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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: 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:
Date: Wed 16 Oct 2019 09:52 AM PDT
Source: Your Central Valley, KSEE/KGPE [edited]

A positive case of rabies was found in a domestic cat, [which had] bitten a Fresno County resident, health officials said. The Fresno County Department of Public Health said it was the 1st confirmed case of feline rabies in the county since 1943.

Fresno County has been identified as a rabies endemic area by state health officials. Although not mandated, it is highly recommended to have your cat vaccinated for rabies. [Interesting, many areas having rabies require both cats and dogs to be vaccinated against the disease. - Mod.TG] Rabies remains a concern among wild mammals in Fresno County, especially among bats and skunks, health officials said. While any mammal can be infected with the rabies virus, bats are the commonest mammal in the county known to carry rabies. In 2018 and 2019, 6 bats tested positive for rabies in Fresno County.  [byline: Paul Schlesinger]
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[HealthMap/ProMED-mail map of California, 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.
*

*

*
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 ...

Sudan

Sudan US Consular Information Sheet
August 29, 2008
COUNTRY DESCRIPTION:
Sudan is a diverse, developing country in northeastern Africa. The capital city is Khartoum. The civil war between the northern and southern regions, which began in 1
83, ended in 2005. A multi-party conflict continues in the west in Darfur, and the armed Ugandan group known as The Lord’s Resistance Army is present in the south. Security conditions are adverse in these and some other regions. Transportation networks and other forms of infrastructure are poor and do not meet western standards. Even where available, water and electric services suffer frequent outages. Read the Department of State Background Notes on Sudan for additional information.

ENTRY/EXIT REQUIREMENTS: The Government of Sudan requires all travelers to present a passport and an entry visa. Most travelers must obtain the entry visa before arrival; only American citizens who also possess a Sudanese national identification document (such as a Sudanese passport or national identification card) may apply for an entry visa at Khartoum International Airport. The Government of Sudan routinely denies visas to travelers whose passports contain visas issued by the Government of Israel or other evidence of travel to Israel such as exit or entry stamps.

Travelers must obtain an exit visa before departure from Sudan as well as pay any airport departure tax not included in the traveler’s airline ticket. Visitors may obtain the latest information and further details from the Embassy of Sudan, 2210 Massachusetts Avenue NW, Washington, DC 20008, tel.: 202-338-8565.

Travel permits issued by the semi-autonomous Government of Southern Sudan (GOSS) or by the South Sudan Relief and Rehabilitation Commission (SSRRC) are not adequate for entry to the country, although travelers may find these documents useful to present to local authorities when in the south. Personal baggage, including computers, is routinely searched upon arrival to and departure from Sudan. The authorities will seize material deemed objectionable, such as alcohol or pornography, and may detain or arrest the traveler. Travelers intending to bring electronic items should inquire about entry requirements when they apply for a visa; restrictions apply to many devices, including video cameras, satellite phones, facsimile machines, televisions, and telephones. Travelers are not allowed to depart Sudan with ivory, some other animal products, or large quantities of gold.

All visitors must register with the authorities within three days of arrival. Travelers must register within 72 hours of arrival in Sudan at the Ministry of Interior. All foreigners traveling more than 25 kilometers outside of Khartoum must obtain a travel permit from the Ministry of Humanitarian Affairs in Khartoum. This applies to all travel, including private, commercial, and humanitarian activities. Americans risk detention by Sudanese authorities when traveling more than 25 kilometers outside of Khartoum without a travel permit issued by the Ministry of Humanitarian Affairs. Travelers must register again with the police within 24 hours of arrival. The government requires a separate travel permit for travel to Darfur. These regulations are strictly enforced and even travelers with proper documentation may expect delay or temporary detention from the security forces, especially outside the capital. Authorities expect travelers to strictly respect roadblocks and other checkpoints.

Travelers who wish to take any photographs must obtain a photography permit from the Government of Sudan, Ministry of Interior, Department of Aliens.

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:
On January 1, 2008, unknown assailants shot and killed two U.S. Embassy employees - an American USAID officer and a Sudanese national driver. Terrorists are known to operate in Sudan and continue to seek opportunities to carry out attacks against U.S. interests. Terrorist actions may include suicide operations, bombings, or kidnappings. U.S. citizens should be aware of the risk of indiscriminate attacks on civilian targets in public places, which include tourist sites and locations where westerners are known to congregate, and commercial operations associated with U.S. or Western interests. Terrorists are known to have targeted both official facilities and residential compounds. Anti-American sentiment is prevalent and Americans should exercise utmost caution at all times.

The U.S. Embassy’s ability to provide consular services in Sudan, including emergency assistance, is severely limited. Many areas outside the capital of Khartoum are extremely difficult to access.

Travel in many parts of Sudan is hazardous. Outside the major cities infrastructure is extremely poor, medical care is limited, and very few facilities for tourists exist.

Conflict among various armed groups and government forces continues in western Sudan, in the states of North Darfur, South Darfur, and West Darfur. Banditry and lawlessness are also common in the west. Many local residents are in camps for internally-displaced persons, and receive humanitarian assistance for basic needs such as food, water, and shelter. Expatriate humanitarian workers have been the targets of carjackings and burglaries.

Land mines remain a major hazard in southern Sudan, especially south of the city of Juba. Visitors should travel only on main roads unless a competent de-mining authority such as the UN has marked an area as clear of mines. The armed Ugandan group known as The Lord’s Resistance Army is present along the southern border and reportedly has announced it will target Americans.
Occasional clashes between armed groups representing communal interests continue to occur in the centrally-located states of Upper Nile, Blue Nile, and Bahr al Ghazal. Banditry also occurs.
Sudan shares porous land borders with nine other countries, including Chad, the Central African Republic, Uganda, Democratic Republic of Congo, Ethiopia, and Eritrea. Conflict in these countries occasionally spills over into Sudan.

Americans considering sea travel in Sudan's coastal waters should exercise caution as there have been incidents of armed attacks and robberies by unknown groups in recent years, including one involving two American vessels. Exercise extreme caution, as these groups are considered armed and dangerous. When transiting in and around the Horn of Africa and/or in the Red Sea near Yemen, it is strongly recommended that vessels convoy in groups and maintain good communications contact at all times. Marine channels 13 and 16 VHF-FM are international call-up and emergency channels, and are commonly monitored by ships at sea. 2182 Mhz is the HF international call-up and emergency channel. Wherever possible, travel in trafficked sea-lanes. Avoid loitering in or transiting isolated or remote areas. In case of emergency, contact the nearest U.S. Embassy or Consulate. In the event of an attack, consider activating Emergency Position Indicating Radio Beacons.

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

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

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

CRIME: Crime is on the increase throughout Sudan. Additional security measures should be taken at places of residence to protect life and property. Anti-American sentiments can be found throughout the country. Americans should exercise caution by avoiding crowded public areas and public gatherings. Americans should avoid traveling alone. Report all instances of anti-American acts and crime targeting westerners to the American Embassy, and report incidents of crime to the Sudanese Police.

Americans should guard their backpacks or hand luggage. When traveling by air, travelers should maintain constant contact with their baggage and assure that they do not contain illicit items, such as alcohol or military ordinance. Americans have been removed from international airlines and detained when suspect items have been detected in checked baggage.

Carjacking and armed robbery continue to occur in western and southern Sudan. Sexual assault is more prevalent in the areas of armed conflict. Travelers who do not use the services of reputable travel firms or knowledgeable guides or drivers are especially at risk. Travel outside of Khartoum should be undertaken with a minimum of two vehicles so that there is a backup in case of mechanical failure or other emergency. Solo camping is always risky.

The Sudanese mail system can be unreliable. International couriers provide the safest means of shipping envelopes and packages, although anything of value should be insured.

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

See our information on Victims of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION: Individuals with medical conditions which may require treatment are discouraged from traveling to Sudan. Medical facilities in Khartoum fall short of U.S. standards; outside the capital, very few facilities exist and hospitals and clinics are poorly equipped. Travelers must pay cash in advance for any medical treatment. Ambulance services are not available. Medicines are available only intermittently; travelers should bring sufficient supplies of needed medicines in clearly-marked containers.

Malaria is prevalent in all areas of Sudan. The strain is resistant to chloroquine and can be fatal. Consult a health practitioner before traveling, obtain suitable anti-malarial drugs, and use protective measures, such as insect repellent, protective clothing, and mosquito nets. Travelers who become ill with a fever or a flu-like illness while in Sudan, or within a year after departure, should promptly seek medical care and inform their physician of their travel history and the kind of anti-malarial drugs used. For additional information about malaria and anti-malarial drugs please see the Center for Disease Control travelers’ health web site, http://www.cdc.gov/malaria/index.htm.

Officially, people with HIV are not granted a visa and are not permitted to enter Sudan. A negative HIV test result must be presented at a Sudanese embassy or at Khartoum airport in order to obtain a visa. However, anecdotal reports indicate this requirement is not enforced in practice. Please confirm this requirement with the Embassy of Sudan at www.sudanembassy.org.

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

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

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

Road conditions throughout Sudan are hazardous due to erratic driver behavior, pedestrians and animals in the roadways, and the lack of basic safety equipment on many vehicles. Only major highways and some streets in the cities are paved; many roads are narrow, rutted, and poorly maintained. Local drivers do not observe conventions for the right-of-way, stop in the road without warning, and frequently exceed safe speeds for road, traffic, and weather conditions. Driving at night is dangerous and should be avoided if possible; many vehicles operate without lights.

In the north and west, dust storms and sand storms, known locally as haboobs, greatly reduce visibility when they occur. Roads in these areas can be quickly covered with shifting sand at any season of the year. Roads in southern Sudan often are impassable during the rainy season, from March to October.
U.S. citizens are subject to the laws of the country in which they are traveling, including traffic laws. In Sudan vehicles have the steering wheel on the left side and drivers use the right side of the road.

Traffic from side streets on the right has the right-of-way when entering a cross street, including fast-moving main streets. Traffic on the right has the right-of-way at stops. Right turns on a red light are prohibited. Speed limits are not posted, but the legal speed limit for passenger cars on inter-city highways is 120 kph (about 70 mph), while in most urban areas the limit is 60 kph (about 35 mph.) The speed limit in congested areas and school zones is 40 kph (about 25 mph).

Many local drivers carry no insurance despite the legal requirement that all motor vehicle operators purchase third-party liability insurance from the government. Persons involved in an accident resulting in death or injury must report the incident to the nearest police station or police officer as soon as possible. Persons found at fault can expect fines, revocation of driving privileges, and jail sentences, depending on the nature and extent of the accident. Persons convicted of driving under the influence of alcohol face fines, jail sentences, and corporal punishment.

Americans may use their U.S. driver's licenses for up to 90 days after arrival in Sudan, and then must carry either an International Driving Permit (IDP) or a Sudanese driver's license. There are no restrictions on vehicle types, including motorcycles and motorized tricycles.

Public transportation is limited to within and between major urban areas. Passenger facilities are basic and crowded, especially during rush hours and periods of seasonal travel. Schedules are unpublished and subject to change without notice. Vehicle maintenance does not meet U.S. standards. There is routine passenger train service on the route from Khartoum to Wadi Halfa (on the border with Egypt) and to Port Sudan (on the Red Sea.) Bus service between major cities is regular and inexpensive. Intra-city bus service in the major urban areas is regular, but most buses and bus stops are privately-operated and unmarked. Taxis are available in the major cities at hotels, tourist sites, and government offices. The motorized rickshaws in common use in Khartoum are unsafe. Travelers are encouraged to hire cars and drivers from reputable sources with qualified drivers and safe vehicles. Irregularly-scheduled mini-buses provide some public transit to rural communities; many areas lack any 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 Sudan, the U.S. Federal Aviation Administration (FAA) has not assessed Sudan’s Civil Aviation Authority for compliance with International Civil Aviation Organization (ICAO) aviation safety standards. For more information, travelers may visit the FAA’s web site at http://www.faa.gov/safety/programs_initiatives/oversight/iasa.

Enforcement of aviation safety standards in Sudan is uneven; civil aviation in Sudan continues to experience air incidents and accidents, including 5 crashes with at least 64 fatalities between November 8, 2007, and June 30, 2008. Incidents included engine failures, collapsed landing gear, and planes veering off the runway. Whenever possible, Americans traveling to Sudan despite the ongoing travel warning are advised to travel directly to their destinations on international carriers from countries whose civil aviation authorities meet international aviation safety standards for the oversight of their air carrier operations under the FAA’s International Aviation Safety Assessment (IASA) program. Adverse seasonal weather conditions, such as dust or sand storms in the north between April and June and severe rain storms in the south between March and October, cause frequent flight cancellations.

Two hijackings originated in Sudan in 2007; no passengers were harmed.

SPECIAL CIRCUMSTANCES: In November 1997, the U.S. imposed comprehensive financial and commercial sanctions against Sudan, prohibiting U.S. transactions with Sudan. Travelers intending to visit Sudan despite the Travel Warning should contact the Department of the Treasury, Office of Foreign Assets Control (OFAC), Office of Compliance, telephone 1-800-540-6322 or 202-622-2490, regarding the effect of these sanctions.

Travelers must be prepared to pay cash for all purchases, including hotel bills, airfares purchased locally, and all other travel expenses. Major credit cards, including Visa, MasterCard, or American Express, cannot be used in Sudan due to U.S. sanctions. Sudan has no international ATMs. Local ATMs draw on local banks only.

Travelers, including journalists, must obtain a photography permit before taking any photographs. Even with a photography permit, photographing military areas, bridges, drainage stations, broadcast stations, public utilities, slum areas, and beggars is prohibited.

Sudan is a conservative society, particularly in the capital and other areas where the Muslim population is the majority. Alcohol is prohibited by law and modest dress is expected. Loose, long-sleeved shirts and full-length skirts or slacks are recommended attire for women visitors. Women who are not Muslim are not expected or required to cover their heads. Men may wear short-sleeved shirts but short pants are not acceptable in public.

Please see our information on Customs Information.

CRIMINAL PENALTIES: While in a foreign country, a U.S. citizen is subject to that country's laws and regulations, which sometimes differ significantly from those in the United States and may not afford the protections available to the individual under U.S. law. Penalties for breaking the law can be more severe than in the United States for similar offenses. Persons violating Sudanese laws, even unknowingly, may be expelled, arrested or imprisoned. Penalties for possession, use, or trafficking in alcohol or illegal drugs in Sudan 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 as well in Sudan.

Sudan’s Public Order Courts have continued to serve as the state mechanism for morality enforcement since the early 1980's. Today the court still issues punishments ranging from fines, to lashings, to lengthy prison sentences for offences such as drinking alcohol, wearing inappropriate clothing, or associating with unmarried women.

Please see our information on Criminal Penalties.

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

REGISTRATION / EMBASSY LOCATION:
Americans living or traveling in Sudan are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department’s travel registration web site so that they can obtain updated information on travel and security within Sudan. 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 Sharia Ali Abdel Latif, Khartoum, Sudan; tel: 249 1 83 774-701, http://sudan.usembassy.gov/.
* * *
This replaces the Country Specific Information dated March 12, 2008, to update sections on Entry/Exit Requirements, Medical Facilities and Health Information, Aviation Safety Oversight, and Criminal Penalties.

Travel News Headlines WORLD NEWS

5th November 2019
http://www.emro.who.int/sdn/sudan-news/who-scales-up-cholera-vigilance-in-khartoum-sudan.html

5 November 2019, Khartoum, Sudan -- To prevent a potential spread of the current cholera outbreak to Khartoum State – including to the country’s capital Khartoum City – and at the request of the Federal Minister of Health Dr Akram Eltoum, WHO is working closely with health partners, nongovernmental organizations, and at-risk communities to ensure that suspected cases are quickly identified and responded to, and that people can effectively protect themselves from infection.  “The risk of cholera spreading is very real. If not properly managed, this could have potentially serious consequences. More than eight million people live in Khartoum State, where the public health system is impacted by the economic crisis, recent flooding, and ongoing outbreaks of infectious diseases,” said Dr Naeema Al Gasseer, WHO Representative in Sudan.

As of 3 November, Sudan’s Ministry of Health reported 332 suspected cases of cholera, concentrated in Blue Nile and Sennar States. Two cases were confirmed in Khartoum State on 19 October.  Together with the Ministry of Health, WHO has conducted initial risk mapping in Khartoum State to identify which areas are more likely to be at increased risk of an outbreak. This will allow for more informed planning to ensure high-risk areas, including Sharq Elnil and Ombada localities, are better prepared to respond as needed.  Scaling up health capacities to detect and respond to cholera

To ensure that health facilities and cholera treatment centres in Khartoum State are equipped to diagnose and treat suspected patients, WHO has delivered cholera medicines and supplies sufficient for 400 severely dehydrated patients, and 500 Rapid Diagnostic Tests used for immediate detection and screening of cholera patients in health facilities.  WHO is also supporting the establishing of two cholera treatment centres in Ombada and Bahri localities by providing additional cholera medicines, medical supplies, and Rapid Diagnostic Tests.

To strengthen disease surveillance in Khartoum State, WHO, with support MSF, is providing refresher training for 271 health staff and paramedics from all 7 localities on cholera detection and management. An additional 35 health staff are being trained to form Rapid Response Teams who will be the first to respond to suspected cases at locality level.  Ensuring communities are aware of prevention and treatment actions.  “A key aspect of preventing and controlling cholera is how well at-risk communities are able to protect themselves by drinking safe water, properly handling food, avoiding defecation in open areas, handwashing, and knowing what to do when they see the first signs of infection,” said Dr Al Gasseer.

WHO and the Khartoum State Ministry of Health are working with more than 1700 male and female health promoters and volunteers who will play a critical role in raising awareness among communities on cholera, hygiene practices, and environmental health, as well as linking communities with available health services and involving them more in health planning activities.

WHO’s work to protect people from cholera in Sudan is made possible through the Sudan Humanitarian Fund.

For more information
Inas Hamam
Communications officer
WHO Regional Office
hamami@who.int
Date: Sun 27 Oct 2019
Source: Radio Dabanga and AllAfrica [edited]

According to the Sudanese Ministry of Health and the World Health Organization (WHO), 323 suspected cholera cases, including 10 deaths, were reported in Blue Nile state, Sennar and Khartoum between the end of August 2019 and [22 Oct 2019]. The 1st case was detected on [28 Aug 2019], the UN Office for the Coordination of Humanitarian Affairs in Sudan says in its latest Sudan Situation Report. Two cases were recently recorded in Ombadda locality in Omdurman, the twin-city of Khartoum.

On [6 Oct 2019], humanitarian partners in Sudan launched the Cholera Readiness and Response Plan, that targets 2.5 million people in 8 high-risk states (Blue Nile state, Sennar, El Gedaref, Kassala, El Gezira, White Nile state, Khartoum, and River Nile state).

An oral cholera vaccine campaign launched on 11 Oct 2019 is ongoing, targeting 1.6 million people in high risk communities in Blue Nile and Sennar states. The aim of the campaign is to contain the outbreak and prevent its spread to neighboring states.

Risk assessment
---------------
Sudan has been facing a continuous surge of acute watery diarrhea/suspected cholera cases since 2016. The current outbreak was reported following recent heavy rains and flooding in 17 out of 18 states across the country. As a result of the flooding, the country reported widespread damage to infrastructure, thus more cholera cases can be expected in the future.
======================
[As stated in Lutwick LI, Preis J, Choi P: Cholera. In: Chronic illness and disability: the pediatric gastrointestinal tract. Greydanus DE, Atay O, Merrick J (eds). NY: Nova Bioscience, 2018; pp 113-136, oral rehydration therapy can be life-saving in outbreaks of cholera and other forms of diarrhea:
"As reviewed by Richard Guerrant et al (1), it was in 1831 that cholera treatment could be accomplished by intravenous replacement, and, although this therapy could produce dramatic improvements, not until 1960 was it 1st recognized that there was no true destruction of the intestinal mucosa, and gastrointestinal rehydration therapy could be effective, and the therapy could dramatically reduce the intravenous needs for rehydration. Indeed, that this rehydration could be just as effective given orally as through an orogastric tube (for example, refs 2 and 3) made it possible for oral rehydration therapy (ORT) to be used in rural remote areas and truly impact on the morbidity and mortality of cholera. Indeed, Guerrant et al (1) highlights the use of oral glucose-salt packets in war-torn Bangladeshi refugees, which reduced the mortality rate from 30 per cent to 3.6 per cent (4) and quotes sources referring to ORT as "potentially the most important medical advance" of the 20th century. A variety of formulations of ORT exist, generally glucose or rice powder-based, which contain a variety of micronutrients, especially zinc (5).

"The assessment of the degree of volume loss in those with diarrhea to approximate volume and fluid losses can be found in ref 6 below. Those with severe hypovolemia should be initially rehydrated intravenously with a fluid bolus of normal saline or Ringer's lactate solution of 20-30 ml/kg followed by 100 ml/kg in the 1st 4 hours and 100 ml/kg over the next 18 hours with regular reassessment. Those with lesser degrees of hypovolemia can be rehydrated orally with a glucose or rice-derived formula with up to 4 liters in the 1st 4 hours, and those with no hypovolemia can be given ORT after each liquid stool with frequent reevaluation."

References
----------
1. Guerrant RL, Carneiro-Filho BA and Dillingham RA. Cholera, diarrhea, and oral rehydration therapy: triumph and indictment. Clin Infect Dis. 2003;37(3):398-405; available at: <http://cid.oxfordjournals.org/content/37/3/398.long>.
2. Gregorio GV, Gonzales ML, Dans LF and Martinez EG. Polymer-based oral rehydration solution for treating acute watery diarrhoea. Cochrane Database Syst Rev. 2009;(2):CD006519. doi: 10.1002/14651858.CD006519.pub2; available at: <http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD006519.pub3/full>.
3. Gore SM, Fontaine O and Pierce NF. Impact of rice based oral rehydration solution on stool output and duration of diarrhea: meta-analysis of 13 clinical trials. BMJ 1992; 304(6822): 287-91; available at: <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1881081/>.
4. Mahalanabis D, Choudhuri AB, Bagchi NG, et al. Oral fluid therapy of cholera among Bangladesh refugees. Johns Hopkins Med 1973; 132(4): 197-205; available at: <http://www.searo.who.int/publications/journals/seajph/media/2012/seajph_v1n1/whoseajphv1i1p105.pdf>.
5. Atia AN and Buchman AL. Oral rehydration solutions in non-cholera diarrhea: a review. Am J Gastroenterol. 2009; 104(10): 2596-604, doi: 10.1038/ajg.2009.329; abstract available at: <http://www.ncbi.nlm.nih.gov/pubmed/19550407>.
6. WHO. The treatment of diarrhea, a manual for physicians and other senior health workers. 4th ed. 2005; available at: <http://whqlibdoc.who.int/publications/2005/9241593180.pdf>. - ProMED Mod.LL]

[HealthMap/ProMED maps available at:
Adamawa State, Nigeria: <http://healthmap.org/promed/p/6479>
Date: Wed, 30 Oct 2019 13:41:25 +0100 (MET)

Juba, Oct 30, 2019 (AFP) - Three aid volunteers working at Ebola screening points along the DR Congo border were killed in clashes in South Sudan, the International Organisation of Migration (IOM) said Wednesday.   "The IOM volunteers, one female and two males, were caught in a crossfire during clashes that broke out" on Sunday, in Morobo County in the Central Equatoria region, the UN agency said in a statement.   Two other male volunteers were injured, while a female volunteer and the son of the woman who was killed were abducted.   "We are deeply saddened by the loss of our colleagues and we extend our heartfelt condolences to their families and friends," said IOM chief of mission in South Sudan, Jean-Philippe Chauzy.

According to the statement, the IOM has suspended screening for Ebola at five sites along the border with the Democratic Republic of Congo.   An Ebola outbreak has killed more than 2,000 people in DR Congo since August 2018, placing the region on high alert, with cases already having spread to Uganda.   "The safety of our personnel is paramount and will not be further jeopardised until we secure guarantees for the security of all our personnel operating in Morobo County," said Chauzy.    The UN's humanitarian agency OCHA also condemned the killings in a statement, noting it was the first reported killing of aid workers in South Sudan since 2018.

At least 115 aid workers, mainly South Sudanese, have been killed since the country plunged into conflict in December 2013 after President Salva Kiir accused his former deputy Riek Machar of plotting a coup against him.   The conflict has left nearly 400,000 dead and displaced millions.   A peace deal was signed in September last year and a ceasefire has largely held, but fighting in the Central Equatoria region has continued between government forces and a holdout rebel group.   A long-delayed unity government is due to be formed by November 12, however Machar is seeking further postponement over crucial outstanding issues.
Fri 11/10/2019 14:43
WorldHealthOrganizationNews@who.int

Attributable to the Federal Ministry of Health in Sudan, WHO and UNICEF

KHARTOUM, 11 October 2019 -  "Sudan has launched an oral cholera vaccination campaign in response to the ongoing outbreak of cholera. More than 1.6 million people aged one year and above in the Blue Nile and Sinnar states will be vaccinated over the coming five days.  “The announcement of the Federal Ministry of Health in Sudan on the cholera outbreak last month allowed national and state authorities, and health partners, to act quickly and respond to the outbreak.

“Since the announcement on 8 September, 262 cases of suspected cholera and eight related deaths have been reported as of 9 October in the Blue Nile and Sinnar states. No cholera-related deaths have been reported since mid-September. “The vaccines were procured and successfully shipped using funding from Gavi, the Vaccine Alliance. In addition, Gavi is providing nearly US$ 2 million to cover operational costs for the campaign.

“We joined efforts to respond as quickly as possible to contain the current outbreak of cholera and prevent it from spreading further in Sudan. The vaccination campaign kicking off today in combination with other measures including scaling up water, sanitation and hygiene activities, enhancing surveillance, prepositioning supplies and case management, will help protect people who are at highest risk.

“The first round of the campaign will conclude on 16 October and will be followed by a second round in four to six weeks to provide an additional dose to ensure people are protected for at least the next three years.  “As part of the campaign, over 3,560 vaccinators, more than 2,240 social mobilizers, and almost 70 independent monitors have been trained and deployed to the two affected states.”
Date: Wed 9 Oct 2019
Source: Dabanga [edited]

Arbaat in El Ganeb locality in Sudan's Red Sea state reported 10 new cases of suspected Rift Valley fever* on Monday and Tuesday [7 and 8 Oct 2019], bringing the total number of registered cases to 5, and 3 deaths.  Doctor Ahmed Dereir told Radio Dabanga about the spread of the disease in 8 villages in the area of Arbaat, pointing out that the cases were transferred to Port Sudan for treatment. He explained that the governor formed an emergency room of 35 people representing various government agencies, medical committees, and members of the Forces for Freedom and Change.

Ali Bayrak, head of the Community Support Committee for the residents of Arbaat called on the government for the explicit announcement of the results of laboratory testing of samples.  The state Ministry of Health committed to provide 2 doctors to the villages of the Arbaat Administrative Unit and training 10 medical staff, and 3 midwives, in addition to the distribution of water chlorination tablets and the provision of 3 spraying vehicles.

As reported by Radio Dabanga on Sunday [6 Oct 2019], one man and more than 20 head of cattle died in Arbaat on Thursday and Friday [3 and 4 Oct 2019], and that to date, so far, 3 people and 420 cows have died of the disease, now suspected to be Rift Valley fever, that hit the area of Arbaat, north of Port Sudan, over the past weeks, medical doctor Ahmed Dereir told Radio Dabanga.

According to the UN World Health Organisation (WHO) Rift Valley fever (RVF) is a viral zoonosis that primarily affects animals but also has the capacity to infect humans. Infection can cause severe disease in both animals and humans. The disease also results in significant economic losses due to death and abortion among RVF-infected livestock.

RVF virus was 1st identified in 1931 during an investigation into an epidemic among sheep on a farm in the Rift Valley of Kenya, and most cases occur in Sub-Saharan Africa.

Key facts:
- Rift Valley fever (RVF) is a viral zoonosis that primarily affects animals but can also infect humans.
- The majority of human infections result from contact with the blood or organs of infected animals.
- Human infections have also resulted from the bites of infected mosquitoes.
- To date, no human-to-human transmission of RVF virus has been documented.
- The incubation period (the interval from infection to onset of symptoms) for RVF varies from 2-6 days.
- Outbreaks of RVF in animals can be prevented by a sustained programme of animal vaccination.
==================
[On Wed 9 Oct 2019, villages in the area of Arbaat in El Ganeb locality in Red Sea state reported 9 new cases suspected to be Rift Valley fever, bringing the total number of reported cases to 65 (<https://www.dabangasudan.org/en/all-news/article/nine-more-cases-of-rift-valley-fever-in-sudan-s-red-sea-state>). In addition to the Red Sea state outbreak mentioned above, a separate report indicates that Rift Valley fever is occurring in Sudan's River Nile state (see Rift Valley fever - Sudan: (RS,NR) human, animal, alert, OIE Archive Number: http://promedmail.org/post/20191014.6726088). These 2 Sudan states mentioned above are adjoining, so it is not surprising that suspected or confirmed Rift Valley fever (RVF) outbreaks are occurring there simultaneously. The Ministry of Health is investigating the outbreaks in both states. Not only are these outbreaks a human health problem, they are clearly an animal health problem as well, with 420 cattle reported dying of the disease. A One Health response is urgently needed, with participation of physicians, veterinarians and entomologists. There was evidence of RVF virus in the neighbouring Central African Republic this year (2019). Last year (2018), human and animal cases occurred in neighboring South Sudan (see Valley fever - South Sudan (09): (EL) human, animal, WHO http://promedmail.org/post/20180410.5735975).

If focal geographic areas of transmission are identified in this Sudan situation, increased surveillance of people and livestock should be initiated and livestock vaccination considered. RVF-infected livestock can pose a significant risk to humans in contact with them, often livestock owners and veterinarians. Abortions in livestock with a loss in productivity present an economic problem for many ethnic groups that depend on them for livelihoods.

The above report mentions abortion storms in a River Nile state outbreak that could have had serious economic, social and public health consequences. It is likely that RVF virus will persist in this area in transovarially infected eggs of _Aedes_ mosquito vectors. These eggs can remain viable for long periods and hatch when flooded during future rain events, with subsequent emergence of infected females ready to transmit the virus. This risk provides justification for maintaining livestock of the area well vaccinated into the future. - ProMED Mod.TY]

[A media (radio) report on an event of human and animal disease, in Sudan's area of Arbaat, north of Port Sudan, Red Sea state, caused by an "unknown fever" killing 3 people and 420 cows, was posted by ProMED-mail on 6 Oct 2019 as "undiagnosed," RFI (http://promedmail.org/post/20191006.6712623). The commentary suggested RVF as possible etiology, requesting further information. According to Sudan's official OIE report, dated 13 Oct 2019, an event of RVF has been diagnosed in "Arabaata dam area, Alghunub Wa Alolaib, Red Sea state" (http://promedmail.org/post/20191014.6726088), the animals affected being goats, which are thus considered, in this event, the virus' primary victims and main source of human infection, directly or through vectors. The samples from the goats were found RVF-infected by ELISA. In difference with the earlier media (radio) report, the OIE report indicated that there are "no cattle and sheep in this area." A media report dated 12 Oct 2019 (<https://khartoumstar.com/en/2019/10/12/ministry-of-health-rift-valley-fever-in-northern-sudan/>) reported RVF "emerging" in Sudan's River Nile state, naming the locations Berber, north of Bawqa, Ftouar, Joule and Sulaimaniya, and the Artoli region of the East Bank. The report cited Hatem Fadl, an official in the epidemiology and emergency department at the Federal Ministry of Health, saying that "4 cases of Rift Valley fever were diagnosed among 17 samples taken last week, [which] were sent to the Central Laboratory in Khartoum." Hatem pointed out that the Federal Minister of Health commissioned a team to investigate the injuries, [which] arrived in the villages of Artoli, Al-Bawqa, and Fatwwar [Fri 11 Oct 2019], before the disease was officially announced (12 Oct 2019). Additional data were included in the same media source on 13 Oct 2019 (<https://khartoumstar.com/en/2019/10/13/attempts-to-control-rift-valley-fever-in-the-nile-river-state/>). No details on animal cases in River Nile state have become available, nor specific lab results of the human samples. Additional information from Sudan, and clarification on the discrepancies between the media reports as far as animal species are concerned, will be welcomed. - ProMED Mod.AS]

[A map showing the location of the 2 states mentioned above can be accessed at:

HealthMap/ProMED map available at:
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World Travel News Headlines

Date: Fri, 8 Nov 2019 12:35:08 +0100 (MET)

Tehran, Nov 8, 2019 (AFP) - An earthquake rocked northwestern Iran before dawn on Friday, killing at least five people and injuring more than 300 in crumbling and collapsed buildings.   The 5.9-magnitude quake struck at 1:17 am (2247 GMT Thursday) about 120 kilometres (75 miles) southeast of the city of Tabriz, in East Azerbaijan province, the Iranian Seismological Centre said.

Described as "moderate", the quake was eight kilometres (five miles) deep and was followed by five aftershocks.    The provincial governor, Mohammad-Reza Pourmohammadi, told Iranian media that rescue operations were underway in 41 villages, but the damage was largely concentrated in two, Varnakesh and Varzaghan.   According to the emergency services, nearly 340 people were admitted to hospital for treatment, but all but 17 were discharged by Friday noon.   Some 40 homes were levelled by the quake and over 200 head of cattle killed.

Around 100 injured residents were pulled out of the rubble of their damaged or flattened homes.   Around noon, emergency teams distributed survival kits, stoves, blankets and tents in 78 villages.   In Varnakesh, an emergency shelter was set up.   State television broadcast images of people who had fled their homes warming themselves around a fire lit on a public highway.   But the damage appeared to be less widespread than initially feared.   The United States Geological Survey (USGS) had issued an alert warning that "significant casualties are likely and the disaster is potentially widespread".

In many areas people had returned to their homes by daybreak after the initial panic subsided and the aftershocks petered out.   The gas supply was restored to all but one of the affected villages.   The quake was felt in the provincial capital Tabriz and as far away as the city of Rasht, near the Black Sea coast 200 kilometres (125 miles) from the epicentre.   Tabriz, which has a population of more than a million, is a historic city which served as Iran's capital several times between the 13th and 16th centuries. Its bazaar is a UNESCO world heritage site.   Iran sits where two major tectonic plates meet and experiences frequent seismic activity.

The country has suffered a number of major disasters in recent decades, including at the ancient city of Bam, which was decimated by a catastrophic earthquake in 2003 that killed at least 31,000 people.     In 1990, a 7.4-magnitude quake in northern Iran killed 40,000 people, injured 300,000 and left half a million homeless, reducing dozens of towns and nearly 2,000 villages to rubble.   Iran has experienced at least two other significant quakes in recent years -- one in 2005 that killed more than 600 people and another in 2012 that left some 300 dead.
Date: Fri, 8 Nov 2019 11:03:11 +0100 (MET)

London, Nov 8, 2019 (AFP) - Royal Mail on Friday made a High Court bid to block a postal strike by workers due next month ahead of Christmas and around the time of Britain's general election.   Members of the Communication Workers Union recently voted to strike amid a dispute with management over pay and other employment conditions.   In a statement, Royal Mail pointed to "potential irregularities in the ballot".   It added: "The company is making this High Court application because the integrity and legal soundness of any electoral process is vital," Royal Mail said in relation to the strike ballot.   "This is particularly the case in relation to potential industrial action around the general election on 12 December 2019.    "Royal Mail is also making this application because of the damage industrial action would do to the company and its customers in the run-up to Christmas," the group added.   It expects the hearing to take place next week.
Date: Thu, 7 Nov 2019 17:15:09 +0100 (MET)

Paris, Nov 7, 2019 (AFP) - Top European medical bodies demanded Thursday that Chinese traditional medicines be subject to the same regulatory oversight as conventional Western methods, despite recent WHO recognition of their use.   "Just because the World Health Organisation includes a chapter on Traditional Chinese Medicine in its new International Classification of Diseases, it is not automatically safe to use without robust evidence," Professor Dan Marhala, President of the Royal Swedish Academy of Sciences, said in a statement issued by top European medical and scientific bodies.   The European Academies' Science Advisory Council (EA SAC) and the Federation of European Academies of Medicine (EAM) said European lawmakers must protect the health of European citizens.

Accordingly, the existing European regulatory framework should be revised to make sure Traditional Chinese Medicine (TC) is held to the same standards of proof and evidence as conventional medicine.   "There have been examples where some Traditional Chinese Medicine has undergone thorough pre-clinical investigation and proven in rigorous clinical trials to contribute significant health benefit -- artemisinin therapy for malaria, for example," Marhala said.   "There may be more leads to diagnosis and therapeutic benefit yet to be discovered but this can in no way mean that other claims can be accepted uncritically."   It was not necessarily the Who's intention to promote the use of TC, but its stamp of approval could lead supporters to promote wider application, the statement cautioned.   As a result, patients could be confused over which diagnosis was appropriate and which therapy was effective.   More serious still, said former EASAC president Jos van der Meer, is that some TCMs "can have serious side effects and interactions with other treatments."   "Moreover, patients may be at risk that severe diseases are treated ineffectively and conventional medical procedures delayed," he added.

The WHO included TCMs in an official classification of diseases coming into effect in January 2022.   In 2015, China's Tu Youyou won the Nobel Prize for medicine for discovering artemisinin, giving a huge boost to the credibility of TCM which many in the west deride as lacking scientific foundation and verging on quackery.   In China, traditional medicine has a long, distinguished history and its practitioners are treated with great respect.   EASAC comprises the national science academies of EU Member states, plus Norway and Switzerland.   FEAM groups medical academies which provide advice to the European authorities.
Date: Thu, 7 Nov 2019 17:11:10 +0100 (MET)

Riga, Nov 7, 2019 (AFP) - Thousands of doctors and nurses rallied Thursday in front of the Latvian parliament in Riga calling for better pay in what was the Baltic state's largest protest in over a decade.   Police said more than 5,000 people, including patients, turned out for the protest, which featured coffins and signs with slogans such as "United for health", "I only want to work one job" and "Patients supporting doctors and nurses".   The LVSADA medical labour union organised the rally to condemn lawmakers for planning to increase their own salaries next year while reneging on a promise to boost wages in the chronically underfunded medical profession.   "We won't allow the healthcare system to be starved again," LVSADA chief Valdis Keris said at the rally, which state hospital employees attended by taking a day of unpaid leave.

Some doctors also participated in the protest by only performing emergency surgery and tending to emergency patients on Thursday while rescheduling everything else.    "The average monthly wage for a doctor at a Latvian public hospital is only between 1,000-3,000 euros ($1,100-$3,300)," protester and doctor Roberts Furmanis said in a statement sent to media.    "I work my daily shift at one hospital, at night I also work overtime driving around in an ambulance, plus sometimes I lecture at medical schools on my rare days off," he added.   "I get less than 3,000 euros a month for those jobs combined. How am I supposed to support my family?"   Last year, lawmakers voted to raise wages for almost all employees of the government-run healthcare system, but now say that they are unable to find the necessary funds in the 2020 state budget.    "I express deep regret for last year's promise, which we cannot carry out," speaker of parliament Inara Murniece told the rally.

Those protesting, however, point out that the 2020 state budget exceeds 10 billion euros for the first time ever in the country of just 1.9 million people -- or 700 million more euros than this year.    Medical workers are upset that while there is no room for better healthcare wages in the new budget, the country's lawmakers and ministers plan to increase their own salaries next year and have also earmarked taxpayer money for their respective political parties.    Thursday's rally was Latvia's largest since some 10,000 people attended a January 2009 protest against government cuts, which grew violent and resulted in dozens of arrests.
Date: Thu, 7 Nov 2019 15:13:02 +0100 (MET)
By Michelle FITZPATRICK

Frankfurt am Main, Nov 7, 2019 (AFP) - Tens of thousands of Lufthansa passengers faced disruptions Thursday as cabin crew in Germany staged a "massive" 48-hour walkout in the biggest escalation yet of a bitter row over pay and conditions.   The strike called by Germany's UFO flight attendants' union started at 2300 GMT on Wednesday and was to last until 2300 GMT on Friday.

Lufthansa said it had scrapped 700 flights on Thursday and some 600 the following day, warning that "around 180,000 passengers will be affected" across Germany.   The UFO union argued that the stoppage was necessary because negotiations with Lufthansa bosses were deadlocked.   But it accepted a surprise olive branch offered by Lufthansa CEO Carsten Spohr on Thursday, and agreed to preliminary talks over the weekend.    The current strike would carry on as planned "but would not for now be expanded", UFO said on its website.   Lufthansa said it regretted the inconvenience to passengers and stressed that it was working "to minimise the impact of this massive strike on our customers".

The carrier was running an alternative flight schedule where possible, and said passengers could rebook their journeys for free or swap their flights for train tickets.  Knut Kress, a passenger at a quieter than usual Munich airport, voiced support for the flight attendants.   "It's good that there are still unions defending something," he told AFP. But 48 hours "is a long time", he added.   Fellow traveller Birgit Kellner complained about the lack of notice for passengers.   "They should inform passengers a little earlier, not just two days before."   The walkout is UFO's biggest call to action since a week-long strike in 2015 hit Lufthansa with mass cancellations.   It is also seen as a test of strength for the union, weakened by months of infighting that have left Lufthansa questioning its right to speak for cabin crew.

- Internal disputes -
Lufthansa's finance chief Ulrik Svensson declined to put a price tag on the strike but said such stoppages typically cost "between 10 and 20 million" euros per day.   The union already staged a day-long warning strike last month at four Lufthansa subsidiary airlines, causing several dozen flights to be axed at Eurowings, Germanwings, SunExpress and Lufthansa CityLine.

But the flagship Lufthansa brand was spared the upheaval after management offered an unexpected two-percent pay rise to avert the strike.   Since then, however, UFO vice-president Daniel Flohr said no progress had been made in talks.   As well as higher pay for cabin crew across the Lufthansa group, UFO is demanding more benefits and easier routes into long-term contracts for temporary workers.

Lufthansa, however, has long argued that UFO no longer has the right to represent its staff following an internal leadership tussle, and has challenged the union's legal status in court.   But CEO Spohr hinted at a shift in position when he told reporters Thursday Lufthansa wanted to try to resolve the existing legal issues with UFO in the weekend meeting, hoping to then start formal arbitration talks.

UFO's internal disputes have cost it support among the Lufthansa group's 21,000 flight attendants, with some members switching to rival unions.   Separately on Thursday, Lufthansa reported a jump in third-quarter net profits but said it was slashing over 700 jobs at its Austrian Airlines subsidiary as the group seeks to trim costs in the face of fierce competition.
Date: Thu, 7 Nov 2019 09:57:41 +0100 (MET)

Singapore, Nov 7, 2019 (AFP) - Tourists visiting Singapore can now check in at some hotels using facial recognition technology under a pilot programme that could cut waiting times and help tackle a labour crunch.  The tech-savvy country of 5.7 million people is increasingly turning to automation to speed up services and deal with workforce shortages, with robots deployed for tasks ranging from cleaning to making noodles.

Under the pilot launched Wednesday, visitors will not need to wait to be checked in by hotel staff but can instead use a phone app fitted with facial recognition technology or machines which scan their passports.   The data from the scan is sent to immigration authorities for checks after which the visitor is issued a room key, said the Singapore Tourism Board and Hotel Association, which announced the initiative this week.

The technology, reportedly being trialled at three hotels and is similar to that used in some airports including Singapore's Changi, could reduce check-in times by up to 70 percent, they said.   Singapore welcomed a record high 18.5 million visitors last year, up 6.2 percent from the year before. The city has more than 400 hotels with 67,000 rooms.
Date: Wed, 6 Nov 2019 15:31:58 +0100 (MET)

Amman, Nov 6, 2019 (AFP) - Eight people, including four tourists, were wounded in a knife attack on Wednesday at the famed archeological site of Jerash in northern Jordan, a security spokesman told AFP.   Four tourists -- three Mexicans and a Swiss woman -- were wounded, along with a Jordanian tour guide and a security officer who tried to stop the assailant, public security directorate spokesman Amer Sartawi said.   The attack took place around noon (1000 GMT) at the Roman ruins of Jerash, a popular attraction 50 kilometres (30 miles) from the capital Amman.   The health ministry confirmed that eight people had been wounded, with Sartawi saying earlier that they had "been transported to hospital for treatment".    He said the assailant had been arrested but did not specify his nationality, noting that the motive was as yet unknown.

Jordanian tour guide Zouheir Zreiqat was at the scene and told AFP that the attack happened "just before midday when around 100 foreign tourists" were at the site.    "A bearded man in his twenties wearing black and brandishing a knife started to stab tourists," according to Zreiqat.   He said others started to shout for help and he, along with three other tour guides and three tourists managed to stop the assailant.   "We chased him until we could grab him and get him on the ground," Zreiqat said.    "We took the knife from him. He stayed silent, without saying a word until the police arrived and arrested him."

- Violent attacks -
It was not the first time tourist sites have been targeted by attacks in Jordan.    In December 2016, in Karak, home to one of the region's biggest Crusader castles, 10 people were killed in an attack that also left 30 wounded.    Seven police officers, two Jordanian civilians and a Canadian tourist were killed in the attack.

The attack was claimed by the Islamic State group (IS) and sparked concern over its impact on tourism, a mainstay of the Jordanian economy.    Ten people were convicted of carrying out the attack, with two sentenced to death.   Several violent incidents struck the country the same year, including a suicide attack in June claimed by IS that killed seven Jordanian border guards near the frontier with Syria.    Amman has played a significant role in the United States-led coalition fight against IS in Syria and Iraq, both neighbouring Jordan.

- Economic troubles -
Lacking in natural resources, the country of nearly 10 million depends on tourism and the kingdom has been working to pull the key sector out of a crisis caused by regional unrest in recent years.   Jordan's economy as a whole was hit hard by the combined impact of the international financial crisis, the Arab Spring uprisings that convulsed the Middle East in 2011 and the conflict in Syria.

Tourism accounts for 10 to 12 percent of gross domestic product and the government aims to double this by 2022, former tourism minister Lina Annab told AFP in an interview last year.  The country boasts 21,000 archaeological and historical sites that span millennia, according to the tourism board.   They include the Roman ruins of Jerash, the ancient city of Petra, the Dead Sea and Wadi al-Kharrar, or Bethany Beyond the Jordan, where some believe Jesus was baptised.   Jordan welcomed seven million tourists in 2010, but arrivals plunged to around three million in each of the following two years, tourism board head Abed Al Razzaq Arabiyat said in April.    Numbers have rebounded as spillover from the war in neighbouring Syria has abated, officials have said, with the government working to bring annual tourist arrivals back up to 7 million by 2020.
Date: Tue, 5 Nov 2019 00:54:14 +0100 (MET)

Nuku'alofa, Tonga, Nov 4, 2019 (AFP) - A 6.6 magnitude earthquake struck off the coast of the Pacific island nation of Tonga on Tuesday, but there was no threat of a tsunami, officials said.    The United States Geological Survey (USGS) said the shallow undersea quake hit about 134 kilometres (83 miles) west of Neiafu, the country's second-largest town.    It said the temblor was not expected to have caused significant damage. The quake was not felt in Tonga's capital, Nuku'alofa, according to an AFP reporter.    There was also no threat of a tsunami, the Pacific Tsunami Warning Center said.    A second quake of 5.5 magnitude was recorded a few minutes later, the USGS said.
Date: Mon, 4 Nov 2019 23:47:26 +0100 (MET)

Santiago, Nov 4, 2019 (AFP) - A strong 6.0-magnitude earthquake shook Chile on Monday, rattling buildings in the capital while a big anti-government demonstration was under way.   The quake struck at 6:53 pm (2153 GMT) with its epicentre near the northern town of Illapel, the US Geological Survey said.   A strong and prolonged shaking was felt in the capital.   Chile's National Seismological Center measured the quake at magnitude 6.1, revising down an earlier estimate of 6.3.   There were no immediate reports of damage or casualties.   "There have been no reports of damage to people, disruption of basic services or infrastructure," the National Emergency Office said.   The Army Hydrographic and Oceanographic Service said the quake was unlikely to cause a tsunami on Chile's Pacific coast.

When the quake hit, police in Santiago were dispersing protesters at the start of the third week of anti-austerity protests targeting the conservative government.   Chile is one of the world's most earthquake-prone countries.   The 9.5-magnitude 1960 Valdivia earthquake was the strongest ever recorded on the magnitude scale, according to the USGS.   In 2010 an 8.8-magnitude followed by a tsunami killed more than 500 people.   Chile lies on the Ring of Fire -- an arc of fault lines that circles the Pacific Basin and is prone to frequent earthquakes and volcanic eruptions.
Date: Mon, 4 Nov 2019 20:37:19 +0100 (MET)
By Eugenia LOGIURATTO

Recife, Brazil, Nov 4, 2019 (AFP) - Months after thick oil began turning idyllic beaches in Brazil into "black carpets," workers and volunteers wearing rubber gloves race against time to scrape off the remaining fragments ahead of the country's peak tourism season.   Paiva, Itapuama and Enseada dos Corais in the northeastern state of Pernambuco are among hundreds of beaches fouled by an oil spill that began to appear in early September and has affected more than 2,000 kilometers (1,250 miles) of Atlantic coastline.

As ocean currents brought large globs of crude to shore near the capital Recife in recent weeks, locals rushed to the normally picturesque beaches and used their bare hands to remove the toxic material coating sand, rocks and wildlife.    "I was shocked, there were people entering the water without gloves, without safety equipment, in the middle of the oil," coconut seller Glaucia Dias de Lima, 35, told AFP as she picked up chunks of crude from Itapuama beach.

Thousands of military personnel have been dispatched to help clean up the oil that has killed dozens of animals, including turtles, and reached a humpback whale sanctuary off Bahia state that has some of the country's richest biodiversity.   It is the third major environmental disaster to strike Brazil this year. In recent months fires ravaged the Amazon rainforest and in January a mine dam collapsed in the southeast, spewing millions of tons of toxic waste across the countryside.    Wildfires are still raging across the Pantanal tropical wetlands.

While thousands of tons of crude waste have been recovered so far, the space agency INPE said Friday there might still be oil at sea being pushed by currents. It could reach as far south as Rio de Janeiro state, the agency said.   President Jair Bolsonaro warned Sunday that "the worst is yet to come," saying only a fraction of the spilled crude had been collected so far.    The government on Friday named a Greek-flagged tanker as the prime suspect for being the source of the oil slicks.   The ship Bouboulina took on oil in Venezuela and was headed for Singapore, it said. The tanker's operators have denied the vessel was to blame.

- Fishing paralyzed -
As the southern hemisphere's summer approaches, people dependent on the fishing and tourism industries are nervously waiting for test results to show if the water is safe to swim in and eat from.   Northeastern Brazil is a popular tourist destination all year round, but visitor numbers usually explode in the hotter months. 

Eco-tourism guide Giovana Eulina said the disaster would affect the sector and she called for a campaign to "encourage people to come here."   Fishing in the region also has been largely paralyzed by the oil spill, even in areas where crude has not been detected.   "We still don't have a concrete answer from a scientist who says that (the water) is really contaminated," said Sandra Lima, head of a local fishing association.    Edileuza Nascimento, 63, stands in muddy water near Recife and extracts shellfish that she will sanitize at home, freeze and then sell.   It was already a struggle for fishermen to make a living, she said. But the oil slick has been "too much."    "It has come to finish off the fishing families."