   Local NGO Without Borders, which runs a de facto ambulance service staffed by volunteers, told AFP she had since been discharged from hospital.

A German foreign ministry spokesman confirmed the incident and said its Yangon embassy was in close contact with Geibler's relatives   Huge swathes of Myanmar's restive borderlands are no-go areas for holidaymakers, with various ethnic armed groups fighting the military for more autonomy in shifting violence that has endured for decades.   Two foreign tourists were injured in a mine blast in 2016 in nearby Kyaukme township, according to local media.

Myanmar was one of the top offenders named in the Landmine Monitor 2019 report published last week.   The watchdog said it was the only country in the world where the use of new anti-personnel mines had been documented over the past year.   Both the military and armed groups stand accused of using mines and the country has so far refused to sign the Mine Ban Treaty.
Date: Mon 19 Aug 2019
Source: Mizzima News [in Myanmar, trans. ProMED Mod.YMA, edited]

From 1 Jan to 16 Aug 2019, 544 people were confirmed to have H1N1 infection and 96 of them died, according to the Ministry of Health and Sports.

Among those deaths, the highest deaths were recorded in Yangon region, with 66 deaths. There were also 12 deaths in Ayeyarwady region, 7 in Bago region, 3 in Sagaing region, 2 from Magway region, and one each from Kachin, Rakhine, and (south) Shan states.

Most of these deaths were found to have underlying diseases such as diabetes mellitus, hypertension, and heart diseases.

In 2018, over 300 people were found to have H1N1 influenza infection. However, no deaths were identified. In 2017, more than 30 deaths out of over 400 confirmed cases were recorded.
=====================
[HealthMap/ProMED-mail map of Myanmar:
14 Aug 2019

48 people died and over 10,757 others were infected by dengue haemorrhagic fever (DHF) across Myanmar in the past 7 months, according to a release from the Public Health Department under the Ministry of Health and Sports on Wednesday [14 Aug 2019]. As of 27 Jul [2019], Ayeyarwady region registered the highest numbers of DHF infection cases with 1974 cases and 5 deaths, followed by Yangon region with 1788 cases and 15 deaths, the department's figures said. The figures showed that children aged 5-9 years old are mostly infected by the dengue virus with 4473 cases registered during the period. In 2018, a total of 187 people died of the mosquitoborne disease in connection with 3649 cases in Myanmar, with 25 deaths in Yangon. Dengue fever mostly occurs in the rainy season from June to August in the country.

HealthMap/ProMED-mail map of Myanmar:
Date: Sun, 11 Aug 2019 13:49:56 +0200 (METDST)

Mawlamyine, Myanmar, Aug 11, 2019 (AFP) - Myanmar troops and emergency responders scrambled to provide aid in flood-hit parts of the country Sunday after rising waters forced residents to flee by boat and a landslide killed at least 52 people.   Every year monsoon rains hammer Myanmar and other countries across Southeast Asia, submerging homes, displacing residents and triggering landslides.   But this season's deluge has tested disaster response after a fatal landslide on Friday in southeastern Mon state was followed by heavy flooding that reached the roofs of houses and treetops in nearby towns.

Hundreds of soldiers, firefighters and local rescue workers were still pulling bodies and vehicles out of the muddy wreckage of Paung township on Sunday.   "The latest death toll we have from the landslide in Mon state was 52," Brigadier General Zaw Min Tun told AFP.   As the rainy season reaches its peak, the country's armed forces are pitching in and have readied helicopters to deliver supplies.   "Access to affected regions is still good. Our ground forces can reach the areas so far," Zaw Min Tun said.   Heavy rains pounded other parts of Mon, Karen and Kachin states, flooding roads and destroying bridges that crumbled under the weight of the downpour.   But the bulk of the relief effort is focused on hard-hit Mon, which sits on the coast of the Andaman sea.   About two-thirds of the state's Ye township remained flooded, an administrator said, as drone footage showed only the tops of houses, tree branches and satellite dishes poking above the waters.

- 'We thought we were dead' -
Families realised they had to leave in the early hours Sunday, packing possessions into boats, rowing towards higher ground or swimming away.    Than Htay, a 40-year-old from Ye town, told AFP that water rose to their waists around 02:00 am and she and her family members started shouting for help.   The heavy rains muffled their pleas but a boat happened to pass by and gave them a ride.   "That's why we survived. We thought we were dead," she said.   Another resident said this year's flooding was the worst they had experienced.

Floodwaters have submerged more than 4,000 houses in the state and displaced more than 25,000 residents who have sought shelter in monasteries and pagodas, according to state-owned Global New Light of Myanmar.   Vice President Henry Van Thio visited landslide survivors in a Paung township village on Saturday and "spoke of his sorrow" while promising relief, the paper reported.   The search for victims continued later Sunday though the rain has made the process more difficult.   "We are still working. We will continue searching in the coming days as well," Paung township administrator Zaw Moe Aung said.   Climate scientists in 2015 ranked Myanmar at the top of a global list of nations hardest hit by extreme weather.   That year more than 100 people died in floods that also displaced hundreds of thousands.
More ...

Bahrain

Bahrain - US Consular Information Sheet
June 27, 2008
COUNTRY DESCRIPTION:
Bahrain is a hereditary kingdom governed by the Al-Khalifa family. In 2002, the country adopted a new constitution that reinstated a parliament, which consists of o
e elected and one appointed chamber. Islamic ideals and beliefs provide the conservative foundation of the country's customs, laws and practices. Bahrain is a modern, developed country and tourist facilities are widely available. The capital is Manama. Read the Department of State Background Notes on Bahrain for additional information.
ENTRY/EXIT REQUIREMENTS:
A passport and a visa are required. Passports should be valid for at least six months after the date of arrival. U.S. passport holders outside of Bahrain may apply and pay for a two-week tourist visa online through the Bahraini government web site at http://www.evisa.gov.bh, or may obtain it upon arrival at the airport. U.S. diplomatic passport holders receive a no-fee two-week visa. Prior to travel, visitors may obtain five-year multiple-entry visas valid for stays as long as one month from Bahraini embassies overseas. Bahrain assesses heavy fines on visitors who fail to depart Bahrain at the end of their authorized stay. The amount of the fine is determined by a formula related to the visa type, duration, and location of issuance. An exit tax is included in the ticket price for flights out of Bahrain, and no additional exit fees are required upon departure. Residents of Bahrain who intend to return must obtain a re-entry permit before departing. For further information on entry/exit requirements, travelers may contact the Embassy of the Kingdom of Bahrain, 3502 International Drive NW, Washington, DC 20008, telephone (202) 342-1111; or the Bahrain Permanent Mission to the U.N., 2 United Nations Plaza, East 44th St., New York, NY 10017, telephone (212) 223-6200. Visit the Embassy of Bahrain web site at www.bahrainembassy.org for the most current visa information.

Information about dual nationality or the prevention of international child abduction can be found on our web site. For further information about customs regulations, please read our Customs Information sheet.
SAFETY AND SECURITY:
Americans in Bahrain should maintain a high level of security awareness. Spontaneous demonstrations take place in Bahrain from time to time in response to world events or local developments. We remind American citizens that even demonstrations intended to be peaceful can turn confrontational and possible escalate into violence. American citizens are therefore urged to avoid the areas of demonstrations if possible, and to exercise caution if within the vicinity of any demonstrations. American citizens should stay current with media coverage of local events and be aware of their surroundings at all times. Information regarding demonstrations in Bahrain can be found on the U.S. Embassy Manama’s web site at http://bahrain.usembassy.gov/information_for_travelers.html.

Visiting U.S. citizens should register with the U.S. Embassy in Manama upon arrival. The Department of State remains concerned about the possibility of terrorist attacks against U.S. citizens and interests throughout the world. Americans should maintain a low profile, vary routes and times for all required travel, and treat mail and packages from unfamiliar sources with caution. In addition, U.S. citizens are urged to avoid contact with any suspicious, unfamiliar objects, and to report the presence of the objects to local authorities. Please report any security concerns to the U.S. Embassy's Regional Security Office at telephone (973) 1724-2700 during office hours or (973) 1727–5126 after hours.
For the latest security information, Americans traveling abroad should regularly monitor the Department’s web site at http://travel.state.gov, where the current Worldwide Caution, Travel Warnings and Travel Alerts can be found.
Up-to-date information on safety and security can also be obtained by calling 1-888-407-4747 toll free in the U.S. and Canada or, for callers outside the U.S. and Canada, a regular toll-line at 1-202-501-4444. These numbers are available from 8:00 a.m. to 8:00 p.m. Eastern Time, Monday through Friday (except U.S. federal holidays).
The Department of State urges American citizens to take responsibility for their security while traveling overseas. For general information about appropriate measures travelers can take to protect themselves in an overseas environment, see the Department of State’s pamphlet A Safe Trip Abroad.
CRIME:
The crime rate in Bahrain is low and violent crime is rare. However, burglary, petty theft, and robberies do occur. Visiting Americans are urged to take the same security precautions in Bahrain that one would practice in the United States. Hotel room doors should be locked when visitors are in their rooms, and travelers are encouraged to store valuables in hotel room safes when they are available. Women are encouraged to keep their purses firmly under their arms, and men should avoid keeping their wallets in their hip pockets while in the old market area. The U.S. Embassy in Manama recommends that travelers using local taxis insist on the use of a meter since unexpectedly high fares may otherwise be charged. Bahrain has a professional police force, and visitors are encouraged to contact the police if problems are encountered.

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. If you are the victim of a crime while overseas, in addition to reporting to local police, please contact the U.S. Embassy for assistance. The Embassy staff can, for example, assist you to find appropriate medical care, contact family members or friends and explain how to transfer funds. 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 Bahrain is 999.
See our information on Victims of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION:
Basic modern medical care and medicines are available in several hospitals and health centers in Bahrain. Two government hospitals, several private hospitals, and numerous private clinics located throughout the country offer a wide range of medical services. Cardiac care, general surgery, internal medicine, obstetrics, gynecology, pediatrics, orthopedics and dentistry services are readily available, as are x-rays, CT-scan and MRI testing. The government hospitals house both trauma and ICU units. Pharmacies are common throughout Bahrain and carry a wide range of medications. Prescriptions are normally required.
Payment at all medical facilities is due at the time of service. Some hospitals have limited direct billing capability for certain insurance carriers. Billing and insurance practices vary among the medical facilities.

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

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

Travel by road in Bahrain is generally safe although unsafe driving practices are common. Highways and major roads in the northern third of Bahrain are four to six lanes wide and well maintained; roads in villages and older parts of Manama and Muharraq are narrow and twisting. As in the United States, traffic in Bahrain moves on the right. Roundabouts (traffic circles) follow the British system, with those automobiles within the traffic circle having right of way over those attempting to enter. Although the Bahraini penal code calls for fines of up to 100 dinars ($270.00) or imprisonment of up to six months for driving above posted speed limits, it is not uncommon for drivers to drive well over the posted speed limits of 50-120 km per hour. The law allows the police to detain drivers for traffic violations until they can appear before a magistrate. It is illegal to use a cell phone while driving.

Under Bahraini law, any sign of having consumed alcohol may be taken as prima facie evidence of driving under the influence, which can lead to imprisonment and/or fines of up to 1,000 Bahraini Dinars (2,700 U.S. dollars). Except for minor accidents, drivers may not move their vehicles after an accident until a report has been filed with the traffic police. This is true even in cases of single-car accidents. Insurance companies may not provide coverage if the cars are moved. However, drivers involved in minor, non-injury accidents no longer need to wait at the scene for the police. Individuals should get their vehicles off the road to avoid further accidents. Drivers can call the accident hotline at 199 (if there are no injuries) or 999 (when someone is injured) where they will be directed to one of five centers to file the accident report. This report must be filed within 24 hours of the accident. Both drivers may be prohibited from leaving the country until the matter is resolved if an accident results in legal proceedings. The main switchboard at the traffic department is 1787-2222.
Emergency numbers are as follows:
Fire/Ambulance/Police: 999
Traffic/Accidents: 199 (no injuries) OR 999 (injuries)
Please refer to our Road Safety page for more information. Visit the web site of Bahrain’s national authority responsible for road safety at http://www.traffic.gov.bh/main.htm.
AVIATION SAFETY OVERSIGHT:
As there is no direct commercial air service to the United States by carriers registered in Bahrain, the U.S. Federal Aviation Administration (FAA) has not assessed Bahrain’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:
Individuals subject to Bahraini court orders arising from indebtedness, labor disagreements, or other legal disputes may be prevented from departing Bahrain until their cases are resolved. Instances have occurred in which departure was prohibited for several years, since the legal process can be both lengthy and complex. The Consular Section of the U.S. Embassy in Manama maintains a list of local attorneys capable of representing Americans.
Please see our Customs Information.
CRIMINAL PENALTIES:
While in a foreign country, a U.S. citizen is subject to that country's laws and regulations, which sometimes differ significantly from those in the United States and may not afford the protections available to the individual under U.S. law. Persons violating Bahrain’s laws, even unknowingly, may be expelled, arrested or imprisoned. Penalties for breaking the law can be more severe than in the United States for similar offenses. Disrespect to officials in word or deed can result in heavy fines. Travelers who are driving should be aware that one drink may be sufficient grounds for a DUI arrest. Penalties for possession, use, or trafficking in illegal drugs in Bahrain 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 Bahrain 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 Bahrain. 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 Bldg. 979, Road no. 3119, Zinj District (next to Al Ahli Sports Club). The mailing address is P.O. Box 26431, Manama, Bahrain. The telephone number is (973) 1724-2700. The after-hours number is (973) 1727-5126. The Consular Section’s fax number is (973) 1725-6242. The Embassy's web site, which includes consular information and the most recent messages to the American community in Bahrain is at http://bahrain.usembassy.gov/. The workweek in Bahrain is Sunday through Thursday.
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This replaces the Country Specific Information for Bahrain dated November 23, 2007 without substantive changes.

Travel News Headlines WORLD NEWS

Date: Mon, 2 Oct 2017 19:26:47 +0200

Dubai, Oct 2, 2017 (AFP) - A "terrorist explosion" during a Shiite procession commemorating Ashura lightly wounded five policemen on Monday, the interior ministry in Sunni-ruled Bahrain announced.   "A terrorist explosion caused five light injuries among policemen deployed as security for a procession along Budaiya Avenue" in western Manama, a tweet from the ministry said.

Shiites in the tiny Gulf kingdom mark Ashura with processions in Manama and in villages around the capital.   The annual Ashura commemorations mark the killing of Imam Hussein by the forces of the Caliph Yazid in 680 AD -- a formative event in Shiite Islam.   Imam Hussein's death was part of a dispute over who should succeed the Prophet Mohammed, which eventually developed into a bitter schism between the Sunni and Shiite branches of Islam.

Bahrain, home to the US Fifth Fleet, has seen sporadic violence since the repression in 2011 of a protest movement by the Shiite majority, demanding a constitutional monarchy and an elected prime minister.   Hundreds of protesters, mainly but not all Shiites, were arrested and sentenced to lengthy prison terms for their role in the demonstrations.   Bahrain says it does not discriminate towards the country's Shiites, and regularly accuses Shiite Iran of meddling in its internal affairs, an allegation Tehran denies.
Date: Sun, 26 Feb 2017 20:11:48 +0100

Dubai, Feb 26, 2017 (AFP) - Four Bahraini policemen were wounded in a bomb attack Sunday near the village of Jaw, south of the capital Manama, the interior ministry said.   "Terrorist blast in police bus near Jua village. 4 policemen injured and they are in a stable condition. Necessary steps are being taken," the ministry said on its Twitter account.   It gave no further details.

On January 1, gunmen attacked the prison in Jaw, killing a policeman and allowing 10 inmates to escape.   Shiites convicted over anti-government protests in Sunni-ruled Bahrain were held at Jaw.   Tiny but strategic Bahrain, home to the US Fifth Fleet, has been rocked by unrest since the authorities crushed Shiite-led protests in 2011 demanding a constitutional monarchy and an elected prime minister.

Hundreds of Shiites have been arrested and many have faced trials over their role in the demonstrations.   One of those on trial is Sheikh Issa Qassem, the country's Shiite spiritual leader.   He was stripped of his citizenship last year for "serving foreign interests" -- a reference to Shiite Iran.   On Sunday, clashes broke out between security forces and protesters in several Shiite villages as a new hearing in Qassem's case was underway, witnesses said.   Protesters chanted anti-government slogans and carried portraits of Qassem, they said.
Date: Wed, 15 Feb 2017 11:55:11 +0100

Dubai, Feb 15, 2017 (AFP) - An explosion wounded two civilian passers-by in Bahrain, the interior ministry said early Wednesday, as demonstrators were marking the sixth anniversary of an anti-government uprising that was bloodily suppressed.   The ministry did not say what caused Tuesday evening's blast in a village outside the capital Manama but demonstrators sometimes throw petrol bombs during the sporadic protests that still grip the Sunni-ruled but Shiite-majority kingdom.   "Terrorist blast in Sitra causes minor injuries to a married couple passing the site. Police at the scene," the ministry said on its Twitter account without elaborating.   It also tweeted a picture of a black 4X4 with a shattered windscreen and significant damage to the front bonnet.   The blast came as demonstrators clashed with police in Manama and several nearby villages.   The demonstration in the capital ended when police fired tear gas and stun grenades, witnesses said.

Activists posted pictures of injured protesters online, but the interior ministry has not published any official statements about the reported demonstrations.   The Shiite-led protests of February 2011 sought a constitutional monarchy and an elected prime minister to replace the current government dominated by the ruling Al-Khalifa family.   Authorities crushed them the following month with the support of Saudi-led forces who secured key installations.   Since then, the authorities have banned the Shiite opposition and handed long jail terms to many of its leaders. Some have been stripped of their citizenship.   Tiny but strategic Bahrain lies just across the Gulf from Iran and is home to the US Navy's Fifth Fleet.
Date: Thu, 19 May 2016 21:53:48 +0000
From: Dr Manaf Alqahtani <drmanaf@gmail.com> [edited]
BDF Hospital, Bahrain
-----------------------------------
Measles is a highly infectious virus that spreads easily from person to person through the air, through breathing, coughing and sneezing. Although measles is largely considered a disease of children, we have noticed increasing numbers of adults infected. Since 9 May 2016, we had a total of 7 cases with measles. 4 were adults (30-40 years old) and 3 children (less than 12 months old). All adults were Bahraini (3 originally born in Yemen and one in Pakistan). All of the adults either have no documentation of MMR or received one dose MMR only.

Regarding the 3 children with measles, all were non-vaccinated and got infected from their infected adult family member.

3 out of 7 cases needed to be admitted for hydration and symptomatic treatment. Luckily, all our HCWs [health care workers] have documented 2 doses of MMR.

In the 2014 measles outbreak in Bahrain, 32 cases were registered, of which 27 were among children under 15 years and 5 among adults. Of the total, 14 cases were detected among expatriates.

Bahrain and the other member states of the EMR [Eastern Mediterranean Region] adopted a resolution for elimination of measles from the region by 2010. In 1996, the Ministry of Health (MOH) developed a plan for measles elimination that included a revised measles immunization schedule, introduction of case-based surveillance, and annual immunization campaigns of school children.

Most of recent measles cases are imported.
------------------------------
Dr. Manaf Alqahtani
BDF Hospital
Bahrain
=================
[ProMED thanks Dr. Alqahtani for sending this information.

Also see: JS Jawad et al. Toward Measles Elimination in Bahrain -- A Middle East Country Experience. The Journal of Infectious Diseases 2011;204:S299-S304

"Abstract
---------
Measles was a leading cause of infant and child morbidity and mortality in Bahrain before the introduction of measles vaccine in 1974. With the establishment of the Expanded Program on Immunization (EPI) in 1981 and the introduction of a 2nd dose of measles vaccine in 1985, coverage for 1st and 2nd doses of measles vaccine increased to 94 percent by 1997 and has been sustained greater than 97 percent since 2001. Measles, mumps, and rubella (MMR) immunization campaigns targeting 12-year-old students were conducted annually during 1998-2006 and achieved coverage of greater than 95 percent. As a result, the incidence of measles in Bahrain has declined markedly over the past 4 decades, to 2.7 cases per million persons in 2009. Recent confirmed measles cases have occurred sporadically, in under-vaccinated children or in infants too young or adults too old to receive measles vaccine. Bahrain has made significant progress toward measles elimination by sustaining high immunization coverage and strengthening case-based measles surveillance activities. Further success will depend on improved identification and immunization of under-vaccinated expatriate workers and their families."

A map of Bahrain can be accessed at <http://healthmap.org/promed/p/127>.
Bahrain is an archipelago in the middle of the Arabian Gulf encompassing 33 islands, the largest of which is Bahrain Island. - ProMED Mod.LK]
Date: Fri 6 Nov 2015
Source: Reuters [edited]

A cholera outbreak in Iraq has spread to Kuwait and Bahrain, and risks turning into a region-wide epidemic as millions of pilgrims prepare to visit the country, UNICEF's Iraq director has said. The disease, which can lead to death by dehydration and kidney failure within hours if left untreated, was detected west of Baghdad in September 2015 and has since infected at least 2200 people in Iraq and has killed 6.

"It [the outbreak] already has a regional dynamic and the risk of that can only be increased by people from all over the region coming into Iraq," UNICEF country director, Peter Hawkins, said on Thu 5 Nov 2015. Hawkins said cholera had spread to Bahrain, Kuwait and Syria, but in a later statement, UNICEF said the cases in Syria were not confirmed: "However, given the scale of the outbreak in Iraq the risk of cholera spreading across Iraq's borders remains high," it said.

Millions of Shi'ite Muslims are due to visit Iraq in December for Arbaeen, a religious ritual marking the end of an annual mourning period for the Prophet Mohammad's grandson Hussein, whose death in 680 AD entrenched the schism between Shi'ites and Sunnis.

Hawkins said UNICEF was working with clerics in the Shi'ite shrine cities of Najaf and Kerbala to convey information about how to guard against cholera, which is endemic in Iraq and the wider region. The outbreak can be traced to a number of factors including low water levels in the Euphrates and winter flooding that has contaminated the river and shallow wells with sewage water.

The war against [the so-called] Islamic State militants who control large swathes of territory in northern and western Iraq has also contributed to the outbreak. The conflict has displaced more than 3 million people, with many living in camps where conditions are conducive to the spread of cholera -- a bite of contaminated food or a sip of contaminated water is enough to cause infection.

Hawkins said UNICEF has only limited access to areas controlled by Islamic State, which swept across the Syrian border in mid-2014 in a bid to establish a modern caliphate.

Higher military expenditure and other costs associated with the battle against Islamist militancy has aggravated a cash crunch for Iraq, a major OPEC oil producer that has suffered from the drop in global crude prices over the past year. A higher proportion of the government budget is also being spent on security at the expense of other services and infrastructure such as water supply, Hawkins said.

1 in 5 of the confirmed cases in Iraq is among children, and in large parts of the country the start of the school year was delayed by a month as a precaution, UNICEF said in a statement. In response to the outbreak, UNICEF is providing bottled water, oral rehydration salts and installing community water tanks, but like most humanitarian operations in Iraq it is severely underfunded.  [byline: Isabel Coles]
=====================
[The conflicts in the Middle East have exacerbated the endemic cholera in Iraq, and it has spread beyond Iraq's borders. The number of cases of cholera in Kuwait and Bahrain are not reported, nor is it clear whether the cases were acquired in these countries or imported. UNICEF has not confirmed any cases in war-torn Syria, but there are informal reports circulating. - ProMED Mod.LL]

[A HealthMap/ProMED-mail map can be accessed at:
More ...

Bahamas

The Bahamas Consular Information Sheet
July 14, 2005

COUNTRY DESCRIPTION:
The Bahamas is a developed, English-speaking Caribbean nation composed of hundreds of islands covering a territory approximately the size of California.
To
rism and financial services comprise the two largest sectors of the economy. Independent from the United Kingdom since 1973, The Bahamas is a Commonwealth nation with a centuries-old democratic tradition.
The capital, Nassau, is located on New Providence Island.
Read the Department of State Background Notes on The Bahamas at http://travel.state.gov for additional information.

ENTRY/EXIT REQUIREMENTS:
On December 31, 2005, the U.S. Government will begin to phase in new passport requirements for U.S. citizens traveling in the Western Hemisphere.
By December 31, 2007, all U.S. citizens will be expected to depart and enter the United States on a valid passport or other authorized document establishing identity and U.S. citizenship.
The Department of State strongly encourages travelers to obtain passports well in advance of any planned travel.
Routine passport applications by mail take up to six weeks to be issued.
For further information, go to the State Department's Consular website: http://travel.state.gov/travel/cbpmc/cbpmc_2223.html.

U.S. citizens must present original proof of U.S. citizenship (valid U.S. passport or certified U.S. birth certificate with a government-issued photo ID) and a return ticket. A passport is recommended as it eases processing upon return to the United States.
Voter registration cards, Social Security cards, driver's licenses, affidavits, and other similar documents are not acceptable as proof of U.S. citizenship. U.S. citizens do not need to obtain visas for stays of up to one month. Travelers arriving via private watercraft are charged docking fees.
See our Foreign Entry Requirements brochure for information on entry to The Bahamas and other countries.
U.S. citizens may also contact The Embassy of The Bahamas at 2220 Massachusetts Ave., NW, Washington, DC 20008 (tel: 202-319-2660), its Consulates in Miami and New York, or by email at bahemb@aol.com.

For entry and exit requirements pertaining to dual nationality and the prevention of international child abduction, read our information at http://travel.state.gov/travel/cis_pa_tw/cis/cis_1469.html.
For Customs Information see http://travel.state.gov/travel/cis_pa_tw/cis/cis_1468.html.

SAFETY AND SECURITY:
The water sports and scooter rental industries in The Bahamas are not carefully regulated.
Visitors should rent equipment only from reputable operators, and should insist on sufficient training before using the equipment.
Every year, people are killed or injured by the improper use of scooters, jet-skis, and personal watercraft or by the careless or reckless operation of such equipment by others.
You should insist on seeing proof that operators have sufficient medical and liability insurance. Travelers should also invest in low-cost traveler's insurance that includes medical evacuations, as most American insurance companies do not cover this.

For the latest security information, Americans traveling abroad should regularly monitor the Department's Internet web site at http://travel.state.gov where the current Travel Warnings and Public Announcements, including the Worldwide Caution Public Announcement, 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).

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 at http://travel.state.gov/travel/tips/safety/safety_1747.html.

CRIME:
While The Bahamas has a relatively low crime rate, visitors should exercise caution and good judgment. Although most criminal incidents take place in a part of Nassau not usually frequented by tourists (the "over-the-hill" area south of downtown), crime and violence has moved into more upscale tourist and residential areas.
Criminals also target restaurants and nightclubs frequented by tourists.
The most common approach for criminals is to offer victims a ride, either as a "personal favor" or by claiming to be a taxi, and then robbing and/or assaulting the passenger once they are in the car. Visitors should take care to ride only in licensed taxis, identifiable by their yellow license plates.

In the last year the U.S. Embassy has received several reports of sexual assaults, including against teen-age girls. Most assaults have been perpetrated against intoxicated young women, some of whom were reportedly drugged. To minimize the potential for sexual assault, the Embassy recommends that young women stay in groups, consume alcohol in moderation or not at all, ride only in licensed taxis, and not accept rides or drinks from strangers.
Travelers should avoid walking alone after dark or in isolated areas, and avoid placing themselves in situations where they are alone with strangers. Be cautious on deserted areas of beaches at all hours. Hotel guests should always lock their doors and should never leave valuables unattended, especially on beaches.
Visitors should store passport/identity documents, airline tickets, credit cards, and extra cash in hotel safes. Avoid wearing expensive jewelry, particularly Rolex watches, which criminals have specifically targeted. Use only clearly marked taxis with yellow license plates and make a note of the license plate number for your records.

The legal age in the Bahamas for consumption of alcoholic beverages is 18. Parents should be aware, however, that enforcement of the drinking age is weak.
It is easy for teenagers to obtain alcoholic beverages and underage drinking is prevalent.
Many of the arrests, accidents and violent crimes suffered by U.S. citizens in The Bahamas involve alcohol.

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 understand the local criminal justice process and find an attorney if needed.

See our information on Victims of Crime at http://travel.state.gov/travel/tips/emergencies/emergencies_1748.html.

MEDICAL FACILITIES AND HEALTH INFORMATION:
High quality medical care is generally available, but expensive, in Nassau and Freeport. Medical care is limited outside of Nassau and Freeport. Bahamian doctors and hospitals do not usually accept U.S. medical insurance policies and typically expect immediate cash payment for professional services. It is the patient's responsibility to seek reimbursement later from their insurance companies. Serious health problems requiring hospitalization and/or medical evacuation to the United States can cost thousands of dollars. Persons with serious or life-threatening conditions who wish to return to U.S. medical facilities for treatment normally must be airlifted.
There is a chronic shortage of blood at Princess Margaret Hospital in Nassau, where most emergency surgery is performed.
Travelers with rare blood types should know the names and locations of possible blood donors should the need arise.
The Lyford Cay Hospital has a hyperbaric chamber for treatment of decompression illness.
Ambulance service is available, but may not be able to respond quickly in the event of a major emergency or disaster.

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); fax 1-888-CDC-FAXX (1-888-232-3299), or via the CDC's Internet site at http://www.cdc.gov/travel.
For information about outbreaks of infectious diseases abroad consult the World Health Organization's (WHO) website at http://www.who.int/en.
Further health information for travelers is available at http://www.who.int/ith.

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 at http://travel.state.gov/travel/cis_pa_tw/cis/cis_1470.html.

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

Traffic in The Bahamas moves on the left side of the roadway. Roads in Nassau and Freeport are generally adequate, but traffic congestion in those cities is endemic.
Rural roads can be narrow, winding, and in poor repair.
Flooding frequently occurs on roads in low-lying areas throughout The Bahamas, including Nassau and Freeport.
Drivers should be alert for unmarked construction zones throughout The Bahamas.
Travel by moped or bicycle can be quite hazardous, especially in the heavy traffic conditions prevalent in Nassau and Freeport. Travelers should exercise appropriate caution when renting motorbikes. Accidents involving U.S. tourists on motorbikes have caused severe injuries and fatalities. Those who choose to ride a moped or bicycle should wear helmets and drive defensively.
Pedestrians need to remember that vehicular traffic comes from the right.
Pedestrians have been hit by cars after failing to check properly for oncoming traffic.

Emergency ambulance service is generally available and can be reached by dialing 911. Roadside assistance is also widely available through private towing services, listed in the phone book.

For specific information concerning driver's permits, vehicle inspection, road tax, and mandatory insurance in The Bahamas, please contact The Bahamas Tourist Board in New York at http://bahamas.com, (tel:
1-800-823-3136).

Please refer to our Road Safety page for more information at http://travel.state.gov/travel/tips/safety/safety_1179.html.
Visit the website of the country's national tourist office and national authority responsible for road safety.

AVIATION SAFETY OVERSIGHT:
The U.S. Federal Aviation Administration (FAA) has assessed the Government of The Bahamas as being in compliance with ICAO international aviation safety standards for oversight of The Bahamas' air carrier operations.
For more information, travelers may visit the FAA's Internet web site at http://www.faa.gov/avr/iasa/index.cfm.

SPECIAL CIRCUMSTANCES:
CUSTOMS:
The Bahamas customs authorities may enforce strict regulations concerning temporary importation into or exportation from The Bahamas of firearms. It is advisable to contact the Embassy of The Commonwealth of The Bahamas in Washington or one of the Bahamian consulates in the U.S. for specific information regarding customs requirements. Tourists who arrive by private boat are required to declare firearms to Bahamian Customs and leave firearms on the boat while in The Bahamas. Please see our information on customs regulations at http://travel.state.gov/travel/cis_pa_tw/cis/cis_1468.html.

BOATING/FISHING:
Boaters should be aware that long-line fishing in Bahamian waters is illegal. All long-line fishing gear is required to be stowed below deck while transiting through Bahamian waters. Fishermen should note that stiff penalties are imposed for catching crawfish (lobster) or other marine life out of season or in protected areas.

TIME-SHARES:
U.S. citizens should exercise caution when considering time-share investments and be aware of the aggressive tactics used by some time-share sales representatives. Bahamian law allows time-share purchasers five days to cancel the contract for full reimbursement. Disputes that arise after that period can be very time-consuming and expensive to resolve through the local legal system.
HURRICANES:
The Bahamas, like all countries in the Caribbean basin, is vulnerable to hurricanes. Hurricane season officially runs from June 1 to November 30, although hurricanes have been known to occur outside that time period. Visitors to The Bahamas during hurricane season are advised to monitor weather reports in order to be prepared for any potential threats. General information about disaster preparedness is available via the Internet from the U.S. Federal Emergency Management Agency (FEMA) 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 in the United States for similar offenses.
Persons violating The Bahamas' laws, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in The Bahamas are severe, and convicted offenders can expect long jail sentences and heavy fines.
Engaging in illicit sexual conduct with children or using or disseminating child pornography in a foreign country is a crime, prosecutable in the United States.
For more information visit http://travel.state.gov/travel/cis_pa_tw/cis/cis_1467.html.

CHILDREN'S ISSUES:
For information on international adoption of children and international parental child abduction, see the Office of Children's Issues website at http://www.travel.state.gov/family/family_1732.html.

REGISTRATION / EMBASSY LOCATION:
Americans living or traveling in The Bahamas are encouraged to register with the nearest U.S. Embassy through the State Department's travel registration website, https://travelregistration.state.gov, and to obtain updated information on travel and security within The Bahamas.
Americans without Internet access may register directly with the U.S. Embassy.
By registering, American citizens make it easier for the Embassy to contact them in case of emergency.
The U.S. Embassy is located next to McDonald's restaurant on Queen Street in downtown Nassau; telephone (242) 322-1181, after hours: (242) 328-2206.
Consular Section hours are 1:00 p.m. - 4:00 p.m. Monday-Thursday and 10:00-12:00 on Fridays. The Embassy is closed on local and U.S. holidays.
You may wish to visit the Embassy's website at http://bahamas.usembassy.gov/ or contact the Consular Section by e-mail at acsn@state.gov .

The U.S. Embassy is also responsible for consular services in the Turks and Caicos Islands (TCIS), a United Kingdom (British) overseas territory.
U.S. citizens may obtain updated information on travel and security in TCIS from the U.S. Embassy in Nassau or the Consular Information Sheet for the Turks and Caicos.
*

*

*
This replaces the Consular Information Sheet dated October 15, 2004, to update Sections on Country Description, Entry/Exit Requirements, Safety and Security, Crime, Traffic Safety and Road Conditions, Special Circumstances, and Registration/Embassy Location; to include a Section on Information For Victims of Crime; and to combine and update the Sections on Medical Facilities and Health Information.

Travel News Headlines WORLD NEWS

Date: Mon, 2 Sep 2019 11:42:27 +0200 (METDST)

Geneva, Sept 2, 2019 (AFP) - Hurricane Dorian has caused "extensive damage" across the Bahamas, the Red Cross said Monday, warning that as many as 13,000 houses may have been severely damaged or destroyed.   "We don't yet have a complete picture of what has happened," Sune Bulow, head of the International Federation of Red Cross and Red Crescent Societies' Emergency Operation Centre in Geneva, said in a statement.   "But it is clear that Hurricane Dorian has had a catastrophic impact," he said, adding that "we anticipate extensive shelter needs, alongside the need for short-term economic support, as well as for clean water and health assistance."

Hurricane Dorian battered the Bahamas with ferocious wind and rain on Sunday, the monstrous Category 5 storm wrecking towns and homes as it churned on an uncertain path toward the US coast where hundreds of thousands were ordered to evacuate.   There was no immediate word on casualties in the low-lying islands.   But IFRC said that up to 13,000 houses may have been severely impacted.

The organisation also warned that extensive flooding on the island of Abaco was believed to have contaminated wells with saltwater.   IFRC said it had released 250,000 Swiss francs ($252,000, 230,000 euros) from its Disaster Relief Emergency Fund to bolster the initial response to the crisis, and to provide some 500 families with emergency shelter assistance.   Packing sustained winds of 185 miles per hour (295 kilometre per hour), Dorian crashed onshore in the Abacos Islands, in the northwest of the Bahamas, as the strongest storm ever to hit the Caribbean chain.

After days of nerve-wracking uncertainty surrounding the storm's path, the southeastern US states of Florida, Georgia and South Carolina finally ordered coastal residents to evacuate in a mass exodus set to affect hundreds of thousands of people.    The American Red Cross estimated that some 19 million people live in areas that could be impacted by the storm, with as many as 50,000 people in Florida, Georgia and South Carolina potentially in need of emergency shelter, depending on the impact.   IFRC said that hundreds of Red Cross volunteers, emergency response vehicles and more than 30 truck loads of relief supplies were being mobilised to help people living in the path of the hurricane.
Date: Mon, 2 Sep 2019 00:55:48 +0200 (METDST)
By Leila MACOR

Riviera Beach, United States, Sept 1, 2019 (AFP) - Hurricane Dorian blasted the northern Bahamas as a monster Category 5 storm on Sunday, pummeling the low-lying island chain with torrential rains and winds of a violence unprecedented in its history.   Packing winds of 185 miles per hour (295 kilometers per hour), Dorian made landfall twice in the Bahamas' Abaco Islands, and was tied for the second most powerful hurricane ever in the Atlantic basin, the National Weather Service said.

Footage posted on social media showed major destruction. There was no immediate word on casualties.   Parts of the Abaco Islands were reported to be under water as forecasters warned it was facing a towering 18 to 23 foot storm surge. Winds were gusting over 220 mph, the National Hurricane Center in Miami said.   Video posted on the website of the Bahamian newspaper Tribune 242 showed water up to the roofs of wooden houses in what ppeared to be a coastal town. Capsized boats floated in muddy brown water dotted with wooden boards, tree branches and other debris.

In other social media footage of what appears to be an inland area, cars were smashed or turned over, telephone poles and trees were snapped like twigs and debris filled the yards of severely damaged homes. AFP could not immediately confirm the authenticity of any of this footage.   Bahamas Prime Minister Hubert Minnis broke down in tears as he addressed a news conference, calling it "probably the most sad and worst day of my life," the Nassau Guardian reported.   "We're facing a hurricane... one that we've never seen in the history of the Bahamas," he said.

Footage shot in Cooper's Town, Abaco and obtained by AFP showed waves crashing violently onshore, sending up huge clouds of spray along the coastline.   Local radio reported that people were calling for help after winds blew the roof off the Island Breezes Hotel in Marsh Harbour, a commercial hub in the Abacos.   "Things are really starting to rock and roll," a post on the Facebook page of the Hope Town Bulletin in Abacos said at 10:00 am local time.    As of 2200 GMT, the storm was 75 miles (120 kilometers) east of Freeport on the island of Grand Bahama and moving slowly west.   In Grand Bahama, thousands have evacuated to get out of Dorian's predicted path.   "It feels like we are standing in a line waiting for a beating," Yasmin Rigby, a resident of Freeport, the island's main city, told AFP.

- Strongest storm to hit Bahamas -
The NHC said Dorian had become "the strongest hurricane in modern records for the northwestern Bahamas."   Describing "catastrophic" conditions in the Abacos Islands, it said the storm was "heading with all its fury towards Grand Bahama," where it was expected Sunday night into Monday.  NHC director Ken Graham on Facebook Live said the Bahamas would be under major hurricane conditions for a punishing 30 hours or more.   "That's major hurricane winds, that's storm surge of 10 and even 20 feet in some of those areas," he said. "That's also torrential rainfall of 15 to 20 inches, isolated 30 inches."

In Washington, US President Donald Trump met with his emergency management chiefs and declared "this looks monstrous."   "We expect that much of the eastern seaboard will be ultimately impacted and some of it very, very severely," he said.   Tropical storm warnings were in effect for parts of the Florida coast, and residents up and down the Atlantic coast braced for a brush with danger.   Florida issued its first evacuation orders in parts of Palm Beach, home of Trump's Mar-a-Lago resort, and Martin Counties.

- 'Very great danger' -
Kevin McAleenan, acting homeland security secretary, said hurricane force winds could hit Florida, followed by a prolonged rain event combined with a storm surge.   "That's going to be very difficult as the storm starts to move northward, mostly like, up the coast of Florida and toward Georgia and South Carolina," he said on ABC's "This Week."   While Miami appeared likely to be largely spared, 30-year-old David Duque, picking up sandbags there on Saturday, noted that "everything could change... I know it could be a scare, but better prepare instead of doing nothing."   The Florida National Guard said roughly 2,000 service members had been mobilized, with another 2,000 poised to join them.

- 'Absolute monster' -
Trump has declared a federal state of emergency in Florida, authorizing US assistance to supplement state and local efforts.   Following a similar state order in Florida, South Carolina Governor Henry McMaster declared a state of emergency Saturday, saying, "Given the strength and unpredictability of the storm, we must prepare for every possible scenario."   Neighboring North Carolina also declared a state of emergency, and Georgia announced a state of emergency for 12 counties.   Orlando International Airport was to protectively halt commercial flights at 2:00 am (0600 GMT) Monday, and Florida's NASA Kennedy Space Center said it was moving an enormous mobile rocket launcher inside to protect it.
Date: Wed 25 Jul 2018
Source: Eyewitness News [edited]

Cases of reported conch poisoning are on the rise in the capital, according to Minister of Health Dr. Duane Sands. The health minister confirmed Tue 24 Jul 2018 that over 3 dozen persons have sought medical attention for conch poisoning since the Ministry of Health announced the new outbreak in New Providence nearly a month ago.

Luckily, there have been no reports of conch poisoning in the Family Islands. Dr. Sands confirmed that the outbreak has been isolated to New Providence. "We can now confirm 25 clinical cases with laboratory testing," he said. "There are an additional 15 clinical cases that meet the definition but are still awaiting finalization of their laboratory data, so there may be as many as 40 clinical cases that might have been presented to the hospital. There are some people who get conch poisoning but it's not severe enough for them to come to the hospital for treatment."

The health minister continued to issue warning to patrons and vendors. "I continue to say that this is a preventable problem, so to the vendors, you have to wash the conch in fresh water. To the patrons, it is a good idea to insist that [the conch] is washed in fresh water."

Conch poisoning occurs when raw conch meat is not thoroughly washed in fresh water. Bacteria that resides on the skin of conch is what leads to the treacherous poisoning. The most recent major outbreak of conch poisoning in the Bahamas dates back to the 1990s.  [Byline: Theo Sealy]
=====================
[The aetiology is _V. parahaemolyticus_, a bacterium in the same family as those that cause cholera. It lives in brackish saltwater and causes gastrointestinal illness in humans. Symptoms include watery diarrhoea, abdominal cramping, nausea, vomiting, and fever and chills. Usually these symptoms begin within 24 hours of exposure. Illness is usually self-limited and lasts approximately 3 days. Severe disease is rare and occurs more commonly in persons with weakened immune systems.

Infections with this organism, which can be normal microflora in seawater, have been associated with the consumption of raw, improperly cooked, or cooked and recontaminated fish and shellfish. A correlation exists between the probability of infection and warmer months of the year. Improper refrigeration of seafood contaminated with this organism will allow its proliferation, which increases the possibility of infection. ProMED-mail covered a large 2005 outbreak in Chile. It was impressive in its size (more than 10 000 cases), continued to spread despite early recognition, and involved clams and mussels rather than the classical oyster vehicle. - ProMED Mod.LL]

[HealthMap/ProMED-mail map:
New Providence Island, New Providence, Bahamas:
Date: 5 Jul 2018
Source: The Nassau Guardian [edited]

The Ministry of Health warned yesterday of a recent outbreak of conch poisoning. Health authorities yesterday [4 Jul 2018] confirmed 4 cases of conch poisoning stemming from Potter's Cay in the past 72 hours but said the outbreak of _Vibrio parahaemolyticus_ could easily be prevented by vendors washing their conch supplies in fresh water.

_V. parahaemolyticus_ is a bacterium found in brackish saltwater, which, when ingested, causes symptoms including abdominal cramps, vomiting, headache, diarrhea and fever. "This is a preventable illness that requires basic hygiene as it relates to conch preparation," said Minister of Health Dr. Duane Sands during a press conference at the Ministry of Health of Meeting Street. He continued, "I think there is no reason why we can't say we will ensure that every single vendor is reminded of the requirement to wash the conch with copious amounts of fresh, clean water. To those in the purchasing public, if your vendor does not have access to fresh tap water or distilled water, and is only washing the conch in seawater, until we get the all clear, don't buy from that vendor."

The 4 patients with confirmed cases of vibriosis are Bahamians. There were at least 6 more people exhibiting symptoms awaiting confirmation of conch poisoning.

Sands assured the public that health officials, who received reports of the cases yesterday morning [4 Jul 2018], have mobilized in conjunction with the Ministry of the Environment to take the necessary steps to protect the health of those affected and, through targeted interventions, prevent further cases. The minister also advised all conch vendors will be required to take a food-handling course and maintain fresh potable water at their stalls.

As it relates to the unconfirmed cases, Sands said those patients, who were admitted to the Emergency Room at Doctors Hospital and Princess Margaret Hospital in the past 24 hours with gastroenteritis, were awaiting lab results. "Bear in mind that gastroenteritis can occur for a number of reasons," he said, "And so, to ascribe a case of gastroenteritis to vibrio would require confirmatory testing."

Sands said one of the priorities of the ministry is to have the conversation with the public early and spread awareness. "The 2nd thing we would like to do and we have started to do is to ensure the environmental health teams speak directly with the vendors, but throughout New Providence [Bahamas] and anywhere else we may suspect a possibility of exposure," the minister said. "We learned back in the 1990s this is easily controlled if people practice very simple techniques of washing conch with fresh water, which minimizes, if not eliminates, the possibility of transmission. And so, we just redouble those efforts combined with public education."

Additionally, Sands advised conch purchasers to ask vendors and restaurants whether the conch has been washed in fresh water before purchasing and eating it. "If the answer is affirmative, then you ought to feel reasonably comfortable you can eat it," he said. "If the answer is no, then I wouldn't suggest you eat or purchase it." No vendor has been closed down as a result of the cases presented. Sands said that would be premature, noting that conch poisoning from _V. parahaemolyticus_ can be easily prevented.

Thousands of visitors frequent Potter's Cay and other venues to sample conch in the variety of ways it is prepared, such as conch salad, in which the conch is consumed raw with vegetables, pepper and lime. According to health officials, cooking the conch removes the chance of it being contaminated.

There were 223 cases of vibriosis in New Providence [Bahamas] in 2003. In 1991 and 1999, there were also outbreaks of conch poisoning with a combined 1100 cases, Sands said.

Regarding testing, Sands was asked whether the ministry has periodically tested random conch batches from vendors. "This is not an issue of the meat itself," he responded. "Vibrio is a bacteri[um] ordinarily living in sea water and is a part of the surface of the conch. The conch meat itself is not infected with _V. parahaemolyticus_, so you can wash it off. Testing the conch meat itself is not the issue."

Sands continued, "We have learned historically you can eliminate this problem by washing the conch in fresh water. If you are washing the conch with _Vibrio_-containing water, you are not going to solve the problem, even though the conch may appear clean on the surface." Sands said while this is a breaking matter and the ministry has a strategic plan, it has not gotten to the stage of testing batches of conch and the storage water, but "that does not mean that we won't get there."

Symptoms of conch poisoning from _V. parahaemolyticus_ can persist for 72 hours, and some patients may require hospitalization for treatment of dehydration. Those experiencing symptoms are asked to contact the ministry's surveillance unit at +1-242-502-4790 between 9 a.m. and 5 p.m. EDT.  [Byline: Torrell Glinton]
====================
[There is now confirmation the agent involved in the conch poisoning situation is the bacterium _Vibrio parahaemolyticus_. I apologize for the error regarding identification of the agent. Laboratory confirmation is always appreciated. [ProMED would like to thank Mr. Ryan Burke for bringing the laboratory confirmation to our attenttion. - ProMED Mod.JH]

_V. parahaemolyticus_ is a bacterium in the same family as those that cause cholera. It lives in brackish saltwater and causes gastrointestinal illness in humans. Symptoms include watery diarrhea, abdominal cramping, nausea, vomiting, and fever and chills. Usually these symptoms begin within 24 hours of exposure. Illness is usually self-limited and lasts approximately 3 days. Severe disease is rare and occurs more commonly in persons with weakened immune systems <http://www.health.state.mn.us/divs/idepc/diseases/vibrio/basics.html>.

Additional information regarding _V. parahaemolyticus_ may be found on the CDC fact sheet <https://www.cdc.gov/vibrio/faq.html> - ProMED Mod.TG]

[Infections with this organism, which can be normal microflora in seawater, have been associated with the consumption of raw, improperly cooked, or cooked and recontaminated fish and shellfish. A correlation exists between the probability of infection and warmer months of the year. Improper refrigeration of seafood contaminated with this organism will allow its proliferation, which increases the possibility of infection. ProMED-mail covered a large 2005 outbreak in Chile. It was impressive in its size (more than 10 000 cases), continued spread despite early recognition, and the involvement of clams and mussels rather than the classical oyster vehicle. - ProMED Mod.LL]

[HealthMap/ProMED-mail map: <http://healthmap.org/promed/p/11584>]
Date: Thu 5 Jul 2018
Source: EW News [edited]

With 4 confirmed cases of conch poisoning in New Providence, [Bahamas], the Ministry of Health cautioned Bahamians against consuming the delicacy in the wake of this latest outbreak. Health Minister Dr. Duane Sands confirmed the 4 Bahamians suffering from the illness. The earliest case, he said, dates back to [Sat 30 Jun 2018].

Dr. Sands revealed that an additional 6 persons have been hospitalized with symptoms of conch poisoning. He said even though the number of cases is considered minimal, the ministry's warning is a proactive measure to prevent future cases. The ministry, he said, is expected to begin dialogue with local vendors to ensure they are utilizing proper cleaning methods in the preparation of conch dishes.

"Conch should be washed with fresh water, and not salt water, to ensure that all bacteria is removed from the conch meat," suggested Dr. Sands. He urged Bahamians to ask local vendors about the processes they employ during the preparation of conch dishes. "If they do not wash the conch in fresh water during the process of preparing it, then do not purchase the conch," he warned.

The early onset of conch poisoning is said to be accompanied by watery diarrhoea and extreme abdominal cramps. Some cases, the health minister said, are severe and can lead to dehydration and subsequent hospitalization.

The last major outbreak of conch poisoning dates back to the 1990s, according to Dr. Sands.  [Byline: Theo Sealy]
=========================
[The group of conchs that are sometimes referred to as "true conchs" are marine gastropod molluscs in the family Strombidae, specifically in the genus _Strombus_ and other closely related genera. For example, see _Lobatus gigas_, the queen conch, and _Laevistrombus canarium_, the dog conch (<https://en.wikipedia.org/wiki/Conch>).

In ciguatera poisoning, the poisonous ingredient is ciguatoxin. This is a poison made in small amounts by certain algae and algae-like organisms called dinoflagellates. Environmental conditions are right for other organisms, mollusks, or fish to ingest the algae and dinoflagellates. Smaller organisms may be ingested by larger organisms, thus transferring the toxic agent to the larger animal.

Ciguatera is a foodborne illness (food poisoning) caused by eating fish that is contaminated by ciguatera toxin. Ciguatera toxin, a heat-stable, lipid-soluble compound produced by dinoflagellates and concentrated in fish organs, can cause nausea, pain, and cardiac and neurological symptoms in humans when ingested.

Ciguatera toxin is harmless to fish but poisonous to humans. The toxin is odorless and tasteless, and cooking does not destroy the toxin. The toxin activates voltage-dependent sodium channels, causing symptoms in gastrointestinal, cardiac, and nerve tissues of humans and other mammals.

Symptoms in people generally begin 6-8 hr after eating the contaminated fish but can occur as early as 2 or as late as 24 hr after ingestion. Symptoms include nausea, vomiting, diarrhea, muscle pain, numbness, tingling, abdominal pain, dizziness, and vertigo. There is no specific antitoxin available for ciguatera toxin.

Some investigators have suggested vomiting should be induced if the victim is awake and alert and has eaten ciguatera toxin-containing fish within the last 3-4 hr. Ipecac, a substance that causes vomiting, was suggested as the medication to use, but many investigators now think ipecac causes too much dehydration. Currently, some physicians recommend gastrointestinal decontamination with activated charcoal. Activated charcoal may absorb the toxin if administered 3-4 hr after ingestion.

Victims should maintain hydration. Intravenous fluids may be necessary for uncontrollable nausea and vomiting. Although there is no specific antidote available, supportive therapy and time usually is curative.

Portions of this comment were extracted from

[HealthMap/ProMED-mail map:
New Providence Island, New Providence, Bahamas:
More ...

France

France and Monaco US Consular Information Sheet
December 22, 2008
COUNTRY DESCRIPTION:
France is a developed and stable democracy with a modern economy.
Monaco is a developed constitutional monarchy.
Tourist facilities are widely
available.
Read the Department of State Background Notes on France and Monaco for additional information.
ENTRY/EXIT REQUIREMENTS:
France is party to the Schengen agreement.
As such, U.S. citizens may enter France for up to 90 days for tourist or business purposes without a visa.
A passport is required and should be valid for at least three months beyond the period of stay.
Anyone intending to stay more than 90 days must obtain the appropriate visa issued by one of the French Consulates in the U.S., prior to departure for France.
This also applies to anyone considering marriage in France.
For further information about travel into and within Schengen countries, please see our fact sheet.
A passport is required to enter Monaco. A visa is not required for tourist/business stays up to 90 days in Monaco.
For further information concerning entry requirements for France, travelers may contact the Embassy of France at 4101 Reservoir Road NW, Washington, DC
20007, tel. (202) 944-6000, email: info@ambafrance-us.org, or the French Consulates General in Atlanta, Boston, Chicago, Houston, Los Angeles, Miami, New Orleans, New York, or San Francisco.

For further information on entry requirements to Monaco, travelers may contact the Embassy of the Principality of Monaco. 2314 Wyoming Avenue, NW Washington, DC
20008, Tel: 202-234-1530, email: embassy@monaco-usa.org, or the Consulate General of Monaco, 565 Fifth Avenue – 23rd floor, New York, NY 10017, tel.: 212-286-0500, email: info@monaco-consulate.com.
For more information, visit the Embassy of France web site at www.consulfrance-washington.org or the Embassy of the Principality of Monaco web site at http://www.monaco-usa.org for the most current visa information.

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

SAFETY AND SECURITY:
The Government of France maintains a threat rating system, known locally as “Vigipirate,” similar to the U.S. Department of Homeland Security Advisory System.
Under this plan, in times of heightened security concerns, the government augments police with armed forces and increases visibility at airports, train and metro stations, and other high-profile locations such as schools, major tourist attractions, and government installations.
Over the last few years, there have been numerous arrests of suspected Islamic militants involved in various terrorist plots.
As with other countries in the Schengen area, France maintains open borders with its European neighbors, allowing the possibility of terrorist operatives entering/exiting the country with anonymity.

Political assassinations and bombings have occurred in France.
The National Front for the Liberation of Corsica (FLNC), as part of its decades-long bombing campaign on the island of Corsica, continues to conduct limited operations in the south of France and on Corsica.
In the 1990s there was a wave of bombings and attacks in Paris carried out by Algerian terrorists.
Today, numerous radical Islamic groups claim sympathizers within France’s large immigrant community, as evidenced by arrests over the last few years.

Although Americans have not been specifically targeted in terrorist attacks in France within the past few years, travelers should maintain vigilance.
Immediately report unattended packages observed in public places or any other suspicious activities. French law enforcement authorities are proactive and will respond immediately.
If there is a security incident or suspicious package, do not linger in the area to observe.

Although violent civil disorder is rare in France, in the past, student demonstrations, labor protests, and other types of demonstrations have developed into violent confrontations between demonstrators and police.
This was the case in March/April 2006, when a series of large demonstrations took place in central Paris. Several weeks of unrest occurred in the suburbs of Paris, as well as in other French cities and towns, in November 2005.
Neither of these periods of disorder exhibited any anti-U.S. sentiment, but it is important to remember that even a passer-by can be harmed should demonstrations devolve into violence.
Americans are advised to avoid street demonstrations, particularly if riot police are on the scene.

For the latest security information, Americans traveling abroad should regularly monitor the Department of State, Bureau of Consular Affairs web site at http://travel.state.gov, where the current Travel Warnings and Travel Alerts, including 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., 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, please see A Safe Trip Abroad.

CRIME:
While both France and Monaco have relatively low rates of violent crime, a limited number of neighborhoods in the larger French cities merit extra caution.
Additionally, although the overall crime rate has fallen slightly in recent years, the violent crime rate has increased.
Thieves commonly target vehicles with non-local license plates, and work in or near tourist attractions such as museums, monuments, restaurants, hotels, beaches, trains, train stations, airports, and subways.
Americans in France and Monaco should be particularly alert to pickpockets in train stations and subways.
Travelers should keep photocopies of travel documents and credit cards separate from the originals, along with key telephone numbers to contact banks for credit card replacement.

Although thieves may operate anywhere, the U.S. Embassy in Paris receives frequent reports of theft from several areas in particular:
Paris: The Paris Police Prefecture published a pamphlet entitled “Paris in Complete Safety,” which provides practical advice and useful telephone numbers for visitors and can be accessed at http://www.prefecture-police-paris.interieur.gouv.fr/prevention/article/paris_securite_anglais.htm. Thieves operate on the rail link (RER) from Charles de Gaulle Airport to downtown Paris, where they prey on jet-lagged, luggage-burdened tourists.
In one common ruse, a thief distracts a tourist with a question about directions while an accomplice steals a momentarily unguarded backpack, briefcase, or purse.
Thieves also time their thefts to coincide with train stops so they may quickly exit the car just before the automatic doors close.
Travelers should consider taking an airport shuttle bus or taxi from the airport into the city.
Reports of stolen purses, briefcases, and carry-on bags at Charles de Gaulle Airport are not uncommon.
Travelers should monitor their bags at all times and never leave them unattended.
As thieves commonly target laptop bags, travelers should avoid carrying passports and other valuables in computer bags.
Another common method involves picking up a traveler’s shoulder bag that has been placed on the floor while the traveler is busy at the ticket counter. Also be aware that unattended bags are subject to destruction by airport security.

There are reports of robberies in which thieves on motorcycles reach into a moving car by opening the car door or accessing an open window or even breaking the window to steal purses and other bags visible inside.
The same technique is used against pedestrians walking with purses/bags/cameras slung over their street-side shoulder.
Those traveling by car should remember to keep the windows up and the doors locked and items that may be attractive to thieves out of sight.
Pedestrians are encouraged to remain aware of their surroundings at all times, and to keep bags slung across the body, with the bag hanging away from the street.

Many thefts occur on the Number One Subway Line, which runs through the center of Paris by many major tourist attractions (including the Grand Arch at La Défense, the Arc de Triomphe, the Champs Elysées, Place de la Concorde, the Louvre, and the Bastille).
Pickpockets are especially active on this metro line during the summer months and use a number of techniques.
The most common, and unfortunately the most successful, is the simple “bump and snatch,” where an individual bumps into the tourist while at the same time reaching into the pockets/purse/bag.
Visitors should be particularly careful when metro doors are closing, as this is a favored moment for the less-sophisticated pickpockets to simply grab valuables and jump through the closing doors, leaving the victim helplessly watching as the thief flees.
Visitors are encouraged NOT to confront thieves aggressively; they often operate in groups and may become violent if cornered.
Simply drawing attention to an attempted theft will most likely stop the operation, and result in a tactical withdrawal by the thief.

Gare du Nord train station, where the express trains from the airport arrive in Paris, is also a high-risk area for pocket-picking and theft.
Travelers should also beware of thefts that occur on both overnight and day trains, especially on trains originating in Spain, Italy, and Belgium.
These involve the theft of valuables while passengers are sleeping, or when the bags are left unattended.

In hotels, thieves target lobbies and breakfast rooms, and take advantage of a minute of inattention to snatch jackets, purses, and backpacks.
While many hotels do have safety latches that allow guests to secure their rooms from inside, this feature is not as universal as it is in the United States.
If no chain or latch is present, a chair placed up against the door and wedged under the handle is usually an effective obstacle to surreptitious entry during the night.
There are, however, reports of thieves breaking into hotel rooms on lower floors through open windows while the occupants are sleeping.
To guard against this, hotel room windows should be kept locked at all times. Whenever possible, valuables should be kept in the hotel safe.

Many Americans report thefts occurring in restaurants and nightclubs/bars, where purses are stolen from the back of a chair or from under the table.
Again, keep valuables on your person and do not leave them unattended or out of sight.
Thefts also occur at the major department stores such as Galeries Lafayette and Printemps where tourists often place wallets, passports, and credit cards on cashier counters during transactions.

Automated Teller Machines (ATMs) are very common in France and provide ready access to cash, allowing travelers to carry as much money as they need for each day.
The rates are competitive with local exchange bureaus, and an ATM transaction is easier than cashing a traveler’s check.
However, crime involving ATMs is increasing.
Travelers should not use ATMs in isolated, unlit areas or where loiterers are present.
Travelers should be especially aware of persons standing close enough to see the Personal Identification Number (PIN) being entered into the machine.
Thieves often conduct successful scams by simply observing the PIN as it is entered and then stealing the card from the user in some other location.
If the card becomes stuck, travelers should immediately report it to the bank where the machine is located.

Large criminal operations in Paris involving the use of ATMs that “eat” the user’s ATM card have been reported.
This most often happens during a weekend or at night when the bank is closed.
The frustrated traveler often walks away after unsuccessfully trying to retrieve the card, with plans to return the first day the bank is open.
In such cases, a criminal gang has modified the machine using an add-on device equipped with a microchip that records the user’s PIN when it is typed in, and also prevents the card from being ejected.
The criminal retrieves the card from the device once the visitor departs, downloads the recorded PIN and then goes to other ATMs and withdraws as much cash as possible.
ATM users are strongly encouraged to carry a 24-hour emergency number for their ATM card and bank account that will enable the immediate prevention of withdrawals from the account if difficulties occur.

Pigalle is the “adult entertainment district” of Paris.
Many entertainment establishments in this area engage in aggressive marketing and charge well beyond the normal rate for drinks.
Reports of threats of violence to coerce patrons into paying exorbitant beverage tabs are not uncommon.
There have also been several violent confrontations between rival gangs in the district, including one in August 2007 one block from the famous Moulin Rouge cabaret.
Visitors are encouraged to avoid this area unless touring with a well-organized and reputable tour company.

Normandy:
There has been an increase in break-ins and thefts from vehicles in the parking lots at the Normandy beaches and American cemeteries common.
Valuables should not be left unattended in a car, and locking valuables in the trunk should not be considered a safeguard.
Thieves often pry open car trunks to steal bags inside.

Southern France: Thefts from cars with unlocked doors or open windows stopped at red lights or caught in slow traffic are very common, particularly along the Riviera of the Nice-Antibes-Cannes area, and in Marseille.
Car doors should be kept locked and windows raised at all times to prevent incidents of "snatch-and-grab" thefts.
In this type of scenario, the thief is usually a passenger on a motorcycle. Break-ins of parked cars are also fairly common.
Valuables should not be left in the car, not even in the trunk, when the vehicle is unattended.

INFORMATION FOR VICTIMS OF CRIME:
The loss or theft abroad of a U.S. passport should be reported immediately to the local police and the nearest U.S. Embassy or Consulate.
If you are the victim of a crime while overseas, in addition to reporting to local police, please contact the nearest U.S. Embassy or Consulate for assistance. The Embassy/Consulate staff can, for example, assist you to find appropriate medical care, to contact family members or friends, and explain how funds could be transferred.
Although the investigation and prosecution of the crime is solely the responsibility of local authorities, consular officers can help you to understand the local criminal justice process and to find an attorney if needed.
Under French law, compensation is available to victims of crime committed on French soil under certain circumstances. To learn about resources in the U.S., including possible compensation, see our information on Victims of Crime
The local equivalents to the “911” emergency line in France are as follows: 17 (police emergency), 18 (fire department) and 15 (emergency medical/paramedic team/ambulance).
In Monaco, the numbers are 17 (police emergency), 18 (fire department) and 9375-2525 (medical/paramedic team/ambulance).

MEDICAL FACILITIES AND HEALTH INFORMATION:
Medical care comparable to that found in the United States is widely available. In France, the phone number for emergency medical services is 15.
In Monaco, the phone number for emergency medical services is 9375-2525.

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

TRAFFIC SAFETY AND ROAD CONDITIONS:
While in a foreign country, U.S. citizens may encounter road conditions that differ significantly from those in the United States.
The information below concerning France and Monaco is provided for general reference only, and it may not be totally accurate in a particular location or circumstance.
Roads in France are generally comparable to those in the United States, but traffic engineering and driving habits pose special dangers.
Usually, lane markings and sign placements are not as clear as in the United States.
Drivers should be prepared to make last-minute maneuvers, as most French drivers do.
The French typically drive more aggressively and faster than Americans, and tend to exceed posted speed limits.
Right-of-way rules in France may differ from those in the United States.
Drivers entering intersections from the right have priority over those on the left (unless specifically indicated otherwise), even when entering relatively large boulevards from small side streets.
Many intersections in France are being replaced by traffic circles, where the right-of-way belongs to drivers in the circle.

On major highways, service stations are situated at least every 25 miles.
Service stations are not as plentiful on secondary roads in France as they are in the United States.
Paris, the capital and largest city in France, has an extensive and efficient public transportation system.
The interconnecting system of buses, subways, and commuter rails serves more than 4 million people a day with a safety record comparable to or better than the systems of major American cities.
Similar transportation systems are found in all major French cities. Between cities, France is served by an equally extensive rail service, which is reliable.
High-speed rail links connect the major cities in France. Many cities are also served by frequent air service.

Please refer to our Road Safety page for more information.
Visit the web site of the French and Monegasque National Tourist Office at http://us.franceguide.com/.
The website contains specific information concerning French and Monegasque driver's permits, vehicle inspection, road tax, and mandatory insurance.
AVIATION SAFETY OVERSIGHT:
The U.S. Federal Aviation Administration (FAA) has assessed the Government of France's Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for oversight of France's air carrier operations.
For more information, travelers may visit the FAA’s web site at http://www.faa.gov/safety/programs_initiatives/oversight/iasa
SPECIAL CIRCUMSTANCES:
French and Monegasque customs authorities enforce strict regulations concerning temporary importation into or export from France of items such as firearms, antiquities, medications, business equipment, sales samples, and other items.
It is advisable to contact the Embassy of France in Washington, DC, one of France's consulates in the United States, or the Consulate General of Monaco in New York for specific information regarding customs requirements.
Please see our Customs Information.

CRIMINAL PENALTIES:
While in a foreign country, a U.S. citizen is subject to that country's laws and regulations, which sometimes differ significantly from those in the United States and may not afford the protections available to the individual under U.S. law.
Penalties for breaking the law can be more severe than in the United States for similar offenses.
Persons violating French or Monegasque laws, even unknowingly, may be expelled, arrested, or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in France or Monaco 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 AND CONSULATE LOCATIONS:
Americans living or traveling in France or Monaco are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department’s travel registration web site, so they can obtain updated information on travel and security within France and Monaco.
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 cases of emergency.

The U.S. Embassy/Consular Section in Paris is located at 4 avenue Gabriel, 75008 Paris (Place de La Concorde, métro stop Concorde), telephone: in country 01-43-12-22-22; from the U.S. 011-33-1-43-12-22-22 (24 hours); fax for Passport Services in country 01-42-96-28-39; from the U.S. 011-33-1-42-96-28-39; for Special Consular Services (emergencies) fax: in country 01-42-61-61-40; from the U.S. 011-33-1-42-61-61-40. Further information can be obtained at the U.S. Embassy's web site at http://france.usembassy.gov/
The Consulate General in Marseille is located at Place Varian Fry, 13006 Marseille, telephone: in country 04-91-54-92-00; from the U.S. 011-33-4-91-54-92-00 (24 hours); Consular Section fax: in country 04-91-55-56-95 and main fax 04-91-55-09-47; Consular Section fax from the U.S. 011-33-4-91-55-56-95, and main fax from the U.S. 011-33-4-91-55-09-47.
Web site: http://france.usembassy.gov/marseille.html.

The Consulate General in Strasbourg is located at 15 Avenue d'Alsace, 67082 Strasbourg, telephone: in country 03-88-35-31-04; from the U.S. 011-33-3-88-35-31-04; fax: in country 03-88-24-06-95; from the U.S. 011-33-3-88-24-06-95.
Web site: http://france.usembassy.gov/strasbourg.html.

The Consulate General in Strasbourg does not produce passports on the premises.
American citizens in this area whose passports are lost or stolen and have urgent travel needs should contact the U.S. Embassy in Paris.

The U.S. Government also has consular representation in Bordeaux, Lyon, Rennes, Nice and Toulouse that provide limited services to Americans, by appointment only.

The American Presence Posts in Bordeaux, Lyon and Rennes do not produce passports on the premises.
American citizens in this area whose passports are lost or stolen and have urgent travel needs should contact the Consular Section of the U.S. Embassy in Paris.

The American Presence Post in Toulouse and the Consular Agency in Nice do not produce passports on the premises.
American citizens in this area whose passports are lost or stolen and have urgent travel needs should contact the U.S. Consulate General in Marseille.

The American Presence Post in Bordeaux is located at 10 place de la Bourse, 33076 Bordeaux (entry on 1 rue Fernand Philippart); telephone: in country 05-56-48-63-80; from the U.S. 011-33-5-56-48-63-80; fax: in country 05-56-51-61-97; from the U.S. 011-33-5-56-51-61-97.
Web site: http://france.usembassy.gov/bordeaux.html
The American Presence Post in Lyon is located at 1, quai Jules Courmont, 69002 Lyon; telephone: in country 04-78-38-33-03; from the U.S. 011-33-4-78-38-33-03; fax: in country 04-72-41-71-81; from the U.S. 011-33-4-72-41-71-81.
Web site: http://france.usembassy.gov/lyon.html
The American Presence Post in Rennes is located at 30, quai Duguay Trouin, 35000 Rennes; telephone: in country 02-23-44-09-60; from the U.S. 011-33-2-23-44-09-60; fax: in country 02-99-35-00-92; from the U.S. 011-33-2-99-35-00-92.
Web site: http://france.usembassy.gov/rennes.html
The American Presence Post in Toulouse is located at 25, Allée Jean Jaures, 31000 Toulouse; telephone: in country 05-34-41-36-50; from the U.S. 011-33-5-34-41-36-50; fax: in country 05-34-41-16-19; from the U.S. 011-33-5-34-41-16-19. Web site: http://france.usembassy.gov/toulouse.html
The Consular Agency in Nice is located at 7, Avenue Gustave V, 3rd floor, 06000 Nice, telephone: in country 04-93-88-89-55; from the U.S.
011-33-4-93-88-89-55; fax: in country 04-93-87-07-38; from the U.S. 011-33-4-93-87-07-38. Web site: http://france.usembassy.gov/nice.html
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This replaces the Country Specific Information for France and Monaco dated May 5, 2008, to update the sections on Entry/Exit Requirements, Safety & Security, Crime, Medical Facilities and Health Information, Children’s Issues and Registration/Embassy Location.

Travel News Headlines WORLD NEWS

Date: Wed 5 Feb 2020
Source: The Local [edited]

Coronavirus might be hogging the headlines at present, but in France, normal seasonal flu is proving far more deadly. On Wednesday 5 Feb [2020], the region of Normandy officially declared itself in epidemic, leading to the whole of mainland France now being in a state of influenza epidemic. Across the whole country, 301 out of every 100,000 people have the flu, taking the illness into epidemic phase. Of the nearly 9000 people that went to the hospital emergency room with flu symptoms last week, 810 of were hospitalised.

Since the start of the outbreak in November [2019], 311 people have been admitted to intensive care with flu, and 26 of them have died. These include 3 children under 15 years of age, 12 cases aged 15-64, and 11 cases aged 65 years and older.

The average age of these serious cases is 52 years, and 73% of them had risk factors for complications (over 65 years of age, chronic illnesses, etc). Among the latter, 3/4 were not vaccinated against influenza (among those whose vaccination status was known).

This year [2020], children seem to be particularly affected. Nearly 1/3 of emergency room visits and hospitalisations for influenza were children under 5 years old, compared with 20% for people aged 75 and over. Every year seasonal flu affects between 2-6 million people in France, and last year [2019], 9500 people died from it.

Health officials advise people to practice normal good hygiene: washing hands regularly, using disposable tissues and throwing them away if you have a cough, and coughing into your elbow. Those who are sick are advised to wear a disposable face mask to help avoid spreading the illness.
Date: Wed, 29 Jan 2020 21:16:14 +0100 (MET)

Paris, Jan 29, 2020 (AFP) - The daughter of a Chinese tourist who is seriously ill in a Paris hospital has become the fifth person in France to be confirmed with the coronavirus, officials said Wednesday.   Her 80-year-old father was the fourth confirmed case in France of the new coronavirus that has killed more than 100 people since it emerged in the Chinese city of Wuhan in December.  "A fifth case has been detected," Health Minister Agnes Buzyn told a news briefing.   "It's the daughter of the Chinese tourist who was hospitalised recently in intensive care in a serious condition," Buzyn added.   The woman in her thirties, "whose condition has worsened, who needs oxygen," has also been placed in intensive care, Buzyn said.   The minister said a first plane was due to fly Wednesday evening to Wuhan, the epicentre in China, to repatriate 200 French people stranded there.
Date: Fri, 17 Jan 2020 12:55:16 +0100 (MET)

Rennes, France, Jan 17, 2020 (AFP) - Several oyster farmers along France's Atlantic and Mediterranean coasts have been forced to halt sales since December after their sites were contaminated by the highly contagious norovirus, which they blame on overflowing sewage treatment plants.   Authorities ordered the suspensions at 23 of the country's 375 designated fields, and recalls of affected oysters as well as mussels and clams, after tests revealed the virus, which can cause severe vomiting and diarrhoea.

The move came just before the year-end holidays, when oysters are a traditional delicacy on millions of French tables.   "The oysters are not sick. They're carrying the virus because it's in the water they are constantly filtering," Philippe Le Gal, president of France's national shellfish council (CNC), told AFP this week.   "They were in the wrong place at the wrong time," he said, adding the ban had prompted many people to stop eating oysters altogether.   Local officials say oyster farmers are paying the price of insufficient spending on wastewater treatment, with facilities strained to the limit even as development of coastal areas has surged in recent years.

Heavy rains before Christmas prompted treatment basins to overflow, they say, spilling tainted water into rivers.   "This was predictable -- they've kept issuing building permits even though treatment sites are already at full capacity," said Joel Labbe, a senator for the Morbihan region in Brittany.   Oyster farmers are demanding compensation, and a delegation met with agriculture ministry officials in Paris last week warning that more than 400 businesses had been impacted by the sales ban.

This week, angry growers dumped trash bins full of oysters and mussels in front of the offices of the regional ARS health authority in Montpellier over the decision to halt sales from a nearby basin on the Mediterranean coast.   "We're the victims, and we shouldn't have to suffer any financial damages," Le Gal said.
Date: Sun, 12 Jan 2020 16:16:24 +0100 (MET)
By Marie-Pierre FEREY

Paris, Jan 12, 2020 (AFP) - A crippling French transport strike dragged into its 39th day on Sunday despite the government's offer to withdraw the most contested measure of the pension reform plans that sparked the protest.   Prime Minister Edouard Philippe said Saturday he would drop plans to increase the official retirement age to 64 from 62 in an effort to end a strike which has paralysed Paris and its suburbs, with bus, train and metro services all badly disrupted.

"I am willing to withdraw from the bill the short-term measure I had proposed," said Philippe, prompting his boss French President Emmanuel Macron to dub the change "a constructive and responsible compromise."   The more reformist trade unions -- the FDT, Unsa and FRC -- welcomed the announcement and said they were now ready to work with employers on the sustainable financing of the state pension system.

The Unsa union for national railway workers maintained its strike call on Sunday while recognising the government's reconciliatory move.   The union "remains on strike " but will return to the negotiating table, secretary general Didier Mathis told AFP.   However the more hardline CGT, FO and Solidaires unions were standing firm, calling for the strike and protests to continue, among them a major demonstration on January 16.

- 'Some want to return to work' -
CGT head Philippe Martinez played down the impact of the CFDT and Unsa's readiness to resume negotiations, and spoke of internal splits within these groups.   "We will see" what these unions' workers have to say on the issue, he said, reiterating his call for the government to withdraw the pension reforms completely which he described at "the major requirement of a majority of unions representing a majority of employees".

However the arrival of empty January pay slips could sap the determination of some striking workers.   "It is clear that some colleagues want to go back to work," said one disillusioned Paris Metro worker during demonstrations on Saturday.   "It's going to get tricky financially," he added.   Private sector workers have not followed the unions' lead on the stoppage to turn the campaign into a true national strike.

- 'We're still here' -
The government's compromise move came a day after meetings with unions in a bid to end a strike that has frustrated Paris commuters, ruined December holiday travel plans, and hurt business.   Demonstrators in the capital on Saturday, some masked and hooded, broke shop windows along their protest route, set fires and threw projectiles at police in riot gear who responded with tear gas.

Several stores were ransacked as marchers brandished union flags and chanted defiantly: "We are still here!" and "Macron resign!"   Protests were also held in Marseille, Toulouse, Lyon, Nantes and several other cities.   The interior ministry said 149,000 people had turned out throughout France.   The CGT put the figure at half a million, saying the 150,000 marched in Paris alone.

- 'Pivot age' -
In one of Macron's signature reforms, the government is seeking to rationalise 42 existing pension schemes into a single, points-based system it says will be fairer and more transparent but which unions fear will see millions work longer for a smaller retirement pay-out.   Particularly vexing was the proposal to impose the 64 "pivot age" that people would have to work to in order to qualify for a full pension.   Union meetings will be held on Monday to decide on the future of the strikes on France's local and national rail services.

The government, employers and unions are also keeping their eyes on the opinion polls.   "Public opinion supports the strikers," Martinez insisted late Saturday.   The government has ruled out cutting pensions but insists that something must be done to boost funding as workers are living longer post-retirement.   French Environment Minister Elisabeth Borne said Sunday that there was "no longer any reason" for the strike to continue now that the prime minister had proposed scrapping the "pivot age" of 64.
Date: Fri, 10 Jan 2020 06:09:20 +0100 (MET)
By Arnaud BOUVIER and David ARRODE

Paris, Jan 10, 2020 (AFP) - Tens of thousands of demonstrators took to streets across France on Thursday in the latest mass protests against a pensions overhaul that critics say could cut benefits even while requiring people to work longer before retiring.

Tensions flared in Paris and other cities as some black-clad protesters smashed glass-panelled shopfronts and bus stops, while others hurled paving stones against police who tried to disperse crowds with tear gas.   It was the fourth day of demonstrations since the protest began on December 5 with a massive public transport strike now in its 36th day.   Police said at least 24 people had been detained in Paris, where 56,000 people marched toward the Saint-Lazare train station, according to the interior ministry.

Some 452,000 protesters turned out across France, the ministry said, as teachers and other public-sector employees joined train and metro workers.   The hardline CGT union said almost 1.7 million people protested around the country.   "Teachers like us stand to lose the most. Some could see their pensions cut by up to 100 euros a month!" Marylou Crampette, a 25-year-old school teacher, said at the Paris march.

Unions have staged their biggest show of strength in decades against plans for a single points-based system that would sweep away the country's 42 pension schemes, many offering early retirement mainly to public workers.   The government on Thursday night unveiled two bills that aim to appease the unions by committing to salary rises for teachers and researchers.   However, the unions are unlikely to agree to the measures, which still contain the key sticking point of the "pivot age" -- that would effectively extend the minimum age for receiving a full pension from 62 to 64.

- Fuel shortages? -
Commuters in Paris were again hit hard by scaled-back metro services, and the Eiffel Tower was shut as during the previous protests.   National train services also remained severely disrupted during what is now France's longest continuous rail strike.   "Between the government's stance of 'We're talking, everything is on the table' and the reality, you have to wonder if it really intends to... take the views of unions into account," CGT's Philippe Martinez said ahead of the Paris march.   Thousands of people also demonstrated in Toulouse, Nantes, Marseilles and other cities against the pension reform, a key plank in President Emmanuel Macron's pledge to shake up the French economy.   Unions have warned the strike could widen, with CGT energy workers this week blockading fuel refineries and depots, raising fears of petrol shortages.

Another day of mass demonstrations has been called for Saturday, and further protests were planned for January 14, 15 and 16, unions said.   A flurry of polls have shown support for the protest eroding in recent days.   "It's normal that they defend their rights, but they're doing it at the expense of the rest of the population," said Cedric Chevalier, 40, a manager at a clothing store in Paris.   Apart from his daily commute having doubled due to the strike, the store's "sales are down at least 20 to 30 percent, which means I'm losing money", he told AFP.

- 'Work a bit longer' -
Even the moderate CFDT union, which backs the plan for a single pension system, baulks at the new pension age of 64, which the government says is needed to plug a gaping deficit.   The CFDT, France's largest union, has urged the government to drop the measure and agree to a separate "financing conference" with unions, who want companies to pay more in payroll taxes to cover pension pay-outs.   Prime Minister Edouard Philippe, who is set to meet labour leaders again on Friday, has said he is open to the idea but wants the "pivot age" of 64 to remain for now in the bill he intends to send to parliament in March.   Budget Minister Gerald Darmanin insisted the measure was "fair" in an  interview with the daily newspaper Figaro on Thursday.   "It's certain that we are going to have to work a bit longer," he said.
More ...

Mongolia

Mongolia US Consular Information Sheet
November 21, 2008
COUNTRY DESCRIPTION:
Mongolia is a vast country of mountains, lakes, deserts and grasslands approximately the size of Alaska.
It peacefully abandoned its communist system in 199
and has been successfully making the transition to a parliamentary democracy.
Economic reforms continue, although the country’s development will depend on considerable infrastructure investment, particularly in the mining, energy, transportation, and communication sectors.
Travelers to Mongolia should be aware that shortcomings in these areas might have an impact on travel plans.
Read the Department of State Background Notes on Mongolia for additional information.

ENTRY/EXIT REQUIREMENTS:
A valid passport is required for American visitors.
No visa is required for Americans visiting for fewer than 90 days; however, visitors planning to stay in Mongolia for more than 30 days are required to register with the Office of Immigration, Naturalization and Foreign Citizens in Ulaanbaatar within the first seven days of arrival.
American visitors who fail to register and who stay longer than 30 days, even for reasons beyond their control, will be stopped at departure, temporarily denied exit, and fined.
It is recommended that visitors who will be in Mongolia beyond 30 days register with the Office of
Immigration, Naturalization and Foreign Citizens within the first seven days of their arrival.

Americans planning to work or study in Mongolia should apply for a visa at a Mongolian embassy or consulate outside of Mongolia.
Failure to do so may result in authorities denying registration, levying a fine, and requiring that the visitor leave the country.
Travelers arriving or departing Mongolia through China or Russia should be aware of Chinese and Russian visa regulations (transiting twice will require a double- or multiple-entry visa) and note that some land-entry points have varying days and hours of operation. Many small land border posts do not operate on a fixed schedule.
Travelers need to check with immigration authorities to make certain the post they intend to use will be open when they want to enter. Travelers planning travel to Russia should get visas prior to arriving in Mongolia, because they are difficult to obtain at the Russian Embassy in Mongolia. For more information on these requirements, see the Country Specific Information for Russia and China.

Travelers without Mongolian visas are subject to an exit tax payable either in U.S. dollars or Mongolian Tugrugs upon departure.
American citizen visitors to Mongolia do not require a visa if they stay less than 30 days and no fee is payable if they depart within the 30 day period.
If they stay longer without having registered with immigration, a penalty fee will be assessed at time of departure.
Travelers should inquire whether the exit tax is included with the price of the airline ticket at the time of purchase. In an effort to prevent international child abduction, many governments have initiated procedures at entry/exit points.
These often include requiring documentary evidence of relationship and permission for the child’s travel from the parent(s) or legal guardian if not present.
Having such documentation on hand, even if not required, may facilitate entry/departure.

Visit the Embassy of Mongolia web site at http://www.mongolianembassy.us for the most current visa information.
Travelers can also contact the Embassy of Mongolia at 2833 M Street NW, Washington, DC
20007, telephone (202) 333-7117 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:
There have been no significant acts of terrorism or extremism in Mongolia. There are no regions of instability in the country.
U.S. citizens are advised to avoid all protests, including political protests, and street demonstrations that occur occasionally in Ulaanbaatar, as the demonstrations may become violent.

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

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

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

CRIME:
Over the past few years there has been a significant rise in street crime in Mongolia, particularly in Ulaanbaatar, the capital.
Violent crime, particularly aggravated assault, is increasing, and it is not advisable to walk alone through the city after dark.
The most common crimes against foreigners are pick pocketing and bag snatching.
There are reports of organized groups operating in open areas, usually after dark, who surround, grab, and choke an individual in order to search the victim’s pockets.
Thieves have also sliced victims’ clothing in attempts to reach wallets, cell phones and other valuables.
U.S. citizens who detect pick pocket attempts should not confront the thieves, as they may become violent.
Caution is advised when using public transportation and in crowded public areas, such as open-air markets, the Central Post Office and the Gandan Monastery.
Crime rises sharply before, during and after the Naadam Summer Festival in July and throughout the summer tourist season, as well as during and after Tsagaan Sar, the Winter Festival, in January or February.

Travelers should be extremely cautious at these specific locations:
Chinggis Khan International Airport in Ulaanbaatar: tourists arriving at and departing from this airport are frequently targeted for robbery and pick pocketing by organized groups.
The State Department Store:
tourists are targeted by organized pick pocket gangs at the entries/exits/elevators and the area surrounding the store.
Naran Tuul Covered Market:
Organized criminal groups look for and target foreigners for robbery and pick pocketing.
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.
American victims of crime in Mongolia should be prepared to hire their own translators and lawyers if they intend to pursue a criminal complaint against a Mongolian.

The local equivalent to the “911” emergency line in Mongolia are 102 to contact the police department and 103 for a medical emergency.

See our information on Victims of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION:
Medical facilities in Mongolia are very limited and do not meet most Western standards, especially for emergency health care requirements.
Many brand-name Western medicines are unavailable.
Ulaanbaatar, the capital, has the majority of medical facilities inside the country; outside of Ulaanbaatar, medical facilities and treatment are extremely limited or non-existent.
Specialized emergency care for infants and the elderly is not available.
Infectious diseases, such as plague, meningococcal meningitis, and tuberculosis, are present at various times of the year. Sanitation in some restaurants is inadequate, particularly outside of Ulaanbaatar.
Stomach illnesses are frequent.
Bottled water and other routine precautions are advisable.

Serious medical problems requiring hospitalization and/or medical evacuation to the United States can cost tens of thousands of dollars.
A June 2005 medical evacuation from Ulaanbaatar to Seoul, Korea, cost the patient $87,000.
Doctors and hospitals usually expect immediate payment in cash for health services.
Medical evacuation companies will not initiate an evacuation without a fee guarantee beforehand and in full.
Please see Medical Information for Americans traveling abroad.

Local hospitals generally do not contact the Embassy about ill or injured Americans in their care; hospitalized American citizens who need Consular assistance from the Embassy should ask the doctor or hospital to contact the U.S. Embassy in Ulaanbaatar.
For more information, please contact the U.S. Embassy in Ulaanbaatar, which has a list of medical facilities available to foreigners (also available on the U.S. Embassy web site at http://mongolia.usembassy.gov/) or the Centers for Disease Control and Prevention’s international traveler’s hotline (see below).
The U.S. Department of State is unaware of any HIV/AIDS entry restrictions for visitors to or foreign residents of Mongolia.

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

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

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

Driving in Ulaanbaatar can be extremely difficult due to poorly maintained streets, malfunctioning traffic lights, inadequate street lighting, a shortage of traffic signs, and undisciplined pedestrians.
There has been a dramatic increase in the number of vehicles on the roads in recent years, but the knowledge and skills of the driving population have not kept pace with the growth in the number of automobiles on the streets. There are many metered taxis in Ulaanbaatar.
There are a few car rental companies, but safety and maintenance standards are uncertain, and rental vehicles should be utilized with caution.
Cars with drivers can be obtained from local tourist companies.
Public transportation within the capital is extensive, cheap, and generally reliable, but it is also extremely crowded (see Information on Crime above), with the result that pickpockets often victimize foreigners.
For specific information concerning Mongolian drivers permits, vehicle inspection, road tax, and mandatory insurance, contact the Embassy of Mongolia at: 2833 M Street NW, Washington, DC
20007, telephone (202) 333-7117.

Please refer to our Road Safety page for more information.
Visit the web site of Mongolia’s national tourist office and national authority responsible for road safety at http://www.mongolianembassy.us/default.php.

AVIATION SAFETY OVERSIGHT:
As there is no direct commercial air service to the United States by carriers registered in Mongolia, the U.S. Federal Aviation Administration (FAA) has not assessed Mongolia’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.

The U.S. Embassy prohibits U.S. government personnel from using the domestic services of Mongolian International Air Transport (MIAT) for official travel because of uncertainties regarding service and maintenance schedules, aircraft certification and insurance status.
This prohibition does not extend to MIAT’s international flights or to the domestic flights of other carriers.
SPECIAL CIRCUMSTANCES:
Traveler’s checks in U.S. dollars are accepted at some hotels and may be converted to dollars or Tugrugs at several banks.
Credit cards can be used at a variety of hotels, restaurants, and shops in Ulaanbaatar.
Outside of the capital, travelers should have cash.
Cash advances against credit cards are available at some commercial banks such as Trade and Development Bank, Golomt Bank, Khan Bank, and Xac Bank.
International bank wire transfers are also possible.
There are a handful of VISA and Maestro/Cirrus ATM machines in Ulaanbaatar, but they do not always function and are not reliable.
ATM machines do not exist outside the capital.

U.S. consular offiers may not always receive timely notification of the detention or arrest of a U.S. citizen, particularly outside of Ulaanbaatar.
American citizens are encouraged to carry a copy of their passport with them at all times, so that, if questioned by local officials, evidence of identity and citizenship are readily available.
Severe fuel shortages and problems with central heating and electrical systems may cause seriously reduced heating levels and power outages in Ulaanbaatar and other cities during the winter.
Smaller towns in the countryside may have no heat or electricity at all.
The Embassy advises all American residents in Mongolia to be prepared to depart if there is a complete energy failure.
General information about natural disaster preparedness is available via the Internet from the U.S. Federal Emergency Management Agency (FEMA) at http://www.fema.gov/.

Mongolian customs authorities enforce strict regulations concerning import and export of items such as firearms, ammunition, and antiquities.
Import of firearms or ammunition requires prior approval from the Government of Mongolia.
Export of antiquities requires a special customs clearance certificate issued by authorized antique shops at the time of purchase. For additional information contact the Embassy of Mongolia at: 2833 M Street NW, Washington, DC
20007, telephone: (202) 333-7117.
Please see our Customs Information.

CRIMINAL PENALTIES:
While in a foreign country, a U.S. citizen is subject to that country's laws and regulations, which sometimes differ significantly from those in the United States and may not afford the protections available to the individual under U.S. law.
Penalties for breaking the law can be more severe than those in the United States for similar offenses.
Persons violating Mongolia’s laws, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession or use of, or trafficking in illegal drugs in Mongolia 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 Mongolia 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 Mongolia.
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: at Micro Region 11, Big Ring Road, Ulaanbaatar.
The telephone number is (976) 11-329-095, the Consular Section fax number is (976) 11-353-788, and the Embassy’s web site is http://mongolia.usembassy.gov/.
The Consular Section can be emailed directly at cons@usembassy.mn.
The Consular Section is open for American Citizens Services Monday and Thursday from 1-3 p.m., except on U.S. and Mongolian holidays.
*

*

*
This replaces the Country Specific Information for Mongolia dated September 22, 2008 to update the sections on Safety and Security, and Aviation Safety Oversight.

Travel News Headlines WORLD NEWS

Date: Mon, 6 May 2019 17:00:57 +0200

Ulaanbaatar, May 6, 2019 (AFP) - A Mongolian couple has died of the bubonic plague after eating raw marmot kidney, triggering a quarantine that left tourists stranded in a remote region for days, officials said Monday.

The ethnic Kazakh couple died on May 1 in Mongolia's westernmost province of Bayan-Ulgii, which borders Russia and China.   "The two dead were local people," said local governor Aipiin Gilimkhaan. "There were no cases reported after them."   A six-day quarantine was declared on residents in the region, preventing nine tourists from Russia, Germany and Switzerland from leaving.   "We are all fine. No one is ill," said a German tourist named Teresa, who did not want to give her last name.

Sebastian Pique, a 24-year-old American Peace Corps volunteer who has lived in the region for two years, said he and the tourists were invited to the governor's office on Friday to be informed about the situation.    "After the quarantine (was announced) not many people, even locals, were in the streets for fear of catching the disease," Pique told AFP.   The quarantine was expected to be lifted late Monday after no other cases of the plague were reported.   Authorities have warned people against eating raw marmot meat because it can carry Yersinia pestis, the plague germ.

At least one person dies of the plague every year in Mongolia, mostly due to consuming such meat, according to the National Center for Zoonotic Disease.   Some people ignore the warnings as they believe that consuming the innards of the large rodent is good for their health.   The Black Death wiped out millions of people in the Middle Ages but cases are now very rare.    Its most common form is bubonic, which is spread by fleas and causes swelling of the lymph node. The more virulent form is pneumonic plague, which can be transmitted between humans through coughing.
Date: Fri 3 May 2019
Source: Mirror [edited]

A married couple has died, leaving their 4 children orphaned after an outbreak of the bubonic plague, which sparked plane panic.

The man, 38, named only as Citizen T, and his pregnant wife, 37, are thought to have fallen ill after hunting and eating contaminated marmot, a large species of squirrel, in Mongolia. The man died on 27 Apr [2019], and the woman died 3 days later, reports the Siberian Times.

The highly contagious bacterial disease is spread by fleas living on wild rodents. It has sparked fears of an outbreak, and urgent measures and precautions have been put in place to stop the infection spreading. Around 158 people have been put under intensive medical supervision after coming into contact directly or indirectly with the couple.

There were dramatic scenes when a flight from Bayan, Ulgii and Khovd in Mongolia -- the area where the couple fell ill -- was met by workers in white anti-contamination suits as [the plane] landed in the country's capital of Ulaanbaatar. Eleven passengers from the west of the country were held at the airport and sent immediately for hospital checks. Others were examined in a special facility at the airport. Paramedics in anti-contamination boarded the flight as soon as it landed.

Some frontier checkpoints with Russia are reported to have been closed, leading to foreign tourists being stranded in Mongolia.

Dr N. Tsogbadrakh, director of National Centre for Zoonotic Dermatology and Medicine, said, "Despite the fact that eating marmots is banned, Citizen T hunted marmot. He ate the meat and gave it to his wife, and they died because the plague affected his stomach. Four children are orphaned."

Bubonic plague is believed to be the cause of the Black Death that spread through Asia, Europe, and Africa in the 14th century, killing an estimated 50 million people.

The plague is a bacterial disease that is spread by fleas living on wild rodents such as marmots. The disease can kill an adult in less than 24 hours if not treated in time, according to the World Health Organisation.  [Byline: Will Stewart and Amber Hicks]
========================
[HealthMap/ProMED-mail map:
Bayan-Olgiy Aymag, Bayan-Olgiy, Mongolia:
Date: Fri, 15 Mar 2019 02:55:29 +0100
By Khaliun Bayartsogt

Bornuur, Mongolia, March 15, 2019 (AFP) - In the world's coldest capital, many burn coal and plastic just to survive temperatures as low as minus 40 degrees -- but warmth comes at a price: deadly pollution makes Ulaanbataar's air too toxic for children to breathe, leaving parents little choice but to evacuate them to the countryside.   This exodus is a stark warning of the future for urban areas in much of Asia, where scenes of citizens in anti-pollution masks against a backdrop of brown skies are becoming routine, rather than apocalyptic.   Ulaanbaatar is one of the most polluted cities on the planet, alongside New Delhi, Dhaka, Kabul, and Beijing. It regularly exceeds World Health Organisation recommendations for air quality even as experts warn of disastrous consequences, particularly for children, including stunted development, chronic illness, and in some cases death.

Erdene-Bat Naranchimeg watched helplessly as her daughter Amina battled illness virtually from birth, her immune system handicapped by the smog-choked air in Mongolia's capital.   "We would constantly be in and out of the hospital," Naranchimeg told AFP, adding that Amina contracted pneumonia twice at the age of two, requiring several rounds of antibiotics.   This is not a unique case in a city where winter temperatures plunge towards uninhabitable, particularly in the districts that rural workers moved to in search of a better life.   Here row upon row of the traditional tents -- known as gers -- are warmed by coal, or any other flammable material available. The resulting thick black smoke shoots out in plumes, blanketing surrounding areas in a film of smog that makes visibility so poor it can be hard to see even a few metres ahead.   Hospitals are packed and young children are vulnerable, common colds can quickly escalate into life-threatening illness.

- Birth defects -
The situation was so bad that doctors told Naranchimeg the only solution was to send her little girl to the clean air of the countryside.   Now aged five, Amina is thriving. She lives with her grandparents in Bornuur Sum, a village 135 kilometres away from the capital.   "She hasn't been sick since she started living here," said Naranchimeg, who makes the three-hour round trip to see Amina every week.   "It was very difficult in the first few months," she said. "We used to cry when we talked on the phone."   But like many parents in Ulaanbaatar, she felt the move was the only way to protect her child.

The levels of PM2.5 -- tiny and harmful particles -- in Ulaanbaatar reached 3,320 in January, 133 times what the World Health Organisation (WHO) considers safe.   The effects are terrible for adults but children are even more at risk, in part because they breathe faster, taking in more air and pollutants.   As they are smaller, children are also closer to the ground, where some pollutants concentrate, and their still-developing lungs, brains, and other key organs are more vulnerable to damage.   Effects to prolonged exposure range from persistent infections and asthma to slowed lung and brain development.   The risks apply in utero, too, because gases and fine particles can enter a mother's bloodstream and placenta, causing miscarriage, birth defects and low birth weights, which can also affect a child for the rest of their lives.   Researchers are now investigating whether pollution, like exposure to tobacco smoke, has health effects that could even be passed down to the next generation.

- 'Terribly afraid' -
Buyan-Ulzii Badamkhand and her husband need to stay in capital for work, but they have decided to send their two-year-old son Temuulen more than 1,000 kilometres away.   The 35-year-old mother-of-three struggled with the decision, even moving from one ger district to another in the hope her son's health would improve.   But successive bouts of illness, including bronchitis that lasted a whole year, finally convinced her to send Temuulen to his grandparents.   Hours after he arrived, she called her mother-in-law to discuss her son's medicines.   "But my mother-in-law asked me 'does he still need medicine? He isn't coughing anymore," she said.   "I tell myself that it doesn't matter that I miss him and who raises him, as long as he is healthy, I am content."   Respiratory problems are the most obvious effect of air pollution, but research suggests dirty air can also put children at greater risk for diabetes and cardiovascular disease later in life.   And the WHO links it to leukaemia and behavioural disorders.   When air pollution peaks in winter, Ulaanbaatar's playgrounds empty and those who are able to are increasingly travelling abroad to wait out the smog.

In desperation, Luvsangombo Chinchuluun, a civil society activist, borrowed money to take her granddaughter to Thailand for all of January.   "We can't let her play outside (in Ulaanbaatar) because of the air pollution, so we decided to leave," she said.   The persistent smog has caused tensions in the city, with those living in wealthier areas blaming the ger residents for the pollution and even calling for the tent districts to be cleared.   But the ger residents say coal is all they can afford.   "People come to the capital because they need sustainable income," said Dorjdagva Adiyasuren, a 54-year-old mother of six.   "It's not their fault," she added.    In a bid to tackle the problem, the local government banned domestic migration in 2017, and a ban on burning coal comes into force from May.   But it is unclear whether the moves will be enough to make a difference.   For Naranchimeg, the problems are serious enough to make her consider whether she wants more children.    She explained: "Now, I am terribly afraid of to give birth again. It is risky to carry a child and what will happen to the child after it is born in this amount of pollution?"
Date: Tue 19 Feb 2019
Source: AFP [edited]

Mongolian authorities have temporarily closed all KFC restaurants in the country after more than 200 customers suffered food poisoning symptoms, and dozens were hospitalized.

The 1st cases emerged earlier this month [February 2019], with 16 people showing symptoms of food poisoning, including diarrhoea, vomiting and high fever after eating at the fried chicken franchise. Ulaanbaatar's Metropolitan Professional Inspection Department said 247 similar cases have been reported, and 42 people have been hospitalized.

The department decided to shut down the country's 11 KFC restaurants, all based in the capital, while it investigates what happened.

A preliminary investigation found that 35 employees at a restaurant were not thoroughly vetted to handle food, with most of them having blank medical examination reports, which is illegal. The restaurant also lacked internal hygiene management.

A bacterium known as _Klebsiella_ spp was detected in water at the restaurant. Traces of _E. coli_ were also found in a soda machine, and 4 people contracted _Shigella, -- which causes diarrhoea and fever -- after coming into contact with KFC staff.
=========================
[The aetiology is not directly stated, but if contacts of the cluster have been diagnosed with shigellosis, the primary illness may well be the same.

Ulaanbaatar, formerly anglicized as Ulan Bator (literally "Red Hero"), is the capital and largest city of Mongolia. The city is not part of any aimag (province) (<https://en.wikipedia.org/wiki/Ulaanbaatar>). - ProMED Mod.LL]

[HealthMap/ProMED map available at:
Ulan Bator, Ulaanbaatar, Mongolia:
Date: Tue, 19 Feb 2019 11:40:36 +0100

Ulaanbaatar, Feb 19, 2019 (AFP) - Mongolian authorities have temporarily closed all KFC restaurants in the country after more than 200 customers suffered food poisoning symptoms and dozens were hospitalised.   The first cases emerged earlier this month, with 16 people showing symptoms of food poisoning, including diarrhoea, vomiting and high fever after eating at the fried chicken franchise.   Ulaanbaatar's Metropolitan Professional Inspection Department said 247 similar cases have been reported and 42 people have been hospitalised.   The department decided to shut down the country's 11 KFC restaurants -- all based in the capital -- while it investigates what happened.

A preliminary investigation found that 35 employees at a restaurant were not thoroughly vetted to handle food, with most of them having blank medical examination reports, which is illegal. The restaurant also lacked internal hygiene management.   A strong bacteria known as Klebsiella spp was detected in water at the restaurant. Traces of E-coli were also found in a soda machine, and four people contracted the Shigella germ -- which causes diarrhoea and fever -- after coming into contact with KFC staff.
More ...

British Virgin Islands

British Virgin Islands US Consular Information Sheet
February 26, 2009
COUNTRY DESCRIPTION:
The British Virgin Islands (BVI) are a British overseas territory, part of the British West Indies, lying about 60 miles east of Puerto Rico.
here are about 50 islands in the BVI, many of them uninhabited.
Tortola is the main island; other islands include Virgin Gorda, Jost Van Dyke, and Anegada.
Tourist facilities are widely available. Read the Department of State Background Notes on the United Kingdom for additional information.
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.

As of June 1, 2009, sea travelers must have a valid U.S. passport or passport card.
While a U.S. passport is not mandatory for sea travel to the BVI, it is required to return to the U.S.
In addition to other documentary requirements, U.S. Citizens should also present onward or return tickets, and sufficient funds for their stay.
Upon initial entry, no more than 60 days will be granted.
At the end of 60 days, visitors must report to the Immigration Department's main office in Road Town for an extension.
Extensions of up to 90 days are issued at the discretion of the Immigration Officer subsequent to an interview.
Visitors entering the BVI by yacht during daylight hours are required to proceed directly to a port of entry and clear immigration controls.
Visitors arriving by yacht outside of business hours should register with Immigration at opening of business the following business day.
Failure to comply with these regulations can lead to heavy fines or imprisonment.

Visit the Embassy of the United Kingdom’s web site at http://www.britainusa.com 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’ website at http://travel.state.gov, where the current Travel Warnings and Public Announcements, including the Worldwide Caution Public Announcement, can be found.
Up-to-date information on safety and security can also be obtained by calling 1-888-407-4747 toll-free in the U.S. and Canada or, for callers outside the U.S. and Canada, a regular toll line at 1-202-501-4444.
These numbers are available from 8:00 a.m. to 8:00 p.m. Eastern Time, Monday through Friday (except U.S. federal holidays).

The Department of State urges American citizens to take responsibility for their own personal security while traveling overseas.
For general information about appropriate measures travelers can take to protect themselves in an overseas environment, see the Department of State’s pamphlet A Safe Trip Abroad.
CRIME:
Thefts, armed robberies, and other violent crimes do occur in the BVI.
Visitors should take common-sense precautions against petty crime.
Travelers should avoid carrying large amounts of cash and use hotel safety deposit facilities to safeguard valuables and travel documents.
Do not leave valuables unattended on the beach or in cars, and do not leave them in plain view in rental properties.
Always lock up boats when going ashore.

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

The local equivalent to the “911” emergency line in the BVI is: 999 or 911.
See our information on Victims of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION:
Medical care in the BVI consists of a small general hospital, Peebles Hospital (Telephone (284) 494-3497), with an emergency room staffed 24 hours a day by physicians, several clinics on Tortola, and one clinic in Virgin Gorda.
Both islands are served by ambulances staffed with paramedics.
There are no medical facilities on the other islands.
A volunteer organization, Virgin Islands Search and Rescue (VISAR), responds 24 hours a day to medical emergencies at sea or on outer islands.
VISAR transports casualties to the nearest point for transfer to ambulance.
To reach VISAR, dial SOS (767) or call on Marine Channel 16.

There is no hyperbaric chamber in the BVI.
Patients requiring treatment for decompression illness are transferred to St. John, U.S. Virgin Islands.
Most sensitive medical cases are transferred to San Juan, Puerto Rico.

Some HIV/AIDS entry restrictions exist for visitors to and foreign residents of the BVI.
Anyone who does not appear to be in good health may be required to undergo a medical exam, including HIV test, prior to being granted or denied entry.
Please verify this information with the Embassy of the United Kingdom at http://www.britainusa.com 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 website at http://wwwn.cdc.gov/travel/default.aspx.
For information about outbreaks of infectious diseases abroad consult the World Health Organization’s (WHO) web site at http://www.who.int/en.
Further health information for travelers is available at http://www.who.int/ith/en
MEDICAL INSURANCE:
The Department of State strongly urges Americans to consult with their medical insurance company prior to traveling abroad to confirm whether their policy applies overseas and whether it will cover emergency expenses such as a medical evacuation.
Please see our information on medical insurance overseas.

TRAFFIC SAFETY AND ROAD CONDITIONS:
While in a foreign country, U.S. citizens may encounter road conditions that differ significantly from those in the United States.
The information below concerning the British Virgin Islands is provided for general reference only, and may not be totally accurate in a particular location or circumstance.
Vehicles drive on the left (the British side) with most steering wheels on the left (the “American” side).
Road signs are limited and seatbelts are required by law.
Drivers often fail to yield the right-of-way to pedestrians, even at painted crosswalks.
Speeding and reckless driving are fairly common in the BVI.
Drivers can encounter nighttime drag racing on main thoroughfares and livestock on roads.
Roads in Tortola's interior can be steep and extremely slippery when wet.
Travelers planning to drive across the island should consider requesting four-wheel drive vehicles and should ensure that tires and brakes are in good operating condition on any rental vehicle.
Please refer to our Road Safety page for more information, as well as the BVI Tourist Board web site.
AVIATION SAFETY OVERSIGHT:
Civil aviation operations in the British Virgin Islands 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 the UK’s air carrier operations.
For more information, travelers may visit the FAA’s web site at http://www.faa.gov/safety/programs_initiatives/oversight/iasa
SPECIAL CIRCUMSTANCES:
The removal of any marine organism from BVI waters is illegal for non-BV Islanders without a recreational fishing permit.
Fishing without a permit, even for sport, may lead to heavy fines or imprisonment.
Contact the Ministry of Natural Resources and Labour at (284) 468-3701 ext. 2147 for information.
Please see our Customs Information sheet..

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 BVI laws, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in BVI are severe, and convicted offenders can expect long jail sentences and heavy fines.
Engaging in sexual conduct with children or using or disseminating child pornography in a foreign country is a crime, prosecutable in the United States.
Please see our information on Criminal Penalties.

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

REGISTRATION / EMBASSY LOCATION:
Americans living or traveling in the British Virgin Islands are encouraged to register with the the U.S. Embassy in Bridgetown, Barbados through the State Department’s travel registration website so that they can obtain updated information on travel and security within the BVI.
Americans without Internet access may register directly with the Embassy.
By registering, American citizens make it easier for the Embassy to contact them in case of emergency.
The U.S. Embassy is located in the Wildey Business Park in St. Michael, Barbados.
The Consular Section can be reached by telephone at 1-246-431-0225, by fax at 1-246-431-0179, contact them by e-mail.
* * * * * * *
This replaces the Country Specific Information for the British Virgin Islands dated April 2, 2008 to update sections on Entry/Exit Requirements, Crime, and Medical Facilities and Health Information.

Travel News Headlines WORLD NEWS

Date: Sat, 16 Sep 2017 22:00:48 +0200
By Cécile AZZARO

Pointe-à-Pitre, Sept 16, 2017 (AFP) - The French-Dutch island of St Martin, where white sands and turquoise waters once drew foreign visitors in droves, is now attracting a different kind of population: rats and mosquitoes.   Just over a week after Hurricane Irma devastated the island and neighbouring St Barthelemy, killing 15 people, pools of stagnant water and mounds of trash seem to be the new normal.   Add to that the absence of fresh running water, and the situation is ripe for a health epidemic.   "Yes, there are risks of outbreaks," said Annick Girardin, the French minister for overseas affairs, who spent a week on St Martin following the Category five storm.   "There is an existing problem on the issue of contaminated water, the issue of trash, basically the issue of hygiene."

In poorer neighbourhoods where many families were not able to evacuate, residents fear the spread of mosquitoes -- which can carry diseases ranging from Zika and dengue fever to Chikungunya.   "My son has a fever maybe due to a mosquito," said Natacha, a resident in the Sandy Ground neighbourhood near Marigot. "We will have to clean to prevent too many mosquitoes, or else there will be outbreaks. But it's difficult without water."   "If we get sick, we'll have to go to Guadeloupe".   According to an AFP journalist, in some neighbourhoods like Concordia, control programs had begun on Wednesday.

- Boiling water -
The island, which is still struggling to get its electricity and telecommunications systems back up and running, has found it difficult to reach residents and warn them about the potential health risks.   To get the word out, the French government has distributed notices and posters in French, Spanish, English and Creole.

Still, French health minister Agnes Buzyn said, "We realise there are people on the island, in certain neighbourhoods, who are not following health instructions".   One of the most important notices reminds people that only bottled water is safe to consume, and that if it is unavailable, boiling water before use is paramount.   "We hand out fresh water all over the territory, but it remains difficult," Buzyn said. "There are zones not easily accessed, people that maybe we haven't been able to reach."   According to the government, 150,000 bottles of water are being distributed to residents every day.   But some people have still been fetching water directly from a reservoir.

A desalination plant destined for St Martin arrived Friday on Pointe-a-Pitre, on the French island of Guadeloupe, about 300 kilometres (185 miles) away.   It will continue its journey to the hurricane-hit island by barge and is expected to be operational by September 25, the authorities said.   Meanwhile drinking water has returned to St Barts, which is now able to produce about 800 cubic metres (176,000 gallons) a day.   "We are not yet at a level of signalling an outbreak, far from it," Buzyn said. "Today, it's mostly an individual risk, which means it is essential that people who live on St Martin drink the bottled water that is distributed".   Buzyn had said last Wednesday that there had been some cases of children with diarrhoea, but did not mention any signs of an outbreak.

- Racing the clock -
Medical epidemiologists are aware of and on the lookout for any sign of outbreaks, and will regularly track patients using health surveys, said Guadeloupe's public health director Patrice Richard.   On Saturday, St Martin's health services coordinator Sergio Albarello said there had been no cases of outbreak on the island.   "As of now, there have been no reported cases" of outbreak, he told reporters, adding that as far as mosquitoes, "we are not talking about carriers of genes that are epidemiologically relevant".   And while many buildings were flattened by the storm, the St Martin hospital is still able to treat people "in excellent conditions", even though one of its buildings was partially destroyed.   Philippe Gustin, the French envoy in charge of the islands' reconstruction, said the immediate plan was to fix the damaged buildings.

According to Gustin, about 30 percent of the buildings on the French side of the island were completely destroyed, but he cautioned that teams were still putting together a final estimate of damages -- which has been put at one billion euros ($1.2 billion) or more for roads and buildings.   But repairing them before the high season, which usually starts in November and runs until April, seems nearly impossible.   Cleaning up also remains a priority for St Martin, particularly in areas where rats could proliferate.   Home to some 35,000 people, St Martin -- whose livelihood rests almost entirely on tourists -- attracts around two million visitors a year, most of them American cruise ship passengers.   While visiting St Barts this past week, French President Emmanuel Macron promised emergency financial aid for those "who have lost everything".   As for the Dutch side of the island, the Dutch Red Cross said Saturday that it had collected 13.3 millions euros following a weeklong donation drive.
Date: Tue, 12 Sep 2017 16:18:07 +0200

London, Sept 12, 2017 (AFP) - Over 100 high-risk prisoners escaped in the British Virgin Islands during Hurricane Irma, a British junior minister said on Tuesday, as he raised the death toll in British territories to nine.   "We had a serious threat of a complete breakdown of law and order in the British Virgin islands (BVI)," junior foreign minister Alan Duncan told parliament.   "The prison was breached, over 100 very serious prisoners escaped," he said.

Duncan said Royal Marines were deployed to cope with the threat but did not disclose how many prisoners had been recovered or how many were still at large.   "We have maintained and kept law and order on the BVI, which at one point, could have dramatically threatened the already unfortunate plight of those who had been hit by the hurricane," he said.   Contacted by AFP, the foreign ministry declined to comment.

The Daily Telegraph said notes from a cabinet meeting that were leaked to the press on Tuesday suggested as many as 60 had yet to be recaptured.   "We are working with St Lucia and BVI authorities to secure the transfer to St Lucia of 40 high-risk prisoners that have escaped in BVI," the briefing notes were reported as saying.   Duncan said a total of nine people died in British Caribbean territories -- five in the BVI and four in Anguilla. The authorities had previously reported one person killed in Anguilla.

Britain's response to Irma has been criticised by some local inhabitants as too slow with some complaining about a breakdown of law and order and being left to fend for themselves.   Briton Claudia Knight said her partner Leo Whitting, 38, was stranded on the island of Tortola in the British Virgin Islands archipelago.   "Everyone's turned feral and no-one's going out without being armed... It's turning really nasty," she told the Press Association news agency.   "Leo carries a knife with him," she said.   But Duncan said he "wholeheartedly and comprehensively reject the criticism".   "I think they are unjustified," he added.
Date: Mon 13 Jan 2014
Source: Government of the British Virgin Islands [edited]

The Ministry of Health and Social Development has confirmed 3 cases of chikungunya [virus infections], following reports of confirmed cases in St Martin and increased surveillance throughout the Virgin Islands. Dr Ronald Georges, medical officer of health in the Ministry of Health and Social Development said, "We have confirmed 3 cases on Jost Van Dyke."

Chikungunya is a viral disease transmitted to humans by the bite of infected mosquitoes.

"It is important to note that these confirmed cases were not exposed to travel, which alerts us that the virus is already in our mosquito population," Dr Georges stated.

According to Dr Georges, the ministry has been coordinating a response with the Environmental Health Division to minimise the impact of chikungunya [virus infections]. He is reminding the public to take appropriate measures to minimise exposure to mosquitoes. As such, the health division has stepped up its fogging programme and will be addressing "hotspot" areas known for mosquito breeding.

Dr Georges explained that chikungunya [virus infection] causes symptoms similar to dengue fever, which last 2-5 days. Symptoms include rash, arthritis-like pain affecting multiple joints, headaches, conjunctival infection, back pain, nausea, vomiting, polyarteritis, and a fever of 102 deg F [39 deg C] or higher. "Anyone experiencing one or more of these symptoms should contact their healthcare provider immediately," he said, adding, "Persons are urged to be vigilant in inspecting their premises for mosquito breeding sites."

He said that measures should also be taken to keep mosquitoes out of homes for example: removing catchment of still water, cover containers storing water, and more importantly necessary precautions should be taken to protect babies by placing a protective net over cribs. In addition the use of insect repellent on adults and children is also useful.

Clinicians and health care providers are asked to continue to report syndromic data to the Surveillance Unit in the Ministry of Health and Social Development, especially fever surveillance within 24 hours for continuous monitoring.

The Environmental Health Division will continue surveillance and control measures at ports of entry. However, residents are asked to remain vigilant in preventing mosquitoes from breeding around their homes and businesses.
------------------------------
communicated by:
Roland Hubner
Superior Health Council
Brussels
Belgium
==================
[Spread of chikungunya virus to other islands continues. In the absence of a commercially available vaccine, mosquito vector control and avoidance of mosquito bites are the only preventive measures that can be taken as noted in the report above. Fogging provides no long-term vector control. Breeding sites must be eliminated or treated with larvicides for effective control. That requires public cooperation and participation. Arrival of chikungunya virus in the dengue virus endemic areas of mainland Americas is probably more a matter of "when" than of "if".

Maps of the British Virgin Islands can be accessed at
Date: Wed, 15 Oct 2008 14:38:28 +0200 (METDST) MIAMI, Oct 15, 2008 (AFP) - Hurricane Omar moved toward the Virgin Islands Wednesday gaining power as warnings were issued across the Caribbean over the latest storm. With its center around 310 miles (495 kilometers) southwest of Puerto Rico's capital San Juan, the US National Hurricane Center said: "Additional strengthening is forecast in the next 24 to 36 hours." The hurricane -- with maximum sustained winds of near 120 kilometers (75 miles) per hour -- was moving slowly northeast toward San Juan. Hurricane warnings were issued for the US Virgin Islands, the British Virgin Islands, Saint Martin, Anguilla and Saint Kitts. "A hurricane warning could be required for Puerto Rico Wednesday morning," the NHC said. On the forecast track, the center of Omar was expected to move over or near the Leeward Islands -- just east of Puerto Rico -- by late Wednesday, the NHC said. Authorities also issued a hurricane warning for the French resort island of Saint Barthelemy, and tropical storm warnings for Antigua, Barbuda and Montserrat. Heavy rain was already falling across far northern Venezuela, where it could produce total rainfall of up to 15 centimeters (six inches), the NHC said. Up to 51 centimeters (20 inches) of rain "will be possible across Puerto Rico and the northern Leeward Islands," the NHC said. "These rains could produce life-threatening flash floods and mud slides," it warned. The busy 2008 hurricane season has included devastating Hurricanes Gustav and Ike, which caused millions of dollars in damage in Haiti, Cuba and the United States. Hurricanes and tropical storms have killed hundreds across the Caribbean and Mexico, with Haiti the worst hit.
Date: July 2008 Source: CAREC Surveillance Report - Communicable Diseases Vol. 28 No. 4 [edited] During epidemiological weeks 1-24, 2008, dengue virus type 2 was identified in the British Virgin Islands, Cayman Islands, Dominica, Grenada, St. Lucia and Trinidad & Tobago. Dengue virus type 4 was also identified in the British Virgin Islands, and virus type 1 was identified in Anguilla and Antigua & Barbuda. ------------------------ [This brief report does not indicate which of the islands had only imported dengue cases and which had local dengue virus transmission. As of mid-December 2007, the Cayman Islands only had imported dengue cases and had mounted an active surveillance and mosquito vector control campaign (see ProMED archive no. 20071218.4074). It would be interesting to know whether the 2008 cases were also all imported cases. An interactive ProMED HealthMap showing the location of the Cayman Islands can be accessed at: . - ProMed Mod.TY]
More ...

World Travel News Headlines

Date: Thu, 13 Feb 2020 13:58:41 +0100 (MET)
By Suy SE

Sihanoukville, Cambodia, Feb 13, 2020 (AFP) - A US cruise ship blocked from several Asian ports over concerns that a passenger could have been infected with the new coronavirus docked at a Cambodian pier Thursday, as frustrated holidaymakers expressed hope their ordeal may soon be over.   The Westerdam was supposed to be taking its 1,455 passengers on a dream 14-day cruise around east Asia, beginning in Hong Kong on February 1 and disembarking on Saturday in Yokohama, Japan.   But the ship was turned away from Japan, Guam, the Philippines, Taiwan and Thailand over fears of the novel coronavirus epidemic that has killed more than 1,300 people in China.

Cruise operator Holland America has insisted there are no cases of the SARS-like virus on board and Cambodia announced Wednesday that the boat would be able to dock in Sihanoukville, on its southern coast.   By evening, the ship moved into the beach town's port, moving past the small fishing vessels that usually ply the waters.   As it slowly approached the pier, people onshore snapped selfies of themselves with the massive vessel.   The mood was equally buoyant on the boat.   "Thank you Cambodia! You believed in us when no one would!" tweeted passenger Lydia Miller around 7 pm (1200 GMT). "We promise to spend lots of money in your country."

Fellow cruiser Christina Kerby -- who has been posting light-hearted updates from the Westerdam -- tweeted she was "feeling rebellious tonight so I'm wearing sneakers in the dining room".   But all passengers would have to remain onboard until flights have been arranged, said provincial governor Kuoch Chamroeun.    "The arrangement of the planes to take them from (Sihanoukville) airport to Phnom Penh airport is underway," he said, explaining that three flights were scheduled Friday morning.    Buses were lined up by the pier ready to transfer passengers to Sihanoukville's airport. Holland America has said they would foot the bill to return all guests.

- 'Disease of fear' -
Before the ship docked, doctors conducted health checks for the passengers.    The samples of 20 on board who were sick were sent to the Pasteur Institute in Phnom Penh to test for the virus, said transport minister Sun Chanthol.    Cambodian premier Hun Sen is a staunch Chinese ally and has been vocal in his support of Beijing's handling of the epidemic, even going so far as to visit China last week in a show of solidarity.   "The permission to dock is to stop the disease of fear that is happenin
around the world," he told state-affiliated media website Fresh News on Wednesday.    "We must help them when they asked us for help," he added.   Neighbouring Thailand, which blocked the Westerdam from docking in its eastern seaboard port, on Thursday received two cruise liners in holiday resort town Phuket. 

Both Seabourne Ovation and Quantum of the Seas were allowed to dock, and passengers to alight for roughly 10 hours as part of the scheduled stop.    "They were all checked by their doctors on the ship, and we also examined them when they disembarked," Phuket governor Pakapong Tawipat told AFP.    He added that the passengers and the crew members "were not Chinese", and that Phuket was part of their regular routes, unlike the Westerdam.    Japan's premier Shinzo Abe expressed worries last week over a possible infection on the Westerdam, and said measures will be taken to "reject entries" for foreigners into the country.    Cambodia, which has one confirmed case of the virus, is the recipient of billions of dollars in soft loans, infrastructure, and investment from China.
Date: Thu, 13 Feb 2020 11:14:36 +0100 (MET)

Jakarta, Feb 13, 2020 (AFP) - Indonesia's Mount Merapi, one of the world's most active volcanoes, erupted Thursday as fiery red molten lava streamed down from the crater and it belched clouds of grey ash 2,000 metres (6,500 feet) into the sky.   Authorities did not raise the rumbling volcano's alert status after the early-morning eruption, but they advised commercial planes to take caution in the area.   But any activity at Merapi raises concern and local residents were ordered to stay outside a three-kilometre no-go zone around the rumbling crater near Indonesia's cultural capital Yogyakarta.    Volcanic ash rained down on a 10-square kilometre area, according to the Volcanology and Geological Hazard Mitigation Centre.

Mount Merapi's last major eruption in 2010 killed more than 300 people and forced the evacuation of some 280,000 residents.   It was Merapi's most powerful eruption since 1930, which killed around 1,300 people, while another explosion in 1994 took about 60 lives.   The Southeast Asian archipelago has more than 17,000 islands and islets -- and nearly 130 active volcanoes.   It sits on the Pacific "Ring of Fire", a vast zone of geological instability where the collision of tectonic plates causes frequent quakes and major volcanic activity.
Date: Thu, 13 Feb 2020 08:13:16 +0100 (MET)

Sydney, Feb 13, 2020 (AFP) - Australia on Thursday announced a ban on travellers from China would extend for at least a week beyond Saturday's planned deadline, as the death toll from the coronavirus soared.    Prime Minister Scott Morrison said the government would maintain "entry restriction on foreign nationals who have recently been in mainland China" for further week "to protect Australians from the risk of coronavirus".   A decision to extend the ban further will be taken week-to-week, he said.   The decision is a blow to Australian tourism operators who have seen business from Chinese visitors dry up, as well as for tens of thousands of Chinese students hoping to return to Australia for the new academic year.

China's official death toll and infection numbers from a new coronavirus spiked dramatically on Thursday after authorities changed their counting methods, fuelling concern the epidemic is far worse than being reported.   The virus has now officially killed more than 1,350 people in China and the World Health Organisation has warned the disease has not yet peaked.   "I just want to assure all Australians, that we are doing everything we can to keep Australians safe at this time, and to ensure that we are mitigating everything that is possible to address any of the threats," Morrison said.
Date: Thu, 13 Feb 2020 06:46:12 +0100 (MET)

Sydney, Feb 13, 2020 (AFP) - Dams near Sydney overflowed Thursday after days of torrential rain, as Australia braced for more storms expected to bring dangerous flash flooding to the country's east.   Recent downpours have brought relief to areas ravaged by bushfires and drought -- as well as chaos and destruction to towns and cities along the eastern seaboard.   On Thursday, Nepean Dam south of Sydney was at full capacity and spilling over, with video footage showing excess water cascading over the dam wall and downstream.   Two other dams in New South Wales, Tallowa and Brogo, were also overflowing and more dams could reach capacity in the coming days, a WaterNSW spokesman told AFP.

Sydney's dams have seen water levels spike dramatically -- the Nepean was just a third full less than a week ago -- though many inland areas are facing severe water shortages missed out on the flows.   A devastating months-long bushfire crisis that killed 33 people has effectively been ended by the downpours, with just one blaze yet to be brought under control in New South Wales.   Hundreds of people have been rescued from floodwaters in recent days.   Police said a man's body was discovered in a flooded river on Queensland's Sunshine Coast on Thursday, though the cause of his death was not immediately clear.

Wild weather is set to ramp up again from Friday, with the Bureau of Meteorology forecasting ex-Tropical Cyclone Uesi would bring "damaging to destructive winds" and heavy rainfall to remote tourist destination Lord Howe Island.   Senior meteorologist Grace Legge said storms were also expected for Queensland and New South Wales -- with areas still recovering from bushfires likely to be hit again.   "Any showers and thunderstorms that do develop are falling on already saturated catchments, so there is a risk with severe thunderstorms of flash flooding," she said.   Emergency services have warned residents in affected areas to be cautious in the dangerous conditions.
Date: Thu, 13 Feb 2020 06:24:23 +0100 (MET)

Vinh Phuc, Vietnam, Feb 13, 2020 (AFP) - Vietnam announced Thursday that a commune of 10,000 people will be placed under quarantine due to fears over the spread of the new coronavirus.    "As of February 13, 2020, we will urgently implement the task of isolation and quarantine of the epidemic area in Son Loi commune," said a health ministry statement.    "The timeline... is for 20 days".    There are 15 confirmed cases of the COVID-19 virus in Vietnam, five of them in Son Loi commune.
Date: Wed, 12 Feb 2020 21:09:17 +0100 (MET)

Geneva, Feb 12, 2020 (AFP) - The UN health agency on Wednesday said it was extending its global emergency designation for the Ebola outbreak in the Democratic Republic of Congo but said the sharp decline in cases was "extremely positive".   The recent outbreak was first identified in August 2018 and has since killed more than 2,300 people in eastern DR Congo -- an area where several militia groups are operating.   "As long as there is a single case of Ebola in an area as insecure and unstable as eastern DRC, the potential remains for a much larger epidemic," WHO chief Tedros Adhanom Ghebreyesus told reporters in Geneva.

The WHO, however, said it was downgrading the national and regional risk of the disease from very high to high, while it kept the global risk at low.    Tedros also voiced hope that the emergency could be lifted within the next three months on the advice of the WHO's Emergency Committee of international experts.   The World Health Organization last July declared it a "public health emergency of international concern" -- a designation that gives the WHO greater powers to restrict travel and boost funding.   Tedros, who will be travelling to DRC on Thursday to meet President Felix Tshisekedi, on Tuesday said only three cases had been reported in the past week.

But for the epidemic to be declared over, there have to be no new cases reported for 42 days -- double the incubation period.   The health emergency designation last year came a few days after a patient was diagnosed with the virus in the provincial capital Goma -- the first case in a major urban hub.   More than a month before that, the WHO reported that the virus had spread to Uganda for the first time.   The Ebola virus is passed on by contact with the blood, body fluids, secretions or organs of an infected or recently deceased person.   The death rate is typically high, ranging up to 90 percent in some outbreaks, according to the WHO.

This is the second worst outbreak of the disease since 2014 when it killed about 11,000 people -- mostly in Guinea, Liberia and Sierra Leone.   Efforts to contain the current outbreak have been hindered by attacks on health workers and conflicts in the east.   The WHO said in November it had moved 49 staff out of the Beni region in eastern DRC because of the insecurity.   The Beni region, straddling the North Kivu and Ituri provinces, has been repeatedly attacked by the Allied Democratic Forces (ADF) rebel group, which activists say has massacred more than 300 people since October.
Date: Wed, 12 Feb 2020 11:48:53 +0100 (MET)

Tomohon, Indonesia, Feb 12, 2020 (AFP) - Bats, rats and snakes are still being sold at an Indonesian market known for its wildlife offerings, despite a government request to take them off the menu over fears of a link to the deadly coronavirus.   Vendors at the Tomohon Extreme Meat market on Sulawesi island say business is booming and curious tourists keep arriving to check out exotic fare that enrages animal rights activists.   But scientists are debating how the new virus, which has killed more than 1,100 people in China and spread to dozens of countries around the world, was transmitted to humans.

A wildlife market in Wuhan, the epicentre of the virus, is thought to be ground zero and there is suspicion it could have originated in bats.    The possible link wasn't on many radar screens at the Indonesian market, however.   Its grubby stalls feature a dizzying array of animals including giant snakes, rats impaled on sticks and charred dogs with their hair seared off by blowtorches -- a gory scene described by some critics as "like walking through hell".

Bat seller Stenly Timbuleng says he's still moving his fare for as much as 60,000 rupiah ($4.40) a kilogram to buyers in the area, where bats are a speciality in local cuisine.   "I'm selling between 40 and 60 kilograms every day," the 45-year-old told AFP.   "The virus hasn't affected sales. My customers still keep coming."   Restaurateur Lince Rengkuan -- who serves bats including their heads and wings stewed in coconut milk and spices -- says the secret is preparation.   "If you don't cook the bat well then of course it can be dangerous," she said.   "We cook it thoroughly and so far the number of customers hasn't gone down at all."

This despite a request from the local government and the health agency to take bats and other wildlife out of circulation -- a call that has been all but ignored.   "We're also urging people not to consume meat from animals suspected to be carriers of a fatal disease," said Ruddy Lengkong, head of the area's government trade and industry agency.   Indonesia has not yet reported a confirmed case of the virus.   In the capital Jakarta, vendors selling skinned snakes and cobra blood on a recent Saturday night didn't have any trouble finding takers.   "It's good for you, sir," said one vendor of his slithering fare.   "Cures and prevents all diseases."
Date: Mon, 10 Feb 2020 17:59:57 +0100 (MET)

Malé, Maldives, Feb 10, 2020 (AFP) - The Maldives' speaker of parliament on Monday apologised to a British tourist after footage of her arrest by several policemen triggered a social media storm.   Tourism is a major earner for the Maldives, a tropical island paradise in the Indian Ocean popular with honeymooners and celebrities.   Police said the bikini-clad woman, who was walking on a main road, was "inappropriately" dressed and allegedly unruly and drunk when she was detained after refusing to comply with requests to cover up on Thursday.   The Maldives previously confined tourists to resort islets separate from the local Muslim population, but in recent years has allowed foreigners to stay on inhabited islands.

Tourists can wear swimwear such as bikinis in the resorts but are subject to local dress codes elsewhere.   Videos shared on social media showed three men trying to detain the traveller, while a fourth person tried to cover her with a towel.   The woman was heard shouting "you're sexually assaulting me" during the incident.   The speaker, Mohamed Nasheed, told parliament he was extending an apology to the woman over the incident, which saw her detained by police for two hours before they released her.

The tourist has since left the nation of 340,000 Sunni Muslims, but Nasheed said he hoped tourism authorities would invite her to return to the luxury vacation spot.   Maldives Police Service Commissioner Mohamed Hameed said on Twitter after the footage was shared online that the incident "seems to be badly handled".   "I apologise to the tourist & the public for this. The challenge I have taken up is to professionalise the police service & we are working on that. This matter is being investigated."   A police statement on Friday called on tourists to respect "cultural sensitivities and local regulations".

The video of the incident also sparked anger among Maldivians. Some took to social media to criticise the tourist's behaviour after other videos showed her grabbing the sunglasses of a police officer.   Former foreign minister Dunya Maumoon criticised both the tourist and the police.   "She should have respected the religious and cultural norms of the country in terms of modest attire in a residential area," Maumoon said on Twitter.   "Condemn the man-handling by the Maldivian police. It could have been handled better and more professionally."
Date: Fri 7 Feb 2020
Source: Food Safety News [edited]

Almost 250 new infections have been recorded in a multi-country outbreak of salmonellosis linked to eggs from Poland. The European Centre for Disease Prevention and Control (ECDC) and European Food Safety Authority (EFSA) reported that as of January 2020, 18 countries have reported 656 confirmed and 202 probable cases since February 2017. There are 385 historically confirmed and 413 historical probable cases going as far back as 2012, making it the largest European _Salmonella_ Enteritidis outbreak ever recorded. However, ECDC officials said the true extent of the outbreak was likely underestimated. Since the last update in November 2018, 248 new cases have been reported, of which 124 were confirmed, 36 probable, 42 historical-confirmed and 46 historical-probable infections.

Belgium, Croatia, Czech Republic, Denmark, Finland, France, Greece, Hungary, Ireland, Italy, Luxembourg, Netherlands, Norway, Poland, Romania, Slovenia, Sweden and the UK have recorded 1656 infections since 2012. The UK has the most with 688 confirmed and probable cases, Netherlands has 280, Belgium has 202 and Czech Republic has 111. Information on hospitalization is available for 427 patients in 12 countries, and 136 needed hospital treatment among the confirmed and historical-confirmed cases. Two historical-confirmed deaths, a child and an elderly patient, were also reported.

In each year from 2016 to 2018, outbreak cases peaked in September, with large waves reported between late spring and early autumn. Such a large seasonal increase was not seen in 2019. Epidemiological, microbiological and food tracing investigations have linked cases before 2018 to eggs from laying hen farms of a Polish consortium. Despite control measures in 2016 and 2017, farms of the Polish consortium were positive in 2018 and 2019 with outbreak strains, suggesting persistent contamination, according to officials. Investigations on the laying hen production and feed supply chains did not find the possible origin of contamination.

One of the outbreak strains was found from 2017 to 2019 in primary production in Germany. This outbreak strain represents two-thirds of confirmed cases.

In September 2018, a cluster of 9 confirmed cases was associated with the consumption of an RTE raw liquid egg-white drink distributed by Dr. Zak's. _Salmonella_-positive samples of RTE liquid egg whites from 2 batches matched those from this outbreak cluster. Both batches were produced by a French company. One was produced with raw materials such as pasteurized white egg from a Spanish company. The other used raw materials from 13 German laying hen farms and 11 Dutch laying hen farms. An investigation of this outbreak showed positive batches were produced with eggs from Spain, the Netherlands and Germany, who all supplied _Salmonella_-free eggs to the French company.

On the same day as production of one of the contaminated batches, a different batch of liquid eggs was produced at the French company with eggs supplied by a Polish packing center from a Polish laying farm belonging to the Polish consortium. However, the possibility of cross-contamination was ruled out due to the different production line used with different equipment (tanks, filling machine) and because of heat treatment on packaged products.

Investigations in the UK identified 14 cases potentially part of the outbreak travelling to Cyprus and staying in the same place between end of May and end of June 2018. This site received eggs from a Polish laying farm through the Polish packing center and a Dutch wholesaler.

Measures taken in 2016 and 2017, including depopulation of positive flocks, were not enough to eliminate contamination in the Polish consortium. So, the laying hen farms of this group were still positive for outbreak strains in 2018 and 2019. Between August 2018 and December 2019, 7 of 13 sampled Polish laying hen farms belonging to the Polish consortium tested positive for _Salmonella_ Enteritidis. >From November 2019 to January 2020, all flocks belonging to the Polish group were tested in accordance with Regulation 2160/2003, but _Salmonella_ was not detected.

Polish authorities reported that all _Salmonella_ Enteritidis positive flocks belonging to the Polish consortium were depopulated, including flocks found positive in May 2019. From 2015 to 2019, 16 laying hen farms, 13 of which belonged to the Polish consortium, were positive for at least one of the 4 SNP addresses causing human infections. Four rearing farms belonging to the Polish company were positive for _Salmonella_ Enteritidis between January 2017 and July 2019.

ECDC officials said the outbreak was still ongoing, and more infections were expected. "Since no evidence has been provided that the source of contamination has been eliminated, it is expected that further infections will occur and that new cases will be reported in the coming months. Additional investigations are necessary to identify the source of contamination."  [Byline: Joe Whitworth]
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[Salmonellosis is often thought to be associated with cracked eggs or eggs dirty with fecal 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 be used only as an ingredient, if pasteurized.

The continuing outbreak was summarized in this 2019 report: Pijnacker R, Dallman TJ, Tijsma ASL, et al. An international outbreak of _Salmonella enterica_ serotype Enteritidis linked to eggs from Poland: a microbiological and epidemiological study. Lancet Infect Dis. 2019;19(7):778-786.

Abstract
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Background: _Salmonella_ spp. are a major cause of food-borne outbreaks in Europe. We investigated a large multi-country outbreak of _Salmonella enterica_ serotype Enteritidis in the EU and European Economic Area (EEA).

Methods: A confirmed case was defined as a laboratory-confirmed infection with the outbreak strains of _S._ Enteritidis based on whole-genome sequencing (WGS), occurring between 1 May 2015 and 31 Oct 2018. A probable case was defined as laboratory-confirmed infection with _S._ Enteritidis with the multiple-locus variable-number tandem repeat analysis outbreak profile. Multi-country epidemiological, trace-back, trace-forward, and environmental investigations were done. We did a case-control study including confirmed and probable cases and controls randomly sampled from the population registry (frequency matched by age, sex, and postal code). Odds ratios (ORs) for exposure rates between cases and controls were calculated with unmatched univariable and multivariable logistic regression.

Findings: A total of 18 EU and EEA countries reported 838 confirmed and 371 probable cases; 509 (42%) cases were reported in 2016, after which the number of cases steadily increased. The case-control study results showed that cases more often ate in food establishments than did controls (OR, 3.4 [95% CI, 1.6-7.3]), but no specific food item was identified. Recipe-based food trace-back investigations among cases who ate in food establishments identified eggs from Poland as the vehicle of infection in October 2016. Phylogenetic analysis identified 2 strains of _S._ Enteritidis in human cases that were subsequently identified in _Salmonella_-positive eggs and primary production premises in Poland, confirming the source of the outbreak. After control measures were implemented, the number of cases decreased but increased again in March 2017, and the increase continued into 2018.

Interpretation: This outbreak highlights the public health value of multi-country sharing of epidemiological, trace-back, and microbiological data. The re-emergence of cases suggests that outbreak strains have continued to enter the food chain, although changes in strain population dynamics and fewer cases indicate that control measures had some effect. Routine use of WGS in _Salmonella_ surveillance and outbreak response promises to identify and stop outbreaks in the future. - ProMED Mod.LL]

[HealthMap/ProMED-mail map:
Date: Sun 9 Feb 2020
Source: San Francisco (CA) Chronicle [subscription required, edited]

Several cases of hepatitis A were confirmed in customers who ate in the same California restaurant, health officials said. The Long Beach Department of Health and Human Services announced [Fri 31 Jan 2020], that the patients ate at 555 East American Steakhouse on or around [24 Dec 2019], KABC-TV reports.

The department did not disclose how many cases were diagnosed. The source of the illness is still under investigation, officials said.

Hepatitis A can be transmitted through consumption of contaminated food or water. Symptoms can include fatigue, low appetite, stomach pain, dark urine, nausea, and jaundice. Most patients eventually recover completely, but some may require hospitalization or develop severe illness, health officials said.

The restaurant's management and staff are cooperating with health officials and there is no continuing risk to the public, officials said.

"We are notifying the public of the exposure so that people can immediately seek medical care if they begin to develop symptoms," Long Beach health officer Dr. Anissa Davis said in a statement. "Individuals who have been vaccinated for hepatitis A or have had the disease are protected," Davis said. "Those who are not immune to hepatitis A should consult their medical provider if they develop symptoms, and let their provider know they may have been exposed to hepatitis A."
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[This cluster (the number of cases is not stated) may be related to an HAV-contaminated food (such as shellfish) or an infected food service worker. If the former were the case, one might expect to see cases related to other restaurants. It would be interesting to know if the HAV strain is that from the still on-going multistate outbreak. This outbreak has been controlled in California and involved primarily homeless and substance abusing individuals and is related to poor sanitation rather than food/water vehicles. - ProMED Mod.LL]

[HealthMap/ProMED map available at:
California, United States: <http://healthmap.org/promed/p/204>]