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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: Tue, 18 Feb 2020 09:07:42 +0100 (MET)

Athens, Feb 18, 2020 (AFP) - Greece was hit with a 24-hour strike Tuesday over a pension reform encouraging people to stay longer in the workforce.   The labour action paralysed public transport in Athens, intercity trains and ferry ship services.   Civil servants are also walking off the job and journalists will stage a three-hour work stoppage against the pension reform.   "This bill is practically the continuation of (austerity) laws introduced in 2010-2019," civil servants' union ADEDY said.

Unions will hold street protests in Athens, Thessaloniki and other major cities later in the day.   The new conservative government says the reform, to be voted by Friday, will make the troubled Greek pension system viable to 2070.   The labour ministry says the overhaul -- the third major revamp in a decade -- will contain pension increases and reduce penalties for pensioners still working.

Successive governments have attempted to reform the pension system, whose previously generous handouts are seen as one of the causes of the decade-long Greek debt crisis.   Chronic overspending and the inaccurate reporting of the budget deficit spooked creditors in 2010, and required three successive bailouts by the European Union and the International Monetary Fund to avert a Greek bankruptcy.   In return for billions of euros in rescue funds, Greece had to adopt unpopular austerity reforms and pension cuts.
6th December, 2019
HSE Health Protection Surveillance Centre

On 27/11/2019, a possible case of diphtheria was reported to the Department of Epidemiological Surveillance and Intervention through the Mandatory Notification System in Greece. It concerned an 8 years old boy of Greek nationality, who was hospitalized in the ICU of General Children's Hospital  where he died.  This child had underlying conditions (severe pulmonary hypertension) and was admitted to ICU  on 22/11/2019 with clinical presentation of laryngitis (without the presence of characteristic pseudo membranes) and pneumonia, immediately intubated, covered with double antibiotic regimen and died due to deterioration of his clinical presentation on 26/11/2019.
 
According to the epidemiological data given , there is no travel history, group living, no connection to another case and the child does not belong to a specific population group. Regarding his immunization status, the child was vaccinated with at least 3 doses against diphtheria-tetanus-pertussis.
 
Laboratory investigation of bronchial exudate isolated Corynebacterium diphtheriae via VITEK. Further laboratory testing was performed by the Public Health England  reference Laboratory for Corynebacteria. On Thursday 5/12/2019, the National Public Health Organization was informed that multiplex PCR testing was positive for C. Diphtheriae and positive for the diphtheria toxin gene. The Elek test was also positive for toxin production. The results of the child's post-mortem exam are pending.

Contact tracing and management is ongoing and has identified most of the close contacts of the patient. The National Public Health Organization provided recommendations on obtaining nasopharyngeal cultures in close contacts to evaluate carriage as well as the necessary preventive measures to protect the child's close contacts as well as the medical staff involved in direct patient care (i.e. awareness for potential compatible with diphtheria symptoms and administration of antibiotic prophylaxis together with booster or complete vaccination series as appropriate) according to the WHO’s Diphtheria Surveillance Standards (September 2018). In addition we have initiated the procedure for the procurement of a limited stockpile of DAT.
Date: Wed, 27 Nov 2019 09:20:47 +0100 (MET)

Athens, Nov 27, 2019 (AFP) - A strong 6.1-magnitude undersea earthquake shook the Greek island of Crete on Wednesday and was felt in other parts of the country, officials said.   "It was a major earthquake, the whole island shook but fortunately so far no damage has been reported," Crete regional governor Stavros Arnaoutakis told state TV ERT.   The Athens observatory said the quake struck at 9:23 am (0723 GMT) and had a depth of over 70 kilometres (44 miles).

The tremor occurred a day after a 6.4-magnitude earthquake in Albania that has left more than 20 dead and hundreds injured.   Shortly after the Albania tremor, a 5.4-magnitude shock hit Bosnia, the European-Mediterranean Seismological Center reported on Tuesday.   Greece lies on major fault lines and is regularly hit by earthquakes but they rarely cause casualties.   In July 2017, a 6.7-magnitude earthquake killed two people on the island of Kos in the Aegean sea, causing significant damage.
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:
More ...

Romania

Romania US Consular Information Sheet
March 02, 2009
COUNTRY DESCRIPTION:
Romania joined NATO in 2004 and the European Union in 2007.
Read the Department of State Background Notes on Romania for additional information.

ENTR
/EXIT REQUIREMENTS:
A valid passport is required.
U.S. citizen visitors are granted 90 days of stay without a visa within a given six-month period.
For stays longer than 90 days, an extension of stay may be obtained in Romania from the Romanian Immigration Office in the area of residence.
An exit visa must be obtained in cases of overstay.
The Romanian Government is enforcing visa regulations more vigorously and a record of visa overstay can result in the assessment of large fines and the denial of entry without a visa for a specified time.
Visit the Embassy of Romania web site for the most current visa information or contact the Romanian Embassy at 1607 23rd St. NW, Washington, D.C. 20008, telephone number (202) 232-4747, or the Romanian Consulates in Los Angeles, Chicago, or New York City.
.

Foreigners are required to carry identification documents at all times. Americans who obtained a temporary or permanent stay permit must be able to present the document upon the request of any “competent authorities.”
Foreigners who do not have a stay permit should present their passports.
(The Embassy recommends carrying a copy of the relevant document).

U.S. visa information for Romanians and other foreign citizens can be found on the web site of the U.S. Embassy in Bucharest
or the Department’s travel website.

Information about dual nationality or the prevention of international child abduction can be found on our web site.
For further information about custom regulations, please read our Customs Information sheet.

SAFETY AND SECURITY:
American citizens are reminded to exercise caution, remain vigilant with regard to their personal security, and monitor media reports.
Prior police notice is required for public demonstrations and police oversight is routinely provided.
Nonetheless, even demonstrations intended to be peaceful can turn confrontational and possibly escalate into violence.
American citizens are therefore urged to avoid the areas of demonstrations if possible, and to exercise caution if within the vicinity of any demonstrations.
Information on specific demonstrations can be found on the Embassy web site on the demonstration notices page.

For the latest security information, Americans traveling abroad should regularly monitor the Department of State, Bureau of Consular Affairs’ web site, where the current Travel Warnings and Travel Alerts, including the Worldwide Caution, can be found.

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

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

CRIME:
While most crimes in Romania are non-violent and non-confrontational, crimes do occur in which victims suffer personal harm.
Crimes against tourists, including robbery, mugging, pickpocketing and confidence schemes, remain a problem in Romania.
Organized groups of thieves and pickpockets, sometimes including minors, operate in train stations and on trains, subways, and buses in major cities.
A number of thefts and assaults have occurred on overnight trains, including thefts from passengers in closed compartments.
The Embassy recommends using the highest class available for train travel, and suggests traveling with at least one other person. As is always the case, travelers should never leave personal belongings unattended, maintaining control over them at all times.

The Embassy has received reports of bar/night club scams.
These scams involve unsuspecting patrons being charged exorbitant prices when they receive their bar bills.
Another scam involves patrons of “adult” establishments (strip clubs) who are charged for the female worker’s drinks or time while talking to the customers.
Because strip clubs frequently are fronts for organized crime, the Embassy recommends avoiding these establishments.
Patrons may be forced to pay the bills or risk physical confrontation.
If you find yourself in this situation, you should pay the bill and make a police report once the incident is over.

Money exchange schemes targeting travelers are common in Romania.
Some of these ploys have become rather sophisticated, involving individuals posing as plainclothes policemen, who approach the potential victim, flash a badge, and ask for the victim's passport and wallet.
In many of these cases, the thieves succeed in obtaining passports, credit cards, and other personal documents.

Credit card and Internet fraud remain among the most common crimes affecting foreigners in Romania.
Romania is largely a "cash only" economy.
While an increasing number of businesses accept credit cards, travelers are advised to use cash for goods and services rendered due to the prevalence of credit card fraud.
Vendors have been known to misuse credit card information by making illegal purchases on a customer’s account.
To make a credit card purchase, a PIN is usually required.
There are an increasing number of ATMs located throughout major cities, and increasingly sophisticated identity theft rings are targeting them.
Travelers should try to use ATMs located inside banks and check for any evidence of tampering with the machine before use.
Travelers' checks are of limited use but may be used to purchase local currency at some exchange houses.

Americans should exercise caution when traveling to Romania to meet individuals known only through contact over the Internet.
A significant number of confidence scams have been uncovered involving Romanians who contact their prospective American victims through chat rooms or personal advertisements. They generally identify themselves as young Romanian women and develop a “relationship” with their victim over time.
Variations of this scam have emerged but money extortion remains the ultimate goal.
Americans who suspect they may have fallen victim to this kind of scam should contact American Citizens Services at the U.S. Embassy.

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 the 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 understand the local criminal justice process and find an attorney if needed.

The local equivalent to the "911" emergency line in Romania is: 112.
English speaking operators are available.
Please see our information on Victims of Crime, including possible victim compensation programs in the United States.

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 Romania’s laws, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession or use of, or trafficking in illegal drugs in Romania are severe, and convicted offenders can expect long jail sentences and heavy fines.
Engaging in sexual conduct with children or using or disseminating child pornography in a foreign country is a crime, prosecutable in the United States.
Please see our information on Criminal Penalties.

Under Romanian law, engaging in sexual conduct with a minor under the age of 15 or a minor between the ages of 15 and 18 where the adult has abused the minor’s trust or had influence/authority over the minor is a crime punishable with a 3-10 year prison sentence.
Engaging in illicit sexual conduct with someone who has a physical or psychological disability is punishable with a 3-12 year prison sentence.
Distribution of obscene materials depicting minors is a crime punishable with a 1-5 year prison sentence.
Prostitution is illegal in Romania, regardless of the age of the participants.

SPECIAL CIRCUMSTANCES:
Abandoned dogs are commonplace in Romania and generally tolerated.
Strays are often fed and are seen frequently on a daily basis especially in or near parks.
Some statistics report one dog bite hourly in Bucharest, the capital city. Because the immunization status of stray dogs is unknown, precautions to prevent rabies are recommended.
See the CDC’s web site for more details.
If you encounter dogs that appear aggressive, it is best to change your path to avoid contact with them.

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 the U.S. Department of Justice, Computer Crime and Intellectual Property Section.

Romania's customs authorities may enforce strict regulations concerning temporary importation into or export from Romania of items such as firearms, antiquities, and medications.
Romanian law allows travelers to bring cash into or out of Romania; however, sums larger than 10,000 Euros or the equivalent must be declared.
Travelers are advised to contact the Embassy of Romania in Washington or one of Romania's consulates in the United States for specific information regarding customs requirements.

DISASTER PREPAREDNESS:
Romania is situated in a seismically active region and has a history of devastating and deadly earthquakes.
While responsibility for caring for disaster victims, including foreigners, rests with Romanian authorities, disaster preparedness is also a personal responsibility.
Additional information is available from the U.S. Embassy in Bucharest.
General information about natural disaster preparedness is available from the U.S. Federal Emergency Management Agency (FEMA).

MEDICAL FACILITIES AND HEALTH INFORMATION:
Medical care in Romania is generally not up to Western standards, and basic medical supplies are limited, especially outside major cities.
Some medical providers that meet Western quality standards are available in Bucharest and other cities but can be difficult to identify and locate.
Travelers seeking medical treatment should therefore choose their provider carefully.
A list of hospitals and physicians is available on the website of the U.S. Embassy in Bucharest.
Information regarding health threats or other medical issues affecting visitors to Romania can also be found at this site. The U.S. Department of State is unaware of any HIV/AIDS entry restrictions for visitors to or foreign residents of Romania.

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

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

Americans who wish to extend their stay in Romania must present proof of health insurance that applies overseas for the duration of their intended stay in Romania.
Useful information on medical emergencies abroad, including overseas insurance programs, is provided on the Department of State's web page, Medical Information for Americans Traveling Abroad.
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 Romania is provided for general reference only, and may not be totally accurate in a particular location or circumstance.

Traffic accidents are arguably the single most dangerous threat for American citizens visiting Romania. The World Economic Forum ranks Romania 126 out of 134 states for road quality.
Currently Romania has a total of only 270 kilometers of freeways.
While major streets in larger cities and major inter-city roads are generally in fair to good condition, many other roads are in poor repair, unpaved, badly lighted, or narrow, or lack marked lanes.
Part of the problem is that the infrastructure has failed to keep pace with the dramatic increase in motor vehicles since 1990.

Roads, especially in the mountains, can be particularly dangerous when wet or covered with snow or ice.
Pedestrians, animals, cyclists, and horse-drawn carts share many roads with motor vehicles and can be extremely difficult to see, particularly at night in rural areas.
Vehicles often block sidewalks, forcing pedestrians to walk in the streets.
Maintain vigilance when driving to avoid hitting those who are walking in the streets.
Cross the street only in crosswalks and always look both ways before crossing.
Crosswalks are generally poorly marked and drivers may ignore crosswalks even if there is a traffic light.

Driving practices in Romania can be aggressive and/or inattentive.
Combined with the substandard road conditions noted above, the result is a significant traffic mortality rate.
According to the European Union Road Federation, Romania has the highest per vehicle rate of traffic fatalities of any country in the E.U.
It is essential for drivers to practice defensive driving techniques.


Romanian traffic laws are very strict.
The traffic police can confiscate any form of driver's license or permit for 1-3 months, and payment of fines may be requested at the time of the infractions.
Some examples when this might occur are failure to yield the right of way, failure to stop at a red light or stop sign, or failure to yield to pedestrians at crosswalks.
While, in theory, drivers must yield to pedestrians at all marked pedestrian crosswalks, many of these are poorly maintained, difficult to see, and sometimes located in unexpected places for foreign drivers.
Pedestrians must take extreme caution when crossing any road.

Romanian traffic laws provide for retention of a driver’s license by the police and possible imprisonment for driving under the influence of alcohol or for causing an accident resulting in injury or death.
There is zero tolerance for driving under the influence of alcohol and police are required to give breathalyzer tests on the scene to all drivers involved in an accident.
Refusal to take a breathalyzer test will result in criminal penalties regardless of whether or not alcohol was involved.

U.S. driver's licenses are only valid in Romania for up to 90 days.
Before the 90-day period has expired, U.S. citizens must either obtain an international driving permit in addition to their U.S. driver's license or a Romanian driver's license.
Wearing a seat belt is mandatory.
Children under 12 years of age may not be transported in the front seat.

Unless otherwise marked with road signs, speed limits are as follows:
·


Inter-city traffic on highways

o
130 km/hr for cars and motorcycles (80 miles/hr)

o
110 km/hr for vans (65 miles/hr)

·


Urban traffic - 50 km/hr (30 miles/hr)

·


Express and European roads

o
100 km/hour for cars and motorcycles (60 miles/hr)

o
90 km/hour for vans (55 miles/hr)

·


All other roads

o
90 km/hr for cars and motorcycles (55 miles/hr)

o
80 km/hr for vans (50 miles/hr)

·


Motor vehicles with trailers and drivers with less than one year of driving experience have speed limits 20 km/hr (or 12 miles) slower than those listed above.

Inter-city travel is generally done via trains and buses, which vary in terms of quality, safety, cost, and reliability.
Pickpockets pose a danger on night trains and in train stations.
Inter-city travel by taxi is much more expensive, and safety depends on the quality of the driver.
Many older taxis are not equipped with seat belts.
To avoid being overcharged, passengers should request the taxi by phone through a reputable company and make sure the taxi has an operational meter or agree upon a price before entering the taxi.
The meter rate per km is posted on both sides of the taxi vehicle.

The host country authority responsible for road safety is the Traffic Police of the Romanian Ministry of Interior.
Emergency roadside help and information may be reached by dialing 9271 for vehicle assistance and towing services.
For ambulance services, fire brigade, or police, dial 112.

Please refer to our Road Safety page and the Bucharest Metropolitan Police Department web site for more information.
Also visit the website of Romania’s national tourist office.

AVIATION SAFETY OVERSIGHT:
The U.S. Federal Aviation Administration (FAA) has assessed the Government of Romania’s Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for oversight of Romania’s air carrier operations.
For more information, travelers may visit the FAA's web site.

CHILDREN'S ISSUES:
For information see our Office of Children’s Issues web pages on intercountry adoption and international parental child abduction.
In 2005, Romania banned intercountry adoptions except by biological grandparents.

REGISTRATION / EMBASSY LOCATION:
Americans living or traveling in Romania are encouraged to register with the U.S. Embassy through the State Department’s travel registration website, and to obtain updated information on travel and security within Romania.
Americans without Internet access may register directly with the U.S. Embassy.
By registering, American citizens make it easier for the Embassy to contact them in case of emergency.
The U.S. Embassy is located at Strada Tudor Arghezi 7-9, telephone (40) 21-200-3300.
In emergencies, an after-hours duty officer may be reached by calling (40) 21-200-3433.
Consular services for U.S. citizens are performed at the Consular Section located at Strada Filipescu 26 (formerly Strada Snagov), one block from the U.S. Embassy at the corner of Strada Batistei.
The Consular Section can be reached through the Embassy operator at (40) 21-200-3300, and faxes can be sent to (40) 21 200-3381 or 200-3578.
*

*

*
This replaces the Country Specific Information sheet dated July 18, 2008 to update the information on Safety and Security, Crime, Traffic Safety and Road Conditions, Special Circumstances, and Disaster Preparedness.

Travel News Headlines WORLD NEWS

Date: Sun 12 Aug 2018
Source: Outbreak News Today [edited]

In a follow-up on the West Nile virus (WNV) situation in Romania, the National Center for Communicable Disease Surveillance and Control reported (computer translated) since the start of surveillance on [2 May 2018], 23 meningitis/meningo-encephalitis have been reported due to West Nile virus infection and a death in the case of a 79-year-old patient who had comorbidities.

Officials say the cases in Romania are sporadic and there is currently no risk of an epidemic.

In addition to Romania (23), in 2018, as of [9 Aug 2018], the EU Member States reported 231 human cases. Italy reported 123 cases, Greece 59 cases, Hungary 23 cases, and France 3 cases. The EU neighbouring countries reported 104 human cases. Serbia reported 102 cases and Kosovo reported 2 cases.

To date, a total of 17 deaths due to West Nile fever have been reported by Serbia (9), Italy (3), Greece (3), Kosovo (1), and Romania (1).
=======================
[In view of the increase in number of WNV cases, the Ministry of Health has advised Romanians to avoid exposure to mosquitoes, to wear shirts and long pants, and to use special window nets so as to minimise the danger of mosquitoes accessing their homes, at the same time maximising their personal health security measures. - ProMED Mod.UBA]

[A HealthMap/ProMED-mail map showing Romania and the other countries mentioned in the report above can be seen at
<http://healthmap.org/promed/p/122>. - ProMed Sr.Tech.Ed.MJ]
Date: 27 Jul 2018
Source: Balkaneu [edited]

Five citizens in Romania have been diagnosed with meningitis caused by the West Nile virus.  The Romanian Ministry of Health recommends to local authorities to take pest control measures as soon as possible to prevent the spreading of the virus, stiri.tvr.ro reported, adding that 80 percent of the people that were infected or get infected have no symptoms.

The only signs and tangible proof that something might be seriously wrong are high fever and headaches. In this case, specialists suggest an immediate visit to the nearest clinic, hospital, or local health centre.

Romanians are advised to avoid exposure to mosquitoes, to wear shirts and long pants, and to use special window nets so as to minimise the danger of mosquitoes accessing their homes, and at the same time, maximize their personal health security measures.  [Byline: Lida Filippakis]
========================
[West Nile virus (WNV) is a significant human, equine and wild bird health problem in the Americas, Europe and the Middle East.

Most WNV infections in people are asymptomatic, and only one infected person in 5 develops fever, headache, body aches, joint pains, vomiting, diarrhoea, or rash. Most individuals recover completely, but fatigue and weakness can last for weeks or months. About one person in 150 will develop neurological disease affecting the central nervous system such as encephalitis or meningitis, and some die [<https://www.cdc.gov/westnile/symptoms/index.html>].

Suspected outbreaks of West Nile virus (WNV) infection have been reported in Romania since the 1950s. Outbreaks of encephalitis, which were serologically confirmed to be caused by WNV infection, were recorded in 1955 in central Transylvania, followed by an outbreak in 1964 in Banat county (central Romania). The largest outbreak of WNV infection in Europe to date was in Romania, when in 1996, over 800 clinical cases of neuro-invasive disease were reported, 393 of which were confirmed for WNV. A total of 17 deaths were reported in this outbreak. The majority of cases were resident (and probably infected) in the capital, Bucharest.

Following this outbreak, Romania implemented a surveillance system for WNV infection. The epidemiological situation until 2009 was characterised by sporadic cases reported from the southern part of the country (south of the Carpathian Mountains). Data from studies conducted between 1997 and 2000 show that 39 confirmed cases were detected. National surveillance data indicate that between 1997 and 2004, a total of 82 neuroinvasive cases were reported in this area (unpublished data; Romanian National Institute of Public Health). Another major outbreak was reported in 2010  [<https://ecdc.europa.eu/sites/portal/files/media/en/publications/Publications/1104_MIR_West_Nile_outbreak_Romania.pdf>].

There have been studies in Romania that provide evidence that wild birds are involved in local West Nile disease enzootic and epizootic cycles. This, in turn, allows virus maintenance and spread and also enhances the chance of new outbreaks [<https://www.ncbi.nlm.nih.gov/pubmed/26824796>]. This indicates that the virus is in circulation in the country, resulting in periodic outbreaks among humans similar to the one reported above. - ProMED Mod.UBA]

[HealthMap/ProMED map available at:
Date: Thu, 19 Apr 2018 05:38:24 +0200
By Mihaela RODINA

Boldesti-Scaieni, Roumanie, April 19, 2018 (AFP) - Measles still claims young lives in Romania, where nearly 40 children have died in an outbreak that many blame on parents being misled by scare stories that vaccinating them is dangerous.   Some 12,000 people have contracted measles since late 2016 in the European Union's second-poorest country, 46 of them died.

Among the dead, 39 were children under the age of three who had not been vaccinated, making Romania one of the worst affected countries in the ongoing measles outbreak in Europe.   "People are mistrustful because they read all sorts of things on the internet," said Dr Silvana Dan, from the southern regional Prahova Public Health Authority, citing persistent rumours that vaccination causes autism.   A girl aged just 11 months died in the region in March after her parents refused to vaccinate her.

Measles is a highly contagious viral disease that affects children in particular but it has largely been brought under control.   The World Health Organization (WHO) says deaths caused by measles plunged from 550,100 in 2000, to just under 90,000 in 2016.   Paradoxically, and to the horror of health authorities worldwide, this very success has seen the public let down its guard and question whether vaccination is now really necessary.

Local officials say health workers are "on the barricades," doing all they can to get the message across, especially in rural areas, that measles is a killer which can be stopped.   It is not straightforward.   "The reasons for people not being vaccinated are different in different population groups," local WHO representative Miljana Grbic told AFP.   "Our research shows that there are specificities such as convenience of services, education, support of family doctors, community support and peer support that play a big role here," Grbic said.

- Roma especially vulnerable -
In Valea Seaca, some 250 kilometres (150 miles) northeast of Prahova, another baby girl of just 10 months died of measles in February.   "Her parents refused, in writing, to have their children vaccinated after seeing reports on television that vaccines kill," local mayor Ioan Pravat told AFP.   The National Centre for the Supervision and Control of Transmissible Diseases says most measles cases are found in more vulnerable, disadvantaged communities, Roma for the most part, who often do not have access to a family doctor or if they do, only ask them for help in an emergency.

The local authorities hope that Roma health workers can help ease that problem.   Aurelia Oprisan, one of them, makes her rounds every day in Boldesti-Scaieni, to the south, knocking on doors to spread the vaccination message.   "Many people are negatively influenced by the press so I tell them that what they are hearing is not true," Oprisan told AFP.   There are signs this approach may be working.   "I don't want to lie to you. At the beginning I, too, was afraid because I had heard that there could be problems, like causing paralysis," said Anisoara Iorga.   "But then I did get my children vaccinated and they had no problems at all."

- Progress but below target -
If there is progress overall, there is also still a way to go.   The WHO recommends a vaccination rate of 95 percent for effective control. But in Romania, it is 87 percent for the first inoculation and only 75 percent for the second, according to the latest official figures from 2016.   Some critics say the authorities share part of the blame because the supply of vaccine is irregular and insufficient.

Stung into action, the government has pledged to improve vaccination rates by making 10 child vaccines compulsory but debates on a draft law submitted last year have made little progress.   "We have received lots of amendments which we are in the process of analysing," said Florin Buicu, a doctor and Social Democrat MP who chairs parliament's health committee.

Many of these have been submitted by anti-vaccine groups who have become increasingly active, Buicu said.   Medical professionals are outraged.   "We have to defend the scientific work (underlying vaccines) while information which has no such basis is taken as the truth," said Dr Alexandru Rafila, head of Romania's microbiology society.
Date: Mon 16 Oct 2017
Source: Romania Insider [edited]

Almost 400 new measles cases have been confirmed in the last month in Romania, according to data from the National Center for Supervision and Control of Transmissible Diseases, quoted by News.ro.

This has brought the total number of confirmed measles cases in the country to more than 9600 since the authorities officially announced the outbreak of this epidemic, at the end of September 2016.

Half of the new cases in the last month have been reported in Brasov county, and a high number of new cases were also reported in Cluj, Satu Mare and Harghita counties.

Overall, in the last 2 years, over 1000 cases were confirmed in Timis county (1228), Caras-Severin county (1112), and Arad county (1014), all in Western Romania.

Since the start of the measles epidemic, 34 people died in Romania because of the disease. Nine deaths were reported Timis county, 6 in Arad, 7 in Dolj, 3 in Caras-Severin, and 1 in Bihor, Cluj, Calarasi, Neamt, Satu Mare, Vaslui, Galati, Mures, and Bucharest, each.

The disease has spread to 41 counties. Tulcea is the only county in Romania where no measles case has been officially recorded yet.

This July [2017], the Romanian Ministry of Health started a vaccination campaign against measles with the involvement of local authorities, which have to identify the children who have not been vaccinated yet and the places where they will be immunized.
=====================
[A HealthMap/ProMED-mail map of Romania can be found at
Date: Mon 16 Oct 2017 at 9:52:16 AM EDT
Source: Outbreak News Today [edited]

Since January 2016, some 19,000 measles cases were reported in Europe, including 44 deaths. (In 2016, 12 deaths occurred in Romania and one in the UK. In 2017, 31 deaths were reported from Romania, Italy [4], Bulgaria [1], Germany [1], Portugal [1], France [1] and Spain [1].)

The list of countries affected is long, with only Latvia, Liechtenstein, Malta and Norway not reporting any cases in 2017.

The most heavily affected continue to be Romania (9539 cases, including 34 deaths with more than 7500 reported in 2017), Italy (4617 cases, including 4 deaths this year), and Germany (891 cases in 2017).

Of all measles cases reported across the one-year period from 1 Sep 2016-31 Aug 2017 with known vaccination status, 87% were not vaccinated.

The latest available figures on vaccination coverage collected by WHO (2016) show that the vaccination coverage for the 1st dose of measles was below 95% in 18 of 30 EU/EEA countries; for the 2nd dose of measles, it was below 95% in 20 of 27 EU/EEA countries reporting 2nd dose coverage data.

According to the European Centre for Disease Prevention and Control (ECDC), in order to achieve the measles elimination goal, the vaccination coverage rates for children targeted by routine vaccination programmes should increase in a number of countries, as the vaccination coverage of the 2nd dose must be at least 95% to interrupt measles circulation and achieve herd immunity.
=====================
[A Google map of Europe may be found at <bit.ly/2t5juKQ>. - ProMED Mod.LK]
More ...

Honduras

Honduras - US Consular Information Sheet
May 19, 2008

COUNTRY DESCRIPTION:
Honduras is a democracy with a developing economy. The national language is Spanish, although English is often spoken in the Bay Islands. The climate is genera
ly pleasant and temperate, with dry and wet seasons. During the dry season from February into May, widespread forest fires and agricultural burning can lead to severely degraded air quality throughout the country possibly causing respiratory problems and airport closures. The terrain includes mountainous areas, coastal beaches, and jungle lowlands. Facilities that would normally be used by tourists, including hotels and restaurants, are generally adequate in the capital city of Tegucigalpa, in San Pedro Sula, Tela, La Ceiba, the Bay Islands, and near the Copan ruins. Large sections of the country, however, lack basic public services or even a governmental presence. Currency exchange is readily available at banks and hotels in the major cities. Read the Department of State Background Notes on Honduras for additional information.

ENTRY/EXIT REQUIREMENTS: A U.S. passport valid for at least three months from the date of entry is required to enter Honduras. Though not required by law, some travelers have reported difficulty departing Honduras using a passport with less than three months of validity beyond the date of departure. A visa is not required, but tourists must provide evidence of return or onward travel. Parents should not rely on birth certificates for their children’s travel; rather, prior to travel they should obtain U.S. passports for infants and minors born in the United States. U.S. citizens are encouraged to carry a photocopy of their U.S. passports with them at all times, so that if questioned by local officials proof of identity and U.S. citizenship are readily available.

In June 2006, Honduras entered a “Central America-4 (CA-4) Border Control Agreement” with Guatemala, El Salvador, and Nicaragua. Under the terms of the agreement, citizens of the four countries may travel freely across land borders from one of the countries to any of the others without completing entry and exit formalities at Immigration checkpoints. U.S. citizens and other eligible foreign nationals who legally enter any of the four countries may similarly travel among the four without obtaining additional visas or tourist entry permits for the other three countries. Immigration officials at the first port of entry determine the length of stay, up to a maximum period of 90 days. Foreign tourists who wish to remain in the four country region beyond the period initially granted for their visit are required to request a one-time extension of stay from local immigration authorities in the country where the traveler is physically present, or travel outside the CA-4 countries and reapply for admission to the region. Foreigners “expelled” from any of the four countries are excluded from the entire “CA-4” region. In isolated cases, the lack of clarity in the implementing details of the CA-4 Border Control Agreement has caused temporary inconvenience to some travelers and has resulted in others being fined more than one hundred dollars or detained in custody for 72 hours or longer.

Dual Nationality: Honduran law permits dual nationality only for minors under the age of 21 and those Honduran-born citizens who have become naturalized citizens of other countries. U.S. citizens who become Honduran citizens by naturalization are not considered to have dual nationality under Honduran law. However, becoming a Honduran citizen will not cause U.S. citizens to lose their U.S. citizenship and all the accompanying rights and privileges. Dual nationals, in addition to being subject to all Honduran laws affecting U.S. citizens, may be subject to other laws that impose special obligations on Honduran citizens. For more information, please contact Honduran Immigration in Tegucigalpa (telephone 504-238-5613), San Pedro Sula (telephone 504-550-3728), Roatan (telephone 504-445-1226), La Ceiba (telephone 504-442-0638), or Puerto Cortes (telephone 504-665-0582).

For further information on dual nationality for U.S. citizens, see the Bureau of Consular Affairs dual nationality flier.

SAFETY AND SECURITY:
Political demonstrations sometimes disrupt traffic, but they are generally announced in advance and are usually peaceful. Travelers should avoid areas where demonstrations are taking place, and they should stay informed by following the local news and consulting hotel personnel and tour guides. Demonstrators frequently block public roads to press for concessions from the government of Honduras. These demonstrations may last several hours and the government rarely seeks to disperse the demonstrators. U.S. citizens should never try to pass such roadblocks. While the Honduran side of the Honduras-Nicaragua border has been largely cleared of land mines, travelers should exercise caution there. For more information, we strongly encourage travelers to visit the U.S. Embassy's web site at http://honduras.usembassy.gov/ and click on Crime and Security Matters. For the latest security information, American citizens traveling abroad should regularly monitor the Department of State, Bureau of Consular Affairs’ web site at http://travel.state.gov, where the current Travel Warnings and Travel Alerts, as well as the Worldwide Caution, can be found.

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

CRIME: Crime is endemic in Honduras and requires a high degree of caution by U.S. visitors and residents alike. U.S. citizens have been the victims of a wide range of crimes, including murder, kidnapping, rape, assault, and property crimes. Sixty-two U.S. citizens have been murdered in Honduras since 1995; only twenty cases have been resolved. Four U.S citizens were murdered in Honduras in 2007, six in 2006, and ten in 2005. Kidnappings of U.S. citizens have occurred in Honduras, including two incidents in 2007. Poverty, gangs, and low apprehension and conviction rates of criminals contribute to a critical crime rate, including horrific acts of mass murder. With a total of 3,855 murders in 2007, and a population of approximately 7.3 million people, Honduras has one of the world’s highest per capita murder rates.

U.S. citizens are encouraged to follow local news reports and seek additional information in the resources listed above. Criminals and pickpockets also target visitors as they enter and depart airports and hotels, so visitors should consider carrying their passports and valuables in a concealed pouch. Two-man teams on medium-size motorcycles often target pedestrians for robbery. There have also been reports of armed robbers traveling in private cars targeting pedestrians on isolated streets. The Honduran government conducts occasional joint police /military patrols in major cities in an effort to reduce crime. Problems with the judicial process include corruption and an acute shortage of trained personnel, equipment, staff, and financial resources. The Honduran law enforcement authorities' ability to prevent, respond to, and investigate criminal incidents and prosecute criminals remains limited. Honduran police generally do not speak English. The government has established a special tourist police in the resort town of Tela and other popular tourist destinations, including Tegucigalpa, San Pedro Sula, La Ceiba, and Roatan, but the number deployed is small and coverage is limited. The San Pedro Sula area has seen occasional armed robberies against tourist vans, minibuses, and cars traveling from the airport to area hotels, even sometimes targeting the road to Copan. Armed men have forced vehicles transporting tourists off the road and robbed the victims, occasionally assaulting the driver or passengers. In past years, several U.S. citizens have been murdered in San Pedro Sula and La Ceiba shortly after arriving in the country. Assaults in these areas may be based on tips from sources at airport arrival areas, so visitors are strongly urged to exercise caution in discussing travel plans in public.

Copan, Roatan/Bay Islands, and other tourist destinations have a lower crime rate than other parts of the country, but thefts, break-ins, assaults, and murders do occur. Exercise particular caution walking on isolated beaches, especially at night. Coxen Hole on the island of Roatan should be avoided after dark.

The Government of Honduras has a very limited presence in Northern Olancho, Colon and Gracias a Dios Departments, which are well known for lumber and narcotics smuggling and violence. Travelers in those areas should use extra caution. See the description of highways/areas to be avoided in the Traffic Safety and Road Conditions section below for details.

Incidents of crime along roads in Honduras are common, including carjacking and kidnapping. There have been frequent incidents of highway robbery on a number of roads including Limones to La Union, Olancho (route 41) via Salama and northward to Esquipulas Del Norte. For more information, please see the section below on Traffic Safety and Road Conditions.

Travelers should always drive with their doors locked and windows rolled up to avoid potential robberies at traffic lights and other places, such as congested downtown streets. Avoid driving at night. All bus travel should be during daylight hours and on first-class conveyances, not on economy buses. Please choose taxis carefully, and note the driver's name and license number. Instruct the driver not to pick up other passengers, agree on the fare before you depart, and have small bills available for payment, as taxi drivers often do not make change.

Do not resist a robbery attempt. Most criminals have weapons, and most injuries and deaths have resulted when victims have resisted. In 2004, an American citizen was murdered while attempting to flee an armed robbery in progress and another American was shot while resisting a carjacking. Two American citizens were murdered while resisting armed robberies in 2005.

Do not hitchhike or go home with strangers, particularly from nightspots. Whenever possible, travel in groups of two or more persons. Use the same common sense while traveling in Honduras that you would in any high crime area in the United States: do not wear excessive jewelry; do not carry large sums of money, or display cash, ATM/credit cards, or other valuables you do not need.

Avoid walking at night in most areas of Honduras. Do not hike alone in backcountry areas, or walk alone on beaches, historic ruins, or trails.

Individuals and groups should register their travel plans with the State Department via the Internet at the Department’s secure travel registration web site, https://travelregistration.state.gov/. Travelers may also register by sending passport, date of birth, and emergency contact information to the American Citizens Services Unit of the U.S. Embassy in Tegucigalpa via fax at 011-504-238-4357, or e-mail at usahonduras@state.gov prior to travel. Individuals as well as groups should always keep in their possession a photocopy of their U.S. passport data page, carry an additional copy in their suitcase, and leave a copy at home with a friend or family member.

INFORMATION FOR VICTIMS OF CRIME: If you are the victim of a crime while in Honduras, contact local authorities immediately, either directly or through the national police emergency number: *199. In addition to reporting to the local police, please contact the U.S. Embassy in Tegucigalpa or the Consular Agency in San Pedro Sula for assistance. The theft of a U.S. passport should be reported immediately. The Embassy and Consular Agency staff can provide you with information about medical care, contacting family members or friends and explaining how funds could be transferred. Although the investigation and prosecution of most crimes are solely the responsibility of local authorities, Consular staff can provide you with a list of attorneys if needed. See our information on Victims of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION: Medical care in Honduras varies greatly in quality and availability. Outside Tegucigalpa and San Pedro Sula, medical care is inadequate to address complex situations. Support staff facilities and necessary equipment and supplies are not up to U.S. standards anywhere in Honduras. Facilities for advanced surgical procedures are not available. Wide areas of the country, including the popular tourist areas of the Bay Islands, do not have a general surgery hospital. Ambulance services are limited in major cities and almost non-existent elsewhere. Emergency services may be contacted directly through their local numbers.

Scuba diving is popular in the Bay Islands, but the limited medical facilities there pose a special risk in the event of an emergency. There is a decompression chamber on Roatan and Utila for divers, but no advanced medical care on either island for diving related accidents.

MEDICAL INSURANCE: The Department of State strongly urges American citizens 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. U.S. medical insurance plans seldom cover health costs incurred outside the U.S. unless supplemental coverage is purchased. Furthermore, U.S. Medicare and Medicaid programs do not provide payment for medical services outside the United States. However, many travel agents and private companies offer insurance plans that will cover health care expenses incurred overseas including emergency services such as medical evacuations. It is important to ensure that you have adequate medical evacuation coverage prior to your trip to Honduras.

When making a decision regarding health insurance, American citizens should consider that many foreign doctors and hospitals require payment in cash prior to providing service and that a medical evacuation to the U.S. may cost tens of thousands of dollars. Uninsured travelers who require medical care overseas often face extreme difficulties. When consulting with your insurer prior to your trip, ascertain whether payment will be made to the overseas healthcare provider or whether you will be reimbursed later for expenses you incur. Some insurance policies also include coverage for psychiatric treatment and for disposition of remains in the event of death.

Useful information on medical emergencies abroad, including overseas insurance programs, is provided in the Department of State's Medical Information for Americans Traveling Abroad.

OTHER HEALTH INFORMATION: Mosquito-borne illnesses are an ongoing problem in Honduras. All persons traveling in Honduras, even for a brief visit, are at risk of contracting malaria. Take a prophylactic regimen best suited to your health profile. The country regularly suffers from outbreaks of dengue fever. Unlike traditional mosquito-borne illnesses, there is no medicinal prophylactic or curative regimen for dengue fever. Travelers should take precautions against being bitten by mosquitoes to reduce the chance of contracting such illnesses, such as avoiding standing water even in the home, wearing long sleeves and pants in both day and night, and applying insect repellent regularly.

Severe air pollution, which can aggravate or lead to respiratory problems, is common throughout the country during the dry season due in large part to widespread forest fires and agricultural burning. Travelers with respiratory or cardiac conditions and those who are elderly or extremely young are at greatest risk for complications from air pollution, which may include coughing, difficulty breathing, wheezing, or chest pain. Acute respiratory infections are also widespread; more than 100,000 cases are reported annually.

Individuals traveling to Honduras should ensure that all their routine vaccinations are up to date. Vaccination against Hepatitis A, Hepatitis B, and Typhoid is strongly recommended for those traveling to Honduras from the United States. Honduras requires vaccination against Yellow Fever for those traveling to Honduras from countries where there is the risk of transmission. Travelers taking prescription medications should bring an adequate supply with them when coming to Honduras and ensure that they are properly labeled.

Honduras also has the highest adult HIV/AIDS prevalence rate in the region. Over 63,000 people in Honduras have HIV/AIDS.

Honduras lacks a substantial infrastructure for maintaining water purity. Travelers are strongly encouraged to avoid drinking tap water or a beverage that contains ice from an unknown source (even alcoholic drinks). Bottles and bags of purified water are widely available. It is also recommended that individuals traveling to Honduras avoid eating untreated raw vegetables, fruits that can’t be peeled on the spot, raw fish like ceviche and undercooked shellfish and products containing mayonnaise, pastry icing, and unpasteurized dairy products. Hot cooked food, fresh bread, dry foods such as crackers, bottled carbonated beverages, coffee, tea, and beer are usually safe, provided such food items are not purchased from street vendors. All fruits and vegetables should be washed thoroughly with detergent and running water. Those that will be cooked or peeled can then be stored in a sealed container until used. Those that will be eaten raw and will not be peeled should be soaked for 15 minutes in a solution of chlorine bleach (or 5% household bleach) in water (one tablespoon of Clorox per gallon of water), rinsed with potable water, and allowed to air dry.

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); fax 1-888-CDC-FAXX (1-888-232-3299), 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 web site at http://www.who.int/en. Further health information for travelers is available at http://www.who.int/ith.

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

Because of crime and poor road conditions, driving can be very dangerous, and travelers should carry a cellular phone in case of an emergency. Travelers should exercise extreme caution while driving on isolated stretches of road and passing on mountainous curves. Rockslides are common, especially in the rainy season (May through December). Traffic signs, even on major highways, are often inadequate, and streets in the major cities are often unmarked. Travelers should always drive with their doors locked and windows rolled up to avoid potential robberies at traffic lights and other places such as congested downtown streets. Please refer to our Road Safety page for more information.

Honduran roads are poorly lit and marked. Vehicles are often driven at night without adequate illumination, and animals and people wander onto the roads at all hours. For these reasons, and because of the high incidence of crime, the U.S. Embassy strongly discourages car and bus travel after dark.

Major cities are connected by an inconsistently maintained, two-lane system of paved roads. Many secondary roads in Honduras are unpaved. During the rainy season, even major highways are often closed due to rockslides and flooding from heavy rains. In the event of an accident, contact the Honduran Transit Authority (“Transito”) immediately. They may be contacted either directly through their local numbers, or through their national emergency number, *189. Honduran law requires that no vehicles involved in an accident be moved until Transit Agents arrive, not even to clear a traffic obstruction, unless you are in serious physical danger.

Some of the most dangerous stretches for road travel include: Tegucigalpa to Choluteca, because of dangerous mountain curves; El Progreso to La Ceiba, because of animal crossings and the poor condition of bridges from flooding; Route 39 through northern Olancho Department between Gualaco and San Esteban; and Limones to La Union, Olancho (route 41) via Salama and northward to Saba. Locals also refer to this latter stretch of road as the “Corridor of Death” because of frequent incidents of highway robbery. In March of 2008, 27 persons died when a bus overturned and rolled down a ravine in La Esperanza, Intibuca, on another infamous stretch of road called “Flight of the Angel.”

The Embassy has received reports of robberies on the road from Tegucigalpa to Danlí. The only recommended route to the north coast from the south is CA-5 to route 21 to CA-13 via Tela to La Ceiba and Trujillo. Hijackings of private and commercial vehicles from the United States to Honduras have occurred. While Honduras and the United States have signed and ratified a Stolen Vehicle Treaty, existing Honduran laws protect good faith buyers (even of stolen vehicles) so the recovery and return of these vehicles to their original owners is not guaranteed. Vehicle insurance may mitigate loss; please check with the National Insurance Crime Bureau at https://www.nicb.org, private insurance carriers, and our Embassy web site information on Commercial Vehicle Hijackings at http://honduras.usembassy.gov/english/mission/sections/RSO/comveh_highsec.htm for more information.

For additional general information about road safety, please see our Road Safety page, which includes links to foreign government sites. For specific information concerning Honduran driving permits, vehicle inspection, road tax, and mandatory insurance, please contact the Honduran National Tourist Organization offices in New York via the Internet at http://www.hondurastips.honduras.com/.

MARINE SAFETY AND OVERSIGHT: The areas off both coasts of Honduras are the subject of maritime border disputes between Honduras and its neighbors. The Honduran Navy patrols these areas, and all private vessels transiting Honduran territorial waters should be prepared to be hailed and possibly boarded by Honduran military personnel to verify documentation. While the Honduran Navy previously used private vessels as patrol vessels, this is no longer the case. In the event that any vessel is hailed in Honduran waters in the Caribbean by a non-military vessel or any suspicious vessel and directed to prepare for boarding, the vessel should immediately contact the U.S. Coast Guard Operations Center by radio or INMARSAT at 305-415-6800. Anyone needing more information can also contact the U.S. Embassy during working hours and request to speak with the U.S. Military Group (USMILGP) office.

There have been incidents of armed assaults against private sailing vessels by criminals posing as fishermen off the northeast coast of Honduras, particularly in the numerous small islands northeast of the Department of Gracias a Dios. Sailors should contact the Coast Guard and yacht facility managers in their areas of travel for current information.

AVIATION SAFETY OVERSIGHT: The U.S. Federal Aviation Administration (FAA) has assessed the Government of Honduras’ Civil Aviation Authority as not being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for the oversight of Honduras’ air carrier operations. For more information, travelers may visit the FAA’s web site at http://www.faa.gov/safety/programs_initiatives/oversight/iasa.

Severe air pollution often leads to the closing of some or all of Honduras’ four international airports during the dry season. Some travelers have been compelled to travel by bus to neighboring countries in order to catch onward flights.

SPECIAL CIRCUMSTANCES:

Real Estate Investment: U.S. citizens should exercise extreme caution before entering into any form of commitment to invest in real property, particularly in coastal areas and the Bay Islands. Honduran laws and practices regarding real estate differ substantially from those in the United States, and fraudulent deeds and titles are common; U.S. citizens considering investing or buying real estate in Honduras should be aware that rights to such property do not enjoy the same level of protection as in the United States. Historically, title insurance has not been available in Honduras. Recently, some American insurance companies have begun offering title insurance in cooperation with Honduran attorneys. However, approximately 80 percent of privately held land is untitled. In addition, there are complaints that the Honduran judicial system often prolongs disputed cases for many years before resolution. American citizens have spent thousands of dollars in legal fees and years of frustration trying to resolve property disputes, even in cases in which local attorneys and Honduran and U.S. real estate agents had given assurances to the investor. Violence has been used against American citizens involved in disputed property cases. Potential investors should engage competent local legal representation before making any commitments. Investors should thoroughly check references of attorneys and real estate agents.

Honduran law places certain restrictions on land ownership by foreigners in coastal and border areas. Squatters claim a number of properties owned by U.S. citizens. U.S. Government officials may not act as agents, attorneys, or in a fiduciary capacity. U.S. citizens who own property abroad and who thereby have assumed responsibilities concurrent with ownership of property in a foreign country should take steps on their own initiative to safeguard their interests and to employ private legal counsel when the need arises. For further information on investing in property in Honduras, please review the State Department’s Investment Climate Statement, part of the Country Commercial Guide at http://www.buyusa.gov/honduras/en/14.html. For information on contracting Honduran legal representation, please check with other investors. You may also refer to the list of attorneys available on the Embassy's home page at http://honduras.usembassy.gov/attorneylistoct07.pdf.

Financial Market Investment: Due to poor regulation and lack of guarantees, investment in the Honduran "Bolsa de Valores," or securities market, as well as banking institution bonds, “fideicomisos” (trusts), and certificates of deposit from uninsured financial institutions pose high risk to investors. Extreme caution should be exercised before and while undertaking such activities, as American citizens have lost large sums of money through investments in such precarious markets. For further information on investing in Honduras, please review the State Department’s Investment Climate Statement, part of the Country Commercial Guide at http://www.buyusa.gov/honduras/en/14.html.

Corruption: Many U.S. firms and citizens operating in Honduras have found corruption to be a serious problem and a constraint to successful investment. While some U.S. firms have satisfactorily resolved cases through the courts, the majority have difficulty navigating the legal system. There are complaints that the Honduran judicial system caters to favoritism, external pressure and bribes. Corruption appears to be most pervasive in government procurement, government permits, and in the buying and selling of real estate (land titling).

Customs Regulations: U.S. citizens who intend to stay in Honduras for an extended period of time and who bring vehicles or household goods into the country should consult Honduran customs officials prior to shipment. With the exception of “antique” cars, all vehicles imported into Honduras by foreigners must be less than ten (10) years old. For specific information regarding customs requirements, please contact the Embassy of Honduras in Washington, DC at http://www.hondurasemb.org/ for more information.

Honduran customs authorities may enforce strict regulations concerning temporary import and export of items such as antiquities, medications, and business equipment. For example, Honduran law prohibits the export of antiques and artifacts from pre-colonial civilizations. To protect the country's biodiversity, it is illegal to export certain birds, feathers, and other flora and fauna. For specific information regarding exportation requirements, please contact the Embassy of Honduras in Washington, DC at http://www.hondurasemb.org/.

The Government of Honduras is strictly enforcing the law that requires a Honduran permit for the importation of firearms into Honduras. Travelers must obtain a firearm importation permit from a Honduran Embassy, Consulate General, or Consulate located in the United States prior to bringing firearms into the country. Please note that a U.S. government-issued or airline-issued permit is not valid for importation of firearms into Honduras. Firearms that arrive without the requisite Honduran permit will be confiscated and the bearer will be prosecuted to the full extent of Honduran law.

For further information about customs regulations, please read our Customs Information sheet.

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 under U.S. law. Penalties for breaking the law can be more severe than in the United States for similar offenses. Persons violating Honduran laws, even unknowingly, may be fined, expelled, arrested, or imprisoned. Penalties for possession, use, or trafficking in illegal drugs in Honduras are severe, and convicted offenders can expect long jail sentences and heavy fines. Assisting or participating in the distribution of illegal drugs is also a crime prosecutable in the United States, and may lead to fines, property seizure, or imprisonment. Anyone offering you illegal drugs should be considered extremely dangerous – there is no “safe” source of illegal drugs.

"Sexual tourists" travel alone or in groups to Honduras for the purpose of purchasing sexual favors from minors. This activity violates Honduran law, and American citizens are imprisoned in Honduras for sexual offenses involving minors. In addition, U.S. citizens and residents charged with these crimes are subject to prosecution upon their return to the United States, regardless of the outcome of the judicial proceedings overseas. Moreover, the prevalence of HIV/AIDS in sex workers in Honduras is estimated to be in excess of 10%. Using or disseminating child pornography in a foreign country is also a crime prosecutable in the United States. Please see our information on Criminal Penalties.

CHILDREN'S ISSUES: International adoptions from Honduras are very complex. Current information on Honduran adoption procedures and the immigrant visa application process is available from the Consular Section of the U.S. Embassy. Prospective adoptive parents are urged to check with the Consular Section to ensure that all required documentation has been approved by the U.S. Bureau of Citizenship and Immigration Services (USCIS) of the Department of Homeland Security and to confirm that their child's adoption is complete before traveling to Honduras to apply for their child's immigrant visa. Adoptive parents are also urged to carry with them complete adoption paperwork when traveling with their adopted child to, from, and within Honduras.

Honduras is a signatory to the Hague Convention on the Civil Aspects of International Child Abduction, but the U.S. Department of State has determined that Honduras has failed to comply with its obligations under the Convention. No child has ever been returned to the United States from Honduras under the provisions of the Convention.

For information on international adoption of children and international parental child abduction, please refer to the Office of Children’s Issues web pages on intercountry adoption and international parental child abduction, or telephone Overseas Citizens Services at 1-888-407-4747. This number is available from 8:00 a.m. to 8:00 p.m. Eastern Standard Time, Monday through Friday (except U.S. federal holidays). Callers who are unable to use toll-free numbers, such as those calling from overseas, may obtain information and assistance during these hours by calling 1-202-501-4444.

REGISTRATION / EMBASSY LOCATION:
American citizens residing or traveling in Honduras are encouraged to register their presence through the State Department’s travel registration web site, and to obtain updated information on travel and security within Honduras. American citizens without Internet access may register directly with the U.S. Embassy in Tegucigalpa. By registering, whether via the Internet or in person at the Embassy, American citizens make it easier for the Embassy to contact them in case of emergency.

U.S. Embassy location:
Avenida La Paz in Tegucigalpa, Honduras
Internet site: http://honduras.usembassy.gov/
Telephone: 011-504-236-9320 or 011-504-238-5114
Office hours are Monday through Friday from 8:00 a.m. to 11:30 am.
American Citizens Services Unit Fax: 011-504-238-4357

Consular Agency in San Pedro Sula location:
Banco Atlantida Building – 11th Floor
San Pedro Sula, Honduras
Telephone: 011-504-558-1580
Office hours are Mondays, Wednesdays and Fridays from 1:00 p.m. to 4:00 p.m.

The Consular Agent is available during limited hours to perform notarial services, assist U.S. citizens with emergencies, and accept U.S. passport and U.S. Report of Birth applications for adjudication at the Embassy in Tegucigalpa. The Consular Agent does not provide visa information or services. For more details about all U.S. Embassy and consular services in Honduras, please see the Embassy web site at http://honduras.usembassy.gov/ or visit the Bureau of Consular Affairs web site at http://travel.state.gov/.
* * *
This replaces the Country Specific Information dated October 12, 2007, to update sections on
Entry/Exit Requirements, Crime, Medical Facilities and Health Information, Other Health Information, and Traffic Safety and Road Conditions.

Travel News Headlines WORLD NEWS

Date: Fri, 26 Jul 2019 03:36:47 +0200
By Noe LEIVA

La Paz, Honduras, July 26, 2019 (AFP) - Of Honduras' 32 public hospitals, 26 are overflowing with patients due to what health authorities are calling the worst dengue fever epidemic in the past half century.   The disease has struck 28,000 people this year, of which 54, mostly children, have died.   The enormous case flow is evident in the western city of La Paz. Inside the local hospital's chapel, two tables are piled high with patient folders, which sit in front of a wooden depiction of Christ.   Even more telling are the beds lining the room, protected by red and blue mosquito nets, from which 10 women are being treated for some of dengue's typical symptoms: bone and joint pain, high fever, vomiting and dehydration.#

Officials have called a national emergency to fight the dengue-causing aedes aegypti mosquito and a fumigation program has been launched in homes and public buildings.   And yet the hospital bursts at the seams. On top of those housed in the chapel, six of the facility's eight rooms are taken up by those stricken by dengue, with some beds even in the corridors.   Three of the rooms house a total of 26 children, age two to 14 -- the most vulnerable group to dengue -- who are connected to IV bags and monitored by concerned parents.   "They're not all out of danger," said a nurse as she looked over the patients.

- 'We're overrun' -
Crista Alexandra Pineda, age seven, is one of the children whose health is worrying hospital staff the most.   She was admitted on Sunday suffering from bleeding, accompanied by her 59-year-old grandmother, Josefina Velasquez.   "We're overrun," hospital spokesman Marco Antonio Rodas told AFP.   "We had to postpone planned operations" to concentrate on the emergencies.   "In 20 years working here, I've never seen this," he added.

Over the last week, the number of patients rose from 53 to 78. The most serious cases were transferred by ambulance to the University Hospital in the capital Tegucigalpa, where already two have died, Rodas said.   He hasn't ruled out the possibility of taking over schools to accommodate patients who are "arriving in ever greater numbers."   Marta Zoila Lopez, 58, told AFP she was at home in Guajiquiro, close to a La Paz, on Sunday when she started feeling symptoms.   "At first I had pain in my stomach, head and bones, vomiting and bleeding" from her nose and gums. She was immediately taken to the hospital where nurses say she's still in a delicate condition.   President Juan Orlando Hernandez summoned all 298 municipal mayors to the capital on Monday and announced a special fund to combat the outbreak.

The only effective measure to halt the epidemic "is to destroy the mosquito's breeding grounds and this is something that every one of us has to do in our homes, where we work and also in every public area," said Hernandez.   He also announced a "massive mobilization" to fumigate and destroy those breeding grounds. Churches, press organizations and business leaders have committed to assisting the effort.   It's a critical situation with the three-month long rainy season about to begin, meaning that breeding grounds will soon proliferate and the mosquito's numbers could soar.
Date: Thu, 20 Jun 2019 09:02:06 +0200

Tegucigalpa, June 20, 2019 (AFP) - Thousands of Hondurans blocked streets across the country Wednesday night demanding the resignation of President Juan Orlando Hernandez as tensions mount over strikes by police and truckers.   Police spokesman Jair Meza told AFP that street occupations were reported in several areas of the country, but the force was working to restore order despite a sit-down strike by special operations units.

Meza said looters had raided and torched businesses in the capital, Tegucigalpa, while others blocked streets with bonfires made from tires and rocks.   He added that the police were receiving reinforcements from the armed forces to control the groups that, in their opinion, are made up of gangs and opponents demanding the resignation of President Hernandez.   Mezo said the striking officers -- mostly riot police -- claim "harassment in the workplace and abuse of authority by many chiefs," according to a statement.   The special forces police officers say they are given "terrible food," that they are sent on missions without their expenses being covered and that they are denied labour rights and salary increases.

The Ministry of Security responded in a statement that police bosses "ordered the review of work days," while recognizing that there had been extra shifts to address the demonstrations.   The conflict deepened when police chief Jose Aguilar visited the area where the strikers were holed up but had to flee after a tear gas canister was thrown at him, another police spokesman Orlin Cerrato told a press conference.

Meza said that there was also a strike by truck drivers, who since Monday have parked their rigs on roads near the capital, demanding a pay rise.    The blockage caused a shortage of fuel in some areas of the country, which in turn led to long lines of vehicles at gas stations, the spokesperson said.
Date: Sun, 19 May 2019 05:17:37 +0200

Tegucigalpa, May 19, 2019 (AFP) - Four Canadians and an American pilot died Saturday when their small plane plunged into the sea off the Honduran island of Roatan where they were vacationing, firefighters said.   The plane crashed near the town of Dixon Cove, a few minutes after taking off from the island's airport, rescuers said.   The dead were identified as Bradley Post, Bailey Sony, Tomy Dubler and pilot Patrick Forseth.

The other Canadian pilot, Anthony Dubler, briefly survived the crash but died at the Roatan hospital of his injuries.   The causes of the crash and the registration information for the aircraft were not immediately available.   It occurred as the tourists were headed toward the city of Trujillo, about 77 kilometres (48 miles) from Roatan.
Honduras. 21 Mar 2019. (Reported)

39 cases with 54% in children under 18 years; DHF/serious 12 cases in past week.

[An 18 Mar 2019 report indicates that there are 789 serious dengue cases with 12 deaths.
Date: Fri 18 May 2018 10:14 HS CST
Source: TVP [in Spanish, machine trans., edited]
<https://tvpacifico.mx/noticias/209149-honduras-acumula-diez-muertos-y-172-casos-confirmados-de-gripe-a>

Honduras has registered 10 deaths and 172 cases of influenza A, with 22 new infections confirmed in the last hours, reported today [18 May 2018] the national coordinator of Health Surveillance, Homer Meja. He also noted that 9 of the deceased patients had "more than one underlying disease, such as diabetes, hypertension, and heart disease." He added that the majority of these infections occurred in San Pedro Sula and Tegucigalpa, the 2 most important cities of the Central American country.

Meja indicated that there are also 2 people who are suspected of having contracted the disease in Comayagua, in the central region of Honduras, so they are being kept under surveillance. The official stressed that the influenza vaccination campaign began on [Mon 14 May 2018] in the main cities of the country, and recommended all pregnant women to be vaccinated because very few do so despite being at risk for the health of the baby. The official said that pregnant women should know that the disease can directly affect the baby, and insisted that these women should be vaccinated, regardless of the time of gestation.

People aged 59 and over, health workers, children under 5, the chronically ill, and pregnant women, are the most vulnerable groups who are receiving the dose first, he added. Mejía said that the vaccination centers have more than one million doses to vaccinate groups at risk and announced that in the 1st week of June [2018] the rest of the population will be vaccinated.

The main symptoms are fever of up to 39 deg C [102.2 deg F], chills, headache, muscle, sneezing, intense and persistent cough, runny nose, tearing, and mild pharyngitis, according to the authorities.
=========================
[There have been reports of increased influenza activity in various countries during the official influenza season in the southern hemisphere. The severity of the current season is similar to the trend seen in the northern hemisphere during the 2017-18 season. Vaccination, particularly for high risk groups, can help reduce morbidity and mortality, provided the vaccine strains are a close match to the circulating viruses. - ProMED Mod.UBA]

[HealthMap/ProMED-mail map Honduras:
<http://healthmap.org/promed/p/22>]
More ...

World Travel News Headlines

Date: Tue, 25 Feb 2020
13:15:00 +0100 (MET)
By Ella IDE and Jastinder KHERA

Rome, Feb 25, 2020 (AFP) - Italy's new coronavirus spread south on Tuesday to Tuscany and Sicily, as the civil protection agency reported a surge in the number of infected people and Rome convened emergency talks.    Prime Minister Giuseppe Conte has blamed poor management in a hospital in the country's north for the outbreak, which has caused seven deaths in Italy so far and infected the largest number of people in Europe.    Tuscany reported its first two cases, including one in the tourist destination of Florence, while Sicily marked one: a tourist from the worst-hit Lombardy region, where 212 people have tested positive. The female tourist in Sicily, who had been staying in a hotel in Palermo, tested positive on the first swab but was awaiting the definitive result from Italy's institute of infectious diseases, civil protection agency chief Angelo Borrelli said.

Health ministers from neighbouring countries were to meet in Rome as the 
number of confirmed infections jumped to 283, with over 50 new cases reported since Monday.    The EU's health commissioner and other international health officials were also expected in the Italian capital Tuesday.    Hundreds of people were confined to their rooms at a Tenerife hotel after an Italian tourist was hospitalised with a suspected case of coronavirus, health officials in the Canary Islands said.  While no neighbouring country has closed its borders with Italy, several governments have announced additional measures for travellers arriving from Italy, in particular from the two northern regions of Lombardy and Veneto.  They range from medical screening to recommendations to self-isolate.

- 'Mission Impossible' -
Several upcoming matches in Italian Serie A and the Europa League will be played behind closed doors to combat the spread of the disease.    Production of the latest "Mission: Impossible" film starring Tom Cruise in Venice has been stopped following the outbreak.    The main centre of infection in Italy has been the town of Codogno, a town of some 15,000 people around 60 kilometres (35 miles) to the south of Milan. Codogno and several others in northern Italy have been put under isolation in an attempt to stem the spread of the virus.

The 38-year-old man dubbed "Patient One" by Italian media was admitted to 
hospital last Wednesday in Codogno, and it is thought a large number of the cases in the worst-hit region of Lombardy can be traced back to him.    His heavily pregnant wife, several doctors, staff and patients at the hospital are thought to have caught the virus from him.    As well as the towns placed under quarantine, further wide-ranging measures have affected tens of millions of inhabitants in the north of Italy, with schools closed and cultural and sporting events cancelled.    Elsewhere in the country officials have also been recommending precautionary measures.  In Calabria in the south, bishops have asked their worshippers not to make the sign of peace during mass, media reported.    All seven of those who have died so far in Italy were either elderly or had pre-existing medical conditions.
Date: Tue, 25 Feb 2020 11:48:12 +0100 (MET)

Madrid, Feb 25, 2020 (AFP) - Hundreds of people were confined to their rooms at a Tenerife hotel Tuesday after an Italian tourist was hospitalised with a suspected case of coronavirus, health officials in the Canary Islands said.   "Hundreds of hotel clients are being monitored for health reasons and the degree of supervision will be assessed during the day, but so far, we're not talking about quarantine," health authority spokeswoman Veronica Martin told AFP, confirming that the Italian tourist "was staying at this hotel while on holiday in Tenerife".
Date: Tue, 25 Feb 2020 11:40:20 +0100 (MET)
By Laurent Thomet with Dario Thuburn in Geneva

Beijing, Feb 25, 2020 (AFP) - Fresh deaths and a surge in new coronavirus cases in Iran, Japan and South Korea on Tuesday fuelled fears of a pandemic, as the disease took root in some of the world's poorest -- and worst-equipped -- countries.  The rapid spread abroad came as the World Health Organization announced that the epidemic had peaked at its epicentre in China, where it has killed more than 2,600 people and infected over 77,000 others.

But the situation has worsened elsewhere with nearly 2,700 other cases and more than 40 deaths globally, prompting restrictions on travellers from infected nations, the cancellation of football matches and national efforts to isolate suspected patients.    South Korea, Italy and Iran have each logged sharp increases in infections and deaths, while several Middle Eastern countries also reported their first confirmed COVID-19 cases.

WHO chief Tedros Adhanom Ghebreyesus insisted the virus could still be contained, praising China's drastic quarantine measures in several cities for helping to prevent an even bigger spread.   "For the moment we are not witnessing the uncontained global spread of this virus and we are not witnessing large-scale deaths," Tedros told reporters in Geneva on Monday.   He added, however, that countries should do everything they can to "prepare for a potential pandemic" -- a term is used to describe an illness that spreads across numerous communities.   The White House plans to spend $2.5 billion to combat the epidemic, according to US media. There are 53 cases in the United States so far.

- Iran hotspot -
Iran has emerged as a major hotspot with the death toll rising to 15 on Tuesday as three more people succumbed to the disease.   The country has been scrambling to contain the epidemic since last week when it announced its first two deaths in Qom, a centre for Islamic studies and pilgrims that attracts scholars from abroad.

Iran has confirmed 61 cases so far, making its mortality rate exponentially higher than anywhere else in the world and raising suspicion that many more people have contracted the disease there.   A WHO team was due in Iran on Tuesday.   Several neighbours have enacted measures to block arrivals from Iran but the virus has already spread to Afghanistan and elsewhere in the Middle East.   The WHO has warned that poorer countries with weak health care systems are the most at risk.

- Games off -
South Korean President Moon Jae-in warned that the outbreak was "very grave" as the country's death toll rose to 10 and the number of confirmed infections approached 1,000 -- the largest total outside China.   Scores of events have been cancelled or postponed as the outbreak has spread in the world's 12th-largest economy, from K-pop concerts to the World Team Table Tennis championship.   Parliament closed for cleaning Tuesday after confirmation a person with the coronavirus had attended a meeting last week.   More than 80 percent of the infections have been in and around Daegu, South Korea's fourth-largest city.

Streets there have been largely deserted for days, apart from long queues at the few shops with masks for sale.   Most of the country's infections are linked to the Shincheonji Church of Jesus, an entity often accused of being a cult.   The US Centers for Disease Control warned Americans against "all nonessential travel to South Korea".   In Japan, a fourth former passenger of the coronavirus-stricken Diamond Princess cruise ship died, according to local media. The man was in his 80s.   Nearly 700 people from the quarantined ship have tested positive for the illness so far.

Infections have also spiked inside Japan, with at least 160 cases including one death.   The government has expanded the number of hospitals that can receive suspected patients and asked people with moderate symptoms to stay home.   Businesses were asked to "let people stay away from offices, to avoid rush hour commuting hours, and to encourage telecommuting," Health Minister Katsunobu Kato said.   Italy -- which has reported seven deaths and over 200 cases -- has locked down 11 towns, while upcoming football matches in its Serie A and the Europa League will be played behind closed doors.    Prime Minister Giuseppe Conte has said that residents could face weeks of lockdown.

- China cases slow -
In China, 508 new cases were reported, with all but nine at the outbreak's epicentre in central Hubei province.   The death toll nationwide reached 2,663 on Tuesday after 71 more people died, the lowest rise in almost three weeks.   Reassured by the official numbers, the country is gingerly returning to business.   Beijing is seeing more cars on the street, factories are resuming work, Apple is reopening several stores, and some regions are relaxing traffic restrictions.   But schools remain closed, the capital has a mandatory 14-day quarantine for returning residents, and authorities are keeping some 56 million people in Hubei under lockdown.
Date: Sun 23 Feb 2020
Source: ZBC News [edited]

Mbire, Mashonaland Central Province has been affected by an outbreak of anthrax prompting the Veterinary Services Department to place an embargo on the movement of cattle from the province.

The acting provincial coordinator, Richard Chipfuwa, said 34 beasts had so far succumbed to the disease in the remote district, which sits on the border with Mozambique and Zambia. "These (the 34) are the reported cases, but we suspect there could be many more that were not reported. We have since mobilized vaccines to the district's 5 dip tanks: Nyatsengwa, Masomo, Tengu, Bonga and Sapa, so that farmers can have the remaining herd saved," he said.

But a poor road network in the district is making it difficult for veterinary officials to access some of the dip tanks, a situation made worse by the ongoing rains. The officials, in addition to treating infected animals, are also educating communities against consuming meat from dead animals, because this could pose health risks to people.

The anthrax outbreak in Mbire, an arid district rich in an assortment of wildlife, is suspected to have been passed on to livestock by infected wild animals such buffaloes, which are typical carriers of the disease. Last year [2019], the province lost nearly 1300 cattle due to anthrax and other livestock diseases.
=====================
[For a description of Mashonaland, go to: <https://en.wikipedia.org/wiki/Mashonaland>. It is in northern Zimbabwe and is made up of 3 provinces, East, West, and Central. For a map showing the location of Mashonaland Central Province go to: <https://en.wikipedia.org/wiki/Mashonaland_Central_Province>.

In these hard to reach areas, it is a constant concern knowing what is happening where. And this goes a long way as to why some 34 animals are reported affected and probably more. And why it is so important to get the necessary volumes of vaccine out to these communities as soon as possible. We wish the provincial veterinary service well and all the luck that they enjoy. - ProMED Mod.MHJ]

[HealthMap/ProMED map available at:
Mashonaland Central Province, Zimbabwe:
Date: Mon, 24 Feb 2020 16:22:59 +0100 (MET)

Dubai, Feb 24, 2020 (AFP) - The new coronavirus hit four more Middle Eastern states on Monday, with Bahrain, Iraq, Kuwait and Oman reporting new cases and the UAE calling on its citizens not to travel to Iran and Thailand.   Oman also halted flights to and from Iran  -- which is battling the deadliest outbreak outside China --with immediate effect.   The move came shortly after two Omani women who had returned from Iran were diagnosed with the disease.

The three cases in Kuwait and the one in Bahrain were also in individuals who had returned from Iran, where the virus has claimed the lives of 12 people.   Bahrain also shut three schools after a man who had transported children to the institutions tested positive after returning from Iran on February 21 via Dubai airport, the health ministry said.

In Kuwait, a 53-year-old Kuwaiti, a 61-year-old Saudi national and a 21-year-old stateless Arab who tested positive had all returned from Iran's holy city of Mashhad, the Kuwaiti health ministry said.   In Iraq, the virus was confirmed in an Iranian national studying in the southern shrine city of Najaf, health officials said.   All seven bourses in the oil-rich Gulf states were down on Monday as fears of a pandemic hit crude prices. The Saudi stock exchange led the slide, shedding 2.95 percent.

- Travel bans -
Iran's confirmed death toll rose to 12 on Monday, with the government vowing to be transparent and dismissing a lawmaker's claim the toll could be as high as 50.   The outbreak has prompted travel bans from nearby countries.

Last week, Kuwait banned entry of all ships from the Islamic republic and suspended flights to and from the country.   Kuwait also banned non-citizens coming from Iran from entering the Gulf state and operated chartered flights to bring back hundreds of Kuwaiti Shiite pilgrims from the Islamic republic.

Around a third of Kuwait's 1.4 million citizens are Shiite Muslims, who travel regularly to Iran to visit religious shrines. Kuwait also hosts roughly 50,000 Iranian workers.   Over half of Bahrain's population of under one million are Shiites, who also travel frequently to Iran.   The United Arab Emirates has already announced 13 cases of the novel coronavirus, all of them foreigners. The latest were a 70-year-old Iranian man, whose condition is unstable, and his 64-year-old wife.

On Monday, Abu Dhabi authorities called on all UAE citizens "to not travel to Iran and Thailand at present and up until further notice" as part of its efforts to monitor and contain the spread of the disease.   UAE airlines have suspended most flights to China -- where the virus first emerged in December -- except to the capital Beijing, but have not yet taken any measures to restrict travel to and from Iran. Around half a million Iranians live and work in the UAE.

Two Gulf states -- Saudi Arabia and Qatar -- remain free of the virus, but all have suspended flights to China.   Qatar Airways said on Monday that people arriving from Iran and South Korea would be asked to stay in home isolation or a quarantine facility for 14 days.   China's death toll from COVID-19 rose to nearly 2,600 on Monday, while the virus has now spread to more than 30 countries.
Date: Mon, 24 Feb 2020 17:49:00 +0100 (MET)

Kolkata, Feb 24, 2020 (AFP) - Rangers have suspended safari rides in a popular nature reserve in eastern India after five one-horned female rhinoceroses died from a suspected infectious disease, officials said Monday.  The animals were found dead over four days last week in Jaldapara National Park, nearly 700 kilometres (434 miles) north of West Bengal state's capital Kolkata.

India is home to two-thirds of the world's remaining one-horned rhinos, a vulnerable species on the IUCN red list   "Blood smears from carcasses have been sent to a laboratory in Kolkata," the reserve's chief conservator Ujjal Ghosh told AFP.   "All the five dead rhinos were adult females. We have put our staff on alert."

The park -- spread over 200 square kilometres (77 square miles) in the foothills of the eastern Himalayas -- is home to 204 rhinos according to the last official count in 2015.  More than 70 captive elephants used for safaris and patrolling also live in the reserve. The safari rides are carried out on elephants.   Activists said the animals may have died from anthrax, a communicable disease that attacks herbivores.

Humans can contract anthrax directly or indirectly from animals or animal products.  "We suspect that the animals died from a communicable disease like anthrax. Jaldapara forest has the odd case of anthrax which killed animals earlier," wildlife activist Animesh Bose told AFP.   Rangers were riding on elephants to reach the rhinos and vaccinate them using dart guns, the Hindustan Times reported.   Drones would try to find out if other animals have died or fallen ill, the newspaper said.
Date: Tue, 25 Feb 2020 04:50:33 +0100 (MET)

Jakarta, Feb 25, 2020 (AFP) - Dozens of Jakarta neighbourhoods were flooded Tuesday after torrential rains pounded Indonesia's capital, less than two months after nearly 70 people were killed in some of the megacity's worst flooding in years.   There were no immediate reports of casualties after the latest deluge, but parts of the city ground to a halt as whole neighbourhoods were swamped in muddy water, while power outages hit some districts.   At least 81 neighbourhoods were inundated with a dozen toll roads closed and some commuter train lines shuttered, according to an announcement by Indonesia's Disaster Mitigation Agency.

More torrential rains were expected later in the day.    "So the flooding will likely spread," agency spokesperson Agus Wibowo said on Twitter.   Floodwaters in some districts were as high as 127 centimetres (4 feet).   The low-lying city is prone to flooding during the wet season which starts around November.   Torrential rain in January triggered flooding and landslides that killed nearly 70 people in and around Jakarta while thousands more were forced to evacuate to shelters.
Date: Mon 24 Feb 2020
Source: Dhaka Tribune [edited]

In Baliadanga upazila of Thakurgaon district, 2 members of a family have died and 3 other members fell sick of an unknown disease. The deceased are MB 35, wife of HI, and her sister in law PB, wife of H from Songaon village of the upazila.

Quoting family members, local schoolteacher SPL said: "MB fell sick and died on Friday [21 Feb 2020] and on Saturday [22 Feb 2020], PB fell sick. "She came back home after undergoing primary treatment at Baliadanga Health Complex; however, she died early Sunday [23 Feb 2020]."

Soon afterwards, 3 other members of the family -- TA, HK and AA -- fell sick and were taken to Adhunik Sadar Hospital, she added.

Thakurgaon Civil Surgeon Dr MD Mahfuzar Rahman Sarker said a representative team of the health department has visited the village to investigate the cause of deaths.

The reasons of the deaths are yet to be known; however, the ones who fell sick are in better condition now, he added.

In 2019, 4 members of a family died due to Nipah virus in the same upazila. Locals are assuming the current deaths are occurring for the same reason.
===================
[With these cases described only as fatal or ill without mention of symptoms, it is not possible to speculate on what the etiology of thisdisease might be. The above report does mention that 4 fatal Nipah virus infections occurred in the same locality last year (2019). Nipah virus must surely be on the list of rule-outs in these current cases. This is the season when Nipah virus is circulating in Bangladesh in giant fruit bats (_Pteropus_ species) with spill-over of the virus by the bats' contamination of fruit or of palm sap juice in collecting pots on the palms. Person-to-person transmission of the virus can also occur. The transmission season is usually January to April.

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

An image of a Pteropus fruit bat can be found at

HealthMap/ProMED map available at:
A map showing the location of the area where the cases occurred can be accessed at the above URL. - ProMED Mod.TY]

24-02-2020 -- Italy has reported a rapid increase in cases of laboratory-confirmed coronavirus (COVID-19) since 21 February 2020. An initial investigation by Italian authorities has found several clusters of cases in different regions of northern Italy, with evidence of local transmission of COVID-19.

A WHO-led team of experts from WHO and the European Centre for Disease Prevention and Control (ECDC) arrived in Italy on Monday 24 February to support Italian authorities in understanding the situation. WHO experts are providing support in the areas of clinical management, infection prevention and control, surveillance and risk communication. At this stage the focus is on limiting further human-to-human transmission.

While limited local person-to-person transmission of COVID-19 in countries outside of China was expected, the rapid increase in reported cases in Italy over the past two days is of concern. However, it should also be noted that based on current data, in the majority of cases (4 out of every 5) people experience mild or no symptoms.

“COVID-19 is a new virus that we need to take very seriously. This mission to Italy is one of the ways in which WHO/Europe is supporting countries across the Region. We are working hard with our Member States to ensure that they are ready for COVID-19, preparing for the arrival of cases and possible localized spread. It is vital that we treat patients with dignity and compassion, put measures in place to prevent onward transmission, and protect health workers,” commented Dr Hans Kluge, WHO Regional Director for Europe.

Health authorities in Italy are implementing measures to prevent onward transmission, including closing of schools and bars and cancelling of sports events and other mass gatherings in the areas affected. This aligns with the containment strategy currently being implemented globally in an effort to stop the spread of COVID-19. “WHO stands by the Government of Italy in its efforts and commitment to mitigate this outbreak and manage the cases effectively. Now is the time for solidarity and cooperation, to work together to protect everyone’s health,” added Dr Kluge.

Countries across the European Region continue to prepare for and respond to cases of COVID-19. This includes establishing how to promptly detect sick people, testing samples from suspect cases, ensuring appropriate infection control and case management to minimize the risk of the virus spreading, and maintaining communication with the public.

Best Regards,
WHO Media Team

Date: Mon, 24 Feb 2020 12:29:01 +0100 (MET)
By David Vujanovic

Tehran, Feb 24, 2020 (AFP) - Iran's government vowed Monday to be transparent after being accused of covering up the deadliest coronavirus outbreak outside China, dismissing claims the toll could be as high as 50.

The authorities in the Islamic republic have come under mounting public pressure since it took days for them to admit to "accidentally" shooting down a Ukrainian airliner last month, killing 176 people.   The government said on Monday that Iran's coronavirus death toll had jumped by four to 12 -- by far the highest outside China -- as its neighbours closed their borders and imposed strict quarantine measures.

But Ahmad Amirabadi Farahani, a lawmaker from the holy city of Qom, south of Tehran, alleged the government was "lying" about the full extent of the outbreak.   The ILNA news agency, which is close to reformists, said the lawmaker spoke of "50 deaths" in Qom alone.   "The rest of the media have not published this figure, but we prefer not to censor what concerns the coronavirus because people's lives are in danger," ILNA editor Fatemeh Mahdiani told AFP.

Farahani was wearing a face mask during the closed session of parliament but left after speaking, as he felt unwell, state news agency IRNA reported, adding sanitary workers then cleaned his seat.   Iran's government rejected his claim that the virus had killed 50 in Qom.   "I categorically deny this information," Deputy Health Minister Iraj Harirchi said in a news conference aired live on state television.   "This is not the time for political confrontations. The coronavirus is a national problem," he added.

- Transparency pledge -
The government pledged transparency over the outbreak.   "We will announce any figures (we have) on the number of deaths throughout the country. We pledge to be transparent about the reporting of figures," its spokesman Ali Rabiei said.   Iran has been scrambling to contain the COVID-19 outbreak since it announced the first two deaths in the holy city of Qom on Wednesday last week.   Authorities have since ordered the closure of schools, universities and other educational centres across the country as a "preventive measure".

A spokesman for Iran's parliament, Assadollah Abbassi, announced the latest four deaths among more than 60 infections after Monday's closed-door gathering of lawmakers.   Citing Health Minister Said Namaki, he said that "the cause of coronavirus infections in Iran are people who have entered the country illegally from Pakistan, Afghanistan and China".   Iran has yet to give a breakdown of where the other deaths occurred.   The worst-hit province for infections is Qom, with 34 cases, according to health ministry figures.

The others are in Tehran with 13 infections, Gilan with six, Markazi with four, Isfahan with two and one each for Hamedan and Mazandaran.   But the health minister said that one person who died of coronavirus in Qom, south of Tehran, was a businessman who had made several trips to China.   Namaki had unsuccessfully pleaded in January for Iran's government to order the suspension of all commercial flights between Iran and China.   In his remarks to state television on Sunday, the minister said direct flights between Iran and China were now suspended, but the Qom businessman had travelled there "on a connecting flight".

- Border closures -
Since it emerged in December, the new coronavirus has killed more than 2,500 people in China.   Iran now accounts for nearly half of the deaths elsewhere in the world, which currently stand at 30.   Many of Iran's neighbours have reported cases of coronavirus in people who had travelled to the Islamic republic.   Afghanistan on Monday reported its first case in a person who had travelled to Qom.   Baghdad also reported its first case on Monday -- an elderly Iranian citizen living in the southern Iraqi city of Najaf.

Iraq has shut its border with the Islamic republic and imposed a travel ban.   Similar preventive measures were imposed by Afghanistan, Armenia, Pakistan and Turkey.    Qom is a centre for Islamic studies and pilgrims, attracting scholars from Iran and beyond.   Kuwait and Bahrain also confirmed their first novel coronavirus cases, all of whom had come from Iran.