WORLD NEWS

Getting countries ...
Select countries and read reports below or

Albania

Albania US Consular Information Sheet November 04, 2008

 COUNTRY DESCRIPTION

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

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

ENTRY/EXIT REQUIREMENTS

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

SAFETY AND SECURITY

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

CRIME

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

MEDICAL FACILITIES AND HEALTH INFORMATION

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

MEDICAL INSURANCE

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

TRAFFIC SAFETY AND ROAD CONDITIONS

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

AVIATION SAFETY OVERSIGHT

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

CHILDREN'S ISSUES

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

REGISTRATION / EMBASSY LOCATION

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

Travel News Headlines WORLD NEWS

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Yemen

Yemen - US Consular Information Sheet
July 21, 2008
COUNTRY DESCRIPTION:
The Republic of Yemen was established in 1990 following unification of the former Yemen Arab Republic (North) and the People's Democratic Republic of Yemen (South). I
lamic and traditional ideals, beliefs, and practices provide the foundation of the country's customs and laws. Yemen is a developing country and modern tourist facilities are widely available only in major cities. Read the Department of State Background Notes on Yemen for additional information.

ENTRY/EXIT REQUIREMENTS: Passports and visas are required for travel to Yemen. Visas may be obtained at Yemeni Embassies abroad; all travelers to Yemen can also potentially obtain entry visas at ports of entry. Travelers to Yemen are no longer required to have an affiliation with and arrange their travel through a Yemeni-based individual or organization to enter Yemen. However, individuals may be asked for supporting evidence of their character, purpose of visit and length of stay. Upon arrival at ports of entry, travelers may be issued a visa valid for a maximum of three months.
Yemeni law requires that all foreigners traveling in Yemen obtain exit visas before leaving the country. In cases of travelers with valid tourist visas and without any special circumstances (like those listed below), this exit visa is obtained automatically at the port of exit as long as the traveler has not overstayed the terms of the visa.
In certain situations, however, foreigners are required to obtain exit visas from the Immigration and Passport Authority headquarters in Sanaa. These cases may include, but are not limited to, foreigners who have overstayed the validity date of their visa; U.S.-citizen children with Yemeni or Yemeni-American parents who are not exiting Yemen with them; foreigners who have lost the passport containing their entry visa; foreign residents whose residence visas are based on their employment or study in Yemen, marriage to a Yemeni citizen, or relationship to a Yemeni parent; or foreign residents who have pending legal action (including court-based "holds" on family members' travel). The loss of a passport can result in considerable delay to a traveler because Yemeni law requires that the traveler attempt to recover the passport by placing an advertisement in a newspaper and waiting a week for a response. All minor/underage U.S. citizens should be accompanied by their legal guardian(s) and/or provide a notarized letter in Arabic of parental consent when obtaining exit visas to depart Yemen. In all of these more complex cases, obtaining an exit visa requires the permission of the employing company, the sponsoring Yemeni family member, the sponsoring school or the court in which the legal action is pending. Without this permission, foreigners -- including U.S. Citizens -- may not be allowed to leave Yemen.
American women who also hold Yemeni nationality and/or are married to Yemeni or Yemeni-American men often must obtain permission from their husbands for exit visas. They also may not take their children out of Yemen without the permission of the father, regardless of who has custody (see Special Circumstances section below).
For more details, travelers can contact the Embassy of the Republic of Yemen, Suite 705, 2600 Virginia Avenue NW, Washington, DC 20037, telephone 202-965-4760; or the Yemeni (Mission to the U.N., 866 United Nations Plaza, Room 435, New York, NY 10017, telephone (212) 355-1730. Visit the Yemeni Embassy home page for more visa information at http://www.yemenembassy.org/.
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 Department of State is concerned that al-Qa‘ida and its affiliates are actively engaged in extremist-related activities in Yemen and the Arabian Peninsula. The Department remains concerned about possible attacks by extremist individuals or groups against U.S. citizens, facilities, businesses and perceived interests.

On March 18, 2008, three mortar rounds landed in the vicinity of the U.S. Embassy in Sanaa. Yemeni students at a nearby school and Yemeni government security personnel posted outside the embassy were injured in the attack. On April 6, 2008, an expatriate residential compound in the Hadda neighborhood of southwestern Sanaa was attacked by mortar fire, and on April 30, 2008, suspected extremists fired two mortar rounds that exploded near the Yemen Customs Authority and the Italian Embassy. No injuries were reported in either incident. A group calling itself al-Qa'ida in Yemen may be responsible for all three attacks. Following the attacks against the Embassy and the residential compound, the Department of State ordered the departure of all American non-emergency embassy staff and family members on April 7, 2008.
On January 18, 2008, suspected al-Qa’ida operatives ambushed a tourist convoy in the eastern Hadramout Governorate, killing two Belgians. On July 2, 2007, suspected al-Qa’ida operatives carried out a vehicle-borne explosive device attack on tourists at the Belquis Temple in Marib, which resulted in the deaths of eight Spanish tourists and two Yemenis. The targeting of tourist sites by al-Qa’ida may represent an escalation in terror tactics in Yemen. On February 3, 2006, 23 convicts, including known affiliates of al-Qa’ida, escaped from a high-security prison in the capital city, Sanaa. Among the al-Qa’ida associates were individuals imprisoned for their roles in the 2000 bombing of the USS Cole and the 2002 attack on the French oil tanker Limburg. In the weeks following the escape, some prisoners voluntarily turned themselves in to authorities; to date, however, some escapees remain at large. Two of the escapees were killed in vehicle-based suicide attacks on oil facilities near Mukalla and Marib on September 15, 2006. Those attacks were followed by the arrest the next day in Sanaa of four suspected al-Qa’ida operatives, who had stockpiled explosives and weapons. On December 5, 2006, a lone gunman opened small arms fire outside of the Embassy compound during the early morning hours. The assailant, wounded by host-nation security personnel and subsequently arrested, was the sole casualty. It appears that, although the gunman was influenced by extremist ideology, he worked alone in planning and executing the attack.
Americans should avoid areas where demonstrations are taking place. A 2005 demonstration against an increase in the fuel price led to two days of widespread demonstrations and rioting throughout Sanaa and other cities. Those demonstrations resulted in a large amount of property damage, looting, and several roadblocks.
In late 2007 and throughout 2008, there has been an increase in anti-government demonstrations in southern Yemen, including the cities of Aden, Taizz, Ibb, and Mukalla, as well as surrounding regions. Some of these demonstrations have resulted in injuries and deaths. Americans should be aware of the potential for further demonstrations when traveling in these areas.
Throughout the country, U.S. citizens are urged to exercise particular caution at locations where large groups of expatriates have gathered. From time to time, the U.S. Embassy in Sanaa may temporarily close or suspend public services as necessary to review its security posture and ensure its adequacy.
In addition, U.S. citizens are urged to avoid contact with any suspicious, unfamiliar objects, and to report the presence of such objects to local authorities. Vehicles should not be left unattended and should be kept locked at all times. Americans in Yemen are urged to register and remain in contact with the American Embassy in Sanaa for updated security information (see section on Registration/Embassy location below).
Yemeni government security organizations have arrested and expelled foreign Muslims, including Americans, who have associated with local Muslim organizations considered to be extremist by security organs of the Yemeni government. Americans risk arrest if they engage in either political or other activities that violate the terms of their admission to Yemen.
Travel on roads between cities throughout Yemen can be dangerous. Armed carjacking, especially of four-wheel-drive vehicles, occurs in many parts of the country, including the capital. Yemeni security officials advise against casual travel to rural areas. The U.S. Embassy sometimes restricts the travel of its own personnel to rural areas, while the Government of Yemen also sometimes places restrictions on Americans traveling outside Sanaa. Please check with the Embassy for the latest restrictions.
Travel is particularly dangerous in the tribal areas north and east of Sanaa. Armed tribesmen in those areas have kidnapped a number of foreigners in attempts to resolve disputes with the Yemeni government. Hostilities between tribesmen and government security forces in the Sadah governorate north of Sanaa have flared up on several occasions since 2005. Serious fighting occurred in the city of Benni Hashish from late May through early June 2008. Americans are urged to avoid this region during periods of conflict.
Travel by boat through the Red Sea or near the Socotra Islands in the Gulf of Aden presents the risk of pirate attacks. If travel to any of these areas is necessary, travelers may reduce the risk to personal security if such travel is undertaken by air or with an armed escort provided by a local tour company.
Other potential hazards to travelers include land mines and unexploded ordnance from the 1994 civil war. This is of particular concern in areas where fighting took place in the six southern provinces. However, most minefields have been identified and cordoned off.
Americans are most vulnerable to terrorist attacks when they are in transit to and from their residences or workplaces, or visiting locations where large groups of expatriates have gathered. All Americans are reminded to vary their routes and times, remain vigilant, report suspicious incidents to the Embassy, avoid areas where large groups of expatriates have gathered, lock car windows and doors, and carry a cell phone.
Based on previous abductions of foreigners in Iraq, Afghanistan and Kuwait, the Embassy recommends that Americans with doubts about the identity of security or police personnel on the roads remain in their vehicles, roll up their windows, and contact the Embassy. For additional information on travel by road in Yemen, see the Traffic Safety and Road Conditions section below.
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, including the Travel Warning for Yemen, as well as the Worldwide Caution, can be found.
Up-to-date information on safety and security can also be obtained by calling 1-888-407-4747 toll-free in the U.S. and Canada, or for callers outside the U.S. and Canada, a regular toll line at 1-202-501-4444. These numbers are available from 8:00 a.m. to 8:00 p.m. Eastern Time, Monday through Friday (except U.S. federal holidays).
The Department of State urges American citizens to take responsibility for their own personal security while traveling overseas. For general information about appropriate measures travelers can take to protect themselves in an overseas environment, see the Department of State’s pamphlet A Safe Trip Abroad.
CRIME: The most serious crime problem affecting travelers to Yemen is carjacking. Travelers have rarely been victims of petty street crime.
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 in Yemen is 199, but operators do not speak English.
See our information on Victims of Crime.
MEDICAL FACILITIES AND HEALTH INFORMATION: Lack of modern medical facilities outside of Sanaa and Aden and a shortage of emergency ambulance services throughout the country may cause concern to some visitors. Doctors and hospitals often expect immediate cash payment for health services. An adequate supply of prescription medications for the duration of the trip is important. While many prescription drugs are available in Yemen, a particular drug needed by a visitor may not be available.
The U.S. Embassy in Sanaa strongly advises all American citizens residing in or traveling to Yemen to ensure that they have received all recommended immunizations (see below).
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/.
The U.S. Department of State is unaware of any HIV/AIDS entry restrictions for visitors to or foreign residents of Yemen.

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 Yemen is provided for general reference only, and may not be totally accurate in a particular location or circumstance.
Based on previous abductions of foreigners in Iraq, Afghanistan and Kuwait, the Embassy recommends that Americans with doubts about the identity of security or police personnel on the roads remain in their vehicles, roll up their windows, and contact the Embassy. For additional information addressing security concerns for Americans in Yemen, please see the Safety and Security section above.
Travel by road in Yemen should be considered risky. Within cities, minivans and small buses ply somewhat regular routes, picking up and dropping off passengers with little notice or regard for other vehicles. Taxis and public transportation are widely available but the vehicles may lack safety standards and equipment. Embassy personnel are advised to avoid public buses for safety reasons. Despite the presence of traffic lights and traffic policemen, drivers are urged to exercise extreme caution, especially at intersections. While traffic laws exist, they are often not enforced, and/or not adhered to by motorists. Drivers sometimes drive on the left side of the road, although right-hand driving is specified by Yemeni law. No laws mandate the use of seat belts or car seats for children. The maximum speed for private cars is 100 kilometers per hour (62.5 miles per hour), but speed limits are rarely enforced. A large number of under-age drivers are on the roads. Many vehicles are in poor repair and lack basic parts such as functional turn signals, headlights and taillights. Pedestrians, especially children, and animals on the roads constitute a hazard in both rural and urban areas. Beyond the main inter-city roads, which are usually paved and in fair condition, the rural roads in general require four-wheel-drive vehicles or vehicles with high clearance.
Yemeni security officials advise against casual travel to rural areas. The U.S. Embassy sometimes restricts the travel of its own personnel to rural areas, while the Government of Yemen also sometimes places restrictions on Americans traveling outside Sanaa. Please check with the Embassy for the latest restrictions.
Travelers should take precautions to avoid minefields left over from Yemen's civil wars. Traveling off well-used tracks without an experienced guide could be extremely hazardous, particularly in parts of the south and the central highlands.
Penalties for driving under the influence of alcohol or drugs, and reckless driving which causes an accident resulting in injury, are a fine and/or prison sentence. If the accident results in death, the driver is subject to a maximum of three years in prison and/or a fine. Under traditional practice, victims' families negotiate a monetary compensation from the driver proportionate to the extent of the injuries -- higher if it is a fatality.
Please refer to our Road Safety page for more information and visit the web site of Yemen’s national tourism office at http//yementourism.com.
AVIATION SAFETY OVERSIGHT: As there is no direct commercial air service to the United States by carriers registered in Yemen, the U.S. Federal Aviation Administration (FAA) has not assessed Yemen’s Civil Aviation Authority for compliance with International Civil Aviation Organization (ICAO) aviation safety standards. For more information, travelers may visit the FAA’s web site at http://www.faa.gov/safety/programs_initiatives/oversight/iasa.
SPECIAL CIRCUMSTANCES: Photography of military installations, including airports, equipment, or troops is forbidden. In the past, such photography has led to the arrest of U.S. citizens. Military sites are not always obvious. If in doubt, it is wise to ask specific permission from Yemeni authorities.
Travelers should be aware that automated teller machines (ATMs) are being introduced in major cities but are still not widely available in Yemen. Credit cards are not widely accepted. The Government of Yemen may not recognize the U.S. citizenship of persons who are citizens of both Yemen and the United States. This may hinder the ability of U.S. consular officials to assist persons who do not enter Yemen on a U.S. passport. Dual nationals may also be subject to national obligations, such as taxes or military service. For further information, travelers can contact the nearest embassy or consulate of Yemen.
American citizens who travel to Yemen are subject to the jurisdiction of Yemeni courts, as well as to the country's laws, customs, and regulations. This holds true for all legal matters including child custody. Women in custody disputes in Yemen may not enjoy the same rights that they do in the U.S., as Yemeni law often does not work in favor of the mother. Parents planning to travel to Yemen with their children should bear this in mind. Parents should also note that American custody orders might not be enforced in Yemen.
American women who also hold Yemeni nationality, and/or are married to Yemeni or Yemeni-American men, are advised that if they bring their children to Yemen they may not enjoy freedom of travel should they decide they want to leave Yemen. Such women often must obtain permission from their husbands for exit visas. They also may not take their children out of Yemen without the permission of the father, regardless of who has custody (See Entry/Exit Requirements section above).
American students and workers in Yemen sometimes report that the sponsors of their residence permits seize their U.S. passports as a means of controlling their domestic and international travel. While the sponsors say they seize the passports on behalf of local security services, there is no law or instruction from Yemeni passport or security offices requiring that passports be seized.
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 Yemeni laws, even unknowingly, may be expelled, arrested, or imprisoned. Penalties for possession or use, or trafficking in illegal drugs in Yemen are severe, and convicted offenders can expect long jail sentences and heavy fines. The use of the mild stimulant "qat” or “khat" is legal and common in Yemen, but it is considered an illegal substance in many other countries, including the United States. 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 Yemen 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 Yemen. 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 Dhahr Himyar Zone, Sheraton Hotel District, PO Box 22347. The telephone number of the Consular Section is (967)(1) 755-2000, extension 2153 or 2266. The fax number is (967) (1) 303-175. The after-hours emergency number is (967) (1) 755-2000 (press 0 for extension) or (967) 733213509. The Embassy is open from Saturday through Wednesday.
* * *
This replaces the Country Specific Information for Yemen dated December 27, 2007, to update the sections on Entry/Exit Requirements, Safety and Security, Information for Victims of Crime, Criminal Penalties and Medical Facilities and Health Information.

Travel News Headlines WORLD NEWS

Date: Mon, 25 Mar 2019 11:52:43 +0100

Sanaa, March 25, 2019 (AFP) - Nearly 110,000 suspected cases of cholera have been reported in war-hit Yemen since the beginning of January, including 190 related deaths, the UN said on Monday.   The UN office for humanitarian affairs (OCHA) said children under the age of five make up nearly a third of 108,889 cases which were reported between January 1 and March 17.

OCHA said the spike, which comes two years after Yemen suffered its worst cholera outbreak, was concentrated in six governorates including in the Red Sea port of Hodeida and the Sanaa province home to the capital.   Early rains could be blamed for the recent increase in suspected cholera cases, it said.   "The situation is exacerbated by poor maintenance of sewage disposal systems in many of the affected districts, the use of contaminated water for irrigation, and population movements," OCHA added.   The waterborne disease is endemic to Yemen, which witnessed the worst cholera outbreak in its modern history in 2017.

More than one million suspected cases were reported within an eight-month period that year. More than 2,500 people died of the infection between April and December 2017.    Yemen's brutal conflict, which pits Iran-linked rebels against a regional pro-government alliance led by Saudi Arabia, has left some 10,000 people dead since 2015 and pushed millions to the brink of famine.    The war has created the perfect environment for cholera to thrive, as civilians across the country lack access to clean water and health care.
Date: Thu 28 Feb 2019
Source: WHO/EMRO [edited]

Outbreak update: Cholera in Yemen, 28 Feb 2019
-----------------------------------
The Ministry of Public Health and Population of Yemen reported 7419 suspected cases of cholera with 8 associated deaths during epidemiological week 5 of 2019 (28 Jan-3 Feb 2019). Ten percent of cases are severe. The cumulative total number of suspected cholera cases from 1 Jan 2018 to 3 Feb 2019 is 413 770, with 543 associated deaths (CFR 0.13%). Children under 5 represent 32% of all suspected cases. The outbreak has affected 22 of 23 governorates and 311 of 333 districts in Yemen.

From week 2 to week 5 in 2019 [7 Jan-3 Feb 2019], the trend of weekly reported suspected cholera cases was stable at the country level, although 223 districts have reported suspected cholera cases within the last 3 weeks. The governorates reporting the highest number of suspected cases of cholera during this reporting period were Al Hudaydah (1583), Amanat Al Asimah (978), Arman (902), Ibb (882), and Sana'a (850).

Of a total 11 275 samples collected since January 2018, 3492 have been confirmed as cholera-positive by culture at the central public health laboratories in Al Hudaydah, Sana'a, Taizz, and Aden governorates. During this reporting period, 7 stool samples -- from Amanat Al Asimah (4), Al Hudayadah (1), Aden (1), and Ibb (1) -- tested positive.

WHO continues to provide leadership and support for activities with health authorities and partners to respond to this ongoing cholera outbreak, including case management; surveillance; laboratory investigations; water, sanitation, and hygiene (WASH); and risk communication. In partnership with the World Bank, WHO delivered 30 mobile laboratory kits to monitor and test water quality in water networks, wells, and water trucks. To further enhance laboratory capacity, WHO trained 25 laboratory technicians on sample collection, transportation, laboratory diagnosis, and proper reporting of cases.
Date: Thu 7 Feb 2019
Source: WHO/EMRO [edited]

Cholera situation in Yemen, December 2018
-----------------------------------------
Highlights
---------
In December 2018, the Ministry of Public Health and Population of Yemen reported a total 47 310 suspected cholera cases including 86 related deaths (case fatality rate: 0.18%), from 20 governorates.

The cumulative number of suspected cholera cases reported in Yemen since October 2016 to December 2018 is 1,417,156 including 2870 related deaths with a case fatality rate of 0.20%. The country experienced a 2nd wave of this outbreak from 27 Apr 2017. The total number of suspected cholera cases reported during the 2nd wave were 1 391,329 including 2 741 related deaths with a case fatality rate of 0.19%.

Since 27 Apr 2017, a total of 12 937 stool specimens were tested. Out of these, 4319 were laboratory confirmed for _Vibrio cholerae_.

The 5 governorates with the highest cumulative attack rate per 10,000 are Amran (1258.21), Al Mahwit (1087.47), Sana'a (781.53), Dahamar (704), and Al Dhale'e (652.50). The national attack rate is 493.95 per 10 000. The governorates with high numbers of deaths are Hajjah (472), Ibb (371), Al Hudaydah (343), and Taizz (221).
=====================
[During the 1st half of 2018, the rate of reported cases of cholera had slowed to fewer than 1000 per month (about 30 per day), but a dramatic upswing has once again occurred, with about 21 000 cases reported in the 1st 2 weeks of September 2018 (about 1500 per day), more than 13,000 in the 1st week of October 2018 (about 1900 cases per day), and about 14,500 in the 3rd week of October (about 2100 cases per day). In December 2018, there were about 12,000 reported cases per week.

The low case fatality rate might suggest that some of the diarrhoea cases may be non-cholera.

[See also, WHO/EMRO at

[Maps of Yemen:
Date: Tue, 29 Jan 2019 10:03:28 +0100

Dubai, Jan 29, 2019 (AFP) - A bomb attack in a market killed seven Yemeni civilians including a photographer for a UAE television channel in the government-controlled town of Mokha, medics and military sources said Tuesday.   At least 20 people were wounded in the overnight blast in the Red Sea town, where pro-government forces backed by a Saudi-led coalition battling the Huthi rebels are based.

The improvised explosive device was planted on a motorcycle parked in the middle of the market, an official in the pro-government forces told AFP.   Seven people were killed, the official and a hospital source said.   A photographer for Abu Dhabi TV, Ziad al-Sharabi, was among the dead, the official Saba news agency quoted information minister Moammer al-Eryani as saying.   A correspondent for the same network, Faisal Al-Zabhani, was among the wounded, he said.   There was no immediate claim of responsibility for the attack, but Saba blamed it on the Iran-aligned Huthis.

The city of Mokha has enjoyed relative calm since coalition-backed government forces seized it from the rebels in July 2017.   Yemen's war escalated in March 2015, when President Abedrabbo Mansour Hadi fled to Saudi Arabia and the coalition intervened.   Since then, the conflict has killed nearly 10,000 people and unleashed the world's worst humanitarian crisis, according to the UN.   UN aid officials say 80 percent of the population -- 24 million people -- are in need of aid and nearly 10 million are just one step away from famine.
Date: Tue 15 Jan 2019
Source: News Yemen [in Arabic, machine trans., edited]

A medical source at the Zaidia rural hospital north of the city of Hodeidah, western Yemen, reported the death of 9 people, including 3 children, after severe watery diarrhoea and vomiting, likely to have cholera. The source explained in an interview with "Newsmen" that the cantre for the treatment of cholera patients in the hospital Zaidiyah received during 3 days 87 cases with watery diarrhoea from the centre of the district and the monasteries located west of the city.

The source said that the outbreak of the epidemic was expected due to the failure to complete the preventive measures that were supposed to be completed in October 2018, accusing the Houthi group, the Iranian arm in Yemen, with the obstruction of the work of the teams on water wells and the completion of periodic inspections according to the epidemiological surveillance map prepared by The Health Office of the Directorate and a UNICEF specialist team. He warned of the high number of victims of cholera, noting that most of the tests proved that the cases that reached the centre were positive, which means that cholera began to spread in the absence of medical centres and medicines, as well as failure to respond to repeated calls. He stressed that the Houthi militia prevented many organizations from reaching the Directorate and intervening to put an end to the epidemic.

In all, 33 people died of cholera in September and October 2018 in the Zaydi district north of Hodeidah. The Houthi militia then allowed a shipment of medicines from the International Organization for Migration (IOM) and a partial intervention by UNICEF in the Directorate. However, the Houthi militia did not allow UNICEF to complete preventive measures and periodic water checks in the area.
===========================
[I have not seen more cumulative numbers on cholera in Yemen in several months, although characteristically the number of cases slows early in the year.

In the 1st half of 2018, the rate of reported cases of cholera had slowed to fewer than 1000 per month (about 30 per day), but a dramatic upswing has once again occurred, with about 21 000 cases reported in the first 2 weeks of September 2018 (about 1500 per day), more than 13 000 in the 1st week of October 2018 (about 1900 cases per day), and about 14 500 in the 3rd week of October (about 2100 cases per day). This report documents about 12 300 cases in the 1st week of November 2018.

The low case fatality rate might suggest that some of the diarrhoea may be non-cholera.
More ...

World Travel News Headlines

Date: Mon, 25 Mar 2019 11:52:43 +0100

Sanaa, March 25, 2019 (AFP) - Nearly 110,000 suspected cases of cholera have been reported in war-hit Yemen since the beginning of January, including 190 related deaths, the UN said on Monday.   The UN office for humanitarian affairs (OCHA) said children under the age of five make up nearly a third of 108,889 cases which were reported between January 1 and March 17.

OCHA said the spike, which comes two years after Yemen suffered its worst cholera outbreak, was concentrated in six governorates including in the Red Sea port of Hodeida and the Sanaa province home to the capital.   Early rains could be blamed for the recent increase in suspected cholera cases, it said.   "The situation is exacerbated by poor maintenance of sewage disposal systems in many of the affected districts, the use of contaminated water for irrigation, and population movements," OCHA added.   The waterborne disease is endemic to Yemen, which witnessed the worst cholera outbreak in its modern history in 2017.

More than one million suspected cases were reported within an eight-month period that year. More than 2,500 people died of the infection between April and December 2017.    Yemen's brutal conflict, which pits Iran-linked rebels against a regional pro-government alliance led by Saudi Arabia, has left some 10,000 people dead since 2015 and pushed millions to the brink of famine.    The war has created the perfect environment for cholera to thrive, as civilians across the country lack access to clean water and health care.
Date: Wed 20 Mar 2019
Source: Outbreak News Today [edited]

Swedish public health authorities, Folkhalsomyndigheten, is reporting an outbreak of psittacosis, or parrot disease, since November 2018. According to officials, some 60 cases have been reported from the regions of Vastra Gotaland, Kalmar, Jonkoping, and Skane. This is the highest number of cases reported in one winter in 2 decades.

Those who have now fallen ill have mainly come into contact with bird droppings from wild birds, for example through the handling of bird tables and other outdoor activities. A smaller number are believed to have been infected by domestic birds (parrots) in cages. The most common way someone gets infected with the bacteria that cause psittacosis (_Chlamydia psittaci_) is by breathing in dust containing dried secretions (e.g., droppings, respiratory) from infected birds. It is rare for psittacosis to spread from person to person.

In general, psittacosis causes mild illness in people. The most common symptoms include fever and chills, headache, muscle aches, and dry cough. Psittacosis can also cause pneumonia (a lung infection) that may require treatment or care in a hospital. Rarely, psittacosis can result in death. Most people begin developing signs and symptoms of psittacosis within 5-14 days after exposure to the bacteria (_C. psittaci_). Occasionally, people report the start of symptoms after more than 14 days.
=================
[The news report above attributes the increase in number of human cases of psittacosis in Sweden since Nov 2018 mainly to contact with wild bird droppings, for example through the handling of bird tables and other outdoor activities. Outbreaks of avian chlamydiosis, due to _Chlamydia psittaci_ or the other Chlamydia species, have been reported occasionally in wild birds including shorebirds, waterfowl, and migratory birds, especially in birds under stress (<http://www.cfsph.iastate.edu/Factsheets/pdfs/psittacosis.pdf>).

An outbreak in Australia was probably caused by organisms carried in wild birds and spread when organisms in bird droppings became aerosolized during activities such as lawn mowing (<https://www.ncbi.nlm.nih.gov/pubmed/15757553>). An increase in psittacosis cases in Sweden in the winter of 2013 was also linked to wild birds, apparently through exposure to wild bird droppings; most cases were associated with tending bird feeders (<https://www.ncbi.nlm.nih.gov/pubmed/23725809>; also see ProMED-mail post Psittacosis - Sweden (02): wild bird http://promedmail.org/post/20130509.1701695).

Vastra Gotaland, Kalmar, Jonkoping, and Skane are counties located in southern Sweden. A map of Swedish counties can be found at <https://fotw.info/flags/se(.html>. - ProMED Mod.ML]

[HealthMap/ProMED-mail map:
Date: Wed 20 Mar 2019
Source: PNA [edited]

A public elementary school in Tubungan town, Iloilo has recorded a total of 36 chickenpox cases from 15 Jan to 3 Mar [2019], the Provincial Health Office (PHO) said. In an interview on Wednesday [20 Mar 2019], Dr. Patricia Grace Trabado, PHO head, said the cases were observed as patients who sought treatment at the rural health units (RHU) and private clinics in Tubungan.

All the cases were recorded in Cadabdab Elementary School, with 21 male and 15 female students affected. Trabado said affected pupils might still be attending school even though they were infected, which resulted in its transmission.

She emphasized that the spread of the infection might have been prevented if the children were advised not to attend school with the onset of infection. "If a child is showing chickenpox symptoms, especially when he or she was previously exposed to an affected person, then the pupil will be advised to stay at home," she said.

Trabado said the source of the infection came from the 1st patient working in Iloilo City but lives in Tubungan town. "The patient might have a family member that attends school in Cadabdab. From there, we see where the infection originated," she said. Trabado, however, did not give figures of the disease other than that from the school.

The RHUs and private clinics were able to monitor and manage the cases, Trabado said. All the student patients were discharged, given medication, and let the viral infection take its course. "And eventually, the patients recovered," she said. However, Trabado warns that a child with chickenpox can get secondary infection when he or she scratches the blisters, creating skin lesions.

She added that cases of chickenpox and mumps are mostly observed during the summer season. Trabado said patients with chickenpox experience fever and headache in the first 1 or 2 days before the itchy blister rash appears.  [Byline: Gail Momblan]
======================
[HealthMap/ProMED-mail map:
Date: Wed 20 Mar 2019
Source: USDA Animal and Plant Health Inspection Services [edited]
<https://content.govdelivery.com/accounts/USDAAPHIS/bulletins/23806a5>

The US Department of Agriculture's (USDA) under secretary for marketing and regulatory programs, Greg Ibach, is alerting international travellers of a deadly swine disease they could unknowingly bring back into the United States on their clothes, shoes, or hands.

African swine fever (ASF) is a highly contagious and deadly disease affecting both domestic and feral (wild) pigs. It does not affect human health and cannot be transmitted from pigs to humans. Recent spread of the disease to new countries in Asia and Europe has triggered a series of actions by USDA, state agriculture departments, and the pork industry to bolster protections against ASF in the United States and keep ASF out of North America.

"ASF has never been detected in the United States," said Ibach, "but an outbreak here would not only affect the pork industry, but also have major impacts on trade and raise food prices for consumers. We are asking international travellers to help prevent the spread of ASF to the United States by understanding what products can be brought back into the United States and declaring any agricultural items in their baggage."

The USDA's Animal Plant and Health Inspection Service's (APHIS) new traveller website provides updated information about potentially harmful pests and diseases that can hitchhike on food or other agricultural products. When returning to the United States, travellers are reminded to declare food items and animal products in their luggage. Failure to declare items may result in serious penalties.

"USDA and US Customs and Border Protection (CBP) recognize the crucial work of detector dog teams at US ports of entry." said Ibach. "While travellers' declarations of any food products brought with them to the United States is a critical step to protecting US agriculture, the dogs and secondary agricultural inspections provide another line of defence to keep ASF out of the country."

Travellers will also see some changes at airports as USDA works with CBP to increase screenings of passenger baggage. This includes training and adding 60 additional beagle teams for a total of 179 teams working at key US commercial, sea, and air ports and ensuring travellers who pose an ASF risk receive secondary agricultural inspection. USDA is also coordinating with CBP to expand arrival screenings, including checking cargo for illegal pork and pork products.

Anyone who visits a farm in an ASF-affected country should take specific precautions before returning to the United States. Follow the farm's biosecurity protocols and wear site specific footwear and coveralls or clothing. Thoroughly clean and disinfect or dispose of clothes and footwear worn on the farm before returning, and declare the farm visit to CBP when re-entering the United States. Travelers should not visit farms or any other locations with pigs -- including livestock markets, zoos, circuses, and pet stores with pot-bellied pigs -- for at least 5 days after returning.

More information on ASF, partner resources, and additional resources for travellers are available on the APHIS ASF webpage
and in this infographic
======================
[This disease would be extremely serious for the US, and likely for all of North America. The warning is appropriate for travellers to be more alert to situations that could ultimately have horrible outcomes. - ProMED Mod.TG]

[HealthMap/ProMED-mail map:
Date: Wed 20 Mar 2019
Source: ReliefWeb [edited]

The Federal Ministry of Health, in collaboration with the World Health Organization (WHO), Gavi, the Vaccine Alliance, and UNICEF, has launched a large-scale mass vaccination campaign in Sudan to vaccinate more than 8.3 million people 9 months to 60 years of age against yellow fever in the states of Blue Nile, Gezira and Sennar during 10-29 Mar 2019.

The campaign represents a crucial step in protecting a large portion of the population and reducing the risk of severe and deadly yellow fever outbreaks in the country. It is the 3rd and final drive thatSudan is undertaking to protect populations at risk and prevent yellow fever epidemics, pending the implementation of infant immunization as routine practice.

The campaign forms a critical part of Sudan's ongoing work to protect all populations against yellow fever epidemics, in alignment with the global Eliminate Yellow fever Epidemics (EYE) Strategy. The country plans to complement these yellow fever mass campaigns and ensure long-term protection through the introduction of yellow fever vaccination into routine immunization in the coming months.

"We acknowledge the commitment of the health authorities in Sudan to avail cash and fuel during this economic crisis to ensure that their people, especially children, are protected with a quality vaccine which will contribute to health security and making the world safer," said Dr. Naeema Al-Gasseer, WHO Representative in Sudan.

"Yellow fever vaccination is the most important tool we have to prevent yellow fever outbreaks. The vaccine will be freely available to any eligible person and will provide life-long protection against the disease. While protecting yourself against mosquito bites is important to reduce the risk of many diseases, only vaccination can eliminate the risk of yellow fever outbreaks," she added.

Yellow fever is a viral disease that is transmitted by certain types of mosquito. Infection can cause fatal illness, including jaundice, and death, and can spread rapidly, locally and internationally, especially in urban areas. However, the disease can be prevented by a single dose of a highly effective and safe vaccine. This campaign aims to boost protection in the general population and will target all eligible people.

Sudan is at high risk for the spread of yellow fever due to a combination of climate and ecological factors, and because there are still areas of low population immunity. Recent years have seen global changes in the epidemiology of yellow fever, with outbreaks occurring in areas that were not previously assessed as being at high risk.

"We are observing a changing nature in yellow fever disease dynamics. It is very important that every eligible person in this campaign receives the vaccine to protect themselves, their families and their communities," said Professor Dr. Babkir Kabaloo, Undersecretary of the Federal Ministry of Health.

"The current campaign represents one of the final phases in the Ministry's efforts to protect the entire nation against yellow fever outbreaks. This campaign will cover Blue Nile, Gezira, and Sennar states. In the coming months, the remaining states of Khartoum, Northern and River Nile will also be covered, completing the protection of the entire Sudanese population," he added.

Sudan's health authorities and partners are working to introduce yellow fever vaccine in the national immunization schedule in the near future. This will help ensure the protection of the whole population and generations to come against this fatal but preventable disease.
=====================
[It is good to see this ambitious yellow fever (YF) vaccination campaign drawing to a close. Incorporating YF vaccine into routine childhood vaccination schedules is prudent and if successful will eliminate the need for intensive, country-wide campaigns to deal with outbreaks. YF is no stranger to Sudan. Between 3 Oct and 24 Nov 2013, a total of 44 confirmed cases of YF were reported, including 14 deaths. A total of 12 localities in West and South Kordofan were affected by that outbreak. There was a large YF outbreak in the Darfur state in 2012-2013. In 2012, the World Health Organisation (WHO) said that more than 840 people were infected with YF in Darfur and that the epidemic affected 35 of 64 localities in the region since September 2012. The total recorded cases of YF in Greater Darfur hit 849 with a 20% death toll during an epidemic in 2012 (see WHO Disease Outbreak News <http://who.int/csr/don/2012_12_03/en> as reported by ProMED post http://promedmail.org/post/20130125.1513849, as noted at the time by Mod.JW). Mounting campaigns in the face of these types of outbreaks is inefficient, logistically difficult, and costly -- financially and in terms of human lives. - ProMED Mod.TY]

[HealthMap/ProMED-mail map:
Date: Thu 21 Mar 2019
Source: SBS News, Australian Associated Press (AAP) report [edited]

An egg recall has been announced following the discovery of a _Salmonella_ outbreak at a Victorian egg farm. The scare has prompted a recall of some brands of eggs from outlets in 4 states.

To date, 5 cases of _Salmonella [enterica_ serotype] Enteritidis have been linked to eggs produced by Victoria's Bridgewater Poultry, the state's health department said on [Thu 21 Mar 2019]. The company's free-range and barn-laid eggs are packaged as Woolworths brand, Victorian Fresh, and Loddon Valley, with best-before dates ranging from [20 Mar to 29 Apr 2019]. They are on shelves in Victoria, New South Wales, Tasmania, and South Australia. All other eggs are safe to eat, Chief Health Officer Brett Sutton said.

"It is important to know that not all eggs are affected, but any eggs carrying the listed brands should return them to the point of sale for a full refund. Alternatively, they can be discarded by throwing them into the garbage, not the garden or compost. "These eggs should not be given to pets or livestock."

Vulnerable people, including the elderly, are urged to avoid eating raw egg products.

Eggs of concern:
- Woolworths 12 Cage Free Eggs 700 g
- Victorian Fresh Barn Laid Eggs 600 g
- Victorian Fresh Barn Laid Eggs 700 g
- Victorian Fresh Barn Laid Eggs 800 g
- Loddon Valley Barn Laid 600 g (Victoria and South Australia only)
========================
[Salmonellosis is often thought to be associated with cracked eggs or eggs dirty with faecal matter, a problem controlled by cleaning procedures implemented in the egg industry. It is clearly the case, however, that most of the salmonellosis outbreaks linked to eggs were associated with uncracked, disinfected grade A eggs, or foods containing such eggs. The undamaged eggs become contaminated during ovulation, and thus were contaminated with the bacteria before the egg shell was formed. To avoid this, uncooked eggs should only be used as an ingredient, if pasteurized. - ProMED Mod.LL]

[Maps of Australia:
Date: Wed 20 Mar 2019 3:50 PM EDT
Source: The Day [edited]

Groton [New London county] public health officials are reminding residents to refrain from feeding or approaching wild or stray animals after a dog found in the area of Midway Oval tested positive for rabies [Wed 20 Mar 2019].

Rabies is a deadly disease caused by a virus that can infect all warm-blooded animals, including people, the Ledge Light Health District said in an alert sent to media outlets.

The disease mostly is spread by wild animals, but stray cats and dogs may also become infected and spread the virus, the district's alert said. The rabies virus lives in the saliva and brain tissue of infected animals, and the disease can be spread by scratches from infected animals or when infected saliva comes into contact with open wounds, breaks in the skin or mucous membranes, including the eyes, nose and mouth.

For more information, contact Ledge Light Health District at (860) 448-4882, extension 1311, or the animal control officer at (860) 441-6709.
======================
[HealthMap/ProMED-mail map of Connecticut, United States:
Connecticut county map:

Please keep your animals up-to-date on their rabies vaccine. It is for their protection and for your protection.

Regarding the 1st article, it sounds like South Carolina could consider using some oral rabies vaccine bait for some of their wild animals.

Unfortunately, wild animals may attack even when you are unaware of their presence.

Animals may be either unusually friendly and timid (dumb rabies) or aggressive and vicious (furious rabies). These are 2 presentations of the same disease but we should be aware of both forms and teach both forms to our children. - ProMED Mod.TG]
Date: Wed 20 Mar 2019
Source: Aiken Standard [edited]

[One person] in Aiken county may have been exposed to rabies following an unfriendly encounter with a wild raccoon, according to the South Carolina Department of Health and Environmental Control [DHEC].

According to a DHEC press release, the victim was on the North Augusta Greeneway Walking Trail on 16 Mar 2019 when they were bitten by a raccoon. The raccoon was later submitted to DHEC and tested positive for rabies. [Apparently the DHEC knows there is a victim so their earlier statement of "may have been exposed" seems a bit odd. - ProMED Mod.TG]

The victim who was bitten has since been referred to their health care provider. The raccoon on the Greeneway trail was the 3rd animal diagnosed with rabies in Aiken county this year [2019]. Statewide, there have been 32 confirmed cases of rabies in 2019. Coyotes, foxes, and skunks are also common carriers of the virus. Although it is extremely rare in people, rabies can be spread to humans and can also claim the lives of pets. The virus causes hallucinations, hydrophobia (fear of water), aggression, and death in its final stages.

Rabies is normally spread through bites but can also be spread when open wounds or areas like the eyes, nose, or mouth come into contact with saliva or blood of an infected animal. Infected areas should be washed with soap and water and medical attention should be sought immediately.  If a wild animal is foaming at the mouth and shows a lack of motor control (stumbling, staggering, or bumping into things) it may have rabies. Rabid animals are often very aggressive and do not fear people or other animals. [This behaviour may describe raccoons with distemper, but although they are not usually aggressive with distemper, they can be. The point is, when an animal is not acting normally it is time to move on and leave it alone and report it to the authorities in your area. - ProMED Mod.TG]

"To reduce the risk of getting rabies, always give wild and stray animals their space," said David Vaughan, Director of DHEC's Onsite Wastewater, Rabies Prevention, and Enforcement Division. "If you see an animal in need, avoid touching it and contact someone trained in handling animals, such as your local animal control officer or wildlife rehabilitator."

DHEC also stresses the importance of keeping pets up to date on their rabies shots to prevent the spread of the disease. For more information, call DHEC's Environmental Affairs Aiken office at 803-642-1637 during normal business hours on weekdays.  [Byline: Kristina Rackley]
========================
[HealthMap/ProMED-mail map of South Carolina, United States:
South Carolina county map:
Date: Thu, 21 Mar 2019 16:10:28 +0100

Kinshasa, March 21, 2019 (AFP) - A six-month-old baby in the eastern DR Congo city of Bunia has died of Ebola, becoming the first fatality of the disease in a provincial capital, the heath ministry said Thursday.   Bunia, which has a population of 300,000, is the capital of Ituri province, which along with neighbouring North Kivu province has been battling an epidemic of Ebola since last August.

The baby is among 610 fatalities out of 980 recorded cases, the ministry said in a statement.   "The parents are apparently in good health," it said.   "Extensive investigations are underway and will include, among other things, analysis of the maternal milk to identify the source of contamination."   The ministry added that it had also registered 97 new cases in the previous three weeks.   This increase "was expected" given the impact of an attack on two Ebola treatment centres by armed groups in the troubled region, it said.
Date: Thu, 21 Mar 2019 22:32:17 +0100

Blantyre, Malawi, March 21, 2019 (AFP) - Heavy rains could cause a dam in southern Malawi to give way if there is no let-up, authorities said Thursday, urging local residents to take shelter.   The warning came after cyclone Idai battered neighbouring Mozambique last Friday killing 242 people    Hurricane-force winds and rains have also ravaged hit eastern Zimbabwe where over 100 have died.

In Malawi, the storm has affected nearly a million people with over 80,000 displaced, according to the WHO.   The Chagwa dam "has had one of its major embankments eroded due to heavy rains," the interior security ministry said in a statement. "(It) is likely to burst in the event of heavy and incessant rains."   The statement advised local residents in the southern African country to evacuate "in case of an emergency".