WORLD NEWS

Getting countries ...
Select countries and read reports below or

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 ...

Tunisia

General Information
************************************
Tunisia is situated in Northern Africa and is a common tourist destination for Irish travellers. It is bordered by Algeria to the west and southwest, Libya to the south east and the Medite
ranean Sea to the east and north. It has a Mediterranean climate with mild rainy winters and hot dry summers. Costal temperatures are less extreme than the inland regions ranging from an average daily low in January of 70C to an average daily high in August of 320C. Rainfall throughout the country varies considerably from about 40" in the northwest down to only 4" in the southwest.
Safety & Security
************************************
Most tourists will not have any significant difficulties in this regard but criminals have targeted tourists and business travellers for thefts, pickpocketing, and scams.
Care should be taken with wallets and other valuables kept in handbags or backpacks that can be easily opened from behind in crowded streets or marketplaces.
Harassment of unaccompanied females occurs rarely in hotels, but more frequently elsewhere.
Health Facilities
************************************
The level of health care facilities in Tunisia will usually be found to be below that normally accepted at home in Ireland. In general the larger hotels will have English speaking doctors in attendance. Unfortunately the hospital/clinic backup for these practitioners is usually very limited.
Food & Water Facilities
************************************
The World Health Organisation statistics suggest that close to 35% of all travellers to these regions will develop significant diarrhoea during their stay. In almost all cases this can be traced back to unwise eating and drinking habits by tourists not taking sufficient care. Most significantly, travellers should stay away from cold foods (especially lettuce) and also all undercooked shell fish (mainly prawns, oysters, mussels and shrimps).
Hotel tap water will frequently not be potable and should not be used for drinking or brushing teeth. Sealed mineral water should be used at all times.
Fruit juice drinks sold by street traders should always be avoided as frequently the drink will have been supplemented with straight tap water.
Malaria in Tunisia
************************************
It is fortunate that this disease is not endemic in Tunisia and so travellers do not require to take prophylactic tablets. Nevertheless there are plenty of mosquitoes and sandflys during the hotter summer months and travellers will need to use insect repellents to protect against these uncomfortable bites. (see Protection against Insect Bites - Tropical Medical Bureau )
Jiggers & Chiggers
************************************
These are uncomfortable parasitic diseases which usually occur on the feet and often present looking like an ingrown toenail. Travellers returning home with unexplained skin rashes should always attend for medical assessment.
Rabies
************************************
This viral disease occurs throughout Africa and is evident in Tunisia. The disease can be transmitted by the bite (or lick or scratch) of any infected warm-blooded animal. Dogs will be the main risk animal but cats and monkeys can also transmit the disease. Any contact must be treated seriously and washed out immediately. An antiseptic should then be applied and further medical attention must always be sought.
Leishmaniasis
************************************
This is a parasitic disease transmitted by the bite of an infected sandfly. The disease occurs in Tunisia mainly during the summer and autumn months. Sandflys are much smaller than mosquitoes and are mainly found hovering around your ankles usually first thing in the morning or during the cooler evening hours. In most cases the bites cause little harm but occasionally deep infection can occur with more serious consequences. Again, travellers should wear sensible clothing and use adequate insect repellent. A bite which is slow to heal needs to be medically checked.
Sunbathing
************************************
One of the common health complaints associated with Tunisia relates to travellers becoming sun burnt while there on holidays. This is particularly the case with smaller children and toddlers. It is essential that travellers use high factor protection creams to lessen the risk of burning and to remember that skin cancer is commonly associated with burnt skin.
Anthrax from Leather Goods
************************************
This bacterial disease has been reported in Tunisia and travellers need to be aware that the disease can be transmitted through unprepared leather goods usually bought in the local market places. Even though this will be rare, any unusual sore should be medically checked after you return home.
Vaccinations for Tunisia
************************************
There are no essential vaccinations for Tunisia but travellers from Ireland are strongly recommended to have vaccination cover against
*
Poliomyelitis (childhood booster)
*
Typhoid (food & water borne disease)
*
Tetanus (childhood booster)
*
Hepatitis A (food & water borne disease)
Those spending longer periods in the country, or trekking, may need to consider vaccination cover
against
Rabies
and
Hepatitis B.
Summary
************************************
Be careful of the intense sun during the summer months. Care with food and water consumption will also be essential at all times.
Further Information
************************************
If you require any further information on staying healthy while overseas please contact either of the help lines at the numbers below.

Travel News Headlines WORLD NEWS

Date: Thu, 27 Jun 2019 14:23:48 +0200

Tunis, June 27, 2019 (AFP) - Two suicide bombers attacked security forces in the Tunisian capital on Thursday, killing a police officer and wounding at least eight people including several civilians, the interior ministry said.   One attack on the main street of Tunis wounded three civilians and two police personnel, the interior ministry initially said.   "Five (are) wounded -- three civilians and two police officers", Interior Ministry spokesman Sofiene Zaag told AFP, before later saying that a police officer had died of his wounds.

Body parts were strewn in the road around a police car on Habib Bourguiba avenue near the old city, according to an AFP correspondent.   "It was a suicide attack, which took place at 10:50 (0950 GMT)," Zaag said.   The second attack targeted a base of the national guard in the capital and wounded four security personnel, the ministry said.   "At 11:00 am (1000 GMT) an individual blew himself up outside the back door" of the base, wounding four security personnel, Zaag said.   Civil protection units and police rapidly deployed to Habib Bourguiba avenue, where the interior ministry is located.    People initially fled in panic, before some crowded around the scene of the attack, expressing anger against the authorities. Shops and offices were closed by police.

Tunisia, the cradle of the Arab Spring uprisings, has been hit by repeated Islamist attacks since the 2011 overthrow of longtime dictator Zine El Abidine Ben Ali.   On October 29, 2018 an unemployed graduate blew herself up near police cars on Habib Bourguiba, killing herself and wounding 26 people, mostly police officers, according to the interior ministry.   The Tunisian authorities said the suicide bomber had sworn allegiance to IS.

The attack was the first to rock the Tunisian capital for over three and a half years.   In March 2015, jihadist gunmen killed 21 tourists and a policeman at the National Bardo Museum in Tunis.   And in June that year, 30 Britons were among 38 foreign holidaymakers killed in a gun and grenade attack on a beach resort near the Tunisian city of Sousse.
Date: Thu, 9 May 2019 17:43:55 +0200
By Caroline Nelly Perrot

Tunis, May 9, 2019 (AFP) - As holidaymakers flock to Tunisia once more following a series of attacks, the country's tourism minister has his sights set on diversifying the industry and taking visitors beyond the beach.   "Practically all the big tour operators here have returned," said Rene Trabelsi, six months into his ministerial post.   He credits "huge efforts" for making the country safe for visitors again, after attacks in 2015 targeting tourists.   Gunmen killed 21 foreign visitors and a Tunisian security guard at the capital's Bardo National Museum, followed by a shooting rampage at a Sousse beach resort which left 38 people dead -- mostly British tourists.

Britain, France and other countries have recently eased their travel warnings, deeming most of Tunisia now safe.   Two million holidaymakers have visited Tunisia so far this year, according to government figures touted by the tourism minister.   That marks a 24 percent jump on the same period last year, and a 7 percent increase compared to the 2010 industry reference point.   But despite tourists returning, revenue has so far failed to reach that of nearly a decade ago.

The indebted industry is heavily reliant upon cheap "all-inclusive" holidays and the government is trying to diversify the tourism sector, which accounts for around 7 percent of GDP.   "During the high season, Tunisia will be packed, but we're interested in the low season, from September to March," said Trabelsi, sitting behind his large desk in the capital Tunis.   The minister wants to attract tourists over the winter months who are also interested in activities away from the beach.   "We're negotiating with the tour operators" to offer charter flights after the summer, said Trabelsi who hopes visitors will sign up for golf, spa treatments and cultural activities.   "This year already, a lot of hotels which closed during winter after the crisis, want to stay open," he said.   An electronic music festival in southern Tunisia is due to take place in September, while a jazz festival is planned in Tabarka near the Algerian border.

- No 'right to fail' -
Whereas half the holidaymakers in 2010 were European, they now make up less than a third of visitors amid an increasing number of tourists from other North African countries and further afield.   The government aims to welcome nine million visitors this year, but Trabelsi said Tunisians still need to tackle "environmental terrorism" to avoid scaring tourists away.   "I'm using that word to shock and alert," said the minister, warning that poor environmental standards can put tourists off "like when there's an attack".

Following Tunisia's 2011 revolution, authorities failed to keep atop of waste management. Municipal councils were elected for the first time a year ago but the clean-up is far from complete.   "We also have a cultural problem," said Trabelsi. "If each person swept outside their front door, that would already be huge."   Trabelsi has for years been co-organiser of an annual Jewish pilgrimage to Djerba, where his father is president of the island's synagogue, and in the 1990s he set up his own travel agency.   But months into his first political post, he said he has no intention of staying in government long-term.   "I want to make a mark, and Tunisians expect a lot from me. I come from the private sector, I have a different religion, so I don't have the right to fail," Trabelsi said.   "But once my mission is accomplished, I'll return to my own affairs."
Date: Sun 16 Feb 2019
Source: Realites Online [in French, trans. ProMED Corr.SB, edited]
<https://www.realites.com.tn/2019/02/tunisie-1318-cas-de-leishmaniose-enregistres-a-gafsa>

As of Sat 15 Feb 209, the Metlaoui Regional Hospital in Gafsa governorate has hosted 1318 patients with leishmaniasis, following the proliferation of mosquitoes [actually leishmania is transmitted by sandflies] near the lakes and wastewater. According to Shems Fm, citing its correspondent in the region, the number of leishmaniasis cases has tripled compared to the year 2017.
============================
[We presume these cases are cutaneous leishmaniasis. Cutaneous leishmaniasis, CL, caused by _Leishmania major_ is a major public health problem in Tunisia. It occurs mainly in central and southwestern Tunisia (semi-arid and arid areas), with thousands of cases. There are foci with a permanent active transmission, so, from time to time, outbreaks occur, related to new agricultural projects or large population movements (introduction to a non-immune population).  In some villages, up to 60 percent of the population is infected.

For a detailed discussion of _Leishmania_ in Tunisia please see Alvar J, Valez ID, Bern C, et al. Leishmaniasis worldwide and global estimates of its incidence.
PLoS One. 2012; 7(5): e35671; <https://doi.org/10.1371/journal.pone.0035671> - ProMED Mod.EP]

[HealthMap/ProMED-mail map of Gafsa, Tunisia:
<http://healthmap.org/promed/p/8782>]
Date: Thu, 17 Jan 2019 17:26:14 +0100
By Aymen Jamli

Tunis, Jan 17, 2019 (AFP) - A public sector strike brought Tunisia to a standstill Thursday as workers heeded calls from a powerful trade union to stay home over demands for wage hikes and economic reforms.   Across the country, schools were closed, public offices shuttered and transport paralysed after calls for a 24-hour strike by the Tunisian General Labour Union (UGTT).   The international airport in Tunis was hit hard, with thousands of travellers stranded without flights or information.   The UGTT had addressed its call to the country's 677,000 civil servants and 350,000 employees of state-owned companies, who make up nearly a quarter of the Tunisian workforce. 

Protesters took to the streets of the capital chanting "the Tunisian people do not accept humiliation", criticising Prime Minister Youssef Chahed's for bowing to reforms dictated by the International Monetary Fund (IMF).    Some held portraits of IMF chief Christine Lagarde, with a bright red X painted over her face.    Tunisia is seen as having had a relatively smooth democratic transition since the January 14, 2011 toppling of president Zine El Abidine Ben Ali after 23 years in power.

But price hikes fuelled by the fall of the Tunisian dinar, combined with tax increases and stubborn unemployment, have spurred social discontent.   In 2016, the IMF granted Tunisia a 2.4-billion-euro loan over the span of four years in exchange for a promise to carry out economic reforms and to control civil service salaries to avoid pushing up the public deficit.   "The UGTT will oppose the failure of the liberal choices of these leaders," UGTT head Noureddine Taboubi told the crowd, speaking from a balcony at the union's headquarters.   In Sfax, the second largest city in the country, thousands of demonstrators took to the streets.    The union has called for wage hikes for public sector employees to counter the decline in purchasing power due to inflation, which stands at 7.5 percent.

In a televised speech Wednesday, Prime Minister Chahed said public finances meant he could not accept the union's demands, adding that dialogue would continue after the strike.   "It is the wage increases conceded after the revolution in the absence of real growth that have led to inflation, debt and declining purchasing power," he argued.    Economist Ezzedine Saidane blamed Tunisia's economic problems on a long-term "lack of overall vision".    He told AFP structural reforms rather than a wage hike were needed "to limit inflation and boost job-creating growth".   Thursday's strike was the first to bring together employees from both the public sector and state-owned companies.    In November, Tunisian civil servants staged the biggest general strike in years.
Date: Mon, 14 Jan 2019 18:49:43 +0100

Tunis, Jan 14, 2019 (AFP) - Tunisia's powerful UGTT trade union on Monday called for a strike as the country, grappling with economic hardships, marked the eighth anniversary of the 2011 revolution that toppled its longtime dictator.   The Tunisian General Labour Union, the UGTT, called on public sector employees to observe the strike on Thursday -- the second since November -- to demand a wage rise and economic reforms.   In a speech at the union's headquarters, secretary general Noureddine Taboubi said the strike should go ahead as talks between the UGTT and the government on social and economic reforms remained deadlocked.

Civil servants represent a sixth of Tunisia's workforce and in November the UGTT said it was demanding 673,000 state employees receive salary hikes equal to those granted in 2018 to public companies, which range from 15 to 30 euros ($17-34) a month.   But President Beji Caid Essebsi has urged a boycott of the strike.   "It is necessary to stop or limit" strikes, he said, during a visit at the Bardo National Museum where an exhibit was on display to pay tribute to Tunisian revolution which sparked the 2011 Arab Spring uprisings.   Essebsi added, however, that "we must take into consideration the deteriorating purchasing power of citizens".

The North African country is seen as having had a relatively smooth democratic transition since the January 14, 2011 toppling of president Zine El Abidine Ben Ali after 23 years in power.   At the same time, price hikes fuelled in particular by the fall of the Tunisian dinar, combined with tax increases and stubborn unemployment, have spurred social discontent that escalated into riots across several cities in January last year.

In 2016, the International Monetary Fund granted Tunisia a 2.4-billion-euro loan over the span of four years in exchange for a promise to carry out economic reforms.   The country is grappling with an inflation rate of 7.5 percent and unemployment stands at more than 15 percent, with those worst hit being young university graduates.

Many Tunisians hope there will be change in 2019 when presidential and legislative elections are due to take place.   Meanwhile on Monday, hundreds of Tunisians, including politicians, took to the streets of the capital to celebrate the ousting eight years ago of strongman Ben Ali, gathering in the landmark Habib Bourguiba Avenue in central Tunis.
More ...

Qatar

Qatar - US Consular Information Sheet
February 26, 2008
COUNTRY DESCRIPTION:
Qatar is a monarchy governed by the ruling Al Thani family in consultation with a council of ministers, an appointed advisory council and an elected municipal cou
cil.
Islamic ideals and beliefs provide the foundation of the country’s customs, laws and practices.
Located in the heart of the Persian Gulf, Qatar is a dynamic, modernizing, rapidly developing country that is among the wealthiest per capita in the world.
The capital is Doha.
Tourist facilities are available.
Read the Department of State Background Notes on Qatar for additional information.
ENTRY/EXIT REQUIREMENTS:
Passports and visas are required.
U.S. citizens may obtain a single-entry tourist or business visa at Doha International Airport upon arrival.
Single entry visas cost $28 and must be paid by credit card only.
Cash is not accepted.
Visas are valid for 30 days and may be extended for an additional 30 days for a $28 fee through the Airport Visas Section of the Immigration Department located next to Doha International Airport.
However, U.S.-citizen travelers will be able to clear Qatari immigration more quickly and be granted a longer stay in country by obtaining visas prior to arrival.
If planning to arrive at another port of entry in Qatar, travelers should obtain a tourist or business visa in advance of their arrival from a Qatari embassy or consulate abroad.
Travelers should also note that the Qatari Government charges $55 for each day that an individual overstays a visa, up to a maximum amount of $3,300.

For further information on visas, residence permits and entry requirements, please visit the Qatari Ministry of Interior’s web site at www.moi.gov.qa/English/index.htm.
Travelers may also contact the Embassy of the State of Qatar (www.qatarembassy.net) at 2555 M Street NW, Washington, DC
20037, tel. (202) 274-1600, fax (202) 237-0061.
They may also contact the Consulate General of the State of Qatar, 1990 Post Oak Blvd. Suite 810, Houston TX 77056, telephone (713) 355-8221, fax (713) 355-8184, send email inquiries to info@qatarembassy.org.

Military personnel are subject to different entry/exit requirements and should refer to www.fcg.pentagon.mil for specific information pertaining to their travel requirements.
NOTE FOR DUAL NATIONALS:
Qatari law requires that Qatari citizens only hold Qatari citizenship and enter and exit on a Qatari passport.
Qatari authorities have confiscated the passports of U.S. citizens who acquired Qatari citizenship through marriage to a Qatari national or by virtue of birth in the U.S.
In several cases, Qatari authorities informed U.S. citizens that their U.S. citizenship had been revoked and was no longer valid.
However, foreign governments have no authority to revoke the citizenship of a U.S. citizen.
If this occurs, please contact the U.S. Embassy in Doha immediately.
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:
Incidents of violence are rare in Qatar, although attacks against Western targets have occurred.
To provide for public security, a large police presence is deployed throughout the country.
American citizens in Qatar are strongly encouraged to maintain a high level of vigilance, be aware of local events and take the appropriate steps to bolster their personal security at all times.

The Department of State remains concerned about the possibility of terrorist attacks against U.S. interests worldwide, including the Middle East.
Both historical and recurring information suggests that al-Qa’ida and affiliated organizations continue to plan strikes against Western targets; these attacks may employ a wide variety of tactics to include assassination, kidnapping, hijacking and bombing.
On March 19, 2005, a suicide bomber detonated a vehicle-borne improvised explosive device (VBIED) at a theater in Doha regularly frequented by westerners; a citizen of the United Kingdom was killed, and several other individuals were injured.

Increased security at official facilities has led terrorists and their sympathizers to seek softer, less fortified targets; the March 2005 theater attack in Doha is one such example.
Other locations of potential concern include any venue where U.S. citizens and other foreigners are known to congregate in large numbers such as public assemblies, sporting events, restaurants, residential areas, clubs, places of worship, schools, hotels, etc.
The Government of Qatar occasionally provides security for such locations and events, but to varying degrees.
In most instances, the Embassy cannot gauge the appropriateness of security for a given event prior to its commencement.
The Embassy strongly encourages American citizens to avoid large crowds and demonstrations whenever possible.
For the latest security information, Americans traveling abroad should regularly monitor the Department’s Internet web site, where the current Worldwide Caution, Travel Warnings and other Travel Alerts and additional resources 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:
The crime rate in Qatar is generally low.
A large police presence is apparent to travelers throughout the country.
Incidents of violence are rare but have occurred more frequently as Doha’s population and economic pressures on expatriate workers have increased substantially during the past few years.
Local and third country national young men have been known to verbally and physically harass unaccompanied, expatriate women.
Reports of petty theft have been growing, including ATM and credit card theft, purse snatching and pickpocketing.
Travelers are cautioned not to leave valuables such as cash, jewelry, and electronic items unsecured in hotel rooms or unattended in public places.

The Qatari Police can be contacted for emergency assistance by dialing 999 from any telephone in Qatar.
INFORMATION FOR VICTIMS OF CRIME:
The loss or theft abroad of a U.S. passport should be reported immediately to the local police and the U.S. Embassy in Doha.
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 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:
Good modern medical care and medicines are available in Doha, although only basic or no medical care may be available in Qatar’s smaller cities or outlying areas.
Serious medical problems requiring hospitalization and/or medical evacuation to the United States can cost thousands of dollars.
Doctors and hospitals expect immediate cash payment for health services.
Information about the Qatari national healthcare system is available at http://www.hmc.org.qa.
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 Qatar is provided for general reference only, and may not be totally accurate in a particular location or circumstance.

Short-term visitors should obtain a valid International Driving Permit prior to arrival and should not drive in Qatar on a U.S. driver’s license.
Short-term visitors and business travelers can also obtain a Temporary Qatari Driving License by presenting their U.S. driver’s license at any branch of Qatar’s Traffic Police.
New and prospective residents should obtain a permanent Qatari Driving License immediately after arrival.
Once an American citizen holds a valid Qatari residence permit, they are no longer permitted to drive in Qatar with an International Driving Permit or a Temporary Qatar Driving License.

Traffic accidents are among Qatar’s leading causes of death.
Safety regulations in Qatar are improving thanks to a more stringent traffic law adopted in October 2007 and a country-wide traffic safety campaign.
However, informal rules of the road and the combination of local and third-country-national driving customs often prove frustrating for first-time drivers in Qatar.
The combination of Qatar’s extensive use of roundabouts, many road construction projects and the high speeds at which drivers may travel can prove challenging.
The rate of automobile accidents due to driver error and excessive speed is declining but remains higher than in the United States.
In rural areas, poor lighting, wandering camels and un-shouldered roads are other hazards.
Despite aggressive driving on Qatar’s roads, drivers should avoid altercations or arguments over traffic incidents, particularly with Qatari citizens who, if insulted, have filed complaints with local police that resulted in the arrest and overnight detention of U.S. citizens.
Drivers can be held liable for injuries to other persons involved in a vehicular accident, and local police have detained U.S. citizens overnight until the extent of the person’s injuries were known.
Due to its conservative Islamic norms, Qatar maintains a zero-tolerance policy against drinking and driving.
Qatar’s Traffic Police have arrested Americans for driving after consuming amounts of alcohol at even smaller levels normally accepted in the U.S.
Any motor vehicle over five years old cannot be imported into the country.
For specific information concerning Qatari driver’s permits, vehicle inspection, road tax and mandatory insurance, please contact either the Embassy of the State of Qatar in Washington, DC or the Consulate General of the State of Qatar in Houston, Texas.
Please refer to our Road Safety page for more information.

AVIATION SAFETY OVERSIGHT:
The U.S. Federal Aviation Administration (FAA) has assessed the Government of Qatar’s Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for oversight of Qatar’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: Qatari customs authorities enforce strict regulations concerning importation into Qatar of items such as alcohol, narcotics, pork products, firearms, or anything deemed pornographic by Qatari authorities.
While importation of religious material for personal use is acceptable, importation of religious material for the purpose of proselytizing is not.
It is advisable to contact the Embassy of the State of Qatar in Washington, DC, or the Consulate General of the State of Qatar in Houston for specific information regarding customs requirements.

Please see our Customs Information.

Pets entering Qatar require an import permit from the Ministry of Agriculture.
Cats with proper documentation are allowed to enter with no difficulty, but some breeds of dogs, especially large dogs, are not admitted.
Application forms for import permits may be obtained from the Ministry of Agriculture through a sponsoring employer.
A copy of the pet's health certificate and vaccination record must be submitted with the application.

Qatari law does not recognize dual nationality.
Persons who possess Qatari citizenship in addition to U.S. citizenship are considered Qatari citizens by the State of Qatar and are subject to Qatar’s laws.
Qatari citizenship imposes special obligations, particularly with regard to child custody and exiting or entering the country.
For additional information, please refer to our dual nationality flyer
or contact the U.S. Embassy in Doha.

All U.S. citizens are encouraged to carry a copy of their passports with them at all times so that, if questioned by local officials, proof of identity and U.S. citizenship is readily available.
Qatari employers/sponsors customarily hold passports of foreign (i.e., non-Qatari) employees during the terms of their employment in Qatar.
Residents carry a Qatari Identification Card (Iqama) for identification in place of a passport.
Foreign nationals, including U.S. citizens, may not leave Qatar without permission in the form of exit visas obtained by their employer/sponsor.
The U.S. Embassy in Doha cannot assist U.S. citizens in Qatar to obtain third country visas for unofficial travel.
Islam provides the foundation of Qatar’s customs, laws and practices.
Foreign visitors are expected to remain sensitive to the Islamic culture and not dress in a revealing or provocative manner, including the wearing of sleeveless shirts and blouses, halter-tops and shorts.
Western bathing attire is worn at hotel pools and beaches.
BUSINESS AND EMPLOYMENT CONTRACTS:
The written, Arabic text of a contract governs employment and business arrangements under Qatari law.
Before signing a contract, U.S. citizens and companies should obtain an independent English translation of the original Arabic to ensure a full understanding of the contract's terms, limits, and agreements.
No U.S. citizen should work in Qatar or make a business arrangement without having seen and understood the full, written contract.
Verbal assurances or side letters are not binding in Qatar.

In the event of a contract or employment dispute, Qatari authorities refer to the Arabic language of a contract.
Since a Qatari sponsor holds the employee's passport and controls the issuance of exit visas, U.S. citizens cannot simply leave Qatar in the event of an employment or business dispute.
Any U.S. citizen who breaks an employment or business contract may have to pay substantial penalties before being allowed to depart Qatar.
Qatari law favors employers over employees, and Qatari sponsors have substantial leverage in any negotiations and may block the departure of the employee or bar future employment in Qatar.

Transferring employment in Qatar requires the permission of the previous employer, which is discretionary, and is subject to approval by the Ministry of the Interior.
The Ministry of the Interior has denied employment transfers in the past, including ordering U.S. citizens deported and barred from re-entry to Qatar for two years.
The U.S. Embassy has no standing in Qatar’s courts, cannot sponsor visas, and cannot adjudicate labor or business disputes.
U.S. consular officers can provide lists of local attorneys to help U.S. citizens settle disputes, but ultimate responsibility for the resolution of disputes through Qatar’s legal system lies with the parties involved.
To obtain a residence permit in Qatar, the Government of Qatar usually requires foreign citizens to provide a police clearance certificate from their home countries.
Prospective residents can obtain a U.S. police clearance certificate two ways: through a local or state law enforcement agency or through the Federal Bureau of Investigations (FBI).
In both cases, the clearance will run against the National Crime Information Center, which contains all federal, state and local criminal records.
This process requires several weeks, and the U.S. Embassy in Doha strongly recommends that prospective residents obtain a U.S. police clearance before they arrive in Qatar.

For more information on business opportunities and practices in Qatar, please visit the Foreign Commercial Service’s Country Commercial Guide for Qatar at http://www.buyusa.gov/qatar.
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.
Criminal offenses are punished according to Qatari laws, which in some cases are based on Islamic law and sometimes more severe than in the United States for similar offenses.
Persons violating Qatari laws, even unknowingly, may be arrested, imprisoned, deported, or subject to a ban from departing Qatar.
Travel bans are not lifted until both parties resolve a dispute and the case is abandoned or, if not, until the matter is resolved by a court, which may require months to process the case.
Qatari law enforcement authorities have detained potential witnesses or relatives without charges or access to legal counsel during the investigation of a crime.
The U.S. Embassy in Doha cautions American citizens that Qatari police can and have arrested American citizens suspected of or witness to a crime, including traffic accidents involving injuries to pedestrians or the occupants of other cars, traffic arguments, slander, and a variety of lesser offenses.
Once arrested, the Qatari Police have no independent authority to grant a release, an authority reserved solely for Qatar’s Public Prosecution and Courts.
As a result, arrested Americans, regardless of the charges, often spend one night in jail awaiting a hearing with Qatar’s Public Prosecution or the appropriate court.
Qatari law enforcement authorities do not routinely notify the U.S. Embassy in Doha of a U.S. citizen’s arrest and, for more serious crimes, may not allow a U.S. Embassy official to visit an arrested U.S. citizen until the initial interrogation is completed.
Upon arrest, U.S. citizens should ask to speak to the U.S. Embassy immediately, and if not allowed, request a friend or family member notify the U.S. Embassy through the contact information below.
Incidents involving insults or obscene language/gestures often result in arrest, overnight imprisonment and/or fines whether the incident occurs between private parties or involves officers of the law.
Drunk driving, public intoxication and other alcohol-related offenses are treated with severity and will result in arrest, heavy fines, imprisonment, or expulsion from the country.
Penalties for possession, use, or trafficking in illegal drugs in Qatar are severe, and convicted offenders can expect long jail sentences and heavy fines.
Homosexual activity is considered to be a criminal offense, and those convicted may be sentenced to lashing and/or a prison sentence, and/or deportation.
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 Qatar are encouraged to register with the U.S. Embassy in Doha through the State Department’s travel registration web site to obtain updated information on travel and security within Qatar.
Americans without Internet access may register directly with the U.S. Embassy in Doha.
By registering, American citizens make it easier for the U.S. Embassy in Doha to contact them in case of emergency.
The U.S. Embassy is located in the Al-Luqta District on 22nd February Street, PO Box 2399, Doha; phone (974) 488-4101, extension 0 or 6500.
For after-hours emergencies, U.S. citizens may call (974) 488-4101, extension 0 or 6600, to reach the duty officer.
On the Internet, you may reach the Embassy web site at http://qatar.usembassy.gov for additional information and operating hours.
The embassy observes a Sunday through Thursday workweek.
Government offices and most businesses in Qatar also observe a Sunday through Thursday workweek.
*

*

*
This replaces the Country Specific Information for Qatar dated November 26, 2007, to update the sections on Entry/Exit Requirements, Medical Facilities and Health Information, Traffic Safety and Road Conditions, Special Circumstances, and Criminal Penalties.

Travel News Headlines WORLD NEWS

Date: Wed 24 May 2017
Source: State of Qatar, Ministry of Public Health - News [edited]

Ministry of Public Health (MOPH) has announced that a new Middle East Respiratory Syndrome Corona Virus (MERS-CoV) case has been confirmed for a 29-years-old, resident in Qatar, marking the 3rd MERS-CoV case to be confirmed in the country this year [2017] and bringing the cumulative number of confirmed MERS-CoV cases since 2012 to 21 cases among whom 7 have died.

The patient is a camel worker and had complaints of fever and dry cough for several days. He sought medical attention in Hamad General Hospital where an X-Ray investigation suggested a severe pneumonia. Consequently and as he reported an occupational frequent contact with camels, further samples were withdrawn from the patient. He ultimately tested positive for MERS-CoV according to Hamad Medical Corporation laboratories.

Despite his stable condition, the patient was admitted to hospital; in consistence with the national infection prevention and control protocol for confirmed and suspected MERS-CoV cases to ensure the appropriate medical attention. However, neither a history of contact with similar cases nor a recent travel outside the country was reported for the patient who has no comorbidities.

Once the case has been confirmed, the rapid response team of the Health Protection and Communicable disease Control (HP & CDC) department at the MOPH, accompanied with the team from Animal Health Department, Ministry of Municipality and Environment, have started a field investigation to assess the possible source of the infection and to verify whether any of the patient contacts has suspected symptoms according to the WHO standard case definition. Consequently, all traced contacts will be monitored over a period of 2 weeks, while those who develop suspected symptoms will then be subjected to confirmatory laboratory investigation.

The Ministry of Public Health advices citizens and residents, in particular those with comorbidities or low immunity, to abide to cough etiquette and handwashing with soap and water thoroughly and avoid unnecessary contact with sick animals.

MOPH proclaimed that Health Protection & CDC Hotlines 66740948 & 66740951 are accessible 24/7 to respond to any notification or enquiry related to infectious diseases.
==================
[The above press release mentioned the participation of animal health experts in the investigation of the described case. Information on their observations and findings, including results of laboratory tests (in case animal samples were taken), will be appreciated.

Qatar officially notified the OIE about its 1st event of MERS-CoV in camels, as an emerging disease, on 28 Nov 2013. The start of the event was, reportedly, dated 14 Oct 2013. The 'affected population' was kept on a "small farm with 14 camels, one sheep, one pigeon cage and some chicken" in Al-Shahanya, Ar Rayyan district. The diagnostic laboratory, given as "the Erasmus Medical Center (Rotterdam) and National Institute for Public Health and the Environment (Bilthoven), the Netherlands (OIE Reference Laboratory)", established the diagnosis of MERS-CoV in camels by PCR, on 26 Nov 2013. The report included the following epidemiological comment: "The health authority in Qatar notified the presence of a confirmed human MERS-CoV case. A joint team from both health and veterinary authorities was sent to the patient farm to investigate the health status of animals and the contact person. A farm worker proved to be positive for MERS-CoV and samples were collected from the 14 existing camels in addition to one sheep, some pigeons and chickens and some environmental samples (water, soil, animal food and grass) and all were sent to the Netherlands for testing. All animals were kept under observation and quarantine and all were apparently healthy". The above immediate notification was followed by 3 follow-up reports (29 Dec 2013, 22 Apr 2014 and 09 Jun 2014).

Follow-up report No 1, submitted a month later, namely on 29 Dec 2013, informed: "There are no new outbreaks in this report". The report, however, included the following epidemiological comments: "The samples from the same herd tested, using the same technique were negative and this may show that MERS-CoV infection in camels is a self-limiting disease. The planned massive survey for MERS-CoV in animals is under implementation and the same herd is under systematic retesting. Follow-up reports will be submitted when there will be new data".

Follow-up report No 2, submitted 22 Apr 2014, addressed "A single barn of 26 camels of different ages" in the same location (Al-Shahanyain), Qatar. The diagnostic laboratory was named as "Department of Viroscience, Erasmus Medical Center, Rotterdam (The Netherlands) (Foreign laboratory)"; the tests were performed on 19 Apr 2014, applying PCR and virus isolation, both positive. The report included the following epidemiological comments: "During an existing survey (pilot phase of the survey), nasal swabs were collected from an 8-month-old camel among healthy dromedary camels. The sample was inoculated on Vero cells and cytopathic changes were observed in cells at 48h post-infection. Human hepatoma cells (Huh-7 cells) were inoculated with MERS-CoV to further functionally characterize this viral isolate. After 2 days, virus-induced cytopathic effects were observed in the inoculated cell cultures. Virus production in Huh-7 cells was blocked by pre-incubating MERS-CoV with a 1/200 dilution of serum from MERS-CoV antibody positive camels. Conclusion: these data demonstrate that the MERS-CoV obtained from a dromedary camel is able to replicate in human cells and uses DPP4 as entry receptor, similar as isolates obtained from MERS patients".

Follow-up report No 3, submitted 9 Jun 2014, involved 3 barns with a total number of 12 camels of different ages, similarly in Al-Shahanya. Of the 12 susceptible camels, there were 5 "cases", indicated as an apparent morbidity rate of 41.67 percent. The diagnostic laboratory was "Erasmus Medical Center (Rotterdam) and National Institute for Public Health and the Environment (Bilthoven), The Netherlands (Foreign laboratory)", which applied SNT. This report included the following epidemiological comment: "Milk was collected according to local customs; cria's (dromedary calves) were not weaned after delivery but kept at the farm in paddocks adjacent to their dams throughout lactation. Dams were reunited with their cria to trigger milk production. Once milk production was initiated, the milk samples were collected by the camel owner or caretaker without specific hygienic precautions". The named follow-up report No 3 was the last report of MERS-CoV in camels submitted so far by Qatar to the OIE. It included the statement "continuing". No additional MERS-CoV reports from Qatar have become available since June 2014.

According to WAHID's archive data, the summary of the event since its start, as of June 2014, was:
Total outbreaks = 3 (Submitted)
Species/ Susceptible/ Cases/ Deaths/ Destroyed/ Slaughtered
Camelidae/ 52/ 9/ 0/ 0/ 0
(see at <http://www.oie.int/wahis_2/temp/reports/en_fup_0000015380_20140610_175414.pdf>).

In May 2017, the OIE updated its case definition for the reporting of MERS-CoV, as follows:

"1. Introduction
Dromedary camels have been confirmed by several studies to be the reservoir of the MERS-CoV infection in humans. Zoonotic transmissions of MERS-CoV from dromedary camels to humans were reported in multiple occasions. MERS-CoV has never been reported as a disease in camels though in experimental infections MERS-CoV has been associated with mild upper respiratory signs. Positive PCR results for MERS-CoV or isolation of the virus from camels is notifiable to the OIE because MERS is an emerging disease with a significant public health impact.

2. Confirmed case:
A dromedary camel with laboratory confirmation (*note 1) of MERS-CoV infection, with or without clinical signs.

3. Suspected case:
a) Observed clinical signs of mild respiratory infection (rhinitis in young dromedaries); and
b) Direct epidemiologic link (*note 2) with a confirmed human or camel MERS-CoV case; and
c) Testing for MERS-CoV is unavailable, negative or inconclusive (*note 4) on a single inadequate specimen (*note 3).

Notes
1 A case may be laboratory confirmed by virus isolation or detection of viral nucleic acid. The presence of viral nucleic acid can be confirmed by 1) a positive RT-PCR result on at least 2 specific genomic targets,
2) a single positive target with sequencing of a 2nd target or
3) a single positive target with positive result in a rapid MERS-CoV Ag Test. Serological investigations are of little value as high percentage of tested dromedaries possess antibodies to MERS-CoV.

2. A direct epidemiological link with a confirmed MERS-CoV dromedary camel may include living or traveling together in close proximity or sharing the same environment with individual dromedaries infected with MERS-CoV.

3. An inadequate specimen would include a specimen that has had improper handling, is judged to be of poor quality by the testing laboratory, or was taken too late in the course of illness.

4. Inconclusive tests may include a positive screening test on a single rRT-PCR target without further confirmation. Animals with an inconclusive initial test should undergo additional sampling and testing to determine if the animal can be classified as a confirmed MERS-CoV case. At herd level, having positive single target PCRs in more than one animal could constitute confirmation. Preference should be a repeat nasopharyngeal specimen. Other types of clinical specimens could also be considered for molecular testing if necessary, including blood/serum, and stool/rectal swab. These generally have lower titers of virus than respiratory tract specimens but have been used to confirm cases when other specimens were inadequate or unobtainable".

As commented by Mod.MPP (see http://promedmail.org/post/20170524.5059234), according to a review of cases reported by Saudi Arabia and classified as "primary" cases (N=560), 27.3 percent had a history of camel exposure, and 72.7 percent were reported as still under investigation for high risk exposures at the time of initial confirmation report. The 85th General Session of the World Assembly of OIE Delegates has been held in Paris during this week (21 to 26 May 2017). According to WHO updated information, MERS-CoV has caused, since its initial detection in Sep 2012, at least 1952 human cases, of which at least 693 deaths in 27 countries. It will be interesting to note if the reporting of this disease, according to the OIE criteria, and its possible control in the animal reservoir have been discussed during the General Session.

Subscribers are referred to a recent review paper (Ref 1), and in particular to figure 3 "Hypothesis of MERS-CoV transmission to humans".

A One Health approach to the MERS-CoV issue, its epidemiology and control, will require the active involvement of the 3 relevant international authorities, namely the FAO, OIE and WHO.

References
M. G. Hemida, A. Elmoslemany, F. Al-Hizab, A. Alnaeem, F. Almathen, B. Faye, D. K. W. Chu, R. A. P. M. Perera & M. Peiris. Dromedary Camels and the Transmission of Middle East. Transboundary & Emerging Diseases 64 (2017) 344-353.  <http://agritrop.cirad.fr/580073/7/Hemida_et_al-2017-Transboundary_and_Emerging_Diseases.pdf>. - ProMED Mod.AS]

[A HealthMap/ProMED-mail map can be accessed at:
Date: Sat, 26 Nov 2016 20:00:07 +0100

Doha, Nov 26, 2016 (AFP) - Rainfall caused widespread flooding in Qatar on Saturday, potentially raising fresh concerns about infrastructure in the Gulf country due to host the 2022 football World Cup.   Several major roads were flooded, prompting official warnings.   "As the rain continues to pour in most parts of the country, motorists are advised to be cautious," the interior ministry tweeted after earlier calling the rainfall "medium to heavy".   Some apartment buildings on the Pearl Qatar, an artificial island in Doha, estimated to have cost $15 billion (13.5 billion euros) to build, suffered flooding, as did the nearby suburb of Qanat Quartier, built to resemble Venice.

The Doha News website reported that the Qatar Animal Welfare Society pleaded urgently for foster homes to take care of its dogs because of the conditions.   The Peninsula English-language newspaper reported that rain caused leaks at major Doha shopping centre the Landmark Mall.   Many people used social media to post videos and pictures, with some questioning how a relatively small amount of rain -- the first of the winter -- could cause such problems.   The wet weather had been predicted and the government "Rain Emergency Team" had already convened to discuss potential problems.

Last November, the government began an inquiry after rain damaged Doha's Hamad international airport, which opened in 2014, flooded roads and streets and caused some schools to close.   Gas-rich Qatar is spending more than $200 billion on major infrastructure such as roads, the airport, a metro system and a new city ahead of the 2022 World Cup, which will be played at this time of year -- from November 21 to December 18.   World Bank figures show Qatar's average annual rainfall is around 75 millimetres.
Date: Mon 13 Jun 2016 01:58 AM (Qatar)
Source: Gulf Times [edited]

The Ministry of Public Health has announced that a new Middle East Respiratory Syndrome Corona Virus (MERS-CoV) case has been confirmed in a 23-year-old male resident, marking it the 3rd to be confirmed in the country this year [2016].

The person was not in contact with a confirmed case and does not suffer from any chronic diseases that usually cause immunity suppression. The patient was admitted to Hamad General Hospital as he reported fever, cough, runny nose, and backache where he tested positive for Mers-CoV. The patient is now stable and receives medical care in the isolation ward.

The ministry said that Health Protection and Communicable Disease Control Hotlines, 66740948 and 66740951, are accessible round-the-clock to respond to any notification or query related to infectious diseases.

MERS-CoV was 1st identified in Saudi Arabia in 2012.

According to the World Health Organization (WHO), globally, since September 2012, it has been notified of 1652 laboratory-confirmed cases of infection with MERS-CoV, including at least 591 related deaths [the most recent report from WHO on 16 May 2016 gives a global tally of 1733 laboratory-confirmed cases of infection with MERS-CoV, including at least 628 related deaths (<http://www.who.int/csr/don/16-may-2016-mers-saudi-arabia/en/>) - ProMED Mod.MPP].

Mers-CoV is a zoonotic virus that is transmitted from animals to humans.
==================
[As mentioned in the above report, this is now the 3rd case of MERS-CoV infection reported in Qatar in 2016. The 1st case was reported in February 2016 in a 66 year old Qatari male who had been, for 2 months preceding onset of illness, in Saudi Arabia where he had a camel farm (see MERS-CoV (35): Saudi Arabia, Qatar ex Saudi Arabia, WHO http://promedmail.org/post/20160311.4085518 and MERS-CoV (24): Qatar ex Saudi Arabia, Saudi Arabia (RI) RFI http://promedmail.org/post/20160222.4041719). The 2nd case was a 40 year old Qatari national camel worker with non-specific, non-respiratory symptoms (see MERS-CoV (56): Qatar, Saudi Arabia, WHO http://promedmail.org/post/20160503.4198200).

According to the most recent ECDC Communicable Disease Threats Report, as of 9 June 2016, there have been a total of 1753 cases of MERS-CoV infection, including 680 deaths reported by health authorities worldwide. Besides, there have been a total of 15 cases of MERS-CoV infection including 5 deaths reported by Qatar as of 9 Jun 2016, making this current case the 16th case reported by Qatar since April 2012.  (<http://ecdc.europa.eu/en/publications/Publications/Communicable-disease-threats-report-11-june-2016.pdf>).

In addition to the 16 cases reported by Qatar, there have been 2 additional cases reported in Qatari nationals treated in Europe (see Novel coronavirus - Saudi Arabia (03): UK HPA, WHO, Qatar
East. Med. (07): Saudi Arabia, UK, Germany

We await further information on possible high risk transmission exposures.

The HealthMap/ProMED map of Qatar can be found at:
Date: Mon 2 May 2016
Source: Gulf Times

A 40-year old camel worker has tested positive for the Middle East respiratory syndrome coronavirus (MERS-CoV), the Ministry of Public Health (MoPH) announced.

It is the 2nd case confirmed in Qatar so far this year [2016].

The worker, who was neither in contact with a suspected patient nor abroad during the last 2 weeks, is free from chronic diseases that usually cause immunity suppression. He was admitted to Hamad General Hospital [in Doha] with general symptoms where routine investigations tested positive for MERS-CoV, despite him not exhibiting any respiratory related symptoms.

The patient is currently in stable condition and receiving the necessary medical care in the isolation ward, according to the national protocol for infection prevention and control, the ministry said in a statement.

After the tests proved positive, the rapid response team of MoPH carried out extensive search to list all potential contacts to check for their possible consistence with the standard case definition of the suspected cases, based on the World Health Organisation guidelines. All traced contacts will be monitored over a period of 2 weeks, while those who develop suspected symptoms will then be subjected to confirmatory laboratory investigation, the ministry added.

While research efforts continue on a global and local level to determine the modes of transmission of MERS-CoV infection, the MoPH has advised citizens and residents who suffer from chronic diseases to avoid direct contact with camels and to wash hands with soap and water thoroughly. Also recommended are implementing respiratory hygiene and cough etiquette and the need to boil camel milk before drinking.

MoPH added that Health Protection & CDC Hotlines 66740948 and 66740951 are accessible 24/7 to respond to any notification or inquiry related to infectious diseases.
==================
[The text of the media report above is almost verbatim from the MoPH announcement, also released today (2 May 2016 and available at <https://www.moph.gov.qa/news/moph-announces-the-second-mers-cov-case-in-2016?backArt=326&page=2>). On 22 Feb 2016, there was a report of a case of MERS-CoV infection in a 66 year old Qatari male who had a farm (with camels and sheep) in Saudi Arabia. The addition of this newly confirmed case brings the total number of cases of MERS-CoV infection reported by Qatar to 15 since 2012. It is noteworthy that in the absence of respiratory symptoms, the history of camel contact most probably led to testing for MERS-CoV infection in this patient, suggesting a high index of suspicion on the part of the medical community treating this patient.

The HealthMap/ProMED map of Qatar can be found at
Date: Thu, 10 Mar 2016 14:54:28 +0100

Doha, March 10, 2016 (AFP) - A 66-year-old Qatari man has died after contracting the MERS virus, in the first fatal case in the Gulf state for 10 months, health officials announced Thursday.   The public health ministry, quoted by the official Qatar News Agency, said the man "had been suffering from several chronic diseases and died of complications from the disease".

This was the first such case of Middle East Respiratory Syndrome reported in Qatar since May 2015 when it claimed the life of a 73-year-old man, the ministry added in a statement.   The ministry "continues to monitor acute respiratory diseases and is working in cooperation with all the health institutions in the public and private sectors to monitor any suspected case," it said.   The latest victim had been diagnosed with the virus in February. He was hospitalised after returning from a "neighbouring country", according to an official statement last month.

MERS is a viral respiratory illness and considered a deadlier but less infectious cousin of the SARS virus that appeared in Asia in 2003, infecting more than 8,000 people and killing hundreds.   Like SARS, it appears to cause a lung infection, with patients suffering coughing, breathing difficulties and a temperature.

MERS differs in that it also causes rapid kidney failure.   It first appeared five years ago in neighbouring Saudi Arabia, which has been the country worst hit by the virus, with 1,286 cases of infection and 551 deaths, according to official figures.   Globally, there have been 1,644 confirmed MERS cases and 590 deaths, according to the World Health Organization.
More ...

World Travel News Headlines

Date: Tue, 12 Nov 2019 13:10:01 +0100 (MET)
By Holly ROBERTSON, Andrew BEATTY, with Daniel De Cartert in Hillville

Sydney, Nov 12, 2019 (AFP) - Bushfires raging across eastern Australia singed Sydney's suburbs on Tuesday, with firefighters scrambling planes and helicopters to douse a built-up neighbourhood with water and red retardant.   Experts have described the conditions as the worst on record, as spring temperatures climbed toward 40 degrees Celsius (104 Fahrenheit) and winds topped 80 kilometres (50 miles) per hour across a zone which has been plagued by persistent drought.   Although the bushfire season is in its infancy, scientists predict it to be one of Australia's toughest ever, with climate change and unfavourable weather cycles helping created a tinderbox of strong winds, low humidity and high temperatures.

Twin blazes in the north shore suburb of Turramurra -- around 15 kilometres (nine miles) from the centre of Australia's largest city -- tore through a eucalypt forest park and sparked spot fires in homes, before eventually being brought under control.   As night fell, authorities said they were bringing another "clearly suspicious" blaze in a national park in the city's southern suburbs under control.    Throughout the day, more than 300 bushfires burned up and down Australia's east coast, fanned by gale-force winds, scorching temperatures and tinder-dry bushland that has brought some of the most dangerous conditions the country has seen.

In Turramurra, gardens smouldered, thick smoke hung heavy in the air and cars, houses and roads were caked in raspberry-red retardant as if hit by a giant paintball.   "It was the embers that floated up that actually went across and set off spot fires in the front yards" resident Nigel Lush told AFP, adding that one roof had been set alight.   Another resident, Julia Gretton-Roberts, said the blaze spread shockingly quickly.   "Next thing I know the fire was opposite our house and it was massive and the police came and grabbed our kids and took them away," she said.   "My daughter is pretty freaked out."   Firefighter Andrew Connon told AFP "a number of homes were threatened but it was contained by the aerial bombing".

- 'Catastrophic conditions' -
From early morning thousands of firefighters spread out across New South Wales in anticipation of what they called "off the scale" fire risk and "catastrophic" conditions.   They were unable to prevent several bushfires from breaching containment lines and trapping residents who had not already evacuated.   New South Wales Rural Fire Service Commissioner Shane Fitzsimmons said so far only a dozen buildings had been damaged Tuesday and a handful non-life-threatening injuries were reported, but the crisis was far from over.

Firefighters will be "working on these fires for days and weeks given the enormity of the firegrounds," he said.    Even before unfavourable weather hit, days of fires had killed three people and destroyed at least 150 homes.   "The conditions are expected to get worse," Fitzsimmons said, warning residents in adjacent areas to stay alert.   "Complacency kills," he added.   Up to 600 schools were closed, as well as many national parks, a total fire ban was introduced for the affected area and Rally Australia -- due to be held in Coffs Harbour at the weekend -- was cancelled.   The military pitched in, helping firefighters with logistics and water-dropping sorties using more than 100 aircraft.

- 'We'll fight it first' -
In the town of Hillville a fire that has ripped through an area the size of 25,000 soccer fields approached the home of Daniel Stevens.   Like many, his family -- including his mother nursing a broken leg -- have packed their bags, but have resisted leaving their house and everything they own.    "We'll fight it first," he told AFP, "but if it jumps the fence line into the paddock, we'll go."

In the nearby town of Taree, dozens of people have already moved to a showground that has become a makeshift evacuation centre.   Fifty-nine-year-old Caroline Watson arrived last night with her husband and their dog.    "The fires are just rife. They are absolutely everywhere" she told AFP. "They didn't ask us to get out, but we figured it was coming."

Further south in the Blue Mountains on the outskirts of Sydney, veteran Winmalee firefighter Alan Gardiner said locals were "terrified and on edge".    The town still bears the scars of a 2013 blaze that destroyed 200 homes, and residents are acutely aware that with few roads in and out of the mountains, a decision to leave late can be fatal.   Efforts to burn fuel in a controlled way have been limited by months of drought-like conditions that made it too dangerous.
Date: Tue, 12 Nov 2019 10:03:07 +0100 (MET)

Denpasar, Indonesia, Nov 12, 2019 (AFP) - An Australian tourist who fly-kicked a motorcyclist and assaulted a man in his own home during a drunken rampage was jailed for four months on Tuesday.   The ruling comes after Nicholas Carr's antics were caught in a viral video that saw him carry out a campaign of destruction in Seminyak, a popular tourist area on the Indonesian holiday island.   "The defendant Nicholas Carr is found guilty and is sentenced to four months" in jail, presiding judge Soebandi, who goes by one name, told the Denpasar District Court.    A lawyer for Carr, charged with assault and property damage, said the 26-year-old would not appeal the ruling.    He is expected to be released next month because of time already served.   In August, Carr ran barefoot on to a street and shouted expletives before the apprentice builder slammed into the bonnet of a moving car and then fly-kicked an unsuspecting motorcycle rider.

The biker, who was thrown from the moving scooter, sustained minor injuries -- later the pair embraced during a court hearing as Carr apologised to the victim.   Carr also shattered a convenience store's glass door before stealing a motorcycle.   Later, he broke into a house where he assaulted the sleeping homeowner, leaving him with injuries, police said earlier.    He was eventually caught by locals and police and taken to hospital.    Pictures that circulated on social media showed at the time showed Carr bloodied and bruised, and trussed with hosepipe and rope.   Shortly after his arrest, Carr apologised and admitted drinking more than 10 small bottles of vodka as well as other alcohol.

After a string of embarrassing incidents by tourists, Bali officials recently warned that boorish visitors may be kicked off the island, which attracts millions annually to its palm-fringed beaches, colourful nightlife and ancient temples.   Australian professional rugby league player David Fifita returned home this week after he was briefly arrested in Bali for assaulting a nightclub security guard.   Several days after Carr's arrest, a Czech couple who were slammed for disrespecting a Balinese temple took part in a ritual purification ceremony.
Date: Mon, 11 Nov 2019 16:19:54 +0100 (MET)

Lyon, Nov 11, 2019 (AFP) - An unusually strong earthquake hit south-eastern France on Monday, injuring four people, one of them seriously, authorities said.   A physicist at a geophysics institute the IPGP said that quakes of this strength are rare in that region, but warned of possible aftershocks and said people should leave fragile buildings.   The quake, with a magnitude of 5.4, was felt in a vast area between the cities of Lyon and Montelimar which are about 150 kilometres (93 miles) apart, the national seismological office said.   "I was leaning against the oven in my mother's bakery when I felt the tremor," said Victoria Brielle, a resident in Privas, some 25 kilometres from the quake's epicentre.   "A customer said her sideboard had moved and all her crockery was broken,"  she said.

Another resident in the area, Didier Levy, who lives in a 15th century castle, told AFP that "chandeliers were still trembling" several minutes after the quake.   Levy, who said his dog starting barking even before humans felt the tremors, added: "I have never experienced anything like it, I could feel the trembling even though these wall are one metre thick."   One person was seriously hurt when some scaffolding collapsed, the regional prefect's office said.   Three other people in the neighbouring Ardeche region were slightly injured.

Quakes in this region are rarely higher than Magnitude 5, said Mustapha Meghraoui of the IPGP's office in Strasbourg.   "We can say that this is a rare one," he added. But he said there might be an aftershock of around 4.5.   "If people are in a fragile house, they would be better leaving it" for something more robust for a while, he said.   The scale of the damage suggested the quake happened at a depth of between five and 10 kilometres, he added. But they were working on a more accurate reading.
Date: Mon, 11 Nov 2019 13:19:54 +0100 (MET)

Goma, DR Congo, Nov 11, 2019 (AFP) - A local radio station that has been involved in the fight against Ebola in eastern DR Congo said Monday it was closing down after one of its broadcasters was murdered.   Joel Musavuli, head of Lwemba radio in Mambasa in Ituri province, told AFP that the station had been targeted by armed groups hostile to the campaign to roll back the Ebola epidemic.

"Each of us have received threats since last month. We have now decided to stop broadcasting, Musavuli said, adding that he himself had escaped two kidnap attempts.   "We are victims of our commitment to the awareness campaign about the spread of Ebola virus disease. We don't know why the militiamen are targeting us."   Nearly 2,200 people have died since the notorious haemorrhagic disease erupted in eastern Democratic Republic of Congo in August 2018, according to the latest official figures.

The fight against the outbreak has been hampered by local fears and superstititions, exploited by militia groups that are rampant in the remote region.   Several health workers have been killed and media that have supported the campaign have received threats.

Several radio stations in the Mambasa area say they have stopped broadcasting anti-Ebola messages because of intimidation.   On November 2, Lwemba broadcaster Papy Mahamba was killed at his home by unidentified men. His wife was injured and their house set ablaze.    The station said the authorities had failed to take action against the threats. It said it would resume broadcasts after "the state has restored authority in the area".
Date: Mon, 11 Nov 2019 11:38:15 +0100 (MET)

Kuwait City, Nov 11, 2019 (AFP) - Hundreds of workers at Kuwait's international airport held a one-hour strike Monday to demand better working conditions, threatening to stage longer walkouts in the coming days.    Ahmed Mohammed al-Kandari, a union representative, said workers were calling for improved treatment and to be compensated for daily exposure to pollution and noise.  Monday's strike by Kuwaiti staff did not affect flights, officials said.   The right to strike is guaranteed for citizens in Kuwait, but such actions remain rare in the Gulf country.

Foreign workers do not have the right to strike.  "Airport traffic is very normal," Sheikh Salman Al-Hamoud Al-Sabah, head of the General Directorate of Civil Aviation, told AFP.    Another official, Saleh Al-Fadaghi, the airport's director of operations, also said flights were not affected. "During the one-hour strike, 19 flights were operated as scheduled. There were five departures and 14 arrivals," he told AFP.

Kandari said the purpose of the strike was not to disrupt operations but "to make our voices heard". He added that Kuwaiti workers would hold a further two-hour strike on Wednesday and a 24-hour strike on Sunday if their demands are not met.    Of 4,500 civil aviation employees, 1,500 took part in Monday's strike, he said.
Date: Mon, 11 Nov 2019 10:39:09 +0100 (MET)

La Jonquera, Spain, Nov 11, 2019 (AFP) - Catalan separatist activists blocked traffic on Monday on a motorway linking Spain and France, in a fresh protest against the sentencing last month of nine of their leaders to lengthy jail terms.   Demonstrators cut the AP7 motorway at La Jonquera near the city of Girona in eastern Spain, a day after a repeat general election in which Prime Minister Pedro Sanchez's Socialist emerged as winners but weakened, while far-right party Vox surged to third place on the back of its hardline stance against separatism.   Dozens of vehicles blocked the motorway near the border with France while some 300 people set up a barricade, according to an AFP photographer at the scene.   Some demonstrators began to set up a stage and speakers which they brought to the scene in vans.   Catalonia's regional road department confirmed the motorway was cut in both directions at La Jonquera.

The protest was called by a new, mysterious organisation called "Democratic Tsunami" which last month sent thousands of people to block access to Barcelona airport in a protest which ended in clashes between demonstrators and police.   "This mobilisation is a cry to the international community so that it makes the Spanish state understand that the only possible path is to sit down and talk," the group said in a message sent to its followers on encrypted messaging service Telegram.   Radical separatist group CDR also called on its supporters to head to La Jonquera to block the highway.   Catalonia was rocked by days of mass, sometimes violent, pro-independence rallies after Spain's Supreme Court on October 14 sentenced nine politicians and activists to jail for up to 13 years for their role in a failed secession bid in 2017.   Demonstrators have frequently cut road and rail links between Spain and France while many shops in downtown Barcelona have been shut during the rallies and there are growing concerns about the impact of the unrest on business in Spain's second largest city.
Date: Sat, 9 Nov 2019 18:59:25 +0100 (MET)

MOUSOUNI ISLAND, India, Nov 9, 2019 (AFP) - Cyclone Bulbul hit India and southern Bangladesh on Saturday, leaving two dead as authorities in the countries ordered more than two million people to get out of the path of the storm.   The cyclone, packing winds of up to 120 kilometres (75 miles) per hour, has "weakened" and "started crossing" India's West Bengal and Bangladesh's Khulna coast at about 9:00 pm (1500 GMT), Dhaka's Meteorological Department said in a special bulletin.   "It is likely to move in a northeasterly direction" and "weaken gradually, and may complete crossing West Bengal-Khulna coast by midnight tonight," the department said.     Airports and ports were shut down and the deaths were reported before the full force of the cyclone had hit.   One person was killed by an uprooted tree in Kolkata and another by a wall that collapsed under the force of the winds in Odisha state, authorities said.

More than 60,000 people were moved away from the coast on the Indian side of the border.   Bangladesh disaster management secretary Shah Kamal told AFP that "2.028 million" have been evacuated and moved to more than 5,500 cyclone shelters.   He said there was no reports of casualties and rejected reports in local media that dozens of local fishermen were missing on the southern coast.    Bangladeshi troops were sent to some villages, while about 55,000 volunteers went door-to-door and making loudspeaker announcements in the streets to get people away from the danger zone in villages, many of which were below sea level.

- Ports closed, flights halted -
A storm surge up to two metres (seven feet) was predicted along the coast, Bangladesh's Meteorological Department said.   About 1,500 tourists were stranded on the southern island of Saint Martin after boat services were suspended due to bad weather.   Bangladesh's two biggest ports, Mongla and Chittagong, were closed because of the storm, and flights into Chittagong airport were halted.   In India, flights in and out of Kolkata airport were suspended for 12 hours because of the storm.   On the West Bengal island of Mousouni, which lies in the path of the storm, frightened residents took shelter in schools and government buildings because they had not been able to escape.   Military planes and ships have been put on standby to help in emergencies, Indian authorities said.

Bulbul hit the coast at the Sundarbans, the world's largest mangrove forest, which straddles Bangladesh and part of eastern India, and is home to endangered species including the Bengal tiger and the Irrawaddy dolphins.   Bangladesh's low-lying coast, home to 30 million people, is regularly battered by cyclones that leave a trail of destruction.   Hundreds of thousands of people have been killed in cyclones in recent decades.   While the frequency and intensity have increased, partly due to climate change, the death tolls have come down because of faster evacuations and the building of 4,000 cyclone shelters along the coast.   In November 2007, Cyclone Sidr killed more than 3,000 people. In May this year, Fani became the most powerful storm to hit the country in five years, but the death toll was about 12.
Date: Sat, 9 Nov 2019 14:18:27 +0100 (MET)

Beirut, Nov 9, 2019 (AFP) - Several petrol stations in protest-hit Lebanon stopped services Saturday, as reserves ran dry due to a shortage of US dollars to pay suppliers, a syndicate head said.   The shuttering of petrol stations came as demonstrators again took to the street across the country, keeping up their three-week-long movement against a political class regarded as inefficient and corrupt.    "The petrol stations that opened today are the ones that still have reserves. They will close down as soon as supply runs out," said Sami Brax, the head of the Syndicate of Gas Station Owners.   He said if officials do not facilitate access to dollars by Tuesday, "we will be forced to stop imports and close down all petrol stations."

Petrol stations receive payment from customers in Lebanese pounds but have to pay importers and suppliers in dollars.    For two decades, the Lebanese pound has been pegged to the US dollar, with both currencies used interchangeably in daily life.   But banks have been reducing access to dollars since the end of the summer, following fears of a shortage in central bank dollar reserves.   In recent days, banks halted all ATM withdrawals in dollars and severely restricted conversions from Lebanese pounds.   Many Lebanese have had to instead buy dollars from money changers at a higher exchange rate, in what amounts to a de-facto devaluation of the local currency that has sparked price hikes.

The official exchange rate has remained fixed at 1,507 Lebanese pounds to the dollar, but the rate in the parallel market has surpassed 1,800.   "The banks are under pressure from people, both inside Lebanon and abroad," said economist Naseeb Ghabreel, after many rushed to withdraw their dollar savings or convert Lebanese pound accounts.   Since September, petrol station owners have accused banks of failing to provide them with the dollars they need and threatened strikes.    In response, the central bank last month pledged to facilitate access to the greenback for importers of petroleum products, wheat and medicine.   But the measure has not yet gone into effect.

Lebanon has since October 17 witnessed an unprecedented popular uprising against everything from power cuts and poor social security to alleged state corruption.   The government yielded to popular pressure and stepped down last month, with the World Bank urging for the quick formation of a new cabinet to prevent the economy from further deteriorating.
Date: Fri, 8 Nov 2019 19:25:02 +0100 (MET)

Madrid, Nov 8, 2019 (AFP) - Spanish health authorities confirmed Friday a case of a man spreading dengue through sex, a world first for a virus which until recently was thought to be transmitted only by mosquitos.   The case concerns a 41-year-old man from Madrid who contracted dengue after having sex with his male partner who picked up the virus from a mosquito bite during a trip to Cuba, said Susana Jimenez of the Madrid region's public health department.

His dengue infection was confirmed in September and it puzzled doctors because he had not travelled to a country where the disease, which causes severe flu-like symptoms such as high fever and body aches, is common, she added.   "His partner presented the same symptoms as him but lighter around ten days earlier, and he had previously visited Cuba and the Dominican Republic," Jimenez said.   "An analysis of their sperm was carried out and it revealed that not only did they have dengue but that it was exactly the same virus which circulates in Cuba."

A "likely' case of sexual transmission of dengue between a man and a woman was the subject of a recent scientific article in South Corea, Jimenez said.   In an e-mail sent to AFP, the Stockholm-based European Centre for Disease Prevention and Control (ECDC), which monitors health and disease in Europe, said this was "to our knowledge, the first sexual transmission of the dengue virus among men who have sex with men."

According to the World Health Organization's website, dengue is transmitted mainly by the Aedes Aegypti mosquito, which thrives in densely-populated tropical climates and breeds in stagnant pools of water.    It is most serious -- and deadly -- in children, especially young girls though scientists don't know why.

Dengue is most commonly caught by people travelling to hotter climates such as southeast Asia, Africa, Australia, the Caribbean and South and Central America.
Date: Sun 10 Nov 2019
Source: The News [abridged, edited]

Another young man is awaiting death in an isolation ward of the Jinnah Postgraduate Medical Centre (JPMC) after developing full-blown rabies, as he was bitten by a rabid dog some 3 months ago but was not administered the rabies vaccine, officials said on Saturday [9 Nov 2019].

"18-year-old Z.K., a resident of Jeva Khan Goth in the Nooriabad area of District Jamshoro, has been brought to the casualty ward of the JPMC with full-blown rabies," Dr Seemin Jamali, the hospital's executive director, told The News.

"According to his family members, the teenager was bitten by a stray dog on the leg around 3 months ago. Unfortunately, neither did the family know about vaccination nor did anybody tell them to get the teenager vaccinated, which resulted in the development of the lethal disease."

Sindh Health Department officials said that this is the 22nd case of rabies in the province this year [2019].

M.K., the ill-fated youngster's father, said that after his son was bitten on the leg, he was taken to a local doctor, who had dressed the wound and given him some medicines but had not asked for the teenager to be vaccinated or referred him to a tertiary-care hospital.

Officials said that right now, dog-bite incidents are on the rise in Karachi as well as in other districts of Sindh, with so far more than 200 000 people falling victim to canine attacks.

They added that the population of rabid dogs is also on the rise, and the animals are not only transmitting the disease to their own species but also attacking humans throughout the province.

Dr Seemin said: "These days any person who is bitten by a dog should be given immunoglobulin as well as the full course of the rabies vaccine to prevent the victim from a painful death. Once rabies is developed in a person, there is no cure for their condition."

She deplored the fact that on the one hand incidents of dog-bite are on the rise and on the other, hospitals in the entire province are facing a shortage of the rabies vaccine, due to which the cases are being referred to the JPMC in Karachi.

"Even the Abbasi Shaheed Hospital, which is considered to be a tertiary-care hospital, is referring dog-bite victims to the JPMC after administering one dose of the vaccine," she said.

"As we don't know the status of their vaccination, we have to vaccinate these patients from zero, but this practice is extremely unprofessional, and it can result in the loss of a precious life."

On the other hand, the shortage of rabies vaccine is becoming a serious issue in Pakistan, especially in Sindh, which requires hundreds of thousands of doses to prevent the people from developing rabies encephalitis.

Pakistan used to get most of its rabies vaccine supplies from Indian biotechnology giants and pharmaceutical companies, but after the deterioration of relations between the 2 countries, Pakistan's next-door neighbour reduced those supplies, while production at the NIH is insufficient to meet the local requirements.

In this scenario, experts say there is an urgent need to control the population of stray dogs in the country by hook or by crook. They believe that at a time when there is not enough rabies vaccine available, the authorities should take measures to save people from canine attacks by reducing the dog population by any means.  [Byline: M. Waqar Bhatti]
=====================
[We have received recently several reports from Pakistan, describing human rabies cases; e.g.
(published 7 Nov 2019),
(published 3 Nov 2019),
(published 15 Oct 2019].

Hopefully, this post will help the professionals involved in getting due attention and required means from the health and municipal authorities for immediate measures undertaken, including timely supply of the required medical preparations.

According to Pakistan's Health Minister, Dr Azra Fazal Pechuho, (on Fri 8 Nov 2019), dog-bite cases were "mishandled" by citizens, as the victims were often brought to hospitals quite late, and the delay caused their deaths (see <https://www.dawn.com/news/1515803>).

WHO's most recent available position paper addressing rabies vaccines and immunoglobulins is available at

[HealthMap/ProMED map available at: