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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: Tue, 26 Nov 2019 09:28:12 +0100 (MET)
By Briseida MEMA

Tirana, Nov 26, 2019 (AFP) - Six people died and some 150 were injured in Albania after the strongest earthquake in decades rocked the Balkan country early Tuesday, destroying buildings and burying victims in rubble.

The epicentre of the 6.4 magnitude quake was about 34 kilometres (about 20 miles) northwest of the capital Tirana, at a depth of 10 km, according to the European-Mediterranean Seismological Centre.   "We have victims," Prime Minister Edi Rama wrote on Twitter. "We are working to do everything possible in the affected areas."   The quake struck at 3:54 am local time (0254 GMT) and sent panicked residents running out onto the streets of Tirana, with people huddling in the open, an AFP correspondent said.

The worst damage appeared to be around the coastal town of Durres. The quake was the strongest to hit this region since 1926, Albanian seismologist Rrapo Ormeni told local television.   Three bodies were pulled from the ruins of damaged buildings in the port town, where a three-story hotel collapsed and other buildings were damaged, according to the defence ministry.   The bodies of a man and a woman were uncovered in rubble in the nearby town of Thumane, the ministry said.

A man in his fifties died after he jumped out of his building in panic in the town of Kurbin, the defence ministry said.   Some 300 armed forces personnel have rushed to Durres and Thumane for rescue operations, where "there are people trapped under the ruins", defence ministry spokeswoman Albana Qahajaj said.

In Thumane, around a dozen rescuers used an excavator to dig through a mountain of debris in search of possible victims.   At least 150 people with injuries have sought first aid in Tirana and Durres, Health Minister Ogerta Manasterliu said.

- Trapped under rubble -
In Thumane, soldiers, rescuers and families were sifting through the rubble of a collapsed five-storey building as cries of people trapped under debris were heard, an AFP reporter said.   Thoma Nika, a 58-year-old who lived in the building, said there were at least six people under rubble.    Another man, Arben Allushi said with tears in his eyes, that his wife and niece missing after the building collapsed.

A man in Durres told local television that his daughter and niece were trapped in the rubble of a collapsed apartment building.    "I talked with my daughter and niece on the phone. They said they are well and are waiting for the rescue. I could not talk to my wife. There are other families, but I could not talk to them," the man said.

The tremors were felt across the Balkan region, from Sarajevo to Bosnia and even in the Serbian city of Novi Sad almost 700 kilometres away, according to reports in local media and on social networks.   It was followed by several aftershocks, including one of 5.3 magnitude, the European-Mediterranean Seismological Centre said. It was described by authorities as the strongest earthquake in the last 20-30 years.   The Balkans is an area prone to seismic activity and earthquakes are frequent.
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:
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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: Tue, 21 Jan 2020 22:23:22 +0100 (MET)
By Issam Ahmed with Helen Roxburgh

Washington/Beijing, Jan 21, 2020 (AFP) - The United States on Tuesday announced its first case of a new virus that has claimed six lives in China and sickened hundreds, joining countries around the world in ramping up measures to block its spread.   The man, a US resident in his 30s who lives near Seattle, is in good condition, according to federal and state officials, and approached authorities himself after reading about the SARS-like virus in news reports.   He is "currently hospitalized out of an abundance of precaution, and for short term monitoring, not because there was severe illness," said Chris Spitters, a Washington state health official.  "This is an evolving situation and again, we do expect additional patients in the United States and globally," added Nancy Messonier, a senior official at the Centers for Disease Control and Prevention (CDC), but stressed that the overall risk to Americans remained low.

The man entered the country on January 15 after traveling to Wuhan, two days before the US began deploying health officials at major airports to screen passengers arriving from that central Chinese city which is at the heart of the outbreak. The efforts are to be extended now to a total of five US airports.   It came as countries ramped up measures to block the spread of the virus -- known by its technical name 2019 Novel Coronavirus or 2019-nCoV -- as the number of cases surpassed 300, raising concerns in the middle of a major Chinese holiday travel rush.

Fears of a bigger outbreak rose after a prominent expert from China's National Health Commission confirmed late Monday that the virus can be passed between people.   That conclusion is shared by the CDC, which said "person-to-person spread is occurring, although it's unclear how easily the virus spreads between people," even as the World Health Organization (WHO) adopted a more cautious approach, saying it is still investigating.   The UN agency will hold an emergency meeting Wednesday to determine whether to declare a rare global public health emergency over the disease, which has also been detected in Thailand, Japan and South Korea and Taiwan.

- Holiday rush -
Authorities previously said there was no obvious evidence of person-to-person transmission and animals were suspected to be the source, as a seafood market where live animals were sold in Wuhan was identified as the center of the outbreak.   Hundreds of millions of people are criss-crossing China this week in packed buses, trains and planes to celebrate the Lunar New Year with relatives.

More than 80 new cases have been confirmed, bringing the total number of people hit by the virus in China to 315, with the vast majority in Hubei, the province where Wuhan lies, according to officials.   But cases have also been confirmed around the country, including Beijing and Shanghai.   The first case on the self-ruled island of Taiwan was also confirmed Tuesday, with a woman taken to hospital on arrival at the airport from Wuhan.   Wuhan mayor Zhou Xianwang told state broadcaster CCTV Tuesday that the death toll had risen from four to six.   The coronavirus has caused alarm because of its genetic similarities to Severe Acute Respiratory Syndrome (SARS), which killed nearly 650 people across mainland China and Hong Kong in 2002-2003.

- Fever checks -
At four airports in Thailand, authorities introduced mandatory thermal scans of passengers arriving from high-risk areas of China.   In Hong Kong, authorities said they were on "extreme high alert," with passengers from Wuhan required to fill out health declarations and face possible jail time if they do not declare symptoms.   Enhanced screening measures have also been set up at airports in Australia, Bangladesh, Nepal, Singapore and Russia, Malaysia and Vietnam.   A man showing symptoms of the disease who had travelled to Wuhan has been put in isolation in Australia as health officials await test results, authorities said Tuesday.   In China, the government announced it was classifying the outbreak in the same category as SARS, meaning compulsory isolation for those diagnosed ith the disease and the potential to implement quarantine measures on travel.

In Wuhan, authorities banned tour groups and police were conducting spot checks for animals in vehicles leaving and entering the city, state media said.   It added that city health authorities had scheduled 800 beds to be made available in three hospitals and 1,200 more would soon be ready, and passengers were being screened for fever at the airport, railway stations and bus terminals.   Doctors at the University of Hong Kong released a study on Tuesday estimating that there have been 1,343 cases of the new virus in Wuhan.   The WHO has only called a global public health emergency a handful of times, including during the H1N1 -- or swine flu -- pandemic of 2009 and the Ebola epidemic that devastated parts of West Africa from 2014 to 2016.
Date: 15 Jan 2020
Source: Fox News [edited]

CDC is facing criticism over its response to a polio-like illness. The Centers for Disease Control and Prevention has confirmed 10 additional cases of acute flaccid myelitis.  An Ohio teen is determined to walk again despite doctors' warnings that she may not after she contracted a rare polio-like illness that's left her paralyzed from the waist down.  IK, a catcher on her middle school's softball team, said it started with what felt like a cramp in her leg on Christmas. "I just thought, 'Oh gosh, it's just growing pains or a Charley horse,'" NK, the 13-year-old's mother, told News 5 Cleveland.  But the next day, IK couldn't stand on her own, and her worried parents rushed her to Akron Children's Hospital, where she was diagnosed with acute flaccid myelitis (AFM). It's a rare but serious condition that affects the nervous system, specifically the grey matter of the spinal cord, which weakens the body's muscles and reflexes.

Health officials have noticed an increase of cases in children occurring every 2 years since 2014, according to the Centers for Disease Control and Prevention (CDC). And while it often is referred to as a "polio-like" illness, tests so far have tested negative for poliovirus.  Symptoms typically begin with sudden onset of arm or leg weakness and loss of muscle tone and reflexes, but can also include facial droop or weakness, difficulty moving eyes, drooping eyelids, difficulty swallowing,  slurred speech, and pain in the arms and legs.  Severe symptoms may include respiratory failure, or serious neurological complications, according to the CDC. Parents are encouraged to seek medical care right away if a child is suspected of developing any symptoms

Since her diagnosis, IK has been working in physical therapy and has received steroid treatments as well as multiple plasma exchange, according to the news outlet. Her mother said it's been like "a bad dream" for the family as they watch her struggle to gain strength.  "It's a lot, but I just try to go with the flow, just to push through," IK, who has received support from her teammates, classmates and members of the community, told News 5 Cleveland.  [Byline: Alexandria Hein]
======================
[Acute flaccid myelitis (AFM) is a rare but serious condition. It affects the nervous system, specifically the area of the spinal cord called gray matter, which causes the muscles and reflexes in the body to become weak.

In 2019, there were 33 total confirmed cases in 16 US states
[<https://www.cdc.gov/acute-flaccid-myelitis/cases-in-us.html>].

The case definition for AFM is based on clinical and lab criteria

Clinical Criteria: An illness with onset of acute flaccid limb weakness.
Laboratory Criteria:
Confirmatory Laboratory Evidence: a magnetic resonance image (MRI) showing spinal cord lesion largely restricted to grey matter and spanning one or more vertebral segments. Supportive Laboratory Evidence: cerebrospinal fluid (CSF) with pleocytosis (white blood cell count over 5 cells/mm3) Case Classification:
- Confirmed: Clinically compatible case AND Confirmatory laboratory evidence: MRI showing spinal cord lesion largely restricted to grey matter and spanning one or more spinal segments.
- Probable: Clinically compatible case AND Supportive laboratory evidence: CSF showing pleocytosis (white blood cell count over 5 cells/mm3)

With the high number of cases reported in 2018 and 2019, CDC enhanced AFM surveillance through collection of data at the national level by encouraging healthcare providers to recognize and report to their health departments all patients whom they suspect may have AFM; health departments are being asked to send this information to CDC to help us understand AFM activity nationwide. - ProMED Mod.UBA]

[HealthMap/ProMED map available at:
Date: Mon 6 Jan 2020
Source: CDC, Viral hepatitis, Outbreaks, Hepatitis A Outbreaks [edited]

When hearing about hepatitis A, many people think about contaminated food and water. However, in the United States, hepatitis A is more commonly spread from person to person.

Since March 2017, CDC's Division of Viral Hepatitis (DVH) has been assisting multiple state and local health departments with hepatitis A outbreaks, spread through person-to-person contact.

The hepatitis A vaccine is the best way to prevent HAV [hepatitis A virus] infection.

The following groups are at highest risk for acquiring HAV infection or developing serious complications from HAV infection in these outbreaks and should be offered the hepatitis A vaccine in order to prevent or control an outbreak:
- people who use drugs (injection or non-injection);
- people experiencing unstable housing or homelessness;
- men who have sex with men (MSM);
- people who are currently or were recently incarcerated; and
- people with chronic liver disease, including cirrhosis, hepatitis B, or hepatitis C.

One dose of single-antigen hepatitis A vaccine has been shown to control outbreaks of hepatitis A and provides up to 95% sero-protection in healthy individuals for up to 11 years.

Pre-vaccination serologic testing is not required to administer hepatitis A vaccine. Vaccinations should not be postponed if vaccination history cannot be obtained or records are unavailable.
=======================
[Overall, the 5 states with the most HAV cases remain Kentucky, Florida, Ohio, Tennessee, and West Virginia with the numbers in Florida still rising notably. In these states, the case fatality rates are Kentucky 1.2%, Florida 1.5%, Ohio 0.5%, Tennessee 0.9%, and West Virginia 0.8%

As the numbers of cases continue to rise in a number of states and news of smaller (so far) outbreaks occur in others, the question at the end of ProMED-mail post http://promedmail.org/post/20190104.6241686 by a Kentucky official -- "This is a disease of developing countries. One has to ask: Why are we seeing it in the USA?" -- is more and more relevant. We are seeing these outbreaks because of the inability to deal with marginalized populations in our midst. The dramatic cutbacks in public health infrastructure in some of these states clearly feed the fire of these outbreaks. They must be addressed by bolstering public health resources and education and in directly addressing the needs of these marginalized populations. - ProMED Mod.LL]

[HealthMap/ProMED map available at:
Date: Sat 4 Jan 2020
Source: Prescott eNews [edited]

Flu activity is now widespread in 48 states, including Arizona. Arizona has had 6816 confirmed cases, and Yavapai County has had 84 confirmed cases. Compared to last year [2019], this season seems to be affecting young people more prevalently -- the 5- to 18-year-old age-group is almost double -- while [the age-group] 50 and older is half to a quarter of last year.

Here's what to do if you or someone you're caring for gets sick:
Steps to take if you get the flu
--------------------------------
- If you get very sick, are pregnant, or are 65 years or older, or are otherwise at high risk of flu-related complications, call your doctor. You might need antiviral drugs to treat flu.
- Stay at home and rest.
- Avoid close contact with well people in your house so you won't make them sick.
- Drink plenty of water and other clear liquids to prevent fluid loss (dehydration).

When caring for people who have the flu
---------------------------------------
- Avoid being face to face with the sick person. If possible, it is best to spend the least amount of time in close contact with a sick person.
- When holding sick children, place their chin on your shoulder so they will not cough in your face.
- Wash your hands often and right way.
- If soap and water are not available, use an alcohol-based hand rub.
- Make sure to wash your hands after touching the sick person. Wash after handling their tissues or laundry.  [Byline: Lynne LaMaster]
Date: Fri 3 Jan 2020
Source: Dayton Daily News [edited]

A surge in flu cases has pushed the Miami Valley Hospital emergency department to capacity, according to a spokeswoman. Doctors at Miami Valley are urging patients with flu symptoms to 1st contact their primary care provider or go to an urgent care for non-emergency flu cases.

Dr. Ryan Babienco, an emergency medicine physician, said people who are not having severe symptoms such as shortness of breath can likely be treated at home or can call their family doctor or visit an urgent care if your provider isn't available.

"That's the appropriate place to be treated if you are not experiencing some of the more severe symptoms, especially the one we worry about the most is that real bad shortness of breath where you're coughing and coughing and you can't walk across the room," Babienco said.

When the emergency department is at capacity, all patients are still seen but patients with less serious symptoms have long waits while patients with more critical needs are seen.

At Grandview Medical Center, also in Dayton, a spokeswoman said Friday [3 Jan 2020] afternoon that the hospital "is experiencing a surge in flu cases today, but they are managing the increase in patients."

Symptoms of flu can include fever, cough, sore throat, body aches, headache, chills and fatigue. Flu vaccination is available at most healthcare providers' offices, local health departments and retail pharmacies. There are no flu vaccine shortages across Ohio.

Flu vaccines are encouraged for everyone 6 months and older. Other ways to avoid getting or spreading the flu include washing hands frequently or using alcohol-based hand sanitizer; covering coughs and sneezes with tissues or coughing or sneezing into elbows; avoiding touching eyes, nose and mouth; and staying home when sick.

"Getting the flu vaccine is the safest and most effective way to prevent the flu for everyone 6 months and older," said Dr. Mark Hurst, Ohio Department of Health medical director. "Flu hospitalizations could still be on the rise. You need to protect yourself, your friends and your family and get a flu shot now if you haven't already."

The federal Centers for Disease Control and Prevention recommend that healthcare providers prescribe one of 2 antiviral drugs as a 2nd line of defense as soon as possible to patients with confirmed or suspected influenza who are hospitalized, have severe illness, or may be at higher risk for flu complications.

"These antiviral medications can reduce the severity of the flu and prevent serious flu complications," Hurst said. "They work best when started within 2 days of getting sick."

>From [22-28 Dec 2019], there were 387 new influenza-associated hospitalizations reported in Ohio. There have been 1003 flu-associated hospitalizations reported in Ohio so far this flu season compared with 555 reported during the same time period last year [2019]. Flu activity typically peaks between December and February.

On Friday [3 Jan 2020], Ohio Department of Health reported the state's 1st flu-associated pediatric death of the 2019-2020 flu season, a 16-year-old girl from Cuyahoga County.  [Byline: Kaitlin Schroeder]
More ...

Colombia

Colombia - US Consular Information Sheet
August 13, 2008

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

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

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

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

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

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

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

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

The Department of State urges American citizens to take responsibility for their own personal security while traveling overseas.
For general information about appropriate measures travelers can take to protect themselves in an overseas environment, see the Department of State’s pamphlet A Safe Trip Abroad.
CRIME:
Although the threat of terrorism has decreased in most of Colombia’s cities, they nevertheless experience much of the same crime that is seen in comparably sized cities throughout the region.
Robbery and other violent crimes, as well as scams against unsuspecting tourists, are common in urban areas.
Generally speaking, if you are the victim of a robbery, you should not resist.
Some of the most common methods used by criminals in Colombia are noted below:
Robberies of ATM customers:
Tourists and others have been robbed after using automatic teller machines (ATMs) on the street.
In some cases, robbers have used motorcycles to approach their victims and later flee the scene.
Americans are urged to use ATMs only inside shopping malls or other protected locations.
Driving to and from the location – rather than walking – provides added protection.
When using an ATM, you should be on the lookout for anyone watching or following you.

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

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

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

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

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

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

MEDICAL INSURANCE:
The Department of State strongly urges Americans to consult with their medical insurance company prior to traveling abroad to confirm that their policy applies overseas and whether it will cover emergency expenses such as a medical evacuation.
Please see our information on medical insurance overseas.
TRAFFIC SAFETY AND ROAD CONDITIONS:
While in a foreign country, U.S. citizens may encounter road conditions that differ significantly from those in the United States.
The information below concerning Colombia is provided for general reference only, and may not be totally accurate in a particular location or circumstance.

Due to the security environment in Colombia, U.S. government officials and their families are not permitted to travel by road between most major cities.
They also cannot use inter- or intra-city bus transportation, or travel by road outside urban areas at night.
All Americans in Colombia are encouraged to follow these same precautions.
Traffic laws in Colombia, including speed limits, are often ignored and rarely enforced, creating dangerous conditions for drivers and pedestrians in major cities.
Under Colombian law, seat belts are mandatory for front-seat passengers in a private vehicle.
Car seats are not mandatory for children, but a child under ten is not permitted to ride in a front seat.
It is against the law to talk on a cellular phone while driving in Colombia, and violators may be fined.
While driving outside major cities, it is mandatory to drive with your lights on.
If an accident occurs, the involved parties must remain at the scene and not move their vehicles until the authorities arrive; this rule is strictly enforced, and moving a vehicle or leaving the scene of an accident may constitute an admission of guilt under Colombian law.
Americans seeking to import their own vehicles into Colombia should consult with their nearest Colombian consulate for information on Colombian taxes and licensing rules, which can be complicated and bureaucratic.
Please refer to our Road Safety page for more information.

AVIATION SAFETY OVERSIGHT:
The U.S. Federal Aviation Administration (FAA) has assessed the Government of Colombia’s Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) safety standards for oversight of Colombia’s air carrier operations.
For more information, please visit the FAA’s website at http://www.faa.gov/safety/programs_initiatives/oversight/iasa.
SPECIAL CIRCUMSTANCES:
Colombia employs strict screening procedures for detecting narcotics smuggling at its international airports.
Americans and other travelers are occasionally questioned, searched, fingerprinted, and/or asked to submit to an abdominal x-ray upon arrival or departure.
Most airport inspectors do not speak English, and travelers who do not speak Spanish may have difficulty understanding what is asked of them.
Please refer to the section on Criminal Penalties for further information on the strict enforcement of Colombia’s drug laws. Please see our Customs Information.
CUSTOMS REGULATIONS:
Travelers generally must not enter or exit Colombia while carrying cash or other financial instruments worth more than 10,000 U.S. dollars.
Colombian authorities may confiscate any amount over $10,000, and may initiate a criminal investigation into the source of the money and the traveler’s reasons for carrying it.
Recovery of the confiscated amount requires a lengthy, expensive legal process and may not always be possible.
Americans wishing to send large sums of money to or from Colombia should contact their nearest Colombian consulate, or speak with Colombian customs officials, and should also consider seeking advice from an attorney or financial professional.

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

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

Colombian law forbids the export of pre-Columbian objects and other artifacts protected by cultural patrimony statutes.
Under an agreement between the United States and Colombia, U.S. customs officials are obligated to seize pre-Columbian objects and certain colonial religious artwork when they are brought into the United States.
Please contact the Embassy of Colombia in Washington or one of Colombia's consulates in the United States for detailed customs guidance.
Please see our Customs Information.
CRIMINAL PENALTIES:
While in a foreign country, a U.S. citizen is subject to that country's laws and regulations, which sometimes differ significantly from those in the United States and may not afford the protections available to the individual under U.S. law.
Penalties for breaking the law can be more severe than in the United States for similar offenses.
Persons violating Colombia’s laws, even unknowingly, may be expelled, arrested, or imprisoned.
Engaging in sexual conduct with children or using or disseminating child pornography in a foreign country is a crime, prosecutable in the United States.
Please see our information on Criminal Penalties.

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

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

CHILDREN'S ISSUES:
For information see our Office of Children’s Issues web pages on intercountry adoption and international parental child abduction.
REGISTRATION / EMBASSY LOCATION: Americans residing or traveling in Colombia are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department’s travel registration website so that they can obtain updated information on travel and security within Colombia.
Americans without
Internet access may register directly with the nearest U.S. Embassy or Consulate.
By registering, American citizens make it easier for the Embassy or Consulate to contact them in case of emergency.
The U.S. Embassy is located at Calle 24 Bis No. 48-50 Bogotá, D.C. Colombia.
Mailing address:
Carrera 45 No. 24B-27 Bogotá, D.C. Colombia.

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

*

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

Travel News Headlines WORLD NEWS

Date: Thu, 5 Dec 2019 05:14:37 +0100 (MET)

Bogota, Dec 5, 2019 (AFP) - Thousands of protesters took part in anti-government demonstrations in Colombia's capital Bogota and other cities Wednesday during the country's third general strike in two weeks.   Strike leaders say they intend to maintain pressure on right-wing President Ivan Duque's government, after brushing aside his appeals to cancel the strike on the grounds its effects were crippling the economy.   But crowds were smaller than previous demonstrations as protests took place for a 14th consecutive day.   Some roads were blocked in the capital and in the northeastern city of Cali, but many businesses remained open.   Around 250,000 people took part in the first demonstration against Duque's 15-month-old government on November 21, when the initial general strike brought the country to a standstill.

Interior Minister Nancy Patricia Gutierrez estimated that 40,000 people took part in demonstrations across the country on Wednesday, but organizers said the number of participants was much higher.   "The Colombian people have woken up!" shouted Paola Jiminez, a 41-year-old lawyer taking part in a pot-banging "cacerolazo" demonstration in Bogota.   "Colombians are finding it more and more difficult financially," she said.   A student taking part in one of several peaceful protests in Bogota, who gave his name as Nicolas, held up a banner saying: "The state lies more than my ex."

Police were deployed in nearby streets, but there were no confrontations of the kind that have marred some protests over the last two weeks, during which four people died. Some 500 have been injured.   On Tuesday, the Colombian National Strike Committee -- comprising unions, students and teacher organizations, indigenous groups and the opposition -- met directly with Duque's advisors for the first time, but reached no agreement.    Another meeting was scheduled for Thursday.

Under fire for his economic policies and corruption in the country, Duque launched a national dialogue with mayors and other officials 10 days ago.   The strike committee has presented Duque with a list of 13 demands, including the withdrawal of his proposed tax reforms, and full compliance with the 2016 peace deal with FARC guerrillas.   Among them is a call to dismantle the feared ESMAD riot police, widely criticized for its heavy handed response to protesters.   Duque has yielded to some of the demands on tax reform, announcing the return of Value Added Tax to the poorest 20 percent of the population and benefits for companies that hire young people.
Date: Wed, 27 Nov 2019 23:59:53 +0100 (MET)
By Hector Velasco

Bogota, Nov 27, 2019 (AFP) - Colombian unions marked their second general strike in a week on Wednesday as tens of thousands poured onto the streets in protest against the government of right-wing President Ivan Duque.   Public transport was largely shut down and shops and offices closed in the centre of the capital as a series of protests that began with a 250,000-strong march last Thursday continued for a seventh consecutive day.

Some protesters banged pots and pans as they made their way through the streets. Large demonstrations were also held in Cali and Medellin.   "We are outraged by so much mistreatment and so much corruption," said David Martinez, a 50-year-old public employee who joined a march in Bogota dressed as a clown.   "I'm dressed as a clown because that's how the government sees us. People have risen up in Ecuador, Chile, in Bolivia, now it's our turn to say: No More!" Martinez told AFP.

The protests have been largely peaceful but sporadic violence has left four dead -- including a young man who died Monday after being wounded in clashes with riot police on Saturday. Some 500 people have been injured.   Police said 184 people had been detained in the protests since last week.   "They have turned Colombia into a democracy where they favor a minority of businessmen and bureaucrats, while the vast majority must try to hang on to their privileges," teachers union Fecode said in a statement.   Duque, under fire over his economic policies and corruption, launched a "national dialogue" Sunday with mayors and other officials in a bid to assuage popular anger.   However, protest leaders reacted angrily when they were initially omitted from direct talks.

- US support -
US Secretary of State Mike Pompeo voiced "steadfast support" for Duque's government in a phone call to the beleaguered president on Wednesday, the State Department said.   Pompeo "welcomed the national conversation that President Duque has convened in Colombia in response to recent demonstrations," it said.   A Gallup poll published on November 7 showed Duque's approval ratings at 26 percent in October, the lowest since he took office in August 2018, while 70 percent of respondents believe the country is heading in the wrong direction.

The National Strike Committee -- which groups unions, students, university lecturers and indigenous groups -- presented a list of 13 demands to the government, including the withdrawal of Duque's proposed tax reforms, and full compliance with the 2016 peace deal with FARC guerrillas.   But perhaps the most controversial is the call to dismantle the feared ESMAD riot police, after the death Monday of 18-year-old protester Dilan Cruz, who was hit in the head by a tear gas canister.

Duque has yielded to some of the demands on tax reform, announcing the return of Value Added Tax to the poorest 20 percent of the population and benefits for companies that hire young people.   "This government is open building towards the future, but it must be done with the whole of society," Duque said in an interview with Colombia's W Radio, insisting that many of the protesters claims were based on disinformation or "false premises."
Date: Fri, 22 Nov 2019 06:03:13 +0100 (MET)

Bogota, Nov 22, 2019 (AFP) - Hundreds of thousands of Colombians took to the streets of the capital Bogota on Thursday amid a general strike to protest the policies of President Ivan Duque's right-wing government.   There were reports of clashes and arrests as trade unions, students, opposition parties and the South American country's indigenous organizations challenged the full gamut of Duque's economic, social and security policies.   At night, a thunderous chorus of pot-banging, unusual in Colombia, took place in the cities of Cali and Medellin, and lasted for hours in Bogota.   "Colombia won on this historic day of citizen mobilization," a statement by organizers from the National Strike Committee said, as they requested an "immediate" meeting with Duque to discuss the protesters' array of complaints.   "We call on all citizens to be ready to take further action in the street if the national government continues to neglect our demands," they added.

Later in the day Duque announced that he had heard the protesters' demands, but did not respond to their request for direct dialogue.   "Today, Colombians spoke. We hear them. Social dialogue has been a main principle of this government and we need to deepen it with all sectors of society," he said.   The protests come amid social upheaval across South America, as a wave of unrest over the past two months has battered governments in Chile, Bolivia and Ecuador.   The popularity of Duque's right-wing government -- a key US ally -- has been on the wane since his election 18 months ago, as it deals with hosting 1.4 million refugees from neighboring Venezuela's economic meltdown as well as the complex fallout of a 2016 peace deal with FARC rebels and rampant drug trafficking.

- Troops deployed -
Troops were deployed in the capital and other cities to protect "strategic facilities," authorities said.   The Colombian office of the UN High Commissioner for Human Rights voiced concern over the deployment, saying states must limit the use of military forces "for the control of internal disturbances."   Spokesmen for several organizations backing the protests said more than one million people had marched nationwide.

Interior Minister Nancy Patricia Gutierrez counted some 207,000 demonstrators, adding that "in general terms the participants marched peacefully" while denouncing "some vandals who wanted to disrupt public order."    At least 42 civilians and 37 police were wounded in clashes, and 36 people were arrested across the country, according to authorities.   In the center of Bogota, clashes took place at nightfall, where people wearing ski masks and hoods threw stones and other projectiles at police, who fought back with tear gas.   A new gathering of people banging pots was called for Friday afternoon, as young protesters continued to demonstrate into the night shouting "Long live the national strike."

The general strike was widely followed in big cities like Bucaramanga in the northeast and Medellin in the northwest, along with Bogota where riot police used stun grenades to turn back thousands of students walking towards the international airport, an AFP journalist said.   Several separate marches converged on Bolivar Square, the historic center of the capital close to the presidency.   "We are marching because in Colombia we are tired of corruption, of impunity, that the government does nothing for the poor," Olga Canon, 55, told AFP.   Organizations that participated in the strike take issue with Duque's security policy as well as attempts to introduce a more flexible labor market, weaken public pension funds and raise the retirement age.   Students are demanding more funding for education, while indigenous communities insist on greater protection in remote areas where 134 activists have been killed since Duque came to power in August 2018.

- 'Afraid to march' -
"We are very afraid to march in the streets but we do it anyway because the state is spreading so much fear with its militarization and by closing the borders," political science student Valentina Gaitan, 21, told AFP.    The borders with Brazil, Ecuador, Peru and Venezuela were closed until Friday to avoid any threat to "public order and security," authorities said.   Duque, who does not hold a majority in parliament, suffers from a 69 percent unpopularity rating, according to polls. His party, the Democratic Center (CD), suffered serious setbacks in October local elections.   Political analyst Jason Marczak said the outrage against the government, the target of several demonstrations in recent months, is part of a "considerable demonstration of discontent in the region."   "The unsatisfied claims and deep polarization are the basis for this massive event," said Marczak, of the Washington-based Atlantic Council.
Date: Thu, 21 Nov 2019 22:38:09 +0100 (MET)

Bogota, Nov 21, 2019 (AFP) - Tens of thousands of Colombians took to the streets of the capital Bogota on Thursday amid a general strike to protest the policies of President Ivan Duque's right-wing government.   There were no reported outbreaks of major violence as trade unions, students, opposition parties and the South American country's indigenous organizations challenged the full gamut of Duque's economic, social and security policies.   "It is an accumulation of situations that we hope to see reviewed after today, including a great national dialogue of conciliation," Robert Gomez, president of the main workers' union, told AFP.   The protest comes amid social upheaval across South America, as a wave of unrest over the past two months has battered governments in Chile, Bolivia and Ecuador.   The popularity of Duque's right-wing government -- a key US ally -- has been on the wane since his election 18 months ago, as it deals with hosting 1.4 million refugees from neighboring Venezuela's economic meltdown as well as the complex fallout of a 2016 peace deal with FARC rebels and rampant drug trafficking.

- Troops deployed -
Troops were deployed in the capital and other cities to protect "strategic facilities," authorities said.   The Colombian office of the UN High Commissioner for Human Rights voiced concern over the deployment, saying states must limit the use of military forces "for the control of internal disturbances."   Authorities said the protests were largely peaceful, though riot police fired tear gas to break up groups of demonstrators in isolated clashes in Bogota and the western city of Cali. Blocked roads in some areas snarled transportation.

The general strike was widely followed in Bogota, and other big cities like Bucaramanga in the northeast and Medellin in the northwest.   Several separate marches converged on Bolivar Square, the historic center of the capital close to the presidency.   "We are marching because in Colombia we are tired of corruption, of impunity, that the government does nothing for the poor," Olga Canon, 55, told AFP.   Organizations that participated in the strike take issue with Duque's security policy as well as attempts to introduce a more flexible labor market, weaken public pension funds and raise the retirement age.   Students are demanding more funding for education, while indigenous communities insist on greater protection in remote areas where 134 activists have been killed since Duque came to power in August 2018.

- 'Afraid to march' -
"We are very afraid to march in the streets but we do it anyway because the state is spreading so much fear with its militarization and by closing the borders," political science student Valentina Gaitan, 21, told AFP.    Duque admitted some of the criticisms were legitimate in a televised speech on the eve of the strike, but said the campaign against his government was based on lies seeking to provoke violence.   "We recognize the value of peaceful protests, but also guarantee order," he said.   The borders with Brazil, Ecuador, Peru and Venezuela were closed until Friday to avoid any threat to "public order and security," authorities said.   Political analyst Jason Marczak said the outrage against the government, the target of several demonstrations in recent months, is part of a "considerable demonstration of discontent in the region."   "The unsatisfied claims and deep polarization are the basis for this massive event," said Marczak, of the Washington-based Atlantic Council.
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:
More ...

Turks and Caicos Islands

Turks & Caicos US Consular Information Sheet
November 17, 2008
COUNTRY DESCRIPTION:
The Turks and Caicos Islands are a British Overseas Territory comprising a small archipelago of eight major islands and numerous uninhabited keys, 500 mile
southeast of Miami.
Most tourist facilities are located on Providenciales ("Provo") Island.
The U.S. dollar is the unit of currency and the larger hotels and shops accept credit cards.
The U.S. Embassy in Nassau, Bahamas, has jurisdiction for consular matters in the Turks and Caicos.
ENTRY/EXIT REQUIREMENTS:
U.S. citizens do not need to obtain visas to visit the Turks and Caicos Islands.
All Americans traveling by air outside the United States are required to present a passport or other valid travel document to enter or re-enter the United States.
This requirement will be extended to sea travel (except closed-loop cruises), including ferry service, by the summer of 2009.
Until then, U.S. citizens traveling by sea must have either a WHTI-compliant document (such as a valid U.S. passport or passport card) or both a government-issued photo identification and a document showing their U.S. citizenship (for example, a certified U.S. birth certificate or certificate of nationalization).
Sea travelers should also check with their cruise line and countries of destination for any foreign entry requirements.
Applications for the new U.S. Passport Card are now being accepted.
The card may not be used to travel by air and is available only to U.S. citizens. Further information on the passport card is available at http://travel.state.gov/passport/ppt_card/ppt_card_3926.html and upcoming changes to U.S. passport policy can be found on the Bureau of Consular Affairs web site at http://travel.state.gov/travel/cbpmc/cbpmc_2223.html.
We strongly encourage all American citizen travelers to apply for a U.S. passport well in advance of anticipated travel.
American citizens can visit travel.state.gov or call 1-877-4USA-PPT (1-877-487-2778) for information on how to apply for their passports.

Visit the British Embassy web site at http://ukinusa.fco.gov.uk/en for the most current entry information, including any visa requirements.
Information about dual nationality or the prevention of international child abduction can be found on our website.
For further information about customs regulations, please read our Customs Information sheet.
SAFETY AND SECURITY:
For the latest security information, Americans traveling abroad should regularly monitor the Department of State, Bureau of Consular Affairs’ web site 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 callers outside the United States 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:
Petty street crime does occur.
Visitors should not leave valuables unattended in their hotel rooms or on the beach.
Visitors should make sure that their hotel room doors are securely locked at all times.
In the Turks and Caicos, carrying illegal/undeclared firearms or ammunition is a very serious crime, as is possession of illegal narcotics.

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 the Turks and Caicos Islands is 999 or 911.
See our information on Victims of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION:
Medical facilities are available but limited in the Turks and Caicos Islands.
There is a small public hospital on Grand Turk and a private clinic on Provo, which has a hyperbaric chamber.
Most serious medical problems require medical evacuation by air from the Turks and Caicos to the United States.

The Turks and Caicos Islands do not have a pathologist to perform services in cases of death.
Medical examiners from neighboring countries visit the island regularly to provide this service.
It can take up to two weeks for the Government of the Turks and Caicos Islands to release the remains of the deceased under normal circumstances, and severe weather during the hurricane season could delay the process even more.The U.S. Department of State is unaware of any HIV/AIDS entry restrictions for visitors to or foreign residents of the Turks and Caicos Islands.

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 website 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 the Turks and Caicos Islands is provided for general reference only, and may not be totally accurate in a particular location or circumstance. Driving in the Turks and Caicos Islands is on the left.
Traffic tends to be light, and the terrain is flat.
When entering roundabouts and other intersections without signs or traffic signals, drivers are required to give way to those on their immediate right.
Driving under the influence of alcohol is illegal, and drivers convicted of the offense may face fines, detention, or both.
Wild donkeys are a common sight and often walk on the roads, presenting a hazard to drivers, especially at night.
Road signs are not prevalent, but as there are few roads on the island, finding one's way with a tourist map is generally not a problem.
Drivers should be alert for unmarked hazards such as blind intersections or changes in road conditions.
Primary roads are generally drivable in both urban and rural areas.
Secondary roads are often unpaved, and have ruts and potholes.
Be aware that, in the event of a breakdown, roadside assistance is generally not available.
For emergencies, drivers may call 999 or 911 for police, fire, or medical assistance.
Visitors require a valid driver's license from their country of residence.
Safety of public transportation in the Turks and Caicos is generally good.
Most car and motor scooter rental agencies will not rent to anyone under the age of 21.
A government tax is levied on all car and motor scooter rentals (insurance is extra).Please refer to our Road Safety page for more information.
Visit the website of the country’s national tourist office at http://www.turksandcaicostourism.com.

AVIATION SAFETY OVERSIGHT:
Civil aviation operations in the Turks and Caicos Islands fall under the jurisdiction of British authorities.
The U.S. Federal Aviation Administration (FAA) has assessed the Government of the United Kingdom’s Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for oversight of the UK’s air carrier operations.
For more information, travelers may visit the FAA’s web site at http://www.faa.gov/safety/programs_initiatives/oversight/iasa
SPECIAL CIRCUMSTANCES:
The importation of firearms to the Turks and Caicos is strictly forbidden without prior approval in writing from the Commissioner of Police.
U.S. citizens may contact the Turks and Caicos Customs Department at (649) 946-2867 for specific information regarding customs requirements. Please see our Customs Information.

The Turks and Caicos Islands, like all countries in the Caribbean basin, are vulnerable to hurricanes.
Hurricane season officially runs from June 1 to November 30, although hurricanes have been known to occur outside that time period.
Visitors to the Turks and Caicos Islands during hurricane season are advised to monitor weather reports in order to be prepared for any potential threats.
General information about disaster preparedness is available via the Internet from the U.S. Federal Emergency Management Agency (FEMA) at http://www.fema.gov
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 Turks and Caicos laws, even unknowingly, may be expelled, arrested, or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in the Turks and Caicos are severe, and convicted offenders can expect long jail sentences and heavy fines.
Engaging in sexual conduct with children or using or disseminating child pornography in a foreign country is a crime, prosecutable in the United States.
Please see our information on Criminal Penalties.

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

REGISTRATION / EMBASSY LOCATION:
Americans residing or traveling in the Turks and Caicos Islands are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department’s travel registration web site so that they can obtain updated information on travel and security within the Turks and Caicos Islands.
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 42 Queen Street, Nassau, The Bahamas.
It is next to the McDonald’s Restaurant on Queen Street and may be reached Monday-Friday at telephone (242) 322-1181 x4406; after-hours (242) 328-2206; fax (242) 356-7174.
The U.S. Embassy web site is http://nassau.usembassy.gov.
Office hours are from 9:00 a.m. to 11:00 a.m. and 1:00 p.m. to 3:00 p.m. Monday-Thursday; 9:00 a.m. to 11:00 a.m. Friday (except for U.S. and Bahamian holidays).
* * *
This replaces the Country Specific Information for the Turks and Caicos Islands dated March 14, 2008, without substantive changes.

Travel News Headlines WORLD NEWS

Date: Wed, 4 Sep 2019 23:41:56 +0200 (METDST)

St. John's, Antigua and Barbuda, Sept 4, 2019 (AFP) - Masked gunman have shot dead a 71-year-old British holidaymaker in a robbery on the tourist paradise of Turks and Caicos, police said Wednesday.

The victim had been visiting a friend in the British territory, around 150 miles (200 kilometres) north of Haiti, when two assailants burst into the home shortly after 11:00 pm Tuesday (0300 GMT Wednesday).   They demanded money, but it was not immediately clear how the situation escalated before the gunmen made off with an undisclosed amount of cash, a ring and a watch, said police spokeswoman Takara Bain.   The friend was treated for non-life threatening injuries at a private residence in Cooper Jack on the tiny island's south coast.

It is the second murder in three days in the archipelago, home to just 35,000 people, taking the 2019 homicide toll to 10, Police Commissioner Trevor Botting said in a statement.   A shooting at a nightclub in Providenciales on Saturday night left one man dead and a second wounded.   "This spike in gun crime simply has to change," Botting said. "No one should be happy with how gun crimes are increasing in the Turks and Caicos Islands."   Earlier this year, the US State Department warned travellers to "exercise increased caution" when visiting the archipelago 600 miles (970 kilometres) southeast of Miami.
Date: Tue, 6 Aug 2019 20:04:36 +0200 (METDST)

St. John's, Antigua and Barbuda, Aug 6, 2019 (AFP) - Three American tourists have drowned in the Turks and Caicos Islands after apparently getting caught in a fast-moving tide fueled by high winds, authorities and local residents said Tuesday.   The victims -- two men and a woman -- were from two families from Texas who were spending the holidays together, along with their two girls, police said.

They had been exploring scenic Bambarra Beach on the sparsely populated island of Middle Caicos when disaster struck on Monday, police and local residents said.   The children were plucked from the ocean by rescuers and were being cared for by local social welfare services.   The body of a 34-year-old woman washed ashore shortly after the incident. Searchers scouring the beaches recovered the second body a few hours later. The third was discovered early this morning with assistance from the US Coast Guard.   Residents said the families may have been attempting to cross the half-mile distance through shallow water from Bambarra Beach to nearby Pelican Cay.

Police Commissioner Trevor Botting described the incident as a "terrible tragedy."   "Five tourists from two families got into difficulties in the waters off Middle Caicos. Whilst two children were thankfully recovered alive from the water, two adults related to one of the girls were recovered but sadly they had died. One other man, related to the other child, was found early today and has also died," he said.   The tragedy has triggered calls locally for increased warning signs on the islands' often deserted beaches.   The Turks and Caicos Islands is British overseas territory that consists of two island chains southeast of the Bahamas.
Date: 12 Jun 2017
Source: TC weekly News [edited]

The Ministry of Health is advising the public of an increase in the number of cases of conjunctivitis in the Turks & Caicos Islands [TCI].

Conjunctivitis, also called "pink eye," is defined as an inflammation of the conjunctiva and can be caused by viruses, bacteria, or an allergy. It can affect children and adults.

Viral conjunctivitis is typically caused by a virus that can also cause the common cold. A person may have symptoms of conjunctivitis alone or as part of a general cold syndrome like fever, a sore throat and runny nose.

Viral conjunctivitis is highly contagious; usually people catch it from touching something that has been in contact with an infected person's eye (e.g. door handle, towel or pillow case), and then that person touches his or her eyes.

Some of the most common symptoms of conjunctivitis are pink or red eyes; the eyes might secrete a gooey liquid or become itchy or burn, get stuck shut, especially when you 1st wake up. These symptoms tend to last for several days.

The ministry stated in a press release: "The treatment depends on the cause. When pink eye is caused by a virus, antibiotics will not help. You can use warm or cool compresses to relieve the pain and irritation in the eyes.

"Most cases of pink eye go away on their own without treatment, but it is best to see your primary care physician if you are experiencing these symptoms so that you can be treated properly.

"Simple hygiene measures can help minimise transmission to others. Adults or children with bacterial or viral conjunctivitis should not share handkerchiefs, tissues, towels, cosmetics, or bed sheets/pillows with uninfected family or friends. Hand washing is an essential and highly effective way to prevent the spread of infection. Hands should be wet with water and plain soap, and rubbed together for 15 to 30 seconds.

"Teach children to wash their hands before and after eating and after touching the eyes, coughing or sneezing. Alcohol-based hand rubs are a good alternative for disinfecting hands if a sink is not available."

Anyone with viral conjunctivitis should remain home from school and work to avoid spreading the virus to others.
================
[The report above does not specify any laboratory confirmation of the conjunctivitis cases.

Conjunctivitis can result from many causes, including viruses, bacteria, allergens, contact lens use (especially the extended-wear type), chemicals, fungi, and certain diseases. Viral conjunctivitis can be caused by the following viruses, with adenoviruses being the most common cause: adenoviruses, picornaviruses (particularly enterovirus 70 and coxsackievirus A24), measles virus, and several herpes viruses.

Viral conjunctivitis is highly contagious. Most viruses that cause conjunctivitis are spread through hand-to-eye contact by hands or objects that are contaminated with the infectious virus. Hands can become contaminated by coming into contact with infectious tears, eye discharge, faecal matter, or respiratory discharges.

Many of the viruses that cause conjunctivitis may be associated with an upper respiratory tract infection, cold, or sore throat. - ProMED Mod.UBA]

[A HealthMap/ProMED-mail map can be accessed at:
Date: Mon 9 May 2016
Source: Outbreak News Today [edited]

Health officials on the Caribbean island group, Turks and Caicos (TCI), are reporting a significant increase in chickenpox [varicella] cases during the 1st 4 months of 2016.

As of the end of the week of 23 Apr 2016, a total of 327 cases have been reported for the year. Of these, 41 (13 percent) were reported by persons younger than 5 years old and 296 (87 percent) were reported by persons older 5 years old.

These cases were reported by TCI Hospital on Providenciales 234 (72 percent) and Grand Turk 5 (1 percent); with 28 cases in North Caicos and 60 (18 percent) cases in clinics in Providenciales. In summary, the majority cases are being reported from Providenciales (90 percent).

By comparison, in all of 2015, a total of 98 cases of chickenpox were reported by TCI Hospital in Providenciales.

Chickenpox is a common, usually benign childhood disease caused by the varicella-zoster virus (VZV), a member of the herpes family. This virus causes 2 distinct diseases; varicella (chickenpox) is the primary infection, and later when VZV reactivates, herpes zoster (shingles).

Chickenpox is highly contagious and is spread by coughing and sneezing, by direct contact, and by aerosolization of the virus from skin lesions. You can also get it by contact with the vesicle secretions from shingles.

The disease is characterized by fever and a red, itchy skin rash of that usually starts on the abdomen, back, or face and then spreads to nearly all parts of the body. The rash begins as small red bumps that appear as pimples or insect bites. They then develop into thin-walled blisters that are filled with clear fluid which collapse on puncture. The blisters then breaks, crusts over, and leaves dry brown scabs.

The chickenpox lesions may be present in several stages of maturity and are more abundant on covered skin rather than exposed. Lesions may also be found in the mouth, upper respiratory tract, and genitals.

Chickenpox is contagious from 1-2 days before the rash forms and continues until all the lesions are crusted over (usually about 5 days).

This disease is more serious in adults than in children. Complications of chickenpox are rare, but include pneumonia, encephalitis, and secondary bacterial infections.

Infection with this virus usually gives lifelong immunity, although 2nd attacks have been documented in immunocompromised people. The viral infection remains latent, and disease may recur years later as shingles.

The TCI Ministry of Health strongly advises persons affected with chickenpox to remain at home during their sick leave period to prevent further spread of this illness within the community and schools.  [Byline: Robert Herriman]
=====================
[Varicella-zoster virus, a member of the herpesvirus family is the causative agent for chickenpox. Humans are the only reservoir of the virus, and disease occurs only in humans. After primary infection as varicella (chickenpox), the virus remains dormant in the sensory-nerve ganglia and can reactivate at a later time, causing herpes zoster (shingles).

Varicella occurs worldwide. In temperate climates, varicella tends to be a childhood disease, with peak incidence among preschool and school-aged children during late winter and early spring. In these countries, less than 5 percent of adults are susceptible to varicella. In tropical climates, the highest incidence was described in the driest, coolest months; overall, infection tends to be acquired later in childhood, resulting in higher susceptibility among adults than in temperate climates, especially in less densely populated areas.

All people, including those traveling or living abroad, should be assessed for varicella immunity, and those who do not have evidence of immunity or contraindications to vaccination should receive age-appropriate vaccination. Vaccination against varicella is not a requirement for entry into any country (including the United States), but people who do not have evidence of immunity should be considered at risk for varicella during international travel.

Varicella vaccine contains live, attenuated varicella-zoster virus. Single-antigen varicella vaccine is licensed for people aged 12 months and older, and the combination measles-mumps-rubella-varicella (MMRV) vaccine is licensed only for children 1-12 years. CDC recommends varicella vaccination for all people aged 12 months and older without evidence of immunity to varicella who do not have contraindications to the vaccine: 1 dose for children aged 1-4 years and 2 doses for people aged 4 years and older. The minimum interval between doses is 3 months for children aged less than 13 years and 4 weeks for people aged 13 years and older. Contraindications for vaccination include allergy to vaccine components, immune-compromising conditions or treatments, and pregnancy. When evidence of immunity is uncertain, a possible history of varicella is not a contraindication to varicella vaccination. Vaccine effectiveness is approximately 80 percent after 1 dose and 95 percent after 2 doses.

(Excerpted and edited from

Maps of the Turks and Caicos Islands may be accessed at
and <http://healthmap.org/promed/p/48358>. - ProMED Mod.LK]
Date: 7 Jul 2014
Source: TC Weekly News [edited]

Pet owners are being cautioned about a tick disease which is becoming a problem in dogs in the Turks and Caicos Islands. Licensed veterinarian Mark Woodring said that the disease, babesiosis, can be transmitted by bites from ticks.

Infected dogs show a number of signs, including decreased appetite, weight loss, fever, an enlarged abdomen, and dark orange or yellow skin and urine. The disease causes the dog's red blood cells to be destroyed, leading to pale gums and fatigue due to anemia. All dogs, including potcakes, (the local indigenous dog of the islands) can be infected. Some breeds are more susceptible to infection, especially greyhounds and all pitbull breeds, both purebred and mixed.

Woodring said that this disease can develop in a dog without ticks after an infected dog bites him or her, even playfully. He said that an infected female will pass along the disease to her puppies before birth.

"Accurate testing for babesiosis can be done with blood sent to the US for DNA studies, but most cases in the TCI are diagnosed by experienced veterinarians based on signs and physical exam. Although the disease is treatable with antibiotics, not every dog responds."

Early treatment is best, but even then, the disease can be fatal. The veterinarian said that another problem is that since 2012, the antibiotics most commonly used to treat tick-borne diseases have tripled in cost.

"Some antibiotics are in very short supply worldwide, to the point of restricting veterinarians from even ordering the medication. Preventing babesiosis means treating dogs and their environments to limit tick exposure."

He said that many prescription and non-prescription flea and tick prevention medications as well as yard treatments like Diatomaceous Earth and chemical preparations are available.

"This can be a difficult, expensive and frustrating task, as ticks eventually can become resistant to most products. To stop the spread of babesiosis, infected dogs should be treated with a full course of antibiotics."

Even after a dog recovers, he or she may still carry the disease. Females who have had the disease, even healthy-appearing ones, should not be bred. Adopting puppies from previously infected dogs or dogs with an unknown infection history is risky. Puppies are more likely to die from it than adult dogs.

Woodring said that the good news is that dogs cannot transmit this to humans.
===============
[Canine babesiosis is a disease caused by the intra-erythrocytic protozoan parasites _Babesia canis_ and _Babesia gibsoni_. Babesiosis is transmitted by ticks to susceptible canine hosts. _Rhipicephalu ssanguineus_ is the most common tick vector in the United States. Splenectomized dogs, immunocompromised dogs and young dogs between the ages of 2 and 8 months are most susceptible to infection. Canine babesiosis occurs worldwide. Within the United States, it is most common in the southeast. Although canine babesiosis is considered uncommon in the U.S., it is of clinical significance due to its morbidity and mortality. It is an important differential when history and clinical signs are consistent with infection and other more common diseases have been ruled out.

Hemolytic anemia and hypotensive shock are typical clinical syndromes of infection. Hemolytic anemia results from direct erythrocyte damage by the parasite, and both intravascular and extravascular immune-mediated destruction of red blood cells. Infection can produce thrombocytopenia, the mechanism of which consists of immune-mediated destruction and sequestration in the spleen. Physical examination reveals splenomegaly, lymphadenomegaly, fever and, less frequently, lethargy, vomiting, hematuria, and icterus. Hypotensive shock results from the release and production of vasoactive amines and cytokines which produce vasodilation. It most often occurs in puppies with the peracute form of the disease. Death may occur and is seen most often in _B. gibsoni_ infections and in puppies affected with _B. canis_ and _B.gibsoni_. Chronic infections, subclinical carrier states and atypical canine babesiosis may also occur.

Infection with _B. canis_ or _B. gibsoni_ is definitively diagnosed by demonstration of the parasites on red cells. Blood smears may be stained with Diff-Quik or preferably Wright's or Giemsa stain.

The most effective drugs used in the treatment of canine babesiosis include diminazene aceturate, phenamidine isethionate, and imidocarb dipropionate, which are not available or approved for use in the United States. Treatment of canine babesiosis in the U.S. is, therefore, mostly aimed at treating signs. The majority of babesia cases diagnosed in dogs in the U.S. are caused by the less virulent strains of _B. canis_, and dogs frequently recover from these infections naturally with supportive therapy. Clindamycin has been successfully used to treat canine babesiosis and may be considered in refractory or more severe and virulent infections.

Prevention of canine babesiosis is mostly aimed at controlling the vector. It is an important aspect since treatment is not always successful. The environment should be treated to decrease tick numbers, dogs should be treated to control tick infestations, and ticks should be removed from parasitized animals as quickly as detected.

Recently, a vaccine which minimizes the severity of infection was developed. The vaccine is reported to be 70 to 100 percent effective in diminishing the pathologic effects which typically ensue upon infection. The vaccine is currently available in Europe where canine babesiosis is a more common life-threatening disease.

Blood transfusion poses a significant risk to recipient animals; therefore, it is recommended that donor animals be tested for infection with babesia organisms. Splenectomy prior to testing significantly improves the likelihood of finding organisms in a blood sample from an infected donor.

Portions of this comment were extracted from:

Turks and Caicos Islands, a British Overseas Territory, may be located on the interactive HealthMap/ProMED-mail map at <http://healthmap.org/promed/p/6007>. - ProMed Mod.TG]
More ...

Martinique

French West Indies US Consular Information Sheet
April 02, 2008
COUNTRY DESCRIPTION:
The French West Indies consists of the islands of Martinique, Guadeloupe, St. Martin (the French side) and St. Barthélemy. These islands are well develop
d. In St. Martin and St. Barthélemy, English is widely spoken, and U.S. currency is accepted. Read the Department of State Background Notes on France for additional information.

ENTRY/EXIT REQUIREMENTS:
All Americans traveling by air outside the United States are required to present a passport or other valid travel document to enter or re-enter the United States.
This requirement will be extended to sea travel (except closed loop cruises), including ferry service, by the summer of 2009.
Until then, U.S. citizens traveling by sea must have government-issued photo identification and a document showing their U.S. citizenship (for example, a birth certificate or certificate of nationalization), or other WHTI compliant document such as a passport card for entry or re-entry to the U.S.
Sea travelers should also check with their cruise line and countries of destination for any foreign entry requirements.

Applications for the new U.S. Passport Card are now being accepted.
We expect cards will be available and mailed to applicants in spring 2008.
The card may not be used to travel by air and is available only to U.S. citizens. Further information on the Passport Card is available at http://travel.state.gov/passport/ppt_card/ppt_card_3926.html and upcoming changes to U.S. passport policy can be found on the Bureau of Consular Affairs web site at http://travel.state.gov/travel/cbpmc/cbpmc_2223.html.
We strongly encourage all American citizen travelers to apply for a U.S. passport well in advance of anticipated travel.
American citizens can visit travel.state.gov or call 1-877-4USA-PPT (1-877-487-2778) for information on how to apply for their passports.

Visas are generally not required for visitors planning to remain for up to 90 days. For further information, travelers can contact the Embassy of France at 4101 Reservoir Road NW, Washington, DC 20007; telephone 1 202 944-6000; or the nearest French consulate in Atlanta, Boston, Chicago, Houston, Los Angeles, Miami, New York, New Orleans or San Francisco. Visit the web site for the Embassy of France at http://www.info-france-usa.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.

SAFETY AND SECURITY:
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 Worldwide Caution, Travel Warnings, and Travel Alerts 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:
Petty street crime, including purse snatching, occurs throughout the French West Indies. Visitors should take care whenever traveling to safeguard valuables and always lock hotel rooms and car doors.

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

See our information on Victims of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION:
Good medical care is available throughout the French West Indies. Not all doctors speak or understand English. Hyperbaric chambers are available in Guadeloupe at the Centre Hospitalier Universitaire in Abymes, http://www.chu-guadeloupe.fr/fr/fw_index.asp, and, in Martinique at the Centre Hospitalier Universitaire in Fort de France, http://www.chu-fortdefrance.fr/pages/sommaire.html.
Cases of dengue fever have been reported in Martinique and Guadeloupe.

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

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

TRAFFIC SAFETY AND ROAD CONDITIONS:
While in a foreign country, U.S. citizens may encounter road conditions that differ significantly from those in the United States.
The information below concerning the French West Indies is provided for general reference only, and may not be totally accurate in a particular location or circumstance.
Driving in the French West Indies is on the right side of the road. Children under 12 are not legally allowed in the front seat. Seatbelt laws are strictly enforced.

The roads in the French West Indies are the best in the Eastern Caribbean. Roads are well paved and well maintained. Main roads are well marked; secondary roads and tourist sites are adequately marked. Excellent maps are available and local residents are helpful, especially if greeted in a friendly manner. Both Martinique and Guadeloupe have expressways. Traffic safety is enforced by the police. Night driving can be dangerous, especially in the mountains and on winding rural roads. Public transportation in the form of taxis, vans, and buses is relatively safe. For specific information concerning French West Indies driver's permits, vehicle inspection, road tax and mandatory insurance, contact the French National Tourist Organization offices at: http://www.franceguide.com/.

Please refer to our Road Safety page for more information.
Visit the web site of the country’s national tourist office and national authority responsible for road safety at http://www.securite-routiere.gouv.fr/index.html.

AVIATION SAFETY OVERSIGHT:
Civil aviation operations in the French West Indies fall under the jurisdiction of French authorities.
The U.S. Federal Aviation Administration (FAA) has assessed the Government of France’s Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for oversight of France’s air carrier operations.
For more information, travelers may visit the FAA’s web site at http://www.faa.gov/safety/programs_initiatives/oversight/iasa.

SPECIAL CIRCUMSTANCES: In addition to being subject to all French laws affecting U.S. citizens, dual nationals may also be subject to other laws that impose special obligations on French citizens. Although France recognizes dual nationality, dual nationals are considered French citizens and are subject to French laws without regard to the other nationality. For additional information, please see our Dual Nationality flyer.

French customs authorities may enforce strict regulations concerning temporary importation into or export from the French West Indies of items such as firearms, medications, animals, etc. For questions, travelers may wish to contact the Embassy of France or a French Consulate for specific information regarding customs requirements. Please see our information on customs regulations.

The French West Indies can be affected by hurricanes. The hurricane season normally runs from June to the end of November, but there have been hurricanes in December in recent years. General information about natural disaster preparedness is available via the Internet from the U.S. Federal Emergency Management Agency (FEMA) at: http://www.fema.gov/.
Please see 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 French West Indies’ laws, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in the French West Indies are severe, and convicted offenders can expect long jail sentences and heavy fines.
Engaging in sexual conduct with children or using or disseminating child pornography in a foreign country is a crime, prosecutable in the United States.
Please see our information on Criminal Penalties.

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

REGISTRATION / EMBASSY LOCATION:
Americans living or traveling in the French West Indies 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 the French West Indies. Americans without Internet access may register directly with the U.S. Embassy in Barbados, which has jurisdiction over the French West Indies. 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 in Wildey Business Park in St. Michael, Barbados; web site: http://barbados.usembassy.gov/.

The Consular Section is open for American Citizens Services from 8:30am to 4:00pm, Monday-Friday, except Barbados and U.S. holidays. For after-hours service, American citizens may contact the U.S. Embassy in Bridgetown, Barbados, telephone 1-246-436-4950. The U.S. Consular Agent in Martinique, Henry Ritchie, is located at the Hotel Valmeniere #615, Avenue des Arawaks, 97200 Fort de France, telephone (011) (596) (596) 75-6754, fax (011) (596) (596) 70-8501, mobile (011) (596) (696) 93-8406, email: hritchie@sbcglobal.net. Consular Agent Henry Ritchie is available Monday through Friday from 9:00am to 12:00pm, except French and U.S. holidays.
* * *
This replaces the Country Specific Information for French West Indies dated June 7, 2007, to update sections on Entry/Exit Requirements, Safety and Security, Traffic Safety and Road Conditions, Medical Facilities and Health Information, and Registration/Embassy Location.

Travel News Headlines WORLD NEWS

Date: Tue, 19 Sep 2017 00:01:29 +0200
By Amandine ASCENSIO with Jean-Philippe LUDON in Fort-de-France

Pointe-à-Pitre, Sept 18, 2017 (AFP) - Islands in the Caribbean still reeling from megastorm Irma braced Monday for a fresh battering as Hurricane Maria approached, wielding potentially lethal force.   In just a few hours, the US National Hurricane Center (NHC) hiked Maria from a Category Two to a Category Four hurricane, packing winds of 130 miles (209 kilometres) per hour that it forecast would strengthen further over the next day or so.

"Potentially life-threatening" storm surges, destructive waves, flash floods and mudslides threatened the Leeward Islands -- the island group that includes Martinique, Puerto Rico and the US and British Vigin islands -- the NHC said.   "The eye and the intense inner core is expected to pass near Dominica in the next few hours," the center warned in its 2100 GMT bulletin, describing Maria as "an extremely dangerous major hurricane".   The French Caribbean island of Guadeloupe -- the bridgehead for aid for Irma-hit French territories -- ordered all at-risk zones to be evacuated.

The order, effective from 4pm local time, bars specific areas considered to be at risk of "flooding, submersion and landslips," according to the statement, issued by the island's prefect.   Islanders on Martinique, which is also part of France, were ordered to stay indoors under a maximum-level "violet" alert.   As heavy rain beat down, energy supplier EDF said power had been cut off from 16,000 homes on Martinique, which has a population of some 400,000.   Dominica, St Kitts and Nevis, St Lucia and the British island of Montserrat are also on alert.

In Pointe-a-Pitre, Elodie Corte, the boss of a metalworking company, said there had been frantic preparations to limit the damage from the storm.   "We spent the morning strapping down the aluminium to stop it from flying away if the winds are strong," she said.   But she worried that the torrential rains forecast could flood her home.   "We'll seal everything as tightly as we can and then we'll certainly go and stay with friends for the night," she said.

- 'Worst-case scenario' -
Criticised for the pace of relief efforts in their overseas territories devastated by Irma, Britain, France and the Netherlands said they were boosting resources for the Caribbean as Maria approaches.   "We are planning for the unexpected, we are planning for the worst," said Chris Austin, head of a UK military task force set up to deal with Irma, as the British Virgin Islands readied for the storm.

On the island of St Martin, which is split between France and the Netherlands, authorities announced a red alert ahead of Maria's arrival.    "We're watching its trajectory very closely, and we're preparing for the worst-case scenario," said local official Anne Laubies.   The Dutch navy tweeted that troops were heading to the two tiny neighbouring islands of Saba and St Eustatius to ensure security following widespread complaints of looting and lawlessness on St Martin after the first hurricane.

French Interior Minister Gerard Collomb said 110 more soldiers would be deployed to the region to reinforce about 3,000 people already there shoring up security, rebuilding infrastructure and distributing aid.   But he warned of "major difficulties" if Guadeloupe is hard hit, noting the territory was "the logistical centre from where we could supply St Martin and organise all the airlifts".   Maria is due to sweep over the south of Sint Maarten -- as the Dutch side of St Martin is called -- on Tuesday. The island was among the worst hit by Irma, with 14 killed.   Air France, Air Caraibes and Corsair have cancelled flights in and out of Martinique and Guadeloupe.

- Hurricane series -
Irma, a Category 5 hurricane, left around 40 people dead in the Caribbean before churning west and pounding Florida, where at least 20 people died.   Irma broke weather records when it whipped up winds of 295 kilometres per hour for more than 33 hours straight.   Another hurricane, Jose, is also active in the Atlantic and has triggered tropical storm warnings for the northeastern United States.   Many scientists are convinced that megastorms such as Irma, and Harvey before it, are intensified by the greater energy they can draw from oceans that are warming as a result of climate change.
Date: Fri 14 Jul 2017
Source: WIC News[edited]

Grenada on alert over spread of 'red eye' outbreak, the number of medical consultations due to conjunctivitis during recent weeks was estimated at between 500 and 600 cases per week in Guadeloupe, and 150 to 250 cases per week in Martinique.

Outbreaks of viral conjunctivitis occur mainly in tropical countries with high population density and a hot, humid climate. Since the chikungunya outbreak a few years ago, Grenada has had an active surveillance and monitoring system that has proven to be effective in subsequent outbreaks, like that of the Zika virus.

The island's health ministry is encouraging people to take all necessary and preventative measures to avoid becoming infected. Red eye is very contagious -- it can easily be spread from person to person -- but it can be effectively treated at home.

The germs are passed on to others through hand-to-hand contact when hands are not washed after contact with discharge from an infected eye. Symptoms include redness or swelling of the white of the eye or inside the eyelid, watering eye and excess tears, increased sensitivity to light, and pus or discharge from the eyelids which result in eyelids being stuck together.  [Byline: Joyce Loan]
===================
[Viral conjunctivitis, commonly known as pinkeye, is a common, self-limiting condition that is typically caused by adenovirus. Other viruses that can be responsible for conjunctival infection include herpes simplex virus (HSV), varicella-zoster virus (VZV), picornavirus (enterovirus 70, Coxsackie A24), poxvirus (molluscum contagiosum, vaccinia), and human immunodeficiency virus (HIV). Viral conjunctivitis is highly contagious, usually for 10-12 days from onset as long as the eyes are red. Patients should avoid touching their eyes, shaking hands, and sharing towels, napkins, pillow cases, and other fomites, among other activities. Transmission may occur through accidental inoculation of viral particles from the patient's hands or by contact with infected upper respiratory droplets, fomites, or contaminated swimming pools. The infection usually resolves spontaneously within 2-4 weeks (extracted from  <http://emedicine.medscape.com/article/1191370-overview>).

Treatment of adenoviral conjunctivitis is supportive. No evidence exists that demonstrates the efficacy of specific antiviral agents other than topical ganciclovir. A combination topical agent that contains betadine and low-dose dexamethasone is currently in confirmatory phase III clinical trials as a broad-spectrum agent for the treatment of adenovirus, HSV, VZV, and other forms of infectious conjunctivitis.

HealthMap/ProMED-mail maps can be found at:
Martinique: <http://healthmap.org/promed/p/528> - ProMED Mod.UBA]
Date: Fri, 20 May 2016 21:03:32 +0200

Fort-de-France, May 20, 2016 (AFP) - The French Caribbean island of Martinique has suffered its first Zika virus-related death, the regional health agency said Friday.   "The patient, aged 84, had been hospitalised for 10 days in intensive care with Guillain Barre Syndrome (GBS)," the agency said, adding that the Zika link came to light late last week.   Some experts believe there is a link between Zika and GBS -- in which the immune system attacks the nervous system.

Doctors tests found that "the death is directly linked to Zika with Guillain-Barre Syndrome associated with Zika as the initial cause," regional health authority ARS said.   "This death is the only one registered in Martinique since the start of the epidemic,"  the agency added.   Before the death, the French Caribbean overseas department had listed 19 patients as confirmed suffering from GBS, which has been linked with Zika, as has paralysis-causing myelitis.   Several cases of the virus have emerged from assumed GBS cases in Martinique's French Caribbean neighbour Guadeloupe as well as French Guyana.

Zika has been linked to birth defects and deaths in new-borns amid surging cases of neurological disorders and birth defects, notably in Brazil.   According to a World Health Organisation report earlier this year, more than 40 countries or territories have reported transmission of Zika within their borders since last year, and eight have reported an increase in Guillain-Barre cases.    Experts agree that Zika is behind a surge in cases of the birth defect microcephaly -- babies born with abnormally small heads and brains -- after their mothers were infected with the virus.

But it is not clear just to what extent the disease, for which there is no vaccine or treatment for Zika, is linked with GBS.   The ARS said that 1,770 people had contacted doctors between May 9 and 15 to ascertain if they might have the virus.   The first Zika-related death was in Brazil last November and two other deaths have followed.   Last week, Puerto Rican health authorities announced the first case of Zika-related microcephaly in a foetus, as the US territory grapples with the spread of the mosquito-borne virus.
Date: Tue, 22 Mar 2016 09:42:21 +0100

Paris, March 22, 2016 (AFP) - French authorities said Tuesday there was "a very strong suspicion" that the first case of microcephaly linked to the Zika virus had been detected on the Caribbean island of Martinique.    The case would be the first on French territory of microcephaly, a birth defect thought to be caused by Zika, the mosquito-borne virus that has spread rapidly through South America.

French Health Minister Marisol Touraine said a total of 130 pregnant women had been diagnosed with the Zika virus in the Antilles islands, which include Martinique, as well as French Guiana on the South American mainland.    "For one of them, we have elements that lead us to believe her baby has contracted microcephaly and that this microcephaly is directly linked to her infection with the Zika virus," said Touraine.
Date: Fri 28 Mar 2014
Source: The Global Dispatch [edited]

The number of confirmed and suspected chikungunya cases in the Caribbean continues to increase; in fact, some new cities on the islands of Martinique and Guadeloupe have reported cases for the 1st time, according to a European Centre for Disease Prevention and Control (ECDC) update today [28 Mar 2014].

To date, there have been 3211 confirmed/probable chikungunya cases reported in the region, including 5 deaths and 15 282 suspected cases.

In addition, a suspected outbreak is being reported in the Dominican Republic according to a Spanish language news source. According to Health Minister Freddy Hidalgo, more than 1000 patients since February 2014 have come to the medical centre with chikungunya-like symptoms. Samples have been sent to the US Centers for Disease Control and Prevention for confirmation. The report does note that there are no confirmed cases of chikungunya to date.
======================
[The presence of chikungunya virus transmission in these Caribbean islands is of economic significance because they are important tourist destinations, and loss of tourism could have serious adverse effects on the economy. If the Dominican Republic cases are confirmed as chikungunya virus infections, that could be especially adverse, because that country has the highest number of tourist stop-overs, with 3 840 761 in 2013. Cruise ship arrivals were highest in St. Maarten. Caribbean tourist stops can be seen at this same source (<http://www.onecaribbean.org/wp-content/uploads/DEC12Lattab13.pdf>).

Maps showing the location of the islands mentioned can be accessed at
(with case numbers as of 17 Mar 2014) and
<http://healthmap.org/r/9NLv>. - ProMed Mod.TY]
More ...

World Travel News Headlines

Date: Wed, 22 Jan 2020 17:37:27 +0100 (MET)
By Helen ROXBURGH

Beijing, Jan 22, 2020 (AFP) - A new SARS-like virus has killed 17 people in China, infected hundreds and reached as far as the United States, with fears mounting about its spread as hundreds of millions travel for Lunar New Year celebrations, which start Friday.   Many countries have stepped up screening of passengers from Wuhan, the Chinese city identified as the epicentre, and the World Health Organization has called an emergency meeting.   Here's what we know so far about the virus:

- It's entirely new -
The pathogen appears to be a never-before-seen strain of coronavirus -- a large family of viruses that can cause diseases ranging from the common cold to Severe Acute Respiratory Syndrome (SARS), which killed 349 people in mainland China and another 299 in Hong Kong between 2002 and 2003.   Arnaud Fontanet, head of the department of epidemiology at the Institut Pasteur in Paris, told AFP the current virus strain was 80 percent genetically identical to SARS.   China has already shared the genome sequencing of this novel coronavirus with the international scientific community.   It has been named "2019-nCoV".

- It's being passed between humans -
The WHO said Monday it believed an animal source was the "primary source" of the outbreak, and Wuhan authorities identified a seafood market as the centre of the epidemic.   But China has since confirmed that there was evidence the virus is now passing from person to person, without any contact with the now-closed market.

The virus has infected more than 400 people across the country, with most cases in Wuhan, according to officials. Li Bin of China's National Health Commission on Wednesday said 1,394 people were still under medical observation.   Doctor Nathalie MacDermott of King's College London said it seems likely that the virus is spread through droplets in the air from sneezing or coughing.   Doctors at the University of Hong Kong published an initial paper on Tuesday modelling the spread of the virus which estimated that there have been some 1,343 cases in Wuhan -- similar to a projection of 1,700 last week by scientists at Imperial College, London.   Both are much higher than official figures.

- It is milder than SARS -
Compared with SARS, the symptoms appear to be less aggressive, and experts say the death toll is still relatively low.   "It's difficult to compare this disease with SARS," said Zhong Nanshan, a renowned scientist at China's National Health Commission at a press conference this week. "It's mild. The condition of the lung is not like SARS."   However, the milder nature of the virus can also cause alarm.

The outbreak comes as China prepares for the Lunar New Year Holiday, with hundreds of millions travelling across the country to see family.   Professor Antoine Flahault, director of the Institute of Global Health at the University of Geneva, told AFP that the fact that the virus seems milder in the majority of people is "paradoxically more worrying" as it allows people to travel further before their symptoms are detected.   "Wuhan is a major hub and with travel being a huge part of the fast approaching Chinese New Year, the concern level must remain high," said Jeremy Farrar, Director of the Wellcome Trust.

- International public health emergency? -
The WHO will hold a meeting on Wednesday to determine whether the outbreak constitutes a "public health emergency of international concern" and if so, what should be done to manage it.   Cases have so far been confirmed in Thailand, Japan, Taiwan, South Korea, Macau and the United States.

The WHO has only used the rare label a handful of times, including during the H1N1 -- or swine flu -- pandemic of 2009 and the Ebola epidemic that devastated parts of West Africa from 2014 to 2016.   The Chinese government announced Tuesday it was classifying the outbreak in the same category as the SARS outbreak, meaning compulsory isolation for those diagnosed with the disease and the potential to implement quarantine measures on travel.   But if the WHO decides to take this step, it would put the Wuhan virus in the same category as a handful of very serious epidemics.

- Global precautions -
As the number of confirmed deaths and infections has risen, so has concern worldwide about the disease spreading to other countries.   In Thailand, authorities have introduced mandatory thermal scans of passengers arriving at airports in Bangkok, Chiang Mai, Phuket and Krabi from high-risk areas in China.

In Hong Kong, where hundreds died during the SARS outbreak of 2002-2003, authorities have said they are on high alert, carrying out scans at the city's airport -- one of the world's busiest -- and at other international land and sea crossing points.

The United States also ordered the screening of passengers arriving on direct or connecting flights from Wuhan, including at airports in New York, San Francisco and Los Angeles.   Taiwan has issued travel advisories, and went to its second-highest alert level for those travelling to or from Wuhan. Vietnam has also ordered more border checks on its border with China.
Date: Wed, 22 Jan 2020 16:53:32 +0100 (MET)
By Beiyi SEOW

Beijing, Jan 22, 2020 (AFP) - The death toll from a new SARS-like virus that has infected hundreds in China rose to 17 on Wednesday, as authorities urged people to steer clear of the city at the centre of the outbreak.   The coronavirus has caused alarm because of its similarity to SARS (Severe Acute Respiratory Syndrome), which killed nearly 650 people across mainland China and Hong Kong in 2002-2003.   With hundreds of millions of people travelling across China this week for the Lunar New Year holiday, the National Health Commission announced measures to contain the disease -- including sterilisation and ventilation at airports and bus stations, as well as inside planes and trains.

In Wuhan, the epicentre of the epidemic, large public events were cancelled and international football matches were moved to a new location. Visitors were urged to stay away, while residents were advised to not to leave the central city, which is home to 11 million people.   "If it's not necessary we suggest that people don't come to Wuhan," Wuhan Mayor Zhou Xianwang told state broadcaster CCTV.    The illness is mainly transmitted via the respiratory tract and there "is the possibility of viral mutation and further spread of the disease", health commission vice minister Li Bin told a news conference in Beijing.   More than 500 cases have now been reported, with the majority in Wuhan, capital of Hubei province.

The virus has now infected at least 444 people in Hubei province alone, said provincial officials at a press conference, adding that the death toll had risen from nine to 17.   Major cities, including Beijing, Shanghai, and Chongqing have also reported cases, as well as provinces in northeastern, central, and southern China.   The World Health Organization started an emergency meeting Wednesday to decide whether or not to declare a rare global public health emergency over the disease, which has now been detected in the United States, Taiwan, Thailand, Japan, South Korea and Macau.

The Chinese government has classified the outbreak in the same category as the SARS epidemic, meaning compulsory isolation for those diagnosed with the illness and the potential to implement quarantine measures.   But they still have not been able to confirm the exact source of the virus.   "We will step up research efforts to identify the source and transmission of the disease," Li said, adding that "the cases are mostly linked to Wuhan".   Countries have intensified efforts to stop the spread of the pathogen -- known by its technical name 2019 Novel Coronavirus (2019-nCoV).   Passengers are facing screening measures at five US airports and a host of transport hubs across Asia. Britain and Italy on Wednesday also announced enhanced monitoring of passengers from Wuhan.

- Virus source -
A prominent expert from China's National Health Commission confirmed this week that the virus can be passed between people.   However, animals are suspected to be the primary source of the outbreak.   A Wuhan market is believed to be the epicentre of the outbreak.

A price list circulating online in China for a business there lists a menagerie of animals or animal-based products including live foxes, crocodiles, wolf puppies and rats. It also offered civets, the animal linked to SARS.   "We already know that the disease originated from a market which conducted illegal transaction of wild animals," said Gao Fu, director of the Chinese centre for disease control and prevention.   He said it was clear "this virus is adapting and mutating".   Hong Kong and British scientists have estimated that between 1,300 and 1,700 people in Wuhan may have been infected.

- Containment -
Health authorities are urging people to wash their hands regularly, avoid crowded places, get plenty of fresh air and wear a mask if they have a cough.   Anyone with a cough or fever was urged to go to hospital.   In Wuhan, city authorities made it mandatory to wear a mask in public places on Wednesday, according to state-run People's Daily.

In response to skyrocketing demand for masks -- which were starting to sell out at pharmacies and on some popular websites -- China's industry and information technology ministry said it would "spare no effort in increasing supply", state media reported.   "These days, I wear masks even in places that are not too crowded, although I wouldn't have done so in the past," said Wang Suping, 50, who works at a Beijing arts school.   At the capital's main international airport, the majority of people were wearing masks.

Hong Kong flag carrier Cathay Pacific said it had agreed to allow staff to wear surgical masks on mainland China flights, and that passengers from Wuhan would be offered masks and antiseptic wipes.   In Wuhan, police were conducting vehicle spot checks for live poultry or wild animals leaving and entering the city, state media said.   Officials also screened people on roads, the airport and the train station for fever.   The local government has cancelled major public activities and banned tour groups from heading out of the city.   Women's Olympics football qualifiers scheduled for February 3-9 in Wuhan have been moved to the eastern city of Nanjing.
Date: Wed, 22 Jan 2020 15:49:25 +0100 (MET)

Montreal, Jan 22, 2020 (AFP) - A Canadian guide died and five French tourists were missing after at least one snowmobile plunged through ice in northern Quebec, police said Tuesday.   The group were riding close to where a river exits the Saint-Jean lake, and were outside the approved area for snowmobiles, police spokesman Hugues Beaulieu told AFP.   Nine people, including the guide, were on the trip on Tuesday evening when the ice broke underneath them.   Police said they were alerted by two of the tourists who had rescued a third tourist from the freezing water.

The 42-year-old guide was pulled out by emergency response teams and taken to hospital, but he died overnight, Beaulieu said, adding "five French tourists are still missing."   The police and army were searching the area on Wednesday, assisted by divers.   "This sector was not part of a marked trail, they were off-piste," said the spokesman.
Date: Wed, 22 Jan 2020 04:55:57 +0100 (MET)

Hong Kong, Jan 22, 2020 (AFP) - Macau on Wednesday reported its first confirmed case of the new SARS-like coronavirus as authorities announced all staff in the city's bustling casinos had been ordered to wear face masks.   The former Portuguese colony is a huge draw for mainland tourists as the only place in China that allows gambling.

With the Lunar New Year approaching this weekend, a huge influx of mainland tourists is expected in the city.   Asian countries have ramped up measures to block the spread of the new virus, which emerged in the Chinese city of Wuhan and has so far killed at least nine people.

On Wednesday, Macau announced its first confirmed case -- a 52-year-old businesswoman from Wuhan who arrived in the city by high-speed rail on Sunday, via the neighbouring city of Zhuhai.    "A series of tests found that she was positive for the coronavirus and had symptoms of pneumonia," Lei Chin-lon, the head of Macau's health bureau, told reporters.    The woman had been staying at the New Orient Landmark Hotel with two friends who were being monitored since her admission to hospital on Tuesday.

Ao Ieong Iu, Macau's Secretary for Social Affairs and Culture, said staff in all casinos would be required to wear masks while anyone arriving at entry ports along the city's border with the mainland would need to fill out health declaration forms.    "We have not banned tourism groups from Wuhan but we are not encouraging them," Ao Ieong said.    "We will stay in close contact with tourism agencies and require them to notify us of all groups going to and coming from Wuhan," she added.
Date: Tue, 21 Jan 2020 22:23:22 +0100 (MET)
By Issam Ahmed with Helen Roxburgh

Washington/Beijing, Jan 21, 2020 (AFP) - The United States on Tuesday announced its first case of a new virus that has claimed six lives in China and sickened hundreds, joining countries around the world in ramping up measures to block its spread.   The man, a US resident in his 30s who lives near Seattle, is in good condition, according to federal and state officials, and approached authorities himself after reading about the SARS-like virus in news reports.   He is "currently hospitalized out of an abundance of precaution, and for short term monitoring, not because there was severe illness," said Chris Spitters, a Washington state health official.  "This is an evolving situation and again, we do expect additional patients in the United States and globally," added Nancy Messonier, a senior official at the Centers for Disease Control and Prevention (CDC), but stressed that the overall risk to Americans remained low.

The man entered the country on January 15 after traveling to Wuhan, two days before the US began deploying health officials at major airports to screen passengers arriving from that central Chinese city which is at the heart of the outbreak. The efforts are to be extended now to a total of five US airports.   It came as countries ramped up measures to block the spread of the virus -- known by its technical name 2019 Novel Coronavirus or 2019-nCoV -- as the number of cases surpassed 300, raising concerns in the middle of a major Chinese holiday travel rush.

Fears of a bigger outbreak rose after a prominent expert from China's National Health Commission confirmed late Monday that the virus can be passed between people.   That conclusion is shared by the CDC, which said "person-to-person spread is occurring, although it's unclear how easily the virus spreads between people," even as the World Health Organization (WHO) adopted a more cautious approach, saying it is still investigating.   The UN agency will hold an emergency meeting Wednesday to determine whether to declare a rare global public health emergency over the disease, which has also been detected in Thailand, Japan and South Korea and Taiwan.

- Holiday rush -
Authorities previously said there was no obvious evidence of person-to-person transmission and animals were suspected to be the source, as a seafood market where live animals were sold in Wuhan was identified as the center of the outbreak.   Hundreds of millions of people are criss-crossing China this week in packed buses, trains and planes to celebrate the Lunar New Year with relatives.

More than 80 new cases have been confirmed, bringing the total number of people hit by the virus in China to 315, with the vast majority in Hubei, the province where Wuhan lies, according to officials.   But cases have also been confirmed around the country, including Beijing and Shanghai.   The first case on the self-ruled island of Taiwan was also confirmed Tuesday, with a woman taken to hospital on arrival at the airport from Wuhan.   Wuhan mayor Zhou Xianwang told state broadcaster CCTV Tuesday that the death toll had risen from four to six.   The coronavirus has caused alarm because of its genetic similarities to Severe Acute Respiratory Syndrome (SARS), which killed nearly 650 people across mainland China and Hong Kong in 2002-2003.

- Fever checks -
At four airports in Thailand, authorities introduced mandatory thermal scans of passengers arriving from high-risk areas of China.   In Hong Kong, authorities said they were on "extreme high alert," with passengers from Wuhan required to fill out health declarations and face possible jail time if they do not declare symptoms.   Enhanced screening measures have also been set up at airports in Australia, Bangladesh, Nepal, Singapore and Russia, Malaysia and Vietnam.   A man showing symptoms of the disease who had travelled to Wuhan has been put in isolation in Australia as health officials await test results, authorities said Tuesday.   In China, the government announced it was classifying the outbreak in the same category as SARS, meaning compulsory isolation for those diagnosed ith the disease and the potential to implement quarantine measures on travel.

In Wuhan, authorities banned tour groups and police were conducting spot checks for animals in vehicles leaving and entering the city, state media said.   It added that city health authorities had scheduled 800 beds to be made available in three hospitals and 1,200 more would soon be ready, and passengers were being screened for fever at the airport, railway stations and bus terminals.   Doctors at the University of Hong Kong released a study on Tuesday estimating that there have been 1,343 cases of the new virus in Wuhan.   The WHO has only called a global public health emergency a handful of times, including during the H1N1 -- or swine flu -- pandemic of 2009 and the Ebola epidemic that devastated parts of West Africa from 2014 to 2016.
Date: Tue, 21 Jan 2020 20:58:18 +0100 (MET)

Lima, Jan 21, 2020 (AFP) - Peru is installing security cameras at its world renowned Machu Picchu site after it was damaged earlier this month by foreign tourists, authorities said Tuesday.   "We are going to strengthen security at Machu Picchu by installing high-tech cameras," Jose Bastante, head of the archaeological park, told AFP.   Bastante said 18 cameras will be located at three strategic points of the citadel as well as access points from surrounding mountains.   "This will allow us to better control visitors and avoid any action or infraction to the regulations, also any type of risk," he said, adding that drones were also being used for security.

Five tourists accused of damaging the iconic site were deported to Bolivia last week and barred from returning to the country for 15 years.    A sixth, from Argentina, was fined $360 and must pay $1,500 to the culture ministry for repairs after he admitted to damaging the Temple of the Sun at the ancient Inca sanctuary.

The Argentine, 28-year-old Nahuel Gomez, also received a suspended sentenced of three years and four months, but can leave the country once the fines are paid.   Gomez admitted to causing a stone slab to fall from a temple wall. It was chipped when it fell, causing a crack in the floor.   "The damaged caused is significant. The integrity of Machu Picchu has been broken," Bastante said.   Members of the group were also suspected of defecating inside the 600-year-old temple.

The Machu Picchu complex -- which includes three distinct areas for agriculture, housing and religious ceremonies -- is the most iconic site from the Inca empire, which ruled over a large swath of western South America for 100 years before the Spanish conquest in the 16th century.   Machu Picchu, which means "old mountain" in the Quechua language indigenous to the area, is at the top of a lush mountain and was built during the reign of the Inca emperor Pachacuti (1438-1471).
Date: Tue, 21 Jan 2020 17:28:23 +0100 (MET)

Johannesburg, Jan 21, 2020 (AFP) - Beleaguered national airline South African Airways (SAA) announced on Tuesday it was cancelling 10 domestic and one international flight in an effort to streamline services and save cash.   The cash-strapped airline was last month placed under a state-approved business rescue plan to avoid total collapse following a costly week-long strike by thousands of its workers.   SAA said in was dropping 10 domestic flights between Johannesburg, Cape Town and Durban, while canning its direct route between Johannesburg and Munich.

Passengers on cancelled domestic flights will be accommodated on its budget sister airline, Mango, while international travellers would be re-routed via its flights between Johannesburg and Frankfurt, and London Heathrow.   "These decisions are in line with SAA's usual policy of reviewing flights and consolidating services with low demand," it said in a statement.   "Furthermore, during the current process of business rescue, these cancellations represent a responsible strategy to conserve cash and optimise the airline's position ahead of any further capital investment."

The company said there might be further flight schedule changes over the coming days.   Aviation analyst Phuthego Mojapele said a spate of cancellations by clients were exacerbating problems for SAA.   "At the moment SAA's perception out there ... it's not really looking good because there is negative news that is being perpetuated on the wires every single day," Mojapele told local television station, eNCA.   "However, SAA's records in terms of safety, in terms of the service has always been excellent," he added.

The debt-ridden carrier, which has failed to make a profit since 2011 and survives on government bailouts, has been awaiting a two-billion rand ($138 million) payout from the Treasury to fund a rescue plan announced in December.   Finance Minister Tito Mboweni last week told journalists that the government was still trying to "find a solution to finance the airline".    Local media have reported that SAA is selling nine older aircraft to make way for new planes, part of a separate plan to rid itself of its most costly aircraft.   SAA, Africa's second largest airline after Ethiopian Airlines, employs more than 5,000 workers. It has a fleet of more than 50 aircraft flying to more than more 35 domestic and international destinations.
Date: Tue, 21 Jan 2020 12:26:16 +0100 (MET)

Taipei, Jan 21, 2020 (AFP) - Taiwan on Tuesday reported its first confirmed case of the new SARS-like coronavirus as the government warned the public against travelling to Chinese city where it emerged.    The patient is a Taiwanese woman in her fifties, living in Wuhan, who returned to the island on Monday with symptoms including fever, coughing and a sore throat.   Asian countries have ramped up measures to block the spread of the new virus as the death toll in China rose to six and the number of cases jumped to almost 300 since it first emerged in the central Chinese city of Wuhan.

The Taiwan patient reported her symptoms to quarantine officials on arrival at Taoyuan airport and was immediately taken to a hospital for treatment, said the island's Centers for Disease Control (CDC).    The woman told officials that she had not visited any local markets or had contact with birds or wild animals while in Wuhan.    Authorities are monitoring some 46 passengers and crew from the same flight, the agency said.

The CDC raised its alert on Wuhan to the highest level, urging the public against travelling to the city unless necessary.    "We ask the public not to panic as the individual was taken to hospital directly from the airport and did not step into the community," it said in a statement, adding that it reported the case to the World Health Organization and China authorities.   The coronavirus has spread to Thailand, Japan, South Korea and Taiwan.
Date: Tue, 21 Jan 2020 12:08:14 +0100 (MET)

Kathmandu, Jan 21, 2020 (AFP) - Eight Indian tourists, including four children, have died after they were found unconscious in their room at a hill resort in Nepal on Tuesday, police said.   The eight -- two couples and their children -- had slept in one room at a hotel in Daman, a popular tourist destination in Makwanpur district about 55 kilometres (34 miles) from Kathmandu.   "They were found unconscious this morning and airlifted to Kathmandu but died during treatment," police spokesman Shailesh Thapa Chettri told AFP.

The families, from the south-eastern state of Kerala, used a gas heater in their room to keep warm, a district official told AFP.   "We suspect they died of suffocation, but autopsy reports will confirm the cause," Chettri added.   India is Nepal's biggest source of tourists, making up some 16 percent of visitors to the Himalayan nation.
Date: Sun, 19 Jan 2020 14:17:42 +0100 (MET)

Kathmandu, Jan 19, 2020 (AFP) - Avalanches, heavy snow and poor visibility hampered the search Sunday for four South Koreans and three Nepalis caught in an avalanche in the popular Annapurna region of the Himalayas, officials said   Relatives of the missing Koreans have arrived in Kathmandu alongside several officials sent by Seoul to help with the emergency rescue efforts, Ang Dorjee Sherpa of the Korean Alpine Federation told AFP.

The missing group was near the Annapurna base camp around 3,230 metres (10,600 feet) above sea level when the avalanche struck after heavy snowfall on Friday.   "Our team reached the area but could not proceed with their search because of more avalanches. We are exploring ways to move the operation forward," said Mira Acharya from Nepal's tourism department.

Rescuers were working with Korean officials to deploy drones in the search on Monday, said Dilip Gurung of the tourism management committee in Chhomrong, which lies on the trekking route.   "It is difficult for people to go. We will try to fly drones to help find something," Gurung said.   Helicopters were sent out on Saturday to rescue about 200 people stranded around Annapurna and other nearby mountains after the incident.

Guesthouses and the trekking route were blanketed in a thick layer of snow.   "The snow was very deep and it took us more than double the time to dig through and walk," said Jeevan Dahal, a guide who was rescued by helicopter.   "We saw the avalanche-hit area from the helicopter. Everything was white."   Tek Gurung, a guesthouse owner aiding the search operation, said more than two metres of snow (6.6 feet) had fallen on the trekking trails and it was "extremely difficult" to search the snow-covered area on foot.

Six of the missing were part of the same expedition, while one Nepali porter was escorting a different group.   The four foreigners -- two men and two women -- were part of an 11-member team of South Korean nationals. Others have safely descended.    Education officials in Seoul said they were part of a team of volunteer teachers working with children in Nepal.

Two more South Koreans were due to arrive in Nepal on Sunday to help with the search, the country's foreign ministry said.   Sherpa said it had snowed heavily around Annapurna in recent days, making the trek risky.   "The weather and snow got worse and, feeling it was becoming dangerous and difficult, they decided to turn. As they were heading back the avalanche hit," Sherpa told AFP on Saturday.

Annapurna is an avalanche-prone and technically difficult mountain range with a higher death rate than Everest, the world's highest peak.    Thousands of trekkers visit the route every year for its stunning views of the Himalayas.   A snowstorm killed about 40 people on the circuit in 2014, in one of the biggest trekking tragedies to hit Nepal.