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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: Fri, 4 Oct 2019 18:04:29 +0200 (METDST)

Washington, Oct 4, 2019 (AFP) - More than 1,200 people have been sickened with measles this year, the highest number since 1992, US health authorities said Friday, though the infectious childhood disease officially remains "eliminated" after the worst-hit region contained its outbreak.   New York health officials Thursday declared the end of the state's nearly year-long epidemic, which accounted for 75 percent of cases nationwide, and occurred mostly among unvaccinated children in Orthodox Jewish communities.   Before the declaration, it had appeared that the US might lose its measles elimination status, which it has had since 2000.

The status is lost if a chain of transmission in a given outbreak is sustained for more than 12 months.   "We are very pleased that the measles outbreak has ended in New York and that measles is still considered eliminated in the United States," said Health and Human Services Secretary Alex Azar.   "But this past year's outbreak was an alarming reminder about the dangers of vaccine hesitancy and misinformation," he added.   "That is why the Trump administration will continue making it a priority to work with communities and promote vaccination as one of the easiest things you can do to keep you and your family healthy and safe."   The Centers for Disease Control and Prevention said there had been 1,249 cases of measles between January 1 and October 4, 2019.

The US is far from alone in experiencing a surge: data from the World Health Organization for the first six months of 2019 shows the highest number of measles cases reported since 2006.   In the last year alone, Britain, Greece, Venezuela and Brazil lost their measles elimination status.    The rise comes as a growing anti-vaccine movement gains steam around the world, driven by fraudulent claims linking the MMR vaccine against measles, mumps and rubella to a risk of autism in children.   Measles is caused by a virus and can lead to serious complications including pneumonia and inflammation of the brain that can do permanent damage and be deadly, especially in small children.
Date: Thu 10 Oct 2019, updated Fri 11 Oct 2019 1:50 p.m. ET
Source: Citizen Times [edited]

Officials with the North Carolina Department of Health and Human Services' [NCDHHS'] Division of Public Health have confirmed a 2nd death in the outbreak of _Legionella_ bacteria, which has now infected dozens of Mountain State Fair attendees with the potentially life-threatening Legionnaires' disease.

On 10 Oct [2019], NCDHHS officials confirmed 134 cases of Legionnaires' disease or Pontiac fever among people who attended the 2019 NC Mountain State Fair, which took place 6-15 Sep [2019] at the WNC Ag Center in Fletcher. Those diagnosed live in in multiple states and several North Carolina counties, according to a news release.

Two people have died, and 88 people have been hospitalized in the outbreak. Personal information of those who have died is not being released, NCDHHS said, to protect privacy of the families. "We send our sincerest condolences to the families of the 2 people who have died and to all those who have been affected by this outbreak," said Dr. Zack Moore, state epidemiologist. "Legionnaires' disease is a serious illness that can lead to complications and death, especially in older individuals or those with underlying conditions."

Seven [8, according to the NCDHHS; see below. - ProMED Mod.ML] of the confirmed cases are actually Pontiac fever, a milder illness also caused by the _Legionella_ bacteria. Symptoms are the eponymous fever, muscle aches, headache, chills, nausea, vomiting, or diarrhea, according to the NCDHHS.

While officials have not yet confirmed a source for the deadly bacteria, officials have pointed to a hot tub display as the most likely culprit. "The preliminary epidemiologic and environmental findings suggest that exposure to _Legionella_ bacteria occurred in the Davis Event Center of the WNC Ag Center, particularly near the hot tubs and during the last 5 days of the fair," the NCDHHS release stated. Hot tubs are a well-established source of aerosolized water exposure and have been associated with previous Legionnaires' disease outbreaks nationally and internationally.

"These results highlight the importance of caring for and maintaining equipment that can aerosolize water," according to the release. "There were no other significant sources of aerosolized water at the WNC Ag Center and no other ongoing potential sources of exposure identified."

The _Legionella_ bacteria enters the body via contaminated water, but it has to reach the lungs to be dangerous. The culprit is usually aerosolized water -- tiny water droplets suspended in the air by something like a misting station, an air conditioner, or steam -- that people unknowingly breathe in.

To report possible cases, call the local health department or the NCDHHS Division of Public Health at (919) 733-3419. In Buncombe County, call BCHHS Communicable Disease at 828-250-5109. In Henderson County, call 828-694-6019.
=======================
[The latest status, as of 9 Oct 2019, of the legionellosis outbreak associated with the Mountain State Fair that was held in western North Carolina between 6 and 15 Sep 2019 at the Western North Carolina Agricultural Center (WNC Ag Center) in Fletcher, a town in Henderson County, can be found at <https://epi.dph.ncdhhs.gov/cd/legionellosis/outbreak.html>.

The number of confirmed cases of legionellosis by county are as follows: Buncombe, 49; Burke, 1; Caswell, 1; Cherokee, 1; Gaston, 1; Granville, 1; Haywood, 12; Henderson, 33; Jackson, 1; Madison, 6; McDowell, 3; Mecklenburg, 4; Mitchell, 2; Polk, 1; Rutherford, 3; Transylvania, 3; Union, 1; Watauga, 1; and Yancey, 1. Nine cases occurred out of state (in South Carolina). Total cases: 134.

Male, 75 (56%)**; female, 57 (44%)**. Median age in years (range): 61 (24-91). Hospitalizations: 88 (68%); deaths 2.
**Some cases reported with unknown gender.

A total of 126 (94%) have Legionnaires' disease, the pneumonic form of the infection, and 8 (6%) have Pontiac fever, the non-pneumonic form of the infection.

The source of the outbreak has still not been identified. However, hot tub displays in one of the buildings (Davis Event Center) has been linked to the outbreak, and _Legionella_ was found in a women's restroom in this building. A site map of the WNC Ag Center that shows the location of the Davis Event Center building can be found at <https://www.wncagcenter.org/p/mountainstatefair/competitions/map>.

Although 97 of the 134 (72.4%) cases reside in 4 adjacent counties (Buncombe, Haywood, Henderson, and Transylvania) near the WNC AG Center, the infection now involves cases in a total of 19 of the 100 North Carolina counties plus counties in the neighboring state of South Carolina. A map showing the location of the North Carolina counties can be found at  <https://geology.com/county-map/north-carolina.shtml>.

The species of _Legionella_ detected in patients or in the environmental isolate from the Davis Event Center is not specified; however, the usual pathogen in the US is _Legionella pneumophila_ serogroup 1. Genotyping clinical and environmental isolates will help identify clusters of cases with a common source and identify the source responsible for infection in these clusters. - ProMED Mod.ML]

[HealthMap/ProMED-mail maps:
North Carolina, United States: <http://healthmap.org/promed/p/235>
South Carolina, United States: <http://healthmap.org/promed/p/242>]
Date: 4 Oct 2019
Source: New Mexico (USA) Department of Health [edited]

The New Mexico Department of Health's (NMDOH) Scientific Laboratory Division has confirmed a case of plague in a 72-year-old man from Torrance County, the 1st human case of plague in New Mexico this year [2019].  Plague is a disease caused by the bacterium _Yersinia pestis_, which is generally transmitted to humans from the bites of infected fleas that live among rodents and rabbits. Plague can also be transmitted by direct contact with infected animals. Pet dogs and cats can become infected with plague when they eat an infected rodent or when they are bitten by an infected flea.

NMDOH staff have gone door-to-door in the affected area to inform neighbours about plague and provided them with education to reduce their risks.  "No matter where you call home in New Mexico, you can reduce the risk of plague by avoiding contact with rodents or their fleas, or outdoor pets by providing appropriate flea prevention for pets year-round," said Secretary of Health Kathy Kunkel.

Symptoms of plague in humans include sudden onset of a fever, chills, headache, and weakness usually within one to 7 days of becoming infected. There may be a painful swelling of the lymph node in the neck, armpit or groin areas, referred to as bubonic plague. The infection can also spread to the blood, causing septicemic plague, or to the lungs, causing pneumonic plague.

With prompt diagnosis and appropriate antibiotic treatment, the fatality rate in people and pets can be greatly reduced. Physicians who suspect plague should promptly report all cases to the New Mexico Department of Health.

To prevent plague, the Department of Health recommends that residents:
- Avoid sick or dead rodents and rabbits, and their nests and burrows.
- Clean up areas near the house where rodents could live, such as woodpiles, brush piles, junk and abandoned or un-used vehicles.
- See a healthcare provider about any unexplained illness involving a sudden and severe fever. Inform your healthcare provider about any flea bites, contact with rodents, or burrows during the previous couple of weeks.
- Wear protective clothing to prevent flea bites while working outside.
- Provide safe and effective flea control for pets as recommended by a veterinarian.
- Sick pets should be examined promptly by a veterinarian.

This is the 1st human plague case in New Mexico since 2017, a year where there was a total of 4 human cases. There has been one animal plague case in a dog in Quay County in 2019 (see Department of Health Reports Plague Case in Quay County). There were 3 cases of animal plague in dogs in 2018, and 28 animal plague cases in 2017 in New Mexico.
=======================
[Earlier comment from ProMED Mod.LL (archive number

"The manifestations of _Yersinia pestis_ infection in this case are not stated in the report but it is likely to have been bubonic plague. Of late, 2015 was a "banner year" for _Y. pestis_ infections in the USA with 15 cases and 4 deaths. In recent decades, an average of 7 human plague cases have been reported each year (range: 1-17 cases per year) with 0-2 deaths.

The following was extracted from: Prentice MB, Rahalison L. Plague. Lancet. 2007; 369(9568): 1196-207, with the citations removed:

"Some plague cases (10-25 per cent) present with primary septicaemia (hypotension, shock) without lymph nodes being obviously affected and these patients have higher mortality than those with bubonic plague. The term septicemic plague can be confusing, since most patients with buboes have detectable bacteremia at some stage and can also have high-density bacteremia with systemic signs of sepsis. Debate about whether septicemic plague is always secondary to frank or subclinical bubonic or pneumonic disease continues, but work in mice lends support to the existence of a syndrome of septicemic disease without histological changes in lymph nodes in a few animals infected by flea bites."

Earlier comment of ProMED Mod.TG (archive number

"Plague is primarily a disease of wild rodents. It is caused by the bacterium _Yersinia pestis_, which is mainly spread by the bites of infectious fleas. The bacterium is not native to North America. When it was introduced, it became established in some rodent populations. Surveillance efforts testing fleas are very important to detect circulation of _Y. pestis_ and risk of infection.

Plague may infect human beings through several routes: 1) the bite of an infected flea carried by a rodent or, rarely, other animals (mentioned previously; 2) direct contact with contaminated tissues, generally from an animal; or 3) in rare cases, inhalation of respiratory secretions from infected people or animals.

Clinical signs in pets involve a localized swelling, such as under the jaw in cats, but also in the inguinal region or under the front leg (the armpit, if you will), lethargy, anorexia, and fever (or chills). These clinical signs may be present in the dog as well. Swelling under the jaw in cats is frequently mistaken as a cat-fight abscess.

If your pets are not on flea prevention, please ask your veterinarian about the best flea prevention. Bathing your pet in dishwashing soap is not sufficient to help your pet avoid diseases carried by fleas. Some of the over the counter flea preventions may be harmful to your pet, so please check with your veterinarian. It is also a good time to make sure your pet is current on a rabies shot.

Keeping your pets inside is best, and being inside a yard will help diminish the ability to consume a dead animal and further reduce the risk of plague to your animal and to yourself." - ProMED Mod.LM]

[HealthMap/ProMED map available at:
New Mexico, United States: <http://healthmap.org/promed/p/233>]
Date: Fri 4 Oct 2019 08:55 PM CDT
Source: ArkLaTex, WVLA [edited]

Health experts say there are more cases of hepatitis A in the state. The Louisiana Department of Health now has the count at 575. Livingston Parish has the most cases ranging from 121 to 240. One death has been reported so far in Louisiana.

Hepatitis A is a contagious viral liver infection easily spread through close contact with an infected person.

There are vaccines to combat the infection. You can get one at your doctor's office or parish health unit. The Louisiana Department of Health has a list of resources for anyone with questions about hepatitis A.  [Byline: Deon Guillory]
=====================
[HealthMap/ProMED-mail map of Louisiana, United States:
Date: Fri 20 Sep 2019
Source: NBCDFW [edited]

Hours after Collin County Health Care Services released information on Fri 20 Sep 2019 about a travel-related case of typhoid fever confirmed in August 2019 in McKinney, the Frisco ISD said it is currently investigating a possible case at an elementary school.

Collin County health officials said on Fri 20 Sep 2019 that people who ate at the Hat Creek Burger Co., 3321 South Custer Road, between 19 Aug 2019 and 22 Aug 2019 may have come in contact with the extremely drug-resistant strain of XDR _Salmonella_ Typhi and could still develop symptoms.

Pam Ritz, a spokesperson for the restaurant, said a worker who contracted the virus had travelled out of the country and only became ill 3 days after returning to work. The worker was at the restaurant on 19-22 Aug 2019 before showing symptoms. Ritz said the worker was sent home when he became ill and was later confirmed to be suffering from typhoid fever. No other employees or customers have reported symptoms of the illness in the past month, and strict sanitation procedures have been followed at the restaurant, the spokesperson said.

Friday afternoon, 20 Sep 2019, officials with the Frisco Independent School District said a student at Talley Elementary is being investigated for having typhoid fever as well. The district said the student is only suspected of having contracted the virus and that it has not yet been confirmed. Frisco ISD told parents in a letter that the Talley campus is being disinfected. It is not clear whether the cases are related or the strains of the bacterium are the same.

Dr. Jawaid Asghar, chief epidemiologist for Collin County Health Care Services, said the disease could be transmitted by a sick person who did not wash their hands after using a toilet before touching the food of a healthy person. He said the McKinney case is the 1st confirmation of the XDR _Salmonella_ Typhi strain in Texas. "This is extremely drug resistant," Asghar said. "It is resistant to drugs we can normally give for typhoid." The worker is still receiving care for the illness and has not returned to work but has improved, Asghar said.

Ashgar said the risk of transmission of the disease from that one sick person is very low, but the press was notified to warn people who were in the restaurant during those 3 days to seek medical attention if they become ill.

Symptoms of typhoid fever may include sustained fever as high as 103-104 F [39-40 C]. Infected individuals may also feel weak, or have stomach pains, headache, diarrhoea, or loss of appetite and constipation more often than diarrhoea in adults. In some cases, patients have a rash of flat, rose-coloured spots. Symptoms can begin in as little as 3 days or as long as 60 days, with an average range of 8-14 days after exposure.

_Salmonella_ is spread through the stool of a person with the bacteria. Objects, food, or water put into someone's mouth that has bacteria on them can cause the illness. The most important way to prevent the spread of this illness is through careful handwashing by everyone. Hands must be washed after using the restroom. Hands must also be washed before preparing food and before eating. Alcohol based hand rubs are effective when soap and water are not available.
====================
[It is likely that the traveling food service worker visited Pakistan, where most of the XDR cases have occurred, and was not vaccinated against typhoid prior to the trip. As a food worker, he or she could then transmit the infection via contaminated food as occurred with the famous "Typhoid Mary."

We await information about the possible secondary case and whether other cases occur. - ProMED Mod.LL]

[HealthMap/ProMED map available at:
Texas, United States: <http://healthmap.org/promed/p/245>]
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 ...

Syria

Syria US Consular Information Sheet
August 13, 2008

COUNTRY DESCRIPTION:
Since March 1963, the Syrian Arab Republic has been ruled by an authoritarian regime dominated by the Socialist Ba'ath Party.
While the ruling Ba'ath party
spouses a largely secular ideology, Islamic traditions and beliefs provide a conservative foundation for the country's customs and practices.
Syria has a developing, centrally-planned economy with large public (30%), agricultural (25%), and industrial (20%) sectors.
Tourist facilities are available, but vary in quality depending on price and location.
Read the Department of State Background Note http://www.state.gov/r/pa/ei/bgn/3580.htm on Syria for additional information.
ENTRY/EXIT REQUIREMENTS:
A passport and a visa are required.
Visas must be obtained prior to arrival in Syria from a Syrian diplomatic mission located in the traveler’s country of residence, although the Syrian visa policy with respect to American diplomats and citizens is currently under review.
Foreigners who wish to stay 15 days or more in Syria must register with Syrian immigration authorities by their 15th day.
Syrian-American men or American men of Syrian origin, even those born in the United States, may be subject to compulsory military service unless they receive a temporary or permanent exemption from a Syrian diplomatic mission abroad prior to their entry into Syria.
(Please see the section on Special Circumstances below.)
Syria charges a departure tax for all visitors except those on diplomatic passports.
As of July 1, 2008, the tax is 1,500 Syrian Pounds if departing from the airport; 500 Syrian Pounds if departing via one of the land borders.

The Syrian government rigidly enforces restrictions on prior travel to Israel, and does not allow persons with passports bearing Israeli visa or entry/exit stamps to enter the country.
Syrian immigration authorities will not admit travelers with Israeli stamps in their passports, Jordanian entry cachets or cachets from other countries that suggest prior travel to Israel.
Likewise, the absence of entry stamps from a country adjacent to Israel, which the traveler has just visited, will cause Syrian immigration officials to refuse admittance.
Entry into Syria via the land border with Israel is not possible.
American-citizen travelers suspected of having traveled to Israel have been detained for questioning.

Syrian security officials are also sensitive about travel to Iraq.
There have been instances in which Americans, especially those of Arab descent, believed to have traveled to Iraq were detained for questioning at ports of entry/exit.
Americans seeking to travel to Iraq through Syria have also on occasion been turned around and/or detained.
On a number of occasions the border between Iraq and Syria has been closed without notice, stranding Americans on either side of the border.
Children under the age of eighteen whose fathers are Syrian or of Syrian descent must have their fathers' permission to leave Syria, even if the parents are separated or divorced and the mother has been granted full custody by a Syrian court.
Women in Syria are often subject to strict family controls.
On occasion, families of Syrian-American women visiting Syria have attempted to prevent them from leaving the country.
This can be a particular problem for young single women of marriageable age.
Although a woman does not need her husband's explicit consent every time she wishes to leave Syria, a Syrian husband may take legal action to prevent his wife from leaving the country, regardless of her nationality.
Once such legal orders are in place, the U.S. Embassy cannot help American citizens leave Syria.
Visit the Embassy of the Syrian Arab Republic, 2215 Wyoming Ave. NW, Washington, DC
20008, telephone (202) 232-6313 or check the Syrian Embassy's home page at http://www.syrianembassy.us for the most current visa information.
Information about dual nationality or the prevention of international child abduction can be found on our web site.
For further information about customs regulations, please read our Customs Information sheet.
SAFETY AND SECURITY: Syria is included on the Department of State's List of State Sponsors of Terrorism.
A number of the terrorist groups that have offices in Syria oppose U.S. policies in the Middle East.
On September 12, 2006, the U.S. Embassy in Damascus was attacked by assailants using improvised explosives, gunfire, and two vehicles laden with explosives.
On February 4, 2006, mobs protesting caricatures of the Prophet Mohammed destroyed the Norwegian and Chilean embassies and severely damaged the Danish and Swedish diplomatic missions.
On April 27, 2004 there was a violent clash in which three people died in an area of Damascus where many foreign citizens reside.
It has never been clear whether the shootout with Syrian security forces involved common criminals or terrorists.
In 1998 and 2000, mobs attacked the U.S. Ambassador’s Residence and the U.S. Embassy, respectively.
In 1997, twenty-two people were killed when a public bus was bombed in downtown Damascus.
All of these attacks serve as reminders that Syria is not immune from political or purely criminal violence.
Americans traveling through the area should remain aware that U.S. interests and citizens might be targeted.
Security personnel may at times place foreign visitors under surveillance.
Hotel rooms, telephones, and fax machines may be monitored, and personal possessions in hotel rooms may be searched.
Taking photographs of anything that could be perceived as being of military or security interest may result in problems with authorities.
Additionally, Americans should be aware that conversations on the topics of political, religious and other freedoms are not seen as merely healthy debate in Syria and could lead to arrest.
Note that possession of specific-use electronic devices including GPS, short-wave or handheld radio equipment, or similar devices in Syria is illegal.

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, including the Travel Warning for Syria, 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:
While a few cases of theft, burglary and assault have been reported to the Embassy, crime is generally not a serious problem for travelers in Syria.
It is important to note, however, that Syria is not crime free. Specifically, incidents of credit card and ATM fraud, and physical harassment of women, are on the rise.

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 the local police, please contact the U.S. Embassy for assistance.
The Embassy staff can, for example, assist you to find appropriate medical care, to contact family members or friends and explain how funds could be transferred.
Although the investigation and prosecution of the crime is solely the responsibility of local authorities, consular officers can help you to understand the local criminal justice process and to find an attorney if needed.

The local equivalents for the “911” emergency line in Syria are:
110 for ambulance, 113 for fire and 112 for the police.
See our information on Victims of Crime.
MEDICAL FACILITIES AND HEALTH INFORMATION:
Basic medical care and medicines are available in Syria's principal cities, but not necessarily in outlying areas.
Serious illnesses and emergencies may require evacuation to a Western medical facility.
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.
Some HIV/AIDS entry restrictions exist for visitors to or foreign residents of Syria.
There are no special immunizations required for entry to Syria.
AIDS tests are mandatory for foreigners’ ages 15 to 60 who wish to reside in Syria.
The AIDS test must be conducted in Syria at a facility approved by the Syrian Ministry of Health.
A residence permit will not be issued until the absence of the HIV virus has been determined.
Foreigners wishing to marry Syrian nationals in Syria must also be tested for HIV.
Syria usually will not give visas or residency permits to students wishing to study religion or Arabic in private religious institutions.
Please verify this information with the Embassy of Syria at http://www.syrianembassy.us/ 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 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 Syria is provided for general reference only, and may not be totally accurate in a particular location or circumstance.
Driving in Syria is hazardous and requires great caution.
Although drivers generally follow traffic signs and signals, they often maneuver aggressively and show little regard for vehicles traveling behind or to the sides of them.
Lane markings are usually ignored.
Vehicles within Syrian traffic circles must give way to entering traffic, unlike in the United States.
At night, it is very hard to see pedestrians, who often walk into traffic with little warning.
Outside major cities it is common to find pedestrians, animals and vehicles without lights on the roads at night.
Pedestrians must also exercise caution.
Parked cars, deteriorating pavement, and guard posts obstruct sidewalks, often forcing pedestrians to walk in the street.
Vehicles often do not stop for pedestrians, and regularly run red lights or “jump” the green light well before it changes.

Please refer to our Road Safety page for more information.
For specific information concerning Syrian driving permits, vehicle inspection, road tax and mandatory insurance, contact the Syrian Embassy in Washington, D.C. at 2215 Wyoming Avenue NW, Washington, DC
20008, tel. 202-232-6313.
AVIATION SAFETY OVERSIGHT:
Sanctions resulting from the passage of the Syria Accountability Act prohibit aircraft of any air carrier owned or controlled by the Syrian government to take off from or land in the United States.
As there is no direct commercial air service to the United States by carriers registered in Syria, the U.S. Federal Aviation Administration (FAA) has not assessed Syria's Civil Aviation Authority for compliance with International Civil Aviation Organization (ICAO) aviation safety standards.
For more information, travelers may visit the FAA’s web site at http://www.faa.gov/safety/programs_initiatives/oversight/iasa.
The U.S. Embassy in Damascus has advised its employees to avoid travel on Syrian Arab Airlines (Syrian Air or SAA) whenever possible due to concerns regarding the airline's ability to maintain its airplanes.
SAA has, on its own initiative, grounded individual aircraft with significant maintenance or service issues; however, concerns persist that some planes still being flown may lack certain safety equipment or may have undergone repairs that have not been reviewed by the manufacturer.

SPECIAL CIRCUMSTANCES:
Syrian customs authorities may enforce strict regulations concerning temporary importation into or export from Syria of items such as weapons, narcotics, alcohol, tobacco, cheese, fruits, pharmaceuticals, modems, cosmetics, and some electrical appliances.
It is advisable to contact the Embassy of Syria in Washington, D.C. for specific information regarding customs requirements.
Please see our Customs Information.
U.S. citizens are encouraged to carry a copy of their U.S. passports with them at all times so that, if questioned by local officials, they will have proof of identity and U.S. citizenship readily available.
Although Syria is a signatory to the Vienna Convention on Consular Relations, Syrian officials generally do not notify the American Embassy when American citizens are arrested. When the American Embassy learns of arrests of Americans and requests consular access, individual police officials have, on their own initiative, responded promptly and allowed consular officers to visit the prisoners.
However, security officials have also in the past denied Embassy requests for consular access, especially in the case of dual citizens.
Foreign currencies can be exchanged for Syrian pounds only at government-approved exchange centers and licensed private banks.
Syrian pounds cannot be changed back into foreign currency.
Very few places in Syria accept credit cards.
Foreigners visiting Syria are required to pay hotel bills in US dollars or Euros.
Travelers’ checks are not accepted for payment in Syria, and banks will not cash them unless the traveler has an account at the bank in question.
There are no US-based banks operating in Syria.
There are six private banks operating in Syria, with branches and ATMs in most major cities.
These ATMs usually honor major debit/credit systems.
Funds may be transferred into Syria through Western Union.
Wiring of funds through private banks is possible only if the traveler already holds an account with the bank in Syria;, transferring funds through the Commercial Bank of Syria is not possible due to U.S. sanctions.
Syrian-American and Palestinian-American men who have never served in the Syrian military and who are planning to visit Syria are strongly urged to check with the Syrian Embassy in Washington, D.C. prior to traveling concerning compulsory military service. American men over the age of 18, even those who have never resided in or visited Syria, whose fathers are of Syrian descent, are required to complete military service or pay to be exempted.
Possession of a U.S. passport does not absolve the bearer of this obligation.
The fee for exemption from military service ranges from $5,000 to $15,000 USD, depending upon circumstances, for Syrian-American and Palestinian-American men who live abroad.
In January 2005 the Syrian government reduced mandatory military service from 30 months to 24 months.
It also announced that Syrians born outside of Syria and residing abroad until the age of 18 have the option of being exempted from their service by paying $2,000 USD.
Those born in Syria who left the country before reaching the age of 11, and have resided abroad for more than 15 years can be exempted by paying $5,000 USD.
Contact the Syrian Embassy in Washington, DC, for more information (See Entry/Exit Requirements section above).
President Bush signed an executive order on May 11, 2004, implementing sanctions in accordance with the Syria Accountability Act.
These sanctions prohibit the export to Syria of products of the United States other than food or medicine, and prohibit any commercial aircraft owned or controlled by the Syrian government from taking off from or landing in the United States.
Under the authority provided in Section 5(b) of the Act, the President has determined that it is in the national security interest of the United States to waive the application of these sanctions in certain cases and for certain products, as specified in the Department of Commerce's General Order No. 2.
For additional information about implementation of the Syria Accountability Act, consult the Department of Commerce web site at (http://www.bis.doc.gov/).
Since 1979, the United States has designated Syria a State Sponsor of Terrorism due to its support for groups such as Hizbollah and Palestinian terrorist groups.
The Terrorism List Government Sanctions Regulations prohibit U.S. persons from receiving unlicensed donations from the Syrian government.
Additionally, U.S. persons are prohibited from engaging in financial transactions which a U.S. person knows or has reasonable cause to believe pose a risk of furthering terrorists' acts in the United States.
For additional information about the Terrorism List Government Sanctions Regulations, consult the terrorism brochure on the U.S. Department of the Treasury, Office of Foreign Assets Control (OFAC) home page on the Internet at http://www.treas.gov/offices/enforcement/ofac/ or via OFAC's info-by-fax service at (202) 622-0077.
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 Syrian laws, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in Syria are strict and convicted offenders can expect prison sentences and heavy fines.
Penalties for possession of even small amounts of illegal drugs for personal use are severe in Syria.
Persons convicted in Syria for growing, processing, or smuggling drugs face the death penalty, which may be reduced to a minimum of 20 years’ imprisonment.
Engaging in sexual conduct with children or using or disseminating child pornography in a foreign country is a crime, prosecutable in the United States.
Please see our information on Criminal Penalties.
CHILDREN'S ISSUES:
For information see our Office of Children’s Issues web pages on intercountry adoption and international parental child abduction.
REGISTRATION / EMBASSY LOCATION:
Americans living or traveling in Syria 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 Syria.
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 2 Al-Mansour St., Abu Roumaneh, Damascus.
The international mailing address is PO Box 29, Damascus.
Mail may also be sent via the U.S. Postal Service to: American Embassy Damascus, Department of State, Washington, DC
20521-6110.
Telephone numbers are (963) (11) 3391-4444, fax number is (963)(11) 3391-3999, e-mail: acsdamascus@state.gov.
The government workweek in Syria is Sunday through Thursday; the private sector generally works Saturday through Thursday.
The U.S. Embassy is open Sunday through Thursday.
Additional information may be found on the Embassy web site at http://damascus.usembassy.gov
*

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This replaces the Country Specific Information dated November 20, 2007 to update the sections on Entry/Exit Requirements, Safety and Security, Crime, Information for Victims of Crime, Medical Facilities and Health Information, Special Circumstances, and Registration/Embassy Location.

Travel News Headlines WORLD NEWS

Date: Fri 21 Jun 2019
Source: WHO/EMRO (Regional Office for the Eastern Mediterranean) [edited]

Situation reports on Al-Hol camp, Al-Hasakah
--------------------------------------------
- Over the past 2 weeks, a total of 633 people have left the camp. This number includes 107 people who returned to their homes in north-east Syria. There were no new arrivals during the reporting period.
- 9 medical points are reporting regularly to the disease Early Warning And Response System (EWARS). Leishmaniasis, acute diarrhoea, bloody diarrhoea, and severe acute malnutrition (SAM) remain the most commonly reported diseases.
- 38 new cases of leishmaniasis were detected. All patients are being treated by a WHO-supported mobile team in coordination with the Al-Hasakeh Directorate of Health.
- 7 suspected cases of measles were reported. No new cases of tuberculosis were detected during the reporting period.
- 30 children with severe acute malnutrition with medical complications were admitted to Al-Hikmah hospital during the reporting period, of whom 22 were discharged, one died, and the remainder are still under treatment. Mortality rates related to severe acute malnutrition remain below the emergency threshold.
- 2 new static health care points have been established, bringing the total number to 12. There is still an acute shortage of health care points in the Foreign Annex.
- 35 water sources were tested for microbial contamination in Al-Hasakeh water national laboratory during the reporting period. All 35 samples tested negative for contamination. WHO continues to test the quality of water from different sources in the camp.
- Stool samples from patients with diarrhoea were tested for
_Salmonella_, _E. coli_, and cholera, with all samples testing negative. Blood samples from patients with suspected measles were also sent for testing, and all samples tested negative.
- Following intensive negotiations by WHO, the local authorities have given their approval in principle to evacuate a patient requiring advanced mental health treatment
===================
[Leishmaniasis has surged throughout Syria during the civil war on all sides and continues to be a health problem in the refugee population. - ProMED Mod.EP]

[HealthMap/ProMED-mail map of Syria:
Date: Wed, 22 May 2019 16:52:39 +0200
By Nazeer al-Khatib with Hashem Osseiran in Beirut

Maaret al-Numan, Syria, May 22, 2019 (AFP) - Syrian government air strikes killed 18 civilians, including a dozen people at a busy market, as fierce fighting raged for the jihadist-held northwest, a war monitor said on Wednesday.   Regime forces battled to repel a jihadist counteroffensive around the town of Kafr Nabuda that has left 70 combatants dead in 24 hours, the Syrian Observatory for Human Rights said.   The Hayat Tahrir al-Sham alliance, led by Syria's former Al-Qaeda affiliate, controls a large part of Idlib province as well as adjacent slivers of Aleppo, Hama and Latakia provinces.   The jihadist-dominated region is nominally protected by a buffer zone deal, but the government and its ally Russia have escalated their bombardment in recent weeks, seizing several towns on its southern flank.   At least 12 people were killed and another 18 wounded when regime warplanes hit the jihadist-held Idlib province town of Maarat al-Numan around midnight (2100 GMT) on Tuesday, the Observatory said.

The market was crowded with people out and about after breaking the daytime fast observed by Muslims during the holy month of Ramadan.   The bombardment blew in the facades of surrounding buildings, and ripped through the flimsy frames and canvas of stalls in the market square, an AFP photographer reported.    The bodies of market-goers were torn apart.   "Residents are still scared," stallholder Khaled Ahmad told AFP.   Three more civilians were killed on Wednesday by air strikes in the nearby town of Saraqib, the Observatory said.    Two others were killed in strikes on the town of Maaret Hermeh, it added.    Another civilian was killed in air raids on the town of Jisr al-Shughur, the monitor said.   The Britain-based Observatory relies on a network of sources inside Syria and says it determines whose planes carried out strikes according to type, location, flight patterns and munitions.

- 'Worst fears'-
The strikes came as heavy clashes raged in neighbouring Hama province after the jihadists launched a counterattack on Tuesday.   Fresh fighting on Wednesday took the death toll to 70 -- 36 regime forces and militia and 34 jihadists, the Observatory said.   It said the jihadists had recaptured most of Kafr Nabuda from government forces, who had taken control of the town on May 8.   State news agency SANA on Wednesday however said the army repelled a jihadist attack in the area, killing dozens of insurgents.

Russia and rebel ally Turkey inked the buffer zone deal in September to avert a government offensive on the region and protect its three million residents.   But President Bashar al-Assad's government upped its bombardment of the region after HTS took control in January.   Russia too has stepped up its air strikes in recent weeks.   The Observatory says nearly 200 civilians have been killed in the flare-up since April 30.   The United Nations said Wednesday that Idlib's civilian population once again faced the threat of an all-out offensive.   "A full military incursion threatens to trigger a humanitarian catastrophe for over 3 million civilians caught in the crossfire, as well as overwhelm our ability to respond," said David Swanson, a spokesman for the UN humanitarian office.   Swanson said more than 200,000 people have been displaced by the upsurge of violence since April 28.   A total of 20 health facilities have been hit by the escalation -- 19 of which remain out of service, Swanson said.   Collectively they served at least 200,000 people, he added.

- 'Break the status quo' -
The September deal was never fully implemented as jihadists refused to withdraw from a planned buffer zone around the Idlib region.   But it ushered in a relative drop in violence until earlier this year, with Turkish troops deploying to observation points around the region.   The Syrian government has accused Turkey of failing to secure implementation of the truce deal by the jihadists.   But Turkish Defence Minister Hulusi Akar accused the Syrian regime late Tuesday of threatening the ceasefire deal.   "The regime is doing all that it can to break the status quo including using barrel bombs, land and air offensives," Akar told reporters.   "Turkish armed forces will not take a step back from wherever they may be", he however added.   Earlier, the US State Department said it was assessing indications that the government had used chemical weapons on Sunday during its offensive in Idlib.   HTS accused government forces of launching a chlorine gas attack on its fighters in the northern mountains of Latakia.   But the Observatory said Wednesday it had "no proof at all of the attack".

7 May 2019, Cairo, Egypt: The World Health Organization (WHO) strongly condemns continuing attacks on health facilities in north-western Syria. Since 29 April, in just nine days, twelve health structures have been hit. 

On 5 May, three facilities were struck in one day alone, including two major hospitals that provide secondary healthcare in the area.  One of the structures, a surgical unit, was supported by WHO. Three health care workers lost their lives as a result of these attacks.  There are now no functioning hospitals in northern Hama, and emergency care is provided by only three surgical units supported by WHO.  Close to 300,000 civilians are affected.   

“These attacks against health facilities and other civilian infrastructure are a grave and totally unacceptable development,” said Dr. Ahmed Al-Mandhari, WHO Regional Director for the Eastern Mediterranean Region. “International humanitarian law safeguards civilians, even in the most violent of conflicts. And according to the Geneva Convention, health facilities and civilians – especially the most vulnerable – must be protected.  Parties to the conflict in northern Hama and in Idleb are flagrantly disregarding those rules; and it is women, children, the elderly and other vulnerable groups who are suffering as a result.”   

The health facilities that were hit in northern Hama and southern Idleb provided a total of 30,000 consultations, 860 hospital admissions and 700 surgeries per month to a highly vulnerable population. 

“We are also deeply concerned about the people who have had to flee their homes and now have no access to basic health services. Over 150,000 people were displaced from northern Hama and southern Idleb in between 29 April and 4 May, doubling the total number of people displaced in the area in the last three months. Saving their lives is our main priority and this requires further strengthening available health services. What is of particular concern is the increasing risk for infectious disease outbreaks due to overcrowding in temporary settlements,” Dr Al-Mandhari added.

WHO continues – with health partners – to ensure the provision of key primary and secondary healthcare and has released emergency health supplies for almost 92,200 treatment courses, including for surgical and trauma care, secondary healthcare, and primary healthcare.

As the conflict in north-western Syria intensifies, WHO reminds all parties to the conflict that attacks on health facilities are a blatant violation of international humanitarian law. Health facilities must never be attacked or damaged, and health workers should be allowed to provide medical treatment and services to all people in need wherever they are.

Date: Tue, 2 Apr 2019 18:54:39 +0200

Beirut, April 2, 2019 (AFP) - More than 40,000 displaced people in north-western Syria have seen their camps flooded by heavy rains in the past three days, a United Nations spokesman said Tuesday.   Around 14 camps were affected in the north-western province of Idlib, David Swanson of the UN Office for the Coordination of Humanitarian Affairs told AFP.

The Idlib region, controlled by Syria's former Al-Qaeda affiliate, is home to more than 3 million people -- more than half of them displaced by the country's eight-year war.   Civil defence workers known as the White Helmets have been working to save people and their scant belongings from the rising muddy waters.   "For the second day in a row, White Helmets... continue to respond to the catastrophic situation in the northern Syria camps," they said on Twitter late Monday.

One video posted by the group on Sunday showed brown water cascading out of a flooded tent.   In another published the same day, civil defence workers clung on to a rope as they waded through a brown torrent above knee level.   The downpour has affected tens of thousands of civilians, displaced persons, crops and livestock in Idlib, as well as in the Aleppo and Hasakeh provinces since Saturday, Swanson said.

In Aleppo province, tents were destroyed in several camps for the displaced and a hospital in the countryside had to shut down due to the flooding.   Syria's war has killed more than 370,000 people and displaced millions since starting in 2011 with the brutal repression of anti-government protests.   Tens of thousands of displaced Syrians in the north of the country depend on handouts from humanitarian aid groups, including food, blankets and heating fuel for the winter months.

Thursday 7th March 2019
http://www.emro.who.int/syr/syria-news/unexploded-mines-pose-daily-risk-for-people-in-northern-syria.html

6 March 2019 - Um Hassan, from rural Aleppo, was collecting truffles in the countryside to sell in local markets. At the end of a long day of backbreaking work in harsh winter conditions, she and her children climbed into a crowded lorry to begin their journey home. Half-way through their trip, the lorry drove over an unexploded mine. Um Hassan’s 10-year old daughter Lolo was killed instantly and two of her other children were seriously injured.

Lolo was one of six people killed in the explosion. Another 15 people were rushed to the WHO-supported University Hospital in Aleppo. Um Hassan’s husband was frantic with worry when his family did not return home. He had no way of getting in touch with his wife and she was unable to get in touch with him. Like many people living in poverty in rural areas of Syria, the family has no mobile phone or landline.

“This is such a tragic event,” said Elizabeth Hoff, WHO Representative in Syria. “Although the security situation in the north has improved recently, tens of thousands of landmines and other unexploded devices continue to pose a severe threat to millions of innocent people. WHO is working to strengthen trauma care and emergency services in Aleppo and other northern governorates, but the underlying problem remains. Sustained efforts must be made to clear mines and other hazards from former conflict areas. Until then, people like Um Hassan and her family will be at risk of similar incidents.”

For Um Hassan and many others like her, there is no choice but to continue working every day, despite the risks. “Life is difficult and we have to keep working in our fields, no matter how hard,“ said Um Hassan. “Our survival depends on it.”

More ...

World Travel News Headlines

Date: Wed, 16 Oct 2019 18:45:39 +0200 (METDST)

Manila, Oct 16, 2019 (AFP) - A child was killed in a strong 6.4-magnitude quake that hit the southern Philippines on Wednesday, a local mayor said, as houses collapsed, power was knocked out and a shopping mall burst into flames.   Residents evacuated homes and buildings across the Mindanao region including a mall that caught fire in the city of General Santos shortly after the quake struck in the evening, officials said.   The child died in a house collapse in the town of Datu Paglas, while four residents of nearby Tulunan town were injured when at least two other houses fell down, Tulunan Mayor Reuel Limbungan told AFP.   "The child was crushed by a collapsed house wall" and pronounced dead in hospital, Limbungan said, adding that he had visited the medical facility and spoken to its director.

Rescue and local officials said there were no immediate reports of deaths elsewhere in Mindanao, and rescue official Anthony Allada told local television that 20 people were treated for injuries in the town of Magsaysay, near the epicentre.   Three other people were hurt in the town of M'lang, added its vice-mayor, Joselito Pinol.   The quake was 14 kilometres (8.7 miles) deep and was followed by at least two aftershocks, according to the United States Geological Survey (USGS).   "It was the most powerful earthquake I have ever experienced," Sara Duterte, mayor of the largest Mindanao city of Davao, and daughter of President Rodrigo Duterte, told local television.

- Falling debris -
The Philippines is part of the Pacific "Ring of Fire", an arc of intense seismic activity that stretches from Japan through Southeast Asia and across the Pacific basin.   An elderly man was treated for injuries after being struck by a falling object during the evacuation of a Davao mall, local TV reported.   Jerome Barranco, civil defence officer for the region, said several people were also injured in the city of Kidapawan "as a result of falling debris".   In General Santos, television footage showed firemen battling a blaze that engulfed the three-storey Gaisano shopping mall.   It was not known if there were still people inside the building, which was evacuated as the quake struck.   The blaze was still raging more than three hours later despite the efforts of nearly 100 firemen, fire officer Redentor Batulan told AFP.

Coastal residents of Davao fled their homes in fear of a tsunami, but rescue workers were trying to convince them to return as no warning was issued, city civil defence chief Rodrigo Bustillo told local television.   "Our volunteers are out to calm the people and tell them there is no tsunami," Bustillo added.   Chief Philippine government seismologist Renato Solidum said there was no risk of a tsunami because the quake occurred inland, but he advised residents to check their homes for possible damage.   "We ran out of the police station, and we also let the inmates at the municipal jail out," patrolwoman Celina Sarte told AFP by telephone from the town of Bansalan.   She said the 10 prisoners were put in handcuffs outside moments later.
Date: Tue, 15 Oct 2019 20:35:37 +0200 (METDST)

Addis Ababa, Oct 15, 2019 (AFP) - Rescue workers on Tuesday used excavators to dig out bodies after a landslide in southern Ethiopia washed away homes and killed more than 20 people, a local official said.    The landslide in the remote district of Konta occurred Sunday following 10 hours of heavy rains, said the official, Takele Tesfu.   "There are 22 people dead and we have only been able to dig up 17 using manpower and machine power," Takele told AFP.   "So far, we cannot get the others, so tomorrow we will continue to dig."     He said the victims included nine women and six children.

While the district -- located in Ethiopia's Southern Nations, Nationalities, and Peoples' Region -- sees landslides with some regularity, Takele said this was the deadliest he could remember.    "The area where this occurred is very mountainous, and this means the landslide was very dangerous," he said.    Ethiopia is nearing the end of its rainy season, but security forces are nonetheless relocating some families for fear that more rain in the coming days could lead to similar disasters, Takele said.
Date: Tue, 15 Oct 2019 10:00:23 +0200 (METDST)

New Delhi, Oct 15, 2019 (AFP) - New Delhi banned the use of diesel generators on Tuesday as pollution levels in the Indian capital exceeded safe limits by more than four times.   Every winter, New Delhi is enveloped in a noxious blanket of smog of car fumes, industrial emissions and smoke from stubble burning at farms outside the megacity of 20 million people.   The ban on generators is part of the Graded Response Action Plan (GRAP) that entered into force on Tuesday.   Other measures that will come into effect as smog levels rise, particularly following the Diwali festival in late October, include banning trucks and setting up a "war room".

From November 4-15, a road-rationing scheme will come into force, meaning cars with odd and even plates would be allowed on alternate days in that period.   "We will hand out anti-pollution masks to schoolchildren next week but the date is yet to be decided," the official told AFP.   Indian authorities have also sought to reduce the burning of stubble by farmers in areas surrounding Delhi.   According to government data, concentrations of particles measuring less than 2.5 microns across -- which can penetrate the lung barrier and enter the blood -- hit 108 icrograms per cubic metre on Tuesday.   This was more than four times the recommended World Health Organization safe daily maximum of 25. In previous years, the level has regularly exceeded 400.   Last year, a UN report found 14 of the world's 15 most polluted cities were in India, with one US study saying it kills a million people prematurely every year.
Date: Tue, 15 Oct 2019 09:50:21 +0200 (METDST)
By Kyoko HASEGAWA

Tokyo, Oct 15, 2019 (AFP) - Rescuers in Japan were working around the clock Tuesday in an increasingly desperate search for survivors of a powerful weekend typhoon that killed nearly 70 people and caused widespread destruction.   Hagibis slammed into Japan on Saturday night, unleashing fierce winds and unprecedented rain that triggered landslides and caused dozens of rivers to burst their banks.   By Tuesday afternoon, local media put the toll at nearly 70, with around a dozen people missing. The government's tally was lower, but it said it was still updating information.   Prime Minister Shinzo Abe said there was no plan to slow rescue operations, with around 110,000 police, coast guard, firefighters and military troops involved.   "Currently in damaged areas rescue work and searches for the missing are continuing around the clock," Abe told parliament.   "Where rivers flooded, work is ongoing to fix spots where banks broke, and water is being pumped out where floods occurred," he added.   The prime minister's office said more than 3,000 people have been rescued in the wake of the disaster, which affected 36 of the country's 47 prefectures.   The defence ministry has called up several hundred reserve troops in addition to active duty soldiers for the first time since the 2011 earthquake and tsunami.

- Rain prompts new warnings -
Government officials warned that more rain was expected throughout the day Tuesday in several parts of the country affected by the typhoon.   "We ask people not to drop their guard and to remain fully alert," chief cabinet secretary Yoshihide Suga. told reporters.   Hagibis crashed into land packing gusts up to 216 kilometres (134 miles) per hour, but it was the storm's heavy rain that caused the most damage.   At least 176 rivers burst their banks, including in central Nagano, where a levee breach sent water from the Chikuma river gushing into residential neighbourhoods and submerging bullet trains in a depot up to their windows.   Deaths were reported across many prefectures and included a man whose apartment was flooded, a municipal worker whose car was caught in rising waters and at least seven crew aboard a cargo ship that sank in Tokyo bay on Saturday night.   By Tuesday morning, some 34,000 households were still without power, and 133,000 homes had no water.   Tens of thousands of people spent Monday night in government shelters, with many unsure when they would be able to return home.   "My frightened daughter can't stop shaking. We want to go home quickly," Rie Nishioka, 39, told Kyodo News agency in Miyagi prefecture.

- Government pledges aid -
The government pledged financial support to affected regions without specifying how much aid it would set aside.   "Support for the victims of the disaster is an urgent task," Abe said.   "There are concerns that the impact on daily life and economic activities may be long-lasting."   Another area affected by the storm was Fukushima, where several bags containing soil and plants collected during nuclear decontamination efforts were washed away.   "Ten bags out of 2,667 were swept into a river during the typhoon, but six of them were recovered yesterday," environment ministry official Keisuke Takagi told AFP, adding that the remaining four bags had been found and would be collected soon.   "Residents must be worried about the environment, but there are no reports that the bags were broken, so there will be nothing to worry about once they have been recovered safely," he said.   Hagibis caused transport chaos over a holiday weekend in Japan, grounding flights and halting train services.   By Tuesday, things were largely back to normal, though some flights were cancelled and train services partially disrupted where tracks or train stock were damaged by the storm.   The typhoon also caused disruption to sporting events, delaying Japanese Grand Prix qualifiers and forcing Rugby World Cup organisers to cancel three matches.   A crunch fixture pitting the hosts against Scotland went ahead on Sunday night, with Japan winning its first-ever quarter final spot.
Date: Mon, 14 Oct 2019 17:55:47 +0200 (METDST)

Harare, Oct 14, 2019 (AFP) - Striking Zimbabwe doctors on Monday defied a court order to return to work, saying a pay rise offered by the government failed to meet everyday costs.   Doctors remained home for a 43rd consecutive day, striking for better pay after their salaries were eroded by the country's spiralling inflation.   Zimbabwe's labour court ruled the action "unlawful" on Friday and ordered the medics back to their wards within 48 hours.

The Zimbabwe Hospital Doctors Association (ZHDA) announced Sunday it would appeal to the Supreme Court.    "We noted the court order but unfortunately we don't have the means by which to comply," said ZHDA spokesman Masimba Ndoro on Monday.   "We remain incapacitated... There is nothing we can do when we don't have the means to go to work and to meet our basic needs," he told AFP.   The doctors say the value of their pay shrank 15-fold over the past year -- a legacy of hyperinflation caused by economic mismanagement under ex-president Robert Mugabe.   His successor Emmerson Mnangagwa has so far failed to redress the situation.    Fuel prices have increased by more than 400 percent since the start of the year, and the ZHDA said that doctors had to use their savings just to show up to hospital each morning.

Negotiations with the government have been deadlocked since the ZHDA rejected a 60-percent salary rise offer.   With pay slips worth less than the equivalent of $100 (91 euros) in some cases, they are demanding doctors' salaries be pegged to the US dollar and have appealed to international bodies to supplement their wages.   "While doctors would want nothing more than to return to work in service of their patients, they continue to be incapacitated and lack the resources to comply with the Labour Court judgement," the ZHDA said in a statement on Sunday.   Nurses joined in the action last week.   "We have reduced the number of days we are coming to work initially to three days a week now we are down to two days," Zimbabwe Nurses Association spokesman Enoch Dongo told AFP.   "If the issue of salaries is not urgently addressed we will soon have a situation where nurses will no longer be able to come to work," he said, adding that nurses were "taking turns" in coming to hospital.      Rural teachers also embarked on strike action on Monday with a stay-at-home protest "against underpayment".   "We urge the government to respect our right to engage in job actions and peacefully protest demanding a living wage," the Amalgamated Rural Teachers Union of Zimbabwe posted on Twitter.
Date: Mon, 14 Oct 2019 16:33:26 +0200 (METDST)
By Daniel BOSQUE

Barcelona, Oct 14, 2019 (AFP) - "I feel fury and a sense of powerlessness," said Joan Guich, a 19-year-old student protesting in Barcelona after Spain's Supreme Court jailed nine Catalan leaders jailed over a failed independence bid.   "They have been convicted for an ideology which I agree with."   Within minutes of the ruling demonstrators had poured onto the streets of the Catalan capital, waving flags and blocking traffic over the conviction of the separatist leaders who organised a 2017 referendum banned by Madrid.   "We have to mobilise and stick up for them ... in a way that has an impact, closing airports, stations, but always avoiding violence," Guich said. "Or at least, it won't be us that provokes it."

Workers rallied outside their offices, university students walked out of classes and regional lawmakers demonstrated inside Catalonia's parliament, where most of the defendants had held a senior role.   "Today is going to be historic, you can feel it in the atmosphere. Serious things are happening, we can't stay home," said Oscar Quiles, a 47-year-old real estate entrepreneur.   News of the verdict reached him as he arrived at the office and he immediately called his mother to join him at a protest in Plaza Cataluna in the centre of Barcelona.   By noon the square was packed with thousands of demonstrators, many waving yellow, red and blue Catalan separatist flags or banners reading "We would do it again" and "Freedom for political prisoners".   The protesters then set off walking towards Barcelona's airport, Spain's second busiest, in the hope of blocking it, just as pro-democracy activists have done recently in Hong Kong.

- 'Weeks of mobilisation' -
Tension gripped Barcelona on Monday morning ahead of the ruling, with a heavy police presence outside the courts, the airport and the city's main train station, as a helicopter flew overhead.    Democratic Tsunami, a group advocating more active forms of civil disobedience, had urged demonstrators to hit the streets as soon as the verdicts were announced.   "Tomorrow everyone ready! When the verdict is out, the response will be immediate," said the group in a message to its roughly 150,000 followers on mobile messaging service Telegram.   Juli Cuellar, a 44-year-old office worker, said he believed the verdict was politically motivated.    "Now all we have left is a life of civil and institutional disobedience," he told AFP, predicting "weeks of mobilisation".   The Catalan National Assembly (ANC) and Omnium Cultural, the region's two biggest grassroots pro-independence groups, have also called supporters to attend an evening rally. They have organised some of the largest separatist protests in recent years.   Several more protests are scheduled over the next few days across Catalonia, as well as a general strike on Friday.

- 'Felt like crying' -
Democratic Tsunami, the group that called the gathering in Plaza Cataluna, only emerged in recent weeks. It says it does not depend on Catalan separatist parties or civil associations for support.   Its leaders remain unknown, keeping in touch with each other through encrypted messaging apps such as Wire.   But supporters tend to be kept in the dark until the last minute.   "We don't know exactly what we have to do," said Arnau Font, a 22-year-old shop assistant who took the week off to protest.   "We have to get involved. Right now I feel really powerless in light of the verdicts," he told AFP.    "When I found out, I felt like crying."   The uncertainty was over a few minutes later when a Telegram message arrived urging everyone to "go to the airport", a 15-kilometre (nine-mile) walk from the city centre.    "The time has come to make our voice felt around the world. The goal: stop the activity of Barcelona's airport," it said.   Spain's airport operator Aena said no flights were disrupted, but many passengers got stuck in traffic jams leading to the airport.
Date: Mon, 14 Oct 2019 14:09:03 +0200 (METDST)

Frankfurt am Main, Oct 14, 2019 (AFP) - German cabin crew union UFO urged members Monday to walk off their jobs at airline giant Lufthansa on October 20, although the carrier contests its right to represent workers.   "We call on all cabin crew... not to show up to work" between six and eleven am (0400 to 0900 GMT) at Germany's two busiest hubs Frankfurt and Munich, Ufo chairman Daniel Flohr said in a video message to staff.   At least five of the Lufthansa group's airlines -- Lufthansa, Eurowings, Germanwings, Cityline and Sunexpress -- would be hit by strikes for higher pay in the coming weeks, Flohr added.

Lufthansa told AFP it would "maintain its entire timetable", calling UFO's call to strike "illegal".   Bosses at the airline group believe UFO may no longer have the legal right to speak for workers and have challenged its status in court.   Internal disputes at the union have cost it members and support among cabin crew, some of whom have now turned to other representative organisations.   Berlin daily Tagesspiegel on Monday called UFO a "half-dead" outfit.   "UFO is battling for its life," agreed business daily Handelsblatt.   "With its far-reaching call for strikes, it wants to show members it remains capable of acting and is representing cabin crew interests."   Lufthansa could also contest before a court whether UFO has the right to initiate a strike -- potentially leaving the worker representatives on the hook for any resulting costs.
Date: Mon, 14 Oct 2019 11:08:10 +0200 (METDST)

Manila, Oct 14, 2019 (AFP) - Parents lined up from sunrise holding sleeping infants as the Philippines launched a campaign on Monday to vaccinate millions of children against polio, which has re-emerged nearly two decades after the nation's last cases.   Years of falling vaccination rates, made worse by the botched rollout of a dengue vaccine, culminated in an outbreak of the preventable disease in September.   "This is for the welfare of my child," Ruth Miranda told AFP after the vaccine was squirted into her child's mouth at the Manila slum they call home.

Miranda's child is among scores who are unprotected in the capital of about 13 million people, where vaccination rates of young children plunged from 77 percent in 2016 to a mere 24 percent in June.   The atmosphere at the event in Manila was festive -- with ice cream vendors and music -- but the stakes for the campaign are high.

Polio, which can cause paralysis and can be fatal in rare cases, has no cure and can only be prevented with several doses of oral and injectable vaccines.   Two cases were detected in September, the first polio infections in the Philippines since 2001, adding to the woes of a country already hit by deadly measles and dengue epidemic.   The risk of the disease spreading within the Philippines is high, according to World Health Organization, due to low immunisation coverage partly blamed to a dengue vaccine scandal.

The Philippines was the first nation to use Dengvaxia in a mass programme in 2016, but a botched rollout led to claims that children had died after being vaccinated.   A dramatic drop in vaccine confidence followed, with trust plunging from 93 percent in 2015 to 32 percent in 2018, according to a study led by the London School of Hygiene and Tropical Medicine.   The Philippines polio outbreak has been traced back to the weakened form of the virus used in vaccines, which is excreted by people for a time after they receive it.   According to the WHO, that form can mutate and spread in the surrounding community when immunisation rates get too low.
Date: Mon, 14 Oct 2019 10:25:38 +0200 (METDST)
By Shingo ITO, Sara HUSSEIN

Tokyo, Oct 14, 2019 (AFP) - Tens of thousands of rescue workers in Japan battled on Monday to find survivors of a powerful typhoon that killed at least 43 people, as fresh rain threatened to hamper efforts.   Typhoon Hagibis crashed into the country on Saturday night, unleashing high winds and torrential rain across 36 of the country's 47 prefectures, and triggering landslides and catastrophic flooding.   "Even now, many people are still unaccounted for in the disaster-hit area," Prime Minister Shinzo Abe told an emergency disaster meeting on Monday.   "Units are trying their best to search for and rescue them, working day and night," Abe said.

But even as rescuers, including troops, combed through debris, the country's weather agency forecast rain in central and eastern Japan that it warned could cause further flooding and new landslides.   "I would like to ask people to stay fully vigilant and continue watching for landslides and river flooding," Chief Cabinet Secretary Yoshihide Suga told a news conference.   In Nagano, one of the worst-hit regions, rain was already falling and was expect to intensify.   "We are concerned about the impact of the latest rain on rescue and recovery efforts," local official Hiroki Yamaguchi told AFP.   "We will continue operations while watching out for secondary disasters due to the current rain."

- 43 dead, 16 missing: NHK -
By late Monday afternoon, national broadcaster NHK said the toll had risen to 43 dead, with 16 others missing and over 200 people injured. The government gave lower figures but was continuing to update its information.   The dead included a municipal worker whose car was overcome by floodwaters and at least seven crew from a cargo ship that sank in Tokyo Bay on Saturday night, a coast guard spokesman said.   Four others, from China, Myanmar and Vietnam, were rescued when the boat sank and the coast guard was still searching for a last crew member.   While Hagibis, one of the most powerful storms to hit the Tokyo area in decades, packed wind gusts of up to 216 kilometres (134 miles) per hour, it was the heavy rains that caused most damage.

A total of 142 rivers flooded, mainly in eastern and northern Japan, with river banks collapsing in two dozen places, local media said.   In central Nagano, a levee breach sent water from the Chikuma river gushing into residential neighbourhoods, flooding homes up to the second floor.   As water slowly receded Monday, television footage showed patients being transferred by ambulance from a Nagano hospital where some 200 people had been cut off by flooding.   Elsewhere, rescuers used helicopters to winch survivors from roofs and balconies, or steered boats through muddy waters to reach those trapped.

- Japan dedicates rugby win to victims -
By Monday afternoon, some 75,900 households remained without power, with 120,000 experiencing water outages.   The disaster left tens of thousands of people in shelters, with many unsure when they would be able to return home.   "Everything from my house was washed away before my eyes, I wasn't sure if it was a dream or real," a woman in Nagano told NHK.   "I feel lucky I'm still alive."   The storm brought travel chaos over the holiday weekend, grounding flights and halting commuter and bullet train services.

By Monday, most subway trains had resumed service, along with many bullet train lines, and flights had also restarted.   The storm also brought havoc to the sporting world, forcing the delay of Japanese Grand Prix qualifiers and the cancellation of three Rugby World Cup matches.   But a crucial decider pitting Japan against Scotland went ahead, with the hosts dedicating their stunning 28-21 win to the victims of the disaster.   "To everyone that's suffering from the typhoon, this game was for you guys," said Japan captain Michael Leitch.
Date: Sun, 13 Oct 2019 23:31:57 +0200 (METDST)

Kinshasa, Oct 13, 2019 (AFP) - Doctors will use a second Ebola vaccine from November in three eastern provinces in the Democratic Republic of Congo to fight the deadly virus, medical officials said Sunday.   "It's time to use the new Ad26-ZEBOV-GP vaccine, manufactured by Johnson & Johnson's Belgian subsidiary," said Dr. Jean-Jacques Muyembe, who leads the national anti-Ebola operation in the DRC.    It will arrive in the eastern city of Goma, in North Kivu province, on October 18 and be used from the beginning of next month, he added.   DRC's latest Ebola epidemic, which began in August 2018, has killed 2,144 people, making it the second deadliest outbreak of the virus, after the West Africa pandemic of 2014-2016.

Muyembe said the communes of Majingo and Kahembe had been selected to receive the vaccine as they were considered the epicentres of the epidemic.   "We will extend this vaccination to our small traders who often go to Rwanda to protect our neighbours," he added.   "If it works well, we will expand vaccination in South Kivu and Ituri."   DR Congo's eastern provinces of Ituri, North Kivu and South Kivu sit on the borders with Uganda, Rwanda and Burundi.   The Belgian laboratory will send a batch of 200,000 doses to neighbouring Rwanda and 500,000 doses in the DRC, Muyembe said.   More than 237,000 people living in active Ebola transmission zones have received a vaccination produced by the pharma company Merck Sharpe and Dohme since August 8, 2018. 

The J&J vaccine had been rejected by DRC's former health minister Oly Ilunga, who cited the risks of introducing a new product in communities where mistrust of Ebola responders is already high.   But Ilunga's resignation in July appears to have paved the way for approval of the second vaccine. He currently faces charges that he embezzled funds intended for the fight against Ebola.   In his letter of resignation Ilunga said "actors who have demonstrated a lack of ethics" want to introduce a second vaccine, but did not elaborate.    Muyembe, who took over the Ebola fight in the DRC in July, said "The Johnson & Johnson vaccine has the most science-based data."