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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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Ireland

Ireland US Consular Information Sheet
December 2, 2008
COUNTRY DESCRIPTION:
Ireland is a highly developed democracy with a modern economy. Tourist facilities are widely available.
Read the Department of State Background Notes on Irela
d for additional information.
ENTRY/EXIT REQUIREMENTS:
A passport is necessary, but a visa is not required for tourist or business stays of up to three months.
Visit the Embassy of Ireland web site (www.irelandemb.org/) for the most current visa information, or contact the Embassy at 2234 Massachusetts Avenue, NW, Washington, DC
20008, tel: 1-202-462-3939, or the nearest Irish consulate in Boston, Chicago, New York or San Francisco.

Information about dual nationality or the prevention of international child abduction can be found on our web site.
For further information about customs regulations, please read our Customs Information sheet.
SAFETY AND SECURITY:
Ireland remains largely free of terrorist incidents.
While the 1998 ceasefire in Northern Ireland is holding, there have been incidents of violence in Northern Ireland associated with paramilitary organizations.
These have the potential for some spillover into Ireland.
Travelers to Northern Ireland should consult the Country Specific Information sheet for the United Kingdom and Gibraltar.

Several Americans have reported incidents of verbal abuse, apparently in reaction to U.S. policy on the war on terrorism.
As elsewhere in Europe, there have been public protests, which for the most part were small, peaceful and well policed.
Americans are advised, nonetheless, to avoid public demonstrations in general and to monitor local media when protests occur.
For the latest security information, Americans traveling abroad should regularly monitor the Department of State, Bureau of Consular Affairs’ web site at http://travel.state.gov, where the current Travel Warnings and Travel Alerts, as well as the Worldwide Caution, can be found.
Up-to-date information on safety and security can also be obtained by calling 1-888-407-4747 toll free in the United States and Canada, 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 A Safe Trip Abroad.
CRIME:
Ireland has a low rate of violent crime.
There have been a limited number of incidents in which foreigners and tourists have been victims of assault, including instances of violence toward those who appear to be members of racial minority groups.
In addition, there have been several reported assaults in Dublin by small, unorganized gangs roaming the streets in the early morning hours after the pubs close.
There is a high incidence of petty crime – mostly theft, burglary and purse snatching – in major tourist areas.
Thieves target rental cars and tourists, particularly in the vicinity of tourist attractions, and some purse and bag snatching incidents in these areas have turned violent, especially in Dublin.
Travelers should take extra caution to safeguard passports and wallets from pickpockets and bag snatchers.

Crimes involving credit and debit cards and automated teller machines (ATMs) are also a concern.
Travelers should protect their PIN numbers at all times and avoid using ATM machines that appear to have been tampered with.
There has been an increase in Ireland of the use of “skimmers” on ATM machines, especially in tourist areas.
Skimmers are usually small electronic devices that are attached to the outside of an ATM machine in order to “skim” the ATM or credit card data for later criminal use.
Most ATMs in Ireland now have electronic warnings about their use and advise customers to look closely at the ATM before using it.


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 in Ireland, in addition to reporting to local police (Gardai), please contact the U.S. Embassy in Dublin for assistance.
The Embassy staff can, for example, assist you in finding appropriate medical care, contacting family members or friends, and learning how funds can be transferred.
Although the investigation and prosecution of the crime are solely the responsibility of local authorities, consular officers can help you to understand the local criminal justice process and to find an attorney if needed.
The Irish Tourist Assistance Service (ITAS) is a free nationwide service offering support and assistance to tourists who are victimized while visiting Ireland. If you are a tourist victim of crime, report the incident to the nearest Garda Station (police station), which will contact ITAS.
All tourist victims of crime are referred to ITAS by the Gardai. To learn about possible compensation in the United States if you are a victim of a violent crime while overseas, see our information on Victims of Crime
The local equivalent to the “911” emergency line in Ireland is 999 or 122.
MEDICAL FACILITIES AND HEALTH INFORMATION:
Modern medical facilities and highly skilled medical practitioners are available in Ireland.
Because of high demand, however, access to medical specialists can be difficult and admissions to hospitals for certain non-life-threatening medical conditions may require spending significant periods of time on waiting lists.
Those traveling to or intending to reside in Ireland who may require medical treatment while in the country should consult with their personal physicians prior to traveling.
Over-the-counter medication is widely available.
Irish pharmacists may not be able to dispense medication prescribed by your U.S. physician and may direct you to obtain a prescription from an Irish doctor before providing you with your required medication.
A list of Irish general practitioners in each area of Ireland may be obtained from the web site of the Irish College of General Practitioners at http://www.icgp.ie/go/find_a_gp. Emergency services usually respond quickly.
The U.S. Department of State is unaware of any HIV/AIDS entry restrictions for visitors to or foreign residents of Ireland.

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’s) web site at http://www.who.int/en.
Further health information for travelers is available at http://www.who.int/ith/en.
FOOT AND MOUTH DISEASE: The Irish Department of Agriculture and Food advises all incoming passengers to Ireland that the current foot and mouth situation in Great Britain represents a high risk of the spread of disease to Ireland.
If you are traveling from Great Britain to Ireland and have visited a farm with cattle, sheep, goats or pigs on your travels, you must report to the Irish Department of Agriculture and Food office at the port of entry.
Fresh meat or unpasteurized milk products purchased in Great Britain may not be brought into Ireland.
If you are carrying any of these products, they must be disposed of in the bins provided at the port of entry.
For further information, please visit the Irish Department of Agriculture, Fisheries and Food at www.agriculture.gov.ie.
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 following information concerning Ireland is provided for general reference only and may not be totally accurate in a particular location or circumstance.
As driving is on the left side of the road in Ireland, motorists without experience in left-drive countries should be especially cautious.
Tourists driving on the wrong side of the road are the cause of several serious accidents each year.
Turning on red is not legal in Ireland.
The vast majority of rental cars are manual transmission; it can be difficult to find automatic transmission rental cars.
Road conditions are generally good, but once travelers are off main highways, country roads quickly become narrow, uneven and winding.
Roads are more dangerous during the summer and on holiday weekends due to an increase in traffic. As in the United States, police periodically set up road blocks to check for drunk drivers.
Penalties for driving under the influence can be severe.
More information on driving in Ireland can be found on the U.S. Embassy in Dublin‘s web site at http://dublin.usembassy.gov/service/other-citizen-services/other-citizen-services/driving.html.

For specific information concerning Irish driving permits, vehicle inspection, road tax and mandatory insurance, please visit the official tourism guide for Ireland at http://www.tourismireland.com.

Taxis are reasonably priced but availability varies with time of day and where you are in the country.
Bus service in the cities is generally adequate, although many buses are overcrowded and frequently late.
Intercity bus and train services are reasonably good.

AVIATION SAFETY OVERSIGHT:
The U.S. Federal Aviation Administration (FAA) has assessed the Government of Ireland’s Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for oversight of Ireland’s air carrier operations.
For more information, travelers may visit the FAA’s web site at http://www.faa.gov/safety/programs_initiatives/oversight/iasa
SPECIAL CIRCUMSTANCES:
Most Irish banks will not accept U.S. $100 bills.
ATMs are widely available, but some, particularly in rural areas, may not accept cards from U.S. banks.
Credit cards are widely accepted throughout Ireland.
A number of travelers have been told by their airline that their passport must remain valid for six months after their entry into Ireland.
The Government of Ireland has advised that this is a recommendation of the airline industry and is not an Irish legal requirement. Travelers must be in possession of a valid passport to travel.
Please see Customs Information.

CRIMINAL PENALTIES:
While in a foreign country, a U.S. citizen is subject to that country's laws and regulations, which sometimes differ significantly from those in the United States and may not afford the protections available to the individual under U.S. law.
Penalties for breaking the law can be more severe than in the United States for similar offenses.
Persons violating Ireland’s laws, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession, use or trafficking in illegal drugs in Ireland are severe, and convicted offenders can expect long jail sentences and heavy fines.
Engaging in sexual conduct with children or using or disseminating child pornography in a foreign country is a crime, prosecutable in the United States.
Please see our information on Criminal Penalties.

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

REGISTRATION / EMBASSY LOCATION:
Americans living or traveling in Ireland are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department’s travel registration web site so that they can obtain updated information on travel and security within Ireland.
Americans without Internet access may register directly with the Embassy in Dublin.
By registering, American citizens make it easier for the Embassy to contact them in case of emergency.
The U.S. Embassy is located at 42 Elgin Road, Ballsbridge, Dublin 4.
The Embassy can be reached via phone at 353-1-668-8777, after hours number 353-1-668-9612, fax 353-1-668-8056, and online at http://dublin.usembassy.gov
*

*

*
This replaces the Country Specific Information for Ireland dated May 12, 2008, and updates sections on Information for Victims of Crime, Medical Facilities and Health Information, and Special Circumstances.

Travel News Headlines WORLD NEWS

Date: Fri 17 Jan 2020
Source: RTE [abridged, edited]

Outbreaks of mumps have become widespread around the country, the Health Service Executive (HSE) has said. There were 132 cases of mumps reported to the Health Protection Surveillance Centre last week.

Mumps is a highly contagious viral infection, and the most common symptom of mumps is a swelling of the parotid glands. The glands are located on both sides of the face, and the swelling gives a person a distinctive "hamster face" appearance.

Speaking on RTE's Morning Ireland, Dr. Kevin Kelleher, the HSE's Assistant National Director of Public Health, said it is happening because a large portion of 15- to 30-year-old people [do not have] full protection against mumps. He said not all of them are getting the MMR [measles, mumps, rubella] vaccine or are getting only one dose, when people need at least 2 doses to be fully protected.

The HSE is warning schools, colleges and universities about the outbreak.
Date: Sat 4 Jan 2020
Source: The Irish Sun [edited]

People have been banned from visiting patients at the Mercy University Hospital (MUH) in Cork after an outbreak of influenza. Visitor restrictions are also in place at Cork University Hospital, The Mater Hospital and University Hospital Waterford.

A Mercy University Hospital spokesman said: "The risk is to patients from visitors, because of the virulence of flu in the community." All visitors have been banned [except] for in exceptional circumstances. The notice came into effect at 8:30 pm on Friday [3 Jan 2020], and the situation being reviewed on a daily basis.

The ban does not include people visiting young patients, those who are critically ill or those being treated in the intensive care unit. The MUH said: "Visiting is prohibited to the hospital in the interest of patient safety and the hospital is seeking the public's co-operation with the restrictions."

In September [2019], the HSE [Ireland's national health service] had urged people to the get seasonal flu jab, which protects against 4 strains of the flu virus. The health service [recommends] that people get the new vaccine each year because the flu viruses which affect people change each year.

The flu vaccine works by helping the immune system produce antibodies to fight the influenza virus. If a person has been vaccinated and they come into contact with the virus, these antibodies will attack it and stop the person from getting sick. The flu vaccine doesn't contain any live viruses and therefore it cannot give people the flu. [Byline: Danny De Vaal]
Date: 27 Dec 2019
Source: Cork Beo [edited]

Four Cork hospitals have been forced to put visiting restrictions in place after a high volume of patients were confirmed with the flu.  Cork University Hospital, Bantry General Hospital, Mallow General Hospital, and Mercy University Hospital have all been affected by the outbreak. They are asking patients with flu symptoms to see their local GP instead of heading straight to the emergency department.  The situation is currently being monitored, and the hospitals will release further updates in the coming days.

A spokesperson for the hospitals said: "Due to a high volume of patients confirmed with influenza in Cork University Hospital, Bantry General Hospital, Mallow General Hospital, and Mercy University Hospital, strict visiting restrictions have been put in place. The hospital would also like to remind the public of the importance of performing hand hygiene when visiting hospitals and would like to thank the public for their cooperation.

It is also important to note that it is not too late to get the flu vaccine, and it is provided free of charge for people in at risk groups, which include everyone aged 65 years and over, pregnant women, anyone over 6 months of age with a long term illness requiring regular medical follow-up such as chronic lung disease, chronic heart disease, diabetes, cancer, or those with lower immunity due to disease or treatment."  [Byline: Cormac O'Shea]
Date: Mon 9 Dec 2019
Source: Irish Times [abridged, edited]

The biggest mumps outbreak in a decade shows no sign of abating, with 103 new cases reported last week. So far this year [2019], 2458 cases of mumps have been reported, compared to 563 notified in all of 2018, according to the latest figures.

With the current outbreak mostly affecting teenagers and young adults, scores of schools and colleges have been affected. The Health Service Executive advises those diagnosed with the disease to stay at home for at least 5 days after their salivary glands swell in order to prevent the infection spreading.

The worst-affected part of the state is the greater Dublin area, which accounted for 1126 of the cases so far this year [2019], according to the HSE's Health Protection Surveillance Centre. In contrast, just 84 cases have been recorded in the Southern Health Board area.

Men are slightly more affected than women, and 869 cases have been recorded among 15-19-year-olds alone.

Public health officials have blamed the current outbreak on a dip in the MMR (measles/mumps/rubella) vaccination rates 20 years ago. This resulted from publicity surrounding the since-discredited claims by Dr Andrew Wakefield linking the vaccine to a rise in autism cases.

Doctors say the MMR vaccine is the best way to prevent the disease and its complications, though it is estimated to be only 88% effective in preventing mumps, and effectiveness wanes over time.

Since 1988 when MMR was 1st introduced, the largest outbreak of mumps was reported in 2009 when more than 3600 cases were notified.

Fortunately, there is no sign of a measles outbreak this year [2019]. Some 75 cases have been reported in the 1st 11 months of 2019, 40 of them in the greater Dublin area.  [Byline: Paul Cullen]
Date: Thu 10 Oct 2019
Source: Vax-Before-Travel [edited]

The Health Protection Surveillance Centre in Ireland reported an increase in typhoid fever notifications in travellers returning from Pakistan [<http://ndsc.newsweaver.ie/epiinsight/1npbbpsg5wm>]. According to the Irish authorities on [9 Oct 2019], there have been 23 cases of _Salmonella enterica_ serovar Typhi (_S._ Typhi) in 2019. This is the 1st time that cases of XDR typhoid fever have been identified by the national reference laboratory in Ireland.

The European Centre for Disease Prevention and Control (ECDC) reported 12 of these cases had a recent travel history to Pakistan [see item [2] below]. Unfortunately, 3 of these 12 cases of typhoid fever with travel history in Pakistan were infected with extensively drug-resistant (XDR) strains.

According to the WHO/EMRO bulletin, Pakistan is experiencing a continuous surge of XDR _S._ Typhi since 2016. As of August 2019, 10 365 cases of XDR typhoid fever were reported from 23 districts in Sindh province, with the Karachi district being the most affected, having 67 percent of the cases. Pakistan is the world's 6th-most populous country with a population exceeding 210 million people, located in South Asia.

The XDR _S._ Typhi strain acquired a plasmid that confers resistance to multiple antibiotics, including the 1st-line antibiotics chloramphenicol, ampicillin, and trimethoprim-sulfamethoxazole, as well as fluoroquinolones and 3rd-generation cephalosporins, says the ECDC. The strain remained susceptible to azithromycin and carbapenems. The increased resistance in typhoid fever limits treatment options and poses a threat to international spread.

In response, the US Centers for Disease Control and Prevention (CDC) issued a Level 1 Travel Alert regarding traveling to Pakistan in 2019 [<https://wwwnc.cdc.gov/travel/notices/watch/xdr-typhoid-fever-pakistan>]. This 'Practice Usual Precautions' Travel Alert published on [30 Sep 2019], is very important since, in rare cases, typhoid fever can be fatal.

According to the Pakistan Tourism Development Corporation, about 1.75 million tourists visited Pakistan in 2017 alone.

The CDC says 'if you are going to South Asia, including Pakistan, protect yourself against typhoid infection by getting a typhoid fever vaccination.' The CDC's Advisory Committee on Immunization Practices (ACIP) recommends 2 typhoid fever vaccines, an oral vaccine, Vivotif, and an injectable vaccine, Typhim VI. The oral vaccine Vivotif is approved for people 6 years of age or older and should be taken as directed, at least one week before departure. The injectable vaccine is approved for people 2 years of age or older. Travelers should receive the injectable vaccine Typhim VI at least 2 weeks before departure. Neither vaccine is 100 percent effective, so travellers should also practice safe eating and drinking while traveling abroad, says the ACIP.

Typhoid fever is a serious disease caused by the bacterium _Salmonella_ Typhi, spread by contaminated food and water. Humans are the only source of these bacteria. The incubation period of typhoid and paratyphoid infections is 6-30 days, says the CDC. Symptoms of typhoid fever often include high fever, weakness, stomach pain, headache, cough, and loss of appetite. People may have diarrhoea or constipation.

If you travel abroad and get sick while traveling, seek medical care ASAP. If you get sick after returning to the United States, seek medical care and tell your health care provider where and when you traveled. Do not prepare food for other people, says the CDC.

An estimated 26 million cases of typhoid fever and 5 million cases of paratyphoid fever occur worldwide each year, causing 215,000 deaths.

Also, the CDC says to ensure you are up-to-date on several vaccinations before visiting Pakistan. These vaccines and related medications can be found at most travel pharmacies in the USA.

Travel Alert news is published by Vax-Before-Travel
More ...

Mauritius

General:
************************************
Mauritius is a Republic island nation situated in the southwestern Indian ocean towards Madagascar. There are excellent tourist facilities and English is well understood throughout the country. The c
imate is subtropical and quite humid. This is particularly the case between December to March each year and cyclones occasionally occur at this time also.
Security Situation:
************************************
The security situation within the country is very
good but petty crime can be a problem against tourists. At night, it is probably unwise to venture alone outside the grounds of your hotel. The central market place in Port Louis is known to be a site for pickpockets so remember to take care. Grand Baie and Flic en Flac are also known concerns for petty crime. Those having a self-catering holiday should be aware that house breaking is becoming more common and so make sure any valuables are well hidden away and not left out on view.
Health Facilities:
************************************
Generally the level of health care is reasonable throughout the main tourist areas and hospital care may be provided free of charge. However, many tourists choose to obtain private medical care while in Mauritius. Make sure your travel and health insurance is up to date before you leave home.
Food & Water Facilities:
************************************
In the main hotels the level of food hygiene is good and with care tourists should be well able to stay perfectly healthy during their time in the country. However, like many other destinations, it is wise to maintain certain commonsense rules regarding what you eat and drink. All food should be freshly prepared and it is much wiser to avoid bivalve shellfish altogether. These include mussels, oysters and clams. Fried prawns are usually okay and boiled crab and lobster should be fine. Cold unprepared vegetables such as lettuce is best avoided. Tap water should be checked for a smell of chlorine and if it is not present that it should not be used for either drinking or brushing your teeth. Brucellosis is a small risk so avoid any unpasteurized milk products.

Insects Bites & Malaria Risks:
************************************
The risk of malaria throughout Mauritius is extremely small and currently (2001) the World Health Organisation does not recommend routine prophylaxis for tourists. However, there is a small amount of transmission in the northern part of the country away from the normal tourist routes. Rodrigues Island is free of this disease. Nevertheless, mosquitoes do occur and can transmit other conditions such as Dengue Fever apart from their rather unpleasant bite. Thus avoid mosquito bites is excellent advice and should be followed at all times.
The mosquitoes mainly bite in the evening out of doors and so at these times wear sensible pale coloured clothing to cover your exposed arms and legs,
don't use perfumes and after shaves and apply plenty of good insect repellent. Ones containing high concentrations of DEET are usually recommended.
The risk of Rabies:
************************************
Mauritius is currently regarded as being free of Rabies but tourists are strongly advised to avoid all contact with warm-blooded animals such as dogs, cats and monkeys. Any close contact (bite, lick, scratch) should be immediately reported to see if treatment may be recommended.
Swimming in Mauritius:
************************************
There have been a number of reports of those swimming in the sea being hit by speedboats while close to the hotel beaches. Take care to swim in recognised safe zones and remember to watch out for warning signs of strong currents etc. The risk from sharks etc is small but never swim alone or far out from the shore. Listen to the local advice and stay safe. If swimming in some of the rivers and lakes throughout the country there is a risk of a fresh water disease known as Schistosomiasis. This disease is mainly found in Port Louis, Pamplemousses and Grand Port.
If you have been at risk remember to contact your travel health advisor on return to talk this through.
Sun Exposure:
************************************
The level of sunshine in Mauritius can be significant so take care not to get over exposed. The main strength of the sun will be between 11am to 4pm and it is probably unwise to sunbathe during these times.
Road Safety:
************************************
In Mauritius they drive on the left side of the road and the conditions are quite variable throughout the country. Hiring cars or motorbikes abroad is one of the most significant risk factors for tourists and generally should be avoided. Hiring a cab to drive you to your destination is usually a safer option but always pick a good quality car and fix your price before leaving.
Local Laws and Customs:
************************************
Always carry photocopies of your passport and other essential travel documents. These may be required by customs and so you can then keep the originals in a safe location. The carrying of pharmaceutical drugs into Mauritius can cause difficulties. In certain cases the customs officials have been known to confiscate drugs which tourists are using for their own personal health. Under these circumstances it is wise to carry any medications in their original packing and also to have a letter from the prescribing doctor outlining your requirements for the medication in question. This is mainly a problem with some of the higher dose painkillers and general asthma, diabetes, blood pressure or heart medication should not present difficulties. The importation of spear-fishing equipment into Mauritius is prohibited.
Vaccinations for Mauritius:
************************************
Providing you are not arriving into Mauritius from a destination in Africa there will be no vaccines required for entry/exit purposes. However, for your own protection it is usually wise to consider cover against the following;
*
Poliomyelitis (childhood booster)
*
Tetanus (childhood booster)
*
Typhoid (food and water borne disease)
*
Hepatitis A (food and water borne disease)
For those undertaking a longer more rural trip other vaccines may need to be considered including Hepatitis B.
Summary:
************************************
Staying healthy and enjoying your time in Mauritius is perfectly possible so long as some commonsense rules are followed at all times. Further information is available through the Tropical Medical Bureau

Travel News Headlines WORLD NEWS

12th May 2019

Mauritius - National.
22 Apr 2019. In total, there are 75 people infected with the dengue virus. During the weekend, a 1st case of dengue fever type 2 was recorded in a 3-year-old child. He is currently hospitalized in a Plaines-Wilhems clinic. "We have not yet done any analysis to find out how this type 2 dengue case happened in Mauritius. It will be done in the coming days," says the Ministry of Health.

What is certain, however, is that of the 75 cases identified, at least 4 cases were imported. At the Ministry of Health, it is said to be certain that these people were infected in India and Reunion. "Moreover, the dengue virus type 2 is prevalent in Reunion," says one.

- National. 29 Apr 2019. Port Louis 37 cases with 29 of those in Roche-Bois. Cases rise to 115.

- National. 9 May 2019. Mauritius passes 127 cases, including one in Grand Bay and one in Trou aux Biches
Mauritius - Residence La Cure. 12 Apr 2019

A 3rd case of dengue was detected this Friday [12 Apr 2019] at Residence La Cure. The 3 victims are from the same family. According to a source from the Ministry of Health, this family was visited by infected people of Vallee-des-Pretres some time ago.
[in French, trans. Corr.SB]
Date: Mon 23 Jul  2018
Source: Outbreak News Today [edited]

The World Health Organization (WHO) says 3 people have died while 453 cases of measles have been confirmed since the latest outbreak hit Mauritius late in March [2018].

According to the WHO African weekly outbreaks bulletin for the week ending 20 Jul, Mauritius has reported measles cases since 21 Mar [2018]. Infections peaked in the week ending 18 Jun, with more than 80 cases confirmed. All came from 9 districts, while the case fatality ratio averaged 0.7 percent.

"The 3 deaths have been in young women with unknown vaccination status, all between the ages of 29 and 31 years. All were immuno-deficient, resulting in the disease being complicated by encephalitis or septicaemia.

"The incidence rate was highest in those aged 0--9 years of age,followed by those aged 20--39 years. The incidence rate of the disease was highest in the districts located in the west of the island including Port Louis, Black River and Plaines Wilhems," the WHO said.

The confirmed cases were notified to the Communicable Disease Control Unit (CDCU) in the Mauritian capital Port Louis. The government has concluded a case analysis which found that 45 percent of the infected people were never vaccinated for measles.

Only 29 percent have previously received at least one dose of some measles-containing vaccine (MCV1), while 26 percent are of unknown vaccination status. Most of the patients are being isolated at home and a public call has been made to limit travels to avoid spreading the disease.

A total of 10 health teams are operating across the island, screening for fever/rash and checking public vaccination status for MMR (measles, mumps, rubella) in all schools in the affected areas.

The WHO said the current outbreak of measles in Mauritius demonstrates the importance of maintaining high levels of vaccination coverage against the disease.

"Prior to this current outbreak, the last detected case of measles in Mauritius was in 2009 and the country consistently had one of the highest (measles) vaccination rates in the WHO African region.

However, the vaccination coverage dropped in the past 2 years, leading to the current outbreak. Supplementary immunisation activities are being planned to halt the spread of the disease.  [Byline: Oscar Nkala]
=======================
[Healthmap/ProMED map of Mauritius:
Date: Thu 16 Oct 2014
Source: International SOS [edited]

"The authorities in several countries have implemented entry restrictions to curtail the spread of Ebola from countries that have Ebola cases...."

Entry restrictions
------------------
Kenya on 10 Oct [2014] announced that it had closed the Suam border crossing (Trans-Nzoia county) with Uganda due to reports of an Ebola-related death in Bukwo district (Uganda). Earlier, the Kenyan authorities on 19 Aug [2014] suspended entry of passengers travelling from and through Guinea, Liberia and Sierra Leone, excluding health professionals supporting efforts to contain the outbreak and Kenyan citizens.

Cape Verde on 9 Oct [2014] announced that it would now deny entry to non-resident foreigners coming from countries with 'intense Ebola transmission' -- Sierra Leone, Guinea and Liberia -- or who have been to those countries in the previous 30 days.

Mauritius on 8 Oct [2014] banned entry to all travellers who have visited Nigeria, Sierra Leone, Guinea, Liberia, Senegal and Congo (DRC) in the last 2 months, rather than just citizens of those countries, as was the case previously. The authorities have announced that entry restrictions for travellers from Senegal and Nigeria will be lifted on 10 Oct & 17 Oct [2014] respectively, if no further cases of Ebola infection are reported [from them].

Seychelles on 8 Oct [2014] suspended entry to travellers who have visited Sierra Leone, Liberia, Guinea-Bissau, Guinea, Nigeria or Congo (DRC) 28 days prior to their journey, with the exception of Seychellois citizens.

Cote d'Ivoire has reopened in early October [2014] its borders with Guinea, Sierra Leone and Liberia.

Equatorial Guinea is denying entry to travellers whose journeys originated in countries affected by Ebola.

Cameroon on 17 Sep [2014] reopened its borders to travellers from Senegal. An 18 Aug [2014] ban remains in place on travel from Nigeria, Guinea, Liberia and Sierra Leone.

Southern African Development Community (SADC) member states -- Angola, Botswana, Democratic Republic of Congo (DRC), Lesotho, Madagascar, Malawi, Mauritius, Mozambique, Seychelles, South Africa, Swaziland, Tanzania, Zambia and Zimbabwe -- have stated that travellers coming from Ebola-affected countries (according to the World Health Organisation, WHO) would be monitored for 21 days and that travel to member countries for any gatherings would be discouraged. The SADC provided no details as to how member countries will carry out the associated screening and follow-up and it is likely that countries will have individual processes. There are also reports that some countries require health documentation for entry. Travellers are advised to contact the embassy or health ministry of their destination country to clarify their individual circumstances and prepare their trips accordingly.

South Sudan has placed a ban on travellers coming from Guinea, Sierra Leone, Liberia or Congo (DRC), or those who have travelled to those countries in the preceding 21 days. According to the health ministry, entry of travellers from Nigeria depends on their travel history in that country and whether they have visited Ebola-affected areas.

Namibia's foreign ministry on 11 Sep [2014] announced that foreigners travelling from countries affected by Ebola would be prohibited from entering the country.

Gambia on 1 Sep [2014] suspended entry of persons who have visited Guinea, Liberia, Sierra Leone or Nigeria in the 21 days prior to travel. Those travelling indirectly from any of the aforementioned countries to Gambia via another country also come under this measure.

Cote d'Ivoire announced on 23 Aug [2014] that it had closed its land borders with Guinea and Liberia.

Gabon stated on 22 Aug [2014] that it was restricting the issuance of entry visas to travellers from Guinea, Liberia, Sierra Leone and Nigeria on a case-by-case basis.

Rwanda, according to the US Department of State on 22 Aug [2014], has banned entry to travellers who have visited Guinea, Liberia or Sierra Leone in the 22 days prior to travel.

Senegal on 21 Aug [2014] closed its land border with Guinea, while the country's sea and air borders will also be closed to vessels and aircraft from Guinea, Liberia and Sierra Leone.

Chad on 21 Aug [2014] closed its land border with Nigeria at Lake Chad. The country previously reportedly banned the entry of any travellers originating or transiting through Guinea, Liberia, Nigeria or Sierra Leone, with airlines serving the country reportedly rerouting flights.

South Africa on 21 Aug [2014] restricted entry for all non-citizens travelling from Guinea, Liberia and Sierra Leone. The government subsequently clarified that this was not a blanket ban and could be waived for 'absolutely essential travel'.

Flights and other transport
---------------------------
Countries that have implemented Ebola-related travel restrictions:

Gambia has banned the entry of flights from Guinea, Liberia, Nigeria and Sierra Leone.

Gabon has banned the entry of flights and ships from countries affected by Ebola.

Senegal has banned flights from Guinea, Liberia and Sierra Leone.

Cameroon has banned flights to and from Nigeria.

Chad has suspended all flights from Nigeria.

Nigeria has suspended flights to the country operated by Gambian national carrier Gambia Bird.

Cote d'Ivoire has now lifted the ban on passenger flights from Guinea, Liberia and Sierra Leone.

Details of airlines that have restricted flights to Ebola-affected countries
----------------------------------------------------------------------------
Air France suspended flights to Sierra Leone from 28 Aug [2014].

The Togo-based carrier Asky Airlines has suspended flights to and from Guinea, Liberia and Sierra Leone.

Arik Air (Nigeria), Gambia Bird and Kenya Airwayshave suspended services to Liberia and Sierra Leone.

British Airways has extended their suspension of flights to Liberia and Sierra Leone until 31 Dec [2014].

Emirates Airlines has suspended flights to Guinea.

Korean Air suspended flights to and from Kenya from 20 Aug [2014].

Senegal Airlines has suspended flights to and from Conakry (Guinea) until further notice.

Other airlines have modified their routes but are still operating regular scheduled services. These include:
- Royal Air Maroc
- Brussels Airlines

Medical screening
-----------------
Entry and exit health screening is now in place in numerous countries throughout West Africa and is being introduced in Europe and North America countries as well; related measures can include the partial closure of land borders, ports and river crossings in an effort to restrict cross-border travel. Members should allow additional time to pass through medical screening and not travel if they are sick. Staff should continue to monitor local media and this website for developments.

[Land and sea border "closures" in Africa -- and elsewhere in the world are likely to be ineffective. Smugglers have always been able to largely circumvent them -- I'm willing to bet even the 3 hermit kingdoms (q.v.) also have smuggling routes -- including international colleagues resident in Switzerland bringing in cases of fine wine bought for less across the border  n France. Every so often, one was caught and fined.... (Like many other internationals, I lived in France, where the cost of living was lower, while working in Geneva, so had no incentive to do that.) - ProMed Mod.JW]
-----------------------------
Communicated by:
Jonathan Ezekiel
<jezekiel@his.com>
Date: Sun, 31 Mar 2013 14:09:00 +0200 (METDST)

PORT LOUIS, Mauritius, March 31, 2013 (AFP) - Ten people were killed in floods caused by sudden rains in Port Louis, the capital of the Indian Ocean island of Mauritius, the police information centre said Sunday.   Police said six bodies were found in a pedestrian subway. One body was found near the port and two more in an underground carpark, while one victim reportedly died of a heart attack as the flood waters rose.   "152 millimetres (six inches) of rain were recorded in the country in less than an hour and a half" on Saturday afternoon, a statement from the island's meteorological services said Sunday.

Average rainfall for the entire month of March, the wettest month of the year, in Port Louis is around 220 millimetres.   "We had forecast bad weather and rain, but not on that scale and not in such a short period of time," said Balraj Dumputh, the head of the meteorological service.   People have been advised to stay at home Sunday as further torrential rain is expected.

There has so far not been any official government reaction. Patrick Assirvaden, head of the ruling labour party, said: "It's unprecedented." He put the torrential rain down to "climate change" and said: "We have to adapt to this situation and to the damage caused by nature."   The head of the opposition Alan Ganoo for his part said the government had not been up to dealing with the situation.   Mauritius, with its palm-fringed white sand beaches, is best known as a top-end holiday and honeymoon destination.
More ...

Guam

No Profile is available at present

Travel News Headlines WORLD NEWS

Date: Tue 19 Mar 2019
Source: Daily Post [edited]

The Department of Public Health and Social Services is monitoring an outbreak of shigellosis on Guam. Shigellosis is an infectious disease caused by a group of bacteria called _Shigella_. Most who are infected with _Shigella_ develop diarrhoea, fever, and stomach cramps starting a day or 2 after they are exposed to the bacteria.

So far in 2019, a total of 10 cases have been reported, 9 have been confirmed. In 2018, a total of 29 cases of shigellosis were reported; 23 were confirmed.

Shigellosis usually resolves in 5 to 7 days. However some people who are infected may have no symptoms at all, but may still pass the _Shigella_ bacterium to others. The spread of shigellosis can be stopped by frequent and careful hand washing with soap and taking other hygiene measures.
=========================
[_Shigella_ was discovered more than 100 years ago by the Japanese microbiologist Kiyoshi Shiga, for whom the genus is named. There are 4 species: _S. boydii_, _S. dysenteriae_, _S. flexneri_, and _S. sonnei_. _Shigella_ organisms can survive transit through the stomach because they are less susceptible to acid than other bacteria; for this reason, as few as 10 to 100 organisms can cause disease. Ingested bacteria pass into the small intestine where they multiply; large numbers of bacteria then pass into the colon, where they enter the colonic cells. Given its relatively low infectious dose, transmission can occur via contaminated food and water or via direct person-to-person spread, including sexual practices more common in MSM (men who have sex with men). Humans are the only natural reservoir for the disease.

The bacterium is the classical cause of bacterial dysentery (formerly known as flux or the bloody flux) is an inflammatory disorder of the colon, which results in severe diarrhoea containing mucus and/or blood in the faeces with fever, abdominal pain, and rectal tenesmus (pain while passing the diarrhoea).

Guam (<https://en.wikipedia.org/wiki/Guam>) is an unincorporated and organized territory of the United States in Micronesia in the western Pacific Ocean. It is the easternmost point and territory of the USA, along with the Northern Mariana Islands. The inhabitants of Guam are called Guamanians, and they are American citizens by birth. Indigenous Guamanians are the Chamorros, who are related to other Austronesian natives of Eastern Indonesia and Philippines and Taiwan.  - ProMED Mod. LL]

[HealthMap/ProMED map available at:
Date: Wed, 23 Aug 2017 10:40:35 +0200

Tokyo, Aug 23, 2017 (AFP) - Guam's number two politican Wednesday rolled out the welcome mat to tourists, promising his sun-kissed tropical island is safe -- despite North Korea's threat to launch missiles toward the Pacific US territory.   Lieutenant Governor Raymond Tenorio made the comments in Tokyo where he was joined by Guam's tourism boss Jon Nathan Denight, amid fears that Pyongyang's sabre-rattling will hammer the key tourism industry.

Last year, Japanese tourists made up about half of the 1.5 million visitors to the island, which is about a four-hour flight from Tokyo.   "We're one of the most protected and safe islands you'll find in the world," Tenorio told reporters at the Foreign Correspondents' Club of Japan.   He added there was a big US military presence on Guam, a strategic outpost in the Pacific with its own missile defence system.

Added Denight: "Guam's brand image was built as a very safe and family-friendly destination. I want to reassure people of Japan that there has been no change and Guam is safe for travel."   The unusual appeal to tourists comes several weeks after Pyongyang said it was considering firing a salvo of missiles toward the island -- prompting an angry reaction from US President Donald Trump.

Unlike Trump, however, Guam's 162,000-odd residents seem to be taking it all in stride, including Tenorio.   "By and large, 99 percent of our population just go about their lives every single day. Things are normal on Guam," he said.   "I have to admit sometimes it's really hard to do my job in my office. If you look outside...(from) where I'm sitting at my desk many times you'll see dolphins chasing the fish."
Date: Fri, 11 Aug 2017 12:10:33 +0200

Hagatna, Guam, Aug 11, 2017 (AFP) - Tourism-dependent Guam is looking to cash in on its new-found fame as a North Korean missile target, tapping an unlikely promotional opportunity to attract visitors to the idyllic island and prove that all publicity is good publicity.   Pyongyang's threats to launch four missile strikes near the US territory has stirred global curiosity in the remote Pacific destination, with it trending heavily on search engines as social media users wondered, "what is Guam?"

Although Guam hosts two US military installations and 6,000 US soldiers, making it the target of North Korea's wrath, tourism authorities are keen to dispel any impression of danger to the tranquil island and its secluded beaches.   "The circumstances are unfortunate but this is a good opportunity for us to educate the world about Guam and our culture, about where we are, and who we are," said Josh Tyquiengco, marketing director at Guam Visitors Bureau, the official agency for the island.

"Guam is more than a military base. We are a safe family destination. We reassure potential visitors that we continue to be a safe... place to visit," Tyquiengco told AFP.   Despite North Korea's threats to prepare plans within days that would surround Guam with "enveloping fire", fears of a potential attack have not deterred tourists from visiting Guam, he said.   "We heard about a few booking cancellations from South Korea, but it's too minimal to affect the industry," he said. 

Governor Eddie Calvo, in a briefing late Friday, said any attack on Guam "would be met with overwhelming force", pointing out that the biggest threat facing the island was the looming typhoon season.   "With that, everybody should conduct their lives like business as usual. It's the weekend. Go out, have a good time, enjoy the beaches tomorrow and live your lives.   "At this point, there are thousands of tourists coming in on a daily basis... from Japan, (South) Korea, Taiwan and China and other areas. It is our belief that they should enjoy themselves here."

As aircraft after aircraft -- packed with tourists -- landed Friday at Guam's international airport, the latest visitors to the island appeared untroubled by the prospect of missile strikes.   Sun Doojin, who arrived with her husband and two-year-old daughter on a flight from Seoul, responded with an emphatic "no" when asked if she was concerned about an attack during her visit.

- 'A hidden gem' -
The Guam Daily Post, in an editorial, said the spotlight on the territory offered an opportunity to show the world why an island of 162,000 people draws more than 1.5 million tourists a year.    "The beach waters are crystal clear, beaches aren't overrun, and nature hiking trails are very accessible.   "The different cultures that are showcased on the island through food make Guam a hidden gem, a tropical vacation getaway but with the amenities and comforts of some of the small cities stateside."

Guam's history of earthquakes and typhoons mean its infrastructure is built to robust standards and authorities insist that the island is prepared for any emergency, including a North Korean strike.   Homeland Security spokeswoman Jenna Gaminde told the Guam Daily News that in the event of an attack, residents would be immediately notified by sirens from the All-Hazards Alert Warning System located throughout the island.   "If you hear the sirens, tune into local media -- radio, print, television -- for further instructions," she said. 

Pyongyang has said it would take less than 18 minutes for a missile to cross the 3,400-kilometre (2,100-mile) distance to the US territory.   In addition to the US military bases, Guam is also equipped with the sophisticated THAAD weapons system which is capable of destroying intermediate-range missiles in the final phase of flight.

Officials, however, have sought to brush off fears and say there has been no change in the threat level for now.   "I don't think there's anything to worry about. No missile is going to land on Guam," said Carl Peterson, who serves on the Guam Chamber of Commerce's armed forces committee.   "We've got defense mechanisms in place... they have the ability to seek out the missiles with kinetic energy and destroy it."
Date: Thu, 8 Jun 2017 21:02:05 +0200

Miami, June 8, 2017 (AFP) - Five percent of women in the US territories who were infected with the Zika virus while pregnant had fetus or babies with defects, including microcephaly, government health data said Thursday.   The report by the US Centers for Disease Control and Prevention covered the US territories of Guam, American Samoa, the US Virgin Islands, Micronesia, the Republic of Marshall Islands and Puerto Rico.   The report is the first based on data from the US territories and the largest study of its kind to date.

CDC experts said the findings are consistent with previous findings about Zika cases in the mainland United States.   "Women in the US territories and elsewhere who have continued exposure to mosquitoes carrying Zika are at risk of infection," said CDC acting director Anne Schuchat.    "We must remain vigilant and committed to preventing new Zika infections."   The rate of birth defects was slightly higher -- eight percent, or one in 12 -- in women whose infections were confirmed early in the pregnancy, during the first trimester, said the report.

The findings were based on the cases of 2,549 women with possible Zika virus infection who completed their pregnancies.   Among these women, 1,508 had confirmed Zika virus infection from January 1, 2016 to April 25, 2017.   Over 120 pregnancies resulted in Zika-associated birth defects, including infants born with unusually small heads, an irreversible condition known as microcephaly.   Other complications in babies included seizures and problems with movement, coordination, eating and near constant crying.

Zika can be spread by the bite of infected mosquito or via sexual contact.  Pregnant women are urged to avoid areas where Zika is spreading.   Since Zika erupted on a large scale in mid-2015, more than 1.5 million people have been infected, mostly in Brazil and other countries in South America.    Some 70 countries have been impacted.   Zika may lead to an itchy rash and although it is dangerous for pregnant women and their fetuses, it often causes no symptoms in adults.   In November 2016, the World Health Organization announced that the Zika virus outbreak no longer poses a world public health emergency, though it warned the epidemic remains a challenge.
Date: Fri 27 Mar 2015
Source: Outbreak News Today [edited]

Health authorities on the Pacific Island of Guam say the pertussis, or whooping cough outbreak has reached 11 cases to date. This comes after the Department of Public Health and Social Services (DPHSS) received 3 additional laboratory confirmed cases of the vaccine-preventable disease in a 9 month old child, 3 year old child, and 41 year old adult. Investigation into the newest cases show no epidemiological linkage with each other or previous reported cases.  [Byline: Robert Herriman]
=======================
[Guam is an organized, unincorporated territory of the United States in the western Pacific Ocean. A map of the island can be found at <http://www.lib.utexas.edu/maps/islands_oceans_poles/guam.gif>.

There are likely a number of reasons for the upswing of pertussis in the USA and elsewhere, which include the well-recognized normal swings in incidence, the increase in the number of unvaccinated individuals whose parents chose not to vaccinate them, and waning immunity which has caused public health officials to advise boosters for all adults and especially pregnant women. However, research by both Dr Frits R Mooi from the Netherlands (Pertussis - Australia (04): newly emerging clones, discussion 20120322.1078115) and Dr Lyn Gilbert from Australia (Pertussis - Australia (03): newly emerging clones 20120321.1076103) have been previously highlighted in ProMED-mail, reflecting antigenic changes in circulating clones of _Bordetella pertussis_ which may be causing the increased number of pertussis cases throughout the world. These changes may result in a need for modifications of the currently used acellular pertussis vaccines. - ProMED Mod.LL]
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Finland

Finland - US Consular Information Sheet
January 13, 2009
COUNTRY DESCRIPTION:
Finland is a highly developed democracy with a modern economy.
It is a member of the European Union.
Tourist facilities are widely available.
Read
the Department of State Background Notes on Finland for additional information.
ENTRY REQUIREMENTS:
Finland is a party to the Schengen agreement.
As such, U.S. citizens may enter Finland for up to 90 days for tourist or business purposes without a visa.
The passport should be valid for at least three months beyond the period of stay.
For further details about travel into and within Schengen countries, please see our Schengen fact sheet.

Travelers can contact the Embassy of Finland at 3301 Massachusetts Avenue, N.W., Washington, DC 20008, tel: (202) 298-5800, or the Finnish Consulates General in Los Angeles or New York.
Additional information is available via the Internet at http://www.finland.org.
The U.S. Embassy in Helsinki is not able to assist private U.S. citizens in obtaining any necessary visas for neighboring countries, including Russia and other countries of the former Soviet Union.

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

SAFETY AND SECURITY:
Finland remains largely free of terrorist incidents.
However, like other countries in the Schengen area, Finland’s open borders with its Western European neighbors allow the possibility of terrorist groups entering/exiting the country with anonymity.
Elements of organized crime groups operating in the former Soviet Union and Eastern Europe are present in Finland, but these do not represent a specific danger to U.S. citizen residents or tourists.
Americans are reminded to remain vigilant with regard to their personal security and to exercise caution.
For the latest security information, Americans traveling abroad should regularly monitor the Department of State, Bureau of Consular Affairs’ web site at http://travel.state.gov, where the current Travel Warnings and Travel Alerts, as well as the Worldwide Caution, can be found.
Up to date information on safety and security can also be obtained by calling 1-888-407-4747 toll-free in the United States and Canada, 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 A Safe Trip Abroad.

CRIME:
Although the crime rate in Finland is low compared to the U.S. and most European countries, it has increased in recent years; however, Finland remains a relatively safe environment.
Americans visiting Finland are seldom victims of crime, but visitors should not be complacent regarding personal safety or the protection of valuables.
The same precautions employed in the U.S. should be followed in Finland.
Finnish police services are excellent. Travelers should be aware that some police officers speak little English.
Due to the low crime rate, Finland has one of the lowest numbers of police officers of any European nation.
Outside of key sites in major urban centers, they rarely project a visible presence; consequently, response times to crisis situations may be unpredictable.
All forms of public transportation are considered safe.
Street crimes, such as muggings and pick-pocketing, remain uncommon, but do occur.

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.

Finland has a program to provide financial compensation to victims who suffer serious criminal injuries.
According to existing regulations, the victim must report the incident to the police and file an application for compensation within 10 years of the date of the crime.
Finnish police routinely inform victims of serious crime of their right to seek compensation.
The relevant forms and further information can be obtained from http://www.treasuryfinland.fi.
The local equivalent to the “911” emergency line in Finland is 112.
Please see our additional information for 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 Finland’s laws, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in Finland are strict and convicted offenders can expect jail sentences and heavy fines.
Engaging in illicit sexual conduct with children or using or disseminating child pornography in a foreign country is a crime, prosecutable in the United States.
Please see our information on Criminal Penalties
SPECIAL CIRCUMSTANCES:
Commercial and financial transactions in Finland are increasingly automated and on-line.
Cash is almost always acceptable (the currency is the euro), but most major credit cards are widely recognized.
Automatic Teller Machines are very common and many U.S.-issued bankcards are compatible with them.

MEDICAL FACILITIES and Health information:
In Finland, medical facilities and their staff are generally excellent and are widely available for emergency services.
English is commonly spoken by Finnish medical personnel.
Helsinki is a frequent medical evacuation point for emergency cases from the countries of the former Soviet Union.
The public hospital system and many private hospitals honor foreign credit cards.
Most pharmacies (“apteekki” in Finnish) are open during normal shopping hours and major cities have at least one 24-hour service pharmacy.
If you are a tourist or temporary visitor to Finland and you require immediate emergency medical assistance, you may visit a local medical center or clinic, called “ensiapuasema” (first-aid station) in Finnish.
Usually these stations are located at hospitals and provide a full range of services.
The emergency telephone number, 112, can be used throughout Finland to contact emergency medical services.
For more detailed information on medicines and medical issues, please visit the website of the Finnish Embassy in Washington, DC at http://www.finland.org.
Travelers with special medical needs should consult with their personal physicians and take appropriate precautions, including bringing adequate supplies of necessary medication.
Medicines may be brought into the country as long as they are intended for the traveler’s personal use, however, there are special requirements concerning the quantity.
Medications categorized as narcotics may only be brought into the country to cover the traveler’s personal use for a maximum of 14 days and must be accompanied by a medical certificate stating why the traveler needs them.
For more detailed information, please contact the Finnish Embassy in Washington, DC at http://www.finland.org
In addition, stringent Finnish customs regulations prohibit travelers from receiving drugs from abroad after having arrived in the country.
Travelers may also find local physicians reluctant to prescribe equivalent quantities of dosages.

The U.S. Department of State is unaware of any HIV/AIDS entry restrictions for visitors to or foreign residents of Finland.
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 Finland is provided for general reference only and may not be totally accurate in a particular location or circumstance.
Finnish roads are comparable to those in the U.S., though secondary roads may be less heavily traveled due to Finland’s sparse population outside the major urban areas.
These secondary routes often narrow to two lanes with a wider shoulder.
Slower vehicles are expected to move onto the shoulder to allow faster moving vehicles to pass.
Finland has an extensive network of highways throughout the country, as well as excellent public transportation services.
A valid U.S. driver’s license may be used while visiting Finland, but drivers must be at least 18 years of age.
Driving in Finland is on the right.
Traffic approaching from the right usually has priority, even if entering a primary roadway from a secondary one.
Road signs use standard international symbols and Finnish text.
Many urban streets have traffic lanes reserved for public transportation only.
Unless otherwise noted on traffic signs, the speed limit is 50 km/h in urban areas, 80 km/h on open roads, and 120 km/h on expressways during summer (reduced to 100 km/h during winter).
Vehicles must use headlights at all times.
Use of seatbelts is mandatory for drivers and all passengers.
Minor children must be seated in approved child or booster seats.

Public transport in Finland is of good quality and is the recommended method of travel.
Passenger trains, intercity buses, and air flights provide regular service over longer distances.
Public transportation in urban centers includes buses, subways, trams, suburban trains, and taxis.
Taxis are more expensive than in major U.S. cities.
Most local residents use public transport in Helsinki as parking can be hard to find and expensive.
The bus, train, and subway systems are relatively safe.
Travelers should be aware that drunk-driving laws are strict and acceptable blood alcohol levels are much lower in Finland than in the U.S.
Police strictly enforce all traffic laws and institute random roadside breath analyzer tests.
Drivers who register .05 or above alcohol content are subject to immediate arrest.
Drivers should be aware that regulations and traffic signs differ significantly from those in the U.S.
Visitors should be familiar with both prior to operating a vehicle in Finland.
Driving in Finland during the winter months can be hazardous.
Daylight hours are very short and one should be comfortable with driving in darkness.
Icy road conditions are common.
If driving in Finland, the vehicle must be winterized with studded snow tires and engine heaters are strongly recommended.
When driving at night, drivers must be alert to moose wandering onto major roadways.
There have been incidents of moose being struck by vehicles, causing severe damage to the vehicle and injury, sometimes fatal, to the occupants.
For real-time updates on road conditions throughout Finland, see the Finnish Road Administration’s travel and traffic information web site at http://www.finnra.fi
Please refer to our Road Safety page for more information.
Visit the website of the country’s national tourist office and national authority responsible for road safety at http://www.mek.fi
AVIATION SAFETY OVERSIGHT:
The U.S. Federal Aviation Administration (FAA) has assessed the Government of Finland’s Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for oversight of Finland’s air carrier operations.
For more information, travelers may visit the FAA’s web site at http://www.faa.gov/safety/programs_initiatives/oversight/iasa
Please see our information on customs regulations.

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

REGISTRATION AND EMBASSY LOCATION:
Americans living or traveling in Finland are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department’s travel registration website, https://travelregistration.state.gov, so that they can obtain updated information on travel and security within Finland.
Americans without Internet access may register directly with the nearest U.S. Embassy or Consulate.
By registering, American citizens make it easier for the Embassy or Consulate to contact them in case of emergency.
The U.S. Embassy is located at Itainen Puistotie 14B.
The telephone number for the American Citizens Services unit is 358-9-616-25-701, 0830 to 1700 Monday to Friday (after hours, 358-9-616-25-0); the fax number is 358-9-616-25-800; e-mail:
HelsinkiACS@state.gov.
The address of the Embassy’s Internet home page is http://www.usembassy.fi
*

*

*
This replaces the Consular Information Sheet dated May 23, 2008 to update the sections on Information for Victims of Crime and Medical Facilities and Health Information.

Travel News Headlines WORLD NEWS

Date: Fri 14 Dec 2018
Source: UUTISET [edited]

An unvaccinated individual, who caught the contagious disease in Poland, attended a large church service in Tampere and infected at least 2 other people. Three adults have been diagnosed with measles in Tampere after attending a Catholic parish church event in late November along with more than 100 people, according to the Pirkanmaa Hospital District.

Two of the adults diagnosed have been vaccinated, so they are not contagious. The source of the outbreak is an unvaccinated person, who caught the measles in Poland. But according to the Pirkanmaa Hospital District, further cases may still arise.

In 1975 Finland began to administer a single dose of the measles vaccine to all one-year-olds and by 1982 Finland began administering the vaccine in 2 doses between the ages of 1 and 6. However some people born in the 1970s are among those who received only one jab. MMR is a triple-dose vaccine that provides protection against measles, mumps and rubella.

Measles spread at religious event
---------------------------------
The event in question was Tampere's Pyhan Ristin (Sacred Cross) Catholic Parish church mass on 25 Nov 2018. It was attended by more than 100 people, including children. Pirkanmaa Hospital District doctor Kirsi Valve, a specialist in infectious diseases, confirmed that the infected individual who caught the measles in Poland was at the church event. The cases came to light when 2 vaccinated individuals contracted high fevers and came down with skin rashes. The unvaccinated person, who infected the others, has had more severe symptoms than the vaccinated individuals.

"The individuals quickly got in touch with healthcare services owing to high fevers, and skin rashes that rapidly spread all over their bodies," says Valve. "It was confirmed that on 25 Nov 2018 the unvaccinated individual who caught the measles in Poland and brought it back to Finland was at the parish event and is the source of the outbreak."

As the source of the outbreak is known, healthcare officials are also looking into whether the person could have possibly exposed others.

Measles in the news
-------------------
Measles has been on the agenda this winter after an unvaccinated child in Ostrobothnia took ill with measles. Meanwhile, it also came to light that many adults in Finland may not have been vaccinated against measles during the early 1970s.

Measles is a rare disease. The previous outbreak was 2 summers ago when 4 vaccinated children caught measles in Italy and started showing symptoms after returning to Finland. The Pirkanmaa Hospital District recommends that anyone who attended the Catholic parish event in late November 2018 and exhibits symptoms that suggest measles or anyone who hasn't been vaccinated with the MMR vaccine contact their healthcare centre.

If those who attended the parish event are healthy, but have not been vaccinated, the Pirkanmaa Hospital District recommends that they contact their healthcare centre to be vaccinated. The measles vaccine is free and administered as part of the MMR shot, which also provides protection against rubella and the mumps.
Date: Fri 2 Nov 2018
Source: UUTISET [edited]

Around 1/3 of the ticks in Finland -- mostly found in the south -- carry at least one pathogen, and 2 percent of the persistent arachnids carry several disease-causing agents, researchers at Turku University said.

About 30 percent of common ticks and 24 percent of taiga tick populations have been found to carry one disease pathogen. Common ticks more commonly carry several disease-causing pathogens than taiga ticks, according to the researchers.

The most common pathogen found in the ticks was _Borrelia burgdorferi_, the bacterial species that causes Lyme disease in humans, an illness referred to locally as borreliosis. The pathogen was found in 17 percent of the ticks at the university's growing tick database bank.

Lyme disease cases are treated with aggressive antibiotics without necessarily determining which specific bacterium is responsible for the infection.

Thanks to a growing tick database at the University of Turku, researchers have new insights into the disease pathogens that the tiny, blood-sucking arachnids carry.

New research has revealed that ticks on the south coast carry the most pathogens, but the region is almost exclusively home to the most common ticks: _Ixodes ricinus_, or castor bean ticks).

Both castor bean ticks and taiga ticks [_Ixodes persulcatus_] are now commonly found in areas across central Finland, the researchers said. Even further north, the tick populations are quite similar to ones in central areas, but the taiga has become more common in the north.

About 3 years ago, researchers at the university asked members of the public to send in ticks they had found, and now the institution has received more than 20 000 ticks. The researchers say that they want to take advantage of the significant amount of information they can learn from the specimens.

Examination of those thousands of tiny arachnids have uncovered many types of disease-causing bacteria, and researchers have new insights into the arachnids themselves and the potential illnesses they carry.

The researchers said they hope to learn more about ticks, saying that their research has only begun, and that their study of the ticks will continue for several years. Ultimately, their goal is to find how tick-borne illnesses are transmitted, they said.
======================
[This is an interesting example of how a large group of people, many undoubtedly non-scientists, can contribute to an effort that requires many hours of collection effort. Although _Borrelia burgdorferi_ is endemic in Finland, finding it and possibly other bacterial pathogens in about 1/3 of the 20 000 ticks collected is of public health significance. _Ixodes ricinus_ is also the tick vector of European tick-borne encephalitis virus, but no mention is made of it in the above report. Perhaps it was not tested for. Images of both ticks can be found in the above report. - ProMED Mod.TY]

[HealthMap/ProMED-mail map:
Date: Thu, 1 Nov 2018 16:46:12 +0100
From: topic@afp.com

Helsinki, Nov 1, 2018 (AFP) - Santa Claus has already begun his preparations in Lapland -- by protecting himself from winter viruses and making sure he hires enough elves.   On Thursday nurse Tiia Kahkonen administered an anti-influenza vaccine to Santa, at his village in the Arctic Circle town of Rovaniemi, northern Finland. 

The jab is likely to be a sensible precaution, as the flu season coincides with the busiest time of the year by far in Lapland.    In December last year 390,000 foreign visitors spent a night in Finnish Lapland, an increase of almost ten percent on the previous Christmas.    By far the largest group of Christmas holidaymakers were Brits, followed by Russian, French and German tourists, according to official statistics.

Meanwhile a recruitment agency in Finnish Lapland, inside the Arctic circle, has put out a call for Christmas elves to look after the hordes of tourists who come to visit Santa in his natural habitat during the winter months.   Prior experience is not essential as the advert, posted by the firm Lapland Staff, promises that training will be provided in "the required elfing and communication skills."   Successful applicants will also be given tips on how to deal with the cold in northern Finland where temeratures rarely rise above zero degrees Celsius, and can drop as low as minus 40.

Although handling Santa's reindeer is not listed among the job's duties, elves will need to herd groups of visitors on and off buses, as well as keep tourists entertained. "Looking after the fireplace and pouring hot juice" are also required, as is supervising the toboggan hill.   Tourism to Lapland has reached an all-time high in recent years, with visitors spending 3.5 million nights in Lapland across the whole year, up from 2.6 million a decade earlier, according to Statistics Finland.    Much of the recent growth has been driven by tourism from Asia.
Date: Sun, 17 Dec 2017 04:43:36 +0100
By Camille BAS-WOHLERT

Rovaniemi, Finland, Dec 17, 2017 (AFP) - In the run up to Christmas tourists from around the world flock to the Santa Claus Village, an amusement park in Finnish Lapland, where temperatures can hit nearly -15 degrees Celsius (5 Fahrenheit).    They buy soft toys and souvenirs from pricey gift shops while a bearded Santa receives hundreds of admirers a day throughout December before embarking on his world tour from the valleys of Finland to the skyscrapers of New York and beyond to deliver gifts.

Holding their winter beanie hats in their hands, visitors wait patiently in line for a brief encounter with "Joulupukki" -- the Finnish word for Santa Claus -- and a photo opportunity in exchange for hard currency.    "We've seen other Santas but that wasn't the real one. But we're told that is the real one," said Mary Gleadall, an eight-year-old tourist from Southampton in the UK, visiting the amusement park with her parents, brother and sister.    According to Christmas lore, Santa lives in a secret place in the middle of the snowy pines of the North Pole. But the question is where?     Since 2010, Rovaniemi, the capital of Finnish Lapland, has marketed itself as Santa's "official home".    Situated a few miles from the city, the Santa Claus Village is located in front of a huge gas station. 

Tourists rush to cross the Arctic Circle, marked by a white line, to meet Santa Claus in his wooden home with a pointed roof.    But entering his private cottage is out of the question as Mother Claus is reportedly protective of their privacy.    In a large room, the white-bearded old man sits in an armchair next to a chest full of letters.    Each year, he receives more than 300,000 visitors, a deluge he embraces with humility.    "I'm very happy. I'm not exhausted but, of course, I get tired once in a while" he says.    And how does Santa Claus regain his energy?    "I love to take nap every once and then. Fifteen minutes sleeping and then all is very good." he says.

- Exalted tourists -
Shizuka Kawahara and Saki Itoi, Japanese tourists in their thirties, flew for more than 24 hours to hug Santa for a few seconds in a precious moment immortalised with a photograph taken by an elf.    The price for one shot starts at 30 euros ($35). Photographing with one's own camera is forbidden as it would ruin the magic of the moment, says the staff of the house.     Four-year-old Harry Gleadall, Mary's brother, approaches Santa without fear.    He quickly states his list of what he wants for Christmas: Transformers and some more Transformers before he skeptically shakes Santa's hand.    "But what if it wasn't the real Santa Claus?" Harry asks with concern.    Eager to set the record straight -- and justify the long trip -- his mother quickly assures him that the chubby red-clothed man is indeed the real deal.    After a tour around the shop which sells hand-made "Lapland" emblems and tons of souvenirs, the family is back in the village square, surrounded by wooden homes, Christmas carols piped out of nearby speakers.

- Polar safari -
In this winter wonderland, tourists have the opportunity to go on a reindeer sleigh ride.    A snow "safari" of 400 metres costs 14 euros per child and 18 euros per adult, an exotic experience for many foreigners who seek to discover the arctic landscapes steeped in pink light.    The -13 degrees Celsius does not discourage the plucky visitors bundled up in their ski suits.    "Everything that have been told to me during childhood, it's come true," said Perpetua, a tourist from Dubai, describing the break from the year round desert climate as "heaven".   "We expected magic and this is what we found," added Max, an Italian tourist. "Everything seems to be magic, the lights, the place, everything here".   But Miriana, a 24-year-old Italian on a university exchange programme in southern Finland, was less convinced.   "The place is really nice. But I think nevertheless that it's a bit commercial," she said.
Date: Tue 18 Oct 2016
From: Tiina Nokireki <tiina.nokireki@evira.fi> [edited]

The Finnish Food Safety Authority (Evira) received a bat (Daubenton's bat, _Myotis daubentonii_) for laboratory analyses. The bat was found by a private person. The bat had neurological signs and then died.

Laboratory analyses conducted during the 13 and 14 Oct 2016, confirmed the presence of rabies by FAT. The virus was then identified as European Bat Lyssavirus type 2 (EBLV-2) by RT-PCR and partial sequencing of the gene for the nucleoprotein. Also cell culture is positive.

The bat originated from Inkoo in the province of Southern Finland and is part of the Uusimaa region. This is the 2nd case of EBLV-2 in a bat in Finland.
-----------------------------------------
Tiina Nokireki
Head of Section, DVM, Specialist in Veterinary Medicine, Infectious
Diseases
Finnish Food Safety Authority Evira
Research Department, Veterinary Virology
Mustialankatu 3,
FI-00790 Helsinki,
Finland
=========================
[Special thanks to Dr. Nokireki for this important contribution. Infections by European Bat Lyssavirus type 2 (EBLV-2) have been previously reported in Northern Europe, not only in bats, but also in humans. EBLV-1 appears to be more prevalent, accounting for the vast majority of all EBLV-infected bats. Reports of EBLV-2 correspond to Daubenton's bats (_Myotis daubentonii_), indicating that this bat species is the reservoir of this _Lyssavirus_ strain.

For a picture of a Daubenton's bat go to

[A HealthMap/ProMED-mail map can be accessed at:
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World Travel News Headlines

Date: Mon, 27 Jan 2020 01:07:04 +0100 (MET)

Wuhan, China, Jan 27, 2020 (AFP) - China's central government said on Monday that the nationwide total of confirmed infections from a deadly respiratory virus had risen to 2,744, with 769 new cases coming to light.   However, it said no new deaths were confirmed outside of Hubei province, which had earlier reported 24 new fatalities to bring the national total to 80 dead.
Date: Sun, 26 Jan 2020 22:16:28 +0100 (MET)

Beijing, Jan 26, 2020 (AFP) - Chinese authorities have ordered the extension of a public holiday in an effort to contain an epidemic that has killed 56 people and infected nearly 2,000 worldwide, state-run media reported.   A working group chaired by Premier Li Keqiang to tackle the outbreak decided on Sunday "to reduce population flows" by extending the Spring Festival holiday which had been scheduled to end on January 30, state news agency Xinhua said.   It was not immediately clear how long the extension is.

The group also ordered changes to "the starting dates of schools" and "people to work from home by working online."   "The meeting stressed that the country is at a crucial time in the prevention and control of the novel coronavirus outbreak, urging Party committees and governments at all levels to take more 'decisive, powerful and orderly, scientific and well-planned' measures to effective curb the spread," Xinhua reported.   In a bid to slow the spread of the respiratory virus, the government had previously locked down hard-hit Hubei, a province in central China that is at the outbreak's epicentre, in an unprecedented operation affecting tens of millions of people.

The previously unknown virus has caused global concern because of its similarity to the Severe Acute Respiratory Syndrome (SARS) pathogen, which killed hundreds across mainland China and Hong Kong in 2002-2003.   Originating in Hubei's capital of Wuhan, the virus has spread throughout China and across the world -- with cases confirmed in around a dozen countries including as far away as the United States.   Several countries were making arrangements to evacuate their citizens from Wuhan, where an eery calm pervades as new restrictions prohibit most road traffic in the metropolis of 11 million.
Date: Sun, 26 Jan 2020 21:47:53 +0100 (MET)

Washington, Jan 26, 2020 (AFP) - US health authorities said Sunday there are now five confirmed cases of the coronavirus in the United States and more are expected.   Nancy Messonnier, head of the respiratory disease section at the Centers for Disease Control and Prevention, said around 100 people in 26 states are being investigated for the virus, which originated in the Chinese city of Wuhan.

Of the confirmed cases, all five people had travelled to Wuhan, Messonier said during a conference call with reporters.   "Every case we have had in the United States is someone who has had direct contact in Wuhan," she said.   Messonier said there are two cases in California and one each in Arizona, Illinois and Washington state. Until now the toll was three.   While Chinese officials have launched an extraordinary emergency response, Messonier insisted that the health risk for Americans in general remains low "at this time."
Date: Sun, 26 Jan 2020 13:44:57 +0100 (MET)

Lagos, Jan 26, 2020 (AFP) - Nigerian health authorities have announced stepped-up emergency measures to tackle a rise in Lassa fever cases after 29 people died this month.   "As at 24th of January 2020, 195 confirmed cases and 29 deaths had been reported in 11 states," the Nigeria Centre for Disease Control (NCDC) said in a statement Saturday.   A national emergency operations centre had been activated to coordinate the response "to the increasing number of Lassa fever cases" across the country.

Endemic to Nigeria, Lassa fever belongs to the same family as the Ebola and Marburg viruses, but is much less deadly.   The virus is spread by contact with rat faeces or urine. It starts with fever and can, in worst case scenarios, lead to severe bleeding and organ failure.   Nigeria declared an outbreak of Lassa fever a year ago and around 170 people died from the virus in 2019.

The number of cases usually climbs in January due to weather conditions during the dry season.    Almost 90 percent of the recent confirmed cases have been in Edo, Ondo and Ebonyi states in southern Nigeria, but their have also been deaths in the north.

The NCDC said that compared to the same period last year the fatality rate had dropped from 23.4 percent to 14.8 percent.    It encouraged Nigerians to "practise good hygiene and take measures to protect themselves and their families".   Nigeria, Africa's most populous nation with a population of some 200 million, has five laboratories with the capability to diagnose Lassa fever.
Date: Sun, 26 Jan 2020 12:18:19 +0100 (MET)

Beijing, Jan 26, 2020 (AFP) - Two Chinese provinces and three cities have ordered citizens to wear face masks in public, to help control the spread of a deadly virus.   The measure is required in the provinces of Guangdong in the south and Jiangxi in the centre, plus the eastern city of Nanjing, Ma'anshan city in Anhui province, and Xinyang city in Henan, according to local authorities.   China's industry and information technology ministry has said it would "spare no effort in increasing supply" after demand for masks skyrocketed.
Date: Sun, 26 Jan 2020 04:03:51 +0100 (MET)

Hong Kong, Jan 26, 2020 (AFP) - Hong Kong's Disneyland announced it was shutting its doors on Sunday until further notice over the deadly virus outbreak in central China, a day after city authorities classified the crisis as an emergency.   "As a precautionary measure in line with prevention efforts taking place across Hong Kong, we are temporarily closing Hong Kong Disneyland park out of consideration for the health and safety of our guests and cast members," the park said in a statement.
Date: 26 Jan 2020
Source: MENAFN [edited]

Two more polio cases have surfaced from Landikotal tehsil in Khyber tribal district, after which the number of reported cases in Khyber Pakhtunkhwa has reached 4 this year [2020].

According to the Emergency Operations Centre (EOC), a 2-year-old [male child] from Nekikhel and another child from Torwela have been diagnosed with polio. The samples of these 2 children were sent for laboratory tests in 2019, so these cases will be counted in the tally of 2019, which stands at 141 now.

The 2 cases in Landiktoal were reported 2 days after the emergence of 3 new polio cases in Qambar, Dadu and Sajawal districts of Sindh. Among them, 2 children contracted the crippling disease in 2019, but the cases were confirmed on Friday [24 Jan 2020].

On [21 Jan 2020], the 1st case of polio in Pakistan in 2020 surfaced in Lakki Marwat, the district with the highest number of cases in 2019.

The year 2019 was worse for Pakistan in polio eradication efforts, as 141 cases surfaced in Pakistan, including 96 cases in KP. Most cases in KP surfaced in Lakki Marwat, where 32 children were diagnosed with the crippling disease. In 2018, only 12 cases were reported, while in 2017, 8 cases were reported.

Currently, Pakistan and Afghanistan are the only 2 countries in the world which have not fully eradicated polio. The main cause behind the emergence of so many polio cases is refusal of parents to cooperate with the vaccination teams. According to media reports citing Health Ministry data, over a million parents refused to cooperate with vaccination teams in 2019. Most of the refusal cases were reported in April last year [2019] when rumours spread in Peshawar that many children had fainted after consuming vaccination drops. A total of 1 089 087 parents refused to give vaccination drops to their children in 2019.

The emergence of so many polio cases in Pakistan, particularly in KP, has brought the federal and provincial governments under pressure over their performance and strategy to control the spread of disease.

Experts believe that polio vaccination efforts cannot succeed completely until the refusing parents are convinced to cooperate with vaccination teams.
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[The End Polio Pakistan website has not added all of the media reported cases as yet, so it's a bit difficult to follow at times and know which cases were 2019 onset and which were 2020 onset. The above media report clearly states 2019 onset and puts the tally for 2019 as 141 cases, but the media reports from Friday's [24 Jan 2020] report is less clear (see Poliomyelitis update (10): global, Pakistan (BA, SD) http://promedmail.org/post/20200124.6911971).

A good map of Pakistan showing districts and provinces can be found at:
Date: Fri 24 Jan 2020
Source: SciTechDaily [abridged, edited]

Citation: Amman BR, Bird BH, Bakarr IA, et al. Isolation of Angola-like Marburg virus from Egyptian rousette bats from West Africa. Nat Commun. 2020; 11:510.  <https://doi.org/10.1038/s41467-020-14327-8>

Scientists have detected Marburg virus in fruit bats in Sierra Leone, marking the 1st time the deadly virus has been found in West Africa. A total of 11 Egyptian rousette fruit bats tested positive for active Marburg virus infection. Research teams caught the bats separately in 3 health districts.

The presence of Marburg virus, a close relative to Ebola virus that also causes hemorrhagic disease in people, was detected in advance of any reported cases of human illness in Sierra Leone. However, the virus's presence in bats means people who live nearby could be at risk for becoming infected. No outbreaks have been reported to date.

The findings, based on PCR, antibody, and virus isolation data, were officially published today [24 Jan 2020] in the journal Nature Communications. Preliminary findings were announced earlier in December 2018 to ensure rapid notification to the citizens of Sierra Leone and the international health community.

The paper highlights the value of collaborating with government and key stakeholders across human, animal, and environmental sectors to engage at-risk communities about the discovery, address health concerns, and communicate risk-reduction strategies before recognized spillovers occur.

Marburg virus was detected by projects led by the Centers for Disease Control and Prevention, the USAID-funded PREDICT project led by the One Health Institute at the UC Davis School of Veterinary Medicine; Njala University, Sierra Leone; and the University of Makeni, Sierra Leone.

"Finding Marburg virus in bats in Sierra Leone before any known cases in people is a huge success, as public health officials and doctors can now include Marburg virus among the possible causes when diagnosing hemorrhagic fever cases in the region," said Tracey Goldstein, co-principal investigator and pathogen detection lead for the PREDICT project from the UC Davis One Health Institute.

To date, there have been 12 known outbreaks of Marburg virus, with the most recent in Uganda in 2017. The largest and deadliest outbreak occurred in Angola in 2005 when 227 people died. Five of the new strains identified among the Marburg-positive bats in Sierra Leone were genetically similar to the strain that caused the outbreak in Angola. This is the 1st time scientists have detected these Angolan-like strains in bats.

The virus-positive bats were all Egyptian rousette bats, the known reservoir for Marburg virus, which primarily feed on fruit. Infected bats shed the virus in their saliva, urine, and feces. Egyptian rousette bats are known to test-bite fruits, urinate, and defecate where they eat, potentially contaminating fruit or other food sources consumed by other animals or people, particularly children. These bats sometimes serve as a food source for local populations as well. People may be exposed to Marburg virus through bat bites as they catch the bats.

Following the announcement of the preliminary findings by the government of Sierra Leone, the PREDICT team worked with government partners, universities, and other key stakeholders to develop and implement evidence-based public health messaging across national, district, and local community levels in Sierra Leone.  "Over a year ago, we worked with our Sierra Leone government colleagues to inform people across the country as fast as possible of this new health risk and remind people not to harm or come in contact with bats," said Brian Bird from the UC Davis One Health Institute and global lead for Sierra Leone and Multi-Country Ebola operations for PREDICT-USAID. "I'm very proud of that work and our teams now that this full report is available."
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Communicated by:
ProMED-mail from HealthMap Alerts
<promed@promedmail.org>
and
Mary Marshall
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[The initial report of this finding, prior to this publication, was posted by ProMED-mail (Marburg virus disease - Sierra Leone (02): bats, additional information http://promedmail.org/post/20181223.6221436) when the virus was detected for the 1st time in fruit bats in Sierra Leone.

According to the CDC (<https://www.cdc.gov/vhf/marburg/index.html>), Marburg virus was 1st recognized in 1967, when outbreaks of hemorrhagic fever occurred simultaneously in laboratories in Marburg and Frankfurt, Germany, and in Belgrade, Yugoslavia (now Serbia). A total of 31 people became ill, initially laboratory workers followed by several medical personnel and family members who had cared for them; 7 deaths were reported. The 1st people infected had been exposed to imported African green monkeys or their tissues while conducting research. One additional case was diagnosed retrospectively.

The reservoir host of Marburg virus is the African fruit bat, _Rousettus aegyptiacus_. Fruit bats infected with Marburg virus do not show obvious signs of illness. Primates (including humans) can become infected with Marburg virus, and may develop serious disease with high mortality.

Ebola virus is closely related to Marburg virus. "Ebola viral RNA fragments were found in an oral swab from a greater long-fingered bat (_Miniopterus inflatus_), captured in 2016 in Liberia's Sanniquellie-Mahn district, which borders Guinea. The bat, which lives in many parts of Africa, roosts in caves and feeds on insects. Scientists had previously found 2 other Ebola species in a related insect-eating bat, _M. schreibersii_. However, most other evidence has pointed to fruit bats as the carriers of Ebola Zaire, Epstein says [J Epstein, veterinary epidemiologist at EcoHealth Alliance in New York City and a member of the PREDICT consortium]. "What it really says to me is that this is a virus that has multiple hosts, and it might be regionally dependent as to which species carries it."

Supporting the variety of bat hosts for Ebola, the bat implicated in the initiation of the West African Ebola virus outbreak in December 2013 was _Mops condylurus_, long-tailed insect-eating bats, that were previously suspected in an outbreak of the Sudan strain of Ebola virus, which is related to the Zaire strain. - ProMED Mod.LK]

[HealthMap/ProMED-mail map:
Date: Sat, 25 Jan 2020 11:49:16 +0100 (MET)
By Su Xinqi, Jerome TAYLOR

Hong Kong, Jan 25, 2020 (AFP) - Hong Kong on Saturday declared a new coronavirus outbreak as an "emergency" -- the city's highest warning tier -- as authorities ramped up measures to reduce the risk of further infections.   The announcement came as city leader Carrie Lam faced criticism in some quarters over her administration's response to the crisis.

Of the five people who have tested positive for the virus in Hong Kong so far, four arrived via a newly built high-speed train terminal which connects with the mainland.   That led to calls from some medical experts and politicians to limit, or even halt, arrivals from China, the epicentre of the outbreak with 41 people dead.

Lam held emergency meetings with health officials on Saturday morning after returning from Davos.   "Today I declare the lifting of the response level to emergency," she told reporters.   Schools and universities, which are currently on a Lunar New Year break, would remain closed until 17 February, Lam said.   All mainland arrivals to Hong Kong will now need to sign health declaration forms, she added, while public events including a new year gala and next month's marathon, would also be called off.    "We haven't seen serious and widespread infections (in Hong Kong), but we are taking this seriously and we hope to be ahead of the epidemic," Lam said.

- Tragic past -
Hong Kong has a recent experience of deadly viral outbreaks.    Nearly 300 people were killed by SARS in 2003, a tragedy that left a profound psychological impact on one of the most densely populated places on earth.   The city's ability to combat the crisis was hampered by moves in mainland China to cover up and play down the outbreak, leaving a lasting legacy of distrust among many Hong Kongers.   Animosity towards the mainland has intensified in recent years as Beijing tightens political control over the semi-autonomous territory.

The outbreak also comes at a sensitive time for Lam, who currently boasts record low approval ratings after seven months of pro-democracy protests.   "We must stand united so that we can prevent and control the disease," she said, in a nod to the political unrest.   The often violent protests have battered Hong Kong's reputation for stability and helped tip it into recession, with the recent virus outbreak compounding the city's economic woes.

Hospitals are already struggling with the winter flu season, but officials are isolating anyone with a history of travel to central China and those exhibiting respiratory tract infections that look similar to the virus.   So far some 300 people have been tested and monitored for the virus. Quarantine centres have been set up in remote holiday parks for anyone found to have come into close contact with people who tested positive.   On Saturday, officials announced a newly built but still-empty public housing block would be used for medical staff on the frontline who did not want to risk returning to their families.
Date: Sat, 25 Jan 2020 06:46:59 +0100 (MET)
By Mahmut Bozarslan and Fulya Ozerkan in Istanbu

Elazig, Turkey, Jan 25, 2020 (AFP) - A powerful earthquake has killed at least 20 people and injured more than 1,000 in eastern Turkey, as rescue teams searched through the rubble of collapsed buildings for survivors on Saturday.    At least 30 people were missing following the magnitude 6.8 quake on Friday night, which had its epicentre in the small lakeside town of Sivrice in the eastern province of Elazig.   "It was very scary, furniture fell on top of us. We rushed outside," 47-year-old Melahat Can, who lives in the provincial capital of Elazig, told AFP.   President Recep Tayyip Erdogan said all steps were being taken to aid people affected by the quake, which caused widespread fear.   "We stand by our people," Erdogan said on Twitter.

The Turkish government's disaster and emergency management agency (AFAD) said the quake hit Sivrice at around 8.55 pm (1755 GMT). Turkey lies on major faultlines and is prone to frequent earthquakes.    Turkish television showed images of people rushing outside in panic, as well as a fire on the roof of a building.   Interior, environment and health ministers, who were in the quake zone, said the casulties were in Elazig province and in the neighbouring province of Malatya, which lies to the southwest.

At least 20 people died and 1,015 others were wounded, according to AFAD.   "There is nobody trapped under the rubble in Malatya but in Elazig search and rescue efforts are currently under way to find 30 citizens," Interior Minister Suleyman Soylu said on Friday.   Rescue teams were searching for survivors trapped in a five-storey collapsed building in a village some 30 kilometres from Elazig, according to AFP journalists at the scene. One person was pulled alive from the rubble.   Emergency staff and people waiting at the scene lit fires in the streets to stay warm in freezing temperatures.   Sports centres, schools and guest houses had been opened to accommodate quake victims in Malatya.

- 'Everybody is in the street' -
Sivrice -- a town with a population of about 4,000 people -- is situated south of Elazig city on the shores of Hazar lake -- one of the most popular tourist spots in the region and the source of the Tigris river.   The lake is home to a "Sunken City", with archaeological traces dating back 4,000 years in its waters.

The tremor was felt in several parts of eastern Turkey near the Iraqi and Syrian borders, the Turkish broadcaster NTV reported, adding that neighbouring cities had mobilised rescue teams for the quake area.   "Everybody is in the street, it was very powerful, very scary," said Zekeriya Gunes, 68, from Elazig city, after the quakes caused a building to collapse on her street.   "It lasted quite long, maybe 30 seconds," added Ferda, 39. "I panicked and was undecided whether to go out in this cold or remain inside."

The US Geological Survey assessed the magnitude as 6.7, slightly lower than AFAD, adding that it struck near the East Anatolian Fault in an area that has suffered no documented large ruptures since an earthquake in 1875.   "My wholehearted sympathy to President @RTErdogan and the Turkish people following the devastating earthquake that has hit Turkey. Our search and rescue teams stand ready to assist," Greek Prime Minister Kyriakos Mitsotakis wrote on Twitter.   In Athens, the Greek premier's office said later that Mitsotakis had spoken by phone to Erdogan.   "The Turkish president... said Turkish teams had the situation under control for now and that it would be re-evaluated in the morning," his office added.

In 1999, a devastating 7.4 magnitude earthquake hit Izmit in western Turkey, leaving more than 17,000 people dead including about 1,000 in the country's largest city Istanbul.    In September last year, a 5.7-magnitude earthquake shook Istanbul, causing residents to flee buildings in the economic capital.   Experts have long warned a large quake could devastate the city of 15 million people, which has allowed widespread building without safety precautions.