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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: 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.
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[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>]
Date: Tue, 1 May 2018 11:13:05 +0200

Yerevan, May 1, 2018 (AFP) - Armenia's hugely popular protest leader Nikol Pashinyan warned lawmakers of the prospect of major unrest if they did not elect him prime minister during a parliamentary vote on Tuesday.   "There is information that (former presidents) Serzh Sarkisian and Robert Kocharyan -- the famous tandem -- are planning to take back power," Pashinyan said during a nail-biting session of parliament in the capital Yerevan.   "I want to warn them -- gentlemen, the mistaken interpretation of people's leniency as weakness can lead to a genuine political tsunami."

"I call on everyone to take to the streets because once again they want to steal the people's victory," he added.   Pashinyan, the leader of mass protests that forced former president turned prime minister Sarkisian from power in the impoverished South Caucasus nation, is the only candidate for the post of prime minister.   He however is a handful of votes short of a majority and lacks the crucial support of the ruling party to get elected.

Speaking to his supporters in the early hours of Tuesday, Pashinyan said that the ruling party planned to derail the vote and urged hundreds of thousands to take to the streets.   A source familiar with the negotiations told AFP on Tuesday that the situation was febrile, saying Pashinyan could still be elected prime minister if several lawmakers from the Republican Party defected and voted for him.

Pashinyan is six votes short of the 53 he needs from the 105-seat legislature, where the Republican Party has a majority.   Ex-Soviet Armenia has been in the grip of a severe political crisis for the past few weeks, with leader Sarkisian stepping down last week after a decade in power in the face of peaceful protests.
More ...

Gambia

General
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The Gambia is situated on the coast of West Africa and is a common tourist destination. It enjoys a tropical climate with a rainy season between May to October each year. Harmattan winds can be experienced
during the dry season.
Stability throughout the country has been in question since a coup in 1994 but generally tourists remain unaware of any particular difficulty in this regard. Civilian rule has been in place since 1996. There is a successful tourist industry and the majority of travellers will remain in the resort regions along the coast.
Safety & Security
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It is uncommon to hear of attacks against tourists but it is considered unwise to flaunt personal wealth. Thus wearing valuable jewellery or watches should be avoided. Use the hotel safety deposit boxes for storing items of value and keep an eye on personal belongings while on the beach, on ferries or walking through market places. Many of the main tourist beaches have police or hotel security but there would be a risk if visiting some of the more isolated areas along the coast.

Road Transport
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In the main tourist regions road transport is perfectly reasonable but travelling throughout the country, particularly during the rainy season, is much more difficult. Paved roads exist in the capital, Banjul, but pedestrians still need to take care while out walking. If leaving the main tourists resorts it is essential to travel with a recognised guide. If driving, take care to stop at all check points and never reverse to avoid a road checkpoint. It is safer to use a taxi where possible (green ones for tourists). Avoid travelling to the Casamance region in Senegal (close to Gambia border), as this area is quite unstable at present. The region around Ziguinchor has also unexploded mines and armed bandits and so it would be wise to avoid.
Ferry Risks
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Taking the Banjul to Barra ferry may involve safety risks as the boat is frequently overcrowded and does not carry enough life belts etc for the number of passengers. All the engines for the ferry do not always work and it may be wiser to consider travelling 150km upriver and use the Yelitenda to Bambatenda ferry.
Health Facilities
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The level of medical facilities varies greatly throughout the country. The Medical Research Council facility in Banjul offers excellent healthcare but travellers are advised to carry sufficient supplies of any personal medication they may require while abroad.
Food & Water Facilities
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The main tourist resorts offer a good standard of food for tourists. However, it is wise to ensure that all food is fresh and well cooked. Avoiding bivalve shell fish (oysters, mussels, clams etc) is essential as these foods are frequently associated with illness among those who partake. The tap water supply may not always be regularly maintained and so it is safer to use sealed mineral water for both drinking and brushing your teeth while in The Gambia. Ice in drinks will be made from tap water and so best avoided. Food and fluids should not be purchased from street vendors except in the case of fruit, which you will then peel yourself. Tinned drinks may be safe but be careful to clean the lip before drinking straight from the can.
Malaria & Mosquitoes
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The risk of malaria in The Gambia is generally between June to December each year. Tourists have seldom been at significant risk up until recently when there has been a significant increase in the numbers of cases returning to Europe with the disease. Malaria prophylaxis should be used throughout the year. Mosquitoes mainly bite between dusk and dawn but other species can bite at any time of the day.
Rabies Risk
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There is an ever-present risk of Rabies in Africa and The Gambia is no exception. The disease is mainly transmitted to humans through the bite of an infected dog but other animals also pose a risk including cats and monkeys. The disease can also be transmitted through licks and scratches’ so avoiding all contact with animals is a wise precaution.
Sun Exposure & Dehydration
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The heat and radiation from sunlight in The Gambia can be very significant especially for fair skinned Irish travellers. Make sure you use a wide brimmed hat and keep covered from the suns rays. Dehydration and salt depletion are also common and you will need to increase the amount of fluid (and salt, unless there is a contraindication) while in this climate.
Local Laws & Customs
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The Gambian authorities take strong action against those involved in any drug trade and so take care not to carry any item for another person at any time. It is a predominantly Muslim country and so care should be taken to respect their customs for example by dressing modestly particularly when away from the main tourist regions. Never take photographs or videos of any police or military installations.
Vaccinations
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If travelling to The Gambia you are advised to consider vaccination cover against the following;
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Yellow Fever (mosquito borne viral disease)
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Poliomyelitis (childhood booster)
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Tetanus (childhood booster)
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Typhoid (food & water borne disease)
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Hepatitis A (food & water borne disease)
Occasionally travellers are advised to also consider protection against diseases like Hepatitis B, Rabies and Meningitis.
Malaria prophylaxis is essential at all times of the year for your personal protection.
Summary
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Tourist holidays to The Gambia are increasing after a lull following the unrest of the mid 90’s. However, the recent increase in malaria during December 2000 among European tourists shows how travel to tropical Africa must be treated with the respect it deserves. The majority of travellers who follow sensible guidelines will travel healthy and well.

Travel News Headlines WORLD NEWS

Date: Thu 22 Nov 2018
From: Vanessa Field vanessa.field@nhs.net

Dr. Bram Goorhuis and Dr Martin Grobusch of the GeoSentinel Surveillance Network site, Center for Tropical & Travel Medicine, AMC, Amsterdam, have reported a patient with confirmed yellow fever (YF) after travel to the Gambia and Senegal. The patient is a 26-year-old male, with no significant medical history, and previously unvaccinated against YF, who had travelled, together with his girlfriend, to the Gambian coastal region, Mansa Konko (14 days) and the Niokolo Park game reserve, Senegal (3 days). He had exposure to insect bites, but not tick bites, and did not have contact with fresh water or animals. He did not take malaria chemoprophylaxis.

On 17 Nov [2018], whilst on his flight home to Amsterdam, Netherlands, he developed a fever, chills, photophobia, and some transient gastrointestinal complaints (frequent liquid stools and abdominal discomfort). On 20 Nov [2018], he was transferred to the Center for Tropical and Travel Medicine, Amsterdam, from a peripheral hospital, with fulminant hepatitis (AST 22,000 U/L; ALT 12,500 U/L) and signs of liver failure. He tested negative for malaria and dengue; yellow fever PCR showed a very high viral load of 3.82 x 109/L. Due to an evolving encephalopathy, and a potential need for liver transplantation, the patient has now been transferred to the Erasmus Medical Center, a GeoSentinel site (Dr. Jan Nouwen and Dr. Perry van Genderen), Rotterdam, Netherlands. More follow-up is pending.

The last reported case of yellow fever in a traveller from the Gambia was in 2001 in a 47-year-old unvaccinated Belgian woman, who acquired yellow fever during a one-week vacation and subsequently died. Ref. Colebunders R et al.: A Belgian Traveler Who Acquired Yellow Fever in the Gambia. Clinical Infectious Diseases. 2002. 35(10): e113-e116. doi: <https://doi.org/10.1086/344180>.

The Ministry of Health in Senegal last notified the WHO in 2001 of 3 cases of yellow fever in K'dougou and Saraya Health districts, near the border with Mali and Guinea Conakry. A mass vaccination campaign followed. There have been no official reports to the WHO from the Gambia.

Ref: WHO Disease Outbreak News

In 2017, there were major yellow fever (YF) outbreaks in Brazil and Nigeria. These outbreaks were not marked by the rapid urban spread seen in 2016 in Angola and the Democratic Republic of the Congo (DRC), yet they illustrate the increased risk of YF and urban outbreaks with international spread. The "Eliminate Yellow Fever Epidemics" (EYE1) strategy was developed with the goal to reduce the risk of YF through a continuum ranging from outbreak detection and response to prevention. The YF surveillance network also identified suspected cases in several other high-risk countries including Congo, DRC, and Liberia.
Ref: World Health Organization (WHO) Weekly epidemiological record, 10 Aug 2018, No. 32, 2018, 93, 409-416; Yellow fever in Africa and the Americas, 2017.
<http://apps.who.int/iris/bitstream/handle/10665/273782/WER9332.pdf?ua=1>.

World Health Organization (WHO) data suggest that the rate of yellow fever transmission is increasing, especially in sub-Saharan Africa. The WHO estimates that, after adjustment for underreporting, about 200 000 cases of yellow fever occur each year. In most of west Africa, with the exception of the Gambia, yellow fever vaccination coverage is low, and there are regular epidemics of yellow fever that fluctuate according to the sylvatic cycle. Since the mid-1990s, epidemics have been reported from Ghana, Gabon, Liberia, Senegal, Benin, and Ivory Coast.

Yellow fever remains endemic in west Africa. Even urban yellow fever has recently been detected in Abidjan, Ivory Coast. Many countries in areas of endemicity in Africa (such as the Gambia) and South America (such as Venezuela) do not require travelers to undergo yellow fever vaccination. International guidelines for travellers recommend vaccination against yellow fever for persons traveling to these countries, but vaccination is not required by the countries themselves.
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Communicated by:
Davidson Hamer, MD (GeoSentinel PI)
Professor of Global Health and Medicine
Boston University School of Public Health and School of Medicine
Boston, MA USA
and
Vanessa Field, MD
Chair, GeoSentinel Tracking and Communication Working Group
International Society of Travel Medicine
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[Drs. Hamer and Field are thanked for this report of the Netherlands case and the overview of the YF situation in endemic countries. The Netherlands case is another example of failure of travellers to receive YF vaccination at least 10 days prior to arrival in an endemic country. Although the Netherlands case presents no risk of initiation of ongoing YF virus transmission, it does illustrate the fact that viremic individuals can travel long distances and, should their destination be an area that could support transmission, such as Central America or south/southeast Asia, can initiate an outbreak in a population that is overwhelmingly unvaccinated. - ProMED Mod.TY]

[Map of the Netherlands:

Maps of Senegal and the Gambia:
Date: Wed, 18 Jan 2017 17:50:39 +0100

Banjul, Gambia, Jan 18, 2017 (AFP) - Gambian President Yahya Jammeh looked determined to cling to power on Wednesday as his mandate came to an end, prompting neighbouring Senegal asking the UN to back regional actions against him.   Jammeh has announced a state of emergency which he said was necessary due to interference of foreign powers in the West African country's December 1 election, which the president of 22 years lost to opponent Adama Barrow.

Barrow, who is currently sheltering in Senegal, maintains his inauguration will go ahead on Thursday on Gambian soil, putting the country on a collision course.   Senegal on Wednesday presented a draft resolution to the UN Security Council seeking support for west African efforts to press Jammeh to step down, diplomats said in New York.   But the text does not explicitly seek council authorisation to deploy troops to The Gambia, they added.   Jammeh's declaration immediately triggered travel advisory warnings by Britain and the Netherlands, with around 1,000 British tourists expected to leave on special flights on Wednesday alone.   The 15-nation Economic Community Of West African States (ECOWAS) has repeatedly urged Jammeh to respect the outcome of the vote and step aside, a call backed unanimously by the international community.

The exact location of the inauguration was "in the hands of ECOWAS," said James Gomez, the inauguration's head organiser who said he had spoken with Barrow twice on Tuesday.   Gomez said that plans for the transfer of power in a huge stadium outside the capital Banjul were now cancelled, but added "there will be a big celebration" despite the state of emergency.   A source at Nigeria's military HQ told AFP a deployment to Senegal, whose territory surrounds The Gambia, would happen "very soon", ramping up expectations of a possible military intervention.   Under the Gambian constitution a state of emergency lasts up to 90 days if the national assembly confirms it -- which the legislature did late Tuesday.   The country's vice-president Isatou Njie-Saidy resigned Wednesday, family sources said, along with environment minister Pa Ousman Jarju, the latest in a mass string of cabinet members deserting Jammeh's government.

- Tourist disappointment -
Tourists were streaming out of the country, leaving the small airport near Banjul struggling to handle extra flights.   Brian and Yvonne Souch, a couple from Witney in southern England, told AFP they were unaware of the potential risk of flying to the country 10 days ago and felt tour company Thomas Cook should have kept them better informed.   "We didn't know anything until we came down for breakfast,"  Brian Souch said, sitting in shorts and sleeveless T-shirt in the lobby of a hotel in the Kololi tourist strip as he awaited a bus to the airport.

Thomas Cook said in a statement Wednesday a programme of additional flights into Banjul airport would bring home the 1,000 package holidaymakers it has in The Gambia, followed by up 2,500 more at the "earliest possible flight availability".   Holidaymakers were told that Thomas Cook flights would stop completely in a few days time, leaving them at risk of being stranded.   The Dutch travel firm TUI Nederland told AFP Tuesday it would repatriate "about 800" clients.   Some tourists were unfazed by the news as the state of emergency, however, as their countries have not issued travel alerts.   "We have over two weeks left and we are staying," said Mariann Lundvall, who flew into Banjul to escape Finland's freezing winter.   "If the Finnish government decides we go, then we go," she added, but with a pained face added "the climate in Helsinki... it is so cold now!"   The panic caused by the state of emergency could prove devastating for the country's economy, which experts say relies on tourism for up to 20 percent of the economy.

- Stockpiling -
Gambians were taking precautions and stocking up on food and supplies in the few shops that remained open in districts near the capital, with roads quiet and street hawkers notably absent.   A source told AFP that patients at Banjul's Edward Francis Small Teaching Hospital, which sits opposite Jammeh's seat of power, were removed for security reasons. Only those in intensive care remained.   Fatou Sarr, a resident of the fishing community of Old Jeshwang, said: "Only a few shops had bread this morning and they ran out of stock very early. If this stalemate drags on for a week or two, the country will run out."   Citizens continue to pack their bags and stream out of Gambia -- a small, narrow enclave of Senegal except for its coast -- by road and ferry heading for Senegal, Guinea-Bissau and Guinea, taking as many possessions as they could carry.   "My two children and I are staying with my aunt. We don't know what will happen tomorrow," said a 50-year-old woman who recently took shelter in Senegal, adding that she hoped to return home soon.
Date: Wed, 18 Jan 2017 04:45:54 +0100

Banjul, Gambia, Jan 18, 2017 (AFP) - Gambia's Yahya Jammeh declared a state of emergency just days before he was due to step down, with British and Dutch travel agencies scrambling to evacuate thousands of tourists Wednesday.   Jammeh, who has ruled The Gambia with an iron fist for 22 years, initially acknowledged opponent Adama Barrow as the victor in December elections, but later rejected the ballot count as flawed and lodged a complaint with the country's Supreme Court.   He declared a state of emergency on Tuesday due to the "unprecedented and extraordinary amount of foreign interference in the December 1 presidential elections and also in the internal affairs of The Gambia," Jammeh announced on state TV.

Citizens were henceforth "banned from any acts of disobedience to the laws of The Gambia, incitement to violence and acts intended to disturb public order and peace," Jammeh said, asking security forces to maintain law and order.   Under the Gambian constitution a state of emergency lasts up to 90 days if the national assembly confirms it -- which the legislature did late Tuesday, a parliamentary source told AFP.   In Washington, the US State Department urged Jammeh to "peacefully hand over power" to Barrow -- who is in Senegal, where he plans to remain until his planned inauguration Thursday.   "Doing so would allow him to leave office with his head held high and to protect the Gambian people from potential chaos," spokesman John Kirby said. "Failure to do so will put his legacy, and more importantly The Gambia, in peril."

The 15-nation Economic Community Of West African States (ECOWAS) has also repeatedly urged Jammeh to respect the outcome of the vote and step aside, a call backed by the UN Security Council, African Union and others.   Jammeh has rebuffed two high-level delegations by west African leaders pleading with him to go.   "The potential for military intervention and civil disturbance is high," the British foreign ministry said on its website, a warning echoed on social media by its Dutch counterpart, who both urged citizens to avoid all but essential travel.   British travel agency Thomas Cook said it had "implemented our contingency plans to bring all our UK customers home," and was trying to arrange evacuation of up to 3,500 tourists from Banjul airport as soon as possible.    "We will operate a programme of additional flights into Banjul airport over the next 48 hours," the company said in a statement, adding this included four extra flights on Wednesday.   The Dutch travel firm TUI Nederland told AFP it would repatriate "about 800" clients.

- String of resignations -
Four more cabinet ministers in Jammeh's government defected, a source close to the regime told AFP on Tuesday.   Foreign minister Neneh Macdouall-Gaye, finance minister Abdou Kolley, trade minister Abdou Jobe and tourism minister Benjamin Roberts all resigned, the source said, requesting anonymity for safety reasons.   They follow the high-profile defection last week of information minister Sheriff Bojang, who is now in neighbouring Senegal.   Citizens continued to pack their bags and stream out of Gambia -- a small, narrow enclave of Senegal except for its coast -- by road and ferry heading for Senegal, Guinea-Bissau and Guinea, taking as many possessions as they could carry.   One traveller told AFP that those arriving at 10:00 am would have to wait until the following day to board a ferry at Banjul port to cross the river headed for Senegal, unless they bribed officials, due to huge numbers exiting the city.

- Military deployment? -
Military intervention in The Gambia seems closer than ever, following declarations by the UN and African Union that boots on the ground could get the green light without a rapid resolution to the crisis.   In Nigeria -- the regional power of west Africa -- a source at the country's military HQ said, "We are deploying to Dakar, Senegal, very soon."   "We are deploying platforms, a few personnel, pilots, technicians and the maintenance crew," said the source, speaking on condition of anonymity.   "You already know that this deployment is in connection with the unfolding development in The Gambia."   In Rabat, it was reported that Morocco had offered Jammeh asylum for accepting the election defeat and stepping down "in return for a golden retirement", but Banjul sources were reluctant to confirm the claim.   Seven journalists -- from Sweden and Senegal, plus four from Kenya and South Africa who were working for a Chinese TV channel -- were expelled late Monday soon after they arrived at Banjul airport to cover the ongoing crisis.
Date: Tue, 13 Dec 2016 05:39:37 +0100
By Jennifer O'MAHONY

Banjul, Gambia, Dec 13, 2016 (AFP) - The cocktails keep flowing by the pool on the tourist strip, but in The Gambia's markets many African migrant traders are packing up their businesses and heading home.   The international community is piling pressure on President Yahya Jammeh to leave power after 22 years and hand over to opposition leader Adama Barrow, who won an election two weeks ago only for Jammeh to later reverse his original concession of defeat.

Of the economy's two main sources of investment from abroad, tourism appears to be weathering the country's political storm far better than the thousands of petty traders who move to The Gambia from the rest of west Africa.   President-elect Barrow told AFP on Monday claims that tourist numbers could be hit were "exaggerated", and with hotels and restaurants full, for the moment he appears to be right.   Flights from Brussels and London are still arriving like clockwork for the peak winter sun season, with many holidaymakers telling AFP they return to the country year after year -- and aren't changing their minds.

"I did think there were more checkpoints," said Elly Preston, a returning retired schoolteacher spending three and a half months in Kololi, the Gambian heartland of full English breakfasts and karaoke bars stuffed with crooning pensioners.   Preston had seen alarming posts on the Tripadvisor tourism website, but with hotel prices as low as £40 a night (48 euros) she stuck with her instinct and left behind the cold and rain of Cleckheaton in northern England.   "I feel safe here. I know everybody and we come together," she said from her sunlounger, waving at a friend she met while on holiday here a few years ago.

Reading a thriller while taking in some rays in the late afternoon, Joseph Fowlis from Liverpool is well aware that Jammeh has refused to stand down, and supports Barrow's fight for change.   "Taxi drivers told me they want a democracy," he told AFP. "And why shouldn't they have one?"   But that hasn't affected his budget break. Apart from a higher than usual level of political conversation in the back of cabs, he said, little had changed from the previous years he has been here.   "If you didn't know about it you wouldn't think anything of it," he said.   Hotel owners are slightly more nervous, but as long as the tour operators keep the flights up, business will boom, they told AFP.

- Trader panic -
The tiny west African state relies on largely British and Scandinavian tourists for 20 percent of its GDP.   Meanwhile Guineans, Mauritanians and Senegalese are well known for importing goods and selling them to the local population.   In a recent speech, Jammeh said 100,000 foreigners were working in The Gambia's markets, but did not specify a source for that figure.   Fifteen minutes down the road from Kololi, the hawkers and fruit sellers of Serekunda market have a very different interpretation of the events unfolding.

Amadou Wurri Jallow, a Guinean shopkeeper, spoke of his fear of soldiers being stationed on the streets of his neighbourhood.   "I do not understand why soldiers armed with machine guns would be deployed every night in built-up areas of Serekunda," Jallow said.   "This is really frightening and disturbing. I am leaving for my country until this political stalemate is resolved peacefully."   Fallou Diop, a Senegalese hawker who has lived and worked in The Gambia for the past few years, told AFP shortly before his departure to the city of Touba in central Senegal that the uncertainty was too much.   "Since no one can tell how this problem would come to an end, I am going back to Touba until the dust settles," he said.
Date: Fri 14 Nov 2014
Source: StarAfrica, APA (Agence Africaine de Presse) report [edited]

The head of disease control in the Gambia, Sanna Sambou, has confirmed the reopening of the country's border to countries affected by the deadly Ebola virus, APA reported on Friday [14 Nov 2014]. Mr Sambou noted that border closure was not the best solution to contain the virus, hence the need to reopen borders to allow in and out movement of people between the Gambia and countries affected by Ebola. According to media reports, the issue of border closure, as a result of the outbreak of the disease, was deemed discriminatory and unworthy by the World Health Organisation (WHO), adding that it should be considered a global pandemic.

Despite the restoration of the border crossing, however, Sambou said the health authorities are poised to continue on the thorough screening of people moving into the country from Ebola hit nations. It could be recalled the Gambia in September [2014] announced that it would no longer be granting entrance to Guineans, Liberians, Nigerians or Sierra Leoneans, due to fear of the disease getting into the country.
More ...

World Travel News Headlines

Date: Tue, 19 Mar 2019 12:35:15 +0100
Watamu, Kenya, March 19, 2019 (AFP) - If you live in a country with venomous snakes, or are travelling to one, here are a few tips to avoid being bitten.

- Do not provoke -

Snakes usually will not attack unless they feel threatened. In the bush, wear sturdy leather shoes and stomp heavily when walking, striking with a stick on the ground in front of you to warn any reptiles you are coming -- they will most likely just slither away.
Most strikes occur when snakes feel cornered or under threat, or when people accidentally step on them.

- Be alert and prepared -

Outside, have a good look around you for snakes that may hang from tree branches or swim in water, and be careful when turning over rocks or other objects. And remember: snakes are evolved to be well-camouflaged in their environment, whether it be the desert, forest or bush.
Thick, protective gloves are recommended for gardening and farming.
Carry a lamp at night.
Birds can help too: Many species possess an alarm cry to alert others of hidden danger.
Inside, check your bed and dark corners -- snakes can enter homes in pursuit of prey, heat or water.
The neater your home, the more likely you will spot an out-of-place snake. A mosquito net around your bed can be an effective snake repellent.

- Once bitten -
If you or someone else is bitten, try and remember the colour and shape of the snake, and seek immediately medical care at a clinic or hospital.
Remove any bracelets, rings or watches that may hamper blood flow in case of swelling.
Do NOT try and catch the snake, apply a tourniquet, cut the wound, suck out the venom, or drink alcohol or coffee.
Also do not seek to inject your own antivenom, which can induce a violent allergic reaction and needs to be administered in a professional environment with adrenaline and oxygen on hand.

Sources: Doctors Without Borders, Centers for Disease Control and Prevention, Health Action International, Bio-Ken research centre.

Date: Tue, 19 Mar 2019 08:06:51 +0100

Sentani, Indonesia, March 19, 2019 (AFP) - At least 89 people are known to have died after flash floods and landslides tore through Indonesia's Papua region, with the toll expected to rise further as rescuers hunt for dozens still missing, the national disaster agency said Tuesday.   Scores have also been injured in the disaster, triggered by torrential rain on Saturday, with some 6,800 people evacuated to temporary shelters.   The military has taken up the grim task of putting mud-caked corpses into body bags, with the search hampered by mountains of debris including rocks and fallen trees.

Seventy-four people remain unaccounted for, while around 150 suffered broken bones, cuts and other injuries.   "Many people are choosing to stay at shelters because they're still traumatised and scared of more flash floods, so some evacuation centres are packed," said national disaster agency spokesman Sutopo Purwo Nugroho.

The government has issued a 14-day state of emergency in Papua, which shares a border with independent Papua New Guinea on an island just north of Australia.   Flooding is common in Indonesia, especially during the rainy season which runs from October to April.   In January, floods and landslides killed at least 70 people on Sulawesi island, while earlier this month hundreds in West Java province were forced to evacuate when torrential rains triggered severe flooding.

Meanwhile, three people were killed -- including two Malaysian tourists -- and some 182 were injured after an earthquake Sunday triggered a landslide on the Indonesian tourist island of Lombok, next to Bali.   Lombok was rocked by several earthquakes last summer, killing more than 500 people and leaving over 150,000 homeless.

Last September, the country was hit by an earthquake and tsunami in Palu on Sulawesi island which killed around 2,200 people.    The Southeast Asian archipelago of some 17,000 islands is one of the most disaster-prone nations on Earth, straddling the Pacific Ring of Fire, where tectonic plates collide. Earthquakes and volcanic eruptions are common.
Date: Mon, 18 Mar 2019 23:35:47 +0100
By Nova SAFO

Chicago, March 18, 2019 (AFP) - The US Midwest struggled Monday with historic flooding that claimed at least three lives, displaced residents and damaged hundreds of homes and businesses.    Swollen waters hit much of Nebraska, as well as parts of Iowa, Wisconsin, and South Dakota, after a major storm last week dumped snow and rain, even as melting snow was already raising the levels of area waterways.   Neighboring states could also be affected as floodwaters drain, officials said.    President Donald Trump on Monday described the floods as "devastating" and said the White House would remain in close contact with state officials.    "Our prayers are with the great people of South Dakota," he said in one tweet.    In another aimed at Iowa residents, he said: "We support you and thank all of the first responders working long hours to help the great people of Iowa!"

- 'Historic' flooding -
The National Weather Service (NWS) described the flooding as "major" and "historic," forecasting that it would continue across large sections of the middle of the country.    "Flood Warnings and Advisories are scattered throughout the Plains, Mississippi Valley, and western parts of the Ohio Valley region, with a focus in Nebraska and western Iowa," the NWS said in an advisory.    "Farther west and north, areal flooding is also possible in the Northwest and Northern Plains as snowmelt continues over frozen ground."   The early damage assessment total for the state of Nebraska was more than $260 million, according to emergency management officials.

Record flooding was reported in 17 locations in the state and 10 American Red Cross shelters were operating for displaced residents.    At its highest point, the Missouri River was expected to crest at 47.5 feet (14.5 meters), beating its 2011 record by more than one foot.    "Comparisons to 2011 were inevitable," the NWS office in Iowa tweeted, "but these floods have resulted in many more rescues and widespread damage in eastern Nebraska and western Iowa."   Failing levees were blamed for flooding in numerous communities -- damaging homes and businesses.    The US Army Corps of Engineers, which maintains federal levee systems, said a majority were compromised along an approximately 100-mile portion of the Missouri River in southeast Nebraska.

- Military base under water -
Hundreds of people were rescued in Nebraska, where 54 cities issued emergency declarations, as did four Native American tribal areas.    Fremont, a city of more than 25,000, was surrounded by floodwaters over the weekend and cut off from aid.    It finally received food and other emergency supplies Sunday after crews managed to clear debris and mud from a road, officials said.    Three dozen Iowa counties were under states of emergency.    Roads were closed throughout Wisconsin and more than 200 people were evacuated, according to officials.

A third of Offutt Air Force Base in Nebraska was overcome with floodwater, and was not expected to be dry again until Thursday.   "It's important to understand that this is going to take weeks and months to recover so this will be a prolonged effort," one of the base's leaders, Kevin Humphrey, said in a statement.    Three people were reported killed.   A Nebraska farmer died Thursday, during the height of the storm, trying to rescue a motorist stranded by floodwaters, the Omaha World-Herald reported.    On the same day, 80-year-old Betty Hamernik died after being trapped by floodwaters in her home in rural Columbus, Nebraska, according to the newspaper.    Aleido Rojas Galan, 55, was killed Friday in Iowa when his vehicle was swept away by floodwaters, TV station KETV said.
Date: Mon, 18 Mar 2019 16:57:59 +0100

Kiev, March 18, 2019 (AFP) - Eleven people have died and more than 30,000 have been infected this year in a major measles outbreak in Ukraine, the European country worst hit by the disease, Kiev said Monday.  The latest victim was a nine-year-old girl who died from complications Saturday after contracting the highly infectious disease, the health ministry said.

Some 30,500 people, including 17,000 children, have been infected so this year.   Authorities said shortages of vaccine in previous years and anti-vaccination sentiment, often driven by online campaigns spreading false information about the alleged risks, were the main reasons behind the outbreak.

The World Health Organization (WHO) recommends a 95-percent vaccination rate to prevent mass hospitalisations and fatalities.   But in Ukraine, just 42 percent of one-year-olds had been vaccinated as of end-2016, according to the United Nations children's agency UNICEF.   Measles cases more than tripled across Europe in 2018, with Ukraine accounting for most of the gain.

Europe as a whole saw nearly 83,000 cases last year, according to WHO figures.  The Ukrainian government reported 54,000 cases in 2018. There were 16 deaths nationwide.  In 2019, the authorities launched a special campaign including sending mobile vaccination teams to rural schools in two western regions particularly hard hit in the outbreak.   Measles is characterised by high fever and a reddish rash. It usually triggers only mild symptoms but remains one of the leading causes of death among young children globally.
Date: Sun, 17 Mar 2019 16:19:02 +0100

Paris, March 17, 2019 (AFP) - Eurostar trains from Paris to London were hit by cancellations and "severe delays" on Sunday as French customs officers staged work-to-rule industrial action.     The customs officers are demanding higher pay and better working conditions while seeking to demonstrate what might happen if full border controls are put in place once Britain leaves the European Union.

Paris-to-London trains were experiencing "severe delays and lengthy queues for our services," Eurostar said on its website. "We strongly recommend that you do not travel today."   Four trains had been cancelled by lunchtime on Sunday, with another three on Monday and one on Tuesday.   Sunday's work-to-rule was just the latest in a string of strike actions by the French customs officers.

Work-to-rule strikes began in early March, in the Channel ports of Dunkirk and Calais, northern France, leading to long delays for trucks waiting to cross to Britain.   The customs workers want better pay but also more staff to cope with British travellers who will no longer have European passports once the UK leaves the European Union.

Brexit is due to happen on March 29 but looks increasingly likely to be delayed as the British parliament is yet to agree on a divorce plan.   On Wednesday French unions representing the around 17,000 customs workers rejected a government offer of a 14 million euro ($15.8 million) payroll boost, saying it was insufficient.
Date: Sun, 17 Mar 2019 16:15:35 +0100

Mataram, Indonesia, March 17, 2019 (AFP) - At least two people were killed and dozens injured Sunday after an earthquake on the Indonesian tourist island of Lombok triggered a landslide, officials said.    The 5.5-magnitude quake is thought to have caused the landslide at the Tiu Kelep waterfall in the north of the island.   "Two people died in the landslide in the Tiu Kelep waterfall after the earthquake, one of them is a Malaysian," a disaster agency spokesman told AFP.   At least 44 people were injured in the earthquake, according to the agency, including eight Malaysians, while more than 30 houses were destroyed and about 500 others slightly damaged.

Indonesia is one of the most disaster-prone nations on Earth due to its position straddling the so-called Pacific Ring of Fire, where tectonic plates collide.   Lombok was rocked by several earthquakes last summer, killing more than 500 people and leaving over 150,000 homeless.   Last September, the country was hit by an earthquake and tsunami in Palu on Sulawesi island which killed around 2,200 people.
Date: Fri 15 Mar 2019
Source: Prothom Alo [edited]

The 3 members of a family from Baliadangi upazila's [2nd-lowest tier of regional administration] Ujarmoni village in Thakurgaon [district] are suspected to have been infected with the deadly Nipah virus, reports United News of Bangladesh [apparently later confirmed as Nipah virus; see below. - ProMED Mod.TY].

The victims include a 28 year old mother; her son, aged 8; and her daughter, aged 4. They were taken to Rangpur Medical College Hospital on Thursday [14 Mar 2019], said ABM Maniruzzaman, the resident medical officer of Baliadangi Upazila Health Complex. He said the victims had been suffering from fever for the last 3 days. They also reported headache and vomiting. The trio was 1st taken to Thakurgaon Modern Sadar Hospital and later shifted to RMCH.

Nipah virus is transmitted from animals to humans and can also be transmitted through contaminated food or directly between people, according to the World Health Organisation. There is no vaccine for the virus, which is spread through body fluids and can cause inflammation of the brain.

The mother's husband said his wife and children fell sick after eating jujube [fruit of the _Ziziphus jujuba_ bush] on Wednesday night [13 Mar 2019].

Thakurgaon civil surgeon Abu Mohammad Khairul Kabir said their blood samples had been collected for testing. A medical team from the Institute of Epidemiology, Disease Control and Research is scheduled to visit RMCH.

In February [2019], 5 members of a family died mysteriously in Baliadanga upazila. It is unclear what caused their deaths [Nipah virus is suspected]. In 2001, Nipah virus was identified as the causative agent in an outbreak of human disease occurring in Bangladesh. Genetic sequencing confirmed this virus as Nipah virus, according to the Centre for Disease Control and Prevention.
======================
[This is the 2nd family in Bangladesh to have been infected by Nipah virus this year [2019]. Nipah virus infections occur sporadically in Bangladesh. As noted in the previous comment (ProMED-mail archive no. http://promedmail.org/post/20150204.3143251), "Giant fruit bats or flying foxes (_Pteropus_ of several species) are reservoirs of Nipah virus, and . . . they contaminate date palm sap or the fruit. [The above report suggests that the family may have eaten contaminated jujube fruit]. This is the season for cases of Nipah virus infection to occur. The transmission season is usually January to April."

"It is unfortunate that the public awareness efforts have not prevented these cases from occurring. Perhaps because cases are sporadic and geographically scattered there is little public perception of risk of infection and serious disease. Until effective public education to prevent infection by avoiding eating contaminated fruit or date palm sap is implemented, sporadic cases will continue to occur."

An image of a _Pteropus_ fruit bat can be found at

[HealthMap/ProMED-mail maps:
Rangpur Division, Bangladesh: <http://healthmap.org/promed/p/16030>]
Date: Fri 15 Mar 2019
Source: Le Journal de Mayotte [in French, trans. ProMED B, edited]

The circulation of Rift Valley fever (RVF) continues in Mayotte. An animal disease of viral origin, Rift Valley fever mainly affects domestic ruminants (cattle, sheep, goats), causing abortions and high mortality in young animals. It can be transmitted from the infected animal to humans.

In total, since the beginning of the epidemic (end of November [2018]),
- samples taken by veterinarians from sick animals or during abortions led to the identification of 8 new outbreaks this week [week of Mon 11 Mar 2019], for a total of 60 cases in animals (including 49 cattle). Animal foci are located mainly in the centre and north west of the island;
- a total of 101 human cases of RVF have been reported to the platform/cell watch and health emergencies of the ARS OI (CVAGS) of Mayotte by the CHM laboratory. Of those who could be interviewed, almost 80% report having been in contact with animals;
- since the beginning of the health alert, human cases have been located mainly in the centre and north west of the island, with nearly 60% of cases in Chiconi and Tsingoni.

Since 25 Feb 2019, the weekly number of new human cases has been on the decrease.  [byline: Anne Perzo]
========================
[This Rift Valley fever (RVF) outbreak has been going on since November 2018. The number of human cases of RVF has increased from 82 to 101 in about 2 weeks. However, it is good to learn that the number of new human cases is decreasing. The above report implies that the human infections are the result of contact with infected animals or their products, with fewer from virus transmission by mosquito vectors. The cattle cases certainly are the result of mosquito transmission.

Because RVF virus can be transovarially transmitted in populations of aedes mosquito vectors, and those resulting eggs can persist for a long period of time in nature, cases can occur periodically when the virus-containing eggs hatch, and infected adult females emerge from them. There is a risk that RVF will reappear on the island after the current outbreak has ended.

Recent studies have shown that RVF virus may severely injure human foetuses if contracted by mothers during pregnancy. There is no indication of whether any of the 101 RVF virus-infected people were pregnant. Abortions in infected livestock are common. There is no vaccine available for human use, but there is for livestock. There is no mention of whether the livestock populations in the area have been vaccinated.

The clinical findings related to the above human cases are not mentioned. In an earlier comment, ProMED noted that: "The most common complication associated with RVF is inflammation of the retina. As a result, approximately 1-10% of affected patients may have some permanent vision loss. Approximately 1% of humans that become infected with RVF virus die of the disease." - ProMED

[ealthMap/ProMED-mail map of Region d'outre-mer de Mayotte, France:
Date: Thu 14 Mar 2019
Source: Outbreak News Today [edited]

Tasmania health officials are advising people who live on the east coast, or plan on travelling there, to ensure they protect themselves against mosquitoes following a number of cases of Barmah Forest virus. To date, 5 confirmed cases of the mosquito borne disease have been reported, with 2 additional cases being investigated. Officials note that these cases represent the 1st time the officials have been able to confirm the virus was contracted in Tasmania.

Public Health Services has partnered with University of Tasmania to conduct mosquito trapping in an attempt to learn more about this outbreak. PHS and UTAS staff will volunteer their time this weekend [16-17 Mar 2019] to set a number of traps on the East Coast. The trapping will attempt to confirm the presence of mosquito species known to carry the virus, and also to hopefully trap a mosquito carrying the virus for further research.

Barmah Forest virus is spread by the bite of an infected mosquito. It is related to Ross River virus. Barmah Forest virus is relatively common in mainland states but has not been thought to be present in Tasmania until recently.

Many people may be asymptomatic. If symptoms are present, they can manifest as fever, headache, aches and pains in muscles and joints, tiredness, rash, and swollen or stiff joints. Symptoms usually develop 3-21 days after being bitten by an infected mosquito. Most people recover completely in a few weeks.

Preventing insect bites will also protect against other mosquito borne diseases, such as Ross River virus, and tickborne diseases, such as Flinders Island spotted fever.

To protect against mosquitoes and ticks,
- avoid mosquito-infested areas when possible;
- cover up with a loose-fitting, long-sleeved shirt and long pants when outside;
- apply mosquito repellent to exposed skin;
- take special care during peak mosquito-biting hours, especially around dawn and dusk, and when outdoors or camping; and
- remove potential mosquito-breeding sites from around the home and screen windows and doors.
=======================
[Clearly, Barmah Forest virus (BFV) is currently being transmitted in Tasmania, reportedly for the 1st time. Interestingly, Dr Steve Berger's comment (Barmah Forest virus - Australia (02): (TS) comment http://promedmail.org/post/20190310.6360212) indicated that 19 cases of BFV infections have been reported in Tasmania from 1999-2018, suggesting that these infections were acquired in other Australian states. The previously ProMED-mail-posted cases of BFV infections have been in Queensland state. It will be interesting to learn which mosquito species are transmitting the virus in Tasmania. The Tasmania Public Health Services' advice to prevent mosquito bites should be taken seriously. - ProMED Mod.TY]

[HealthMap/ProMED-mail map of Tasmania, Australia:
Date: Fri, 15 Mar 2019 19:08:37 +0100
By Joaquim Nhamirre

Maputo, March 15, 2019 (AFP) - Tropical cyclone Idai battered Mozambican coastal city Beira Friday, leaving half a million people virtually cut off after power lines crashed, airport shut and roads were swamped by flooding that killed 66 people nationwide.   "There is no communication with Beira. Houses and trees were destroyed and pylons downed," an official at the National Institute of Disaster Management (NIDM) told AFP.   Authorities had to close Beira international airport after the air traffic control tower, the navigation systems and the runways were damaged by the storm.   "Unfortunately there is extreme havoc," said the official.   "Some runway lights were damaged, the navigation system is damaged, the control tower antennas and the control tower itself are all damaged.    "The runway is full of obstacles and parked aircrafts are damaged."

Late on Wednesday, the national carrier LAM cancelled all flights to Beira and Quelimane, which is also on the coast, as well as to Chomoio, which is inland.    Power utility Electricidade de Mocambique said in a statement that the provinces of Manica, Sofala and parts of Inhambane have been without power since Thursday.   Officials did not report any confirmed deaths, but local Beira station STV reported a child had died in Manica province west of the city, apparently the victim of a falling roof.   "There was no tsunami-type storm but Beira and Chinde (400 kilometres, 250 miles northeast of Beira on the coast) were badly hit," added the NIDM official.

Another official, Pedro Armando Alberto Virgula, in Chinde, said a hospital, police station and seven schools there lost their roofs and four houses were destroyed.   Virgula added that efforts were under way to assess the damage caused after Idai made landfall late on Thursday.   Local officials said that this week's heavy rains claimed 66 lives, injured 111 people and displaced 17,000 people.   The World Food Programme (WFP) said it would move 20 tonnes of emergency food aid to the affected areas.   The UN Office for the Coordination of Humanitarian Affairs (OCHA) had warned that the storm could pack winds of up to 190 kilometres per hour (118 miles per hour).

- 'Devastation' -
At least 126 people were killed by the downpour that has struck parts of Mozambique, Malawi and South Africa over the past week, officials said.   Heavy rains in neighbouring Malawi have affected almost a million people and claimed 56 lives, according to the latest government toll.   Authorities there have opened emergency relief camps where malaria and shortages of supplies have led to dire conditions, according to AFP correspondents.

Malawian President Peter Mutharika this week declared a natural disaster.   Mozambique's weather service has warned that heavy rain will continue to batter Beira and surrounding areas until Sunday.   The UN warned of damage to crops, "including about 168,000 hectares (415,000 acres) of crops already impacted by flooding in early March, which will undermine food security and nutrition".   Mozambique and Malawi, two of the poorest countries in the world, are prone to deadly flooding during the rainy season and chronic drought during the dry season.   In neighbouring Zimbabwe, weather services have warned that violent thunderstorms, lightning and strong winds will be experienced in the eastern regions of the country.