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Albania

Albania US Consular Information Sheet November 04, 2008

 COUNTRY DESCRIPTION

Albania is a parliamentary democracy that is transforming its economy into a market-oriented system. Albania's per capita income is among the lowest in Eu

ope, but economic conditions in the country are steadily improving. Tourist facilities are not highly developed in much of the country, and though Albania's economic integration into European Union markets is slowly underway, many of the goods and services taken for granted in other European countries are not yet available. Hotel accommodations are limited outside of major cities. Read the Department of State Background Notes on Albania for additional information.

ENTRY/EXIT REQUIREMENTS

 A passport is required. All travelers entering or exiting Albania must have six months or more validity on their passport. Customs officers strictly enforce this law. U.S. citizens do not require a visa prior to entering Albania, but those traveling without a visa will be charged a fee for an entry stamp at the point of entry, which is valid for a stay of up to 90 days. This fee is currently 10 Euros, or the equivalent in any easily convertible currency, including U.S. dollars. Travelers without a visa who intend to stay in Albania for more than 90 days should be aware that Albanian law allows a traveler without a visa to remain in Albania for 90 days only within a specific 180-day period. That 180-day period is defined from the first day of entry. For example, a traveler entering without a visa on January 1 may remain in Albania for 90 days total during the period of time between January 1 and June 28. Departing Albania during this time period does not "restart the clock." Travelers attempting to reenter Albania without a visa and within 180 days of a previous entry and after an aggregate stay of 90 days may be denied entry. For stays exceeding 90 days within a 180-day period, those interested must apply for a Residency Permit at the police station with jurisdiction over the city of residence. Information on how to apply for a residency permit is available on the Embassy of Albania web site at http://www.embassyofalbania.org/. There is also a departure fee of ten Euros, or the equivalent in any easily convertible currency, including U.S. dollars. Visit the Embassy of Albania web site at http://www.embassyofalbania.org/consular.html#visa for the most current visa information. Dual Nationality: The Albanian government considers any person in Albania of Albanian parents to be an Albanian citizen. In addition to being subject to all Albanian laws affecting U.S. citizens, dual nationals may be subject to Albanian laws that impose special obligations. Male Albanian citizens are subject to compulsory military service regulations. If such persons are found guilty of draft evasion in Albania, they are subject to prosecution by the Albanian court. Those who might be affected should inquire at an Albanian Embassy or Consulate outside Albania regarding their status before traveling. In some instances, dual nationality may hamper U.S. Government efforts to provide protection abroad. 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

Although the overall security situation in Albania has improved in recent years, organized criminal activity continues to operate in all regions, and corruption is pervasive. US Government employees need permission to travel to the northern administrative districts of Shkoder, Malesi E Madhe and Tropoje (with the exception of the route along the national road to Montenegro and the city of Shkoder) and to the southern town of Lazarat, with such travel restricted to secure vehicles with escort. Travel restrictions for U.S. Government employees have been lifted for overnight stays in the city of Shkoder. In most cases, police assistance and protection is limited. A high level of security awareness should be maintained at all times. Photographing anything that authorities regard as being of military or security interest may cause travelers problems. All gatherings of large crowds should be avoided, particularly those involving political causes or striking workers. For the latest security information, Americans traveling abroad should regularly monitor the Department of State, Bureau of Consular Affairs’ web site at http://travel.state.gov, where the current Travel Warnings and Travel Alerts, as well as the Worldwide Caution, can be found. Up-to-date information on safety and security can also be obtained by calling 1-888-407-4747 toll free in the U.S. and Canada, or for callers outside the U.S. and Canada, a regular toll-line at 1-202-501-4444. These numbers are available from 8:00 a.m. to 8:00 p.m. Eastern Time, Monday through Friday (except U.S. federal holidays). The Department of State urges American citizens to take responsibility for their own personal security while traveling overseas. For general information about appropriate measures travelers can take to protect themselves in an overseas environment, see the Department of State’s A Safe Trip Abroad.

CRIME

In the latest State Department assessment, Albania’s crime rating is “medium.” Crime against foreigners is rare in Albania, as targeting foreigners is often viewed as too risky. Visitors should maintain the same personal security awareness that they would in any metropolitan U.S. city. Caution should be exercised in bars in Tirana where violent incidents, some involving the use of firearms, have occurred in the past, particularly in the early morning hours. Within the last years there have been fewer cases of carjacking compared with previous years. Anyone who is carjacked should surrender the vehicle without resistance. Armed crime continues to be more common in northern and northwestern Albania than in the rest of the country. Street crime is fairly common in Albania, particularly at night. Criminals do not seem to deliberately target U.S. citizens or other foreigners, but do seek targets of opportunity, and select those who appear to have anything of value. Vehicle theft is still one of the biggest problems in Albania. Pick-pocketing is widespread; U.S. citizens have reported the theft of their passports by pick-pockets. INFORMATION FOR VICTIMS OF CRIME: The loss or theft abroad of a U.S. passport should be reported immediately to the local police and the nearest U.S. Embassy or Consulate. If you are the victim of a crime while overseas, in addition to reporting to local police, please contact the nearest U.S. Embassy or Consulate for assistance. The Embassy/Consulate staff can, for example, assist you to find appropriate medical care, contact family members or friends and explain how funds could be transferred. Although the investigation and prosecution of the crime is solely the responsibility of local authorities, consular officers can help you to understand the local criminal justice process and to find an attorney if needed. The local equivalent to the “911” emergency line is 129, though coverage is inconsistent at best. See our information on Victims of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION

Medical facilities and capabilities in Albania are limited beyond rudimentary first aid treatment. Emergency and major medical care requiring surgery and hospital care is inadequate due to lack of specialists, diagnostic aids, medical supplies, and prescription drugs. Travelers with previously diagnosed medical conditions may wish to consult their physicians before travel. As prescription drugs may be unavailable locally, travelers may also wish to bring extra supplies of required medications. Recent electricity shortages have resulted in sporadic blackouts throughout the country, which can affect food storage capabilities of restaurants and shops. While some restaurants and food stores have generators to properly store food, travelers should take care that food is cooked thoroughly to reduce the risk of food-borne illness. Water in Albania is not potable. Visitors should plan to purchase bottled water or drinks while in country. The U.S. Department of State is unaware of any HIV/AIDS entry restrictions for visitors to or foreign residents of Albania. Information on vaccinations and other health precautions, such as safe food and water precautions and insect bite protection, may be obtained from the Centers for Disease Control and Prevention’s (CDC) hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747) or via the CDC’s web site at http://wwwn.cdc.gov/travel/default.aspx. For information about outbreaks of infectious diseases abroad consult the World Health Organization’s (WHO) web site at http://www.who.int/en. Further health information for travelers is available at http://www.who.int/ith/en

MEDICAL INSURANCE

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

TRAFFIC SAFETY AND ROAD CONDITIONS

While in a foreign country, U.S. citizens may encounter road conditions that differ significantly from those in the United States. The information below concerning Albania is provided for general reference only, and may not be totally accurate in a particular location or circumstance. Major roads in Albania are often in very poor condition. Traveling by road throughout Albania is the most dangerous activity for locals and tourists. Vehicle accidents are the major cause of death, according to police statistics. Electricity shortages have resulted in sporadic blackouts throughout the country that can happen any hour of the day or night. Such outages affect traffic signals and street lights, making driving increasingly treacherous at any time of day. Travel at night outside the main urban areas is dangerous and should be avoided due to deplorable road conditions. During the winter months, travelers may encounter dangerous snow and icy conditions on the roads throughout mountainous regions in northern Albania. Buses travel between most major cities almost exclusively during the day, but they are often unreliable and uncomfortable. Many travelers looking for public transport prefer to use privately owned vans, which function as an alternate system of bus routes and operate almost entirely without schedules or set fares. Please note that many of these privately owned vans may not have official permission to operate a bus service and may not adhere to accepted safety and maintenance standards. Persons wishing to use privately owned vans should exercise caution. There are no commercial domestic flights and few rail connections. Please refer to our Road Safety page for more information. Visit the website of the country’s national tourist office at www.albaniantourism.com.

AVIATION SAFETY OVERSIGHT

As there is no direct commercial air service to the United States by carriers registered in Albania, the U.S. Federal Aviation Administration (FAA) has not assessed Albania's Civil Aviation Authority for compliance with International Civil Aviation Organization (ICAO) aviation safety standards. For further information, travelers may visit the FAA's web site at http://www.faa.gov/safety/programs_initiatives/oversight/iasa SPECIAL CIRCUMSTANCES: Albania's customs authorities may enforce strict regulations concerning temporary importation into or export from Albania of some items. It is advisable to contact the Embassy of Albania in Washington, D.C. or one of Albania's Consulates in the United States for specific information regarding customs requirements. As noted previously, the Albanian government considers any person in Albania of Albanian parents to be an Albanian citizen. In addition to being subject to all Albanian laws affecting U.S. citizens, dual nationals may be subject to Albanian laws that impose special obligations. Male Albanian citizens are subject to compulsory military service regulations. See our information pertaining to dual nationality. Albania is a cash economy. Credit cards and travelers checks are not generally accepted, except at the major new hotels in Tirana and some international airline offices. Travelers' checks can be changed at banks in larger towns. Automated Teller Machines (ATMs) are available in most cities. Please see our Customs Information CRIMINAL PENALTIES: While in a foreign country, a U.S. citizen is subject to that country's laws and regulations, which sometimes differ significantly from those in the United States and may not afford the protections available to the individual under U.S. law. Penalties for breaking the law can be more severe than in the United States for similar offenses. Persons violating Albania’s laws, even unknowingly, may be expelled, arrested or imprisoned. Penalties for possession, use, or trafficking in illegal drugs in Albania 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. Under Albanian law, police can detain any individual for up to 10 hours without filing formal charges. U.S. citizens are encouraged to carry a copy of their U.S. passports with them at all times to show proof of identity and U.S. citizenship if questioned by local officials.

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 Albania 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 Albania. Americans without Internet access may register directly with the nearest U.S. Embassy or Consulate. By registering, American citizens make it easier for the Embassy or Consulate to contact them in case of emergency. The U.S. Embassy is located at Rruga Elbasanit 103, tel. (355)(4) 2247285; fax (355)(4) 2232222. The U.S. Embassy web site is http://tirana.usembassy.gov/ * * * This replaces the Consular Information Sheet dated June 10, 2008, to update sections on Entry and Exit Requirements, Medical Facilities and Health Information, and Traffic Safety and Road Conditions.

Travel News Headlines WORLD NEWS

Date: Fri, 9 Mar 2018 16:28:50 +0100

Tirana, March 9, 2018 (AFP) - The military has been deployed in northern Albania to help hundreds of people trapped by floods following heavy rainfall, authorities said on Friday.   More than 9,230 hectares (22,800 acres) of agricultural land is underwater in the Shkodra region, including villages where the only means of transport is by boat, the defence ministry said.

Army personnel are evacuating residents and securing food supplies in the affected areas, 100 kilometres (60 miles) north of the capital, Tirana.   The torrential rain in recent days has caused landslides damaging dozens of homes and flooding roads, said the transport ministry.   The rain has also forced the Albanian authorities to release excess water from a hydroelectric plant, which has added to the flooding in northern areas of the country.   Weather forecasters say the rain is likely to ease from Saturday.
Date: Sun, 3 Dec 2017 12:29:40 +0100

Tirana, Dec 3, 2017 (AFP) - Thousands of police and soldiers have been deployed in Albania to rescue stranded residents after heavy rainfall triggered major flooding, and caused the death of a utility worker, officials and the power company said Sunday.   The victim, Sabri Vlinga, died while he was working on a electricity pole at Roskovec in the flooded south of the country, the power company said in statement.   Two other people were injured in similar accidents. it added.   Some 6,400 police and soldiers have been sent to help rescue people stranded by the floods, Prime MInister Edi Rama said Saturday, calling the situation "very critical".

Around 1,500 people in the affected areas have been rescued, while several thousand homes were without electricity as many utility poles have been swept away by mudslides, said Shemsi Prenci, head of civil protection.   More than 7,874 hectares (19,450 acres) of farm land as well as 3,193 homes are under water and several roads in the south remained impassable.

Army forces have built a temporary bridge at Darezeze, about 70 kilometres (44 miles) from the capital Tirana, to come to the aid of 2,000 residents stranded by the floods, the defence ministry said.    In neighbouring Macedonia, the heavy rains have also caused flooding as several rivers include the main Vardar river have burst their banks, the MIA news agency reported.
Date: Sat 5 Aug 2017
From: Edmond Puca <edmond_puca@yahoo.com> [edited]

Here in Albania, we have 2 imported cases of haemorrhagic fever with renal syndrome (HFRS), one imported from the north of Greece and another from Macedonia in a village near the border with Albania.

The patient from Macedonia is 25 years old. He presented in the emergency room on 31 Jul [2017]. Right now, he is in good condition and will survive. He presented with fever, nausea and vomiting, abdominal pain, and lower back pain.

The other patient from Greece had been in our service for the previous 2 weeks and now is at home in good condition.

The disease is caused by Dobrava-Belgrade virus infection.
---------------------------------
Dr Edmond Puca
Infectologue
Department of Infectious Disease
UHC "Mother Teresa"
Tirana, Albania
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[ProMED-mail thanks Dr Edmond Puca for sending in this report.  This and the previous report are the 1st reports of hantavirus infections in Macedonia that ProMED-mail has posted. There is also evidence of HFRS in Greece, although ProMED-mail has not posted reports previously. Sero-epidemiological investigations conducted in several Balkan countries revealed an overall seroprevalence of 4 per cent in Greece (<http://www.sciencedirect.com/science/article/pii/S0168170213004887#>). There doubtless have been Dobrava-Belgrade virus infections in Greece and the Balkans over the years, given that this virus is known to circulate widely in the Balkans.

The yellow-necked field mouse (_Apodemus flavicollis_) is the principle vertebrate host for Dobrava-Belgrade virus. - ProMED Mod.TY]

[A HealthMap/ProMED-mail map can be accessed at:
Date: Mon, 6 Feb 2017 04:30:32 +0100
By Briseida MEMA

Tirana, Feb 6, 2017 (AFP) - Emira Sela covers her face with her hand to hide a disfiguring abscess, the traumatic result of unregulated cosmetic treatments now rampant across Albania.   The 31-year-old began to worry when wrinkles appeared on her face. Sela's hairdresser told her that a simple injection, costing around 60 euros ($65), would banish the signs of ageing.   "She assured me that I would not risk anything. She even listed well-known names" of women who had undergone such treatment, said Sela.   "I did not think twice, I trusted her without asking questions," said the blonde woman with green eyes, her voice trembling.

Albanian hair and beauty salons lacking expertise and medical supervision are offering such cosmetic treatments, unregulated in a legal vacuum, much to the alarm of qualified doctors.   A single injection of a product whose content and dosage Sela knew nothing about was enough to ruin her life in late August.    Despite antibiotics she has permanent pain, fever and nausea, while the abscess on her right cheek forces her eye to half-close and her face is nearly paralysed.   "I am so disfigured that I tried to commit suicide," said Sela, who lost her job in a bank. Her only hope now is corrective surgery at an Italian hospital, scheduled for this month.

- Desiring Kardashian look -
"There are more and more impostors with syringes," said Panajot Papa, a plastic surgeon at a private clinic in Tirana.   "The problem is also the products... Forbidden in Europe, they enter illegally from Turkey or China."    Eriona Shehu, a dermatologist at Tirana's university hospital, said these unregulated synthetic products, such as injected liquid silicone and acrylamide, were being offered at temptingly low prices.

"Cosmetic interventions have become a lucrative industry. The patient is only a customer, exposed to a number of risks."   Shehu said the desire to look like voluptuous US reality television star Kim Kardashian was "destroying the lives of young Albanian girls looking for beauty".   Albanian doctors say the typical age of clients for such procedures is between 16 and 28.    In the country of about three million people, the demand for cosmetic interventions rose more than 50 percent in 2015, according to a study published by Albania's economic magazine Monitor.

Promotional offers can be seen everywhere, such as a beauty salon advertising 20 percent reductions for three people coming together for treatment during the holiday season.   Papa says he has treated a dozen young women aged between 20 and 27 who suffered complications after having their lips and cheekbones swollen with injected liquid silicone for 40 to 50 euros.    The product has been banned for cosmetic use in countries such as Italy and France for more than 15 years.   Papa said such botched interventions left these women prone to particularly bad swellings during their menstrual period, requiring further treatment -- and he warned they may suffer such symptoms for life.

- Closing legal gap -
Albanian doctors are worried about foreign practitioners who come from Italy, Turkey and Greece to work just for a weekend.   "They may not have a diploma, qualification or licence for these kind of interventions or for assuming the responsibility of a patient's medical follow-up," said Besim Boci, head of the otolaryngology department at Tirana's university hospital.   Due to legal loopholes, the judiciary cannot step in.    A spokesman at Tirana's tribunal, Alba Nikolla, admits that it is currently impossible to "open investigations and prosecute based only on complaints" against practitioners.

But authorities are set to tackle this with a draft law to control cosmetic products and beauty salons, which is due to be introduced in parliament in the next few months.   The law complies with the requirements of the European Union, which Albania aspires to join, and will enable authorities to shut down rogue establishments using synthetic products.    When health is adversely affected, practitioners could be imprisoned for three to 10 years.    Such regulations could go some way to easing the trauma of women like Elisa Lura, a 22-year-old economics student.   She underwent a laser treatment to restore her natural look after paying 50 euros to a neighbourhood salon for permanent eyebrow tattoos, which went wrong. But the laser made things much worse.   "Everything is spoiled!" she said of her face now covered with painful scars.
Date: Wed, 13 Jan 2016 04:21:54 +0100
By Briseida MEMA

Tirana, Albania, Jan 13, 2016 (AFP) - With her sick daughter in the arms, Mira Lela pushes her way through the hallway of the doctor's clinic, crowded with patients ailing from heavy pollution in Albania's capital.   "This is an emergency, she has difficulty breathing," said the tearful woman, forcing open the door to the office of Bardhyl Vaqari, who has worked in the specialist Tirana clinic for more than 20 years.   "An acute asthma attack," said the doctor on seeing the child.   "The number of people with respiratory allergies and cardiovascular problems has greatly increased," he told AFP, adding that the number of patients on the clinic's books has more than doubled to 8,000 in the last four years.

On the noisy and congested streets outside, clapped-out bangers and Hummer trucks cross paths with Mercedes, BMWs and overloaded buses that leave a trail of black smoke and heavy odour.    Having been cut off from the world under a strict communist regime until 1991, the Western Balkan city had just a few hundred cars on its roads in the 1990s.

But today, through a mixture of pride, luxury-seeking and necessity, given the lack of public transport, there are more than 190,000 cars circulating in a city of about one million people.   "Albanians take the car even when going to buy bread in a nearby store. That's why the traffic is overloaded all day and this increases pollution levels," said Altin Duka, a despairing 65-year-old shopkeeper.

The average age of vehicles on Tirana's roads is around 16 years, twice the European average, according to Gani Cupi, deputy manager of Albania's Road Transport Services.    Many of the vehicles do not meet the standards of the European Union, which Albania hopes to join.   "The traffic load, the age of vehicles, their technical condition but also the poor quality of fuel are all factors contributing to the capital's pollution," said Cupi.

- Taxing dilemmas -
In a bid to clean up the air, Albanian authorities considered doubling taxes on ageing vehicles but then dropped such plans. Analysts suggested the cost would weigh too heavily on citizens in one of the poorest countries in Europe.   New cars are already exempt from paying annual tax for the first three years, but authorities in 2012 lifted a levy on the import of old vehicles as the EU considered it a "fiscal discrimination".

Tirana's Mayor Erion Veliaj has pledged to battle against the fumes by increasing the number of green spaces, introducing hybrid buses and improving infrastructure in the city, which is crammed with mostly illegal constructions.   "The number of vehicles does not stop growing," he told AFP, pointing out that about 500 people die in the city each year "because of respiratory or cardiovascular problems related to pollution".

A report this year from the European Environment Agency noted a 20 to 30 percent decrease in Tirana's concentration levels of PM10 and PM2.5 -- damaging particulate matter -- according to data assessment from 2011 to 2013.   But Laureta Dibra, head of the air and climate change department at Albania's Environment Ministry, told AFP that PM10 levels had actually been rising in areas of heavy traffic in recent years.   Tirana remains "among the most polluted cities in Europe", added the director of the National Environment Agency, Julian Beqiri.   "The level of the population's exposure to pollutants is still a problem," he said.

- On your bikes -
In an effort to improve air quality in the capital and educate residents, Tirana organised two car-free days in 2015, when the air was said to be at least four times less polluted than usual.   Worried activists are campaigning to promote the bicycle as a means of transport and a way of life.   Ecovolis, a bike sharing system, rents out at least 200 bicycles from different tations around Tirana, at 60 leke (44 euro cents, $0.47) per bike per hour -- but many people still prefer getting behind the wheel.

Although Albania's energy minister claims that 95 percent of fuel meets the required standards, even Prime Minister Edi Rama attacked its quality in May last year.   "It is so bad that even a strong car like a Mercedes ends up being bad for Albanians' lungs," he said, calling for urgent measures to improve fuel controls.   The government says restrictions have since been tightened, but those at the frontline of the fumes remain unhappy.   "I come home in the evening with a completely dry throat and a bitter taste my mouth," said Bequir Veseli, 37, a traffic policeman who spends eight hours a day at the centre of a chaotic roundabout.   "I have trouble breathing but what can I do? The next day I have to go back to my post".
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Seychelles

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

Travel News Headlines WORLD NEWS

18th Oct 2017
http://www.who.int/mediacentre/news/releases/2017/seychelles-plague-negative/en/ 

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

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

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

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

WHO currently assesses the risk of spread of plague in the Seychelles to be low.
Date: Fri 13 Oct 2017
Source: Medical Xpress [edited]

The Seychelles government ordered schools to close [Fri 13 Oct 2017], after the discovery of 2 suspected cases of plague thought to have been brought from Madagascar where the disease has killed scores. The health ministry has also put under surveillance 320 people who have come into contact with the 2 patients. A total of 12 people showing plague-like symptoms have been admitted to hospital and given antimicrobials.

Panic gripped parents on the Indian Ocean archipelago after some students developed fevers in recent days, leading to the school closures.

"We made this decision as a precautionary measure to reassure parents," said Merida Delcy, an adviser to the education ministry, noting that they would not reopen until [Wed 18 Oct 2017], at the earliest.

Preliminary tests on the 2 people, including a Seychellois who returned from Madagascar a week ago, showed they could have plague, the health ministry said.

"It has not yet been confirmed that the 2 people are sick due to plague, samples will be sent this weekend to the Institut Pasteur (in France)," said public health commissioner Jude Gedeon. The results are expected next week [week of Sun 15 Oct 2017].

The sick include a student at Anse Boileau Elementary School on the main island of Mahe where all students have since been given antimicrobials.

As fear of plague spreads, there has been a run on surgical masks which people hope will offer protection against the highly infectious disease. Plague outbreaks are common on Madagascar, 1800 kilometres (1120 miles) to the south, where the disease is endemic. But this year [2017] both bubonic plague, spread by infected rats via flea bites, and the pneumonic type, spread person-to-person, have hit urban areas, including the capital Antananarivo, leaving at least 54 dead.

A Seychellois basketball coach who was visiting Madagascar is among the victims. The Seychelles government has begun to quarantine people who have arrived from Madagascar in the last week [week of Sun 1 Oct 2017]. The latest Madagascar health ministry report this week says 500 cases and 54 deaths [now 561 and 57 - ProMED Mod.LL] have so far been recorded, with around half of each occurring in the capital.
=====================
[There is no confirmation about any cases acquired on Seychelles on the Ministry of Health facebook page <https://www.facebook.com/mohseychellesofficial/>. ProMED awaits confirmation of additional cases of _Y. pestis_ infection on Seychelles in addition to the imported case from Madagascar. - ProMED Mod.LL]

[A HealthMap/ProMED-mail map can be accessed at:
Date: Wed 11 Oct 2017
Source: Seychelles Ministry of Health [summ., edited]

Dr Jude Gedeon met with the media on Wed 11 Oct 2017, to give an update on the pneumonic plague situation in Seychelles. Speaking to several media houses, he addressed the case of pneumonic plague that was confirmed yesterday, 10 Oct 2017. He also stressed on current and additional measures being taken by the Ministry of Health to prevent this from spreading.

New measures being implemented against pneumonic plague:
- everyone entering Seychelles from Madagascar will immediately be referred to the isolation centre in Perseverance [Perseverance Island is an artificial island in Seychelles, lying 2 km (1.3 mi) from the capital Victoria]. - ProMED Mod.LL]
- no foreigners coming to Seychelles from Madagascar will be granted entry. Only Seychelles citizens will be allowed to enter the country.
- a Travel Advisory has been issued, in collaboration with Seychelles Tourism Board requesting all transiting points (Mauritius, Kenya, and Reunion) to redirect all passengers who are not a citizen of Seychelles.
- cargo ships will continue to be monitored as before. If anyone presents with symptoms within less than 7 days of leaving Madagascar, the ship will remain in isolation at sea. If anyone on board is sick, they will receive treatment;
- cruise ships are advised to remain at sea for at least 7 days before entering the port after visiting Madagascar. If it is less than 7 days (incubation period) all passengers and crew will remain under surveillance for the recommended time before entering the country.
*******************************
Date: Wed 11 Oct 2017 12:59 SCT
Source: Seychelles News Agency [edited]

Visitors to Seychelles who have visited Madagascar or transited through that island nation in the last 7 days will be placed under observation by health officials upon arrival to Mahe.

The Minister of Health, Jean-Paul Adam, made the statement in the National Assembly on [Wed 11 Oct 2017] when answering an urgent question from the Leader of the Opposition, Wavel Ramkalawan. Adam was called to the National Assembly after the 1st case of pneumonic plague in Seychelles was confirmed on Tue 10 Oct 2017. The patient is a man who returned to Mahe, the main island, last [Fri 6 Oct 2017], on board the last Air Seychelles flight from Madagascar.

The health minister also confirmed that 258 people are currently under observation and receiving treatment after the case of pneumonic plague was detected. "The 258 includes 41 passengers and 7 crew from the flight, 12 close family members, and 18 staff and patients from the Anse Boileau health centre where the man went when he fell ill."

The man disobeyed instructions given upon his arrival to remain at home for a period of time and attended a party that same evening. The minister explained that the result of the tests conducted on the infected man was sent to the Pasteur Institute in Paris, which confirmed the pneumonic plague.

Adam said that "all the 170 people who were at the party including the 13 staff working at the venue are also under passive surveillance. We were already putting Seychellois and tourists under active observation at their homes or at hotels. But as from today [11 Oct 2017], all those arriving from Madagascar will be put in isolation for 6 days," the Minister said.

Adam added that the authority will be using the Seychelles Coast Guard military academy as the isolation centre located at Perseverance, a reclaimed island on the outskirts of Victoria.

The national airline -- Air Seychelles -- had suspended all flights to Madagascar, following guidance and requests of the Seychelles' Public Health Authority amid concerns over the outbreak of the plague in Madagascar. To date, there are 449 cases confirmed in Madagascar and 48 people have died [now 500 cases and 54 deaths - ProMED Mod.LL]. Air Seychelles is the only airline in the region to suspend all its flights to the island.

The health ministry has also liaised with the Seychelles Fishing Authority to get fishermen who may have travelled to Madagascar recently to report their trips and if necessary to seek advice from health professionals. "We are also in contacts with boats, and we want to urge those who may have travelled to Madagascar informally to stop this practice and to report to their nearest health centres." Adam said this is important for assessment and also "for us to decide if they need to be placed under surveillance for treatment. We are also liaising with travel agents to discourage people from visiting the island."

Seychelles, a group of 115 islands in the western Indian Ocean, is on high alert ever since it was confirmed that a Seychellois basketball coach, who died in a hospital in Madagascar in September 2017, had contracted the plague.
====================
[Seychelles seems to have responded in appropriate ways related to the single importation (so far) of a person who developed pneumonic plague after returning from Madagascar. It is not clear if this case had any relationship to the basketball tournament that had occurred on Madagascar. Since there is no comment in this report regarding institution of antimicrobial prophylaxis to any of the contacts. - ProMED Mod.LL]

[HealthMap/ProMED-mail maps can be accessed at
Date: Sat, 14 Oct 2017 16:49:58 +0200

Mogadishu, Oct 14, 2017 (AFP) - More than 20 people were killed when a car bomb exploded on a busy street in Somalia's capital Mogadishu on Saturday, a police official said.   "Initial reports from emergency departments indicate more than 20 bodies picked up off the street and many more are under the wreckage of buildings destroyed by the blast", said Ibrahim Mohamed, a senior police officer.   Government security official Mohamed Aden said that bombing took place in a busy part of the city.    "There was a huge blast caused by a truck loaded with explosives. It went off at the entrance of a hotel alongside the K5 intersection," he said.   There was no immediate claim of responsibility, but the Al-Qaeda aligned Shabaab carries out frequent suicide bombings in the capital and elsewhere as it fights to overthrow the internationally-backed government.
Date: Fri, 13 Oct 2017 16:03:29 +0200

Victoria, Seychelles, Oct 13, 2017 (AFP) - The Seychelles government ordered schools to close Friday, after the discovery of two suspected cases of plague thought to have been brought from Madagascar where the disease has killed scores.   The health ministry has also put under surveillance 320 people who have come into contact with the two patients.

A total of 12 people showing plague-like symptoms have been admitted to hospital and given antibiotics.   Panic gripped parents on the Indian Ocean archipelago after some students developed fevers in recent days, leading to the school closures.   "We made this decision as a precautionary measure to reassure parents," said Merida Delcy, an adviser to the education ministry, noting that they would not reopen until Wednesday at the earliest.
 
Preliminary tests on the two people, including a Seychellois who returned from Madagascar a week ago, showed they could have plague, the health ministry said.   "It has not yet been confirmed that the two people are sick due to plague, samples will be sent this weekend to the Institut Pasteur (in France)," said public health commissioner Jude Gedeon.   The results are expected next week.   The sick include a student at Anse Boileau Elementary School on the main island of Mahe where all students have since been given antibiotics.

As fear of plague spreads, there has been a run on surgical masks which people hope will offer protection against the highly infectious disease.   Plague outbreaks are common on Madagascar, 1,800 kilometres (1,120 miles) to the south, where the disease is endemic. But this year both bubonic plague, spread by infected rats via flea bites, and the pneumonic type, spread person-to-person, have hit urban areas, including the capital Antananarivo, leaving at least 54 dead.

A Seychellois basketball coach who was visiting Madagascar is among the victims. The Seychelles government has begun to quarantine people who have arrived from Madagascar in the last week.   The latest Madagascar health ministry report this week says 500 cases and 54 deaths have so far been recorded, with around half of each occurring in the capital.
More ...

World Travel News Headlines

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

- Do not provoke -

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

- Be alert and prepared -

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

An image of a _Pteropus_ fruit bat can be found at

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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