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Netherlands Antilles

Netherland Antilles US Consular Information Sheet
May 12, 2008
COUNTRY DESCRIPTION:
The five islands of Bonaire, Curaçao, Saba, St. Eustatius (or “Statia”) and St. Maarten (Dutch side) comprise the Netherlands Antilles, an autonomous
art of the Kingdom of the Netherlands. Tourist facilities are widely available. Read the Department of State Background Notes on the Netherlands Antilles for additional information.
ENTRY/EXIT REQUIREMENTS: All Americans traveling by air outside the United States are required to present a passport or other valid travel document to enter or re-enter the United States. This requirement will be extended to sea travel (except closed loop cruises), including ferry service, by the summer of 2009. Until then, U.S. citizens traveling by sea must have government-issued photo identification and a document showing their U.S. citizenship (for example, a birth certificate or certificate of nationalization), or other document compliant with the Western Hemisphere Travel Initiative, 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. Based on current projections, we expect to begin production of the passport card in June 2008 and be in full production in 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 is available at http://travel.state.gov/passport/ppt_card/ppt_card_3926.html and upcoming changes to U.S. passport policy can be found on the Bureau of Consular Affairs web site at http://travel.state.gov/travel/cbpmc/cbpmc_2223.html. We strongly encourage all American citizen travelers to apply for a U.S. passport well in advance of anticipated travel. American citizens can visit travel.state.gov or call 1-877-4USA-PPT (1-877-487-2778) for information on how to apply for their passports.
The U.S. Consulate recommends traveling in the Netherlands Antilles with a valid U.S. passport to avoid delays or misunderstandings. A lost or stolen passport is also easier to replace when outside the United States than other evidence of citizenship. Visitors to the Netherlands Antilles may be asked to show onward/return tickets or proof of sufficient funds for their stay. Length of stay is granted for two weeks and may be extended for 90 days by the head office of immigration. For further information, travelers may contact the Royal Netherlands Embassy, 4200 Linnean Avenue, N.W., Washington, D.C. 20008, telephone (202) 244-5300, or the Dutch Consulate in Los Angeles, Chicago, New York, Houston or Miami. Visit the web site for the Embassy of the Netherlands at http://www.netherlands-embassy.org/homepage.asp for the most current visa information.

We have more information pertaining to dual nationality and international child abduction. Please refer to our customs information to learn more about customs regulations.

SAFETY AND SECURITY:
Drug-related organized crime exists within the Netherlands Antilles but has not directly affected tourists in the past.
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, 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., 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: In recent years, street crime has increased, especially in St. Maarten. Valuables, including passports, left unattended on beaches, in cars and hotel lobbies are easy targets for theft, and visitors should leave valuables and personal papers secured in their hotel. Burglary and break-ins are increasingly common at resorts, beach houses and hotels. Armed robbery occasionally occurs. The American boating community has reported a handful of incidents in the past, and visitors are urged to exercise reasonable caution in securing boats and belongings. Car theft, especially of rental vehicles for joy riding and stripping, can occur. Incidents of break-ins to rental cars to steal personal items have been reported by American tourists. Vehicle leases or rentals may not be fully covered by local insurance when a vehicle is stolen. Be sure you are sufficiently insured when renting vehicles and jet skis.
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, to contact family members or friends and explain how funds could be transferred. Although the investigation and prosecution of the crime is solely the responsibility of local authorities, consular officers can help you to understand the local criminal justice process and to find an attorney if needed.
Please see our information for American Victims of Crime Overseas.
MEDICAL FACILITIES AND HEALTH INFORMATION: Medical care is generally good in Curaçao and St. Maarten, but may be limited on the other three islands. Hospitals have three classes of services i.e.: First Class: one patient to a room, air conditioning etc.; Second Class: two to six patients to a room, no air conditioning; Third Class: 15 to 30 people in one hall. Patients are accommodated according to their level of insurance.
Bonaire: The San Francisco hospital is a medical center (35 beds) with decompression facilities. The hospital has an air ambulance service to Curaçao and Aruba.
Curaçao: St. Elizabeth hospital is a public hospital that may be compared to midrange facilities in the United States. St. Elizabeth's hospital has a decompression chamber and qualified staff to assist scuba divers suffering from decompression sickness. Several private clinics provide good to excellent medical service.
St. Maarten: St. Maarten Medical Center (79 beds) is a relatively small hospital where general surgery is performed. Complex cases are sent to Curaçao.
Statia: Queen Beatrix Medical Center (20 beds) is a medical facility well equipped for first aid. Surgery cases are sent to St. Maarten.
Saba: Saba Clinic (14 beds) is a well-equipped first aid facility. Surgery cases are sent to St. Maarten. The Saba Marine Park has a decompression chamber and qualified staff to assist scuba divers suffering from decompression sickness.
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.
MEDICAL INSURANCE: The Department of State strongly urges Americans to consult with their medical insurance company prior to traveling abroad to confirm whether their policy applies overseas and whether it will cover emergency expenses such as a medical evacuation. Please see our information on medical insurance overseas.
TRAFFIC SAFETY AND ROAD CONDITIONS: While in a foreign country, U.S. citizens may encounter road conditions that differ significantly from those in the United States. The information below concerning the Netherlands Antilles is provided for general reference only, and may not be totally accurate in a particular location or circumstance.
Driving in the Netherlands Antilles is on the right hand side. Right turns on red are prohibited, and traffic conditions require somewhat defensive driving. Local laws require drivers and passengers to wear seat belts and motorcyclists to wear helmets. Children under 4 years of age should be in child safety seats; children under 12 should ride in the back seat.
Nonexistent or hidden and poorly maintained street signs are the major road hazard in the Netherlands Antilles. Therefore, drivers should proceed through intersections with caution. Roads in the Netherlands Antilles are extremely slippery during rainfall. Night driving is reasonably safe in the Netherlands Antilles as long as drivers are familiar with the route and road conditions. Most streets are poorly lit or not lit at all. In Curacao, drivers should be aware of herds of goats that may cross the street unexpectedly. In Bonaire, wild donkeys may also cross the road.
Taxis are the easiest, yet most expensive form of transportation on the islands. As there are no meters, passengers should verify the price before entering the taxi. Fares quoted in U.S. dollars may be significantly higher than those quoted in the local currency. Vans are inexpensive and run non-stop during daytime with no fixed schedule. Each van has a specific route displayed in the front of the windshield. Buses, which run on the hour, have limited routes. The road conditions on the main thoroughfares are good to fair.
See road safety information at the following sites; http://www.curacao.com, http://www.statiatourism.com, http://www.sabatourism.com, http://www.infobonaire.com, http://www.st-maarten.com/.
Please refer to our Road Safety page for more information.
AVIATION SAFETY OVERSIGHT: The U.S. Federal Aviation Administration (FAA) has assessed the Government of the Netherlands Antilles’ Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for oversight of the Netherlands Antilles’ 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:
Dutch law in principle does not permit dual nationality. However, there are several exceptions. For example, American citizens who are married to Dutch citizens are exempt from the requirement to abandon their American nationality when they apply to become a Dutch citizen by naturalization. For detailed and specific information on this subject, contact the Embassy of the Netherlands in Washington or one of the Dutch consulates in the U.S. In addition to being subject to all Dutch laws affecting U.S. citizens, dual nationals may also be subject to other laws that impose special obligations on Dutch citizens.
Time-share buyers are cautioned about contracts that do not have a "non-disturbance or perpetuity protective clause" incorporated into the purchase agreement. Such a clause gives the time-share owner perpetuity of ownership should the facility be sold. Americans sometimes complain that the timeshare units are not adequately maintained, despite generally high annual maintenance fees. Because of the large number of complaints about misuse of maintenance fees, particularly in St. Maarten, prospective timeshare owners are advised to review the profit and loss statement for maintenance fees. Investors should note that a reputable accounting firm should audit profit and loss statements.
Potential investors should be aware that failed land development schemes involving time-share investments could result in financial losses. Interested investors may wish to seek professional advice regarding investments involving land development projects. Real estate investment problems that reach local courts are rarely settled in favor of foreign investors.
An unusually competitive fee to rent vehicles or equipment could indicate that the dealer is unlicensed or uninsured. The renter is often fully responsible for replacement costs and fees associated with any damages that occur during the rental period. Visitors may be required to pay these fees in full before leaving the Netherlands Antilles and may be subject to civil or criminal penalties if they cannot or will not make payment.
Netherlands Antilles customs authorities may enforce strict regulations concerning temporary importation into or export from the Netherlands Antilles. For example, it is strictly prohibited to export pieces of coral and/or seashells. Please see our information on customs regulations.
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 the laws of the Netherlands Antilles, even unknowingly, may be expelled, arrested or imprisoned. Penalties for possession, use, or trafficking in illegal drugs in the Netherlands Antilles are severe, and convicted offenders can expect long jail sentences and heavy fines. The Netherlands Antilles has strict gun control laws; even a stray bullet in a suitcase can trigger a fine or time in jail. 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 on international adoption of children and international parental child abduction, see the Office of Children’s Issues web site.
REGISTRATION / EMBASSY LOCATION:
American citizens residing or traveling in the Netherlands Antilles are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department’s travel registration web site, and to obtain updated information on travel and security within the Netherlands Antilles. 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 J.B. Gorsiraweg #1, Willemstad, Curaçao, telephone (599-9) 461-3066; fax (599-9) 461-6489; e-mail address: acscuracao@state.gov.
* * *
This replaces the Country Specific Information dated May 7, 2007, to update the Entry/Exit, Crime, Traffic Safety and Road Conditions, and Registry / Embassy Location sections.

Travel News Headlines WORLD NEWS

Date: Thu, 16 May 2019 23:41:35 +0200

Washington, May 16, 2019 (AFP) - The Church of Scientology said Thursday all the passengers from a cruise ship that was quarantined over a measles case had been cleared to leave.    "All passengers and crew (100%) of the Freewinds have been fully cleared of any possible risk of being infected by the measles or infecting others," the organization said in a statement.   "All passengers and crew are free to come and go as they wish," a spokesman added to AFP.

The infected individual was a member of the crew who, according to the Church, had fully recovered and was given a clean bill of health a week ago. She had been earlier confined on the ship.   The ship, which is based in Willemstad on the island of Curacao in the Dutch West Indies, was quarantined after its arrival in Saint Lucia on April 30.   It remained there for two days before returning to Willemstad on May 4 where local authorities ordered a fresh quarantine to give them time to confirm the passengers were either immunized or had no risk of contracting the virus.
Date: Sat, 4 May 2019 20:37:18 +0200
By Sara MAGNIETTE

The Hague, May 4, 2019 (AFP) - The Dutch territory of Curacao said Saturday it would do what is needed to prevent measles spreading from a Scientology cruise ship, after a crew member came down with the disease.   The Freewinds, which left the Caribbean island of St. Lucia on Friday, arrived back in its home port of Curacao at around 9:00 am (1300 GMT) Saturday, according to myshiptracking.com.

The Curacao government said in a statement that it would "take all necessary precautions to handle the case of measles on board of the Freewinds," including vaccinations.   "An investigation will also be done to determine who will be allowed to leave the ship without (posing) a threat to the population of Curacao," it said.   "It is imperative to make all efforts to prevent a spread of this disease internationally."   Dutch broadcaster NOS reported that three health officials had boarded the boat to examine those on board. Only people able to prove that they have been vaccinated against measles or had already had the disease would be able to leave the boat, its correspondent there reported.

- Anti-vaccine movement -
The Church of Scientology says the 440-foot (134-meter) vessel is used for religious retreats and is normally based in Curacao.   The vessel had arrived in St Lucia from Curacao on Tuesday, when it was placed under quarantine by health authorities there because of a measles patient, said to be a female crew member.   According to NOS, the crew member concerned is a Danish national, who arrived in Curacao from Amsterdam on April 17. It was only when the boat was at sea, on route to St Lucia, that a doctor discovered she had measles, their correspondent said.

The resurgence of the once-eradicated, highly contagious disease is linked to the growing anti-vaccine movement in richer nations, which the World Health Organization (WHO) has identified as a major global health threat.   The authorities in Curacao nevertheless urged local people not to panic, as the risk of the disease spreading in this case was fairly low.   Several people did however visit the cruise ship between April 22 and April 28 before it set sail for St Lucia and the authorities asked them to make themselves known to health officials.

Officials said the Freewinds had travelled between Curacao, St Lucia and another Dutch-held island, Aruba, several times towards the end of April.   There were about 300 people aboard the ship, according to Saint Lucia authorities, which placed the vessel in quarantine. They said they provided 100 doses of measles vaccine at no cost.   The Scientology church, founded by science fiction writer L Ron Hubbard in 1953, did not respond to requests for comment.   Its teachings do not directly oppose vaccination, but followers consider illness a sign of personal failing and generally avoid medical interventions.
Date: 4 Jul 2017
From: Harry Vennema <harry.vennema@rivm.nl> [edited]

On several of the Caribbean islands, epidemics of viral conjunctivitis are ongoing. Recently, general practitioners in the overseas territories of the Netherlands reported an increased incidence of this syndrome.

As of 26 May 2017, an outbreak of conjunctivitis occurred in a nursing home on Bonaire. In total, 14 patients and 13 healthcare workers presented with conjunctivitis. Patients were between 71 to 94 years of age. The number of new cases peaked in week 20 through 22. After week 22, a significant reduction was seen (1-3 new cases per week). Initially, conjunctival swabs from 5 patients were tested for the presence of adenovirus by PCR; all 5 were negative.

Subsequently, swabs from 4 patients were analyzed for the presence of enterovirus by RT-PCR, and all 4 were positive. The enterovirus from 3 samples was further characterized by partial VP1 sequence analysis. In all 3 samples, the enterovirus was characterized as Coxsackievirus A24, which belongs to Enterovirus C. Coxsackievirus A24 has been identified frequently as the causative agent of epidemic viral conjunctivitis. The strain from Bonaire is at least 5 percent different from any of the previously isolated and sequenced CV-A24 strains available in Genbank in a 330nt VP1 fragment. The strain involved in the most recent outbreak of CV-A24 conjunctivitis on La Reunion in 2015 is 6 percent different from the Bonaire 2017 strain.

[Andert Rosingh, Yingbin Celestijn-Wu, Fundashon Mariadal Hospital, Clinical Microbiology, Kralendijk, Bonaire, Caribbean Netherlands Annelies Riezebos, University Medical Centre Utrecht, Medical Microbiology, Utrecht, Netherlands Harry Vennema, Kim Benschop, Johan Reimerink, Hans van den Kerkhof, National Institute for Public Health and the Environment, Centre for Infectious Disease Control, Bilthoven, Netherlands]
--------------------------------------------
Harry Vennema
National Institute for Public Health and the Environment
Centre for Infectious Disease Control
Bilthoven, Netherlands
=========================
[ProMED thanks Harry Vennema and colleagues for this report.  Acute hemorrhagic conjunctivitis (AHC) is characterized by sudden onset of painful, swollen, red eyes with subconjunctival haemorrhages and excessive tearing. Most cases are self-limited but highly contagious, with the potential for causing considerable illness. Adenoviruses and picornaviruses can cause AHC outbreaks (1). Among picornaviruses, enterovirus 70 and coxsackievirus A24 variant (CA24v) have caused large outbreaks of AHC[2].

Coxsackieviruses are transmitted primarily via the fecal-oral route and respiratory aerosols, although transmission via fomites is possible. The viruses initially replicate in the upper respiratory tract and the distal small bowel. They have been found in the respiratory tract up to 3 weeks after initial infection and in feces up to 8 weeks after initial infection[3]. The potential for exponential spread is, therefore, quite considerable.

It is important to understand that sequential outbreaks of AHC due to CA24v might occur in the same location after a considerable period, and public health precautions are necessary to control these outbreaks.

References:
1. Hierholzer JC, Hatch MH. Acute hemorrhagic conjunctivitis. In: Darrell RW, editor. Viral diseases of the eye. Philadelphia: Lea & Febiger; 1985. p. 165-96.
2. Kono R. Apollo 11 disease or acute hemorrhagic conjunctivitis: a pandemic of a new enterovirus infection of the eyes. Am J Epidemiol. 1975;101:383-90.

[A HealthMap/ProMED-mail map can be accessed at:
Date: Published ahead of print 7 Dec 2015
Source: American Journal of Tropical Medicine & Hygiene Published on line doi:10.4269/ajtmh.15-0308 [edited]

Noellie Gay, Dominique Rousset, Patricia Huc, Severine Matheus, Martine Ledrans, Jacques Rosine, Sylvie Cassadou, and Harold Noel. Seroprevalence of Asian Lineage Chikungunya Virus Infection on Saint Martin Island, 7 Months After the 2013 Emergence.

Abstract
--------
At the end of 2013, chikungunya virus (CHIKV) emerged in Saint Martin Island, Caribbean. The Asian lineage was identified. 7 months after this introduction, the seroprevalence was 16.9 percent in the population of Saint Martin and 39.0 percent of infections remained asymptomatic. This moderate attack rate and the apparent limited size of the outbreak in Saint Martin could be explained by control measures involved to lower the exposure of the inhabitants. Other drivers such as climatic factors and population genetic factors should be explored. The substantial rate of asymptomatic infections recorded points to a potential source of infection that can both spread in new geographic areas and maintain an inconspicuous endemic circulation in the Americas.
--------------------------------
Communicated by:
Roland Hubner
Superior Health Council
Brussels
Belgium
===================
[Asymptomatic or very mild infections may be an important source of infectious blood meals for vector mosquitoes. These infections should not be overlooked in epidemiological assessments of chikungunya virus outbreaks and implementation of control measures in the field. - ProMed Mod.TY]
Date: Wed, 26 Aug 2015 16:43:59 +0200 (METDST)

Miami, Aug 26, 2015 (AFP) - Tropical storm Erika took aim at the Lesser Antilles Wednesday as storm warnings went up there and in Puerto Rico in anticipation of heavy rains, US forecasters said.   With winds of 75 kilometres (45 miles) per hour, Erika was 540 kilometres (335 miles) east of Antigua at 1200 GMT, the Miami-based National Hurricane Center reported.

Advancing at a speed of 28 kilometres (17 miles) per hour, it was expected to sweep over the Lesser Antilles Wednesday night and then head toward Puerto Rico and the Virgin Islands.   Tropical storm warnings were up in Puerto Rico, the Virgin Islands, Antigua and Barbuda, Guadeloupe, Montserrat, St Kitts and Nevis, Anguilla, Saba, St Eustacia and St Maarten.

A US Air Force hurricane hunter aircraft that flew into the storm found it was slightly increasing in strength.   "Some slow strengthening is forecast during the next 48 hours," the hurricane centre said.   According to the NHC's projections, Erika could become a hurricane by the end of the week, or early next, as it nears Florida.   But "the intensity forecast remains very uncertain," it said.

Erika is arriving on the heels of Danny, the season's first hurricane which petered out before reaching the Caribbean.   Experts said earlier this month that there was a 90 percent chance the 2015 hurricane season in the Atlantic would be less active than usual.
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Greece

Background
Greece offers a great variety of attractions for the international traveller. A beautiful climate linked with great beaches, a vibrant nightlife and historical monuments to rival any other location throughout the world. All of this located
within western Europe and a short flight away from many of the cooler northern destinations - like Ireland. Travellers from these regions descent on Greece in very significant numbers each year and for the vast majority of them they will have a splendid and healthy time. However for some this may not be the case and serious illness and accidents are regularly reported. Following some commonsense rules would go a long way to avoiding disaster and ensuring that this trip is truly one to be remembered for all the right reasons.
Climate
Situated in southern Europe the country enjoys mild winters but very hot summers. There may be occasional cool breezes (meltemia) but these can serve only to fool the traveller into thinking that they are unlikely to burn. Rain is very uncommon during the height of summer (July and August) and all travellers should be advised to use very adequate sun-block lotion at all times.
Slip, Slop, Slap
Following the Australian mantra of Slip, Slop and Slap makes perfect sense. Slip on a shirt, slop on sunscreen and slap on a hat when out and about during the day and this should help protect against the intense suns rays. Nevertheless, despite all their best intentions, travellers get burnt. This is particularly a problem in the first few days after their arrival when they do not realise the intensity of the suns rays and how easily they can be exposed. Falling asleep beside the hotel's swimming pool or on the beach is a very common problem and must be avoided against. The tips of the ears, shoulders (especially along the bra-strap line, ankles and behind the knees are commonly exposed and forgotten areas.
After Sun care
To treat significant sunburn it is important to increase fluid intake but also to take extra salt on your food (unless medically contraindicated for some specific condition like high blood pressure etc). Soothing water soluble lotions (especially ones containing a mild anaesthetic and/or steroid cream) are probably best but certainly avoid any of the ones which paste the skin with a thick layer - which is almost impossible to remove without causing serious pain! The more severe sunburn cases may need medical care and even hospitalisation which really ruins a holiday.
Food & Water
As a European destination Greece has a good level of food and water hygiene. Unfortunately this can vary - especially as you move away from the main tourist destinations and also as the summer temperatures rise and food goes 'off' more quickly. Eating hot food, avoiding cold foods (side-salads, lettuce etc) and never eating undercooked bivalve shellfish (mussels, oysters, clams etc) makes perfect sense. Eating food or taking fruit juice drinks from street vendors is a risk just not worth taking.
Insect bites
There may be both mosquitoes and sandflys about so having good repellents (DEET based ones) is worthwhile. The biggest problem will be early in the morning and towards the end of the daylight hours. However sitting in the shade while having lunch may be nice and cool but it is also often a place where these insects tend to hover looking for their next meal. Just don't allow that meal to be the blood in your unguarded ankle!
Seeing the Monuments
As mentioned previously Greece is covered with ancient monuments and these attract many thousands of tourists each year. The ruins are often not the most hospitable places for sun-sensitive tourists so taking care against the suns rays is essential - especially while standing carefully listening to the tour guide explain some complicated piece of history while the back of your legs get roasted! The other issue, for those trekking through the ruins, is the distinct possibility of a nasty twisted ankle.
Laser Night shows
Many of the ancient sites have beautiful night shows which depict something of the past splendour and are definitely worth seeing. However it is wise to wear good shoes as stumbling across loose stones is a particular problem at night and also bring a small torch, if possible, to guide your way. Getting separated from your travelling companions, or not being able to find your return bus, can lead to some understandable panic so listen carefully to any instructions and look out for some land marks before you get too far away into the night time crowd.
Animal bites
Some tourists may forget that rabies is a problem in many countries throughout the world and, even though Greece is regarded as rabies-free', there is always a problem if someone should get bitten. The possibility that this animal could have been recently smuggled into the country cannot be out ruled and so many would advise full post exposure treatment should this contact occur. Children may be at particular risk due to their inquisitive nature.
Swimming
Sunburn and swimming go hand in hand but drowning can also occur all too frequently within this region. Strong currents, swimming after meals (or alcohol) and the ever popular romantic midnight swim are all serious risk factors. Also children running around the deep end of the pool may lose their footing and topple in without warning. Unfortunately a very small child sinks instantly with very little sign of the emergency to those close by. Parents need to keep aware of this risk at all times.
The summer working holiday
Many of our students head towards Greece for 2 to 3 months during the summer to work. The attractions are obvious but commonsense and sensible life-style choices are needed throughout their stay to lessen the risk of illness or them returning home with an infection they had not bargained for. Unfortunately many return home with life-long illnesses which have been contracted from a single unprotected sexual contact.
Vaccinations for Greece
As a general rule the usual travel vaccines are not recommended for most short-term travellers to this region. However for the student planning to spend a more prolonged period it would be sensible to consider cover against both Hepatitis A and Hepatitis B and also to check that their Tetanus cover is up-to-date.
Summary
This is still one of the most popular destinations for northern European travellers and, in the vast majority of cases, they will have a fantastic time with only good memories. Unfortunately some less prepared folks will end up with serious sunburn and other illnesses or diseases which perhaps are frequently associated with their own lack of care and protection rather than anything specific to this beautiful country.

Travel News Headlines WORLD NEWS

Date: Wed, 2 Oct 2019 12:31:30 +0200 (METDST)

Athens, Oct 2, 2019 (AFP) - Greek workers staged a fresh 24-hour strike Wednesday against government plans to deregulate the labour market, paralysing road and rail transport, closing banks and shutting down news outlets.   Buses and trams stayed in their depots, the Athens metro was shut down and ferries serving islands on both sides of Greece stayed in port. The action also hit rail services, including to Athens airport.   Banks were closed Wednesday and Poesy, the journalists' union, said there would be no news bulletins over the 24-hour strike period.

The strike caused long traffic jams in Athens as the GSEE, the largest union representing private-sector workers, organised a rally in the city centre to protest the planned legislation.    It denounced "the suppression of collective conventions" and what it said was an assault on the unions.   This was the second strike in a week against the planned reforms of conservative Prime Minister Kyriakos Mitsotakis, which he argues will open the way to investment and encourage growth of more than two percent.   A strike last week hit transport, hospitals, schools and the courts.   The unions say the proposed reforms will undermine collective agreements and make it harder to organise strikes.

The proposed law would require a more-than 50 percent turn-out of the workforce in any strike vote for it to be valid.   Union leaders have also denounced a law passed in August which they say makes it easier to sack people in the private sector.   Adedy, the federation of public-sector unions, which organised last week's strike, called on its members to join Wednesday's action.   Mitsotakis came to power in July, replacing the left-wing government of Alexis Tsipras.
Date: Thu 12 Sep 2019, 7:54 PM
Source: Ekathimerini [edited]

The death toll from the West Nile virus since June this year has risen to 20, according to this week's report by the National Health Organization (EODY).

Up until [12 Sep 2019], authorities had diagnosed a total of 176 cases of the mosquito-borne virus. Of these, 109 developed illnesses affecting the central nervous system such as encephalitis or meningitis.

EODY is urging the public to spray insect repellent on bare skin and clothing, to install mosquito nets and screens, to remove stagnant water from basins, vases and gutters, to regularly mow lawns and to water plants in the morning.
=============================
[The first report mentions 20 fatal human cases as compared to the latest ECDC update that mentions 19 and the total case number is 176 versus 171 (ECDC report).

West Nile fever is a disease caused by West Nile Virus (WNV), which is a _Flavivirus_ related to the viruses that cause St. Louis encephalitis, Japanese encephalitis, and yellow fever. It causes disease in humans, horses, and several species of birds. Most infected individuals show few signs of illness, but some develop severe neurological illness which can be fatal. West Nile Virus has an extremely broad host range. It replicates in birds, reptiles, amphibians, mammals, mosquitoes and ticks <https://www.oie.int/doc/ged/D14013.PDF>.

The reservoir of the virus is in birds. Mosquitoes become infected when they bite an infected bird ingesting the virus in the blood. The mosquitoes act as carriers (vectors) spreading the virus from an infected bird to other birds and to other animals. Infection of other animals (e.g. horses, and also humans) is incidental to the cycle [as also evident in the ECDC update above] in birds since most mammals do not develop enough virus in the bloodstream to spread the disease.

Key to preventing the spread of West Nile fever is to control mosquito populations. Horses should be protected from exposure to mosquitoes. Likewise, people should avoid exposure to mosquitoes especially at dusk and dawn when they are most active, use insect screens and insect repellents, and limit places for mosquitoes to breed. - ProMED Mod.UBA]

[HealthMap/ProMED maps available at:
Date: Sun, 15 Sep 2019 15:38:29 +0200 (METDST)

Athens, Sept 15, 2019 (AFP) - More than 160 firefighters on Sunday battled to contain a large fire near Athens blazing for a second day amid gale force winds, officials said.   And in another emergency, authorities evacuated dozens of people from two villages and a hotel on the island of Zakynthos after a new fire broke out on Sunday.

The fire department said the blaze near Athens burned in the mountains above Loutraki, a coastal resort some 60 kilometres (35 miles) west of Athens.   "The fire is burning near the top of the mountain," Stefanos Kolokouris, the fire department's deputy chief of operations, told state TV ERT.   "We are trying to create a perimeter but the terrain is very difficult, with ravines," he said.   Four water bombers and six helicopters were participating in operations. Given a lack of roads in the area, two squads of firefighters had to be carried to the mountaintop by Super Puma helicopter, state agency ANA said.   Officials had already evacuated 50 people from a local monastery when the fire broke out on Saturday, but stressed that other inhabited areas were not in danger.

On Zakynthos, officials ordered the evacuation of the villages of Agalas and Keri in the south of the island. Some 120 tourists were also relocated to a safe area.   The Greek fire department on Sunday said it had been called to nearly 80 fires over the past 24 hours.   It has already faced more than 9,600 rural and urban fires this year.
Date: Tue, 13 Aug 2019 11:40:19 +0200 (METDST)

Athens, Aug 13, 2019 (AFP) - Dozens of firefighters Tuesday battled a major wildfire that forced the evacuation of a monastery on the Greek island of Evia as smoke from the blaze reached as far as Athens, authorities said.   Authorities also placed on alert two villages threatened by the blaze on the island, Greece's second largest after Crete and located northeast of Athens.   The fire started at about 3 am (0000 GMT) at the side of a road and was quickly spread by strong winds through the dry and dense vegetation in the centre of the island, the semi-official news agency ANA said.

The monastery of Panagia Makrymallis was evacuated as a precaution and residents of the villages of Kontodespoti and Stavros were told to be ready to leave also, TV SKAI said.   "Everything is ready in case it is necessary to evacuate the villages. The evacuation can be done in a few minutes. We are totally prepared," Fani Spanos, the governor of central Greece who was coordinating the operations, told SKAI.   He warned the fire was not yet under control and was spreading in an area that was inaccessible overland.

Around 80 firefighters were fighting the blaze backed by some 40 fire trucks and two water-bombing helicopters and a plane.   The strong winds blew the smoke from the blazing pine forest north toward the Magnesia region and south to the Attica peninsula and Athens.   ANA said the pine forests on Evia are part of the "Natura 2000" European network of protected areas and habitats.   Greece has been hit by a spate of wildfires since the weekend amid gale-force winds and temperatures of 40 degrees Celsius (104 F).

On Monday, a major forest fire threatening homes in Peania, an eastern suburb of Athens, was brought under control. At least two houses were burned but there were no reports of injuries.   On Sunday, a fire on the small island of Elafonissos, in the Peloponnese region, was brought under control after a two-day battle.   Two more fires were doused on Saturday in Marathon, close to Mati, the coastal resort where last year 102 people died in Greece's worst fire disaster.
Date: Sun, 11 Aug 2019 14:32:21 +0200 (METDST)

Athens, Aug 11, 2019 (AFP) - A French man was charged in Greece on Sunday over a boat accident that left two dead and another person seriously injured, state TV ERT reported.   The 44-year-old was charged with negligent manslaughter by a prosecutor and given 24 hours to prepare his defence, ERT said.  The man's lawyer Nikos Emmanouilidis had earlier told reporters that his client "will assist in every way any request by the Greek authorities."

The suspect has admitted to driving a 10-metre (32-foot) speedboat which struck a smaller wooden fishing boat on Friday evening near the Peloponnese resort of Porto Heli, 170 kilometres (105 miles) southwest of Athens.   The collision killed two elderly Greek men on board. A 60-year-old Greek woman, reportedly their sister, was seriously injured and taken to Athens for treatment.

The suspect could not be located for several hours after the incident before turning himself in on Saturday.   He has denied trying to evade arrest, and claims he was also injured in the incident and had sought first aid.   The suspect has said he did not see the fishing boat, which may have had insufficient lighting, state news agency ANA reported.   He has taken a blood alcohol test, with the results to be available on Monday.   "The first indications point to excessive speed by the powerboat driver," Merchant Marine Minister Yiannis Plakiotakis told ERT on Saturday.

Ten other French nationals who were also on the speedboat -- two men, three women and five children aged three to 14 -- were initially taken to Porto Heli for questioning after helping to bring the injured woman and one of the bodies to shore, the coastguard said.   They were all released on Saturday.   Speedboat accidents involving swimmers or other boats are common in Greece during the busy summer holiday season.

Another speedboat on Friday injured a 32-year-old swimmer at the Athens coastal suburb of Glyfada. The driver was arrested.   In 2016, four people including a four-year-old girl were killed when a speedboat sliced into their wooden tourist vessel near the island of Aegina.   Nobody was sanctioned as the prime suspect, an elderly Greek man, died a year after the accident.
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Indonesia

*****
Information for Bali
*******
General
************************************
Bali is one of the main tourist destinations for many Irish travellers to Indonesia. The island is well developed for the tourist industry and genera
ly the climate is tropical and humid throughout the year. Many Irish travellers will use the island as a stopover. If this is for only 24 to 28 hours the extent of your jetlag may leave you little time to enjoy the country and its people.
Safety & Security
************************************
Throughout Indonesia there are many regions where it is unsafe to travel. The Parliament in Indonesia may impeach the President in the near future. Civil disturbance with student demonstrations in the capital Jakarta, earthquakes in the island of Sumatra, unrest regarding the independence of Timor and profound warring fractions on the island of Borneo has the potential to spill over into Bali. Nevertheless during the past years Bali has remained stable and there have been few reports of serious disturbances that have affected tourists or business travellers. Lombok is an island close to Bali often visited by tourists. It is regarded as more unstable and recently (Dec 2000) four explosions during fighting between two villages (Bongor & Parampuan). The main tourist region around Senggigi has remained quiet.

Local Customs
************************************
The laws against illegal drugs are severe and travellers should ensure that they carry sufficient well-marked medication that they may require for their time in Indonesia. Travellers are required to show identification at any time and so carrying photocopies of your passport is a wise precaution. Keep all valuable documents in a safe place and do not flaunt personal wealth while travelling around the island.
Night Activities
************************************
The nightlife in Bali is one of the main attractions for many tourists but sensible precautions are required. Travelling alone is unwise. Take care to ensure that your drink could not be spiked at any stage and do not walk at night, use an authorised taxi where possible. The level of HIV infection among the bar workers is high and close personal contact is very unwise.
Medical Facilities
************************************
The level of available health facilities varies greatly through Bali and other parts of Indonesia. In general most of the main hotels will have English speaking doctors but care would be required if your illness requires hospitalisation.
Food and Water
************************************
It is wise to maintain a high level of care with regard to your food and water while in Indonesia. This includes even those in high quality hotels but also particularly for those eating from street vendors. Bivalve shellfish (e.g. oysters, mussels, clams etc) should be avoided at all times due to inadequate cooking. Bottled water should be purchased from your hotel or good quality shops to ensure that it is pure.
Mosquitoes and Insect Bites
************************************
Malaria transmission occurs throughout Indonesia all year but the risk in Bali is so low that prophylaxis is not generally recommended for most tourists. Nevertheless for those visiting Lombok (overnight visits) the risk exists and prophylaxis should be considered. Other mosquito borne diseases also occur throughout Indonesia and care must be taken to avoid insect bites. In Jakarta and other main cities there is a particular problem with a viral disease called Dengue Fever. The mosquito, which transmits this disease, typically bites during the day and in main urban centres.
Sun Exposure
************************************
The strength of the sun in Bali is considerable higher than that experienced in Ireland at any time of the year. Sufficient head covering should be worm when exposed and travellers should ensure that their fluid intake is sufficient. Salt depletion also needs to be replaced in times of significant perspiration.
Swimming
************************************
If swimming in pools, make sure that sufficient chlorination has been used. Take care with small children when close to the deep end of the pool. If sea swimming make sure that there are always others around and that you heed any local advice and warning signs. Never swim soon after alcohol or for an hour after mealtime.
Jet Lag
************************************
The extent of jet lag, which you will experience, depends on the duration of your flight and the amount of rest you were able to get before arrival. Try to rest for the first 24 hours to allow your body to acclimatise and make sure you do not fall asleep beside the swimming pool during this initial period.
Vaccinations for Bali
************************************
There are no essential vaccines or entry to Bali from Western Europe. However for your personal protection travellers are recommended to consider vaccination cover against;
*
Poliomyelitis (childhood booster)
*
Tetanus (childhood booster)
*
Typhoid (food & water disease)
*
Hepatitis A (food & water disease)
Other travellers planning a more rural or extensive trip may need to consider other vaccine cover against diseases like Hepatitis B, Japanese B Encephalitis, Rabies.
Summary
************************************
The majority of those visiting Bali will enjoy the many tourist attractions on the island. However commonsense and care is required to ensure that you do not expose yourself to unnecessary risk. The staff of the Tropical Medical Bureau can be contacted at either of the numbers below if you require further information.

Travel News Headlines WORLD NEWS

Date: Mon, 18 Nov 2019 08:37:15 +0100 (MET)

Jakarta, Nov 18, 2019 (AFP) - An endangered Sumatran Tiger has mauled to death an Indonesian farmer and seriously injured a domestic tourist, a conservation official said Monday.   The fatal attack happened Sunday at the farmer's coffee plantation on Sumatra island where the 57-year-old wrestled with the big cat before it killed him, according to Genman Hasibuan, head of the South Sumatra conservation agency.   "The farmer was attacked while he was cutting a tree at his plantation," he told AFP on Monday.   The mauling came a day after the same tiger attacked a group of Indonesian tourists who were camping at a local tea plantation in South Sumatra's Mount Dempo region.

One of the tourists was rushed to hospital for wounds to his back after the cat stormed into his tent, Hasibuan said.   The animal, which remains loose in the protected-forest area, is believed to be one of just 15 critically endangered tigers in South Sumatra, which has seen five tiger attacks this year, including two fatal incidents, Hasibuan said.

Human-animal conflicts are common in the vast Southeast Asian archipelago, especially in areas where the clearing of rainforest to make way for palm oil plantations is destroying animals' habitats and bringing them into closer contact with people.   In March last year, a man was killed by a tiger in Sumatra's Riau province while several months earlier a tiger also killed a plantation worker in the area.   Sumatran tigers are considered critically endangered by protection group the International Union for Conservation of Nature, with 400 to 500 remaining in the wild.
Date: Tue, 12 Nov 2019 10:03:07 +0100 (MET)

Denpasar, Indonesia, Nov 12, 2019 (AFP) - An Australian tourist who fly-kicked a motorcyclist and assaulted a man in his own home during a drunken rampage was jailed for four months on Tuesday.   The ruling comes after Nicholas Carr's antics were caught in a viral video that saw him carry out a campaign of destruction in Seminyak, a popular tourist area on the Indonesian holiday island.   "The defendant Nicholas Carr is found guilty and is sentenced to four months" in jail, presiding judge Soebandi, who goes by one name, told the Denpasar District Court.    A lawyer for Carr, charged with assault and property damage, said the 26-year-old would not appeal the ruling.    He is expected to be released next month because of time already served.   In August, Carr ran barefoot on to a street and shouted expletives before the apprentice builder slammed into the bonnet of a moving car and then fly-kicked an unsuspecting motorcycle rider.

The biker, who was thrown from the moving scooter, sustained minor injuries -- later the pair embraced during a court hearing as Carr apologised to the victim.   Carr also shattered a convenience store's glass door before stealing a motorcycle.   Later, he broke into a house where he assaulted the sleeping homeowner, leaving him with injuries, police said earlier.    He was eventually caught by locals and police and taken to hospital.    Pictures that circulated on social media showed at the time showed Carr bloodied and bruised, and trussed with hosepipe and rope.   Shortly after his arrest, Carr apologised and admitted drinking more than 10 small bottles of vodka as well as other alcohol.

After a string of embarrassing incidents by tourists, Bali officials recently warned that boorish visitors may be kicked off the island, which attracts millions annually to its palm-fringed beaches, colourful nightlife and ancient temples.   Australian professional rugby league player David Fifita returned home this week after he was briefly arrested in Bali for assaulting a nightclub security guard.   Several days after Carr's arrest, a Czech couple who were slammed for disrespecting a Balinese temple took part in a ritual purification ceremony.
Date: Sat, 3 Aug 2019 22:33:09 +0200 (METDST)

Jakarta, Aug 3, 2019 (AFP) - Five people died and several were injured after a powerful undersea earthquake rocked Indonesia's heavily populated Java island, triggering a brief tsunami warning, the national disaster agency said Saturday.   The 6.9 magnitude quake on Friday evening sent residents fleeing to higher ground, while many in the capital Jakarta ran into the streets.

An official from Indonesia's national disaster agency warned the quake could generate a tsunami as high as three metres (10 feet), but the alert was lifted several hours later.   Three people died of heart attacks as the strong quake rocked the region, agency spokesman Agus Wibowo said on Saturday.   Another person fell to his death while trying to flee his house when the jolt happened, he said, while a fifth victim died from a panic attack.   Four more people were injured and more than 200 buildings were damaged, with about 13 houses destroyed, he added.

More than 1,000 people, who had earlier fled to temporary shelters, returned home after authorities convinced them it was safe to do so, Wibowo said.   "There was thundering noise -- it sounded like a plane overhead -- and I was just so scared that I ran," said 69-year-old Isah, who like many Indonesians goes by one name, at an evacuation shelter in Pandeglang at the southwest end of Java.   In December, the area was hit by a volcano-sparked tsunami that killed more than 400 people.

Indonesia experiences frequent seismic and volcanic activity due to its position on the Pacific "Ring of Fire", where tectonic plates collide.   Last year, a 7.5-magnitude quake and a subsequent tsunami in Palu on Sulawesi island killed more than 2,200 people, with another thousand declared missing.   On December 26, 2004, a 9.1-magnitude earthquake struck off the coast of Sumatra and triggered a tsunami that killed 220,000 across the Indian Ocean region, including around 170,000 in Indonesia.
Date: Sun, 14 Jul 2019 12:47:38 +0200

Labuha, Indonesia, July 14, 2019 (AFP) - A major 7.3-magnitude earthquake hit the remote Maluku islands in eastern Indonesia Sunday, sending panicked residents running into the streets, but no tsunami warning was issued.   The shallow quake struck about 165 kilometres (100 miles) south-southwest of the town of Ternate in North Maluku province at 6:28 pm (0928 GMT), according to the US Geological Survey.
 
"The earthquake was quite strong, sending residents to flee outside. They are panicking and many are now waiting on the roadside," said local disaster mitigation official Mansur, who like many Indonesians goes by one name.   Officials were assessing the situation but there were no immediate reports of casualties, he told AFP.

In the town of Labuha, one of the closest to the epicentre, panicked residents took to motorcycles in a bid to flee to higher ground, according to an AFP photographer in town when the earthquake hit.   Local disaster official Ihsan Subur told Metro TV that no damage or casualties had been reported there so far, but residents took to the streets and many evacuated to higher ground.   "Electricity went of during the earthquake, but now it's back to normal," ubur said, adding that at least seven big aftershocks were felt after the initial quake.

The province was also hit by a 6.9-magnitude tremor last week.   Indonesia experiences frequent seismic and volcanic activity due to its position on the Pacific "Ring of Fire", where tectonic plates collide.   Last year, a 7.5-magnitude quake and a subsequent tsunami in Palu on Sulawesi island killed more than 2,200 people, with another thousand declared missing.   On December 26, 2004, a devastating 9.1-magnitude earthquake struck off the coast of Sumatra and triggered a tsunami that killed 220,000 across the Indian Ocean region, including around 170,000 in Indonesia.
Date: Mon, 24 Jun 2019 05:38:33 +0200

Jakarta, June 24, 2019 (AFP) - A powerful magnitude 7.3 quake struck eastern Indonesia on Monday, US seismologists said, but no tsunami warning was issued and there were no immediate reports of major damage or casualties.   The quake hit at a depth of 208 kilometres (129 miles) south of Ambon island in the Banda Sea at 11:53 local time, the US Geological Survey said.

The Pacific Tsunami Warning Center said there was no threat of a tsunami as the quake was too deep.   The strong temblor came hours after a 6.1-magnitude earthquake hit Papua, also in the eastern part of the Southeast Asian archipelago.   That quake hit about 240 kilometres (150 miles) west of the town of Abepura in Papua province, at a relatively shallow depth of 21 kilometres, according to the USGS.

There were also no immediate reports of casualties after the earthquake.   A shallower 6.3-magnitude hit the area last week, but the damage was not extensive.   Indonesia experiences frequent seismic and volcanic activity due to its position on the Pacific "Ring of Fire", where tectonic plates collide.   Last year, a 7.5-magnitude quake and a subsequent tsunami in Palu on Sulawesi island killed more than 2,200 with a thousand more declared missing.   On December 26, 2004, a 9.1-magnitude earthquake struck Aceh province, causing a tsunami and killing more than 170,000.
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Sao Toma and Principe

Sao Tome and Principe US Consular Information Sheet
August 15, 2008
COUNTRY DESCRIPTION:
São Tomé and Príncipe is a developing nation, comprising the islands of São Tomé and Príncipe, located off the western coast of central Africa.<
R />Facilities for tourism are limited, but adequate.
Read the Department of State Background São Tomé and Príncipe for additional information.

ENTRY/EXIT REQUIREMENTS:
A passport, visa, and evidence of yellow fever vaccination are required for entry.
Visas must be obtained in advance.
Travelers can obtain visas and the latest information on entry requirements from the Permanent Mission of São Tomé and Príncipe to the UN, 400 Park Ave., 7th Floor, New York, NY
10022, telephone (212) 317-0533, fax (212) 317-0580.
Travelers transiting through Gabon can also obtain visas and the latest information on entry requirements from the São Tomé and Príncipe Embassy to Gabon, B.P. 49, Libreville, Gabon, telephone (241) 72-15-27, fax (241) 72-15-28.
Overseas, inquiries should be made at the nearest São Toméan and Príncipian embassy or consulate.

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:
Americans should maintain security awareness at all times.
There have been recent, isolated incidents of civil unrest in the capital city.
Large gatherings or any other events where crowds have congregated to demonstrate or protest should be avoided.

Americans may contact the U.S. Embassy in Gabon for the most up-to-date information on safety and security.
The Embassy informs the registered resident U.S citizen community of security matters through a warden system (please see the Registration/Embassy Location section below for more information).

In the event of a fire, dial 112 on the telephone.
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:
Crimes such as burglary, pick-pocketing and armed robberies in homes do occur on the islands, particularly around the winter holidays.
Such crimes can occur anywhere, but are more prevalent in public places, such as in markets, on the streets, or near hotels.
Do not display large amounts of cash in public.
If possible, leave valuables and extra cash at your hotel while sightseeing or visiting the beach.
When dining in restaurants or visiting markets, it is recommended that one carry only minimal amounts of cash and avoid wearing excessive amounts of jewelry.
If involved in an attempted robbery or carjacking, Americans are encouraged to comply with the attacker to avoid injury and to report all incidents to the police and the U.S. Embassy in Libreville.
Police response time to reports of crime can be slow.

While scams and confidence schemes are not common, travelers should exercise caution.
The prevalence of sexual assault is low, and no specific groups seem to be targets for victimization.

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

The local equivalent to the “911” emergency line in São Tomé and Príncipe to reach the police is 22-22-22.
See our information on Victims of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION:
Medical facilities in São Tomé and Príncipe are extremely limited.
There is one hospital in the country, on the island of São Tomé, and several foreign-run clinics.
However, the level of care is low.
For all but minor medical needs, it is necessary to travel to Libreville (Gabon), Lisbon (Portugal), or elsewhere.
Additionally, some medicines are not available; travelers should carry properly labeled required medicines and medications with them.

The U.S. Department of State is unaware of any HIV/AIDS entry restrictions for visitors to or foreign residents of São Tomé and Príncipe.

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

Streets in the city of São Tomé are paved, but large potholes are common.
Major roads outside of town are also paved.
Pedestrians, bicyclists, motorcyclists, and animals on the roads can be a major hazard.
Outside of the city of São Tomé, there are no sidewalks or shoulders along the side of roads.
In rural areas outside of the capital city, drivers are expected to honk the car’s horn periodically as a warning signal of their approach.
There is no street lighting outside of the capital.
Some roads may be impassable without a four-wheel-drive vehicle.

Only a few miles of improved roads exist on the island of Príncipe; the conditions are similar to those found on São Tomé.
Although taking taxis is fairly safe, it is advisable to rent a car instead.
If you must take a taxi, exercise caution, and negotiate the rate before entering the taxi.

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 São Tomé and Príncipe, the U.S. Federal Aviation Administration (FAA) has not assessed São Tomé and Príncipe’s Civil Aviation Authority for compliance with International Civil Aviation Organization (ICAO) aviation safety standards.
For more information, travelers may visit the FAA’s web site at http://www.faa.gov/safety/programs_initiatives/oversight/iasa.

SPECIAL CIRCUMSTANCES:
São Tomé and Príncipe is a lusophone country; travelers who do not speak Portuguese may face difficulties associated with the language barrier.

Americans should always carry identification with them in the event they are stopped by police.

Taking photographs of military or government buildings is strictly forbidden.
São Tomé and Príncipe is largely a cash economy.
Credit cards are accepted at only a few major hotels.
Travelers’ checks can be cashed or dollars exchanged for dobra at hotels and at one private bank in São Tomé city, but transaction fees can be high.
U.S. dollars are widely accepted at tourist establishments.

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 São Toméan and Príncipian laws, even unknowingly, may be expelled, arrested, or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in São Tomé and Príncipe 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:
Although there is no U.S. Embassy in São Tomé and Príncipe, the U.S. Embassy in Libreville, Gabon is also accredited to São Tomé and Príncipe and can provide assistance to Americans there.
All Americans in São Tomé and Príncipe are encouraged to register with the U.S. Embassy in Gabon through the State Department’s travel registration web site so that they can obtain updated information on travel and security within São Tomé and Príncipe.
Americans without Internet access may register directly with the nearest U.S. Embassy or Consulate.
By registering, Americans make it easier for the Embassy or Consulate to contact them in case of emergency.

The U.S. Embassy is located in downtown Libreville on the Boulevard du Bord de Mer.
The mailing address is Centre Ville, B.P. 4000, Libreville, Gabon.
The telephone numbers are (241) 76-20-03 or (241) 76-20-04.
The fax numbers are (241) 74-55-07 or (241) 76-88-49 and the web site is http://libreville.usembassy.gov/.
*

*

*
This replaces the Country Specific Information dated November 8, 2007 to update sections on Entry/Exit Requirements, Safety and Security, Crime, Information for Victims of Crime, Medical Facilities and Health Information, Traffic Safety and Road Conditions, Special Circumstances, and Registration/Embassy Location.

Travel News Headlines WORLD NEWS

Date: Tue, 12 Dec 2017 02:47:28 +0100
By Caroline CHAUVET

Sao Tome, Sao Tome and Principe, Dec 12, 2017 (AFP) - A big roadside poster announces a "Pest Control Campaign" in Sao Tome and Principe, with a man in a white face mask wielding an insecticide spray fuelled by a tank on his back.   The island nation in the Gulf of Guinea is at war against malaria, as it has been twice a year since 2003, with such success that the disease no longer routinely claims lives.   In mainland central Africa, the incidence of malaria spread by infected female mosquitos is among the highest rates in the world.

Malaria killed some 445,000 people around the planet in 2016, according to the World Health Organisation (WHO), out of 216 million estimated cases that year.   "Our last death was in 2016. It was a Portuguese man who failed to take measures for prevention and treatment," said Hamilton Nascimento, coordinator of the National Programme to Fight Paludism (PNLP) in Sao Tome.   In 2005, malaria claimed more than 5,000 lives out of about 50,000 infected people in Sao Tome and Principe, according to the WHO.   The humid tropical climate of the islands provides an ideal breeding ground for the female mosquitos that carry the parasitic infection from one person to another with their bloodsucking bites.

- National priority -
Yet since 2014, the number of deaths has fallen to none on Sao Tome, apart from the Portuguese victim. On Principe, lying to the north, malaria has been eradicated, in official terms.   The government wants to wipe it out everywhere by 2025, but the WHO has warned that a sizeable part of future funding is at risk.   The battle against a once endemic disease began as a national priority in the 1980s, in the wake of independence from Portugal in 1975, Nascimento told AFP.

The islands of Sao Tome and Principe, which have a combined land surface of 1,000 square kilometres (386 square miles), benefit from their offshore location west of Gabon and from a small population of less than 200,000 inhabitants.   "We have three strategies: spraying inside houses, distributing mosquito nets impregnated (with insecticide) and the fight against larvae using a biological insecticide that we spread in stagnant waters," Nascimento said.   The population of Sao Tome also has access to free medication to treat malaria and to testing campaigns nationwide. If a case of malaria is detected, "the hospital follows up the patient for 28 days," he added.   "Sick people are given free care by the health centres and medicine is
accessible everywhere in the country."

For all the successes in tackling a disease that has no available vaccine and is prone to mutate, residents of the islands have begun to grow weary of the repeated campaigns.   "The number of people who open their doors to the mosquito sprayers has gone down," Health Minister Maria Jesus Trovoada said, concerned that this refusal to take part "puts all the efforts of the government in peril".   Authorities in Sao Tome and Principe have been clear about their desire to reduce dependence on foreign aid, which accounts for about 90 percent of the nation's resources, and the battle with malaria is part of that goal.   At the end of the 1980s and again in 2012-2013, the disease ravaged the country because of a shortfall in funding and spreading resistance to insecticides, Hamilton said.   "We must often -- about every 10 years -- change the insecticide, because the mosquitos develop resistance," he explained.

- Funding cuts? -
While the government recently stepped up its contribution, the Global Fund to Fight AIDS, Tuberculosis and Malaria, a foundation partnered with the WHO, finances most measures to beat the disease on the islands.   The grant from the Global Fund may be slashed by more than 50 percent, the WHO warned in a recent report. Sao Tome and Principe would then "need more or less $5 million (4.2 million euros) between 2018 and 2021 to go on getting good results".   "The impact of lack of funding is unknown. However, if current efforts to control malaria have to be reduced due to lack of funds a high risk of a relapse exists," Rebekka Ott, the Global Fund representative on Sao Tome, told AFP.

The foundation is also concerned about Sao Tome's cutting of diplomatic ties with Taiwan at the end of 2016 in order to develop relations with China. Taiwan previously paid more than 30 percent of the cost of fighting malaria.   China, whose flag has already been mounted at the National Centre for Endemics, is expected to take up the baton, but by providing "technical assistance" rather than financial aid.   Whatever the obstacles, the WHO announced in April 2016 that 21 countries in the world may eliminate malaria by 2020. Six of those nations are in Africa: Algeria, Botswana, Cape Verde, Comoros, Swaziland and South Africa.
Date: Wed 8 Feb 2017
From: Raquel Tavares <raquelmrtavares@gmail.com> [edited]
[Re: ProMED-mail posts Buruli ulcer - Sao Tome and Principe
http://promedmail.org/post/20170208.4824961 and http://promedmail.org/post/20170210.4830051]
----------------------------------------------------------------------
In March 2016 we started following a patient from Sao Tome with severe leg ulcer, complicated with bacterial infection and extension to bone. In December 2016, an _Aspergillus fumigatus_ DNA was found in a bone biopsy. The patient has improved since, with anti-fungal therapy (first with itraconazole and in the last 2 months changed to voriconazole). I think this is a possible aetiology. It was a very difficult diagnosis, because normal fungal cultures were negative. We also did DNA and culture for _Mycobacterium ulcerans_ and it was negative.
------------------
Raquel Tavares,
MD Infectious Diseases Specialist
Hospital Beatriz Angelo
Loures Portugal
raquelmrtavares@gmail.com
Date: Fri 3 Feb 2017 13:46 CET
Source: L'Express, Agence France-Presse (AFP) [in French, machine trans., edited]
<http://goo.gl/DUrF3d>

A disease of unknown origin, manifested by a violent cutaneous ulcer, torments the inhabitants of Sao Tome. 1094 cases have been registered since October [2016] among a population of less than 200,000 inhabitants, the health authorities of the small African archipelago announced this [Fri 3 Feb 2017]. The authorities have requested support from the World Health Organization (WHO), which has sent a Benin specialist in Buruli ulcer.
=======================
Dr Irene Lai International SOS
irene.lai@internationalsos.com
=======================
[ProMED-mail thanks Irene Lai for submitting the news report above. Sao Tome, with a population of 56,945 residents, is the capital city of the island nation of Sao Tome and Pri­ncipe, in the Gulf of Guinea, off the western equatorial coast of Central Africa. (<https://en.wikipedia.org/wiki/Sao_Tome>). Buruli ulcer (also known as the Bairnsdale ulcer in Australia) is a chronic skin and soft tissue infection due to _Mycobacterium ulcerans_ with large ulcers usually on the legs or arms that can lead to adjacent bone infection and permanent disfigurement and disability.

Buruli ulcer is named after a county in Uganda. _M. ulcerans_ needs a temperature between 29-33 deg C (84.2-91.4) to grow in vitro (<http://jcm.asm.org/content/36/11/3420.full>). The organism produces a unique toxin -- mycolactone, which causes tissue damage and inhibits the immune response. Local immunosuppressive properties of the mycolactone toxin enable the disease to progress with no pain and fever.

The diagnosis can be confirmed by polymerase chain reaction (PCR), direct microscopy, histopathology, and culture. Buruli ulcer has been reported in over 30 countries usually with tropical climates in Africa, South America, Asia, and Western Pacific regions, as well as Australia. Countries in West and Central Africa -- Benin, Cameroon, Cote d'Ivoire, Democratic Republic of the Congo and Ghana -- report the majority of cases. In Africa, most cases occur in children under 15 years, whereas in Australia, only 10 per cent are children under 15 years; and in Japan, 19 per cent are children under 15 years.

_M. ulcerans_ has been identified in fresh and brackish water and soil in swampy areas. Abrasions of the skin after contact with contaminated water, soil, or vegetation are likely routes of entry. _M. ulcerans_ is not believed to be transmitted from person to person; but the exact mode of transmission is unknown and may vary by geographic region. Vectors, in particular aquatic insects and mosquitoes, may also play a role in some locations.

In south-eastern coastal Australia, possums, which have laboratory-confirmed _M. ulcerans_ skin lesions and/or _M. ulcerans_ PCR-positive faeces, may be a reservoir (ProMED-mail post Buruli ulcer - Australia: (VI) M. ulcerans, possum faeces http://promedmail.org/post/20140913.2771412).

Buruli ulcer has been reported to develop in travellers at the site of a trauma after having left a disease-endemic area. 80 per cent of cases detected early can be cured with a combination of antibiotics; however, late diagnosis can result in long and costly hospitalizations with significant morbidity and disability.

Medical treatment is rifampin, combined with either streptomycin, clarithromycin, or moxifloxacin for 8 weeks, in addition to surgical wound management.

Pictures of Buruli ulcers can be seen at (<https://www.youtube.com/watch?v=XCQ67NGmytI>). - ProMED Mod.ML]

[A HealthMap/ProMED-mail map can be accessed at: <http://healthmap.org/promed/p/63>.]
Date: Thu, 5 Jan 2006 From: ProMED-mail Source: Adventist Development and Relief Agency (ADRA) [edited] In response to a cholera outbreak that struck Sao Tome and Principe in Oct 2005, the Adventist Development and Relief Agency (ADRA) is helping to control the outbreak by distributing disinfectants among the community, as well as promoting improved health and sanitation practices through campaigns that teach villagers how to prevent the transmission of this contagious disease. ADRA has organized an awareness campaign among 50 rural community groups targeting 1000 women, focusing primarily on the districts of MeZochi and Caue. With this training, the women become health promoters in their communities, teaching other people the same health and hygiene practices they have been taught. Each woman will receive training on how cholera is transmitted, how it can be treated, and how to prevent it. They will also receive bottles of lye, which they will use to safely disinfect water, food, and any other potential contaminant. In addition, ADRA will distribute 10 health education leaflets to each woman; one for her personal use, and 9 additional leaflets to share among her community. ADRA will also perform a theatre play that will be performed in 24 communities to educate the community on the cholera outbreak. As of 1 Jan 2006, nearly 30 people have succumbed to the disease, since the outbreak began 3 months ago, out of an estimated 1849 severe cases that have been reported since its inception.
Date: Tue, 20 Dec 2005 From: ProMED-mail Source: XinHuaNet.com [edited] The 2-month-old cholera epidemic sweeping Sao Tome and Principe shows no sign of letup, having claimed 5 more lives and doubling the number of reported cases. According to reports reaching here on Mon, 19 Dec 2005, the spokesman for the national committee overseeing the anti-cholera campaign, Jose Manuel de Carvalho, said that 5 more people had died from the disease in the preceding 2 weeks for a total of 25 fatalities. In the same period, de Carvalho added, the number of cases more than doubled to 1374 from 650. The outer island of Principe has so far been spared. He repeated government appeals for increased attention to personal and public hygiene to help staunch the highly infectious disease. Last week, a riot erupted in the archipelago's capital when a police officer tried to enforce a ban on the sale of street food at a Sao Tome market.
More ...

Algeria

Algeria US Consular Information Sheet
May 08, 2008
COUNTRY DESCRIPTION:
Algeria is the second-largest country in Africa, with over four-fifths of its territory covered by the Sahara desert.
The country has a population of 35 million p
ople mainly located near the northern coast.
Algeria is a multi-party, constitutional republic.
Facilities for travelers are available in populated areas, but sometimes limited in quality and quantity.
Read the Department of State Background Notes on Algeria for additional information.

ENTRY/EXIT REQUIREMENTS:
Passports and visas are required for U.S. citizens traveling to Algeria.
The Algerian visa application must be typed.
The Algerian Embassy no longer accepts handwritten visa applications.
For further information on entry/exit requirements, travelers may contact the Embassy of the People's Democratic Republic of Algeria at 2137 Wyoming Avenue NW, Washington, DC 20008, telephone (202) 265-2800.
Visit the Embassy of the People's Democratic Republic of Algeria web site at http://www.algeria-us.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: Although no Americans are known to have been killed by terrorists in Algeria, more than 120 foreigners were murdered at the height of the terrorism threat in Algeria in the 1990s.
In response to the terrorist threat, the U.S. government substantially reduced the number of U.S. Government personnel in Algeria during the 1990s.
Small-scale terrorist activities, including bombings, false roadblocks, kidnappings, ambushes, and assassinations, occur regularly.
Since early 2007, vehicle-borne suicide bomb attacks have emerged as a terrorist tactic in Algeria, including in the capital.
Suicide car bomb attacks in December 2007 targeted the UN Headquarters and the Algerian Constitutional Council in Algiers.
The attacks occurred in areas where many diplomatic missions and residences are located.
The group that claimed credit for the December attacks has pledged more attacks against foreign targets, and specifically American targets.

The Travel Warning for Algeria contains the most current information concerning the threat from terrorism.
Currently, Embassy staffing is at full capacity and the Embassy is able to provide full services. U.S. Government employees traveling between cities must be accompanied by a security escort.
U.S. citizens should also carefully consider the security risks involved when using public transportation such as buses and taxis.

For the latest security information, Americans traveling abroad should regularly monitor the Department of State, Bureau of Consular Affair’s 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:
The crime rate in Algeria is moderately high and increasing.
Serious crimes have been reported in which armed men posing as police officers have entered homes and robbed the occupants at gunpoint.
False roadblocks/checkpoints have been employed to rob motorists (see Traffic Safety and Road Conditions section below).
Some of these incidents resulted in the murder of the vehicles' occupants; there has been an increase in the kidnapping of vehicle occupants who appear to be wealthy.
Petty theft and home burglary occur frequently, and muggings are on the rise, especially after dark in the cities.
Theft of contents and parts from parked cars, pick-pocketing, theft on trains and buses, theft of items left in hotel rooms and purse snatching are common.
Alarms, grills, and/or guards help to protect most foreigners' residences.

In many countries around the world, counterfeit and pirated goods are widely available. Transactions involving such products may be illegal under local law.
In addition, bringing them back to the United States may result in forfeitures and/or fines.
More information on this serious problem is available at http://www.cybercrime.gov/18usc2320.htm.

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, to contact family members or friends and explain how funds could be transferred.
Although the investigation and prosecution of the crime is solely the responsibility of local authorities, consular officers can help you to understand the local criminal justice process and to find an attorney if needed.

See our information on Victims of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION:
Hospitals and clinics in Algeria are available and improving in the large urban centers, but are still not up to Western standards. Doctors and hospitals often expect immediate cash payment for services.
Most medical practitioners speak French; English is not widely used.
Prescription medicines are not always readily available.
Some pharmacies may at times be out-of-stock.
In addition, the medicine may be sold under a different brand name and may contain a different dosage than in the U.S.
Please be aware that some newer medications may not yet be available in Algeria.
It is usually easy to obtain over-the-counter products.
Emergency services are satisfactory, but response time is often unpredictable.
In all cases, response time is not as fast as in the U.S.

Cases of tuberculosis are regularly reported, but do not reach endemic levels.
Every summer, public health authorities report limited occurrences of water-borne diseases, such as typhoid.
In addition, HIV/AIDS is a concern in the remote southern part of the country, especially in border towns.

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

Algerian roads are overcrowded and traffic-related accidents kill a large number of people every year.
Drivers will encounter police and military checkpoints on major roads within and on the periphery of Algiers and other major cities.
Security personnel at these checkpoints expect full cooperation.
Motorists should be aware that terrorists employ false roadblocks as a tactic for ambushes and kidnappings, primarily in the central regions of Boumerdes and Tizi Ouzou and some parts of eastern Algeria (see Crime section above).

Travel overland, particularly in the southern regions, may require a permit issued by the Algerian government.
For specific information concerning Algerian driver's permits, vehicle inspection, road tax, and mandatory insurance, contact the Algerian Embassy.

Please refer to our Road Safety page for more information.
Visit the website of the national authority responsible for road safety at http://www.ministere-transports.gov.dz/ .

AVIATION SAFETY OVERSIGHT:
As there is no direct commercial air service to the United States by carriers registered in Algeria, the U.S. Federal Aviation Administration (FAA) has not assessed Algeria’s Civil Aviation Authority for compliance with International Civil Aviation Organization (ICAO) aviation safety standards.
For more information, travelers may visit the FAA’s web site at http://www.faa.gov/safety/programs_initiatives/oversight/iasa.

SPECIAL CIRCUMSTANCES:
Algeria maintains restrictions on the import and export of local currency.
Foreign currency must be exchanged only at banks or authorized currency exchange locations, such as major hotels.
Photography of military and government installations is prohibited.
It is also illegal to import weapons, body armor, handcuffs or binoculars.
Please see our Customs Information.

PROSELYTIZING:
Islam is the state religion of Algeria.
The Algerian government allows non-Muslim religious worship only in structures exclusively intended and approved for that purpose. Activities such as proselytizing, engaging in activities which the Algerian authorities could view as encouraging conversion to another faith, and convening religious ceremonies in private residences are prohibited under a March 2006 law.

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 Algerian laws, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in Algeria 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 on intercountry adoption and international parental child abduction, please see our Office of Children’s Issues web pages.

REGISTRATION / EMBASSY LOCATION:
Americans living or traveling in Algeria 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 Algeria.
Americans without Internet access may register directly with the nearest U.S. Embassy or Consulate.
By registering, American citizens make it easier for the Embassy or Consulate to contact them in case of emergency.
The U.S. Embassy is located at 5 Chemin Cheikh Bachir El-Ibrahimi, B.P. 408 (Alger-gare) 16000, in the capital city of Algiers.
The telephone number is [213] 770-08-20-00 which can also be reached after hours.
The fax number is [213] 21-9822-99.
The U.S. Embassy work week is Saturday through Wednesday.
* * * * * *
This replaces the Country Specific Information dated March 26, 2008, to update the section on Crime.

Travel News Headlines WORLD NEWS

Date: Mon, 9 Sep 2019 11:25:29 +0200 (METDST)

Paris, Sept 9, 2019 (AFP) - Some 13,000 passengers, mainly booked on flights to and from Algeria, are still stranded after France's second-largest airline Aigle Azur went into receivership, a senior French official said Monday, adding that several potential buyers had been identified.   The airline, which employs almost 1,200 staff, filed for bankruptcy and suspended flights last week after losses which prompted a shareholder coup that ousted the chief executive.   "Out of 19,000 passengers who found themselves in difficulty at the peak of the crisis, there are still 13,000" who have yet to be repatriated, the secretary of state for transport, Jean-Baptiste Djebbari, told the Le Parisien daily.

He said these included 11,000 passengers booked on flights into and out of Algeria, 600 on Mali flights as well as other destinations ranging from Russia to Lebanon.   Air France chartered two special flights on Saturday and then again on Sunday to help passengers booked on Algeria flights, which flew out one quarter full but were full on the return.   "The hardest moment of the crisis will be over before the end of the week. At least half the passengers (affected) will have been repatriated," Djebbari said.

The airline transported last year some 1.9 million passengers, with destinations in Algeria making up half of its operations that brought in 300 million euros ($329 million) of revenue.   "There needs to be a serious buyer who is capable of offering guarantees for a maximum number of employees. The good news is that many (potential buyers) have expressed interest," said Djebbari.

He said the former chief executive of Air France's subsidiary Hop!, Lionel Guerin, was among interested parties, backed by a team of aviation professionals with financial support.   He added that Air France itself also appeared interested in making an offer.    "This shows there is still an interest in Aigle Azur," he added. Neither party has so far publicly confirmed an interest, with Air France declining to comment on an "evolving" situation.

According to union officials, Air France could be interested in the medium-haul routes to Algeria and the Dubreuil group, the majority shareholder in Air Caraibes, the long haul routes to destinations like Brazil and Mali.   The largest shareholder in Aigle Azur is the Chinese conglomerate HNA Group, which owns Hainan Airlines, with a 49-percent stake.    David Neeleman, an American airline entrepreneur whose companies include JetBlue and TAP Air Portugal, owns 32 percent, and French businessman Gerard Houa owns 19 percent.
Date: Fri 30 Aug 2019
Source: Depeche de Kabylie [in French, translated, edited]

The current human brucellosis epidemic in Ath Mansour has again claimed new victims. These are 2 citizens of Ath Vouali, hospitalized Wednesday [28 Aug 2019] at the EPH Kaci Yahia M'Chedallah. The affected subjects are a 40-year-old father and his 15-month-old son. Met in the halls of the hospital, the father indicated that he and his family have consumed raw milk from the farmer whose goats were infected almost 2 months ago.

After these 2 new victims, 6 cases of human brucellosis have been detected since last week [18-24 Aug 2019] in this commune and hospitalized at M'Chedallah hospital. In this context, we learned that a Daira commission, composed of a member of the APC executive of Ath Mansour, the subdivisionary of agriculture of Ahnif, a member of the prevention of the Ahnif EPSP and the M'Chedallah Civil Protection Unit, was set up on the instructions of the Daira Chief.

This commission has already visited the premises where the goat farmer in question resides, in Rodha, south of the capital of the commune, to make the necessary arrangements, such as the census of the animals and their quarantine (isolation) with slaughter orientation on those carrying this disease. It should be remembered that caprine brucellosis was detected by an animal health practitioner at the farm level in June 2019 and that part of the herd was already slaughtered at the municipal slaughterhouse.

A total of 75 goats were slaughtered out of 300 heads, with carcass burial as stipulated by the regulations in force. "The transmission of this epidemic was made from the consumption of milk that the farmer of the contaminated livestock sold to a merchant of this commune. This product, raw or curd, was then sold retail to customers. It should be noted that the brucellosis virus has an incubation period that can last several months before the 1st symptoms, which are fever and nausea followed by a general weakness, begin to appear. The treatment is also spread over a long period of time," says a medical source who expects more cases to be detected in the coming days.

Distraught, the citizens of Ath Mansour storm the health institutions of the region where samples are taken for the purposes of screening. A source close to the agricultural services says that none of the citizens hitherto infected by this bacterium has goats.  [Byline: Oulaid Soualah]
==========================
[This infection, a bacterial zoonosis, is classified among the category B biowarfare agents. Natural transmission to humans occurs after occupational exposure or through ingestion of contaminated food products. Although brucellosis has become a rare entity in the USA and many industrialized nations because of animal vaccination programs, this condition remains a significant health problem in many developing countries.

Each species of _Brucella_ has a specific animal reservoir in which chronic disease is present. The bacilli tend to localize in the reproductive organs of the animals, causing sterility and abortions, and are shed in large numbers in the animal's urine, milk, and placental fluid. This localization allows for efficient spread to farmers, veterinarians, slaughterhouse workers, and consumers.

Among the 4 species known to cause disease in humans, _Brucella melitensis_ (from goats, sheep, or camels) may be the most virulent, producing the most severe and acute cases of brucellosis with disabling complications. A prolonged course of illness, which may be associated with suppurative destructive lesions, is associated with _B. suis_ (from feral or commercially raised pigs) infection. _B. abortus_ (from cattle, buffalo, and camels) is associated with mild-to-moderate sporadic disease that is rarely associated with complications. - ProMED Mod.LL]

[HealthMap/ProMED-mail map:
Date: Mon 10 Jun 2019
Source: Algerie 360, a Lequotidien-oran.com report [in French, trans. ProMED Corr.SB, edited]

A total of 3 cases of brucellosis, known as "Malta fever", a disease that affects farm animals, were recorded at Ksar-Chellala, in the far east of the Tiaret wilaya (province). These are 3 women who consumed curd in the last days of Ramadan, according to doctors at the local hospital. In all, more than 150 cases of brucellosis in humans have been recorded since the beginning of 2019.

According to the Department of Health and Population (DSP), the wilaya of Tiaret has recorded 154 cases of brucellosis in humans in 25 municipalities since the beginning of 2019. Due mainly to the consumption of dairy products and unpasteurized derivatives, cases of brucellosis have been recurrent in the wilaya of Tiaret for several years. Blood samples from cattle and goats were collected as part of an epidemiological survey, in collaboration with the Mostaganem Regional Veterinary Laboratory, which has already confirmed cases of brucellosis in localities in the eastern part of the country in wilayat such as Zmalet Emir Aek and Ksar Chellala.

However, the services concerned, starting with the veterinary inspection of wilaya, have always warned against the consumption of natural raw milk without boiling or direct contact with the infected animal.  [Byline: El-Houari Dilmi]
=========================
[This infection, a bacterial zoonosis, is classified among the category B biowarfare agents. Natural transmission to humans occurs after occupational exposure or through ingestion of contaminated food products. Although brucellosis has become a rare entity in the United States and many industrialized nations because of animal vaccination programs, this condition remains a significant health problem in many developing countries.

Each species of _Brucella_ has a specific animal reservoir in which chronic disease is present. The bacilli tend to localize in the reproductive organs of the animals, causing sterility and abortions, and are shed in large numbers in the animal's urine, milk, and placental fluid. This localization allows for efficient spread to farmers, veterinarians, slaughterhouse workers, and consumers.

Among the 4 species known to cause disease in humans, _Brucella melitensis_ (from goats, sheep, or camels) may be the most virulent, producing the most severe and acute cases of brucellosis with disabling complications. A prolonged course of illness, which may be associated with suppurative destructive lesions, is associated with _B. suis_ (from feral or commercially raised pigs) infection. _B. abortus_ (from cattle, buffalo, and camels) is associated with mild-to-moderate sporadic disease that is rarely associated with complications.

In the Maghreb and the Middle East, human brucellosis is usually contracted through consumption of raw goat/ewe's milk or local artisanal cheese made from raw milk, and _Brucella melitensis_ is responsible for the great majority of the reported cases, with a marked predominance of its biovar 3, as in other Mediterranean countries. - ProMED Mod.LL]

[HealthMap/ProMED map available at:
12th May 2019

Algeria - National.
8 May 2019. 358 confirmed cases [of Dengue] and 1100 records of patients with fever
Date: Thu 28 Feb 2019
Source: Algeria Press Service [In French, trans. by ProMED Corr.SB, abridged, edited]

An upsurge of cases of cutaneous leishmaniasis was observed in 2018 in the wilaya [administrative district] of Ghardaia, compared with previous years, reveals a report from the local direction of public health. Cases of cutaneous leishmaniasis, a parasitic zoonosis transmitted by the sandfly, numbered 444 in 2018 compared with 323 cases in 2017 and 383 cases in 2016.

The distribution of cases of cutaneous leishmaniasis corresponds broadly to the epidemiological situation of the past 5 years in the wilaya, always placing the region of Guerrara with 281 cases, followed by Ghardaia (55), Metlili (36) and Berriane (32), among the affected localities, the authorities say. This cutaneous-type pathology has been increasing in the wilaya, particularly in Guerrara, despite the establishment of a system for the control of epidemiological disease vectors and the construction of sanitation networks and other treatment plants in these areas.

The campaign against the infection has experienced several difficulties, including disturbances in the spraying of [insecticides] against the sandflies and disinfection of homes in several municipalities of the wilaya, the lack of environmental hygiene, and habitats for the animal reservoir in urban neighbourhoods. Many health facility officials, who have indicated that this zoonotic disease is a "heavy financial burden", also have indicated that leishmaniasis is likely to increase because of the deterioration of environmental health, living conditions and the environment, plus the anarchic urbanization that constitutes a "risk factor" in the wilaya.
=================
[Both Libya and Tunisia are endemic for leishmaniasis, most frequently cutaneous leishmaniasis. In Libya, the main species are _Leishmania major_ and _Leishmania infantum_. In Tunisia, _L. infantum_, _L. major_ and _Leishmania tropica_ are found with a high endemicity in the northern part of the country. For more details and maps with the distribution of leishmania in the 2 countries, please refer to Alvar J et al. Leishmaniasis worldwide and global estimates of its incidence. PLoS One 2012;7(5):e35671 <https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0035671> -- S54 Libya and S91 Tunisia. - ProMED Mod.EP]

[HealthMap/ProMED-mail maps:
More ...

World Travel News Headlines

Date: Wed, 20 Nov 2019 22:35:51 +0100 (MET)

Manila, Nov 20, 2019 (AFP) - Philippine police were ordered Wednesday to arrest anyone caught vaping in public, just hours after Philippine President Rodrigo Duterte announced he would ban e-cigarettes.   The abrupt prohibition, revealed by Duterte late Tuesday adds to a growing global backlash against a product once promoted as less harmful than tobacco smoking.

Duterte, a former smoker, called the devices "toxic" and said vaping introduced "chemicals" into the user's body.   He ordered the arrest of anyone vaping publicly in a country that already has some of Asia's toughest anti-smoking rules.    No formal, written order has been made public that spells out the scope of the ban or penalties for violations.   Duterte is notorious internationally for his deadly anti-narcotics crackdown, but he has also targeted tobacco with a wide-ranging ban on smoking in public.   Citing "the order of the president", on Wednesday a statement from the head of the Philippine police ordered "effective today, all police units nationwide to enforce the ban on use of vapes; ensure that all violators will be arrested".

The ban came days after Philippine health authorities reported the nation's first vaping-related lung injury, which resulted in a 16-year-old girl being hospitalised.   Vaping has taken off in the Philippines, with speciality shops and vapers puffing away in public a common sight.     E-cigarette users were caught off guard by the ban and questioned the utility of arresting people who, at worst, were hurting themselves.   "It's inappropriate. In any case, we don't hurt people, the environment or animals," said 22-year-old student Alexis Martin.   "Why are vapers being targeted?"

E-cigarettes warm flavoured liquid to produce vapour that is free of the estimated 7,000 chemicals in tobacco smoke, but does contain a number of substances that could potentially be harmful.  Critics say that apart from being harmful in themselves, the multiple exotic flavours of e-cigarette liquids appeal particularly to youngsters and risk getting them addicted to nicotine.

The devices have become hugely popular in the past decade but a rash of vaping-linked deaths and illnesses in the United States is feeding caution about the product, already banned in some places.   In September 2019 India became the latest country to ban the import, sale, production and advertising of e-cigarettes, citing in particular concerns for its youth.   The devices are already banned in several places such as Brazil, Singapore, Thailand and the US state of Massachusetts.
Date: Wed, 20 Nov 2019 17:17:39 +0100 (MET)

Lagos, Nov 20, 2019 (AFP) - Nigerian President Muhammadu Buhari on Wednesday announced a campaign to end defecation in public, in a country where tens of millions of people going to the toilet outside poses a major health risk.    "Nigeria has committed to end open defecation throughout the country by 2025," a statement by the presidency said a day after the United Nations marked World Toilet Day.     The decree set up a new body called the Clean Nigeria Campaign Secretariat to ensure "that all public places including schools, hotels, fuel stations, places of worship, market places, hospitals and offices have accessible toilets and latrines within their premises". 

According to the United Nations children agency, UNICEF, Nigeria has amongst the highest number of people practising open defecation in the world, estimated at over 46 million people -- almost a quarter of the population.   Around Nigeria each year 87,000 children die from diarrhoea, with more than 90 per cent of deaths caused by a lack of water, sanitation and hygiene, according to the World Bank.   The new agency will be disbanded when the goal of ending open defecation has been met, the presidency said.
Date: Wed, 20 Nov 2019 12:59:15 +0100 (MET)

Kampala, Nov 20, 2019 (AFP) - Global health charity Marie Stopes said Wednesday it had recalled hundreds of thousands of faulty condoms on sale in Uganda, where HIV rates are among the highest in the world.   The recall followed a warning from Uganda's National Drug Authority (NDA) that the Life Guard brand condoms had failed manufacturing "quality tests" because they contained holes and may burst.   The affected condoms were manufactured by India-based MHL Healthcare in April 2019 and have an expiry date of April 2024, the government regulator said.   Marie Stopes Uganda spokesman David Kamu told AFP on Wednesday that the two affected batches each contained "around 400,000" condoms.

Earlier reports had suggested millions of condoms could have been involved but NDA spokesman Fred Ssekyana told AFP the figure was below one million.   Marie Stopes Uganda said more than half of the condoms of concern had been recalled.   "While the LifeGuard brand follows strict quality controls, unfortunately two recent batches have fallen short of the quality we demand," the charity's country director, Carole Sekimpi, said in a statement Tuesday.   Marie Stopes is the largest and most specialised sexual reproductive health organisation in Uganda, the charity says on its website.   According to UNAIDS, 1.4 million Ugandans are living with HIV.   Last year 53,000 people were newly infected with the disease in the East African country, the UN agency said.
Date: Wed, 20 Nov 2019 15:08:18 +0100 (MET)

Luanda, Nov 20, 2019 (AFP) - Angola recorded an outbreak of polio this week after almost a decade without cases of the paralysing viral disease, the government said.   The highly infectious condition mainly affects children under the age of five. It attacks the nervous system and can lead to total paralysis, or in some cases death.   "After seven years without polio we are unfortunately confronted with a difficult situation," Angola's health minister Sante Silvia Lutucuta said on Monday, at the launch of a new vaccination campaign in the capital Luanda.   "We have recorded 44 new cases in ten of the country's 18 provinces," she added.

The vaccination campaign is expected to reach 2.5 million children aged five and under.   "All children must be protected by three doses of the oral anti-poliomyelitis vaccine," said Lutucuta, adding that the campaign would span over two weeks to "control the epidemic".   Two out of three strains of the wild polio virus have been eradicated so far, according to the World Health Organization (WHO).           While only 33 wild polio cases were reported globally last year, vaccine-derived polio still breaks out sporadically in some parts of Africa and Asia.    The Centers for Disease Control and Prevention has recommended that all travellers to Angola be fully vaccinated against the virus.
Date: Thu, 21 Nov 2019 01:34:32 +0100 (MET)

Bangkok, Nov 21, 2019 (AFP) - A 6.1-magnitude earthquake hit north-western Laos near the Thai border early Thursday, the United States Geological Survey reported.    The shallow quake hit at 6:50 am local time (2350 Wednesday GMT), USGS said. 
Date: Thu, 21 Nov 2019 01:25:15 +0100 (MET)

Sydney, Nov 21, 2019 (AFP) - The fire danger was elevated across wider swathes of southern Australia on Thursday, with residents warned to avoid at-risk areas as smoke from bushfires choked Sydney and other major cities.   Devastating fires along the country's east coast have claimed six lives and destroyed more than 500 homes since mid-October, with climate change and unseasonably hot, dry conditions fuelling the unprecedented blazes.   Now the fire danger has moved into states further south, with a so-called "Code Red" -- the highest possible fire risk in Victoria -- being declared in the state's northwest for the first time in a decade.   "What that means is that if we see fires in those areas they will be fast moving, they will be unpredictable, they will be uncontrollable," emergency management commissioner Andrew Crisp told reporters.

Country Fire Authority chief Steve Warrington told people living in rural areas to leave for the safety of cities.   "We are saying, 'do not be there, do not be there when a fire occurs, because you will not survive if you are there'," he said.   "There is a good chance if a fire occurs that your home will be destroyed."   The fire danger was also elevated to "severe" in the island state of Tasmania off mainland Australia's southeastern coast,  where a total fire ban was declared.   Two bushfires in the state's northeast did not pose an immediate threat to residents, the Tasmania Fire Service said.

For the second time in two days, smoke from bushfires blanketed Sydney, Australia's biggest city and home to more than five million people, sending air quality plummeting to hazardous levels.   More than 110 fires are still burning in worst-hit New South Wales and neighbouring Queensland, while in South Australia more than 40 fires broke out during catastrophic fire conditions Wednesday.    A South Australia Country Fire Service spokeswoman said all of those blazes had been brought under control or extinguished by Thursday, with the exception of a major fire on the Yorke Peninsula that had come perilously close to a small town.

Conditions were expected to ease in the coming days in South Australia, where the state capital Adelaide was also shrouded in bushfire smoke and residents were being told to stay indoors for health reasons.   Bushfire-prone Australia has experienced a horror start to its fire season, which scientists say is beginning earlier and becoming more extreme as climate change pushes temperatures higher and saps moisture from the environment after months of severe drought.   Growing calls to curb fossil fuels and drastically cut greenhouse gas emissions are being ignored by the country's conservative government, which is eager to protect its lucrative mining industry.   The country is bracing for challenging fire conditions to continue throughout the Southern Hemisphere summer.
Date: Mon 18 Nov 2019
Source: 112.UA [edited]

Eight school classes in Odesa [Odessa] have been closed for quarantine. More than 30% of school students in these classes are sick with Coxsackie virus, a highly contagious respiratory disease, said Olena Buynevych, the director of the city hall's department for science and education, as quoted by UNN news agency.

"More than 30% of students in these classes are sick wi h acute
respiratory diseases, which include cases of cases and Coxsackievirus," the official said. She urged the parents to keep the children away from schools in case they have any symptoms of acute respiratory diseases.

The symptoms are basically the same as flu; the key difference is the rash on the palms, in case of the Coxsackievirus.

Coxsackievirus is a member of a family of viruses called enteroviruses. Enteroviruses are made up of a single strand of ribonucleic acid (RNA). The enteroviruses are also referred to as picornaviruses ("pico" means "small," so, "small RNA viruses"). They are present all over the world and spread by fecal-oral route. About 90% of infections don't cause symptoms or present with a fever only. Infants and young kids are particularly susceptible to symptomatic coxsackie.
======================
[Coxsackievirus belongs to a family of nonenveloped, linear, positive-sense, single-stranded RNA viruses, Picornaviridae and the genus _Enterovirus_, which also includes poliovirus and echovirus. Enteroviruses are among the most common and important human pathogens, and ordinarily its members are transmitted by the fecal-oral route. Coxsackieviruses share many characteristics with poliovirus. With control of poliovirus infections in much of the world, more attention has been focused on understanding the nonpolio enteroviruses such as coxsackievirus.

Coxsackieviruses are divided into group A and group B viruses based on early observations of their pathogenicity in neonatal mice. In general, group A coxsackieviruses tend to infect the skin and mucous membranes, causing herpangina, acute hemorrhagic conjunctivitis, and hand, foot, and mouth (HFM) disease. Both group A and group B coxsackieviruses can cause nonspecific febrile illnesses, rashes, upper respiratory tract disease, and aseptic meningitis.

Group B coxsackieviruses tend to infect the heart, pleura, pancreas, and liver, causing pleurodynia, myocarditis, pericarditis, and hepatitis (inflammation of the liver not related to the hepatotropic viruses). Coxsackie B infection of the heart can lead to pericardial effusion.

The development of insulin-dependent diabetes (IDDM) has recently been associated with recent enteroviral infection, particularly coxsackievirus B pancreatitis.

It is common for the coxsackievirus to cause a febrile upper respiratory tract infection with sore throat and/or a runny nose. Some patients have a cough resembling bronchitis. Less commonly, coxsackievirus may cause pneumonia. Some people with coxsackievirus have a rash. In many, this is a nonspecific generalized red rash or clusters of fine red spots. The rash may not appear until the infection has started to get better.

Coxsackievirus is spread from person to person. The virus is present in the secretions and bodily fluids of infected people. The virus may be spread by coming into contact with respiratory secretions from infected patients. If infected people rub their runny noses and then touch a surface, that surface can harbor the virus and become a source of infection. People who have infected eyes (conjunctivitis) can spread the virus by touching their eyes and touching other people or surfaces. Conjunctivitis may spread rapidly and appear within one day of exposure to the virus. Coxsackieviruses are also shed in stool, which may be a source of transmission among young children. The virus can be spread if unwashed hands get contaminated with fecal matter and then touch the face. This is particularly important for spread within  day-care centers or nurseries where diapers are handled. Diarrhoea is the most common sign of coxsackievirus intestinal infection.

Most infections are self-limiting, and no specific treatment is required or available. Some options include intravenous immune globulin (IVIG), which contains antibodies and may be somewhat effective.

HealthMap/ProMED-mail map:
Odesa oblast, Ukraine: <http://healthmap.org/promed/p/51897>]
Date: Tue 19 Nov 2019 6:07 AM GMT
Source: 3 FM [edited]

There's been an outbreak of a highly contagious disease among wood pigeons on [Isle of Man]. That's according to Manx Wild Bird Aid (MWBA) which says its already taken in a number of the animals from Douglas, Groudle, and Crosby which are suffering with 'canker'.

The infection isn't harmful to humans or mammals but the organisation says it can cause growths in the birds' mouths which can lead them to starve to death.

MWBA is offering advice to people about how to help stop it spreading, including strict hygiene on bird-feeding tables and if you come across a sick pigeon to take it to the nearest vet as soon as possible.  [Byline: Rob Pitchard]
========================
[_Trichomonas gallinae_ is a common protozoan parasite of pigeons (Columbiformes) which principally infects the upper alimentary tract where it can cause necrotic ingluvitis. Epidemic mortalities in columbiform species are sporadically reported, and the parasite may infect other avian taxa such as birds of prey and songbirds. (<http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0012215>). - ProMED Mod.PMB]

[HealthMap/ProMED-mail map of the Isle of Man:

HealthMap/ProMED map available at:
Date: Tue 19 Nov 2019
Source: Caracas Chronicles [edited]

The Venezuelan Public Health Society and the Let's Defend The National Epidemiology Network issued an alert after a case of yellow fever was confirmed in the state of Bolivar, after 14 years without the disease. The Health Ministry hasn't published information about the case or issued an alert, but Venezuela must formally report it to international institutions, due to the risk to a population that isn't vaccinated, having the vector (mosquitoes) in all of the territory (increasing the odds of an epidemic), and the poor access to an epidemiologic report [about the case]. Doctor Julio Castro wrote about the case for Prodavinci.  [Byline: Naky Soto]
======================
[There is little information about this case: where and when it occurred in Bolivar state, tests used to diagnose the case, condition of the patient, and any follow-up measures taken by public health authorities. Yellow fever (YF) virus is endemic in Venezuela as it is in many South American countries.

The most recent ProMED-mail report of YF in Venezuela was in 2010, in Anzoategui state, where there were 3 probable YF cases in monkeys. This outbreak was enzootic, as determined by the Ministry of Health (see Yellow fever - South America: Venezuela (AN) monkey, susp http://promedmail.org/post/20101112.4114).

Presumably, this current case is one of spill-over from the sylvan (forest) transmission cycle. Maintenance of a high level (80-90%) of coverage is essential to prevent cases and avoid outbreaks involving the urban cycle with _Aedes aegypti_ transmission. - ProMED Mod.TY]

[HealthMap/ProMED-mail map of Venezuela:
Date: Thu 14 Nov 2019
Source: WHO Emergencies preparedness, response, Disease Outbreak News (DONs) [edited]

On 10 Oct 2019, the National IHR Focal Point for Sudan notified WHO of 47 suspected [human] cases of Rift Valley fever (RVF), including 2 deaths in Arb'aat Area, Towashan Village, in El Qaneb locality, Red Sea State. The suspected cases presented with high-grade fever, headaches, joint pain, vomiting. There were no hemorrhagic signs or symptoms observed. The 1st case presented to the health facility on 19 Sep 2019.

On 28 Sep 2019, a total of 14 samples were sent to the National Public Health Laboratory in Khartoum, and 5 tested positive for RVF by immunoglobulin M (IgM) enzyme-linked immunosorbent assay (ELISA) and reverse-transcriptase polymerase chain reaction (RT-PCR). These samples were also tested for malaria and were found negative.

On 13 Oct 2019, a total of 10 suspected RVF cases were recorded in Barbar and Abu Hamed localities, of River Nile State. Of the 10 suspected RVF cases, 5 samples were tested and 4 were found positive for RVF. From 19 Sep 2019 until 11 Nov 2019, a total of 293 suspected human RVF cases, including 11 associated deaths have been reported from 6 states; including the Red Sea (120), River Nile (168), Kassala (2), White Nile (1), Khartoum (1), and Al Qadarif (1) States. The most affected age group is 15-45 years old, which accounts for 83% of the total suspected cases. The male to female ratio is 2.6, with a high proportion of the cases being farmers (37.5%).

These human RVF cases are concomitant with abortions and deaths among goats in the areas where the human suspected and confirmed cases have been reported. From 25 Sep through 3 Nov 2019, 21 goats in Red Sea State were reported as positive for RVF, including 4 deaths; and in River Nile State 16 goats, with 3 deaths, and 37 sheep, with 5 deaths, were confirmed positive for RVF by ELISA test at the Central Veterinary Research Laboratory in Khartoum.

Public health response
----------------------
Red Sea State
-------------
- Activation of RVF task force committee;
- printing and distribution of RVF guidelines;
- deployment of surveillance teams for daily reporting and active case finding in the affected areas;
- establishment of 2 health centers and one dispensary with a capacity of 11 beds, laboratory items, drugs, and supplies to provide health services in the affected villages;
- conducting household inspections and fogging: In Arb'aat area, a total of 452 households were inspected, out of which 30 were found positive for the presence of a competent vector; in Port Sudan, out of 1225 households inspected, 29 were found positive for the competent vector, and fogging was provided to 1949 households;
- the Veterinary Epidemiology Department of the Ministry of Animal Resources conducted vector control in 4 animal enclosures in the affected villages.

River Nile State
- A joint investigation conducted by the State Ministry of Health (SMoH) and WHO on 12 Oct 2019;
- initiation of an RVF Action plan by the SMoH and WHO;
- initiation of Integrated Vector Management (IVM), surveillance, case management, and Rapid Response Team (RRT) activities.

WHO risk assessment
-------------------
RVF is endemic in Sudan. There have been 3 outbreaks affecting humans previously documented in 1973, 1976, and 2008. During the outbreak in 2008, a total of 747 laboratory-confirmed cases were reported, including 230 deaths.

The recent floods, following heavy rains on 13 Aug 2019, caused flash floods in 17 of the 18 states, including Abyei area in West Kordofan State. These floods have favored vector abundance, distribution, and longevity. The current RVF outbreak started on 19 Sep 2019 and has affected states impacted by the floods.

The uncontrolled movements of animal populations within and outside the country borders may increase the spread of the disease to new areas.

RVF can cause significant economic losses due to livestock travel and trade restrictions, as well as high mortality and abortion rates among infected animals.

In a country where the export of livestock is one of the major sources of the national income, the current RVF outbreak, in the context of political unrest and a debilitated health system requires an urgent need for external assistance.

WHO advice
----------
Rift Valley fever (RVF) is a mosquito-borne viral zoonosis that primarily affects animals but also has the capacity to infect humans. The majority of human infections result from direct or indirect contact with the blood or organs of infected animals. Herders, farmers, slaughterhouse workers, and veterinarians have an increased risk of infection.

Awareness of the risk factors of RVF infection and measures to prevent mosquito bites is the only way to reduce human infection and deaths. Public health messages for risk reduction should focus on:
- reducing the risk of animal-to-human transmission resulting from unsafe animal husbandry and slaughtering practices;
- practicing hand hygiene as well as wearing gloves or other personal protective equipment when handling sick animals or their tissues and when slaughtering animals;
- reducing the risk of animal-to-human transmission arising from the unsafe consumption of raw or unpasteurized milk or animal tissue. in endemic regions, all animal products should be thoroughly cooked before eating;
- reducing the risk of mosquito bites through the implementation of vector control activities (e.g. insecticide spraying and use of larvicidal to reduce mosquito breeding sites), use of insecticide-impregnated mosquito nets and repellents, light-coloured clothing (long-sleeved shirts and trousers);
- restricting or banning the movement of livestock to reduce the spread of the virus from infected to uninfected areas;
- routine animal vaccination is recommended to prevent RVF outbreaks. Vaccination campaigns are not recommended during an outbreak as they may intensify transmission among the herd through needle propagation of the virus;
- outbreaks of RVF in animals precede human cases, thus the establishment of an active animal health surveillance system is essential in providing early warning for veterinary and public health authorities.

WHO advises against the application of any travel or trade restrictions with the affected country based on the current information available on this event.
=====================
[The report above provides a good overview of the development of the current Rift Valley fever outbreak. Surveillance and responses require a One Health approach since both humans and animals are affected and environmental change, in this situation extensive flooding, has promoted vector abundance. Effective vector control over extensive geographical areas is difficult to achieve and is expensive. Maintenance of herd immunity through vaccination of animals can be a successful preventive measure prior to the occurrence of cases. - ProMED Mod.TY]

[Neighbouring Egypt, which suffered introductions of RVF from Sudan in the past, has undertaken preventive measures. This relates initially to the 2 governorates bordering Sudan, namely the Red Sea and the New Valley governorates. In the Red Sea governorate, vaccination has already started. Reportedly, as of 18 Nov 2019, a total of 12 801 animals have been vaccinated, including 11 568 sheep and goats, 712 camels, and 421 cows and buffalo. The vaccination, which is free of charge, is being continued. In the New Valley governorate, 62 guidance seminars about RVF for animal breeders in the 5 provincial centers have been undertaken; the implementation of a "magnified immunization campaign for a month" is said to commence "next Saturday" (23 Nov 2019), "aimed at immunizing 120 000 cattle, goats, and sheep." Intensified surveillance in animals has, reportedly, been applied in both governorates; no suspected cases detected. - ProMED Mod.AS]