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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: Sat, 21 Sep 2019 20:39:17 +0200 (METDST)

Tirana, Sept 21, 2019 (AFP) - Albania was rattled by its strongest earthquake in decades Saturday, officials said, sending people fleeing into the streets in several cities, damaging buildings and triggering power cuts in the capital.   The epicentre of the shallow 5.6-magnitude quake, was near Durres, less than 40 kilometres (25 miles) west of the capital Tirana, according to the US Geological Survey.

Albania's defence ministry said it was the "strongest earthquake in the country in the last 20 to 30 years".   "There are no deaths," defence ministry spokeswoman Albana Qajaj said.   Some 80 people sought medical help in both Tirana and Durres, 21 of whom were hospitalised due to injuries caused by falling objects or parts of walls as well as for panic attacks, Health Minister Ogerta Manasterilu said.   Qajaj told AFP that houses and buildings in Tirana had been damaged but were still standing and that the ministry was accessing damage in other towns and villages.   Prime Minister Edi Rama cancelled his scheduled trip to the United States following the quake, which cut electricity and telephone lines in Tirana and a number of other towns and villages.

Many people remained outside their homes for several hours in the capital, fearful of aftershocks.   "I fear to return because such a strong earthquake could be followed with others," Drita Lohja, a resident in her fifties, told AFP.    Falling debris pulverised parked cars in parts of the city.   AFP reporters and witnesses saw windows broken and deep fissures in the facades of buildings in Durres, as well as in the capital.   Media reported that a large building in Tirana was seriously damaged and that residents were being evacuated.   A University of Tirana building was also damaged, witnesses said.

According to local media reports, at least two people were lightly injured and a dozen houses collapsed in the village of Helmes, 10 kilometres from Tirana.   Two other earthquakes followed the strong one that occurred at around 4:00 pm (1400 GMT) and was felt in neighbouring Montenegro and Italy, but also on the Greek island of Corfu according to some Twitter users.
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
===================
[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.
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United States of America

FCO - UK information on the United States
Updated: 25 July 2002

SUMMARY
Most visits to the United States are trouble-free. However, visitors should continue to be vigilant about their personal security.

SAFETY AND SECURITY<
R />Travellers to the United States should use common sense and take basic precautions.

If staying in a hotel, do not leave your door open at any time.

Do not wear ostentatious jewellery and avoid walking in obviously run down areas.
If arriving at night, take a taxi to your hotel and collect your hire car the next day.
If departing on an evening flight avoid leaving luggage and souvenirs in view in your hire car during the day. Thieves are targeting these vehicles and stealing the contents.
Drive on main highways and use well-lit car parks.

Do not stop if your car is bumped from behind. Instead, indicate to the other driver to follow you to the nearest public area and call for police assistance.
Do not sleep in your car on the roadside or in rest areas.
LOCAL LAWS AND CUSTOMS
Travellers wishing to visit Canada during their stay should contact the Canadian Consulate and US Immigration and Naturalisation Service for entry clearance requirements. If travellers have 90 day visa waiver for US, they should not wait until the end of their stay to travel between US and Canada. Travellers must not overstay past expiration date of their visa as they may risk being denied entry in either country or be deported. Travellers need to carry passports, round trip airline tickets showing their confirmed departure for return from US or Canada to country of origin, and they may need to show proof of sufficient funds to cover their stay.

Travellers should be aware that the age of consent varies from state to state in the US, as does the age at which someone may legally buy and consume alcohol.
ENTRY REQUIREMENTS
Foot and Mouth Disease:
Travellers are prohibited from carrying into the US any agricultural products, particularly animal products – including dairy products – that could spread FMD. (Some hard cheeses and canned meats are permitted. If you are in any doubt, you must check with a US customs or US Department of Agriculture (USDA) official immediately on arrival in the airport terminal). Passengers are required to tick the appropriate box on the US Customs declaration form if they have recently visited a zoo, or been on a farm or in contact with livestock. Passengers are specifically required to identify any farm contacts to US Customs and USDA officials. All luggage is subject to inspection. Penalties for not declaring farm visits or prohibited items can run to $1,000.

All US ports of entry and airports are on heightened alert to ensure that passengers, luggage and cargo are checked as appropriate. This includes placing additional inspectors and dog teams at airports to check incoming flights and passengers.

USDA are saying that soiled shoes, clothing or luggage will be disinfected on arrival. Food products and any other items suspected of potentially carrying the FMD virus will be confiscated and destroyed.
HEALTH
Medical treatment can be very expensive; there are no special arrangements for British visitors. The British Embassy and Consulates-General cannot assist with medical expenses.

Travellers who are HIV-positive
Travellers to the United States who are HIV-positive are not eligible, under current United States visa law, to travel visa free under the Visa Waiver Programme. They are required to apply for a visa and a waiver of the ineligibility before travelling. US immigration authorities state applicants’ details will remain confidential and an applicant’s HIV status will not/not be declared on their passport. For more details contact the US Embassy in London.
GENERAL
Comprehensive travel and medical insurance is essential.
NATURAL DISASTERS
Visitors to the United States will be aware of reports of large-scale wild and forest fires throughout the country. Those travelling to affected areas should be particularly vigilant and pay attention to advice from local authorities and press and radio announcements about personal safety and how to avoid starting fires. Further information can be obtained from the National Interagency Fire Centre, 3833 S. Development Avenue, Boise, Idaho, 83705-5354; tel: +1 208 387 5512; Website: www.nifc.gov

Travel News Headlines WORLD NEWS

Date: Mon 4 Nov 2019
Source: WGME [edited]

Bath [Maine] police say they had another rabid fox attack Sunday [3 Nov 2019]. Police say around 11:45 am, they received a report in the area of 305 Washington Street that a fox had bit a 52-year-old man.

The man had been in his yard doing yardwork when he was attacked. He suffered bites and scratches on his legs.

Officers say they located the fox and killed it. The fox was confirmed to be rabid at the DHHS Health and Environmental Testing Lab in Augusta [Maine]. According to the lab, Bath has had 13 positive test results for rabies this year [2019].
======================
[In the USA, there exist several wildlife variants of _Lyssavirus_ that circulate in bats, raccoons, skunks, foxes and coyotes. Transmission rarely occurs between species, and these "spillover events" generally are not perpetuated in the recipient species.

While bats with rabies are found throughout the USA, main terrestrial reservoirs differ depending on the geographical location. Foxes are common carriers of rabies in New Mexico, Nevada and Alaska but not in Maine (see map here: <https://www.cdc.gov/rabies/exposure/animals/wildlife_reservoirs.html>). The main host for rabies in Maine is raccoons.

It is very important to make sure to keep the vaccination schemes of all domestic carnivores (i.e., dogs, cats, ferrets) in the area up to date and not to approach wildlife with unusual behavior. - ProMED Mod.PMB]

[HealthMap/ProMED-mail map:
Bath, Maine, United States: <http://healthmap.org/promed/p/26463>]
Date: Sun 3 Nov 2019
Source: The Citizen's Voice [edited]

A rare mosquito-transmitted virus that can be fatal to humans was recently confirmed in a deer found in Luzerne County. On [9 Oct 2019], the Pennsylvania Game Commission received a report of an emaciated deer standing on Swamp Road in Hunlock Township.

According to the agency, the deer -- a doe -- stood with its head down and didn't respond when humans approached. The animal was euthanized by Game Commission officials, and subsequent testing revealed it was infected with eastern equine encephalitis [EEE].

While there have been no reported cases of EEE in humans in the state, there have been several confirmations of the virus appearing in wildlife and livestock during October [2019].

In addition to the deer in Hunlock Twp, EEE has also been found in captive pheasants in Monroe County, horses in Carbon County, and 2 wild turkeys in Erie County.

Kevin Wenner, a biologist with the Game Commission in the Northeast Region Office, said the deer in Hunlock Twp represents the 1st instance of EEE in wildlife in the area, but it's difficult to predict if more cases will follow.

"We're not experiencing any significant mortality with deer and this happens to be one individual that was tested," he said. "It's possible that we're not aware of every case because a sick animal could die and never be found, but we're not getting an increase in calls regarding sick deer."

Equine encephalitis is transmitted to people, mammals, and birds through the bites of mosquitoes that have fed on infected birds. Most birds with EEE do not show any symptoms and never become ill. However, EEE can cause illness and death in some bird species -- most often pigeons, pheasants, turkeys and quail.

According to the Centers for Disease Control, symptoms of EEE in people develop 4 to 10 days after being bitten by an infected mosquito.

There are 2 types of illness that occur -- systemic and encephalitic. The former resembles flu-like symptoms and lasts up to 2 weeks. In the case of encephalitic illness (swelling of the brain), approximately a 3rd of all people afflicted die from the disease, according to the CDC. An average of 7 human cases of EEE are reported annually in the United States.

While the occurrence of EEE is not widespread in the region or state, Wenner said the threat will go away once cold weather arrives and knocks out the mosquito population.

"It sounds like this is a disease that comes and goes. It's not new, but we'll go through stretches where there are no cases for years and then it shows up," he said.

But right now, EEE is here, and since the disease has infected a deer in the wild, what does it mean for hunters? With archery deer season remaining open until [16 Nov 2019] and the statewide firearms season set to begin on [30 Nov 2019], are hunters at risk simply contacting a deer that harvest?

"There shouldn't be a fear that every deer out there has this and they shouldn't be consumed," Wenner said. "It's pretty uncommon in deer, and while people shouldn't be scared, they should be aware and take simple precautions to help prevent exposure."

Additionally, EEE can only be transmitted via a bite from an infected mosquito and not by direct contact, such as field dressing a deer. There is also no evidence that transmission can occur from consuming the meat of an infected animal, according to the Game Commission.

And even though birds are the primary host for the virus, Wenner said it doesn't mean that people should refrain from feeding birds. "Just take the necessary precautions to avoid being bitten by mosquitoes, such as using repellent and getting rid of any standing water around your home," he said.

Equine encephalitis is one of several diseases in Pennsylvania that can impact deer. Chronic wasting disease turned up in 2012 and has spread through parts of the south-central and south-western areas of the state, and epizootic hemorrhagic disease -- which is transmitted by biting flies -- has turned up in Pennsylvania in localized areas since 2002.

"It makes you think," said Game Warden Gerald Kapral, whose district includes Hunlock Twp. "Everyone sees a sick deer and they assume its chronic wasting disease, but this EEE case is an example that there's more out there."  [Byline: Tom Venesly]
===================
[Eastern equine encephalitis (EEE) virus (Togaviridae, _Alphavirus_) is maintained in an enzootic transmission cycle involving ornithophagic mosquitoes, specifically _Culiseta melanura_ (Diptera: Culicidae), and passerine birds in freshwater swamp foci. The virus is focally endemic in eastern North America, the Caribbean, and Central and South America.

Because there are very few reports of disease due to EEEV in deer, coupled with a relatively high antibody prevalence at endemic sites, we believe that deer are commonly infected with this virus but are relatively refractory to clinical disease. EEE, therefore, may not be an important disease in white-tailed deer in the eastern United States. - ProMED Mod.PMB]

[HealthMap/ProMED-mail map of Pennsylvania, United States:
Pennsylvania county map:
Date: Sun 3 Nov 2019
Source: The North Platte Telegraph [edited]

The Southwest Nebraska Public Health Department has confirmed a case of [a] hantavirus [infection] in the 9-county [Chase, Dundy, Frontier, Furnas, Hayes, Hitchcock, Keith, Perkins, and Red Willow] health district. This is the 1st reported case of hantavirus in the southwest Nebraska area in over 6 years.

According to the Centers for Disease Control and Prevention, hantavirus infection is usually found in rural areas where forest, fields, and farms offer suitable habitat for rodents. Hantavirus in the US is spread to people from rodents like mice, most commonly when fresh rodent urine, droppings, or nesting materials are stirred up. Tiny droplets containing the virus get into the air and are then breathed in.

"This can easily happen when cleaning out grain bins, barns or old abandoned buildings," said Melissa Propp, RN.

Symptoms of hantavirus usually start out with vague flu-like symptoms approximately several days to 6 weeks after exposure. A fever for 3-5 days, headache, muscle aches, chills, non-productive cough, nausea, vomiting or other gastrointestinal symptoms like diarrhea or abdominal pain are common. Tiredness and lightheadedness may also be present. Most people recover fully but some cases of hantavirus may be severe or even fatal. "If you have flu-like symptoms and have cleaned out a building with evidence of rodents, alert your provider," states Propp.  It is important not to stir up dust by sweeping or vacuuming.
Hantavirus [infections] can be prevented by following these tips:
- air out the building for a least 30 minutes prior to starting your cleaning. Open doors and windows to allow good air flow and leave the area while airing out;
- wear gloves while cleaning up urine and droppings. A dust mask may also be worn as additional protection;
- dampen the urine, droppings, and nesting materials with a mixture of 1-part bleach to 10 parts water or use a disinfectant. Allow to soak for 5 minutes prior to removal;
- clean counters, cupboards and other surfaces with disposable towels;
- mop floors rather than sweeping or vacuuming;
- for dirt floors wet the area down with bleach solution or disinfectant before removal of debris to keep down the dust;
- disinfect any tools used in the cleaning process with a bleach solution.
- wash hands thoroughly with soap and water after cleaning tools and disposing of materials.

For more information about hantavirus visit
====================
[This is not the 1st case of a hantavirus infection in Nebraska. In May 2005, a western Nebraska man in his early 50s died after being infected with hantavirus. A 37-year-old rural Grant man became the state's 4th person to test positive for the potentially deadly hantavirus on 31 Aug 2002. A 30-year-old male of Lyman became the 1st person in 2002 to die from the disease in Nebraska on 13 Jun 2002. Other Nebraska cases include those of a 41-year-old male, of Champion, who was hospitalized in Kearney from 24 Jun 2002 to 14 Jul 2002 and another male, age not specified, of Benkleman, was diagnosed with the 1st known case of hantavirus in Nebraska in 1998. Both recovered. As of January 2017, Nebraska has reported 9 cases of hantavirus infection (<https://www.cdc.gov/hantavirus/surveillance/reporting-state.html>)

Although not mentioned, the hantavirus involved in these and the above case is likely Sin Nombre virus and its rodent host is the deer mouse (_Peromyscus manipulates_). Nebraska is within the geographic range of this rodent. Individuals in Nebraska and elsewhere within the range of this rodent are well advised to follow the recommendations listed above to avoid exposure to this virus.

An image of a deer mouse (_Peromyscus maniculatus_) can be accessed at

[HealthMap/ProMED-mail map of Nebraska, United States:
Nebraska county map:
Date: Tue 29 Oct 2019
Source: The Narragansett Times [edited]

The Rhode Island Department of Health (RIDOH) [has] confirmed [that] 2 individuals have been treated for exposure to the rabies virus since September [2019] after encounters with rabid wild animals in Narragansett [Washington County]. The department also noted [that] 4 wild animals from Narragansett have tested positive for the potentially deadly virus since March [2019].

Four animals submitted for testing at RIDOH's State Health Laboratories have tested positive for rabies this year [2019]. The 1st came in March -- a rabid skunk on Tarzwell Drive. In August, a raccoon spotted on Kathy Street tested positive for the virus. Then, in September, a woodchuck/groundhog seen on Onondega Road was confirmed
to possess the virus. Most recently, this month [October 2019], a skunk on Wild Field Farm Road tested positive for rabies after an encounter with a dog in the yard of a residence on the street.

"We received confirmation of another skunk captured on [Fri 18 Oct 2019] after attacking a dog, tested positive for rabies," wrote Narragansett Animal Control on its Facebook page on 21 Oct 2019.

Residents have become concerned regarding the prevalence of the virus locally, though RIDOH stated the increase in confirmed cases of the virus was not cause for alarm. "The number of rabid animals identified in any given community varies from year to year," said Joseph Wendelken, RIDOH public information officer. "The number of rabies-positive animals [confirmed in Narragansett] in 2019 has been higher than expected, but we're dealing with relatively small numbers. The increase in 2019 is not considered statistically significant, meaning the increase is likely due to chance. For example, we have seen year-to-year increases like this in other communities in the past."

According to RIDOH, 5 wild animals from Narragansett were tested by the department in 2016; 4 in 2017, and 9 in 2018. All of these tests were negative. In 2019, 7 animals have so far been tested by RIDOH. 4 have tested positive. According to Monica Tutko, who works full time as a Narragansett animal control officer, the animal control department has received over 50 calls for animals "appearing to be sickly in some manner" since June of last year [2018]. The animal control officer also stated in July of this year, a fox believed to be possibly rabid attacked multiple people and animals in a 24-hour period and was never caught for testing, despite efforts to do so.

Tutko said the situation in Narragansett needed to be taken "quite seriously." RIDOH said while the increase did not indicate a concerning trend upward, residents should still take precautions to decrease risk of exposure. "You can't tell if an animal has rabies by just looking at it," said Wendelken when asked how rabid animals could be identified. "The only way doctors can know for sure if an animal or a person has rabies is to do laboratory tests. A clue though is if the animal is acting strangely. Some animals may act mad when they have rabies. They will be hostile and may try to bite people or other animals. Other animals may act timid or shy when they have rabies. A wild animal might move slowly or act tame. The best thing to do is to never feed or approach a wild animal. Be careful of pets you do not know."

One resident posted to a private resident Facebook page about a September [2019] encounter he had with a rabid woodchuck leaving both he and his wife in need of multiple shots after a recommendation for treatment from RIDOH. The resident concluded the post by asking what was being done to combat the rise in local rabid wild animals.

If a human is bitten by an animal believed to be possibly rabid, washing the wounded area with soap and water for 10-15 minutes is recommended by RIDOH to help remove the virus. The department also strongly suggests contacting a doctor or hospital ER immediately and alerting the local animal control officer of the incident in an effort to further protect others from potential exposure. The public can also call the Rhode Island Department of Health Rabies Control Program to report an exposure (401-222-2577 Monday-Friday from 8:30 am to 4:30 pm; 401-276-8046 after hours). If the animal is a stranger's pet, ask for the owner's contact information, according to RIDOH.

The department also had recommendations when it comes to pet safety. "If your pet has been bitten, try to find out what animal attacked your pet," said Wendelken. "Do not touch the attacking animal. Wear rubber gloves and use a hose to wash your pet's wounds. Do not touch your pet with bare hands. There may be saliva from the attacking animal on your pet. Call your pet's vet immediately, even if the wound is minor. Local animal control should be contacted to report the incident."

RIDOH stated even if a pet has already been recently vaccinated for the virus, a veterinarian should still be contacted immediately and the incident should still be reported to the local animal control. Further recommendations include never approaching a wild animal, being careful around pets one is not familiar with, refraining from petting stray cats or dogs and contacting local animal control if any animal is observed acting strangely.

In the United States, animals most likely to carry rabies are wild animals such as bats, raccoons, skunks, foxes, and woodchucks. Dogs, cats, and ferrets can also carry rabies, but they are less likely to be infected because of the high vaccination rates among pets.

"Rabies is a fatal but preventable viral disease," concluded Wendelken. "The virus infects the central nervous system. If a person does not receive the appropriate medical care after a potential rabies exposure, the virus can cause disease in the brain, ultimately resulting in death. However, rabies can be prevented by vaccinating pets, staying away from wildlife, and seeking medical care after potential exposures before symptoms start."

Due to the recent exposures, the Narragansett Animal Control is stepping up its number of posts concerning the virus on social media and is hosting a public rabies vaccination clinic for pets at the Narragansett Community Center on Sat 9 Nov 2019 from 10 am to 12 pm. USD 10 cash only and attendees are asked to bring previous pet vaccination records if available. The general public is invited and attendance is not restricted based on Narragansett residence.

Rabies is considered a rare disease in the United States with fewer than 1000 confirmed cases per year.  [byline: Philip Cozzolino]
=====================
[HealthMap/ProMED-mail map of Rhode Island, United States:
 county map:

It is very sad that the person in North Carolina had to have his dog euthanized. But it could have been avoided if he had gotten his pet vaccinated. Let's all learn the lesson here and get our pets vaccinated, and keep those vaccinations up to date. Protecting your pet against this fatal disease applies to all pets, including dogs, cats, horses, cattle, sheep, and goats.

Often it is a skunk or raccoon wandering through a pasture who nips the horse or cow on the nose, thus transmitting this virus. Any animal with rabies can be frightening but a large animal of many pounds more than most of us is exceedingly unsettling. Please vaccinate your pets.

The Rhode Island article is the only article in this group doing community wide low-cost rabies vaccinations for pets. I wonder how many horses or goats or other animals will be brought for a rabies vaccination. Reporting a bite is important, but especially if it is a wild animal or an animal you are unfamiliar with. Remember your life is worth more than guessing if an animal has been vaccinated. - ProMED Mod.TG]
Date: Tue 22 Oct 2019 5:37 PM EDT
Source: WBTV [edited]

Gaston County officials have confirmed the 13th case of rabies discovered in the area in 2019. The incident was reported after a family dog was discovered playing with a deceased raccoon at a residence off of Oakwood Drive in Belmont. Authorities sent the raccoon to officials in Raleigh who determined it tested positive for rabies on [Tue 22 Oct 2019].

The dog involved in the incident was euthanized because it had not received the required rabies vaccinations previously. Citations for this penalty were issued to the pet's owners. The Gaston County Police Department Animal Care and Enforcement unit stresses the importance of having a valid rabies vaccination for all of your pet's health and safety as well as the health and safety of their owners and community.
==================
[HealthMap/ProMED-mail map of North Carolina, United States:
 county map:
More ...

Colombia

Colombia - US Consular Information Sheet
August 13, 2008

COUNTRY DESCRIPTION:
Colombia is a medium-income nation of some 44 million inhabitants.
Its geography is very diverse, ranging from tropical coastal areas and rainforests t
rugged mountainous terrain.
Tourist facilities in Colombia vary in quality and safety, according to price and location.
Security is a significant concern for travelers, as described in the Department of State’s Travel Warning for Colombia.
Read the Department of State Background Notes on Colombia for additional information.

ENTRY/EXIT REQUIREMENTS:
All U.S. citizens who are not also Colombian citizens must present a valid U.S. passport to enter and depart Colombia, and to return to the United States.
Dual U.S-Colombian citizens must present a Colombian passport to enter and exit Colombia, and a U.S. passport to return to the United States.
Be aware that any person born in Colombia may be considered a Colombian citizen, even if never documented as such.
U.S. citizens born in Colombia or who otherwise have Colombian citizenship, will need both a Colombian passport and a U.S. passport for the trip.
U.S. citizens traveling to Colombia do not need a Colombian visa for a tourist stay of 60 days or less.
Travelers entering Colombia are sometimes asked to present evidence of return or onward travel, usually in the form of a round-trip plane ticket.
Americans traveling overland must enter Colombia at an official border crossing.
Travelers arriving by bus should ensure, prior to boarding, that their bus will cross the border at an official entry point.
Entering Colombia at unauthorized crossings may result in fines or incarceration.
Travelers planning to enter Colombia over a land border should carefully read our information on Traffic Safety and Road Conditions below.
The length of stay granted to travelers is determined by the Colombian immigration officer at the point of entry and will be stamped in your passport.
Extensions may be requested by visiting an office of the Colombian immigration authority, known as the Departamento Administrativo de Seguridad, or DAS, after arrival in Colombia.
Fines are levied if a traveler remains in Colombia longer than authorized, and the traveler cannot leave Colombia until the fine is paid.
Any traveler possessing a Colombian visa with more than three months’ validity must register the visa at a DAS immigration office within 15 days of arrival in Colombia or face fines.
The DAS immigration office in Bogota is located at Calle 100 and Carrera 11B.
No arrival tax is collected upon entry into Colombia, but travelers leaving by plane must pay an exit tax at the airport, in cash.
The tax varies with the dollar/peso exchange rate, but is usually between $50 and $70.
Some airlines include all or a portion of this tax in the cost of your airline ticket; check with your airline to find out how much you will have to pay at the airport.
U.S. citizens whose U.S. passports are lost or stolen in Colombia must obtain a new U.S. passport before departing.
They must then present the new passport, along with a police report describing the loss or theft, to a DAS office.
Information about obtaining a replacement U.S. passport in Colombia is available on the U.S. Embassy’s website at http://bogota.usembassy.gov.
Contact information for DAS is available in Spanish at http://www.das.gov.co.
The Embassy in Bogotá or the U.S. Consular Agency in Barranquilla can provide guidance on contacting DAS when you apply for your replacement passport.
For further, specific guidance on Colombian entry requirements, including information about Colombian visas, travelers should contact the Colombian Embassy at 2118 Leroy Place NW, Washington, DC 20008; telephone (202) 387-8338; website: http://www.colombiaemb.org; or the nearest Colombian consulate.
Consulates are located in Atlanta, Boston, Chicago, Houston, Los Angeles, Miami, New Orleans, New York, San Francisco, and San Juan, Puerto Rico.

Also see the Department of State’s general information on Entry and Exit Requirements.
Visit the Embassy of Colombia website at http://www.colombiaemb.org for the most current visa information.
Information about dual nationality or the prevention of international child abduction can be found on our web site.
For further information about customs regulations, please read our Customs Information sheet.
ADDITIONAL EXIT REQUIREMENTS FOR MINORS:
To prevent international child abduction, Colombia has implemented special exit procedures for Colombian children under 18 who are departing the country without both their mother and their father or a legal guardian.
These procedures apply even if the child is also a U.S. citizen.
Complying with the procedures can be complex and time-consuming, especially if an absent parent is outside Colombia at the time.
Advance planning is essential.

The procedures are as follows: Upon exiting the country, the person traveling with the child (or the child him/herself) must present a certified copy of the child’s birth certificate, along with written, signed authorization from the absent parent(s) or legal guardian.
The authorization must explicitly grant permission for the child to travel alone, with one parent, or with a third party, by name.
When a parent is deceased, a notarized copy of a death certificate is required instead of written authorization.
When one parent has sole custody of the child, that parent may present a custody decree instead of the other parent’s written authorization.
If the documents to be presented originated in the United States, they must first be translated into Spanish and then signed in front of a Colombian consul at a Colombian consulate.
Then, upon arrival in Colombia, the documents must be presented to the Colombian Ministry of Foreign Affairs for certification of the consul’s signature.

Alternatively, the documents can be translated into Spanish, then notarized by a notary public in the United States, and authenticated by requesting an apostille from the competent authority in the state where the documents were prepared.
The document, translation, and apostille can then be presented to immigration officers at the airport when the child travels.
If the documents originated in Colombia and are written in Spanish, only notarization by a Colombian notary is required.
For documents originating in countries other than the United States or Colombia, please inquire with the Colombian embassy serving that country.
In cases where the absent parent refuses or is unable to provide consent, the other parent can request assistance from the Colombian child protective service, Instituto Colombiano de Bienestar Familiar (ICBF).
In appropriate cases, ICBF will investigate and may issue a document that will allow the child to travel without both parents’ consent.
This process may take a significant amount of time and is not within the control of the U.S. government.
SAFETY AND SECURITY:
Violence has decreased markedly in many urban destinations, including the cities of Bogota, Medellin, Barranquilla, and Cartagena.
Cali has made less progress combating crime than most other large cities.
The level of violence in Buenaventura remains high.
Small towns and rural areas of Colombia can be extremely dangerous due to the presence of narco-terrorists.
Common crime remains a significant problem in many urban and rural areas, as described in the section on crime below.

The incidence of kidnapping in Colombia has diminished significantly from its peak at the beginning of this decade.
Nevertheless, terrorist groups, including the Revolutionary Armed Forces of Colombia (FARC), and other criminal organizations, continue to kidnap and hold civilians for ransom or as political bargaining chips.
No one is immune from kidnapping on the basis of occupation, nationality, or other factors.
On July 2, 2008, the GOC effected a successful military rescue of three Americans, Ingrid Betancourt, and eleven members of the Colombia security forces. President Uribe called on the FARC to release the remaining hostages and seek peace. Although the U.S. government places the highest priority on the safe recovery of kidnapped Americans, it is U.S. policy not to make concessions to kidnappers.
Consequently, the U.S. government’s ability to assist kidnap victims is limited.

Official and personal travel by U.S. Embassy employees outside most urban areas is subject to strict limitations and reviewed by security officers on a case-by-case basis.
U.S. Embassy employees are allowed to travel by air, but inter- and intra-city bus transportation is off limits to them.
For the latest security information, Americans traveling abroad should regularly monitor the Department of State, Bureau of Consular Affairs’ website at http://travel.state.gov, where the current Travel Warnings and Travel Alerts, as well as the Worldwide Caution, can be found.

Up-to-date information on safety and security can also be obtained by calling 1-888-407-4747 toll-free in the United States and Canada, or for overseas callers, 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:
Although the threat of terrorism has decreased in most of Colombia’s cities, they nevertheless experience much of the same crime that is seen in comparably sized cities throughout the region.
Robbery and other violent crimes, as well as scams against unsuspecting tourists, are common in urban areas.
Generally speaking, if you are the victim of a robbery, you should not resist.
Some of the most common methods used by criminals in Colombia are noted below:
Robberies of ATM customers:
Tourists and others have been robbed after using automatic teller machines (ATMs) on the street.
In some cases, robbers have used motorcycles to approach their victims and later flee the scene.
Americans are urged to use ATMs only inside shopping malls or other protected locations.
Driving to and from the location – rather than walking – provides added protection.
When using an ATM, you should be on the lookout for anyone watching or following you.

Robberies of taxi passengers:
Robbery of taxi passengers is a serious problem in Bogota.
Typically, the driver – who is one of the conspirators – will pick up the passenger and then stop to pick up two or more armed cohorts, who enter the cab, overpower the passenger, and take his/her belongings.
If the passenger has an ATM card, the perpetrators may force the passenger to withdraw money from various ATM locations.
Such ordeals can last for hours.
In almost every case of taxi-related crime, the victims have been riding alone and have hailed taxis off the street.
Rather than hailing a taxi, you should use the telephone dispatch service that most taxi companies offer.
Many hotels, restaurants, and stores will call a taxi for you, and the taxi usually arrives within minutes.
When a taxi is dispatched by telephone, the dispatcher creates a record of the call and the responding taxi.

Robberies while departing airports:
U.S. citizens arriving at major Colombian airports have occasionally been victimized by armed robbery while en route from the airport to their hotel or home.
The perpetrators typically scout out victims at the airport and then follow their vehicles before robbing the occupants at a stoplight.
Travelers should remain vigilant at airports and report to local airport police if they suspect they are being observed.
Robberies on Hiking Trails:
Several U.S. citizens were robbed in 2007 while hiking on nature trails in and around Bogota.
Because hiking trips generally take place in isolated settings, participants are especially vulnerable.
Hikers in Colombia are more protected if they travel in large groups.
Use of disabling drugs:
The Embassy continues to receive reports of criminals in Colombia using disabling drugs to temporarily incapacitate tourists and others.
At bars, restaurants, and other public areas, perpetrators may offer tainted drinks, cigarettes, or gum.
Typically, victims become disoriented or unconscious, and are thus vulnerable to robbery, sexual assault, and other crimes.
Avoid leaving food or drinks unattended at a bar or restaurant, and be suspicious if a stranger offers you something to eat or drink.
Counterfeit money scam:
U.S. citizens in Colombia routinely fall victim to a scam in which purported undercover police officers approach them on the street and request to examine their money, supposedly to determine if it is counterfeit.
The “officers,” who are in fact criminals, then flee with the money.
In a variation of this scam, the thieves may ask to see jewelry.
Legitimate Colombian police officers do not make such requests.

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

The local equivalent to the “911” emergency line in Colombia is 112 for police and 119 for fire.
There will not be an English speaker answering the phone[g1] .

See our information on Victims of Crime.
MEDICAL FACILITIES AND HEALTH INFORMATION:
Medical care is adequate in major cities but varies greatly in quality elsewhere.
Emergency rooms in Colombia, even at top-quality facilities, are frequently overcrowded and ambulance service can be slow. Many private health care providers in Colombia require that patients pay for care before treatment, even in an emergency.
Some providers in major cities may accept credit cards, but those that do not may request advance payment in cash.
Uninsured travelers without financial resources may be unable to obtain care, or relegated to seeking treatment in public hospitals where care is far below U.S. standards.
The Embassy regularly receives reports of U.S. citizens in Colombia who have died or suffered complications from liposuction and other elective surgeries intended to treat obesity.
Before undergoing such a procedure in Colombia, the Department of State recommends that you consult with your personal physician, research the credentials of the provider in Colombia, and carefully consider your ability to access emergency medical care if complications arise.
It is important to confirm that your medical insurance provides coverage in Colombia, to include treatment of complications from elective procedures or medical evacuation if necessary.
Should you suffer complications as a result of medical malpractice, collecting damages from your surgeon may be difficult.
Colombia has seen a recent increase in the use of unregulated drugs that purport to enhance sexual performance.
Several American tourists recently died after using these substances, which come in liquid, powder, or tablet form.
You are urged to seek guidance from a physician before ingesting any such substances in Colombia.
Travelers to the capital city of Bogota may need time to adjust to the altitude of 8,600 feet, which can affect blood pressure, digestion, and energy level, and cause
mild dyspnea with exercise, headaches, sleeplessness, , and other discomfort.
Travelers should drink liberal fluids to maintain hydration,, and should avoid strenuous exercise unti they have acclimated to the altitude.
Travelers with circulatory or respiratory problems should consult a physician before traveling to Bogota or other high-altitude locations.
Information on vaccinations and other health precautions, such as safe food and water and insect bite protection, may be obtained from the Centers for Disease Control and Prevention’s hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747) or via the CDC’s website at http://wwwn.cdc.gov/travel/default.aspx.
For information about outbreaks of infectious diseases abroad consult the World Health Organization’s (WHO) website at http://www.who.int/en.
Further health information for travelers is available at http://www.who.int/ith/en.

Colombia has imposed HIV/AIDS travel restrictions on groups of travelers subject to restrictions or bans.
Entry is restricted to PLWHA (customs officials on the lookout). A waiver may be requested from the Colombian embassy (Source: NAM April 2006, USSD December 06).
Please inquire directly with the Embassy of Colombia at http://www.colombiaemb.org before you travel.

MEDICAL INSURANCE:
The Department of State strongly urges Americans to consult with their medical insurance company prior to traveling abroad to confirm that 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 Colombia is provided for general reference only, and may not be totally accurate in a particular location or circumstance.

Due to the security environment in Colombia, U.S. government officials and their families are not permitted to travel by road between most major cities.
They also cannot use inter- or intra-city bus transportation, or travel by road outside urban areas at night.
All Americans in Colombia are encouraged to follow these same precautions.
Traffic laws in Colombia, including speed limits, are often ignored and rarely enforced, creating dangerous conditions for drivers and pedestrians in major cities.
Under Colombian law, seat belts are mandatory for front-seat passengers in a private vehicle.
Car seats are not mandatory for children, but a child under ten is not permitted to ride in a front seat.
It is against the law to talk on a cellular phone while driving in Colombia, and violators may be fined.
While driving outside major cities, it is mandatory to drive with your lights on.
If an accident occurs, the involved parties must remain at the scene and not move their vehicles until the authorities arrive; this rule is strictly enforced, and moving a vehicle or leaving the scene of an accident may constitute an admission of guilt under Colombian law.
Americans seeking to import their own vehicles into Colombia should consult with their nearest Colombian consulate for information on Colombian taxes and licensing rules, which can be complicated and bureaucratic.
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 Colombia’s Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) safety standards for oversight of Colombia’s air carrier operations.
For more information, please visit the FAA’s website at http://www.faa.gov/safety/programs_initiatives/oversight/iasa.
SPECIAL CIRCUMSTANCES:
Colombia employs strict screening procedures for detecting narcotics smuggling at its international airports.
Americans and other travelers are occasionally questioned, searched, fingerprinted, and/or asked to submit to an abdominal x-ray upon arrival or departure.
Most airport inspectors do not speak English, and travelers who do not speak Spanish may have difficulty understanding what is asked of them.
Please refer to the section on Criminal Penalties for further information on the strict enforcement of Colombia’s drug laws. Please see our Customs Information.
CUSTOMS REGULATIONS:
Travelers generally must not enter or exit Colombia while carrying cash or other financial instruments worth more than 10,000 U.S. dollars.
Colombian authorities may confiscate any amount over $10,000, and may initiate a criminal investigation into the source of the money and the traveler’s reasons for carrying it.
Recovery of the confiscated amount requires a lengthy, expensive legal process and may not always be possible.
Americans wishing to send large sums of money to or from Colombia should contact their nearest Colombian consulate, or speak with Colombian customs officials, and should also consider seeking advice from an attorney or financial professional.

Colombian law prohibits tourists and business travelers from bringing firearms into Colombia.
Illegal importation or possession of firearms may result in incarceration.

In many countries around the world, counterfeit and pirated goods are widely available. Buying or selling them is illegal in Colombia, and bringing them back to the United States may result in forfeitures and fines.

Colombian law forbids the export of pre-Columbian objects and other artifacts protected by cultural patrimony statutes.
Under an agreement between the United States and Colombia, U.S. customs officials are obligated to seize pre-Columbian objects and certain colonial religious artwork when they are brought into the United States.
Please contact the Embassy of Colombia in Washington or one of Colombia's consulates in the United States for detailed customs guidance.
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 Colombia’s laws, even unknowingly, may be expelled, arrested, or imprisoned.
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.

If you are arrested, the U.S. government cannot request your release.
Colombia and the United States do not have a prisoner transfer agreement, and so any sentence for a crime committed in Colombia is ordinarily served in a Colombian prison.
Penalties for possession, use, or trafficking of illegal drugs in Colombia are severe, and convicted offenders can expect long prison sentences under harsh conditions, with significant expense and great hardship for themselves and their families.
Colombian police make multiple arrests daily for drug trafficking at major airports, and have sophisticated means for detecting illegal drugs in baggage or on your person.
Travelers are sometimes requested to undergo an x-ray to ensure that they are not smuggling narcotics within their own bodies.
There are more than 30 Americans incarcerated in Colombia for attempting to smuggle drugs out of the country.

The hardships resulting from imprisonment do not end even after release from prison:
Colombian law requires that serious offenders remain in the country to serve a lengthy period of parole, during which the offender is given no housing and may lack permission to work.
As a result, family members must often support the offender, sometimes for more than a year, until the parole period expires.
DISASTER PREPAREDNESS: Colombia is an earthquake-prone country.
Flooding and mudslides also sometimes occur in parts of the country.
General information about natural disaster preparedness is available from the U.S. Federal Emergency Management Agency (FEMA) at http://www.fema.gov/.
If a serious natural disaster occurs in Colombia, the Embassy will publish important information for American citizens on its website at http://bogota.usembassy.gov.

CHILDREN'S ISSUES:
For information see our Office of Children’s Issues web pages on intercountry adoption and international parental child abduction.
REGISTRATION / EMBASSY LOCATION: Americans residing or traveling in Colombia are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department’s travel registration website so that they can obtain updated information on travel and security within Colombia.
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 Calle 24 Bis No. 48-50 Bogotá, D.C. Colombia.
Mailing address:
Carrera 45 No. 24B-27 Bogotá, D.C. Colombia.

In case of a serious emergency that jeopardizes the health or safety of an American citizen in Colombia, please call the Embassy at (571) 315-0811; Embassy fax: (571) 315-2197;
Consular Section phone: (571) 315-1566. The Embassy’s American Citizens Services office provides routine information at http://bogota.usembassy.gov.
For questions not answered there, inquiries may be sent by email to ACSBogota@state.gov.
Email messages are answered by the next business day.
The Embassy’s American Citizens Services office is open for passport applications, notary services, and routine in-person inquiries from 8:30 a.m. to 12:00 noon Monday through Thursday, excluding U.S. and Colombian holidays.
Inquiries concerning Social Security and other federal benefits can be made in-person from 2:00 to 3:00 p.m. Monday through Thursday, except holidays.
The American Citizens Services fax number is (571) 3152196/7.
The U.S. Consular Agency in Barranquilla, which accepts passport applications and performs notarial services, is located at Calle 77B, No. 57-141, Piso 5, Centro Empresarial Las Americas, Barranquilla, Atlantico, Colombia; telephone (575) 353-2001; fax (011-57-5) 353-5216.
The Consular Agency is not staffed to respond to after-hours emergencies; in case of an emergency in the Barranquilla/north coast area, please contact the Embassy in Bogota at (571) 315-0811.
*

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This replaces the Country Specific Information issued May 29, 2008, to update sections throughout.

Travel News Headlines WORLD NEWS

Date: Sat 2 Mar 2019
Source: Outbreak News Today [edited]

Health officials are reporting a malaria outbreak in Cauca department in southwestern Colombia, according to a RCN Radio report (computer translated).

The outbreak has affected 322 people in the rural areas of Guapi and Timbiqui: (the towns of Calle larga, Belen, San Agustin, Pascualero, and Cascajero (in Guapi) and in the mining area of Santa Maria, Chacon Playa, and Coteje (in Timbiqui).

The strain of malaria was identified as _Plasmodium falciparum_. The report notes it was indicated that the presence of malaria was recorded in sites never considered endemic, which would be related to factors such as climate change and issues associated with mining that exacerbated the situation.

"This required an immediate displacement of our surveillance team to deal with this outbreak. Visits were made to the area where the cases were presented to make diagnoses with rapid tests and to initiate immediate treatments, "said the department's Health Secretary, Hector Andres Gil Walteros.

On the other hand and as a preventive action, 402 mosquito nets were delivered to 107 homes, benefiting more than 600 inhabitants in the outbreak areas, and treatment was given to the affected people.
=======================
[The Cauca Department is located south of Cali and is considered a malaria risk area by the CDC, see map here:
<https://wwwnc.cdc.gov/travel/yellowbook/2018/infectious-diseases-related-to-travel/yellow-fever-malaria-information-by-country/colombia#5317>.

According to the text an outbreak is highly unusual in the area and mining is mentioned as a likely explanation. Mining especially illegal gold mining create numerous new breeding sites and there is usually a lack of control in the form of larvicidal spraying. - ProMED Mod. EP]

[Maps of Colombia:
Date: Tue, 11 Dec 2018 22:14:43 +0100

Bogota, Dec 11, 2018 (AFP) - The abandoned building where Colombian drug lord Pablo Escobar lived will be covered in posters paying tribute to the victims of his Medellin Cartel before it is torn down next year.   The exhibition is part of a move by municipal authorities to tell the other side of Escobar's story -- that of his victims -- to counter a surge of television series glamorizing his life and that of his cartel.   "Respect our pain, honour our victims (1983-1994). 46,612 fewer lives," reads the message on one of the posters that now greet Medillin's "narco-tourists" flocking to the Monaco apartment block.

Portraits of slain journalist Guillermo Cano, gunned down in 1986, former presidential candidate Luis Carlos Galan and police chief Valdemar Quintero -- both murdered in 1989 -- are emblazoned over a message that reads, in English: "It is not fiction, it is reality."   Mayor Federico Gutierrez told reporters that the tourist site had become a "symbol of illegality."   "Now, there are messages that should lead us to reflect," he said.   The posters will remain affixed to the building until municipal workers tear it down on February 22, more than 25 years after Escobar was shot dead by police in 1993.     The former luxury block will be replaced by a municipal park.
Date: Tue 4 Dec 2018 08:48 AM COT
Source: El Tiempo [in Spanish, machine trans., abridged, edited]

Department health authorities turned on the alarms in Santander after the National Institute of Health confirmed the 1st case of measles in a 6-year-old child from Venezuela residing in Bucaramanga.

The Secretary of Health of Santander, Luis Alejandro Rivero Osorio, explained that "this minor who arrives from Venezuela does not have any vaccines. Fortunately, in the department we try to make sure that parents have their children up to date with their vaccinations."

Rivero Osorio emphasized that the protocols of treatment and follow-up were already activated in the event cases are presented from the Hospital Local del Norte, where the minor from the state of Valencia [Venezuela] was treated, to give attention also to the family and to avoid the spread of the virus.

In Santander there are about 50 possible cases of measles pending confirmation, and since the beginning of this 2018 hospitals and health centres remain alert to the risk posed by the massive arrival of Venezuelans to the region without the complete set of vaccines.
=====================
[Vaccinations are scarce in Venezuela with the current economic situation. As a consequence, vaccine-preventable diseases such as measles are being spread as people leave Venezuela seeking work or new lives in neighboring countries. See next report. - ProMED Mod.LK]

[HealthMap/ProMED-mail maps:
Date: Wed 21 Nov 2018
Source: Outbreak News Today [extracted, edited]

A measles outbreak in Colombia has prompted the Centers for Disease Control and Prevention (CDC) to issue a travel notice last week.

Between March and October this year [2018], Colombia has reported 129 confirmed measles cases.

Of the 129 confirmed cases, 45 were imported, 75 were import-related (25 cases of secondary transmission among persons coming from Venezuela and 50 related to imported cases among Colombians), and 9 with the source under investigation. No deaths have been reported.

The cases were reported in the departments of Antioquia, Arauca, Atlantico, Bolivar, Cauca, Cesar, La Guajira, Magdalena, Norte de Santander, Risaralda, Sucre, and in the districts of Barranquilla, Bogota, Cartagena, and Santa Marta.

Cartagena District and Norte de Santander Department account for 65 percent of the total confirmed cases.

CDC says travellers to Colombia should make sure they are vaccinated against measles with the MMR (measles, mumps, and rubella) vaccine.
Date: Thu, 11 Oct 2018 18:45:51 +0200

Bogota, Oct 11, 2018 (AFP) - Eleven people were killed when a landslide swept away part of a town in central Colombia's coffee-growing region amid heavy rainfall, emergency officials reported Thursday.   Colombia's UNGRD disaster risk management unit said seven females and four males were buried in the landslide that struck the Los Andes suburb of the town of Marquetalia.   Four other people were injured.

Searches for possible missing persons were suspended because of continued heavy rains, it said.   The town is located in the coffee-growing department of Caldas.   "Of the 11 people dead, four were minors, six aged between 20 and 50 years old and one was an older adult," the UNGRD said in statement.   Marquetalia Mayor Luis Carlos Betancourt told journalists the mountain town had been hit by torrential rainfall late Wednesday.   The South American country is currently experiencing its second rainy season, with mountainous regions and part of the Caribbean coast on alert.
More ...

Comoros

Comoros US Consular Information Sheet
May 21, 2008
COUNTRY DESCRIPTION:
The Union of the Comoros is a developing nation located in the Indian Ocean off the east coast of Africa.
Comoros consists of three islands, Ngazidja (also known
s Grand Comore), Moheli, and Anjouan, that cover about 900 square miles.
A fourth island, Mayotte, is claimed by Comoros but remains a territory of France.
Ngazidja is home to the capital city, Moroni, and is the most developed of the three islands.
Facilities for tourism are limited and telecommunication links are unreliable.
French, Arabic, Swahili, and Comorian Creole are spoken.
Read the Department of State Background Notes on the Union of Comoros for additional information.
ENTRY/EXIT REQUIREMENTS:
A passport and onward/return ticket are required.
Visas are available from the Comoran Mission to the United Nations in New York; American citizens visiting Comoros can obtain a free, 24-hour transit visa upon entry.
The following day, visitors are required to go to the immigration office in Moroni to change their visa status.
A fee is charged, depending on length of stay.
Travelers should obtain the latest details from the Mission of the Union of Comoros, 420 East 50th Street, New York, NY 10022; telephone number (212) 972-8010, fax (212) 983-4712.

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:
Comoros has experienced frequent strikes and civil unrest, resulting in violent clashes between police and demonstrators.
The most recent unrest involved the de facto separation of Anjouan from the Union government.
In March 2008, Union forces re-took Anjouan and are preparing the island for elections.
The former leader of Anjouan, Mohamed Bacar, has applied for asylum with France and is being held on the French Island of Reunion while his asylum claims is adjudicated.
As the government completes the transition to constitutional federalism and as Bacar’s asylum claim is pending, periodic strikes and protests will likely continue to occur.
U.S. citizens should avoid political rallies and street demonstrations as even demonstrations intended to be peaceful can turn confrontational and possibly escalate into violence.
American citizens are therefore urged to avoid the areas of demonstrations if possible, and to exercise caution if within the vicinity of any demonstrations.
Conditions are subject to rapid change on each of the three islands of the Comoros due to weak political institutions and a lack of economic development.
In a rare, apparently religious-based attack, a clinic run by a foreign Christian organization was firebombed on the island of Grande Comore in August 2007.
Religious intolerance and religious-based violence remain very unusual in Comoros.

Although foreign residents and visitors have not been targeted, the potential for further outbreaks of civil disorder remains high, and Americans should exercise caution and good judgment, keep a low profile, and remain vigilant with regard to their personal security.
U.S. citizens are encouraged to register with the U.S. Embassy in Antananarivo, Madagascar, if visiting or residing in Comoros.
Embassy contact information is provided below.
For the latest security information, Americans traveling abroad should regularly monitor the Department’s web site, where the current Travel Warnings and Public Announcements, including the Worldwide Caution, can be found.
Up-to-date information on safety and security can also be obtained by calling 1-888-407-4747 toll free in the U.S. 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:
U.S. travelers are advised to be vigilant against pick-pocketing and other forms of petty crime when visiting crowded market areas, parks, and at the beaches.
Violent crime is uncommon.
The most commonly reported crime is breaking into homes.
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, help you find appropriate medical care, to contact family members or friends and explain how funds could be transferred.
Although the investigation and prosecution of the crime is solely the responsibility of local authorities, consular officers can help you to understand the local criminal justice process and to find an attorney if needed.
See our information on Victims of Crime.
MEDICAL FACILITIES AND HEALTH INFORMATION:
Medical facilities in Comoros are poorly equipped.
Travelers should bring their own supplies of prescription drugs and preventive medicines. Malaria is prevalent in Comoros.
Travelers to Comoros should take malaria prophylaxis.
The serious and sometimes fatal strain of malaria, P. falciparum, is resistant to the anti-malarial drug chloroquine.
Because travelers to Comoros are at high risk for contracting malaria, the Center for Disease Control and Prevention (CDC) advises that travelers should take one of the following antimalarial drugs: mefloquine (Lariam™), doxycycline, or atovaquone/proguanil (Malarone™).
The CDC has determined that a traveler who is on an appropriate antimalarial drug has a greatly reduced chance of contracting the disease.
In addition, other personal protective measures, such as the use of insect repellents, help to reduce malaria risk.
Travelers who become ill with a fever or flu-like illness while traveling in a malaria-risk area and up to one year after returning home should seek prompt medical attention and tell the physician their travel history and what antimalarials they have been taking.
For additional information on malaria, protection from insect bites, and anitmalarial drugs, please visit the CDC Travelers' Health web pages.
The East African Indian Ocean islands have seen a rise in the cases of chikungunya, a viral dengue-like ailment, and dengue itself.
As with malaria, chikungunya and dengue are transmitted by mosquitoes.
Every effort should be made to use repellants, proper clothing and barriers that discourage/prevent mosquito bites.
The CDC web site contains further information on chikungunya at http://www.cdc.gov/ncidod/dvbid/chikungunya/ and dengue at http://wwwn.cdc.gov/travel/yellowBookCh4-DengueFever.aspx.
There have been occurrences of measles in Comoros, with outbreaks of greater severity on the islands of Anjouan and Moheli.
Travelers are advised to ensure that their measles vaccinations are up to date.
Further, 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.
MEDICAL INSURANCE:
The Department of State strongly urges Americans to consult with their medical insurance company prior to traveling abroad to confirm whether their policy applies overseas and if it will cover emergency expenses such as a medical evacuation.
Please see our information on medical insurance overseas.

TRAFFIC SAFETY AND ROAD CONDITIONS:
While in a foreign country, U.S. citizens may encounter road conditions that differ significantly from those in the United States.
The information below concerning Comoros is provided for general reference only, and may not be totally accurate in a particular location or circumstance.
In Comoros, one drives on the right side of the street.
Roads are ill-maintained, congested, very narrow and poorly lit at night.
Travelers should exercise extreme caution when driving after dark.
Most urban roads are paved, but many rural roads are not.
Many roads are full of potholes and dangerous curves.
Most roads have no posted speed limits, but road conditions limit speeds to below 30 miles an hour.
Drivers and front seat passengers are required to wear seat belts.
There are no laws regarding child safety seats.
There are no organizations in Comoros that provide emergency or roadside assistance.
Individuals involved in accidents rely on passersby for assistance.
Taxis or a rental car with driver are preferable to public transportation.
Please refer to our Road Safety page for more information.
AVIATION SAFETY OVERSIGHT:
As there is no direct commercial air service to the United States by carriers registered in Comoros, the U.S. Federal Aviation Administration (FAA) has not assessed Comoros’ Civil Aviation Authority for compliance with International Civil Aviation Organization (ICAO) aviation safety standards. For more information, travelers may visit the FAA’s web site at http://www.faa.gov/safety/programs_initiatives/oversight/iasa.
SPECIAL CIRCUMSTANCES: While religions other than Islam are permitted in Comoros, evangelization is illegal.
Violators of this law can be fined or imprisoned.
Few establishments accept credit cards in the Comoros and most prefer Comoran Francs or Euros to dollars.
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 the laws of Comoros, even unknowingly, may be expelled, arrested, or imprisoned.
Penalties for possession, use or trafficking in illegal drugs in Comoros are strict, with convicted offenders receiving a mandatory minimum five-year jail sentence and heavy fines.
Engaging in sex 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:
The United States has no Embassy in Comoros.
Americans living or traveling in Comoros are encouraged to register with the U.S. Embassy in Antananarivo, Madagascar through the State Department's travel registration web site, and to obtain updated information on travel and security within Comoros.
Americans without Internet access may register in person at the U.S. Embassy in Antananarivo.
By registering, American citizens make it easier for the Embassy to contact them in case of emergency. The U.S. Embassy is located at 14-16 Rue Rainitovo, Antsahavola, Antananarivo.
The mailing address is B.P. 620, Antsahavola, Antananarivo, Madagascar; telephone [261] (20) 22-212-57; fax [261] (20) 22-345-39.
The Embassy web site is http://www.usmission.mg/.
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This replaces the Country Specific Information dated October 26, 2007 to update the section on Safety and Security.

Travel News Headlines WORLD NEWS

Date: Sat 11 May 2019
Source: Revue Francophone des Laboratoires May 2019, no. 512, p. 18 [in French, transl., abridged, edited]

In February 2019, 63 cases of Rift Valley fever were diagnosed by PCR at the Mayotte hospital laboratory. The first 5 cases were detected in November 2018 by the hospital laboratory and confirmed by the Reunion Reference Center. The vector control center and the health emergency unit of the ARS OI [The Indian Ocean Health Agency] were able to analyze the epidemiology of 36 cases: 21 subjects had been in direct contact with animals and 5 others lived nearby; the last 5 declared no direct or indirect contact with animals. In addition, in 15 cases, patients had consumed raw or curdled milk. Finally, it is interesting to note that 21 patients resided in the communes of west-central Mayotte. With regard to the 63 confirmed cases, the average age of the patients was 38 years (range, 10 to 74 years), of which 16% were under 20 years, with a male/female sex ratio of 4. In addition, 29 patients lived in rural or semi-urban dwellings, 9 of whom lived in traditional huts. In terms of symptoms, 24 patients had headache, 19 arthralgia, 17 myalgia, 14 asthenia, 6 retro-orbital pain, and 6 nausea and vomiting. An entomological survey found several mosquito species, especially _Culex_, _Aedes_, _Anopheles_ and _Mansonia_.

At the same time, samples taken from farms in which abortions were reported identified 33 outbreaks of 1 to 6 animals, including 25 cattle and 8 small ruminants [the figures have increased since; see in comments].

Rift Valley fever, which has been present in Mayotte for a long time, had disappeared in the past decade, with 10 patients detected in 2008 following an epidemic in Kenya. Then there was a steady regression of verified seroprevalence on ruminants. But this seroprevalence rose to 3.6% in 2017 and then to 10.1% in 2018, indicating a new circulation of the virus. This is probably due to illegal and continuous importation of contaminated livestock.  [By: Dr. Patrice Bouree]
============================
[Mayotte's health authorities published on Sat 11 May 2019 the following update.

"Epidemiological situation as of May 10, 2019. In total, since the beginning of the epidemic (end of November 2018):
1. Animals.
Samples taken by veterinarians on sick animals or during abortions have identified 119 foci of sick animals (of which 95 are cattle and 24 small ruminants). Animal foci are mainly located in the center and northwest of the island. Additional outbreaks have appeared since the end of March [2019] in the communes of Dembeni, as well as on Petite Terre.
2. Humans.
The CHM laboratory reported 130 human cases of RVF [Rift Valley fever] at the monitoring and health emergencies platform of the ARS OI (CVAGS) of Mayotte.

The number of reported cases has remained stable since the beginning of April [2019] (on average, 4 to 5 reported cases per week). Since the beginning of the health alert, human cases have remained mainly in the center and northwest of the island." (<https://lejournaldemayotte.yt/2019/05/11/fievre-de-la-vallee-du-rift-a-mayotte-stabilite-du-nombre-de-nouveaux-cas/>).

Application of the following measures will contribute to the prevention of future RVF events in animals and humans in Mayotte:
1. Preventing illegal introduction of ruminants;
2. Preventive vaccination of cattle, sheep and goats (preferably, with an inactivated RVF vaccine; see http://promedmail.org/post/20190422.6434655). - ProMED Mod.AS]

[It would be of interest to know what role, if any, mosquito vectors are playing in transmission of RVF virus during the current outbreak. If _Aedes_ mosquitoes are involved, there is a risk of transovarial transmission of the virus that can persist for months in mosquito eggs with resumption of transmission when those eggs hatch and infected adult female mosquitoes emerge. - ProMED Mod.TY]

[HealthMap/ProMED-mail map:
Region d'outre-mer de Mayotte, France:
Date: Mon, 25 Mar 2019 15:42:31 +0100
By Philippe ALFROY

Bambao, Comoros, March 25, 2019 (AFP) - The Bambao hospital, nestled in a tropical forest on Anjouan island in the Comoros, was meant to bring state-of-the-art medical care to the poor Indian Ocean nation.   Just two years later, the hospital is deep in debt and shunned by potential patients who find it too costly.   "A poisoned chalice", "a colossus with feet of clay", "a sinking ship" are among the cliches that chief paediatrician Ahmed Rakibou used to describe the facility funded and built under a Chinese aid scheme.   "If they had consulted us while building it, this could have been a jewel," the doctor said, regretting that "today it's all going straight to hell".   The hospital is some 30 kilometres (about 20 miles) east of Mutsamudu, the capital of Anjouan, the poorest of the three islands comprising the Union of the Comoros.

The aim was to make the hospital a flagship of Comoran healthcare, with 120 beds in a brand-new building, a team of 167 staff, many recruited locally, and modern equipment including a digital radio scanner.   China's ambassador to the Comoros, Xiao Ming, hailed a "new page in the annals of cooperation" at the opening ceremony, saying "public health has always had a priority place in Sino-Comoran cooperation".   But a project that cost four billion Comoran francs (8.1 million euros, $9.2 billion) today looks more like a ghost ship, with a handful of patients wandering its corridors in stifling heat. For lack of funds, about 100 staff jobs have not been filled.

- 'Not many patients' -
In the emergency ward, a doctor silently examines a child's injured arm. The lethargic mood is broken only by the arrival of an ambulance carrying the victim of a motorcycle accident.   "Our activity is very varied," nurse Ali Mosthadoi says cautiously before going further. "In fact, we don't have many patients."

Deputy director Sidi Chaanbane was more forthcoming. Since the hospital was opened by President Azali Assoumani in 2017, it has faced mounting difficulties, he said.   "At the start, the road from Mutsamudu was in a very bad state and patients had trouble getting here," the administrator said. "It's been repaired since, but our real problem is that we sorely lack equipment and staff."   In addition to staff salaries, the Comoran state provides just five million francs (10,000 euros) a month, but the hospital needs three times as much to pay its bills.   "We can't balance the budget," Chaanbane said.

Day-to-day management is a nightmare. The scanner broke down soon after it was first used. Repairs were not covered by the Chinese cooperation agreement, so the hospital took out a loan to get the machine working again.   The main problem is the cost of treatment, which is not free in the former French colony, independent since 1975.   Much of the funding comes from the French Development Agency (AFD) in its aid budget. France still rules over the fourth major island in the archipelago, Mayotte.   The three islands forming Comoros lack the standard of living on Mayotte and are far from able to make up the remaining health budget.

- 'Expensive' -
Rakibou said the hospital charges 125,000 Comoran francs for a Caesarean birth.   "What Comoran can pay that?" he asks. "No -- this hospital is not made for the population."   Kanissa Adbou, 27, brought her eight-year-old daughter who trod on a nail to the hospital. "The treatment is expensive. If I could afford it, I would go to Mayotte because there, hospital is free."   Those who believed that providing a modern hospital on Anjouan would dissuade Comorans from trying their luck on Mayotte have been disappointed, although the trip is illegal.   "People here prefer to pay 1,000 euros to go to Mayotte by kwassa kwassa (human traffickers' dugouts) than to come to us," a nurse said. "They trust only white doctors."

The failure to put the sophisticated equipment at Bambao to regular good use enrages Ahmed Abdallah, secretary general of the Hombo public hospital in Mutsamudu.   "The money spent there would have been enough to repair our buildings, replace our equipment and build roads so that sick people could come from nearby villages," he said.   "We don't have even a single ambulance, yet the government has I don't know how many four-wheel drives."   Health Minister Fatma Mbaraka declined to respond to requests for comment from AFP.   But Rakibou refuses to throw in the towel. He hopes that the winner of Sunday's presidential election and the international community will come up with increased funding. "It wouldn't take much to change our lives!" he said.
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: Fri 22 Feb 2019
Source: Le Journal de Mayotte [in French, trans. ProMED Corr. SB, edited]

Rift Valley fever (RVF) continues to circulate in Mayotte among the herds of ruminants, and the number of human cases is increasing.

The prefecture of Mayotte, in collaboration with the ARS Indian Ocean and the Directorate of Food, Agriculture and Forestry of Mayotte (DAAF) reminds the population of the importance of implementing recommendations and preventive actions to avoid being ill.

Epidemiological situation as of 22 Feb 2019:
- Samples taken by veterinarians from sick animals or during abortions have identified 33 animal FVR outbreaks.
- Since late November [2018], 63 human cases of RVF have been reported to the monitoring and health emergencies platform of the ARS OI (CVAGS) of Mayotte by the CHM laboratory.

Rift Valley fever (RVF) is a zoonosis (infectious disease that can be transmitted from animals to humans) of viral origin, which mainly affects domestic ruminants (cattle, sheep, goats), causing abortions and high mortality in young animals.

Transmission to humans can occur in different ways:
- By contact with blood, body fluids, or tissues of a sick animal (during slaughter, cutting of meat, calving, care, etc.). The most exposed people are therefore professionals such as breeders, slaughterhouse employees, and veterinarians.
- By mosquito bite, vectors of the disease near infected flocks, often in the rainy seasons.
- When eating unboiled milk or unpasteurized curd from an infected animal.

There is no [direct] person-to-person transmission of RVF [virus].

The disease in humans is usually manifested by an influenza-like illness that clears in a few days and includes symptoms such as high fever (39 deg C [102 deg F]), muscle and / or joint pain, intense headaches, and fatigue. However, in 5% of cases, more serious forms may occur: ocular meningitis / meningoencephalitis, haemorrhagic fever.

Recommendations for protection against the disease-causing virus:

For farmers and people in contact with animals:
- Wash hands with soap after contact with domestic ruminants (cattle, sheep, goats).
- Do not handle unprotected or diseased animals or abortion products without protection.
- Do not handle animal carcasses without protection.
- Wear gloves, goggles, and especially a mask for the slaughter of any animal. Infected animals may have no signs, although they can transmit the virus.

For food consumption:
Transmission by ruminants
- Boil the milk
- Do not consume curd unless it has been boiled and curdled with lactic fermentation.
- Wash hands after cutting meat.
- Do not eat uncooked meat.
- Do not consume the meat of a sick animal.

To protect yourself from mosquito bites:
- Eliminate breeding sites; empty all containers that may contain water.
- Use mosquito nets and repellents.

In case of appearance of symptoms, consult your doctor immediately.

Management measures:
By the Directorate of Food, Agriculture, and Forestry: The monitoring of Rift Valley fever involves the monitoring of abortions. Farmers are asked to report to veterinarians without delay any abortions occurring in their animals in order to take samples for the disease. The prevalence of RVF in the exchange zone with Mayotte being important, the risk of spread of the disease is not negligible in case of uncontrolled import of animals.

By the Indian Ocean Health Agency: Since the1st report, each ill person is interviewed by the ARS Indian Ocean to identify the risk factors for the disease.

A treatment of larval breeding and a mosquito control are done by the service of the Anti-vector Fight [unit] to the homes of the sick persons and around the houses. Information to health professionals was made to strengthen surveillance and identification of human cases.  [Byline: Anne]
======================
[This Rift Valley fever (RVF) outbreak has been going on since November 2018. The numbers of human cases of RVF have increased from 31 to 63 in about 2 weeks. The above report does not indicate whether the human infections are the result of virus transmission by mosquito vectors, but the cattle cases certainly are. 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. Recent studies have shown that RVF virus may severely injure human fetuses if contracted by mothers during pregnancy. There is no indication of whether any of the 63 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, but the symptoms associated with RVF infections in general are listed. In an earlier comment, Mod.CP 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 Mod.TY]

[HealthMap/ProMED-mail map:
Region d'outre-mer de Mayotte, France:
Date: Fri 1 Feb 2019
Source: Outbreak News Today [edited]

In the Indian Ocean, between Madagascar and the coast of Mozambique, sits the archipelago of Mayotte, a Department of France.  Health officials have reported an increase in autochthonous Rift Valley fever (RVF) cases in the past 6 weeks. Since the 1st human case was detected on [Tue 11 Dec 2018], health officials have reported 19 human cases. Most of the cases were located in the western part of the island.  Samples made on ruminants present around human cases were analyzed at CIRAD in Reunion for the search for the RVF virus. The results identified several positive animals in different villages located in west and center of the island.

In addition, an IgM-positive cattle has been reported in Mamoudzou. This 2-year-old cattle belongs to a breeding herd of 8 cattle, including 4 adults and 4 2-month-old calves. Biological control and investigations are underway.  ECDC reports that the detection of autochthonous Rift Valley fever cases on Mayotte is not unexpected, but the occurrence of 19 cases within a short time period is of concern, as current weather conditions (rainy season from November to March) are favorable for the vectors.

Rift Valley fever (RVF) is an illness that is primarily spread by direct contact with blood, fluids, or tissues of infected animals such as cattle, buffalo, sheep, goats, and camels. Less commonly, it can also be spread through mosquito bites.  Most people with RVF do not feel sick or have only mild illness. Symptoms of RVF include fever, weakness, back pain, dizziness, and weight loss. However, a small percentage (8-10%) of people may have more serious illness, such as severe bleeding, swelling of the brain, or eye disease. Approximately 1% of people who get RVF die from the disease.  [Byline: Robert Herriman]
*************************************
Date: Sat 2 Feb 2019
Source: ECDC Communicable Diseases Threats Report Week 5, 27 Jan - 2
Feb 2019 [edited]

According to Institut de Veille Sanitaire (InVS), from 11 Dec 2018 - 28 Jan 2019, 19 Rift Valley fever cases were confirmed on Mayotte. All cases were locally acquired. Among these cases, 14 are male and 5 are female, with an age range of 27-64 years.

Most of the cases were located in the western part of the island. Further investigations identified several positive ruminants in the western and central parts of the island.

According to CIRAD, Rift Valley fever seroprevalence among ruminants has decreased from 2008 to 2017, but significantly increased in 2017 and 2018 (3.6%, CI 95% [2.3-5.6%]) and 2018 and 2019 (10.1% CI 95% [6.5-15.3%]). In addition, according to InVS, one case imported from Comoros was reported by authorities on Mayotte in 2011.

The detection of autochthonous Rift Valley fever cases on Mayotte is not unexpected, but the occurrence of 19 cases within a short time period is of concern, as current weather conditions (rainy season from November to March) are favourable for the vectors.

ECDC will continue monitoring this event through epidemic intelligence activities and report again if there is a relevant epidemiological update.

[Map] Distribution of RVF human cases and ruminants, Mayotte, 11 Dec 2018 to 28 Jan 2019

[Graph] Distribution of RVF confirmed human cases, Mayotte, 11 Dec 2018 to 28 Jan 2019

Year-Week / Number of cases
2018-50 / 1
2018-51 / 0
2018-52 / 2
2019-01 / 2
2019-02 / 0
2019-03 / 2
2019-04 / 8
2019-05 / 4
========================
[It is not surprising to have both human and cattle Rift Valley fever (RVF) cases occur simultaneously. The above report does not indicate if the human infections are the result of virus transmission by mosquito vectors, but the cattle cases certainly are. 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. Recent studies have shown that RVF virus may severely injure human fetuses if contracted by mothers during pregnancy. There is no indication if any of the 19 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.

The clinical findings related to the above human cases are not mentioned. In an earlier comment, ProMED Mod.CP 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 Mod.TY]

[HealthMap/ProMED-mail map:
Region d'outre-mer de Mayotte, France:
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: