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Armenia

Armenia US Consular Information Sheet
January 05, 2009
COUNTRY DESCRIPTION:
Armenia is a constitutional republic with a developing economy. Tourist facilities, especially outside Yerevan, the capital, are not highly developed, and many of
he goods and services taken for granted in other countries may be difficult to obtain. Read the Department of State’s Background Notes on Armenia for additional information.
ENTRY/EXIT REQUIREMENTS: A passport and visa are required. U.S. citizens may purchase visas in advance for a stay of up to 120 days online at http://www.armeniaforeignministry.am/ for the fee of USD 60; however, this visa is valid only for entry at Zvartnots airport in Yerevan. At this time a visa valid for 120 days may also be obtained upon arrival at the port of entry for the fee of 15,000 Armenian Drams (approx. USD 50). Visas for up to 120 days may be purchased at the Armenian Embassy in Washington, D.C. or the Consulate General in Los Angeles for the fee of USD 69. For further information on entry requirements, contact the Armenian Embassy at 2225 R Street NW, Washington, DC 20008, tel. (202) 319-1976 and (202) 319-2983; the Armenian Consulate General in Los Angeles at 50 N. La Cienega Blvd., Suite 210, Beverly Hills, CA 90211, tel. (310) 657-7320, or visit the Armenian Embassy’s web site at http://www.armeniaemb.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:
A cease-fire has been in effect since 1994 around the self-proclaimed “Republic of Nagorno-Karabakh,” an unrecognized ethnic Armenian enclave within Azerbaijan. However, intermittent gunfire along the cease-fire line and along the border with Azerbaijan continues. Because of the existing state of hostilities, consular services are not available to Americans in Nagorno-Karabakh. Travelers should exercise caution near the Armenia-Azerbaijan border and consult the Country Specific Information for Azerbaijan if considering travel to Nagorno-Karabakh from Armenian territory. Armenia's land borders with Turkey, Azerbaijan, and the Nakhichevan Autonomous Republic of Azerbaijan remain closed and continue to be patrolled by armed troops who stop all people attempting to cross. There are still land mines in numerous areas in and near the conflict zones.

Political rallies in the aftermath of the February 2008 presidential elections turned violent. Clashes between government security forces and opposition demonstrators resulted in dozens of casualties, including 10 fatalities, in early March 2008. While the opposition continued to hold periodic protests over the summer and early fall, there have been no violent confrontations since the March events.
Americans should be mindful that even demonstrations intended to be peaceful could turn confrontational and possibly escalate into violence. American citizens are urged to avoid the areas of demonstrations if possible, and to exercise caution if within the vicinity of any demonstrations.

Armenia is an earthquake- and landslide-prone country. In addition to these natural disasters, there exists the possibility of chlorine gas spills and radiation poisoning due to industrial accidents.
The Soviet-era Armenia Nuclear Power plant is located in Metsamor, approximately 30 kilometers southwest of Yerevan.
Armenia is currently under international pressure to close the plant permanently, due to safety concerns.

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

Up-to-date information on safety and security can also be obtained by calling 1-888-407-4747 toll free in the U.S. and Canada or for callers outside the U.S. and Canada, a regular toll-line at 1-202-501-4444. These numbers are available from 8:00 a.m. to 8:00 p.m. Eastern Time, Monday through Friday (except U.S. federal holidays).
The Department of State urges American citizens to take responsibility for their own personal security while traveling overseas. For general information about appropriate measures travelers can take to protect themselves in an overseas environment, see the Department of State’s A Safe Trip Abroad.

CRIME: Crime against foreigners is relatively rare in Armenia. Break-ins, particularly of vehicles, and theft are the most common crimes, but there have been instances of violent crime as well.
While the incidence of violent crime remains lower than in most U.S. cities, American citizens are urged to exercise caution and to avoid traveling alone after dark in Yerevan. Several American investors have also reported being involved in disputes over property ownership, and have had to seek legal recourse through a long, and in the majority of cases, unsuccessful court proceeding.
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 U.S. Embassy. If you are the victim of a crime while overseas, in addition to reporting to local police, please contact the nearest U.S. Embassy for assistance. The Embassy 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. For information on assistance in the U.S. including possible compensation, see our Victims of Crime.
The local equivalents to the “911” emergency line in Armenia are: 101 - fire emergency; 102 - police emergency; 103 - medical emergency; and 104 - gas leak.
MEDICAL FACILITIES AND HEALTH INFORMATION: Though there are many competent physicians in Armenia, medical care facilities are limited, especially outside the major cities. The U.S. Embassy maintains a list of English-speaking physicians in the area. Most prescription medications are available, but the quality varies. Elderly travelers and those with existing health problems may be at risk due to inadequate medical facilities.
The U.S. Department of State is unaware of any HIV/AIDS entry restrictions for visitors to or foreign residents of Armenia.

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 Armenia is provided for general reference only and may not be totally accurate in a particular location or circumstance.
Travel in Armenia requires caution. Public transportation, while very inexpensive, may be unreliable and uncomfortable. Travel at night is not recommended, and winter travel can be extremely hazardous in mountain areas and higher elevations.
Travelers should avoid the old highway between the towns of Ljevan and Noyemberyan in the Tavush region, as well as the main highway between the towns of Kirants and Baghanis/Voskevan. The U.S. Embassy has designated this portion of the road off-limits to all U.S. Government personnel because of its proximity to the cease-fire line between Armenian and Azerbaijani forces, a line which has seen numerous cease-fire violations over the years.

On weekends, there are an increased number of intoxicated drivers on Armenian roads. American citizens are urged to exercise particular vigilance while traveling on the main highway from Yerevan to the resort areas of Tsaghkadzor and Sevan. Traffic police will attempt to stop individuals driving erratically and dangerously, but police presence outside of Yerevan is limited.

Armenia does have emergency police and medical services, but they may take time to reach remote regions.
With the exception of a few major arteries, primary roads are frequently in poor repair, with sporadic stretches of missing pavement and large potholes. Some roads shown as primary roads on maps are unpaved and can narrow to one lane in width, while some newer road connections have not yet been marked on recently produced maps.
Secondary roads are normally in poor condition and are often unpaved and washed out in certain areas. Street and road signs are poor to nonexistent. Truck traffic is not heavy except on the main roads linking Yerevan to Iran and Georgia, i.e. the roads virtually all travelers need to use when traveling overland to those countries. Minibuses are considered more dangerous than other forms of public transportation. Travelers who choose to ride minibuses should exercise caution because these vehicles are often overcrowded and poorly maintained, commonly lack safety measures including seatbelts, and are frequently involved in accidents.

People driving in Armenia should be aware that “road rage” is becoming a serious and dangerous problem on Armenian streets and highways.
For safety reasons drivers are encouraged to yield to aggressive drivers.
Incidents of physical aggression against drivers and pedestrians have occurred

Though crime along roadways is rare, the police sometimes seek bribes during traffic stops. Drivers in Armenia frequently ignore traffic laws, making roadways unsafe for unsuspecting travelers.
Pedestrians often fail to take safety precautions and those driving in towns at night should be especially cautious. In cities, a pedestrian dressed in black crossing an unlit street in the middle of the block is a common occurrence.

The quality of gasoline in Armenia ranges from good at some of the more reliable stations in cities to very poor. The gasoline and other fuels sold out of jars, barrels, and trucks by independent roadside merchants should be considered very unreliable.

Please refer to our Road Safety page for more information.

AVIATION SAFETY OVERSIGHT:
As there is no direct commercial air service to the United States by carriers registered in Armenia, the U.S. Federal Aviation Administration (FAA) has not assessed Armenia’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.
Travelers on Armavia International Airways may experience prolonged delays and sudden cancellations of flights. Air travel to Armenia via European carriers is typically more reliable. Ticketed passengers on flights leaving Yerevan should reconfirm their reservations 24 hours prior to departure.
SPECIAL CIRCUMSTANCES:
Armenia remains largely a cash-only economy. Credit cards are accepted at some businesses, including major hotels and restaurants in Yerevan, but rarely outside of the capital. Limited facilities exist for cashing traveler's checks and wiring money into the country. There are a number of ATMs in the center of Yerevan. Dollars are readily exchanged at market rates. Travelers may experience problems with local officials seeking bribes to perform basic duties.

Armenian customs authorities may enforce strict regulations concerning temporary importation into or export from Armenia of items such as firearms, pornographic materials, medication, and communications equipment. For export of antiquities and other items that could have historical value, such as paintings, carpets, old books, or other artisan goods, a special authorization is required in advance from the Armenian Ministry of Culture. It is advisable to contact the Embassy of Armenia in Washington, DC or Consulate General in Los Angeles for specific information regarding customs requirements.

Please see our Customs Information.

Dual Nationals: Changes to Armenian legislation now permit Armenian citizens to hold dual citizenship. This means that U.S. citizens who emigrated from Armenia to the U.S. and subsequently acquired U.S. citizenship without explicitly giving up their Armenian citizenship may be able to (re)acquire Armenian citizenship along with all the associated rights and duties, e.g. the right to vote in Armenian elections and/or the duty for certain males to perform military service. The new law also means that dual citizens need to enter and leave Armenia on their Armenian passport, i.e. they would no longer need an Armenian visa. U.S. citizens interested in obtaining Armenian citizenship must register their dual citizenship with Passport and Visa Department of the Police of the Republic of Armenia (formerly OVIR) by simply presenting proof of their other citizenship (e.g. passport). For more information, please consult with Passport and Visa Department of the Police (tel.: +37410-501439) and/or http://www.armeniaforeignministry.am.

Compulsory Military Service: In addition to being subject to all Armenian laws affecting U.S. citizens, dual nationals are also subject to other laws that impose special obligations on Armenian citizens. Male U.S. citizens over the age of 18 who are also considered to be Armenian citizens may be subject to conscription and compulsory military service upon arrival, and to other aspects of Armenian law while in Armenia.
Armenian authorities have regularly detained U.S. citizens on these grounds upon their arrival in or departure from Armenia. In most cases, ethnic Armenian travelers who are accused of evading Armenian military service obligations are immediately detained and later found guilty of draft evasion. Penalties for those convicted are stiff and include jail time or a substantial fine. Those who may be affected are strongly advised to consult with Armenian officials and inquire at an Armenian embassy or consulate to their status before traveling. For additional information on dual nationality, see our dual nationality flyer.
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 offences. Persons violating Armenian laws, even unknowingly, may be expelled, arrested or imprisoned. Penalties for possession, use, or trafficking in illegal drugs in Armenia 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 Armenia 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 Armenia. Americans without Internet access may register directly with the nearest U.S. Embassy or Consulate. The American Citizen Services section of the U.S. Embassy in Yerevan maintains a computer terminal in the consular waiting room available to U.S. citizens for registration. The U.S. Embassy provides Internet access to the general public through the American Corners program and through the U.S. Embassy's Information Resource Center. American Corners are located in Yerevan (2 Amiryan Street, tel. +374-10-56-13-83), Gyumri (68 Shirakatsi Street, tel. +374-312-22153), Vanadzor (25, Vardanants Street, tel. +374-322-21672), and Kapan (6, Shahumyan Street, tel. +374-285-22151). By registering, American citizens make it easier for the Embassy or Consulate to contact them in case of emergency. The U.S. Embassy in Yerevan is located at 1 American Avenue, tel. +374-10-46-47-00 and fax: +374-10-46-47-42. The Consular Section is open from 9:00 a.m. until 5:00 p.m., with time reserved for American citizen services from 1:30 p.m. until 4:30 p.m., Monday through Friday, except for official U.S. Embassy holidays. For more information, see the Embassy's web site at http://yerevan.usembassy.gov/
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This replaces the Country Specific Information dated June 9, 2008 to update sections on Entry and Exit Requirements, Safety and Security, Traffic Safety and Road Conditions, and Special Circumstances.

Travel News Headlines WORLD NEWS

Date: Tue 20 Aug 2019, 4:29 PM
Source: Arka News Agency [edited]

Anthrax cases have been reported in Geghhovit community of Armenia's Gegharkunik province, the press office of Armenia's health ministry reported on [Tue 20 Aug 2019]. According to the ministry's press release, 2 residents of the community came to a medical centre in Martuni with sores on their fingers. The patients told doctors that they had taken part in butchering a cow of a fellow villager.

The health ministry has dispatched its experts to the community. As a result of joint efforts with local medical centres' workers, 6 other infected people have been found. All the patients are being treated now, and the community is under medical control now. The Armenian Food Safety Agency has been informed.
===================
[Gegharkunik province is on the eastern border of Armenia and pokes into Azerbaijan; see:
<http://legacy.lib.utexas.edu/maps/commonwealth/armenia_pol_2002.jpg>

Geghhovit is south of Sevana Lich (lake); see:

When the dust settled there were 2 initial cutaneous cases subsequent to them butchering a neighbour's cow, which would have been sick or dead. The first report suggests that they might have butchered a number of "cattle" carcasses, though the 2nd report has a single cow. And in due course another 6 villagers came down with cutaneous anthrax as they were sent to the local hospital merely for diagnostic confirmation.

Anthrax is sporadic in Armenia and thus the risks of butchering sick and dead animals are only realised after the onset of human anthrax lesions. And the number of human cases can exceed the indirectly reported livestock cases. - ProMED Mod.MHJ]

[HealthMap/ProMED map available at:
Date: Fri 8 Mar 2019
Source: Nouvelles Armeni Magazine [in French, trans. ProMED Corr SB, abridged, edited]

A 2nd case of measles infection was reported in Armenia on Wednesday [6 Mar 2019], the country's Ministry of Health press office reported. A person infected with this disease arrived on 20 Feb [2019] in Armenia through the territory of Georgia. Clinical symptoms became visible on 25 and 26 Feb [2019], which was initially explained as drug intolerance, but later, on 6 Mar [2019], a laboratory test diagnosed measles disease.

According to the Ministry of Health, the 1st measles infection was reportedly found in Armenia by a Ukrainian citizen who arrived in Yerevan by plane from Kiev on 24 Feb [2019].

The 2 infected people had contact with many people, particularly those in the airport lobby and at the hospital.
17th February 2019

- National. 14 Feb 2019. 57 cases of dengue in Armenia [have been] recorded to date; the figure increased in 2019 compared to the year 2018. The increase in records so far in 2019 is 25.
Date: Sun, 29 Jul 2018 12:23:52 +0200
By Mariam HARUTYUNYAN

Arinj, Armenia, July 29, 2018 (AFP) - When Tosya Gharibyan asked her husband to dig a basement under their house to store potatoes, she had little idea the underground labyrinth he would eventually produce would prove to be one of Armenia's major tourist draws.   Their one-storey house in the village of Arinj outside the capital Yerevan may not look like much but today it brings in visitors from all over the globe after a 23-year labour of love by Tosya's late husband, Levon Arakelyan.   They come to see a twisting network of subterranean caves and tunnels known as "Levon's divine underground."

In the cold and quiet, Tosya leads tourists through corridors that connect seven chambers adorned with Romanesque columns and ornaments like those on the facades of mediaeval Armenian churches.   "Once he started digging, it was impossible to stop him," she said of the project that began in 1995. "I wrangled with him a lot, but he became obsessed with his plan."   A builder by training, Levon would toil for 18 hours a day -- only pausing to take a quick nap and then rush back to the cave, confident that he was being guided "by heaven".   "He never drew up plans and used to tell us that he sees in his dreams what to do next," his widow told AFP.

Over more than two decades he hammered out the 280-square-metre (3,000 square-foot) space, 21 metres deep into strata of volcanic rocks -- only using hand tools.   "My primary childhood recollection is the loud knock of my father's hammer heard at night from the cave," said his 44-year-old daughter Araksya.   At the start he had to break through a surface layer of black basalt, but at the depth of a few metres Levon reached much softer tufa stone and the work progressed.   He pulled out 600 truckloads of rocks and earth, using only hand-held buckets.   Levon died in 2008 at the age of 67 from a heart attack after destroying the last wall that separated two tunnels.

- 'Amazing place' -
A decade on from the project's completion, Tosya also runs a small museum commemorating her husband's work in the village of some 6,000 people.   The underground complex has several analogues in the world.   An eccentric man named William Henry "Burro" Schmidt spent more than three decades digging a half-a-mile tunnel to transport gold through a granite mountain in California, beginning his work in the early 1900s during the state's gold rush.

In Ethiopia a man named Aba Defar began carving churches on a mountainside after claiming divine inspiration from years of dreams.   Today the Armenian cave features prominently in travel brochures, regularly drawing busloads of visitors.   Milad, a 29-year-old Iranian tourist, called the maze an "amazing place".   He said it made him realise just "how boundless the spiritual and physical capabilities of a person can be".
Date: Fri 18 May 2018
Source: Armenpress [edited]

The investigation into a foodborne incident in Armenia's Armavir province continues. The suspected cause -- food poisoning -- has been confirmed through lab tests. Salmonellosis has been discovered in all victims.

63 from the overall 88 victims of the food poisoning have already been treated and discharged. The healthcare ministry says they confirm that the cause was food poisoning. Earlier, the state service for food safety has dispatched agents to Armavir province to probe the suspected food poisoning incident in the plant of Tierras de Armenia, a viticulture and winemaker known for its Karas wines. Earlier, doctors said they suspected the cause of the poisoning to be a lunchtime snack, which all of the employees consumed in the cafeteria of the plant.

Agents have taken samples from the facility and sent them for laboratory analysis. Food safety agents also ceased the operation of a businesswoman's food supply business in relation to the incident as a precaution. The businesswoman, Alvina Melkonyan, supplied Tierras de Armenia with lunch-time food on the day when the incident happened. A company, who in turn is supplying Melkonyan, is also under investigation. All patients are in satisfactory states, doctors say.

The likely cause of the mass poisoning in Armavir province is thought to be lunch-time snacks containing chicken, cheese and potatoes, which the victims have consumed in the cafeteria of the plant, a doctor of the Armavir medical center told Armenpress. Earlier, it was unclear whether the poisoning was food-related.
======================
[The specific food is not yet stated, but chicken is a common vehicle, either undercooked or cross-contaminated after cooking. - ProMED Mod.LL]

[HealthMap/ProMED-mail map:
Armavir Province, Armenia: <http://healthmap.org/promed/p/46276>]
More ...

Bermuda

Bermuda US Consular Information Sheet
March 10, 2009
COUNTRY DESCRIPTION:
Bermuda is a highly developed British overseas territory with a stable democracy and modern economy. Tourist facilities are widely available. Read the Department of
tate Background Notes on Bermuda for additional information.

ENTRY/EXIT REQUIREMENTS:
Travelers may contact the British Consulate in New York, telephone (212) 745-0273/3206/0281, or the British Consulate in Atlanta, Boston, Chicago, Dallas, Los Angeles, or San Francisco or the Bermuda Department of Immigration.

All Americans traveling by air outside of 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 and have been in full production since July 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 and upcoming changes to U.S. passport policy can be found on the Bureau of Consular Affairs web site.
We strongly encourage all American citizen travelers to apply for a U.S. passport well in advance of anticipated travel.
American citizens can visit our web site or call 1-877-4USA-PPT (1-877-487-2778) for information on how to apply for their passports.

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:
For the latest security information, Americans traveling abroad should regularly monitor the Department of State, Bureau of Consular Affairs’ web site, 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:
Bermuda has a moderate but growing crime rate. Recent crime statistics can be viewed at the official web site of the Bermuda Police Service.
Examples of common crimes include theft of unattended baggage and items from rental motorbikes, purse snatching (often perpetrated against pedestrians by thieves riding motorbikes), mugging, and theft from hotel rooms. Valuables left in hotel rooms (occupied and unoccupied) or left unattended in public areas are vulnerable to theft. The Consulate regularly receives reports of thefts of money, valuables, and passports and advises that travelers keep their hotel windows and doors locked at all times. Criminals often target transportation systems and popular tourist attractions.

Travelers should exercise caution when walking after dark or visiting out-of-the-way places on the island, as they can be vulnerable to theft and sexual assault, and because narrow and dark roadways can contribute to accidents.
In the past, there have been incidents of sexual assault and acquaintance rape; the use of “date rape” drugs such as Rohypnol has been reported in the media and confirmed by local authorities. Travelers should also note an increase in gang presence in Bermuda and should take regular precautions to avoid confrontation. The back streets of Hamilton are often the setting for nighttime assaults, particularly after the bars close.

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.

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 Bermuda laws, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in Bermuda 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.

SPECIAL CIRCUMSTANCES:
The Department of State warns U.S. citizens against taking any type of firearm or ammunition into Bermuda.
Entering Bermuda with a firearm, some kinds of knives or even a single round of ammunition is illegal, even if the weapon or ammunition is taken into the country unintentionally.
The Bermudian government strictly enforces its laws restricting the entry of firearms and ammunition.
Permission to import or own a gun in Bermuda must be sought in advance from the Bermuda Police Service. Any privately owned firearms must be secured at Bermuda Police Headquarters. Violations may result in arrests, convictions, and long prison sentences.

ATMs are widely available in Bermuda. Local banks may not accept checks drawn on U.S. accounts, but some Front Street stores catering to the tourist trade will accept U.S. checks as payment. The local American Express office will cash U.S. checks up to $500.00 for a three-percent fee. Credit cards are widely accepted at all establishments.
U.S. citizens who are taking prescription medication must inform Bermuda customs officials at the point of entry. Medicines must be in labeled containers. Travelers should carry a copy of the written prescription and a letter from the physician or pharmacist confirming the reason the medicine is prescribed.

Bermuda customs authorities may enforce strict regulations concerning temporary importation into or export from Bermuda of items such as animals, arms, ammunition and explosives, building sand, crushed rock, gravel, peat and synthetic potting media, foodstuffs (animal origin), fumigating substances, gaming machines, historic articles (relating to Bermuda), lottery advertisements and material, motorcycles, motor vehicles, obscene publications, organotin anti-fouling paint, plants, plant material, fruits and vegetables (living or dead, including seeds), pesticides, prescription drugs, prohibited publications, seditious publications, soil, VHF radios, radar and citizens band (CB) radios. For additional information on temporary admission, export and customs regulations and tariffs, please contact Bermuda Customs at telephone 1-441-295-4816, by email, or visit the Bermuda Customs web site.

The emergency number in Bermuda for police, fire, and medical assistance is 911.
Please see our Customs Information.

MEDICAL FACILITIES AND HEALTH INFORMATION:. Good medical care is available, though extremely expensive. The hospital performs general surgery and has an intensive care unit. Serious or complex medical problems will likely require medical evacuation to the United States. Most Bermudian health care providers (including the local hospitals) do not accept overseas insurance and will expect payment at the time of service.

The U.S. Department of State is unaware of any HIV/AIDS entry restrictions for visitors to or foreign residents of Bermuda.
However, visitors with visible indicators of any communicable disease can be refused entry into Bermuda.
Foreign residents who test positive for TB are required to submit x-rays before approval is granted for them to reside in Bermuda.

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.
For information about outbreaks of infectious diseases abroad, consult the World Health Organization’s (WHO) web site.
Further health information for travelers is available from the WHO.

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 Bermuda is provided for general reference only, and may not be totally accurate in a particular location or circumstance.

Traffic in Bermuda moves on the left side of the road and the roads are very narrow, often with no defined shoulder. The maximum speed limit in the city of Hamilton is 25 kph (15 mph) and 35 kph (21 mph) on the rest of the island. Under Bermudian law, non-residents are not allowed to own, rent, or drive four-wheeled vehicles. Non-residents must rely on taxis, the excellent local bus system, or motor scooters. Traffic is moderate, but road accidents - particularly involving motorbikes - are common and often result in serious injuries or death.

Rental motor scooters are readily available, and the required helmet is provided. However, visitors should carefully consider whether or not it is worth the risk to ride a scooter. Motor scooters provide the greatest road peril in Bermuda; local operators tend to abuse the speed limit more than other drivers, and they will often pass on the left or right with no warning. Those unfamiliar with driving on the left are likely to find the roundabouts and regulations for yielding at junctions confusing and dangerous. In addition, vehicles often stop on the side of the road, blocking one lane of traffic. Main roads, while generally in good condition, are extremely narrow and tend to be bordered by heavy vegetation or low stone walls. Travelers who rent scooters should be aware that scooter accidents involving visitors are relatively common, and they can be fatal or involve serious injuries.

Taxis are readily available. The local bus system, which is excellent and relatively inexpensive, services the length of the island and stops close to most beaches, hotels, the downtown shopping area, and other points of interest. In addition, water ferry service to a variety of stops around the island is available seven days a week, and is a very safe and enjoyable mode of transportation.

For specific information concerning Bermuda driver's permits, vehicle inspection, road tax and mandatory insurance, please contact the Bermuda Department of Tourism offices at 310 Madison Avenue, Suite 201, New York, NY, telephone (212) 818-9800.

Please refer to our Road Safety page for more information.
You may also visit Bermuda’s Ministry of Tourism and Transportation online.

Emergency services may be called at 911, and response time is generally good.
AVIATION SAFETY OVERSIGHT:
The U.S. Federal Aviation Administration (FAA) has assessed the Government of Bermuda’s Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for oversight of Bermuda’s air carrier operations.

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 Bermuda 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 Bermuda.
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. Consulate General is located at Crown Hill, 16 Middle Road, Devonshire DV03, and telephone 1-441-295-1342. Office hours for American Citizens Services are 1:30-3:30 Monday-Wednesday and 8:30-10:30 on Thursdays, except Bermudian and U.S. holidays. American citizens in need of after-hours emergency assistance may call the duty officer at telephone 1-441-335-3828. The Consulate General’s American Citizen Services office provides routine information online.
* * *
This replaces the Country Specific Information for Bermuda dated 23 June 2008, to update sections on entry/exit requirements, crime, information for victims of crime, special circumstances and medical facilities & health information.

Travel News Headlines WORLD NEWS

Date: Wed, 18 Sep 2019 03:56:31 +0200 (METDST)

Washington, Sept 18, 2019 (AFP) - Hurricane Humberto strengthened to a major Category 3 storm on Tuesday and was expected to pass near Bermuda, threatening it with dangerous waves and heavy rain, the US National Hurricane Center said.   "Hurricane conditions are expected to reach Bermuda by Wednesday night and continue into early Thursday morning," the Miami-based NHC said.   "Some fluctuations in intensity are likely during the next day or so, but Humberto should remain a powerful hurricane through Thursday," it said.   As of 8:00 pm (0000 GMT), the storm had maximum sustained winds of 115 miles per hour (185 kilometers per hour) and was moving east-northeast at 12 miles per hour.
Date: Thu, 16 Oct 2014 15:04:20 +0200 (METDST)

WASHINGTON, Oct 16, 2014 (AFP) - Hurricane Gonzalo gained strength overnight into Thursday as it barrelled in the Atlantic toward Bermuda, which was bracing for a hit from the powerful Category Four storm.   Gonzalo's winds were whirling at 140 miles (220 kilometres) per hour, taking it back up a notch on the five-point Saffir-Simpson scale, The US National Hurricane Center said.    It was expected to pass Friday near Bermuda, which could see flooding along the coast. A hurricane warning was in effect for the British overseas territory.

At 1200 GMT, it was located about 525 miles (225 kilometres) south-southwest of the Bermudian archipelago. It was moving north at nine miles per hour, according to the Miami-based NHC.   "This general motion is expected to continue today," the NHC said.   "A turn toward the north-northeast and an increase in forward speed are expected tonight and Friday."   But the forecasters stressed that major hurricanes like Gonzalo tend to fluctuate in strength.    The storm could weaken later Thursday and on Friday, but Gonzalo is on track to be a "dangerous hurricane" when it moves near Bermuda, the NHC said.

The NHC noted that elevated and hilly terrain could face especially strong winds, since wind speeds atop and on the windward sides can often be up to 30 percent stronger than at the surface.   "A dangerous storm surge is expected to produce significant coastal flooding in Bermuda," the NHC said.   "Near the coast, the surge will be accompanied by large and destructive waves."   Up to six inches (15 centimetres) of rain were expected over Bermuda.   Large swells triggered by Gonzalo were already affecting parts of the Virgin Islands, the northern coast of Puerto Rico and the Dominican Republic, as well as portions of the Bahamas.

Swells were expected to reach much of the US East Coast and Bermuda later Thursday.   "These swells are likely to cause life-threatening surf and rip current conditions," the NHC said.   Three people were reported missing in the islands of St Martin and St Barthelemy after the storm passed, and French authorities expressed concern about four other people they were trying to contact.   The storm caused property damage on both islands, which were battered by strong winds and heavy rains.

- Seventh storm of the season -
Gonzalo is the seventh storm of the Atlantic season -- which stretches from June to November -- and the third hurricane to slam the Caribbean this year.    Hurricane Cristobal left at least four people dead in late August when it trashed the Bahamas, Turks and Caicos Islands and Dominican Republic with heavy rains causing serious flooding.     The NHC predicted that storm activity will be lower than average this year.
Date: Wed, 27 Aug 2014 01:09:20 +0200 (METDST)

MIAMI, Aug 26, 2014 (AFP) - Strengthening Hurricane Cristobal killed at least four people in the Caribbean and then trained its deadly sights Tuesday on the holiday paradise of Bermuda, officials and meteorologists said.   The storm dumped torrential rain on the Bahamas, Turks and Caicos Islands and Dominican Republic, triggering flooding and killing four people, authorities there said.

Cristobal was packing maximum sustained winds of 75 miles (120 kilometres) per hour, the Miami-based National Hurricane Center (NHC) said in its latest forecast, at 2100 GMT.   It was moving north towards Bermuda at 10 miles per hour, the NHC said, warning its impact was also being felt in the United States.   "The centre of Cristobal is expected to pass northwest of Bermuda on Wednesday and Wednesday night," the NHC said.   It added: "Swells generated by Cristobal are affecting portions of the United States coast from central Florida northward to North Carolina and will spread northwards later this week."

A tropical storm watch was already in effect for Bermuda, forecasters said, meaning inclement conditions were possible in the next 24 hours.   Cristobal, a category one hurricane, is the third hurricane of the Atlantic storm season.   It comes hot on the heels of Hurricane Marie, which briefly reached the highest possible category five destructive power but was weakening in the Pacific off Mexico.   Marie's crashing waves over the weekend caused a fishing vessel to capsize, with three of its occupants still missing and presumed dead.
Date: Tue, 26 Aug 2014 10:34:53 +0200 (METDST)

WASHINGTON, Aug 26, 2014 (AFP) - Hurricane Cristobal churned slowly toward Bermuda on Tuesday after dumping rain on the Bahamas and the Turks and Caicos Islands, US forecasters said.   The storm was due to pass west and north of Bermuda on Wednesday, the US National Hurricane Center said.   Cristobal was packing maximum sustained winds of 75 miles (120 kilometre) per hour as it whirled some 655 miles southwest of Bermuda.

A turn to the northeast with a gradual increase in forward speed is forecast to occur over the next 48 hours, an NHC bulletin said.   A tropical storm watch was in effect for Bermuda.   Meanwhile, Hurricane Marie was pounding heavy waves into Mexico's Pacific coast, where three fishermen went missing after their boat capsized.   An estimated 10,000 families were affected by the storm as it flooded homes, damaged roads and caused rivers to overflow their banks.   The storm weakened to a category three hurricane on the five-point Saffir-Simpson scale late Monday.   No coastal watches or warnings were in effect.
Date: Wed, 11 Sep 2013 00:14:11 +0200 (METDST)

MIAMI, Florida, Sept 10, 2013 (AFP) - Bermuda braced Tuesday for Tropical Storm Gabrielle, as US forecasters warned it was strengthening and on track to hit or closely pass by the popular vacation spot.   Meanwhile, fellow Tropical Storm Humberto, churning far off land in the Atlantic, appeared on the cusp of becoming a hurricane.

Packing maximum sustained winds near 70 miles per hour (110 kilometers per hour), Humberto was about 245 miles (400 kilometers) west of the southernmost Cape Verde Islands, the National Hurricane Center said.   "Humberto (is) almost a hurricane," it said in a 2100 GMT advisory, adding the storm could surge to hurricane force either later Tuesday or Wednesday.   However, no coastal watches or warnings were in effect.

Gabrielle, with maximum sustained winds near 60 miles per hour (96 km/h), was some 55 miles (88.5 km) south of Bermuda, according to a separate 2100 GMT advisory from the Miami-based center.   "Gabrielle is expected to pass over or near Bermuda in the next few hours," the forecasters said.   Winds have already picked up on Bermuda as Gabrielle -- which could strengthen further over the next 48 hours -- approaches, they added.    A tropical storm warning was in effect for the tourist haven, which could see up to six inches (15 centimeters) of rainfall and storm surges of two to three feet (0.6 to 0.9 meters) above normal.
More ...

Costa Rica

Costa Rica - US Consular Information Sheet
June 05, 2008
COUNTRY DESCRIPTION:
Costa Rica is a middle-income, developing country with a strong democratic tradition.
Tourist facilities are extensive and generally adequate.
The capi
al is San Jose.
English is a second language for many Costa Ricans.
Read the Department of State Background Notes on Costa Rica for additional information.

ENTRY/EXIT REQUIREMENTS:
For entry into Costa Rica, U.S. citizens must present valid passports that will not expire for at least thirty days after arrival, and a roundtrip/outbound ticket.
Some U.S. airlines may not permit passengers to board flights to Costa Rica without such a ticket.
Passports should be in good condition; Costa Rican immigration will deny entry if the passport is damaged in any way.
Costa Rican authorities generally permit U.S. citizens to stay up to ninety days; to stay beyond the period granted, travelers must submit an application for an extension to the Office of Temporary Permits in the Costa Rican Department of Immigration.
Tourist visas are usually not extended except under special circumstances, and extension requests are evaluated on a case-by-case basis.
There is a departure tax for short-term visitors.
Tourists who stay over ninety days may experience a delay at the airport when departing.
Persons who overstayed previously may be denied entry to Costa Rica.
Persons traveling to Costa Rica from some countries in South America and Sub-Saharan Africa must provide evidence of a valid yellow fever vaccination prior to entry.
The South American countries include Bolivia, Brazil, Colombia, Ecuador and Venezuela.
See “SPECIAL CIRCUMSTANCES” for information on requirements to carry documentation within Costa Rica and on travel by dual national minors.


The most authoritative and up-to-date information on Costa Rican entry and exit requirements may be obtained from the Consular Section of the Embassy of Costa Rica at 2114 “S” Street NW, Washington, DC 20008, telephone (202) 234-2945/46 , fax (202) 265-4795 , e-mail consulate@costarica-embassy.org, web site http://www.costarica-embassy.org, or from the Costa Rican consulates in Atlanta, Chicago, Houston, Los Angeles, Miami, New Orleans, New York, San Juan (Puerto Rico), San Francisco, and Tampa.
The Costa Rican immigration agency web site is http://www.migracion.go.cr.
It is advisable to contact the Embassy of Costa Rica in Washington or one of Costa Rica's consulates in the United States for specific information regarding customs requirements before shipping any items.
Visit the Embassy of Costa Rica web site at http://www.costarica-embassy.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:
There have been no recent acts of terrorism in Costa Rica.
Visitors to Costa Rica may experience the effects of civil disturbances such as work stoppages and strikes.
Although infrequent, these acts can create inconveniences for visitors.
On both the Caribbean and Pacific coasts, currents are swift and dangerous, and there are few lifeguards or signs warning of dangerous beaches.
Every year eight to twelve American citizens drown in Costa Rica due to riptides or sudden drop-offs while in shallow water.
Extreme caution is advised.

Adventure tourism is popular in Costa Rica, and many companies offer white-water rafting, bungee jumping, jungle canopy tours, deep sea diving, and other outdoor attractions.
Americans are urged to use caution in selecting adventure tourism companies.
The government of Costa Rica regulates and monitors the safety of adventure tourism companies; enforcement of safety laws is overseen by the Ministry of Health.
Registered tourism companies with operating permits must meet safety standards and have insurance coverage.
The safety regulations enforced in Costa Rica are not the same as safety regulations enforced in the United States.

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

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

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

CRIME:
Over one and a half million foreign tourists, the majority American, visit Costa Rica annually.
All are potential targets for criminals, primarily thieves looking for cash, jewelry, credit cards, electronic items and passports.
U.S. citizens are encouraged to exercise the same level of caution they would in major cities or tourist areas throughout the world.
Local law enforcement agencies have limited capabilities and do not act according to U.S. standards.
Travelers should minimize driving at night, especially outside urban areas.

Americans should avoid areas with high concentrations of bars and nightclubs, especially at night, and steer clear of deserted properties or undeveloped land.
For safety reasons, the Embassy does not place its official visitors in hotels in the San Jose city center, but instead puts them at the larger hotels in the outlying suburbs.
Americans should walk or exercise with a companion, bearing in mind that crowded tourist attractions and resort areas popular with foreign tourists are common venues for criminal activities.
Travelers should ignore any verbal harassment, and avoid carrying passports, large amounts of cash, jewelry or expensive photographic equipment.
Tourists are encouraged to carry photocopies of the passport data page and Costa Rican entry stamp on their persons, and leave the original passport in a hotel safe or other secure place.
Costa Rican immigration authorities conduct routine immigration checks at locations, such as bars in downtown San Jose and beach communities, frequented by illegal immigrants.
American citizens detained during one of these checks who have only a copy of the passport will be required to provide the original passport with appropriate stamps.



Travelers should purchase an adequate level of locally valid theft insurance when renting vehicles, park in secured lots whenever possible, and never leave valuables in the vehicle.
The U.S. Embassy receives several reports daily of valuables, identity documents, and other items stolen from locked vehicles, primarily rental cars.
Thefts from parked cars occur in downtown San Jose, at beaches, in the airport and bus station parking lots, and at national parks and other tourist attractions.
Travelers should use licensed taxis, which are red with medallions (yellow triangles containing numbers) painted on the side.
Licensed taxis at the airport are painted orange.
All licensed taxis should have working door handles, locks, seatbelts and meters (called "marias"); passengers are required to use seatbelts.
When traveling by bus, avoid putting bags or other personal belongings in the storage bins.
At all times have your belongings in your line of sight or in your possession.

Thieves usually work in groups of two to four.
A common scam has one person drop change in a crowded area, such as on a bus, and when the victim tries to assist, a wallet or other item is taken.
The most prevalent
scam involves the surreptitious puncturing of tires of rental cars, often near restaurants, tourist attractions, airports, or close to the car rental agencies themselves.
When the travelers pull over, "good Samaritans" quickly appear to change the tire - and just as quickly remove valuables from the car, sometimes brandishing weapons.
Drivers with flat tires are advised to drive, if at all possible, to the nearest service station or other public area, and change the tire themselves, watching valuables at all times.
In late 2006, the government of Costa Rica established a Tourist Police force, and units were established in popular tourist areas throughout the country.
The Tourist Police can assist with the reporting of a crime, which can be difficult for victims due to language barriers and the requirement that only investigative police can accept crime reports.

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:
Medical care in San Jose is adequate, but is limited in areas outside of San Jose.
Most prescription and over-the-counter medications are available throughout Costa Rica.
Doctors and hospitals often expect immediate cash payment for health services, and U.S. medical insurance is not always valid outside the United States.
A list of local doctors and medical facilities can be found at the website of the U.S. Embassy in San Jose, at http://sanjose.usembassy.gov.
An ambulance may be summoned by calling 911.
Most ambulances provide transportation but little or no medical assistance.
The best-equipped ambulances are called “unidad avanzada.”
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 Costa Rica is provided for general reference only, and may not be totally accurate in a particular location or circumstance.

Costa Rica has one of the highest vehicle accident rates in the world.
The fatality rate for pedestrians and those riding bicycles and motorcycles is disproportionately high.
Traffic laws and speed limits are often ignored, turns across one or two lanes of traffic are common, turn signals are rarely used, passing on dangerous stretches of highway is common, and pedestrians are not given the right of way.
Roads are often in poor condition, and large potholes with the potential to cause significant damage to vehicles are common.
Pedestrians, cyclists, and farm animals may use the main roads.
Traffic signs, even on major highways, are inadequate and few roads are lined.
Shoulders are narrow or consist of drainage ditches.
All of the above, in addition to poor visibility due to heavy fog or rain, makes driving at night especially treacherous.
Landslides are common in the rainy season.
All types of motor vehicles are appropriate for the main highways and principal roads in the major cities.
However, some roads to beaches and other rural locations are not paved, and many destinations are accessible only with high clearance, rugged suspension four-wheel drive vehicles.
Travelers are advised to call ahead to their hotels to ask about the current status of access roads.
Costa Rica has a 911 system for reporting emergencies.
In the event of a traffic accident, vehicles must/must be left where they are.
Both the Transito (Traffic Police) and the Insurance Investigator must make accident reports before the vehicles are moved.

Please refer to our Road Safety page for more information.
Visit the website of Costa Rica’s national tourist office and national authority responsible for road safety at http://www.mopt.go.cr and www.visitecostarica.com.

AVIATION SAFETY OVERSIGHT:
The U.S. Federal Aviation Administration (FAA) has assessed the Government of Costa Rica’s Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for oversight of Costa Rica’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:
Land Ownership and Shoreline Property: U.S. citizens are urged to use caution when making real estate purchases, and consult reputable legal counsel and investigate thoroughly all aspects before entering into a contract.
Coastal land within fifty meters of the high tide line is open to the public and therefore closed to development, and construction on the next one hundred fifty meters inland is possible only with the approval of the local municipality.

Squatters: Organized squatter groups have invaded properties in various parts of the country.
These squatter groups, often supported by politically active persons and non-governmental organizations, take advantage of legal provisions that allow people without land to gain title to unused agricultural property.
Local courts may show considerable sympathy for the squatters.
Victims of squatters have reported threats, harassment, and violence.
Documentation Requirements: Visitors are required to carry appropriate documentation at all times.
However, due to the high incidence of passport theft, tourists are permitted and encouraged to carry photocopies of the datapage and entry stamp from the passport, leaving the passport in a hotel safe or other secure place.
However, as noted under CRIME, Costa Rican immigration authorities conduct routine checks for illegal immigrants, especially in bars located in downtown San Jose and in beach communities.
An American citizen detained during one of these checks and carrying only the copy of the passport will be required to produce the original passport.
Tourists should consider carrying their passports when traveling overnight or a considerable distance from their hotel.
Tourists who carry passports are urged to place them securely in an inside pocket.

Exit Procedures for Costa Rican Citizens: Costa Rican children may only depart the country upon presentation of an exit permit issued by immigration authorities.
This policy, designed to prevent international child abduction, applies to dual national U.S./Costa Rican citizens.
Parents of minors who obtained Costa Rican citizenship through a parent or through birth in Costa Rica are advised to consult with appropriate Costa Rican authorities prior to travel to Costa Rica, especially if one (or both) parent(s) is not accompanying the child.



Disaster Preparedness: Costa Rica is located in an earthquake and volcanic zone.
Serious flooding occurs annually on the Caribbean side near the port city of Limon, but flooding occurs in other parts of Costa Rica as well, depending on the time of year and rainfall.
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/.

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 Costa Rica’s laws, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in Costa Rica 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 Costa Rica 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 Costa Rica.
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 in Pavas, San Jose, and may be reached at (506) 2519-2000; the extension for the Consular Section is 2453.
The Embassy is open Monday through Friday, and is closed on Costa Rican and U.S. holidays.
Those seeking information are strongly encouraged to utilize the embassy web site http://sanjose.usembassy.gov/, and can email consularsanjose@state.gov with any questions/concerns.
For emergencies arising outside normal business hours, U.S. citizens may call (506) 2220-3127 and ask for the duty officer.
*

*

*
This replaces the Country Specific Information for Costa Rica dated August 15, 2007, to update sections on Registration/Embassy Location and Special Circumstances.

Travel News Headlines WORLD NEWS

Date: Tue 21 Jan 2020
Source: Ahora Noticias, Costa Rica [in Spanish, machine trans., edited]
<https://www.ahoranoticiascr.com/2020/01/21/autoridades-cerraron-pizzeria-debido-a-casos-de-hepatitis-a-en-san-ramon/>

As many as 22 people suffered from hepatitis A infection in San Ramon de Alajuela, and consequently the Health authorities closed a pizzeria in the area. A source close to this media confirmed the existence of the cases which were detected since 13 Jan 2020.

The cases were thought to be related to food consumption in that establishment 4 of patients were employees of the pizzeria. In statements to the media La Nación, Azalea Espinoza of the Directorate of Surveillance of the Ministry of Health, said they intervened in the business, issued a closing health order, and proceeded to cleaning and disinfecting it. [Byline: Carlos Miranda]
========================
[Although the eating establishment was identified as a pizzeria, pizza itself is not likely to be the vehicle of transmission as it is cooked before serving unless ingredients are added after the cooking process. It is unclear if the pizzeria employees were the source of, or just part of, the outbreak.

With an incubation period averaging 28 but up to 45 days, more cases may occur. The cases are not broken down in regard to age. In children, most cases of HAV infection are subclinical so it is likely that the cases reported were in adults. In the developing world, HAV is not reported much in adults as most children have been infected, and therefore immune to subsequent infection, by the age of 10. That outbreaks are occurring in the area suggests improvement in potable water so fewer children are infected and therefore still susceptible to HAV as adults. - ProMED Mod.LL]

[HealthMap/ProMED map available at: Costa Rica:
<http://healthmap.org/promed/p/17>]
Date: Wed, 8 Jan 2020 02:28:38 +0100 (MET)

San José, Jan 8, 2020 (AFP) - Costa Rica on Tuesday vehemently objected to the US government's decision to raise the alert level for tourists visiting the Central American country due to the risk of crime.   "We express energetic protest on the part of the Costa Rican government for the decision to change the recommendation level for American tourists," said foreign minister Manuel Ventura.

Ventura's statement came shortly after the US government issued a new travel advisory for visitors to Costa Rica.   According to the alert, "petty crime is the predominant threat for tourists in Costa Rica."   But the advisory warns that "armed robbery, homicide and sexual assault" could also occur.   Costa Rica also rose from Level 1, the lowest level, to Level 2 on he US State Department's travel alert scale. The highest is Level 4, which recommends no visiting.

The Central American country, known for its natural resources and beaches, attracts 1.2 million US tourists each year, according to official figures. In 2019, a total of more than 3 million foreign tourists visited.   "The change is surprising, because it puts Costa Rica -- which ended 2019 with a rate of 11 homicides per 100,000 inhabitants -- on par with countries on the continent that are among the most violent in the world," the Costa Rican foreign ministry said in a statement.

Data from the Ministry of Public Service indicates that there were 688 cases of theft of mobile phones, passports and money from tourists in 2019 -- only 0.02 percent of visitors to Costa Rica.   Tourism in Costa Rica has been shaken in recent years by several murders of female tourists, as well as sexual violence, including a Venezuelan-American woman who was killed near her hotel outside of the capital San Jose.
Date: Thu 8 Jan 2020
Source: Outbreak News Today [edited]

The Costa Rica Ministry of Health reported [Tue 7 Jan 2019] (computer translated) on the 2nd ever _Naegleria fowleri_, or "brain-eating amoeba" infection in their history.

The case is a 15-year-old who is presenting with a clinical picture of primary amebic meningoencephalitis (PAM) remains in a serious state at the Liberia Hospital. The investigation into the case shows the young man acquired the amoeba by inhaling water in the thermal springs of Guayabo de Bagaces.

The 1st case of primary amebic meningoencephalitis in the history of Costa Rica was recorded in 2014 in an American child who later died.

_Naegleria fowleri_ is a microscopic amoeba which is a single-celled living organism. It can cause a rare and devastating infection of the brain called primary amebic meningoencephalitis (PAM). The amoeba is commonly found in warm freshwater such as lakes, rivers, ponds and canals.

Infections can happen when contaminated water enters the body through the nose. Once the amoeba enters the nose, it travels to the brain where it causes PAM (which destroys brain tissue) and is usually fatal. Infections usually occur when it is hot for prolonged periods of time, which results in higher water temperatures and lower water levels.  _Naegleria fowleri_ infections are rare. Most infections occur from exposure to contaminated recreational water. Cases due to the use of neti pots and the practice of ablution have been documented.

[Byline: Robert Herriman]
=======================
[Amoebic meningoencephalitis is rare but is found worldwide and the reservoir is fresh water sources like lakes and rivers. It has been discussed if it is found in household water supplies, but so far cases have not been linked to tap water although it is possible in theory. - ProMED Mod.EP]

[HealthMap/ProMED map available at:
Date: Fri 25 Oct 2019
From: Donald J. Brightsmith <dbrightsmith@cvm.tamu.edu> [edited]

There have been 37 cases of autochthonous transmission of malaria in 2019 as reported by the Costa Rican Ministry of Health (<https://www.ministeriodesalud.go.cr/index.php/vigilancia-de-la-salud/analisis-de-situacion-de-salud>). The ministry also reports 39 cases of malaria in country that were likely contracted in foreign countries, mostly in Nicaragua.

The autochthonous cases came mostly from the northern part of the country in the district of Crucitas, but cases were also reported from other areas of the country.
---------------------------------------------------
Donald J. Brightsmith
University College of Veterinary Medicine & Biomedical Sciences
Texas A&M University
College Station, TX
=============================
[ProMed thanks Dr. Donald J. Brightsmith for communicating this to us.

This is a comment from the WHO website, "Costa Rica: 'Ripe' for malaria elimination?"

"Costa Rica is one of 21 countries identified by WHO as having the potential to eliminate malaria by 2020. Its success in bringing down cases of indigenous malaria -- that is, transmission of the malaria parasite within a country's own borders -- has been commendable, so much so that it has received an award from the Pan American Health Organization in recognition of the strides made. Notably, no one has died from malaria since 2009.

"However, after recording 3 consecutive years of zero indigenous cases between 2013 and 2015, local transmission of the disease has slowly been creeping upwards: 4 cases in 2016 and 12 in 2017. Of equal concern is imported malaria: To date, 21 such cases have been detected in 2018, up from 5 for all of 2017.

"In June 2018, the Costa Rican Ministry of Health issued a public health alert following the reporting of 10 imported malaria cases in just one week in the country's northern region bordering malaria-endemic Nicaragua. The Ministry is working to quickly identify and treat imported cases to prevent onward transmission to local communities in high-risk zones of the country. The areas of concern are mainly agricultural sites, like banana plantations.

"One such area is the canton of Matina, home to some of Costa Rica's largest plantations that grow the yellow fruit. Situated next to a major port on the Caribbean Sea, the canton's agricultural produce is shipped to markets worldwide, making Matina an important economic hub.

"Although Matina is far from the area of the recent alert, and no cases of malaria have been reported this year, all 4 indigenous cases reported in 2016 originated from the canton, as well as 2 of the 12 indigenous cases in 2017. Health authorities are not taking any chances and are working with the canton's fincas bananeras (banana plantations) to step up malaria surveillance activities, particularly among plantation workers and nearby communities." - ProMED Mod.EP]

[HealthMap/ProMED-mail map:
Date: Sun, 21 Jul 2019 00:04:32 +0200

San José, July 20, 2019 (AFP) - Alcohol tainted with potentially toxic levels of methanol has killed 19 people in Costa Rica, where authorities issued an alert against drinking some half-dozen brands.   The Ministry of Health issued the national warning Friday while also updating the death toll.   Of 34 people who have been poisoned, 14 men and five women, age 32 to 72, have died since the first week of June, the ministry said.   Authorities warned that it was not known how much alcohol had been adulterated, but have confiscated some 30,000 bottles and are carrying out a countrywide investigation.

The doctored alcohol contained between 30 to 50 percent methanol, according to Donald Corella, head of emergency services at Calderon Guardia Hospital in San Jose, who was quoted in the daily La Nacion.   He said six people who were treated at his hospital had died, while four others survived but suffered "very serious after-effects" ranging from irreversible total blindness to brain lesions that cause tremors similar to Parkinson's disease.   If ingested in large quantities, methanol can cause blindness, liver damage and death.   According to authorities, the majority of the 19 deaths occurred among homeless and alcoholic individuals.
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Grenada

Grenada US Consular Information Sheet
March 30, 2007
COUNTRY DESCRIPTION:
Grenada is a developing Caribbean island nation.
The capital is St. George’s. Tourism facilities vary, according to price and area. Read the Department of Sta
e Background Notes on Grenada for additional information.
ENTRY/EXIT REQUIREMENTS: Although Grenada has its own entry requirements, the Intelligence Reform and Terrorism Prevention Act of 2004 requires all U.S. citizen travelers to and from the Caribbean to have a valid, unexpired passport to depart or enter the United States by air. Effective January 23, 2007, U.S. citizens, including infants and children, must have a valid, unexpired U.S. passport, or a “passport card” (which is now under development) when departing or entering the U.S. by air.
IMPORTANT NEW INFORMATION:The new passport requirement will be extended to all land border crossings as well as sea travel no later than June 1, 2009.
We strongly encourage all American citizen travelers to apply for a U.S. passport or “passport card” 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. Until the passport requirement is in place for sea travel, U.S. citizens traveling by ship to Grenada may refer to our Foreign Entry Requirements brochure for documentation that is acceptable for travel to and from Grenada.
There is no visa requirement for stays up to three months. There is an airport departure fee of US$20 for adults and US$10 for children between the ages of five and twelve.
See our Foreign Entry Requirements brochure for more information on Grenada and other countries.

For additional information concerning entry/exit requirements, travelers may contact the Embassy of Grenada, 1701 New Hampshire Avenue, N.W., Washington, D.C. 20009, telephone: (202) 265-2561, Fax: (202) 265-2468: e-mail: grenada@oas.org, or the Consulate of Grenada in New York.
Read our information on dual Nationality and the prevention of international child abduction. Also, please see our Customs Information.
SAFETY AND SECURITY:
For the latest security information, Americans traveling abroad should regularly monitor the Department’s Internet web site, where the current Worldwide Caution Public Announcement, Travel Warnings and Public Announcements 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:
Street crime occurs in Grenada.
Tourists have been victims of armed robbery especially in isolated areas and thieves frequently steal credit cards, jewelry, U.S. passports and money.
Mugging, purse snatching and other robberies may occur in areas near hotels, beaches and restaurants, particularly after dark.
Visitors should exercise appropriate caution when walking after dark or when using the local bus system or taxis hired on the road.
It is advisable to hire taxis to and from restaurants.
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:
Medical care is limited.
U.S. citizens requiring medical treatment may contact the U.S Embassy in St. George’s for a list of local doctors, dentists, pharmacies and hospitals.
Serious medical problems requiring hospitalization and/or medical evacuation to the U.S. can cost thousands of dollars.
Doctors and hospitals often expect immediate cash payment for health services.
Pharmacies are usually well stocked, and prescription medicine is available, but travelers are advised to bring with them sufficient prescription medicine for the length of their stay as occasionally there are temporary shortages of medicines; most pharmacies will check with others in the area to see if they can get what is needed.

Grenada chlorinates its water, making it generally safe to drink.
However, during especially heavy rains, quality control can slip, particularly in the city of St. George’s.
It is recommended that visitors to Grenada request bottled water, which is widely available and relatively inexpensive.
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 Internet site at http://www.cdc.gov/travel.
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.
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 Grenada is provided for general reference only, and may not be totally accurate in a particular location or circumstance.
Traffic moves on the left in Grenada; the majority of vehicles are right hand drive. Grenada’s roads, paved and unpaved, are mostly narrow and winding, with many blind corners and narrow or no shoulders.
Road surfaces often deteriorate; especially in the rainy season (June –November) before maintenance work begins.
Driving conditions in Grenada, including road conditions, increasing numbers of vehicles, and sometimes undisciplined minibus drivers all require caution and reduced speed for safety.
The Government of Grenada has a seat belt law; drivers and passengers found not wearing seat belts are subject to a fine of EC$1,000 (US$400).
Getting a local temporary drivers license, based on valid U.S. drivers license plus EC$30 (US$12), is highly recommended.
In the event of an accident, not having a valid local driver’s license may result in a fine, regardless of who is at fault.
Rental vehicle companies are widely available; most of them will assist in applying for temporary driving licenses.
The adequacy of road signage varies, but is generally poor to nonexistent.
For specific information concerning Grenada driver’s permits, road safety, vehicle inspection, road tax and mandatory insurance, please contact the Grenada Board of Tourism in New York at 317 Madison Avenue, Suite 1704, New York, N.Y. 10017, telephone 1-800-927-9554, (212) 599 0301; Fax: 212-573-9731; e-mail: gbt@caribsurf.com or www.grenadagrenadines.com
Please refer to our Road Safety Page for more information.
Visit the website of the country’s national tourist office at www.grenadagrenadines.com.
Additional general information can be found on Grenada’s Internet website at: http://www.grenadaconsulate.org.
AVIATION SAFETY OVERSIGHT:
The U.S. Federal Aviation Administration (FAA) has assessed the Government of Grenada’s Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for the oversight of Grenada’s air carrier operations.
For more information, travelers may visit the FAA’s internet website at http://www.faa.gov/safety/programs_initiatives/oversight/iasa.
SPECIAL CIRCUMSTANCES:
Recovery efforts have been made from the damage caused by Hurricane Ivan in September 2004 and Hurricane Emily in July 2005.
All utilities have been restored.
Cruise ships have returned and all the main shopping areas are open.
While the majority of hotels are up and running, there is still one major resort (Le Source), which remain closed.
The resort’s management hopes to have the hotel open by the time Cricket World Cup 2007 Super Eight games take place in Grenada (alternate days April 10-21).

The February 1 merger of Liat and Caribbean Star airlines has reduced the number of daily flights between Grenada and the other Eastern Caribbean islands from six to three.
Travelers coming into the region from the U.S. and elsewhere should verify in advance directly with Liat that they have a valid reservation.
Some travelers making reservations from outside the region have arrived in the Eastern Caribbean and discovered that the reservation they thought they had on Liat, is not recognized by the airline, resulting in delayed travel as well as additional hotel costs.

Grenada experiences tropical storms during the hurricane season, from June through November. 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.
It is difficult to cash personal U.S. checks in Grenada.
If accepted, they will take approximately six weeks to clear by a local bank. Major credit cards are widely accepted, and ATM facilities are available at most banks.
Most hotels and restaurants take U.S. currency; however, change will be in local currency.
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 Grenada laws, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in Grenada 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.
For more information, please see our information on criminal penalties.
CHILDREN'S ISSUES:
For information on international adoption of children and international parental child abduction, see the Office of Children’s Issues website.
REGISTRATION / EMBASSY LOCATION:
Americans living or traveling in Grenada are encouraged to register with the U.S. Embassy through the State Department’s travel registration website , and to obtain updated information on travel and security within Grenada.
Americans without Internet access may register directly with the U.S. Embassy.
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 on the main road to Lance Aux Epines after the Christian Scientist Church, and is approximately 15 minutes from the Point Salines International Airport. Telephone: 1-(473) 444-1173/4/5/6; Fax: 1-(473) 444-4820; Internet e-mail: usemb_gd@caribsurf.com. Embassy hours are 8:00 am to 12:30 pm, Monday to Friday except local and American holidays.
*

*

*
This replaces the Consular Information Sheet dated October 13, 2006, to update all sections.

Travel News Headlines WORLD NEWS

Date: Mon 7 Mar 2016
Source: Outbreak News Today [edited]

Two weeks ago, health officials in Grenada reported on a chickenpox outbreak that affected 17 students at St. George's Anglican Junior School. The school was closed for the week to monitor and treat affected students.

This pustulovesicular rash represents a generalized herpes outbreak due to the Varicella-zoster virus (VZV) pathogen/CDC.

Last week, the Ministry of Health screened over 400 students from the St. George's Anglican School. The exercise saw a team of qualified nursing personnel conducting screening and evaluation of students at the St. George's Anglican Junior and Senior Schools.

A total of 255 and 183 students from the junior and senior schools respectively were examined on the compound as the institution reopened its doors following the completion of sanitation and cleaning operations.

During the screening/examination at the school, several students with skin lesions, fever, cold, headaches and skin rashes were identified and were not given clearance for a return to the classroom. Some of the students were referred to the doctor, and others were requested to be observed at home.

Meanwhile, the ministry will undertake a daily monitoring of the school, conduct education sessions with teachers and undertake another medical evaluation of students, in particular the ones that are to be observed at home and referred.

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 VSV 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 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 break, crust over, and leave 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.

According to the Centers for Disease Control and Prevention (CDC), the chickenpox vaccine is the best protection against chickenpox. The vaccine is made from weakened varicella virus that produces an immune response in your body that protects you against chickenpox. The chickenpox vaccine was licensed for use in the United States in 1995.  [Byline: Robert Herriman]
===================
[A map of Grenada can be found at <http://healthmap.org/promed/p/34>. - ProMED Mod.LK]
Date: Sat 28 Aug 2010
Source: Spice Grenada.com, The New Today [edited]
<http://www.spicegrenada.com/index.php?option=com_content&view=article&id=2505:dengue-fever-is-present&catid=546:august-28th-2010&Itemid=143>

After weeks of speculation among the population that there are dengue cases on the island, the officials within the Ministry of Health confirmed last week that 39 people in Grenada had come down with the fever. Head of the Epidemiology Unit within the Ministry of Health, Dr Alister Antoine, told reorters last week Tuesday [24 Aug 2010] that every parish, including Carriacou, has been affected by dengue fever, with the youngest case being a 2 year old and the oldest being 72.

He said: "In total, we have 20 males and 19 females. The figures we have now are what we have just confirmed with the lab, meaning that there were 17 new cases diagnosed during the 1st week in August [2010]." According to Dr Antoine, there was a noted increase in infection during the months of July and August. As compared to only one case in February, 6 by June, and with the number jumping to 15 in July.

"People should be making it difficult for the mosquitoes to breed, just make it difficult by cleaning up the place," he said. Presently there are 2 types of [dengue virus] strains recorded in Grenada -- type 1 and type 2, and there have been 2 cases of DHF both of which were mild and were treated successfully.
========================
[A HealthMap/ProMED-mail interactive map showing the location of Grenada in the southern Caribbean can be accessed at <http://healthmap.org/r/05Pe>. - ProMed Mod.TY]
Date: Mon, 3 Sep 2007 11:53:29 +0200 (METDST) MIAMI, Sept 3, 2007 (AFP) - A potentially catastrophic class-five Hurricane Felix ripped across the warm waters of the Caribbean early Monday towards Honduras and Belize after damaging homes and power lines in Grenada. The storm was so powerful that it tossed around a US 'hurricane hunter' data gathering airplane and forced it to abort its mission, the Miami Herald reported. At 0900 GMT the center of Felix was located some 445 kilometers (275 miles) south-southeast of Kingston, Jamaica, packing winds of 270 kilometers (165 miles) per hour, with higher gusts, the Florida-based National Hurricane Center said in its latest advisory. The hurricane was moving west at around 33 kilometers (21 miles) per hour, and "on this track the center of Felix will be near the coasts of extreme northeastern Nicaragua and northeastern Honduras early on Tuesday morning," the Hurricane Center said. Felix is then forecast to head for Belize and Mexico's Yucatan peninsula, where it could make landfall on Wednesday. No casualties were reported since Felix became the second hurricane of the Atlantic storm season on Saturday, though one person was reported missing in northern Venezuela. In just 15 hours on Sunday, Felix jumped from a Category Two storm with winds at 160 kilometers (100 miles) per hour to a rare Category Five hurricane, the most powerful on the Saffir-Simpson scale. The speed at which Felix reached maximum strength was one of the fastest ever recorded, Hurricane Center specialists said. Felix was so powerful that one of the US National Oceanic and Atmospheric Administration's 'hurricane hunter' airplanes was caught in a rapid updraft-downdraft cycle as it gathered data, the Miami Herald reported. The violent cycle placed four times the weight of gravity on those aboard the plane. "Four Gs can put a fair strain on the aircraft, and it also got some very heavy hail that can rip the paint off the plane," Hurricane Center forecaster James Franklin told the newspaper. The airplane, a modified Orion P-3 that normally carries 14 people, was ordered backto its base at Saint Croix, one of the US Virgin Islands, Franklin said. The storm, nourished by the warm Caribbean ocean, was expected to maintain its strength as it followed the general path that another Category Five storm, Hurricane Dean, took just last week. Though extremely powerful, Felix "has a very small wind field," the Hurricane Center said. "Hurricane force winds extend outward up to 45 kilometers (30 miles) from the center, and tropical storm force winds extend outward up to 185 kilometers (115 miles)," the Hurricane Center said. The Honduran government early Monday warned officials along its Caribbean coast to prepare for the hurricane. Hurricane conditions "are also possible over extreme northeastern Nicaragua," the Hurricane Center said. In Venezuela civil defense officials said a person went missing as beaches were evacuated in Puerto Cabello, 120 kilometers (75 miles) west of Caracas, where Felix generated high winds, heavy rains and up to three meter (10 foot) swells. There were no immediate reports of damage as the storm skimmed just north of the Paraguana peninsula, site of Venezuela's main oil refineries. Meanwhile Jamaica, which lay well to the north of Felix's track, was under a tropical storm watch as it prepared to hold elections Monday, already postponed from one week ago by Hurricane Dean. Warnings for Aruba, Bonaire and Curacao were discontinued as Felix swiped the popular tourist destinations in the Netherlands Antilles after wreaking some damage in Grenada, ripping roofs, downing power lines and knocking radio and TV stations off the air. Last week, Dean, also reaching category five, swept through the Caribbean with severe winds and rains, leaving a wide swathe of damage and a death toll of 30 from Martinique to Mexico.
Date: Thu, 14 Jul 2005 17:59:59 +0200 (METDST) MIAMI, July 14 (AFP) - Hurricane Emily, the Atlantic's second big storm of the season, headed west, gathering strength Thursday, the National Hurricane Center said, just after its predecessor Dennis carved a trail of death and destruction across the region. Packing 100-mile-per-hour (160-kilometer-per-hour) winds and growing stronger, Emily -- now a Category Two hurricane on the Saffir-Simpson intensity scale, on which five is the top-force storm -- lashed Grenada and headed toward Hispaniola island. Shared by the Dominican Republic and Haiti, Hispaniola's southern coast was grazed last week by Dennis, leaving at least 40 people dead in Haiti. Dennis went on to kill 16 in Cuba and one man in Jamaica. Emily was expected to produce heavy rain across much of the southern Caribbean and northern Venezuela, as well as the Netherlands Antilles. "These rains could produce life-threatening flash floods and mudslides," the center warned. In Grenada, where 30,000 people -- one-third of the permanent population -- remain homeless 10 months after Hurricane Ivan, there were widespread fears about the new storm. There were no immediate reports of fatalities in Grenada Thursday, though authorities said they were inspecting damage. At 1500 GMT, the storm's center was about 560 miles (905 kilometers) southeast of Santo Domingo in the Dominican Republic, moving west-northwest near 18 miles (30 kilometers) per hour, the US center said. "Additional strengthening is forecast during the next 24 hours," the center added. The government of the Dominican Republic has issued a tropical storm watch from Punta Salinas westward to the Haitian border. And the government of Haiti has issued a tropical storm watch from the border with the Dominican Republic to Port-au-Prince. In Haiti, civil protection agency spokesman Jeffe Delorges said after Dennis roared past last Thursday that 23 bodies were found in the southwestern town of Grand-Goave. Most were killed when a bridge collapsed. Another 10 were killed in the Grande-Anse region, also in the southwest, along with five in the southeast and two in the southern city of Cayes. The agency estimates that about 15,000 people are without homes or means to feed themselves, with hundreds of houses completely destroyed. It said there had been widespread flooding and damage to plantations. The Haitian government announced emergency aid totaling the equivalent of 30,000 dollars. Cuban President Fidel Castro said in a televised address late Monday that the toll from Dennis had climbed to 16 and that Dennis destroyed or damaged 120,000 homes and caused more than 1.4 billion dollars in damage. Castro also read from a lengthy list of agricultural devastation: "The entire crop of citrus fruits was lost -- 200,000 tonnes of grapefruit fell from the trees, as did 160,000 tonnes of oranges. "At hundreds of dollars per tonne, that's a huge loss for our exports," he said. Dennis, the first hurricane of the season, was estimated to have caused a further one billion to five billion dollars in insured losses in the United States, according to Risk Management Solutions.
Date: Thu, 7 Oct 2004 03:19:49 +0200 (METDST) by Laura Bonilla POINT SALINES, Grenada, Oct 6 (AFP) - US Secretaty of State Colin Powell flew over the Caribbean island state of Grenada on Wednesday to survey the damage caused by Hurricane Ivan and vowed to bring more help to this devastated spice island. The hurricane killed 39 people and destroyed 90 percent of the tiny island's buildings when it blasted across the Caribbean on September 7, causing an estimated 800 million dollars in damage. This island of 90,000 people is heavily dependent on tourism and nutmeg production, which together account for 40 percent of the economy. The United States has given one million dollars in aid to Grenada and pledged an additional 3.6 million, US officials said. The island will receive additional help in a 100-million-dollar emergency aid package that US President George W. Bush has requested from Congress for Caribbean nations hit by a wave of hurricanes this storm season, Powell said. "We'll do everything we can to expedite the flow of that money," Powell said in a news conference at the airport in Point Salines, the island's southernmost point, after surveying the destruction from his plane's cockpit. "There's an urgent need to reconstruct the economy as well as rebuilding houses and rebuilding schools," Powell said, noting that Grenada's schools, homes, farms and power system were hit by the hurricane. Residents are receiving food and water, "but it'll be a continuing challenge," he said. Shelters need to be built for people who remain homeless, the infrastructure needs to be repaired and power needs to be restored, he said. Only one-third of the island has electricity. Grenada's Prime Minister Keith Mitchell said his government's priority is to reopen schools, which remain closed. "After the devastation arrived we've gone through quite a lot in every respect," Mitchell said. He told Powell: "You understood what was happening, you had a good grasp of the problems that we've faced." From an airplane, much of the island appeared still in ruins. Some areas appeared deserted, while some buildings looked as if they had been eaten up by a raging blaze and palm trees stood leafless. "When those roofs went away, there was water damage done in all of these homes, in some cases destroying a family's entire possessions, all that they owned," Powell said. "What makes this situation so difficult for Grenada is that not only was their infrastructure hit -- schools, housing, roads, the power system -- but their means of production and the economic base of the country," he said. The nutmeg industry -- Grenada is world's second producer of the aromatic seed -- was devastated, and it takes five to 10 years for its evergreen trees to regrow, Powell said. "We want to see if there are things we can do to help with that or perhaps diversify the agricultural sector," he said.
More ...

Thailand



*****
Travel in Health in Thailand
*****
General Introduction:
Irish travellers are going to Thailand in great numbers. The relatively cheap cost and also the contrast in culture has captured many hearts. Some are travelli
g for a once off 2 week trip and for others the exploration of Thailand will take longer. It is truly a beautiful country and the people have a charm all of their own but nevertheless your journey can be so very easily ruined by taking health risks.
Water-Borne Disease:
In most of the major cities of Thailand the water supply is well chlorinated and so the risks associated with drinking mains tap water are limited. However many of the bedrooms will not be supplied with mains water so take care. Smell the water and if there is a distinct chlorine odour then it should be safe. Also remember that when you travel around the country, especially around the northern regions, the water supply may be grossly contaminated and so never drink the water or use it for brushing your teeth. Also no ice in your drinks under these circumstances.
Food-Borne Disease:
There is a good selection of food in Thailand and you should have no great difficulty in finding food to suit your taste. In the majority of the restaurants the food is well cooked and maintained in a healthy sterile fashion. These are the places to eat. As you walk around the cities you will see many street traders selling food stuffs from their carts. The level of hygiene is very low and frequently the food will be contaminated. Never indulge yourself by eating from street vendors.
Mosquito-Borne Disease:
Under this title most travellers will only consider the possibility of developing malaria. This is of course one of the most important illnesses transmitted via mosquitoes but by no means the only one in Thailand. For most travellers to Thailand there will be no need to take malarial prophylaxis as the cities are deemed to be free of malaria. This does not mean that you will not be bitten by mosquitoes and develop some of the other diseases such as Dengue Fever or perhaps Japanese Encephalitis. Many travellers also develop a very severe reaction to the mosquito bite and so for all these reasons it is prudent to avoid being bitten whenever possible.
Entertainment-Borne Disease:
It would be wrong not to emphasize the very high risk which travellers face if they are unwise enough to indulge in any form of sexual activity in Thailand. The percentage of street girls with the Aids virus is rising each year and is now thought to be over 80%. This figure may be an underestimate. Be especially careful if you have taken any alcohol. The cities of Bangkok and Pattaya are thought to be among the main centres of HIV transmission throughout the world and within the next few years the extent of the Aids problem in S.E. Asia will have exceeded Africa. There is limited availability of condoms.
Road-Borne Disease:
The traffic situation in Thailand is severe. The motorbikes have no insurance as they are too often involved in accidents. Use only regular taxi cabs and fix your price before you leave.
Vaccination Schedule:
There are no compulsory vaccines for entry into Thailand from Ireland. Nevertheless the usual recommended vaccines include Polio, Typhoid, Tetanus and Hepatitis A cover. For those trekking or staying for longer periods then cover against Hepatitis B and Rabies would be worth discussing.
Most travellers should start their vaccines about 4 to 5 weeks before they leave Ireland.
Note:
For the vast majority of Irish travellers a holiday in Thailand will be a time of great pleasure and, later, fond memories of the people, their customs and the countryside. Just remember that illness can occur so follow some good common sense rules and so you can enjoy yourself
and Travel in Health.

Thailand

Travel News Headlines WORLD NEWS

Date: Mon, 13 Jan 2020 16:12:29 +0100 (MET)
By Nina LARSON

Geneva, Jan 13, 2020 (AFP) - A new virus from the same family as the deadly SARS disease has spread beyond China's borders for the first time with a case emerging in Thailand, UN and Thai officials said on Monday.   Thai doctors diagnosed a Chinese traveller with mild pneumonia on January 8 later confirmed to have been caused by the so-called novel coronavirus -- which has already given rise to 41 pneumonia-like cases and one death in China.   The outbreak has caused alarm because of the link with SARS (Sudden Acute Respiratory Syndrome), which killed 349 people in mainland China and another 299 in Hong Kong in 2002-2003.

The UN health agency (WHO) confirmed that the outbreak in the city of Wuhan was caused by a previously unknown type of corona virus, a broad family ranging from the common cold to more serious illnesses like SARS.   "Laboratory testing subsequently confirmed that the novel coronavirus was the cause," WHO spokesman Tarik Jasarevic told AFP in an email, referring to the case in Thailand.   WHO said it might soon host an emergency meeting on the spread of the new virus.   Thai Health Minister Anutin Charnvirakul stressed to reporters in Bangkok Monday that a 61-year-old Chinese woman who had travelled from Wuhan "was infected with the virus from outside Thailand".   Thai health officials said on Monday she was recovering.   Authorities in Wuhan said a seafood market in the city was the centre of the outbreak. It was closed on January 1.   There is so far no indication of human-to-human transmission of the virus.

- 'Not unexpected' -
Scientists in Hong Kong's Department of Health said on Saturday that genetic sequencing of the virus from a Wuhan patient, published online by a Chinese expert, indicated it was 80 percent similar to SARS found in bats.   WHO said on Monday it was not surprising that the virus had spread beyond China.   "The possibility of cases being identified in other countries was not unexpected, and reinforces why WHO calls for ongoing active monitoring and preparedness in other countries," it said in a statement.   Thai authorities have been on high alert, with airport officials checking all passengers coming from Wuhan to the kingdom's major airports.   An official from the Public Health Emergency Operation Center told AFP the infected woman travelling from Wuhan had been intercepted on arrival in Thailand, after airport officials determined she had a fever.

WHO said it had issued guidance on how to detect and treat people with the new virus and stressed that China's decision to rapidly share the genetic sequencing of the virus made it possible to quickly diagnose patients.   WHO has not recommended any specific measures for travellers or restrictions on trade with China, but stressed on Monday it was taking the situation seriously.   "Given developments, WHO Director-General Dr Tedros Adhanom Ghebreyesus will consult with Emergency Committee members and could call for a meeting of the committee on short notice," it said in a statement.   During such meetings, experts determine whether the UN health agency should declare an international health emergency -- a designation used only for the gravest epidemics.
Date: Mon, 23 Dec 2019 04:22:26 +0100 (MET)
By Sophie DEVILLER and Jonathan KLEIN

Ban Ta Klang, Thailand, Dec 23, 2019 (AFP) - Separated from their mothers, jabbed with metal hooks, and sometimes deprived of food -- many Thai elephants are tamed by force before being sold to lucrative tourism sites increasingly advertised as 'sanctuaries' to cruelty-conscious travellers.   Balanced precariously on hind legs, two-year-old Ploy holds a ball in her trunk and flings it towards a hoop, e of many tricks she is learning in Ban Ta Klang, a traditional training village in the east.   Here young elephants are "broken" to interact with tens of millions of tourists who visit Thailand every year, many eager to capture social media-worthy encounters of the kingdom's national animal playing sports, dancing and even painting.

Villagers in Ban Ta Klang who have been working with the large, gentle animals for generations say taming is necessary for safety reasons and that the force is not excessive.       "We do not raise them to hurt them... if they are not stubborn, we do nothing to them," said mahout Charin, as he stroked Ploy's head affectionately and spoke of her as part of his family.   Charin makes about $350 a month in a profession that was handed down from his father and grandfather.    "I have always lived with them," he added.   But animal welfare advocates argue the taming technique -- where babies are removed from the care of fiercely devoted mothers at the age of two -- is cruel and outdated.   It is also little-known, one of many murky aspects of an evolving elephant tourism trade often kept from view of tour operators and travellers.

- Big business -
Elephants were phased out of the logging industry about 30 years ago, leaving their mahouts unemployed.   So they turned to Thailand's flourishing tourism industry, a burgeoning sector of amusement parks offering elephant rides and performances.    A tamed elephant can now fetch up to $80,000, a colossal investment that then requires gruelling hours of work and increasingly bizarre stunts to be recouped.    Mae Taeng park in the northern city of Chiang Mai receives up to 5,000 visitors per day and charges an entrance fee of about $50.   Many come to see Suda, who holds a brush in her trunk and paints Japanese-style landscapes for visitors who can later buy the prints for up to $150 before taking an elephant ride through the hills.    As tourists become more aware of the potential cruelty of such activities, a growing number of places have opted to use the term 'sanctuary' or 'refuge'.

Many do not permit rides or animal performances. Instead tourists are encouraged to feed, groom and care for elephants, gaining an unforgettable experience with one of nature's most majestic creatures.   But charities warn that even seemingly benign options, like bathing them, could still be problematic.    "Bathing with elephants...is often stressful for elephants and mahouts especially when dealing with groups of excited young people," Jan Schmidt-Burbach of World Animal Protection told AFP.   "The best option is to leave it to the elephant to decide if and how to bath and ask tourists to stand back to observe and enjoy this moment without interference."   But even this may not be enough.    Some animal rights experts warn it can be hard to discern the treatment of the animals after the crowds have gone home. Some reported cases of elephants at so-called sanctuaries being chained for long hours, forced to sleep on concrete, and malnourished.

- Ethical tourism? -
Of the 220 elephant parks identified across the country, even if many promise ethical tourism, "only a dozen ensure truly satisfactory living conditions", according to WAP.   It is working with ChangChill, a small organisation near Chiang Mai, bordered by a river in the middle of rice terraces.    In a few months, it changed its methods to give elephants more space, fewer interactions, and an environment resembling life in the wild.     "We don't force them to do what they wouldn't instinctively do," says director Supakorn Thanaseth.    As a result, they are "less sick, calmer". 

The risk of accidents with tourists has decreased as the animals are less stressed, though mahouts still have a hook in a bag for emergencies.    ChangChill hopes to become profitable in the current high season, but it will only be able to receive around 40 tourists a day to visit its six elephants as part of its aim to put the creatures first.    That is a drop in the bucket when Thailand has nearly 4,000 "domesticated" elephants.   Thai authorities are reluctant to reintroduce them into natural habitats, as advocated by some NGOs, because of a lack of space and potential conflict with humans.

The compromise, some argue, is to better regulate the sector and improve standards.   But there is little impetus to enact more stringent rules that would cut into the Thai tourism industry, which welcomed more than 38 million visitors this year.    A committee of several animal welfare associations submitted recommendations to the government last year advocating stricter controls for elephants in captivity.   But according to activist Sovaida Salwala from Friends of the Asian Elephants, an NGO who helped compile the report, their requests "remain unanswered so far".   In fact, there is some evidence the animals' situation is getting worse.    Schmidt-Burbach said their last research in 2015 found some 1,771 elephants whose welfare was in question.    He explained: "There are 357  more elephants in poor conditions compared to our 2010 study."
Date: Thu, 21 Nov 2019 09:12:36 +0100 (MET)

Bangkok, Nov 21, 2019 (AFP) - A shallow 6.1-magnitude earthquake hit north-western Laos near the Thai border early Thursday, the United States Geological Survey reported, alarming locals who felt buildings shake as far away as Bangkok.  The quake hit at 6:50am (2350 GMT Wednesday), roughly three hours after a 5.7-magnitude earthquake in the same region triggered an immediate suspension to Laos' largest-capacity power plant located near its epicentre.    Tremors could be felt more than 700 kilometres (435 miles) away in the Thai capital, where Pope Francis is currently on a four-day visit.    "The shaking... was the main shock from a quake in Laos at 6:50 am and was felt in northern and northeastern Thailand and Bangkok and suburbs," said Sophon Chaila, an official at the Thai Meteorological Department.

The department said the quake affected nine provinces in Thailand and there were four lesser aftershocks.    It also became a top trending topic on Twitter in Thailand, as locals shared videos of swaying overhead lights and rattling window blinds in office buildings.    Residents in the Vietnamese capital Hanoi also felt buildings sway.    "The ceiling lights were shaking quite strongly. I felt dizzy and scared," said Hanoi resident Tran Hoa Phuong, who felt the earthquake in her 27-storey apartment building.    After the first quake, the 1,878-megawatt Hongsa Power Plant -- Laos' largest-capacity thermal energy generator -- immediately suspended operations according to a statement from the Thai-owned company.

No "fundamental" damages or injuries have been found so far, "merely damages to the external texture of the buildings", it said, adding that Hongsa is expected to take 24 hours to complete its inspection.    Photos shared by Thai news showed portions of the power plant's walls had collapsed, and debris littered its premises.    Nearby Xayaburi dam project, one of Laos' largest hydropower dams, has seen "no impact" so far, and is continuing to generate electricity "as normal", said a statement from CK Power.   Information is slow to trickle out of the closed communist state, and there were similarly no official reports of injuries after the twin quakes hit early Thursday.

Impoverished Laos has ploughed ahead with ambitious dam-building projects that critics say lack transparency and stringent safety measures.   The cost was laid bare last year when a massive hydropower project collapsed in southern Laos, killing dozens and leaving thousands homeless.   Pope Francis arrived in Bangkok on Wednesday and has a busy agenda Thursday meeting officials and the Thai king before he leads a mass in the evening.    There was no word from his team on whether he felt the quake.    Powerful earthquakes occasionally strike hard in Southeast Asia.   In 2016 a 6.8-magnitude quake struck Myanmar, killing at least three people and damaging temples in the ancient temple town of Bagan.
Date: Fri, 15 Nov 2019 05:28:34 +0100 (MET)

Bangkok, Nov 15, 2019 (AFP) - A French tourist has died after falling from a waterfall while trying to take a selfie in Thailand, police said Friday.   The accident happened Thursday afternoon on the tropical island of Koh Samui, whose palm-fringed, white-sand beaches are a magnet for both backpackers and high-end tourists.   The 33-year-old man fell from Na Mueang 2 waterfall, the same spot where a Spanish tourist died in a fall in July, Lieutenant Phuvadol Viriyavarangkul of the island's tourist police told AFP.

"It took several hours to retrieve his body because the waterfall is slippery and steep," he said by phone, adding that the spot is roped off and there is a sign warning tourists of the danger.   "His friend said he was trying to take a selfie and then he slipped and fell."   Thailand is largely considered a safe destination for tourists and typically draws more than 35 million visitors each year.    But the industry took a hit in 2018 after a ferry carrying Chinese visitors in the country's south sank last year, killing 47 people.   The accident highlighted lax safety rules in the tourism sector and authorities have been scrambling to restore the country's image since.
Date: Sat, 26 Oct 2019 11:56:37 +0200 (METDST)

Bangkok, Oct 26, 2019 (AFP) - Hundreds of dead fish washed ashore on a luxury tourist resort on Thailand's south coast, officials said Saturday, blanketing a long stretch of pristine white sands in a rotting stench.   Some 300 metres (950 feet) of beach on Naka Yai island was littered with dead ponyfish, Phuket provincial fisheries chief Siripong Panasonthi told AFP, adding authorities were working to determine the cause of the deaths but had ruled out pollution in the water.   "We have checked the water quality... It cannot cause the fish to die en masse," Siripong said.   He said he believed the catch of ponyfish -- which, when caught alive are sold to make animal feed but are worthless when dead -- had been dumped by local fishing trawlers.
More ...

World Travel News Headlines

Date: Fri, 24 Jan 2020 12:26:57 +0100 (MET)

Beijing, Jan 24, 2020 (AFP) - China has quarantined cities and shut major tourist attractions from Disneyland to the Forbidden City and a section of the Great Wall as it scrambles to stop a deadly SARS-like virus from spreading further.   The drastic moves come as hundreds of millions of people criss-crossed the country in recent days to celebrate the Lunar New Year holiday, which officially started Friday and is typically a joyous time of gatherings and public celebration.   Here is a rundown of the measures taken so far in an unprecedented quarantine effort:

- Cities under lockdown -
Public transport has been stopped in 13 cities in central Hubei province, with train stations shut, events cancelled and theatres, libraries and karaoke bars closed in some locations.   The epicentre of the outbreak is provincial capital Wuhan, the biggest city on lockdown, where the government has halted all travel out of the Yangtze River metropolis of 11 million.   Wuhan residents have been told to stay home and authorities are limiting the number of taxis allowed on roads. There are few flights available to the city, deepening the isolation.   Similar quarantine measures are being taken in the other, smaller cities. These include strict controls on weddings and funerals, temperature screening of people as they arrive and the suspension of online taxi services.   More than 41 million people in total are affected by the city shutdowns.

- Festivities cancelled -
Wuhan and Beijing have cancelled public events that usually attract hundreds of thousands of people to temples during the New Year holiday.   Gao Fu, head of the Chinese Center for Disease Control and Prevention, has asked China's 1.4 billion citizens to forego New Year gatherings and confine themselves at home until all is clear.   To discourage nationwide travel, the government also said all tickets for rail, air, road, or water transport could be refunded.

- Attractions closed -
The historic Forbidden City, a sprawling imperial palace in Beijing that is one of the country's most revered cultural sites, will temporarily close from Saturday.   Other famous landmarks including a section of the Great Wall, the Ming Tombs and Yinshan Pagoda are also not open to visitors.   Shanghai Disneyland said it would shut for an indefinite period "to ensure the health and safety of our guests and cast".   Women's Olympics football qualifiers scheduled for February 3-9 in Wuhan have been moved to the eastern city of Nanjing.

- Temperature checks -
Staff in full body protective suits were seen checking the temperatures of people entering a subway station in Beijing on Friday.   The country has ordered sterilisation and ventilation at airports and bus stations, as well as inside planes and trains, while travellers are being screened for fever.   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.   In Wuhan, city authorities have made it mandatory to wear a mask in public places.   In response to skyrocketing demand for masks -- 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".

- A new hospital -
In Wuhan, authorities are rushing to build a new hospital in a staggering 10 days as a rising number of patients are infected by the new coronavirus.   The facility is expected to be in use by February 3 and will have a capacity of 1,000 beds spread over 25,000 square metres, according to state media.   Dozens of excavators and trucks were filmed working on the site by state broadcaster CCTV.   Its construction began after reports surfaced of bed shortages in hospitals designated as dealing with the outbreak, which has now infected 830 people across China.
Date: Fri, 24 Jan 2020 11:22:00 +0100 (MET)

Beijing, Jan 24, 2020 (AFP) - China announced Friday it will close a section of the Great Wall and other famous Beijing landmarks to control the spread of a deadly virus that has infected hundreds of people across the country.   A range of Lunar New Year festivities have been cancelled to try to contain the virus, and Beijing's Forbidden City and Shanghai's Disneyland have also been closed temporarily.

The Ming Tombs and Yinshan Pagoda will also be closed from Saturday, the authority that oversees the sites said, while the Bird's Nest stadium -- the site of the 2008 Olympic Games -- was shuttered from Friday.   The Great Wall attracts around 10 million tourists a year and is a popular destination for visitors during the New Year holiday.   The Juyongguan section will close, while the Great Wall temple fair was cancelled at the Simatai section of the famous landmark.

Tourists at the Gubei water town by the Simatai section will have their temperature tested, the authority said in a statement on the WeChat social media app.   The Bird's Nest will be closed until January 30 in order to "prevent and control" the spread of the virus, authorities said. An ice and snow show taking place on the pitch will be closed.   The measures in the capital are the latest to try and control the outbreak of the new coronavirus, after authorities rapidly expanded a mammoth
quarantine effort that affected 41 million people in central Hubei province.

The previously unknown virus has caused alarm because of its similarity to SARS (Severe Acute Respiratory Syndrome), which killed hundreds across mainland China and Hong Kong in 2002-2003.   Although there have only been 29 confirmed cases in Beijing, city authorities have cancelled large-scaled Lunar New Year events this week.   The city government said it would call off events including two popular temple fairs, which have attracted massive crowds of tourists in past years.   Beijing's Forbidden City -- which saw 19 million visitors last year -- is usually packed with tourists during the Lunar New Year festival, when hundreds of millions of people travel across China.
Date: Fri, 24 Jan 2020 10:40:12 +0100 (MET)
By Sébastien RICCI

Wuhan, China, Jan 24, 2020 (AFP) - Chinese authorities rapidly expanded a mammoth quarantine effort aimed at containing a deadly contagion on Friday to 13 cities and a staggering 41 million people, as nervous residents were checked for fevers and the death toll climbed to 26.

While the World Health Organization (WHO) held off on declaring a global emergency despite confirmed cases in half a dozen other countries, China expanded its lockdown to cover an area with a total population greater than Canada's.   A range of Lunar New Year festivities have been cancelled, while temporary closures of Beijing's Forbidden City, Shanghai's Disneyland and a section of the Great Wall were announced to prevent the disease from spreading further.   The previously unknown virus habeis caused alarm because of its similarity to SARS (Severe Acute Respiratory Syndrome), which killed hundreds across mainland China and Hong Kong in 2002-2003.

The WHO said China faced a national emergency but stopped short of making a declaration that would have prompted greater global cooperation, including possible trade and travel restrictions.   The outbreak emerged in late December in Wuhan, an industrial and transport hub of 11 million people in China's centre, spreading to several other countries including the United States.   China is in the midst of its Lunar New Year holiday, a typically joyous time of family gatherings and public festivities.   But on Friday Wuhan was a ghost town, its streets deserted and stores shuttered.

- Worried patients -
Hospitals visited by AFP journalists bustled with worried patients being screened by staff wearing full-body protective suits.   At a temperature-check station, a medical staffer in bodysuit, face mask and goggles took a thermometer from a middle-aged woman, pausing to examine the reading before quickly turning back to the patient.   "Have you registered? Then go and see the doctor," the staffer said.   One 35-year-old man surnamed Li voiced the fears of many.   "I have a fever and cough, so I'm worried that I'm infected," he said.   "I don't know the results yet."

With hundreds of millions of people on the move across China for the holiday, the government has halted all travel out of Wuhan, shut down its public transport and told residents to stay home. Deepening the isolation, there were few flights available to the city.   "This year we have a very scary Chinese New Year. People are not going outside because of the virus," said a taxi driver in the city, who asked not to be named.   But said a prolonged shutdown should not pose food-shortage problems because many Chinese had stocked up for the holiday.

Besides Wuhan, 12 other smaller cities nearby have battened down the hatches, with most of them going public on Friday with various measures ranging from closing public venues and restricting large gatherings to halting public transportation and asking citizens not to leave their cities.   Several of the cities have populations numbering several million, led by Huanggang, which has 7.5 million.    The pathogen -- 2019 Novel Coronavirus (2019-nCoV) -- has caused many outlets in Shanghai, Beijing and other cities to sell out their stocks of face masks.   As reports surfaced of bed shortages in Wuhan hospitals, state media said authorities were rushing to build a new facility devoted to the outbreak in a mind-blowing 10 days.

The Wuhan hospital is targeted to be ready by February 3. Dozens of excavators and trucks were filmed working on the site by state television.   To discourage nationwide travel, the government has said all tickets for rail, air, road, or water transport could be exchanged for a refund.   On Friday, staff in full body protective suits were seen checking the temperatures of people entering a subway station in Beijing.   Thermal cameras scanned passengers arriving at Beijing's West Railway Station.

- 'Work as one' -
Chinese authorities said the number of cases leapt overnight to more than 800, with 177 in serious condition. There were another 1,072 suspected cases.   Officials also said that a virus patient died in Heilongjiang province in China's far northeast, the second death outside the Wuhan epicentre.   Beijing has been praised for its response in contrast to SARS, when it took months to report the disease and initially denied WHO experts any access.

Gao Fu, head of the Chinese Center for Disease Control and Prevention, asked China's people to forego New Year gatherings this year and confine themselves at home until the all-clear.    "If we all work as one, we can contain the virus in Wuhan and add no more cases exported from Wuhan, so as to stem the virus nationwide," Gao told state TV.   Beijing has cancelled popular New Year public events at temples in the capital, the historic Forbidden City will close from Saturday, and Shanghai Disneyland said it also will shut down for an indefinite period from Saturday to protect visitors and staff.
Date: Fri, 24 Jan 2020 07:46:42 +0100 (MET)

Shanghai, Jan 24, 2020 (AFP) - Shanghai Disneyland will close until further notice this weekend due to a deadly virus outbreak that has infected hundreds of people in China, the amusement park said Friday.   The closure comes as China entered its nearly week-long Lunar New Year holiday, and the home of Mickey Mouse had prepared special "Year of the Mouse" celebrations for its guests.

But the park and resort said on its website it would temporarily close from Saturday "in response to the prevention and control of the disease outbreak and in order to ensure the health and safety" of its guests and staff.   "We will continue to carefully monitor the situation and be in close contact with the local government, and we will announce the reopening date upon confirmation," it said, adding that guests who had purchased tickets or booked a resort hotel would be reimbursed.   The entertainment conglomerate opened its $5.5 billion theme park in Shanghai in June 2016, Disney's sixth amusement park and third in Asia.
Date: Fri, 24 Jan 2020 03:33:13 +0100 (MET)
By Rusmir SMAJILHODZIC with Emmy VARLEY in Belgrade

Sarajevo, Jan 24, 2020 (AFP) - As winter grips the Balkans, the poor are caught in a cruel bind, being forced to light fires at home for heating while fuelling a pollution crisis smothering the region.   In recent weeks, Balkan capitals from Belgrade and Sarajevo to Skopje and Pristina have been ranked among the world's top 10 most polluted major cities, according to the monitoring application AirVisual.

While these are small cities compared to leading Asian polluters like New Delhi and Dhaka, a combination of coal-fired power plants, old cars and fires to heat homes are pumping the air with toxins.   "I know it is polluting. I am not an idiot but my only other choice would be to heat this home with electricity and that is damn expensive," said Trajan Nestorovski, who like many in his working-class Skopje neighbourhood burns wood to stay warm in winter.   His wife Vera added: "There are a couple of factories near our neighbourhood that are burning God knows what in the evenings".

Thanks to the rise of mobile phone apps that measure air quality, like the local Moj Vozduh (My Air) created by a Macedonian developer, citizens are finally grasping the full extent of the crisis.    "Serbia is suffocating, has anyone seen the minister of the environment?", said a recent headline in Belgrade's local Blic newspaper, speaking of the fog and dirty air enveloping the city.   Protests have been erupting around the region in recent days.

In Skopje, the capital of North Macedonia, young people have taken inspiration from Swedish activist Greta Thunberg by holding a spate of protests on Fridays.    "Greta inspired all of us," said 17-year-old Iskra Ilieska.   "In winter, half of my school class is absent because of lung problems. That is not normal," she said.

In neighbouring Bosnia, several hundred people wearing face masks gathered in the city of Tuzla to demand a plan from authorities to tackle pollution and phase out coal-fired plants in the next five years.   "The only recommended measures are that we stay shut up at home... when you go out on the streets, in the playgrounds, you won't see children anywhere," said Alisa Kasumovic, a mother in her forties.

- Silent killer -
According to a recent UN environment report, air pollution causes nearly 20 percent of premature deaths in 19 Western Balkan cities.   The main sources of the dust, soot and smoke are low-grade coal plants and household heating, the report said.    More than 60 percent of people in the region rely on coal and firewood to heat their homes, the report said. Only 12 percent of buildings are connected to district heating systems.

Governments need to make "clean energy more accessible", ban old polluting vehicles and tighten regulations on industry emissions and power plants, the UN urged.    Many people cannot afford cleaner heating options at home in countries where average wages are around 500 euros or less.   Sali Ademi, a 78-year-old in Kosovo's capital Pristina, uses coal.     "There's no worse thing, but what can you do?" he said in a city whose air is already poisoned by two nearby coal-fired power plants running on outdated technology.

- Cable car escape -
Those who warm their homes with fires also bear the brunt of health risks, according to experts.   "Some of the emissions from these stoves stay in the house and poison them," warned Anes Podic, president of an environmental group in Bosnia who has called on the government to replace inefficient wood stoves in the country.

In cities like Sarajevo and Skopje, a circle of mountains helps trap the hazardous air in the valleys where residents live.   Sakiba Sahman, 60, is a Sarajevan taking advantage of a recent reduction on ticket prices for a cable car that rides to the top of the 1,160-metre-high (3,800-foot-high) Mount Trebevic, which peaks above the smog over the Bosnian capital.   "We've come to spend a few hours to ventilate the lungs," she told AFP.   Down below, "the pollution is enormous, there are a lot of cars, everything is dirty, grey and depressing."
Date: Fri, 24 Jan 2020 00:46:15 +0100 (MET)

Lima, Jan 23, 2020 (AFP) - Peru's government promised on Thursday to protect the Machu Picchu sanctuary and other Inca ruins when building a new airport to serve the ancient civilization's capital of Cusco.   Machu Picchu and the Inca road system are UNESCO World Heritage sites, and the UN agency has previously expressed concerns over the proposed airport at Chinchero, less than 60 kilometers from the Inca sanctuary that was built in the 15th century.   "We have made a commitment that before work begins on constructing the Chinchero airport, in June of this year, we will present the heritage impact study that UNESCO demands," Transport Minister Edmer Trujillo, who is responsible for the project, told journalists.

UNESCO has told Peru that even though the airport will be built outside of the archeological areas, it is necessary to study how a potential increase in tourists would affect them.   The new airport will be able to receive six million passengers per year -- 60 percent more than the current Cusco airport, which has a capacity for 3,000 passengers a day but receives 5,000.

The existing airport cannot grow because it is inside Cusco, a major Andean city in southeast Peru.   Machu Picchu -- the most iconic site from the Inca empire that ruled a large swathe of western South America for 100 years before the Spanish conquest in the 16th century -- is Peru's most popular tourist attraction, located about 100 kilometers (60 miles) from Cusco.   Trujillo said construction of the new airport would be constantly monitored
by culture ministry experts in case archeological ruins are found.

The airport will be built at 3,780 meters above sea level in the old Inca Sacred Valley.   Many have criticized the impact it could have not only on the country's national treasures but on rural communities.   "Building an airport in the Sacred Valley will have irreparable effects in terms of noise, increase in traffic and uncontrolled urbanization," historian Natalia Majluf said in August.   But local Cusco authorities say it will bring in vital tourism revenue, which the region depends on.
Date: Tue 21 Jan 2020
Source: Channels TV [edited]

In Ondo state, 16 people have been confirmed killed as a result of a Lassa fever outbreak. The state chief epidemiologist, Dr Steven Fagbemi, disclosed this on Tuesday [21 Jan 2020] at the governor's office in the Government House in Akure, the state capital.

Dr Fagbemi made the disclosure while briefing Governor Oluwarotimi Akeredolu as well as the local government chairmen from Ondo North and Central senatorial districts of the state. He also revealed that 84 cases have been reported so far in the state since 1 Jan 2020.

According to the epidemiologist, 16 of the patients have passed on, as their cases had reached the advanced stage before they were taken to the hospital. He added that 47 patients on admission were responding to treatment, while 21 others had already been treated and discharged.

The outbreak is said to have affected Owo, Akoko South-West, Akure South, and Ondo West LGAs of the state.

Also confirming the outbreak, the commissioner for health, Dr Wahab Adegbenro, noted that the disease has been occurring in the state for some years, especially during the dry season. He therefore advised Nigerians to visit hospitals when they noticed symptoms of fever.

Earlier, Governor Akeredolu advised the local government chairmen in the state to deploy cleaners to markets and public places to prevent the outbreak of diseases. He also called on residents to maintain a high level of hygiene to curtail further spread of the Lassa virus in the state.
====================
[The 81 new confirmed and 159 suspected cases in week 3 of 2020 indicate that Lassa fever (LF) virus transmission is continuing to accelerate. The 1st report above confirms that Ondo state has the majority of cases, tied with Edo state. Nigeria is now entering the period of the year when fewer cases usually occur, as illustrated in the graph in Figure 6 (at the source URL above). There has been a peak in case numbers between weeks 1 and 11 (January-March) over the past 3 years and probably will be the case again this year (2020).

Transmission of LF virus occurs when individuals are in contact with rodent reservoir host excreta or are within healthcare facilities. It would be interesting to know whether the prevalence of Lassa fever virus has been increasing in populations of rodent hosts in areas where human cases are occurring.

Images of the rodent reservoirs of Lassa fever virus:
_Mastomys natalensis_: <https://www.inaturalist.org/taxa/45326-Mastomys-natalensis>
_Mastomys erythroleucus_ and _Hylomyscus pamfi_: <http://punchng.com/nigerias-large-rat-population-threatens-lassa-fever-war/>

The pygmy mouse (_Mus baoulei_) has recently been implicated as a reservoir species in West Africa but not in Nigeria.

There is no specific mention in the plans above of public education for avoidance of contact with these rodents and their excreta. - ProMED Mod.TY]

[Maps of Nigeria:
Date: Tue 21 Jan 2020
Source: Ahora Noticias, Costa Rica [in Spanish, machine trans., edited]
<https://www.ahoranoticiascr.com/2020/01/21/autoridades-cerraron-pizzeria-debido-a-casos-de-hepatitis-a-en-san-ramon/>

As many as 22 people suffered from hepatitis A infection in San Ramon de Alajuela, and consequently the Health authorities closed a pizzeria in the area. A source close to this media confirmed the existence of the cases which were detected since 13 Jan 2020.

The cases were thought to be related to food consumption in that establishment 4 of patients were employees of the pizzeria. In statements to the media La Nación, Azalea Espinoza of the Directorate of Surveillance of the Ministry of Health, said they intervened in the business, issued a closing health order, and proceeded to cleaning and disinfecting it. [Byline: Carlos Miranda]
========================
[Although the eating establishment was identified as a pizzeria, pizza itself is not likely to be the vehicle of transmission as it is cooked before serving unless ingredients are added after the cooking process. It is unclear if the pizzeria employees were the source of, or just part of, the outbreak.

With an incubation period averaging 28 but up to 45 days, more cases may occur. The cases are not broken down in regard to age. In children, most cases of HAV infection are subclinical so it is likely that the cases reported were in adults. In the developing world, HAV is not reported much in adults as most children have been infected, and therefore immune to subsequent infection, by the age of 10. That outbreaks are occurring in the area suggests improvement in potable water so fewer children are infected and therefore still susceptible to HAV as adults. - ProMED Mod.LL]

[HealthMap/ProMED map available at: Costa Rica:
<http://healthmap.org/promed/p/17>]
Date: Thu, 23 Jan 2020 17:57:34 +0100 (MET)
By Eva XIAO

Beijing, Jan 23, 2020 (AFP) - The first fatality of China's new virus would come to represent a common set of traits for those who died to the disease: he was over the age of 60 and in poor health.   Since China reported the emergence of a new coronavirus at the end of December, the SARS-like virus has infected more than 500 and killed 17.   So far, the majority of the victims were elderly individuals with pre-existing health conditions, such as diabetes and liver cirrhosis.   All hailed from central Hubei province, where a local seafood market in the capital city of Wuhan is believed to be the epicentre of the epidemic.   But while older individuals have died from the Wuhan virus, some younger patients -- including a 10-year-old boy -- have since been released from the hospital.   Here's what we know so far about the deaths:

Most victims were over 60
According to details released by China's National Health Commission (NHC) on Thursday, the 17 victims of the virus were between 48 and 89 years old.   Only two were under the age of 60, while the average age of the victims was 73.   Most of them died this week, according to the NHC.   Among those who have been discharged from the hospital were younger patients, including a 35-year-old man from Shenzhen, a bustling tech hub in southern Guangdong province.   He was released from the hospital on Thursday, according to the local health commission, as well as the 10-year-old boy who had visited relatives in Wuhan before falling ill.

Many had pre-existing health conditions
Many of those who died from the virus also had pre-existing health issues before contracting the Wuhan disease, such as diabetes and hypertension.   One man, an 86-year-old who was hospitalised on January 9, had surgery for colon cancer four years prior, on top of suffering from high blood pressure and diabetes.   Another, an 80-year-old woman surnamed Hu, had Parkinson's Disease and more than 20 years of high blood pressure and diabetes in her medical history.

Some were hospitalised for weeks before dying
Several of the 17 victims were hospitalised for weeks before dying -- raising questions on the preparedness of hospitals that may have to treat patients for long periods of time.   The youngest victim of the Wuhan virus, a woman surnamed Yin, was hospitalised for more than a month before succumbing to the virus.   On December 10, the 48-year-old woman reported a fever, coughing, body soreness, and fatigue, and underwent anti-infection treatment for two weeks, according to the NHC.   Later in the end of the month, Yin suffered shortness of breath and chest tightness, and she passed away on January 20.

Not all of them had a fever
Currently, Wuhan authorities are screening passengers for fever at the airport, railway stations, and bus terminals.   At four airports in Thailand, authorities introduced mandatory thermal scans of passengers arriving from high-risk areas of China.   But not all those who died after being infected reported a fever before being hospitalised, according to the NHC.   A 66-year-old man surnamed Luo reported a "mainly dry cough" but no fever on December 22 before suffering from shortness of breath more than a week later.

By mid-January, Luo required a ventilator to help him breathe.   "A major concern is the range of severity of symptoms this virus is causing," said Dr Jeremy Farrar, Director of the Wellcome Trust.   "It is clear some people are being affected and are infectious while experiencing only very mild symptoms or possibly without experiencing symptoms at all," he said in an emailed statement.   "This may be masking the true numbers infected and the extent of person to person transmission," he added.
Date: Thu, 23 Jan 2020 16:05:30 +0100 (MET)

Singapore, Jan 23, 2020 (AFP) - Singapore Thursday confirmed its first case of the new SARS-like virus which has killed 17 people in China and spread to multiple countries including the United States.   The Ministry of Health (MOH) said the patient was a 66-year-old man from Wuhan who arrived in Singapore with his family on Monday.    He was immediately isolated after arriving at a hospital with a fever and cough, and test results later confirmed he was infected with the coronavirus.   One of his travelling companions, a 37-year-old man from Wuhan, has also been admitted to hospital as a suspect case.

Prior to admission, they had stayed at a hotel on the resort island of Sentosa, the ministry said.   It added that Singapore was expecting more cases and alarms "given the high volume of international travel".   Singapore's Changi Airport started screening flights from Wuhan at the beginning of the month, and on Wednesday extended the checks to all flights from China.   The travel hub receives over 430 flights from China every week.   The virus has caused alarm in China and abroad 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.

Singapore was among the hardest hit by SARS with 33 deaths.   Prime Minister Lee Hsien Loong, who is in Davos for the World Economic Forum, said there was "no need to panic".   Speaking to reporters travelling with him, Lee said Singapore has beefed up its hospital facilities and laid out response measures since the SARS epidemic.   "I think we are much better prepared now," he said in remarks carried by the Straits Times newspaper.