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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 ...

Syria

Syria US Consular Information Sheet
August 13, 2008

COUNTRY DESCRIPTION:
Since March 1963, the Syrian Arab Republic has been ruled by an authoritarian regime dominated by the Socialist Ba'ath Party.
While the ruling Ba'ath party
spouses a largely secular ideology, Islamic traditions and beliefs provide a conservative foundation for the country's customs and practices.
Syria has a developing, centrally-planned economy with large public (30%), agricultural (25%), and industrial (20%) sectors.
Tourist facilities are available, but vary in quality depending on price and location.
Read the Department of State Background Note http://www.state.gov/r/pa/ei/bgn/3580.htm on Syria for additional information.
ENTRY/EXIT REQUIREMENTS:
A passport and a visa are required.
Visas must be obtained prior to arrival in Syria from a Syrian diplomatic mission located in the traveler’s country of residence, although the Syrian visa policy with respect to American diplomats and citizens is currently under review.
Foreigners who wish to stay 15 days or more in Syria must register with Syrian immigration authorities by their 15th day.
Syrian-American men or American men of Syrian origin, even those born in the United States, may be subject to compulsory military service unless they receive a temporary or permanent exemption from a Syrian diplomatic mission abroad prior to their entry into Syria.
(Please see the section on Special Circumstances below.)
Syria charges a departure tax for all visitors except those on diplomatic passports.
As of July 1, 2008, the tax is 1,500 Syrian Pounds if departing from the airport; 500 Syrian Pounds if departing via one of the land borders.

The Syrian government rigidly enforces restrictions on prior travel to Israel, and does not allow persons with passports bearing Israeli visa or entry/exit stamps to enter the country.
Syrian immigration authorities will not admit travelers with Israeli stamps in their passports, Jordanian entry cachets or cachets from other countries that suggest prior travel to Israel.
Likewise, the absence of entry stamps from a country adjacent to Israel, which the traveler has just visited, will cause Syrian immigration officials to refuse admittance.
Entry into Syria via the land border with Israel is not possible.
American-citizen travelers suspected of having traveled to Israel have been detained for questioning.

Syrian security officials are also sensitive about travel to Iraq.
There have been instances in which Americans, especially those of Arab descent, believed to have traveled to Iraq were detained for questioning at ports of entry/exit.
Americans seeking to travel to Iraq through Syria have also on occasion been turned around and/or detained.
On a number of occasions the border between Iraq and Syria has been closed without notice, stranding Americans on either side of the border.
Children under the age of eighteen whose fathers are Syrian or of Syrian descent must have their fathers' permission to leave Syria, even if the parents are separated or divorced and the mother has been granted full custody by a Syrian court.
Women in Syria are often subject to strict family controls.
On occasion, families of Syrian-American women visiting Syria have attempted to prevent them from leaving the country.
This can be a particular problem for young single women of marriageable age.
Although a woman does not need her husband's explicit consent every time she wishes to leave Syria, a Syrian husband may take legal action to prevent his wife from leaving the country, regardless of her nationality.
Once such legal orders are in place, the U.S. Embassy cannot help American citizens leave Syria.
Visit the Embassy of the Syrian Arab Republic, 2215 Wyoming Ave. NW, Washington, DC
20008, telephone (202) 232-6313 or check the Syrian Embassy's home page at http://www.syrianembassy.us for the most current visa information.
Information about dual nationality or the prevention of international child abduction can be found on our web site.
For further information about customs regulations, please read our Customs Information sheet.
SAFETY AND SECURITY: Syria is included on the Department of State's List of State Sponsors of Terrorism.
A number of the terrorist groups that have offices in Syria oppose U.S. policies in the Middle East.
On September 12, 2006, the U.S. Embassy in Damascus was attacked by assailants using improvised explosives, gunfire, and two vehicles laden with explosives.
On February 4, 2006, mobs protesting caricatures of the Prophet Mohammed destroyed the Norwegian and Chilean embassies and severely damaged the Danish and Swedish diplomatic missions.
On April 27, 2004 there was a violent clash in which three people died in an area of Damascus where many foreign citizens reside.
It has never been clear whether the shootout with Syrian security forces involved common criminals or terrorists.
In 1998 and 2000, mobs attacked the U.S. Ambassador’s Residence and the U.S. Embassy, respectively.
In 1997, twenty-two people were killed when a public bus was bombed in downtown Damascus.
All of these attacks serve as reminders that Syria is not immune from political or purely criminal violence.
Americans traveling through the area should remain aware that U.S. interests and citizens might be targeted.
Security personnel may at times place foreign visitors under surveillance.
Hotel rooms, telephones, and fax machines may be monitored, and personal possessions in hotel rooms may be searched.
Taking photographs of anything that could be perceived as being of military or security interest may result in problems with authorities.
Additionally, Americans should be aware that conversations on the topics of political, religious and other freedoms are not seen as merely healthy debate in Syria and could lead to arrest.
Note that possession of specific-use electronic devices including GPS, short-wave or handheld radio equipment, or similar devices in Syria is illegal.

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

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

The Department of State urges American citizens to take responsibility for their own personal security while traveling overseas.
For general information about appropriate measures travelers can take to protect themselves in an overseas environment, see the Department of State’s pamphlet A Safe Trip Abroad.
CRIME:
While a few cases of theft, burglary and assault have been reported to the Embassy, crime is generally not a serious problem for travelers in Syria.
It is important to note, however, that Syria is not crime free. Specifically, incidents of credit card and ATM fraud, and physical harassment of women, are on the rise.

INFORMATION FOR VICTIMS OF CRIME:
The loss or theft abroad of a U.S. passport should be reported immediately to the local police and the nearest U.S. Embassy or Consulate.
If you are the victim of a crime while overseas, in addition to reporting to the local police, please contact the U.S. Embassy for assistance.
The Embassy 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.

The local equivalents for the “911” emergency line in Syria are:
110 for ambulance, 113 for fire and 112 for the police.
See our information on Victims of Crime.
MEDICAL FACILITIES AND HEALTH INFORMATION:
Basic medical care and medicines are available in Syria's principal cities, but not necessarily in outlying areas.
Serious illnesses and emergencies may require evacuation to a Western medical facility.
Information on vaccinations and other health precautions, such as safe food and water precautions and insect bite protection, may be obtained from the Centers for Disease Control and Prevention’s hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747) or via the CDC’s web site at http://wwwn.cdc.gov/travel/default.aspx.
For information about outbreaks of infectious diseases abroad consult the World Health Organization’s (WHO) web site at http://www.who.int/en.
Further health information for travelers is available at http://www.who.int/ith/en.
Some HIV/AIDS entry restrictions exist for visitors to or foreign residents of Syria.
There are no special immunizations required for entry to Syria.
AIDS tests are mandatory for foreigners’ ages 15 to 60 who wish to reside in Syria.
The AIDS test must be conducted in Syria at a facility approved by the Syrian Ministry of Health.
A residence permit will not be issued until the absence of the HIV virus has been determined.
Foreigners wishing to marry Syrian nationals in Syria must also be tested for HIV.
Syria usually will not give visas or residency permits to students wishing to study religion or Arabic in private religious institutions.
Please verify this information with the Embassy of Syria at http://www.syrianembassy.us/ before you travel.
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 Syria is provided for general reference only, and may not be totally accurate in a particular location or circumstance.
Driving in Syria is hazardous and requires great caution.
Although drivers generally follow traffic signs and signals, they often maneuver aggressively and show little regard for vehicles traveling behind or to the sides of them.
Lane markings are usually ignored.
Vehicles within Syrian traffic circles must give way to entering traffic, unlike in the United States.
At night, it is very hard to see pedestrians, who often walk into traffic with little warning.
Outside major cities it is common to find pedestrians, animals and vehicles without lights on the roads at night.
Pedestrians must also exercise caution.
Parked cars, deteriorating pavement, and guard posts obstruct sidewalks, often forcing pedestrians to walk in the street.
Vehicles often do not stop for pedestrians, and regularly run red lights or “jump” the green light well before it changes.

Please refer to our Road Safety page for more information.
For specific information concerning Syrian driving permits, vehicle inspection, road tax and mandatory insurance, contact the Syrian Embassy in Washington, D.C. at 2215 Wyoming Avenue NW, Washington, DC
20008, tel. 202-232-6313.
AVIATION SAFETY OVERSIGHT:
Sanctions resulting from the passage of the Syria Accountability Act prohibit aircraft of any air carrier owned or controlled by the Syrian government to take off from or land in the United States.
As there is no direct commercial air service to the United States by carriers registered in Syria, the U.S. Federal Aviation Administration (FAA) has not assessed Syria's Civil Aviation Authority for compliance with International Civil Aviation Organization (ICAO) aviation safety standards.
For more information, travelers may visit the FAA’s web site at http://www.faa.gov/safety/programs_initiatives/oversight/iasa.
The U.S. Embassy in Damascus has advised its employees to avoid travel on Syrian Arab Airlines (Syrian Air or SAA) whenever possible due to concerns regarding the airline's ability to maintain its airplanes.
SAA has, on its own initiative, grounded individual aircraft with significant maintenance or service issues; however, concerns persist that some planes still being flown may lack certain safety equipment or may have undergone repairs that have not been reviewed by the manufacturer.

SPECIAL CIRCUMSTANCES:
Syrian customs authorities may enforce strict regulations concerning temporary importation into or export from Syria of items such as weapons, narcotics, alcohol, tobacco, cheese, fruits, pharmaceuticals, modems, cosmetics, and some electrical appliances.
It is advisable to contact the Embassy of Syria in Washington, D.C. for specific information regarding customs requirements.
Please see our Customs Information.
U.S. citizens are encouraged to carry a copy of their U.S. passports with them at all times so that, if questioned by local officials, they will have proof of identity and U.S. citizenship readily available.
Although Syria is a signatory to the Vienna Convention on Consular Relations, Syrian officials generally do not notify the American Embassy when American citizens are arrested. When the American Embassy learns of arrests of Americans and requests consular access, individual police officials have, on their own initiative, responded promptly and allowed consular officers to visit the prisoners.
However, security officials have also in the past denied Embassy requests for consular access, especially in the case of dual citizens.
Foreign currencies can be exchanged for Syrian pounds only at government-approved exchange centers and licensed private banks.
Syrian pounds cannot be changed back into foreign currency.
Very few places in Syria accept credit cards.
Foreigners visiting Syria are required to pay hotel bills in US dollars or Euros.
Travelers’ checks are not accepted for payment in Syria, and banks will not cash them unless the traveler has an account at the bank in question.
There are no US-based banks operating in Syria.
There are six private banks operating in Syria, with branches and ATMs in most major cities.
These ATMs usually honor major debit/credit systems.
Funds may be transferred into Syria through Western Union.
Wiring of funds through private banks is possible only if the traveler already holds an account with the bank in Syria;, transferring funds through the Commercial Bank of Syria is not possible due to U.S. sanctions.
Syrian-American and Palestinian-American men who have never served in the Syrian military and who are planning to visit Syria are strongly urged to check with the Syrian Embassy in Washington, D.C. prior to traveling concerning compulsory military service. American men over the age of 18, even those who have never resided in or visited Syria, whose fathers are of Syrian descent, are required to complete military service or pay to be exempted.
Possession of a U.S. passport does not absolve the bearer of this obligation.
The fee for exemption from military service ranges from $5,000 to $15,000 USD, depending upon circumstances, for Syrian-American and Palestinian-American men who live abroad.
In January 2005 the Syrian government reduced mandatory military service from 30 months to 24 months.
It also announced that Syrians born outside of Syria and residing abroad until the age of 18 have the option of being exempted from their service by paying $2,000 USD.
Those born in Syria who left the country before reaching the age of 11, and have resided abroad for more than 15 years can be exempted by paying $5,000 USD.
Contact the Syrian Embassy in Washington, DC, for more information (See Entry/Exit Requirements section above).
President Bush signed an executive order on May 11, 2004, implementing sanctions in accordance with the Syria Accountability Act.
These sanctions prohibit the export to Syria of products of the United States other than food or medicine, and prohibit any commercial aircraft owned or controlled by the Syrian government from taking off from or landing in the United States.
Under the authority provided in Section 5(b) of the Act, the President has determined that it is in the national security interest of the United States to waive the application of these sanctions in certain cases and for certain products, as specified in the Department of Commerce's General Order No. 2.
For additional information about implementation of the Syria Accountability Act, consult the Department of Commerce web site at (http://www.bis.doc.gov/).
Since 1979, the United States has designated Syria a State Sponsor of Terrorism due to its support for groups such as Hizbollah and Palestinian terrorist groups.
The Terrorism List Government Sanctions Regulations prohibit U.S. persons from receiving unlicensed donations from the Syrian government.
Additionally, U.S. persons are prohibited from engaging in financial transactions which a U.S. person knows or has reasonable cause to believe pose a risk of furthering terrorists' acts in the United States.
For additional information about the Terrorism List Government Sanctions Regulations, consult the terrorism brochure on the U.S. Department of the Treasury, Office of Foreign Assets Control (OFAC) home page on the Internet at http://www.treas.gov/offices/enforcement/ofac/ or via OFAC's info-by-fax service at (202) 622-0077.
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 Syrian laws, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in Syria are strict and convicted offenders can expect prison sentences and heavy fines.
Penalties for possession of even small amounts of illegal drugs for personal use are severe in Syria.
Persons convicted in Syria for growing, processing, or smuggling drugs face the death penalty, which may be reduced to a minimum of 20 years’ imprisonment.
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 Syria 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 Syria.
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 2 Al-Mansour St., Abu Roumaneh, Damascus.
The international mailing address is PO Box 29, Damascus.
Mail may also be sent via the U.S. Postal Service to: American Embassy Damascus, Department of State, Washington, DC
20521-6110.
Telephone numbers are (963) (11) 3391-4444, fax number is (963)(11) 3391-3999, e-mail: acsdamascus@state.gov.
The government workweek in Syria is Sunday through Thursday; the private sector generally works Saturday through Thursday.
The U.S. Embassy is open Sunday through Thursday.
Additional information may be found on the Embassy web site at http://damascus.usembassy.gov
*

*

*
This replaces the Country Specific Information dated November 20, 2007 to update the sections on Entry/Exit Requirements, Safety and Security, Crime, Information for Victims of Crime, Medical Facilities and Health Information, Special Circumstances, and Registration/Embassy Location.

Travel News Headlines WORLD NEWS

Date: Thu, 20 Feb 2020 16:20:39 +0100 (MET)

Damascus, Feb 20, 2020 (AFP) - A bomb explosion wounded two people in Damascus Thursday, the state news agency reported, the latest of several such attacks in the Syrian capital.   "An explosive device planted on a pickup truck went off in the Marjeh area" in central Damascus, SANA said, adding that two civilians were wounded by the blast.

The Syrian Observatory for Human Rights war monitor said the device was a "sticky bomb" planted on a military vehicle, although it was not immediately clear what the target was.   There was no immediate claim of responsibility for the blast, nor for a similar explosion that wounded five people in another neighbourhood of Damascus on Tuesday. The Syrian capital was routinely targeted by major car bomb attacks in the course of the nine-year-old conflict but blasts have been less frequent since regime forces reclaimed full control of the Damascus region in 2018.
Date: Thu 5 Dec 2019 6:11 PM EET
Source: Enab Baladi [edited]

[Leishmaniasis] is spreading widely among residents of Deir ez-Zor, and especially children. Some of the areas affected are controlled by the Kurdish self-administration while others are under the control of the Syrian regime. Medical sources counted hundreds of infected civilians and confirmed the disease's rapid spread.

According to Atef al-Tawil, a manager of the Leishmania & Environmental Health Programme at the Syrian regime's Ministry of Health, most infections in eastern Deir ez-Zor are spread among school children.

In a Facebook comment on a post by Twasol agency, al-Tawil claimed that cases of leishmaniasis were detected, at the end of November [2019], in primary schools in eastern Deir ez-Zor and its surrounding villages (al-Jalaa, al-Salihiyah, al-Tawtha, al-Abbas, al-Mujawdeh, al-Hasarat, al-Saial, al-Ghabrah).

According to al-Tawil, 455 infections of children were detected. A treatment team of 10 members was formed in the affected locations, to help control the disease to aid in early detection.

The Syrian Ministry of Health acted after several appeals by civilians residing in the area as they noticed the disease spreading among their children. Al-Tawil said that this rapid spread was due to the fact that all the infected people have lately returned to their original areas which lack medical centers.

Autonomous administration areas
-------------------------------
According to Euphrates Post network, leishmaniasis is also widely spread in areas controlled by the Syrian Democratic Forces (SDF). In its post on [Sun 1 Dec 2019], the network claimed that the spread of leishmaniasis is mostly concentrated in the eastern countryside of Deir ez-Zor.

According to the network, unofficial statistics by the SDF-affiliated local council shows more than 7000 leishmaniasis infections among children in al-Baghouz, Hajin, Diban, al-Sha'afa, al-Kishkiye, Abu Hamam, and Gharanij. The local councils' attempts of controlling the disease are still substandard, according to the Euphrates Post.

The network also quoted doctors and nurses calling for international organizations to interfere and provide hospitals and clinics with the required vaccine [there is no vaccine for leishmaniasis; ed.], and to train specialized medical staff in each clinic to deal with the disease.

The autonomous-administration-affiliated media center in Deir ez-Zor also confirmed the spread of leishmaniasis and pointed out that the authorities took actions, by the end of November [2019], to provide treatments.

According to the media center, special medical teams and cadres were distributed among the clinics to provide 12,000 ampoules of the required [medicine] to treat leishmaniasis with the support of the World Health Organization.

Leishmaniasis is a parasitic disease transmitted by the bite of infected female phlebotomine sandflies -- a very small yellow fly that is active at night and makes no sound when it bites -- and the main cause for its spread is dirt and lack of hygiene.  [Byline: Enab Baladi]
========================
[Deir ez-Zor is east and south of the locations in the previous ProMED reports (see below), indicating further increase in cases of cutaneous leishmaniasis beyond its historical concentration in western Syria (<https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4861536/>) and beyond the area of the MENTOR initiative in northern Syria (<https://wwwnc.cdc.gov/eid/article/24/11/17-2146_article>).

Cutaneous leishmaniasis is endemic in Syria with its reservoir in rodents. It has been a problem throughout the Syrian civil war and in ISIS controlled areas during the war due to a breakdown in rodent and vector control. - ProMED Mod.EP]

[Maps of Syria:
Date: Mon, 2 Dec 2019 11:19:53 +0100 (MET)

Beirut, Dec 2, 2019 (AFP) - Regime air strikes Monday killed 10 civilians in Syria's last major opposition bastion, where deadly clashes between regime forces and armed groups have escalated in the past two days, a monitor said.   The raids also wounded 15 civilians in a market in the town of Maaret al-Numan in the jihadist-run province of Idlib, the Britain-based Syrian Observatory for Human rights said.
Date: Fri 21 Jun 2019
Source: WHO/EMRO (Regional Office for the Eastern Mediterranean) [edited]

Situation reports on Al-Hol camp, Al-Hasakah
--------------------------------------------
- Over the past 2 weeks, a total of 633 people have left the camp. This number includes 107 people who returned to their homes in north-east Syria. There were no new arrivals during the reporting period.
- 9 medical points are reporting regularly to the disease Early Warning And Response System (EWARS). Leishmaniasis, acute diarrhoea, bloody diarrhoea, and severe acute malnutrition (SAM) remain the most commonly reported diseases.
- 38 new cases of leishmaniasis were detected. All patients are being treated by a WHO-supported mobile team in coordination with the Al-Hasakeh Directorate of Health.
- 7 suspected cases of measles were reported. No new cases of tuberculosis were detected during the reporting period.
- 30 children with severe acute malnutrition with medical complications were admitted to Al-Hikmah hospital during the reporting period, of whom 22 were discharged, one died, and the remainder are still under treatment. Mortality rates related to severe acute malnutrition remain below the emergency threshold.
- 2 new static health care points have been established, bringing the total number to 12. There is still an acute shortage of health care points in the Foreign Annex.
- 35 water sources were tested for microbial contamination in Al-Hasakeh water national laboratory during the reporting period. All 35 samples tested negative for contamination. WHO continues to test the quality of water from different sources in the camp.
- Stool samples from patients with diarrhoea were tested for
_Salmonella_, _E. coli_, and cholera, with all samples testing negative. Blood samples from patients with suspected measles were also sent for testing, and all samples tested negative.
- Following intensive negotiations by WHO, the local authorities have given their approval in principle to evacuate a patient requiring advanced mental health treatment
===================
[Leishmaniasis has surged throughout Syria during the civil war on all sides and continues to be a health problem in the refugee population. - ProMED Mod.EP]

[HealthMap/ProMED-mail map of Syria:
Date: Wed, 22 May 2019 16:52:39 +0200
By Nazeer al-Khatib with Hashem Osseiran in Beirut

Maaret al-Numan, Syria, May 22, 2019 (AFP) - Syrian government air strikes killed 18 civilians, including a dozen people at a busy market, as fierce fighting raged for the jihadist-held northwest, a war monitor said on Wednesday.   Regime forces battled to repel a jihadist counteroffensive around the town of Kafr Nabuda that has left 70 combatants dead in 24 hours, the Syrian Observatory for Human Rights said.   The Hayat Tahrir al-Sham alliance, led by Syria's former Al-Qaeda affiliate, controls a large part of Idlib province as well as adjacent slivers of Aleppo, Hama and Latakia provinces.   The jihadist-dominated region is nominally protected by a buffer zone deal, but the government and its ally Russia have escalated their bombardment in recent weeks, seizing several towns on its southern flank.   At least 12 people were killed and another 18 wounded when regime warplanes hit the jihadist-held Idlib province town of Maarat al-Numan around midnight (2100 GMT) on Tuesday, the Observatory said.

The market was crowded with people out and about after breaking the daytime fast observed by Muslims during the holy month of Ramadan.   The bombardment blew in the facades of surrounding buildings, and ripped through the flimsy frames and canvas of stalls in the market square, an AFP photographer reported.    The bodies of market-goers were torn apart.   "Residents are still scared," stallholder Khaled Ahmad told AFP.   Three more civilians were killed on Wednesday by air strikes in the nearby town of Saraqib, the Observatory said.    Two others were killed in strikes on the town of Maaret Hermeh, it added.    Another civilian was killed in air raids on the town of Jisr al-Shughur, the monitor said.   The Britain-based Observatory relies on a network of sources inside Syria and says it determines whose planes carried out strikes according to type, location, flight patterns and munitions.

- 'Worst fears'-
The strikes came as heavy clashes raged in neighbouring Hama province after the jihadists launched a counterattack on Tuesday.   Fresh fighting on Wednesday took the death toll to 70 -- 36 regime forces and militia and 34 jihadists, the Observatory said.   It said the jihadists had recaptured most of Kafr Nabuda from government forces, who had taken control of the town on May 8.   State news agency SANA on Wednesday however said the army repelled a jihadist attack in the area, killing dozens of insurgents.

Russia and rebel ally Turkey inked the buffer zone deal in September to avert a government offensive on the region and protect its three million residents.   But President Bashar al-Assad's government upped its bombardment of the region after HTS took control in January.   Russia too has stepped up its air strikes in recent weeks.   The Observatory says nearly 200 civilians have been killed in the flare-up since April 30.   The United Nations said Wednesday that Idlib's civilian population once again faced the threat of an all-out offensive.   "A full military incursion threatens to trigger a humanitarian catastrophe for over 3 million civilians caught in the crossfire, as well as overwhelm our ability to respond," said David Swanson, a spokesman for the UN humanitarian office.   Swanson said more than 200,000 people have been displaced by the upsurge of violence since April 28.   A total of 20 health facilities have been hit by the escalation -- 19 of which remain out of service, Swanson said.   Collectively they served at least 200,000 people, he added.

- 'Break the status quo' -
The September deal was never fully implemented as jihadists refused to withdraw from a planned buffer zone around the Idlib region.   But it ushered in a relative drop in violence until earlier this year, with Turkish troops deploying to observation points around the region.   The Syrian government has accused Turkey of failing to secure implementation of the truce deal by the jihadists.   But Turkish Defence Minister Hulusi Akar accused the Syrian regime late Tuesday of threatening the ceasefire deal.   "The regime is doing all that it can to break the status quo including using barrel bombs, land and air offensives," Akar told reporters.   "Turkish armed forces will not take a step back from wherever they may be", he however added.   Earlier, the US State Department said it was assessing indications that the government had used chemical weapons on Sunday during its offensive in Idlib.   HTS accused government forces of launching a chlorine gas attack on its fighters in the northern mountains of Latakia.   But the Observatory said Wednesday it had "no proof at all of the attack".
More ...

Cuba

General:
**********************************
Cuba is an independent island country situated in the Caribbean. It is the largest of the islands and covers 42,000sq miles. The climate is sub tropical throughout the year with most of the rainfall in
the northern parts of the country. Temperatures of between 20C to 35C are fairly standard throughout the year. Generally the winter effects of the American continent only last for short periods.
Safety & Security:
**********************************
The majority of tourists visiting Cuba will have no difficulty but bag snatching and other street crime appears to be increasing. The old Havana area and other major tourist resorts may be particular areas of concern in this regard. On arrival be careful to only use your recognised tour operator. If you are taking a taxi at any stage make sure it is a registered one and not a private vehicle. It is unwise to carry large quantities of money or jewellery away from your hotel and try not to flaunt wealth with your belongings. Pickpockets are too common an occurrence on buses and trains and at train stations so be careful with your essential documents and credit cards. Valuables should not be stored in suitcases when arriving in or departing from Havana as there have been a number of thefts from cases during the time the cases are coming through baggage handling. There is an airport shrink-wrap facility for those departing Havana which reduces the risk of tampering. Remember to carry a photocopy of your main documents (passport, flight tickets etc).
Road Safety:
**********************************
Following a number of serious road accidents involving tourists, you are advised not to use mopeds for travelling around Cuba or in Havana. Also, if you are involved in any accident a police investigation will be required to clear you and this may significantly delay your travel plans. On unlit roads at night there have been a number of accidents associated with roaming cattle (sounds like Ireland!). The traffic moves on the right side of the roads. There is a main highway running the length of the country but many of the country roads are in poor repair.
Local Laws & Customs:
**********************************
When arriving into Cuba make sure you are not carrying any items which could be considered offensive. Any illicit drug offense is treated very seriously and Cuban law allows for the death penalty to be used under these circumstances. If you require personal medication for your health, make sure it is in original packing and carry a letter from your doctor describing the medication. Never agree to carry any item for another individual and always secure your cases once they are packed. Taking photographs of military or police installations or around harbours, rail and airport facilities is strictly forbidden.

Currency:
**********************************
Since 1993 it is now possible to use US dollars for all transactions within Cuba. Remember, there is a 20$ airport departure tax. Certain travellers cheques and credit cards may not be acceptable within Cuba. This is particularly true of American Express cheques and cards but check your situation with the travel operator before departure.
Health Facilities:
**********************************
Generally healthcare facilities outside of Havana are limited and many standard medications may not be available. It is important to carry sufficient quantities of any medications which may be required for the duration of your time in Cuba.
Food & Water:
**********************************
The level of food and water hygiene varies throughout the country and between resorts. On arrival check the hotel cold water supply for the smell of chlorine. If it is not present then use sealed bottled water for both drinking and brushing your teeth throughout your stay. Cans and bottles of drinks are safe but take care to avoid pre-cut fruit. Peel it yourself to make sure it is not contaminated. Food from street vendors should be avoided in most cases. Bivalve shellfish are also a high risk food in many countries and Cuba is no exception in this regard. (Eg Mussels, Oysters, Clams etc)
Malaria & Mosquito Borne Diseases:
***********************************************
Malaria transmission does not occur within Cuba and so prophylaxis is not required. However, a different mosquito borne disease called Dengue has begun to reoccur in the country over the past few years. This viral disease can be very sickening and even progress to death. It is rare for tourists to become infected but avoiding mosquito bites is a wise precaution.
Swimming, Sun & Dehydration:
************************************
The extent of the Cuban sun (particular during the summer months (April to October) can be very excessive so make sure your head and shoulders are covered at all times when exposed. Watch children carefully as they will be a significant risk. Drink plenty of fluids to replace what will be lost through perspiration and, unless there is a reason not to,
take extra salt either on your food or in crisps, peanuts etc. Take care if swimming in the Caribbean to stay with others and to listen to local advice. Never swim after a heavy meal or alcohol.
Rabies Risk in Cuba:
**********************************
This viral disease does occur throughout Cuba and it is essential that you avoid any contact with all warm blooded animals. Dogs, cats and monkeys are the most commonly involved in spreading the disease to humans. Don't pick up a monkey for a photograph! If bitten, wash out the wound, apply an antiseptic and seek urgent medical attention.
Vaccinations for Cuba:
**********************************
There are no essential vaccines for entry / exit if coming from Ireland. However, for your own personal protection travellers are advised to have cover against the following;
*
Tetanus (childhood booster)
*
Typhoid (food & water borne disease)
*
Hepatitis A (food & water borne disease)
For those planning a longer or more rural trip vaccine cover against conditions like Hepatitis B and Rabies may also need to be considered.
Summary:
**********************************
Cuba is becoming a popular destination for tourists and generally most will stay very healthy. However commonsense care against food and water borne disease is essential at all times. Also take care with regard to sun exposure, dehydration and mosquito bites.

Travel News Headlines WORLD NEWS

Date: Tue, 28 Jan 2020 21:50:13 +0100 (MET)

Havana, Jan 28, 2020 (AFP) - A major earthquake that hit the Caribbean Tuesday rocked the Cuban capital Havana, causing buildings to be evacuated and sending thousands of people into the streets.  The quake rattled several tall buildings in the city, which were immediately evacuated by authorities.

The earthquake was felt in several provinces including Guantanamo and Santiago de Cuba in the east, Cienfuegos in the centre and Havana in the northwest, the official Cubadebate website reported.   There were no preliminary reports of damage or injuries, however.  The US Geological Survey reported the 7.7 magnitude quake hit at a depth of 10 kilometres (six miles), at 1910 GMT -- 125 kilometres northwest of Lucea, Jamaica.
Date: Fri, 18 Oct 2019 22:45:46 +0200 (METDST)

Washington, Oct 18, 2019 (AFP) - The US moved to further hurt Cuba's vital tourism industry by tightening the ability of the country's airlines to lease aircraft.   The US Department of Commerce said it was revoking existing licenses for US companies leasing aircraft to Cuban carriers, and will deny future applications for aircraft leases.   The move could make it harder for Cuba to service its rapidly growing tourism sector, a key source of foreign revenue for the poor country.

Washington has stepped up pressure on Havana due to its support for the embattled regime of Venezuelan President Nicolas Maduro.   "This action by the Commerce Department sends another clear message to the Cuban regime -- that they must immediately cease their destructive behaviour at home and abroad," Secretary of Commerce Wilbur Ross said in a statement.

It was not immediately clear how many aircraft the move would impact.   Cuba's cash-poor carriers depend on aircraft rented from leasing companies or other airlines, which are often very old.   In May 2018, 112 people died in the crash of a 39-year-old Boeing 737 leased by national carrier Cubana de Aviacion from a small Mexican firm, Global Air.

In June of this year, US President Donald Trump announced a US ban on cruise ship stopovers by Americans on the island, forcing Havana to cut its 2019 tourism target by 15 percent to 4.3 million visitors.   Nearly 900,000 tourists visited the island on cruise ships last year, and almost 40 percent were American, according to official figures.   The announcement Friday also expanded restrictions on imports from Cuba and on products with US content that can be sold to the country.
Date: Wed 3 Jul 2019
Source: 660 City News [edited]

A Newfoundland woman is warning travellers to do their research before adventurous excursions abroad after she and several other Newfoundlanders became ill from a mysterious disease traced back to a cave she visited in Cuba. The illness was eventually identified as a respiratory infection called histoplasmosis, or "cave disease," caused by spores from bird or bat droppings in damp soil. [She] of Paradise, NL, travelled to Cuba with her husband on 27 Apr [2019], but her fever-like symptoms didn't appear until 21 May [2019], weeks after she returned home. X-rays showed nodules in her lungs and tests showed low blood counts. Her condition baffled local doctors, who initially thought her lung infection could be some form of pneumonia. The clue to her illness came from a chance meeting she'd made on the trip with a family of Newfoundlanders who had a mutual friend. [She] and her husband had travelled with the group on a tour that included cave diving in the Matanzas province of Cuba.

Back in Canada, a number of their new friends had also fallen ill. [She] and the travellers informed their doctors that they knew each other and were experiencing the same symptoms, and their illness was identified as a respiratory infection called histoplasmosis, or "cave disease." [She] said pinpointing the source of her condition offered some relief from what she called a terrible, alarming health issue that she feared might have been cancerous. "You didn't want to be too excited about the fact that somebody else was sick, but at least cancer was off the table," [she] said by phone Wednesday [3 Jul 2019].

Eastern Health, [her] local health authority, has issued an advisory for travellers heading to the Americas, Africa, East Asia and Australia to avoid contracting the disease. Histoplasmosis is a treatable disease, contracted by breathing in airborne spores where bird or bat droppings are disturbed in damp soil. Eastern Health described its symptoms as including "cough and chest pain, shortness of breath, fever and chills, headaches and flu-like illness." The disease is treatable and most people who contract it never show symptoms, but it can be serious for infants or people with compromised immune systems. The health authority said the advisory was issued after a low number of histoplasmosis cases were confirmed in the Eastern Health region. An exact number of cases could not be provided for privacy reasons, but [the patient] said she's heard of at least 5 others.

While the disease is treatable, it is rare in Newfoundland, making treatment more complicated. [The patient] said she's waiting to receive an anti-fungal medication that had to be approved from outside of the province, and she's been told she'll have to take the drug for treatment for the next 3 months to a year. [The patent] said she's still experiencing fatigue and a persistent cough, and her voice is still scratchy and strained from an illness she contracted from what was one of the most breathtaking excursions on her vacation. "It was absolutely amazing," she said of the cave. "It was so pristine and so nice-looking when we went in."

[She] said she'd advise other travellers to do a thorough background check on the regions they're visiting and any planned excursions. "It's without a doubt that you have to go and you have to research the excursion that you're going on," she said. "You have to know the region, the areas, 100%. [She] wrote a Facebook post about her experience that's been shared thousands of times, and she said people as far as France have written to her about experiencing similar, undiagnosed symptoms after travelling abroad.  [Byline: Holly McKenzie-Sutter]
====================
[_Histoplasma capsulatum_, a dimorphic fungus that grows in a mycelial form at ambient temperatures and as yeast at body temperature in mammals, is found worldwide in soil enriched by bird or bat droppings. Contaminated soil can be potentially infectious for years. Fungal spores become airborne during activities that disturb the contaminated soil, such as spelunking, mining, construction, excavation, demolition, roofing, chimney cleaning, farming, or gardening, which can lead to clusters of cases of histoplasmosis that follow inhalation of the aerosolized spores. The spores can travel distances downstream from the source in currents of air. Because of the presence of bats in caves, cave exploration is a known risk factor for histoplasmosis, which is sometimes known as "cave fever" (<https://www.ncbi.nlm.nih.gov/pubmed/10403317>). Physicians should be aware of the association between histoplasmosis and caving when caring for individuals who develop an acute febrile respiratory illness after cave exploration (<http://tinyurl.com/yxjust7x>).

Another disease that has also acquired the name "cave fever" is tick-borne relapsing fever (TBRF). See ProMED-mail posts Tick-borne relapsing fever - Israel: spelunkers, tourists http://promedmail.org/post/20180422.5761531 and Tick-borne relapsing fever - USA: (TX) cave workers, 2017 http://promedmail.org/post/20180420.5759542.

Although birds cannot be infected by the _H. capsulatum_ and do not transmit the disease, bats can become infected by _H. capsulatum_ and may harbor the fungus in their gut (<https://academic.oup.com/jtm/article/15/2/133/1801173>).

In the US, histoplasmosis is endemic in the Ohio, Missouri, and Mississippi River valleys, where it is caused by _H. capsulatum_ var. _capsulatum_. Histoplasmosis has also been reported in Mexico, Central and South America, Oceania, Asia, Africa, and Europe (<https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4535725/>). In Africa, histoplasmosis occurs most commonly in west and central Africa, where it is caused by the _duboisii_ variety, which has yeast cells that average about twice the size of _H. capsulatum_ var. _capsulatum_  (<http://www.reviberoammicol.com/1997-14/155159.pdf>).

Most individuals with histoplasmosis are asymptomatic. Those who develop clinical manifestations are usually immunocompromised or are exposed to a large number of spores. Disseminated disease is especially more common in HIV/AIDS co-infected cases. - ProMED Mod.ML]

[HealthMap/ProMED-mail maps:
Newfoundland, Newfoundland and Labrador, Canada:
Date: Wed, 5 Jun 2019 03:22:19 +0200
By Paul HANDLEY

Washington, June 5, 2019 (AFP) - The Trump administration clamped down on US tourist visits to Cuba Tuesday, aiming to cut the flow of dollars to a country that Washington accuses of helping prop up Venezuelan President Nicolas Maduro.

The Treasury Department banned group educational travel, cruise ship and private yacht visits by Americans, taking aim at the most common ways US tourists and Cuban-Americans visit the Caribbean island.   The move could constitute a heavy hit on Cuba, which saw more than a quarter-million US visitors in the first four months of 2019, almost double the figure from a year earlier.   "The United States holds the Cuban regime accountable for its repression of the Cuban people, its interference in Venezuela, and its direct role in the man-made crisis led by Nicolas Maduro," the State Department said in a news release.   "Empowered by Cuba, he has created a humanitarian disaster that destabilizes the region."

White House National Security Advisor John Bolton said the aim was to end what the administration considers "veiled tourism" to Cuba.   "We will continue to take actions to restrict the Cuban regime's access to US dollars," Bolton said on Twitter.   The Cuban government condemned the move, which could cost the country's economy tens of millions of dollars a year in lost income.   "They seek to stifle the economy and damage the standard of living of Cubans to wrest political concessions," said Foreign Affairs Minister Bruno Rodriguez in a tweeted statement. "They'll fail again."

- Reverses Obama's historic opening -
American tourism in Cuba took off after then-president Barack Obama moved to ease the half-century trade embargo against the communist government in 2014 -- even though continuing restrictions kept visits nominally in the realm of cultural and artistic exchanges and business dealings.   Cuba and the US restored ties in 2015 and Obama himself visited Havana in a historic presidential trip in March 2016, meeting with then-president Raul Castro. Weeks later, the ban was lifted on US commercial ship visits, opening the door for the Caribbean cruise ship industry to expand stops in Cuba.

But President Donald Trump came into office attacking the Obama opening, and within months began tightening relations, first by banning individual visits and limiting commercial interactions.   The State Department tied the new ban directly to Havana's support for Maduro -- whose embattled regime faces a direct challenge from US-backed opposition leader Juan Guaido, the self-declared acting president of Venezuela.  "Veiled tourism has served to line the pockets of the Cuban military, the very same people supporting Nicolas Maduro in Venezuela and repressing the Cuban people on the island," the State Department said.

- 'Political grandstanding' -
Collin Laverty, president of Cuba Educational Travel, one of the US agencies which arranges visits to Cuba, accused the Trump administration of playing politics by trying to appease conservative anti-Havana Cuban immigrants in Florida, an important election swing state where they carry significant political weight.   "This political grandstanding aimed at Florida in the run up to the 2020 elections is so unfortunate for the millions of Cubans that will feel the crunch from less US visitors," said Laverty.   "This has nothing to do with empowering the Cuban people and has everything to do with empowering a handful of people in Florida that have never even been to Cuba."   Travel industry officials said that people who are booked on tours now will be able to go, ensuring that advanced-booked cruise ships will likely be operating from Florida to Havana throughout this year.   But Royal Caribbean Cruises said ships leaving Wednesday and Thursday of this week will skip previously scheduled stops in Cuba as the company examines the new US policy.

Norwegian Cruise Lines said they are seeking additional information on the new policy to see how it will affect future travel.   Tessia Aral, the owner of ABC Charters in Miami, said it could have a huge impact on her business, which arranged trips to Cuba for about 10,000 people last year.   She said it will hurt not only companies like hers but also those of the many entrepreneurs in Cuba who have built businesses to serve tourists.   "The people making the rules have never been to Cuba. They don't know how things have changed" in recent years, she said.   "What they are doing is counter-productive. I believe it's really going to hurt the private entrepreneurs in Cuba -- all the private restaurants, all the private homes" who serve tourists.
Date: Sun, 10 Mar 2019 04:13:11 +0100
By Katell ABIVEN

Havana, March 10, 2019 (AFP) - In Havana, there's a shop selling a camera for more than $25,000 -- roughly 850 times the average monthly wage in Cuba.   The eye-popping sum earned predictable scorn on social media, but it begins to make sense when seen through the lens of the island's fledgling bid to tap into the luxury tourism market.

The exclusive camera store and other boutiques featuring A-list brands like Versace and Armani are located in a shopping gallery on the ground floor of the swanky Gran Hotel Manzana.   The mere existence of the shops certainly seems incongruous in a country that has been governed as a one-party communist state since 1959, and where the average wage is $30 a month.   But the hotel isn't exactly looking for locals to buy in -- it attracts "a clientele of private airplanes... princes and celebrities," according to general manager Xavier Destribats.

The Gran Hotel Manzana, the first ever five-star establishment in Havana, opened in 2017 in a sumptuous historic building that was, at the beginning of the 20th century, the island's first shopping mall.   The property run by Swiss group Kempinski is "the first genuine luxury hotel in Havana," said Destribats.   "It's the first hotel with a 1,000-square-meter spa," he said. All the rooms are at least 40 square meters (430 square feet), with prices ranging from $370 for a basic room in low season to $5,000 for the presidential suite.   "There was a certain type of clientele that didn't travel to Havana, or Cuba, because there wasn't the standard of luxury five-star hotel like in cities such as Paris or London," Destribats added.

- 'Feels like Miami' -
The hotel terrace offers stunning views over Havana's colorful historic neighbourhood, where many Cubans live in dilapidated buildings that have fallen into disrepair or have vegetation sprouting from them.   "It really doesn't feel like Cuba, clearly not -- it feels like being in the United States, Miami or Puerto Rico," said Celia Liegeois, a 26-year-old tourist from Paris.   Having traveled around the island nation for three weeks, she and a friend had decided to spend their last few days relaxing by the hotel's rooftop pool.

Nearby, Suki Lu, a recently arrived 28-year-old Chinese television presenter, is impressed at what she sees.   "It's beautiful. Look at the sunset! It's truly addictive," she said.   "I live in Dubai so when you talk about luxury hotels, the level there is really high, but I think I'll like this hotel," she said, while her friend used a drone to get an aerial view of the building.   The largest single group of visitors to the Gran Hotel Manzana -- one-fifth of the total -- are tourists from the United States, although there are plenty of visitors from Europe, Asia and the Middle East.

The Kempinski group, which hopes to open two or three more hotels in Cuba, is of course not the only chain to show an interest in the ultra-luxury market.   In September 2018, Spain's Iberostar opened its second five-star hotel, the Grand Packard.   French hotel giant Accor is planning on opening its own luxury establishment on the Malecon, Havana's famous seaside boulevard, in September.   It will include a chocolate shop on its ground floor and a restaurant and concert space on its roof.   The employees' outfits will be designed by Spanish fashion designer Agatha Ruiz de la Prada.

- US blacklist -
However, there is a slight catch: in every case, the hotels are owned by Gaviota, the Cuban army's branch dedicated to tourism.   The foreign hotel groups are only allowed to run the establishments, all built by French group Bouygues, which has a long-standing local presence.   Authorities don't publish the army's revenues, but this alliance between hoteliers and the military landed the luxury hotels on Washington's blacklist.

US tourists are technically banned from staying in the hotels -- but the restriction can be easily circumvented by either paying in cash or booking through travel agents.   Beyond hotels, developers have more ideas to entice those with deep pockets.   "There's a plan to build golf courses in partnership with real estate groups," said industry expert Jose Luis Perello.   The opening of a luxury hotel means Cuba has turned a corner, he said.   "Since it opened up to international tourism more than 20 years ago, Cuba has focused all its plans and strategies" on "sun and beach tourism" for the masses, Perello said.   That category currently accounts for 73 percent of the 70,000 hotel rooms on offer in Cuba. And those who rent them usually don't spend much money.

The same goes for cruise ship tourists -- while the number of cruises docking in Cuba has exploded, passengers only spend an average of $15 a day on land.   That isn't great news for Cuba, which welcomed 4.7 million tourists in 2018 -- it needs the cash.   The government, which has been subjected to US sanctions since 1962, used to depend on aid from its oil-rich ally Venezuela.   But with Venezuela in turmoil, Cuba is scrambling for other sources of hard currency and its economic growth has stagnated at around one percent -- not enough to cover the population's basic needs.   Opening luxury hotels is "a new stage," but also "a necessity," Tourism Minister Manuel Marrero Cruz says.
More ...

Lesotho

Lesotho US Consular Information Sheet
May 28, 2008
COUNTRY DESCRIPTION:
Lesotho is a constitutional monarchy with a democratically elected lower house of parliament.
The upper house, the Senate, is comprised of appointed hereditary ch
efs and politicians.
A Prime Minister is the head of the government.
Geographically, Lesotho is an extremely mountainous developing nation completely surrounded by the country of South Africa.
The capital, Maseru, is at 5,000 feet (1,500M) above sea level, and the mountains reach to 11,400 feet (3,500M). Facilities for tourism are limited.
A limited number of restaurants are available in Maseru.
Read the Department of State Background Notes on Lesotho for additional information.

ENTRY/EXIT REQUIREMENTS:
A passport is required, but no visa for U.S. citizens is needed for visits of 180 days or less.
Vaccination for yellow fever is a common requirement and travelers should carry their international vaccination cards with them.
For more information concerning entry requirements, travelers may contact the Embassy of the Kingdom of Lesotho, 2511 Massachusetts Avenue NW, Washington, DC 20008, telephone (202) 797-5533.
Visit the Embassy of Lesotho’s web site at http://www.lesothoemb-usa.gov.ls/ for the most current visa information.

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

SAFETY AND SECURITY:
Lesotho held a general election in February 2007, which international and local observers considered peaceful and independent.
Opposition parties disputed the allocation of parliamentary seats following the election, leading to a protracted political impasse, massive rallies, and several work stoppages in 2007 which disrupted public transportation and some commercial activity.
Although the Southern African Development Community (SADC) undertook a mediation effort aimed at achieving dialogue and reconciliation, senior political and government figures were targeted in a spate of armed attacks in June 2007.
These attacks, including the kidnapping of Lesotho Defense Force (LDF) guards and the seizure of military weapons, resulted in a government-imposed daily curfew from June 15 to June 22, 2007, and reports of harassment at security checkpoints and roadblocks.
Efforts by the Maseru City Council to disperse unlicensed street vendors in the central business district led to confrontations between police and vendors.
U.S. citizens should avoid political gatherings and street demonstrations and maintain security awareness at all times.

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

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

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

CRIME:
U.S. citizens should remain vigilant about their surroundings at all times.
Lesotho has a high level of crime and foreigners are frequently targeted, robbed and sometimes killed.
American citizens reported an increased number of incidents in the first half of 2008, including armed and unarmed confrontations, carjackings, and home invasions.
However, there are no indications that U.S. citizens are being specifically targeted or that there is an increase in the overall crime rate.

The Lesotho Mounted Police Service reported the presence of a number of armed gangs.
Lesotho’s high unemployment rate, aggravated by the return of large numbers of unemployed miners from South Africa, and the ongoing effects of social upheaval due to high HIV/AIDS rates of infection, continue to contribute to an increasing number of reported crimes.
These types of crimes occur primarily in the capital city of Maseru, but can occur elsewhere in Lesotho.
Crime scenes have included popular restaurants, pedestrian overpasses, unlit or poorly lit roads, and other locations foreigners are known to frequent.
Victims have included foreign diplomats, volunteer workers, employees of non-governmental organizations, and nationals of Lesotho.
U.S. citizens are advised to avoid large groups and demonstrations, walking and driving at nighttime if possible, and walking in the capital city of Maseru even during daylight.
Personal crime is more likely to occur at night, but there have been numerous recent incidents in the middle of the day.
Traveling alone or at night is particularly dangerous.
The Lesotho Mounted Police Service handles policing duties.
Police resources are limited and response time varies widely.
U.S. citizens should report crime to the police and to the Embassy consular section.

There is a serious baggage pilferage problem at Johannesburg International Airport, also known as Oliver Tambo International Airport, in South Africa.
Persons traveling by air to Lesotho must travel via Johannesburg.
The pilferage problem particularly affects travelers changing airlines and those flying on smaller airlines.
Passengers flying on major international carriers may not be affected to the same degree.
Travelers are encouraged to secure their luggage, use an airport plastic wrapping service, and avoid placing currency, electronics, jewelry, cameras or other valuables in checked luggage.
Make an inventory of items in checked baggage to aid in claims processing if theft does occur.
The claims processing procedure can be time-consuming.

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

See our information on Victims of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION:
Medical facilities in Lesotho are limited.
Good medical service is available in Bloemfontein, South Africa, 90 miles west of Maseru.
There is no reliable ambulance service in Lesotho.
The Embassy maintains a list of physicians and other health care professionals in Lesotho who may see U.S. citizen patients.
The Embassy does not guarantee their services or provide recommendations.
Many medicines are unavailable at facilities in Lesotho; travelers should carry with them an adequate supply of needed medicines and/or prescription drugs, along with copies of prescriptions.
Lesotho has a very high HIV/AIDS prevalence rate, currently estimated at over thirty percent of the adult population.
Information on vaccinations and other health precautions, such as safe food and water precautions and insect bite protection, may be obtained from the Centers for Disease Control and Prevention’s hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747) or via the CDC’s web site at http://wwwn.cdc.gov/travel/default.aspx.
For information about outbreaks of infectious diseases abroad consult the World Health Organization’s (WHO) web site at http://www.who.int/en.
Further health information for travelers is available at http://www.who.int/ith/en.

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

TRAFFIC SAFETY AND ROAD CONDITIONS:
While in a foreign country, U.S. citizens may encounter road conditions that differ significantly from those in the United States.
The information below concerning Lesotho is provided for general reference only, and may not be totally accurate in a particular location or circumstance.
Traffic moves on the left, with right-hand drive vehicles.
Never assume right-of-way, as aggressive and undisciplined local driving habits result in frequent collisions.
Lesotho has a high number of traffic-related deaths and injuries given its small size.
The previous king died in a road accident in 1996.
Driving after dark is dangerous due to the absence of street lighting, livestock on the roads, and the prevalence of crime, including incidents of carjacking.
American citizens may encounter roadblocks manned by unauthorized or off-duty police officers soliciting cash payments for alleged traffic violations.
Travel is best done by private car.
Rental cars are available, and cars rented in neighboring South Africa may be brought into Lesotho with written permission from the rental company.
Although bus and public taxi services exist, chronic overloading combined with inadequate vehicle maintenance and lack of driver training make them unsafe.
Some private taxi service exists in the capital, but roving mini-bus taxis should be avoided.
There is no passenger train service in the country.
Although the number of paved roads is gradually increasing, the majority of Lesotho’s 5,000 miles of roads are unpaved.
A few main rural highways are comparable to U.S. two-lane rural roads, but lane markings, signs, shoulders and guardrails are not to U.S. standards, and unfenced livestock pose a particular danger.
Lesotho's mountainous terrain makes driving on secondary roads hazardous.
Unpaved roads in the interior, often narrow, twisty and steep, are poorly maintained. For travel in the interior, especially in wet or snowy weather, a high ground clearance or four-wheel-drive vehicle is recommended.
Four-wheel-drive is required for entering Lesotho through the Sani Pass on the eastern border.
The authority for road safety issues rests with the Lesotho Mounted Police Service.
There are no auto clubs or reliable ambulance services.
Drivers should contact the police in emergencies.
Please refer to our Road Safety page for more information.
Visit the web site of the country’s national tourist office and national authority responsible for road safety at http://www.lesothoemb-usa.gov.ls/tourism.htm.

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

The only scheduled air service is between Maseru and Johannesburg on a South African Airways subsidiary. There is no scheduled service among towns within Lesotho.

SPECIAL CIRCUMSTANCES:
Tap water is not reliably potable.
Visitors to the interior of Lesotho should bring clothing and equipment suitable for cold weather during the winter months (June - October).
In the mountains, weather conditions can deteriorate rapidly.
In winter snow often closes mountain passes and temperatures often drop below freezing during the night, even in the lowlands.

Please see our 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 Lesotho laws, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in Lesotho 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 Lesotho 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 Lesotho.
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 254 Kingsway, Maseru West; the mailing address is PO Box 333, Maseru 100, Lesotho.
The telephone number is 266-22-312-666. The Embassy’s e-mail address is infomaseru@state.gov and the URL is http://maseru.usembassy.gov/.
*

*

*
This replaces the Country Specific Information for Lesotho dated December 19, 2007 to update sections on Entry/Exit Requirements, Crime, and Traffic Safety and Road Conditions.

Travel News Headlines WORLD NEWS

Date: Mon 27 May 2019
Source: The Post [edited]

Over 50 people were taken ill this week after they ate meat from cattle that died of anthrax in Qeme last Saturday [18 May 2019]. About 55 were rushed to nearby clinics while 18 of them were given prophylaxis and treated as outpatients. Most of the victims developed blisters and had swollen limbs while others suffered from severe stomach-aches and diarrhoea. So far more than 20 cattle have died from anthrax.

The Ministry of Agriculture and Food Security this week declared that there had been an anthrax outbreak in Qeme area. The disease was 1st noticed in the villages of Ha-Tseka and Ha-Au in Qeme last Saturday [18 May 2019] after the villagers informed the ministry that their cattle were dying. The minister of agriculture, Mahala Molapo, told the post that they ensured that the carcasses were buried and those who ate meat of dead cattle were rushed to health centres for treatment.

A rapid response team comprising the Ministries of Agriculture and Health has since responded to the outbreak in the district. The team is comprised of experts from the Disease Control Unit, the World Health Organisation (WHO) and the epidemiologists who swiftly moved to contain the disease. "Our main focus is treating those who ate the infected animals and how to properly bury the carcasses," Molapo said. "We are also testing water sources in the area." He said they are also going to hold public gatherings where they are going to sensitize the communities about the disease. Molapo said they have also banned the movement of animals in and out of the Qeme area, and next week they are going to embark on vaccination campaigns.

The minister said no one has died so far as a result of eating the contaminated meat. He said neighbouring countries have been notified and no movement of animals will be allowed between Lesotho and its neighbours until the disease is contained. He added the country's export of animal products such as skins and meat has also been banned until the crisis is addressed. "We are also planning to provide vaccines countrywide to prevent other diseases like Black Quarter," he said. The minister maintained they have put in place control measures to contain the disease in the affected areas to prevent more cattle from dying.

Meanwhile, the district administrator of Maseru, Mpane Nthunya, said they will start the vaccination campaigns next week. Nthunya said their work will be to meet the community leaders in the affected areas to sensitize them about the outbreak.  [byline: Tokase Mphutlane]
-----------------------------------------------
communicated by:
Sabine Zentis
Castleview English Longhorns
Gut Laach
D-52385 Nideggen
Germany
===========================
[These human cases are in relation to the same villages reported in the previous OIE report (See: ProMED-mail. Anthrax - Lesotho: (MS) cattle, OIE http://promedmail.org/post/20190524.6485405.] With 3 villages affected a human case load of 50 is not unexpected in spite of the optimistic response of the local authorities. To locate the affected area go to the OIE report to see their map. - ProMED Mod.MHJ]

[HealthMap/ProMED map available at:
Date: Fri, 9 Sep 2016 05:27:46 +0200
By Julie JAMMOT

Semonkong, Lesotho, Sept 9, 2016 (AFP) - Across the rough grasslands of Lesotho, jockeys wearing wool balaclavas and scruffy old helmets urge their horses towards the finishing post as hundreds of spectators cheer from a nearby hillside.

Horseracing in the mountain kingdom of Lesotho is not like at Ascot or Longchamp, but it is still highly competitive, involves lots of gambling and is a major social occasion.   The course at Semonkong, in the centre of the landlocked nation, hosts races once a month in the winter, with the most prestigious days marking King Letsi III's birthday in July and independence day in October.   Before each race, the horses are paraded in front of a crowd that expertly assesses breeding, formation and fitness of runners with such exotic names as "4x4", "Cain" and "Jerusalem".   Then the gambling begins.

Most bets are head-to-head wagers over which of two selected horses will be faster, rather than the overall race winner.   "It's an entertainment but it's also our culture, and it refreshes the mind," Mohale Mpapa, 45, a leading racehorse owner and farmer, told AFP.   "It's important to me because I get money if my horse wins, and for the country it's very important because we teach kids how to ride horses.   "If you take care of someone, if you respect him, you make them a good jockey. It's the same with a horse, you need to treat it well."   The horses are either cross-breeds, thoroughbreds from neighbouring South Africa or local "Basotho" ponies, which are better suited to the terrain and climate, and are still used for everyday transport.

- The will to win -
Mpapa's current jockey is Modikeng Tladi, 16, who also works for him as a shepherd.   Tladi -- wearing bright earrings -- rises at dawn and looks after racehorses and sheep that all live in one small, corrugated-iron shed.   "I will be very excited if I win, and very proud, because I will have won a professional race in front of everyone," he said before a recent race meeting.

"In my first race, I was so scared, now I'm used to it. I feel comfortable and excited when I ride the horse, I want to win all the time."   Tladi takes the patchwork blanket off a horse called "Kodi-a-Malla" and walks him over the hills to the racecourse -- a difficult job as the animal is twice his size and full of energy.   When race time finally comes, tensions mount as Mpapa checks the small saddle and issues last-minute instructions to Tladi before helping him on board.

Without stalls, the horses line up chaotically and -- after several false starts -- set off at a furious pace when an official waves his white flag and just avoids being trampled.   Tladi only manages fourth, but the team is happy enough.   "During training my horse got injured, so I didn't train him very hard, and next time it will be better," said Mpapa, who owns 15 horses in total.

- Unique heritage -
The Lesotho races are growing as a cultural event, and have received government sponsorship to boost visitor numbers to a nation that boasts stunning landscapes and a unique heritage independent from surrounding South Africa.

The owners of the first four horses in each race win between $20 and $70, with more than $1,000 on offer during the day.   "I have loved horses since I was very young, and they're part of my business," said Jonathan Hales, 46, who owns the nearby Semonkong Lodge that caters for tourists.   "The future of the horses of Lesotho comes out of these races, where all the breeders and owners can analyse and look at them.   "Tourism is also connected to the horses, so we promote them and care for them -- it's all about fun, not about winning and losing."

Jockeys such as Tladi may not agree.   After riding in several races and making some small bets, he made about $60 during the day -- 10 days of normal pay.   While the owners of victorious horses celebrate with joyful dancing, the jockeys barely manage a smile as they quickly ride over to collect their cash.   For the spectators, many of them wearing traditional blankets, racing combines their passion for animals with a chance to test their luck and judgement.   "The horse I bet on just lost, but I will keep gambling, I just love horses," said 50-year-old Motseki Pakela.
Date: Sat, 13 Aug 2016 05:04:53 +0200
By Julie JAMMOT

Sephareng, Lesotho, Aug 13, 2016 (AFP) - For farmer Mohlakoane Molise, the view of the enormous Katse dam from his smallholding high in the mountains of Lesotho taunts him daily.   His country is suffering through its worst drought in 35 years, but the vast and vital water reserves remain out of reach, destined instead for export to neighbouring South Africa.   "I am very angry about that water, because it could benefit us, we could use it to water the crops when there is a drought. But that's not happening," the 65-year-old widower told AFP.

Kneeling in front of his round, thatch-roofed hut, he sorted through his maize, examining each grain, one-by-one.   The operation didn't take long. His total annual harvest filled just two large sacks, in place of the usual dozen.   According to the World Food Programme (WFP), the 2016 harvest for Lesotho's primary crop maize is estimated at 25,000 tonnes, a dramatic drop from last year's 78,000-tonne haul.

Instead, the mountainous kingdom -- entirely landlocked by South Africa -- must import food from its larger neighbour.   But it too has been hit by the drought after the El Nino weather phenomenon wreaked havoc on the region's rainfall patterns, and maize prices have sky-rocketed by 60 percent in the last year.   According to the United Nations, 40 million people across southern Africa risk malnutrition by next year's harvest.   "From September, we'll have nothing left and we'll struggle to buy maize from the shop," said Molise.   Below, the immense dark blue of the dam stood out in stark contrast to the bare, brown mountains.

- 'It's like a desert' -
The valley here was flooded in the nineties to make way for Katse. The deal: hydroelectricity for impoverished Lesotho in exchange for a reliable water supply to the bustling cities of Johannesburg and Pretoria.   "There were fields around the river before the dam was built, and there were trees, but they are covered by water," said Molise.   "Since the dam is here, it's difficult to get water. The crops are very poor, even the grazing land. It's like a desert."   In Sephareng, the village tap has run dry for months. Residents must instead make their way up the mountain -- a good half-hour walk along a rocky trail -- to a communal pump. There, a feeble trickle of water fills their buckets, while their cows and donkeys drink from the small puddles left behind by a vanishing stream.

For its part, Africa's second-largest dam is fulfilling its mandate, despite the drought.   "The level today is about 63.4 percent, which is quite low," said Tatuku Maseatile, Katse acting branch manager for the Lesotho Highlands Development Authority (LHDA).   "We are still able to meet our annual targets in terms of both generation and water transfer."   From his office high up on the soaring dam wall, he had an unparalleled view of the waters below.   "I do think people are benefiting from the dam," he said, ticking the projects off: a water supply system, construction jobs, two industrial fishing projects, schools.   "And roads in the mountains, tarred roads brought by the project -- another direct spin-off -- and a clinic built and transferred to the government."

- Disastrous consequences -
Along those tarred roads, women trudged uphill for hours to reach the clinic for the WFP's monthly food distribution.   "We give them four packs each," explained Mamakase Grace Sello, 21, a nutrition student interning with the WFP.   "It's for lactating or pregnant mothers, and infants below the age of two. But we know that often the whole family eats some, including the fathers, even if they should not. The nutrients are for the babies."   In a country where the overwhelming majority of families depend on their own crops for food and where nearly a quarter of the population is affected by AIDS, charities are predicting disastrous consequences by next year's harvest.

Earlier this year, the Lesotho government declared the drought a natural disaster.   "I've never seen a drought like this," said shepherd Ntoaesele Mashongoane, 32.   "This drought is really terrible, especially for the pregnant sheep. They don't have enough grass and there's no water."   His flock moved down the steep mountainsides to the water's edge for a drink -- a small consolation -- and the deep blue of the dam reflected the skies above, not a raindrop in sight.
Date: Thu, 1 Nov 2012 17:33:42 +0100 (MET)

MASERU, Lesotho, Nov 01, 2012 (AFP) - The Lesotho government fears it may not raise enough cash to avert a pending food crisis caused by two successive crop failures, the head of the country's disaster management authority said Thursday. "We are far from reaching the amount required to bail the country out of the food crisis it's facing, we may not even get half of that money and we strongly appeal for more donors to assist us," said Mats'eliso Mojaki. The tiny mountainous country is trying to raise 1.8 billion maloti, or around $200 million it believes is needed to avert disaster caused by unfavourable weather. "We are in a dire situation and can only appeal to the international community to assist."

Mojaki indicated that the country has not developed alternative plans in case they fail to get the entire amount. "At the present moment we do not have a plan B, but are however devising a long term prevention and adaptation plan. UNICEF Deputy Representative Naqib Safi described the situation as "dire". "More than two thirds of the country's population is facing a serious food crisis and we need assistance." Around 725,000 people out of a population of 1.8 million are said to be at serious risk this year and next. The kingdom relies on subsistence agriculture for income.
Date: Fri, 28 Sep 2012 15:15:28 +0200 (METDST)

GENEVA, Sept 28, 2012 (AFP) - More than 725,000 people face a food crisis in the tiny southern African nation of Lesotho after successive disastrous harvests cut production by 70 percent, the World Food Programme said Friday.   "Lesotho is facing the devastating effects of two successive crop failures due to drought and late rainfall," WFP spokeswoman Elisabeth Byrs told reporters in Geneva.

More than one third of the country's nearly two million people were at risk because of the poor harvests, Byrs said, describing the crop deficit as a "catastrophe for this little country".   Production of maize, the main staple food in Lesotho, has declined by 77 percent compared with last year, the food agency said.

Levels of other cereals such as sorghum and wheat were down by 80 percent and 52 percent respectively, meaning that the country will have less than 10 percent of its requirements for 2012/13, the WFP added in a statement.   Among those facing the food crisis, 230,000 people were "particularly vulnerable" to hunger, the agency said, especially the very poor, orphans and those with HIV/AIDS, an illness that affects 25 percent of the population.

Announcing an appeal for $38 million (29.3 million euros) in association with other humanitarian partners, the WFP said it aimed to provide life-saving help to 118,000 "of the most deprived".   It would also meet the needs "of all 725,000 food-insecure people" by boosting crop production and improving food security, health and nutrition.   The development follows Lesotho's declaration of an emergency food crisis on August 9, Byrs said.
More ...

French Polynesia

French Polynesia US Consular Information Sheet
August 13, 2008
COUNTRY DESCRIPTION: French Polynesia is a French overseas territory located in the middle of the Pacific Ocean.
It is made up of several groups of islands, the largest and mos
populated of which is Tahiti.
Tourist facilities are well developed and are available on the major islands.
For more information visit Tahiti’s web site at http://www.go-to-tahiti.com/.
ENTRY/EXIT REQUIREMENTS:
A passport valid for six months beyond duration of stay is required.
Visas are not required for stays of up to one month.
Extensions for up to three months may be granted locally by applying to the border police at the airport or to the Haut Commissionaire (The French High Commissioner).
The application for an extension must be presented with a fiscal stamp, which can be purchased in a post office.
For further information about entry requirements, travelers, particularly those planning to enter by sea, may contact the French Embassy at 4101 Reservoir Road NW, Washington, DC 20007, telephone 202-944-6200, fax 202-944-6212, or visit the Embassy of France's web site at http://www.info-france-usa.org/.
Additional information is available at GIE Tourisme, Fare Manihini, Boulevard Pomare, B. P. 65, Papeete, French Polynesia, Telephone: (689) 50-57-00, Fax: (689) 43-66-19.

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

Up-to-date information on safety and security can also be obtained by calling 1-888-407-4747 toll- free in the U.S. and Canada, or for overseas 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:
Although French Polynesia has one of the lowest crime rates within France and its territories, petty crime, such as pick-pocketing and purse snatching, is occurring more frequently.
Visitors should secure valuables at all times.
Common sense precautions should be taken, especially at night, to avoid becoming a target of opportunity.
INFORMATION FOR VICTIMS OF CRIME:
The loss or theft abroad of a U.S. passport should be reported immediately to the local police and the U.S. Consular Agent in French Polynesia at (689) 42- 65-35.
If you are the victim of a crime while overseas, in addition to reporting to local police, please contact the U.S. Consular Agent in French Polynesia for assistance.
The U.S. Consular Agent can, for example, assist you to find appropriate medical care, contact family members or friends and explain how funds could be transferred.
Although the investigation and prosecution of the crime is solely the responsibility of local authorities, the Consular Agent can help you to understand the local criminal justice process and to find an attorney, if needed.
The local equivalent to the “911” emergency line in French Polynesia is 15 for ambulance and medical emergencies, 18 for fire, and 17 for police.

See our information on Victims of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION:
Medical treatment is generally good on the major islands, but is limited in more remote or less populated areas.
Patients with emergencies or serious illnesses are often referred to facilities on Tahiti for treatment.
In Papeete, the capital of Tahiti, two major hospitals and several private clinics provide 24 hour medical service.
Serious medical problems requiring hospitalization and/or medical evacuation to the United States can cost thousands of dollars.
Although some doctors and hospitals are beginning to accept credit card and U.S. insurance payments, others still expect immediate cash payment for health services.
Information on vaccinations and other health precautions, such as safe food and water precautions and insect bite protection, may be obtained from the Centers for Disease Control and Prevention’s hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747) or via the CDC’s web site at http://wwwn.cdc.gov/travel/default.aspx.
For information about outbreaks of infectious diseases abroad consult the World Health Organization’s (WHO) web site at http://www.who.int/en.
Further health information for travelers is available at http://www.who.int/ith/en.
The U.S. Department of State is unaware of any HIV/AIDS entry restirictions for visitors to or foreign residents of French Polynesia.

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 French Polynesia is provided for general reference only, and may not be totally accurate in a particular location or circumstance.
While most major roads are paved, many secondary roads are not.
In urban areas, traffic is brisk and all types of vehicles and pedestrians jockey for space on narrow streets.
Crosswalks are marked, and the law requires that motor vehicles stop for pedestrians; however, this is not always done.
Tourists should exercise caution when driving, particularly at night.
While extensive sections of the road circumnavigating Tahiti have streetlights, many streets do not.
Pedestrians walk along the sides of darkened roadways and sometimes cross in unmarked areas.
Bicycles and mopeds are frequently driven without headlights and taillights.
Tourists who rent bicycles or mopeds should be particularly attentive to their driving and the driving of others and not underestimate the danger, even on roads with little traffic.
Please refer to our Road Safety page for more information.

AVIATION SAFETY OVERSIGHT:
Civil aviation operations in French Polynesia fall under the jurisdiction of French authorities.
The U.S. Federal Aviation Administration (FAA) has assessed the Government of France’s Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for oversight forofof France’s air carrier operations.
For further information, travelers may visit the FAA’s web site at http://www.faa.gov/safety/programs_initiatives/oversight/iasa/.
SPECIAL CIRCUMSTANCES:
French customs authorities may enforce strict regulations concerning temporary importation into or export from French Polynesia of some items. It is advisable to contact the Embassy of France in Washington, D.C. or one of the French consulates in the United States for specific information regarding customs requirements.
The web site for French customs is http://www.finances.gouv.fr/.
Goods arriving on pleasure yachts must be declared at the first point of arrival in French Polynesia.
Arms, animals, alcohol, cigarettes, cameras, etc., must be included in this declaration.
Please see our Customs Information
U.S. citizens are encouraged to carry a copy of their U.S. passports with them at all times, so that if questioned by local officials, proof of identity and U.S. citizenship are readily available.
If detained, U.S. citizens are encouraged to request that the U.S. Consular Agent in French Polynesia be notified.
The cyclone season is November through April.
French Polynesia is located in an area of high seismic activity.
Although the probability of a major earthquake occurring during an individual trip is remote, earthquakes do occur.
General information regarding disaster preparedness is available via the Bureau of Consular Affairs’ web site, and from the U.S. Federal Emergency Management Agency (FEMA) home page at http://www.fema.gov/.
Some visitors to French Polynesia have reported problems using ATMs with certain kinds of credit and debit cards at ATM machines.
Visitors should verify that their cards can be used in French Polynesia.
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 those in the United States for similar offenses.
Persons violating French Polynesia’s laws, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession of, use of, or trafficking in illegal drugs in French Polynesia are severe, and convicted offenders can expect long jail sentences and heavy fines.
Engaging in sexual conduct with children or using or disseminating child pornography in a foreign country is a crime, prosecutable in the United States.
Please see our information on Criminal Penalties.

CHILDREN'S ISSUES:
For information on international adoption of children and international parental child abduction, see the Office of Children’s Issues web pages.
REGISTRATION / EMBASSY LOCATION:
There is no U.S. eEmbassy or cConsulate in French Polynesia.
However, there is a U.S. Consular Agent in French Polynesia who can provide assistance.
Americans living or traveling to French Polynesia are encouraged to register with the local U.S. Consular Agent or the U.S. Embassy in Suva, Fiji, or through the State Department’s travel registration web site and to obtain up-to-date information on travel and security within French Polynesia.
Americans without Internet access may register directly with the nearest eEmbassy or cConsulate.
By registering, American citizens make it easier for the eEmbassy or cConsulate to contact them in case of emergency.
To contact the U.S. Consular Agent, call (689) 42 65 35 or fax (689) 50 80 96 or e-mail usconsul@mail.pf.
The U.S. Consular Agency is located at Centre Tamanu Iti, 1er etage, Punaauia, B.P. 10765, 98711 Paea, Polynesie Francaise.
The U.S. Embassy in Suva, Fiji, which oversees the U.S.Consular Agent in French Polynesia, can also provide assistance for U.S. citizens.
It is located in the capital city of Suva at 31 Loftus Street, P.O. Box 218, telephone 679-331-4-466, fax 679-3302-267.
Information may also be obtained by visiting the Embassy’s home page at http://fiji.usembassy.gov/.
*

*

*
This replaces the Country Specific Information for French Polynesia dated February 219, 20087, to update sections on Entry/Exit Requirement, Safety and SecurityInformation for Victims of Crime and , Medical Facilities and Health Information, and Traffic Safety and Road Conditions.

Travel News Headlines WORLD NEWS

Date: Tue, 22 Oct 2019 06:44:29 +0200 (METDST)

Papeete, Oct 22, 2019 (AFP) - A French tourist has been seriously injured in a rare shark attack in the palm-fringed Pacific islands of Polynesia, emergency services said Tuesday.   The 35-year-old woman was swimming during a whale-watching trip on Monday in the French overseas territory when the oceanic whitetip shark tore into her chest and arms.   "Luckily for her, there were two nurses on the scene who could deliver first aid," firefighter Jean-Jacques Riveta told AFP.   The woman lost both hands and a lot of blood in the attack and was airlifted to hospital, he said.
19 Aug 2019

358 indigenous cases and 2 imported cases of dengue 2 have been confirmed since the beginning of 2019, according to the latest Health Watch bulletin. Tahiti is still in an epidemic phase: all communes are affected except Mahaena, Pueu, and Teahupoo. In the islands, Bora-Bora is in epidemic phase (at least 3 cases without epidemiological link): Vaitape and Faanui are affected. Moorea is in an epidemic phase: The communes of Afareaitu, Haapiti, and Paopao are affected. Six islands are in the alert phase: Nuku-Hiva (Taiohae), Fakarava, Raiatea, Rangiroa, Huahine, and Hiva Oa (Atuona). Since dengue type 2 has not circulated in the country since the year 2000, the population is poorly immunized, and the epidemic may be large. People under 20 or arriving in French Polynesia after 2000 are most at risk of becoming infected.

HealthMap/ProMED-mail map of French Polynesia:
- Taihiti (French Polynesia). 13 Apr 2019

DEN-2 confirmation of several autochthonous cases
Date: Mon 12 Feb 2018
Source: MVariety [edited]

The Department of Health Services is informing the public that its syndromic surveillance system shows that Yap has exceeded the threshold for diarrhoea cases. Diarrhoea can be caused by parasites such as amoeba or giardia, bacteria in food poisoning or contamination of water by viruses spread through unsanitary conditions.

Frequent and proper hand-washing is the best way to reduce the chance of spreading infections. Most of these infections are transmitted primarily through the fecal-oral route, either by consumption of faeces-contaminated food or water, or by direct person-to-person spread.
==================
[The aetiology of the gastroenteritis cases here is not stated.  Yap traditionally refers to an island located in the Caroline Islands of the western Pacific Ocean, a part of the Federated States of Micronesia. The name "Yap" in recent years has come to also refer to the state within the Federated States of Micronesia, inclusive of the Yap Main Islands and its various outer islands. The area can be found on a map at <https://en.wikipedia.org/wiki/Yap>. - ProMED Mod.LL]

[The mortality from cholera and most diarrhoeal illnesses is related to non-replacement of fluid and electrolytes from the diarrheal illness.

As stated in Lutwick LI, Preis J, Choi P: Cholera. In: Chronic illness and disability: the pediatric gastrointestinal tract. Greydanus DE, Atay O, Merrick J (eds). NY: Nova Bioscience, 2017 (in press), oral rehydration therapy can be life-saving in outbreaks of cholera and other forms of diarrhea:

"As reviewed by Richard Guerrant et al (1), it was in 1831 that cholera treatment could be accomplished by intravenous replacement, and, although this therapy could produce dramatic improvements, not until 1960 was it 1st recognized that there was no true destruction of the intestinal mucosa, and gastrointestinal rehydration therapy could be effective, and the therapy could dramatically reduce the intravenous needs for rehydration. Indeed, that this rehydration could be just as effective given orally as through an orogastric tube (for example, refs 2 and 3) made it possible for oral rehydration therapy (ORT) to be used in rural remote areas and truly impact on the morbidity and mortality of cholera. Indeed, Guerrant et al (1) highlights the use of oral glucose-salt packets in war-torn Bangladeshi refugees, which reduced the mortality rate from 30 percent to 3.6 percent (4) and quotes sources referring to ORT as "potentially the most important medical advance" of the 20th century. A variety of formulations of ORT exist, generally glucose or rice powder-based, which contain a variety of micronutrients, especially zinc (5).

"The assessment of the degree of volume loss in those with diarrhea to approximate volume and fluid losses can be found in ref 6 below. Those with severe hypovolaemia should be initially rehydrated intravenously with a fluid bolus of normal saline or Ringer's lactate solution of 20-30 ml/kg followed by 100 ml/kg in the 1st 4 hours and 100 ml/kg over the next 18 hours with regular reassessment. Those with lesser degrees of hypovolaemia can be rehydrated orally with a glucose or rice-derived formula with up to 4 liters in the 1st 4 hours, and those with no hypovolemia can be given ORT after each liquid stool with frequent reevaluation."

References
----------
1. Guerrant RL, Carneiro-Filho BA and Dillingham RA. Cholera, diarrhea, and oral rehydration therapy: triumph and indictment. Clin Infect Dis. 2003;37(3):398-405; available at
2. Gregorio GV, Gonzales ML, Dans LF and Martinez EG. Polymer-based oral rehydration solution for treating acute watery diarrhoea. Cochrane Database Syst Rev. 2009;(2):CD006519. doi: 10.1002/14651858.CD006519.pub2; available at
3. Gore SM, Fontaine O and Pierce NF. Impact of rice based oral rehydration solution on stool output and duration of diarrhea: meta-analysis of 13 clinical trials. BMJ 1992; 304(6822): 287-91; available at
4. Mahalanabis D, Choudhuri AB, Bagchi NG, et al. Oral fluid therapy of cholera among Bangladesh refugees. Johns Hopkins Med 1973; 132(4): 197-205; available at
5. Atia AN and Buchman AL. Oral rehydration solutions in non-cholera diarrhea: a review. Am J Gastroenterol. 2009; 104(10): 2596-604, doi: 10.1038/ajg.2009.329; abstract available at
6. WHO. The treatment of diarrhea, a manual for physicians and other senior health workers. 4th ed. 2005; available at
Date: Thu 30 Nov 2017
Source: Tahiti Infos [in French, trans. ProMED Corr.SB, edited]

Three cases of salmonellosis have been officially confirmed in Taravao in addition to the suspected case of a 4th person who died after having shown the symptoms of salmonella infection.

In a statement, released Thursday morning, 30 Nov 2017, the Ministry of Health said: "3 cases of salmonellosis confirmed and a suspected case, occurred in Taravao." These infections were reported to the Bureau de Veille Sanitaire between 20 and 28 Nov 2017. Above all, "one person has died," says this information, while indicating that "the main cause of death remains uncertain."

This person died in the night of 18 to 19 Nov 2017, a few hours after eating an egg dish (Kai Fan). His wife suffered a salmonella infection following this meal. One of 2 other confirmed cases of salmonellosis also consumed a Kai Fan. These takeaway meals were all purchased in the same Taravao business.

"We were not able to take samples from the deceased person," says Dr. Marine Giard. "It is thought that this person also had salmonellosis, but the doctor who observed the death did not remember that the person's episode of gastroenteritis was the direct cause of death. [He] died at home and did not call a doctor during the episode of illness. (...) He had the same symptoms as his wife, who was confirmed with salmonellosis," said the head of the Bureau de Veille Sanitaire, noting that "it is unusual for a healthy person, as it seemed to be his case, to die of salmonellosis, which is why this case is still very surprising. There was no autopsy."

The statement released on Thu 30 Nov 2017 said that an "inspection was conducted in this store by the Center for Hygiene and Public Health." Two types of analyses are in progress, the Ministry of Health said, stating that they are interested in the "remains of the food consumed" and "water withdrawals made due to recent rainy episodes." The sanitary survey is currently underway: "We will try to explore all leads; the dishes sold in this shop are being analyzed, water samples were taken; we are going back to the egg production chain and examining people who were preparing the dishes," says Dr. Giard.

Regarding the salmonellosis found in Taravao: "More than 10 days later, we have had no new cases declared; we have good reasons to assume that the infectious source has dried up," the Bureau de Veille Sanitaire stated.
=====================
[Certainly, undercooked eggs are a well-recognized vehicle for the transmission of salmonellosis. It is unclear whether salmonellosis was the proximate cause of death in the man mentioned, as most fatalities in salmonellosis are in the very young and very older and those with underlying diseases. It is not clear whether the decedent had any substantial risk factors for more severe disease.

Salmonellosis is often thought to be associated with cracked eggs or eggs dirty with faecal matter, a problem controlled by cleaning procedures implemented in the egg industry. It is clearly the case, however, that most of the salmonellosis outbreaks linked to eggs were associated with uncracked, disinfected grade A eggs, or foods containing such eggs. The undamaged eggs become contaminated during ovulation, especially with _S._ Enteritidis_, and thus were contaminated with the bacteria before the egg shell was formed. To avoid this, uncooked eggs should only be used as an ingredient if pasteurized. - ProMED Mod.LL]

[Tahiti, with a population of 183 645 residents in 2012, is the most populous island of French Polynesia, accounting for 68.5 percent of its total population; the small town of Taravao is situated on a short isthmus that connects the larger northwestern portion of Tahiti, where Papeete, the capital of French Polynesia is located, with the much smaller southeastern portion (<https://en.wikipedia.org/wiki/Tahiti>). - ProMED Mod.ML]

[HealthMap/ProMED-mail map:
Tahiti, French Polynesia: <http://healthmap.org/promed/p/22997>]
More ...

Chad

Chad - US Consular Information Sheet
March 29, 2007
COUNTRY DESCRIPTION: Chad is a developing country in north central Africa with one of the lowest per capita incomes in the world. Chad faces challenges in the areas of political stability and
conomic development. Years of war, drought, and lack of economic growth have severely damaged the country's institutions and its infrastructure. Facilities for tourism are limited. The capital is N'Djamena. French and Arabic are the primary languages. Read the Department of State Background Notes on Chad for additional information.
ENTRY/EXIT REQUIREMENTS: A valid passport and visa are required. Visitors must check in with the National Police and obtain a registration stamp within 72 hours of arrival. Further entry information may be obtained from the Embassy of the Republic of Chad, 2002 R St. N.W., Washington D.C. 20009, telephone (202) 462-4009. Overseas, inquiries should be made at the nearest Chadian embassy or consulate. Some travelers originating in countries with no Chadian embassy or consulate can arrange for airport entry visas. This process is generally limited to business or official travelers, and arrangements must be made by the traveler’s local contact in Chad several days in advance of arrival. The U.S. Embassy is not in a position to assist private U.S. citizens with their visa application for travel to Chad.

See our Foreign Entry Requirements brochure for more information on Chad and other countries.

See Entry and Exit Requirements for more information pertaining to dual nationality and the prevention of international child abduction. Please refer to our Customs Information to learn more about customs regulations.

SAFETY AND SECURITY: See the Department of State’s Travel Warning for Chad.

For the latest security information, Americans traveling abroad should regularly monitor the Department’s website where the current Travel Warnings and Travel Alerts, including the Worldwide Caution, can be found.

Up-to-date information on safety and security can also be obtained by calling 1-888-407-4747 toll free in the U.S., 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: Americans and Europeans are perceived to be wealthy and certain precautions should be taken. Travelers are advised not to leave cash or valuables unsecured in their hotel room and not to wear expensive jewelry or show large amounts of cash. Travelers are also advised to dress modestly, not to walk outside after dark, and to lock their car doors. Petty crimes such as purse snatching, pick-pocketing and theft from vehicles do occur, particularly in areas frequented by expatriates. Violent crime is somewhat rare, but does occur. Burglary and vehicle thefts increase during times of political instability. Expatriate residences have been targeted for armed robbery, and some foreigners have been assaulted in the process. Travelers to northern Cameroon should contact the U.S. Embassy’s Regional Security Officer in N'Djamena prior to crossing the Chad/Cameroon border because of a high incidence of road attacks there.

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

See our information on Victims of Crime.
MEDICAL FACILITIES AND HEALTH INFORMATION: Medical facilities in Chad are extremely limited. Medicines are in short supply or unavailable, including many over-the-counter preparations sold in the United States. Travelers should carry any needed, properly labeled, medicines with them. In the event of major injury or illness, visitors generally will require medical evacuation.

There are two medical clinics in the capital of N’Djamena, International SOS and the Centre Medico-social de l’Ambassade de France. Advance membership is required to access these two clinics.

Malaria is a serious and sometimes fatal disease.
Plasmodium falciparum malaria, the type that predominates in Chad, is resistant to the antimalarial drug chloroquine.
Because travelers to Chad are at high risk for contracting malaria, the Centers for Disease Control and Prevention (CDC) advises that travelers should take one of the following antimalarial drugs: mefloquine (Lariam - TM), doxycycline, or atovaquone/proguanil (Malarone -TM).
Travelers who become ill with a fever or flu-like illness while traveling in a malaria-risk area and up to one year after returning home should seek prompt medical attention and tell the physician their travel history and what antimalarials they have been taking.
For additional information on malaria, including protective measures, visit the CDC Travelers’ Health web site at http://www.cdc.gov/travel/malinfo.htm.

Other widespread diseases in Chad include diarrhea and upper respiratory infections. AIDS is becoming an increasingly serious problem as infection rates have risen to alarming levels (up to 25 percent in high-risk groups). Meningitis outbreaks usually occur annually and several other diseases (cholera, diphtheria, chicken pox, typhoid) periodically appear.

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

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

TRAFFIC SAFETY AND ROAD CONDITIONS: While in a foreign country, U.S. citizens may encounter road conditions that differ significantly from those in the United States. The information below concerning Chad is provided for general reference only, and may not be totally accurate in a particular location or circumstance.

Roads are in poor condition and dangerous. In the capital city of N'Djamena, only the main roads are paved; the rest of the roads are either hard-packed dirt or looser dirt and sand. During the summer rainy season (mid-June to mid-September) many roads become impassable or are restricted by rain barriers, while during the drier season, clouds of dust rising from the roads reduce visibility.

Visitors should take great care while driving. Both paved and unpaved roads are poorly maintained, and often have large ruts and potholes. All drivers should adjust their speed accordingly. At night, streets are not lit; it is imperative to watch for pedestrians, bicyclists, motorcyclists, and livestock, as they may not become visible until they are in very close proximity.

Driving in Chad tends to be erratic both in cities and in rural areas. In cities, particularly N'Djamena, motorists share the roads with bicycles, motor scooters, pedestrians, and non-motorized wheelchairs. Lanes are not marked, and it is not uncommon for a normally two-lane thoroughfare to become a four-lane road during rush hours (generally 7:00 a.m.-9:00 a.m. and 3:00 p.m.-6:00 p.m. Monday-Thursday; 7:00 a.m.-9:00 a.m. and 11:00 a.m.-12:30 p.m. on Friday). Drivers are urged to be particularly observant at these times because motorists often attempt to overtake slower traffic by moving into oncoming lanes, usually at high speeds.There are only a few traffic lights in N'Djamena, and these are often out of service. Drivers yield to traffic on their right, particularly when entering the many traffic circles.

In rural areas, drivers should watch for livestock crossing the roads, and for large hawks that rest on the roads. These birds can be fearless, and cause damage by smashing into drivers' windshields; drivers may avoid this by slowing down when approaching the hawks, and allowing them sufficient time to fly away. Finally, drivers should be alert to older transport trucks traveling between cities, which do not always have functioning headlights.

No emergency services exist, so drivers should exercise extreme caution. Travelers should always wear seat belts. When traveling by car, be sure to carry a spare tire. Roadside service is limited to good Samaritans and children who will help push cars to the side or out of holes. When traveling outside the capital, it is imperative to carry sufficient quantities of drinking water. Drivers should ensure that their gas tanks are at least half-full at all times, as gas stations are not widely available. Gas may be purchased in an emergency in bottles from roadside stands, but it is generally of poor quality.

Travelers on roads in all areas of the country are subject to attack by armed bandits.
Please refer to our Road Safety page for more information.

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

SPECIAL CIRCUMSTANCES: All photography requires a government permit. Taking photos of military sites, official buildings, and airports is strictly prohibited, even with a permit. Such sites are not always clearly marked. Film and cameras may be confiscated, often by undercover police.

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

CHILDREN'S ISSUES: Embassy N’Djamena does not issue immigrant visas. Therefore, American citizens who adopt children in Chad are required to travel to the U.S. Embassy in Yaounde, Cameroon, or another Embassy for visa processing before return to the United States.

For information on international adoption of children and international parental child abduction, see the Office of Children’s Issues website.

REGISTRATION / EMBASSY LOCATION:
Americans living or traveling in Chad are encouraged to register with the U.S. Embassy in Chad through the State Department’s travel registration website , Americans withoutInternet access may register directly with the nearest U.S. Embassy or Consulate. By registering, American citizens make it easier for the Embassy to contact them in case of emergency. The U.S. Embassy in Chad is located in N'Djamena on Avenue Felix Eboue; mailing address is B.P. 413; telephone (235) 51-62-11, 51-70-09, 51-77-59, 51-90-52, 51-92-18 and 51-92-33, fax (235) 51-56-54.
* * *
This replaces the Country Specific Information dated July 10, 2006 with no updates.

Travel News Headlines WORLD NEWS

Date: Tue 18 Feb 2020
Source: CIDRAP (Center for Infectious Disease Research & Policy) News [edited]

The WHO's African regional office said that both Chad and the Central African Republic (CAR) are in the midst of measles outbreaks, with both countries reporting increasing case counts since [1 Jan 2020].

In Chad, 1276 cases, including 14 deaths have been reported since 1 Jan 2020, with 352 suspected measles cases and 4 deaths reported in the week ending on 9 Feb 2020.  "Most, 78%, of the investigated cases never received any vaccination against measles," the WHO said. "60% of the investigated cases were under 5 years of age while 19% were between 5 and 14 years and 14% were 15 years and above."

In CAR, a total of 1498 suspected measles cases, including 15 deaths, have been recorded since [1 Jan 2020]. The outbreak has been ongoing since early 2019. From 1 Jan 2019, through 9 Feb 2020, a total of 5724 suspected measles cases, including 83 deaths (case fatality rate, 1.45%) have been reported in 13 health districts.  Almost 3/4 of the cases (72%) are in children under the age of 5.
=======================
[HealthMap/ProMED-mail maps
Central African Republic: <http://healthmap.org/promed/p/6>]
Date: Thu 30 Jan 2020
Source: ReliefWeb [abridged, edited]

A provisional total of 53 cases of Guinea worm disease were reported in 2019, The Carter Center announced Wednesday [29 Jan 2020].  Intensified surveillance and reporting incentives in endemic areas in recent years have produced expected fluctuations in the small number of Guinea worm cases. When The Carter Center assumed leadership of the program in 1986, about 3.5 million human cases occurred annually in 21 countries in Africa and Asia.

The campaign against the disease, also called dracunculiasis, has taken on additional complexity in recent years with the rise of infections in animals, primarily dogs in Chad. The world's foremost experts and partner governments are responding vigorously.  "The time to eradicate Guinea worm is now," said Adam Weiss, director of The Carter Center Guinea Worm Eradication Program. "To prevent unnecessary suffering, the remaining endemic countries are going all out with every intervention available."

For example, in Chad, the national program intensified surveillance and broadly promoted cash incentives for reporting suspected infections. As a result, in 2019, rumors of human cases rose 137% and rumours of animal infections rose 268% compared with 2018. The program investigated 95% of those rumors within 24 hours. Additionally, the larvicide Abate was applied to water sources in 408 villages in 2019, compared with 72 villages the previous year [2018].

During 2019, 47 human cases of the disease were reported in Chad, 4 in South Sudan, one in Angola, and one in Cameroon that is believed to have been imported from Chad. No human cases have been reported for 2 years in Ethiopia or 4 years in Mali, but the 2 countries are still considered endemic. As for Guinea worm infections in animals (mainly dogs but also a handful of cats and baboons), 1973 were detected in Chad, 9 in Mali, 8 in Ethiopia, and one in Angola; none [were reported] in South Sudan or Cameroon. (All 2019 figures are provisional until officially confirmed in March 2020. Further details can be found in the latest issue of Guinea Worm Wrap-Up.)

Interventions to stop transmission include community-based health education, filtering all drinking water, keeping people and animals with emerging Guinea worms from entering water sources, and targeted use of Abate in stagnant water sources.

Only one human disease has ever been eradicated; that was smallpox, 40 years ago. For a disease to be declared eradicated, every country in the world must be certified free of human and animal infection, even those where transmission has never taken place. To date, 199 countries have been certified free of Guinea worm; only 7 have not.

Wednesday's [29 Jan 2020] announcement comes on the eve of the inaugural World Neglected Tropical Disease (NTD) Day, created to draw attention to a group of little-known conditions, including Guinea worm, that disproportionately affect the world's poorest and most marginalized people.

In late 2019, the World Health Organization and the NTD community agreed to adjust and accelerate elimination targets for NTDs to align with the United Nations' 2030 Sustainable Development Goals. The Carter Center, the WHO, and the independent International Commission for the Certification of Dracunculiasis Eradication all agreed that Guinea worm's goal could fit into the adjusted plan. As a result, the target date for eradication of Guinea worm disease -- including for the 1st time the certification process, which takes at least 3 years -- now is by 2030. The WHO is the only body that can certify disease eradication.

"The Carter Center's goal is to end the human suffering caused by the disease as soon as possible, and the revised target of 2030 would include that goal," said Dr. Donald R. Hopkins, a veteran of the campaign to eradicate smallpox who is The Carter Center's special advisor for Guinea worm eradication.

"The fight against Neglected Tropical Diseases is long and difficult, but so is every battle worth fighting," added Dr. Mwelecele Ntuli Malecela, director of the WHO Department of Neglected Tropical Diseases. "Victory cannot be achieved merely by dreaming. The way to victory is marked by honest goals, good science, and focused work. We are bringing all of these to bear against Guinea worm disease."

The Carter Center Board of Trustees announced in September 2019 a USD 40 million fundraising campaign, including a USD 20 million Carter Center Challenge Fund, toward the eradication of Guinea worm disease. The Challenge Fund will match donations up to USD 10 million per year in 2019 and 2020, for a total of USD 20 million in matching funds.

"Our successes are a testament to the fierce persistence of people on the front lines and our committed partners," Jason Carter, chair of The Carter Center Board of Trustees, said. "We are grateful for every ally standing with us as we seek to eradicate the 1st parasitic disease in human history, and we are so committed that we are investing our own endowment funds into the effort."

Considered a neglected tropical disease, Guinea worm disease (dracunculiasis) is usually contracted when people consume water contaminated with tiny crustaceans (copepods) that carry Guinea worm larvae. The larvae mature and mate inside the patient's body. The male worm dies. After about a year, a meter-long female worm emerges slowly through a painful blister in the skin. Contact with water stimulates the emerging worm to release its larvae into the water and start the process all over again. Guinea worm disease incapacitates people for weeks or months, reducing individuals' ability to care for themselves, work, grow food for their families, or attend school.

Without a vaccine or medicine, the ancient parasitic disease is being wiped out mainly through community-based interventions to educate people and change their behavior, such as teaching them to filter all drinking water and preventing contamination by keeping patients from entering water sources.
==========================
[This is a timely update from The Carter Center (<https://www.cartercenter.org/health/guinea_worm/index.html>), which has been leading efforts in Guinea worm eradication for many years. The review discusses in detail the challenges and the results. The finding of a reservoir in dogs has complicated the efforts in Chad. - ProMED Mod.EP]

[HealthMap/ProMED map available at:
Date: Wed, 14 Aug 2019 15:14:41 +0200 (METDST)

N'Djamena, Aug 14, 2019 (AFP) - A female suicide bomber killed six people after blowing herself up in western Chad early Wednesday, a senior army officer said, in an attack attributed to Nigeria's Boko Haram jihadists.   "Six people died, including a soldier," in the attack in Kaiga-Kindjiria district, said the source, speaking on condition of anonymity.    A number of people were also injured, the officer said, without giving figures.   A provincial security official said a woman wearing an explosives-laden belt "blew herself up near the home of a traditional chief".   Four guards as well as a soldier were among the dead, and five people were wounded, the official said.   The death toll of six was confirmed by Chadian army spokesman Colonel Azem Bermandoa, and by a local NGO.   There was no immediate claim of responsibility.

Kaiga-Kindjiria lies in Lac province, which abuts the vast Lake Chad -- a region shared by Chad, Cameroon, Niger and Nigeria.   Boko Haram launched an insurgency in northeastern Nigeria a decade ago that has since spilled over into neighbouring countries.   It has carried out at least 10 cross-border attacks in Chad since 2018, mainly targeting army positions.   In March, 23 troops were killed when their forward position on the northeastern side of the lake came under attack.   In June, 11 soldiers were killed and six were wounded in clashes at Tchoukoutalia, according to the authorities, who said 26 jihadists were killed.   Boko Haram's campaign has left some 27,000 people dead and displaced around two million in Nigeria alone, according to some estimates.   In 2015, the four Lake Chad countries, together with Benin, set up a combined force to fight Boko Haram with the help of local groups of armed citizens.
Date: Sun, 26 May 2019 12:12:06 +0200

N'Djamena, May 26, 2019 (AFP) - Four Chadian soldiers and a television reporter were killed when their vehicle hit a mine on a road in eastern Chad, security sources said Sunday.   The victims were headed towards an army position that had been attacked by elements of the Boko Haram Islamist group overnight Friday, the sources said.   "This delegation of the Chadian army was headed to Ngounboua (on Lake Chad), where elements of Boko Haram had attacked an army position overnight, illing at least one on our side," a security source told AFP. 

The source said 23 Boko Haram fighters were killed, confirming a toll given by Chadian army spokesman Azem Bermandoa on national television.   Dimouya Soiapebe, the head of Lake Chad Province, said soldiers and a journalist for the national broadcaster had gone to the scene to "raise the morale of the troops" when the bomb went off.   "Terrorists often lay explosive devices on the roads leading to positions they have attacked," Soiapebe said.

In March, 23 soldiers were killed in the Lake Chad region in the deadliest attack yet on the Chadian army by Boko Haram, which launched an insurgency in Nigeria a decade ago.   The revolt has claimed more than 27,000 lives and uprooted some 1.8 million people.
Date: Thu, 11 Apr 2019 05:29:58 +0200
By Amaury HAUCHARD

Adré, Chad, April 11, 2019 (AFP) - Dinar Tchere is fighting time and the sun, and he fears he may be losing.   This morning, the health worker is expected in a remote village of eastern Chad, where he will administer the measles, mumps and rubella vaccine to poor children.   But he's behind schedule -- and there is limited time before his enemy, the blistering Sahelian heat, will destroy his precious drugs.  Tchere takes his gear and the ice-packed cooler that shields the vaccines, puts them in an NGO pickup and heads out from his clinic in Hilouta, in Ouaddai province, on the dusty untarmacked road.

Twenty minutes later he is in Agang, a village of 400 people, and there, another private dread has turned to reality. No-one is there to be vaccinated.   "It's just what I feared -- most of the mums have gone off to the market to do their shopping," groans Tchere, a stocky, shaven-headed man in his fifties.    There is nothing to do but hope that the mothers and their children will return. He stretches out a mat on the soil, under a mango tree.   His luck starts to turn. One by one, mothers with their children make their way to the spot, and soon there is no room on his mat for youngsters waiting for their jab.

- Cold chain -
Always worried by the heat -- the thermometer now reads 40 degrees Celsius (104 degrees Fahrenheit) -- Tchere dips his finger into the cooler to check that the ice has not melted, and starts the vaccination.   "Our biggest headache is ensuring that the vaccines are always kept cold," says Tchere, who heads one of 21 health centres in the region.   "Since the troubles of 2007, we no longer have a solar panel or fridge."   The "troubles" refer to years-long violence by armed groups on the tense border between Sudan and Chad.   Hilouta, which lies less than two kilometres (one mile) from the border, became a combat zone.   With no power, how does Tchere keep his vaccines cool?   "I stock them in Sudan, in a clinic on the other side of the border. They've got a fridge," he explains.

But there's a problem: because of security concerns, Sudan refuses to let people cross the border by motorbike -- Tchere's only form of transport when he cannot use the pickup.   So on the eve of every immunisation session, Tchere walks into Sudan, carrying his cooler, fills it up with vaccines, and walks back into Chad.   His clinic administers to about 60 villages. He says e does four vaccination sessions per month -- two in the clinic, and two in the villages.   Most often, he does the outside trips on his motorbike, always taking care never to take the same route back home, in order to avoid holdups.

The state no longer pays the running costs of his health centre -- a French NGO, Premiere Urgence Internationale (PUI), has stepped in, using financial help provided by the European Union.   In Arkoum, about 50 kilometres (30 miles) from Hilouta, Felix Djembonoudji, a nurse who runs the health centre, says that the stockpile of vaccines -- held in the district's main town of Adre, several hours away by road -- has run out.   "The people (in Adre) sometimes don't receive any -- we've been without MMR (vaccine) for five days," he says.

- Measles threat -
Measles is often dismissed by so-called anti-vaxxers who oppose immunisation as a disease of the past or non-threatening.   Experts say that it is neither -- measles is on the comeback trail.    And out of every 20 children who catch measles, as many as one will suffer from pneumonia, according to the US Centers of Disease Control (CDC). Blindness, encephalitis and severe diarrhoea are also serious complications.   Only one child in five in Chad is fully vaccinated against measles, according to a 2017 survey.   "Measles can also cause malnutrition in non-vaccinated children, which in itself is a cause of premature death," said PUI's mission chief in Chad, Fabienne Mially.

According to UN figures, more than one child in 10 in Chad will die before their fifth birthday.   In Agang, the measles vaccination session comes to an end, and Tchere is packing up his gear when a horse appears on the horizon, its hooves kicking up dust, bearing a man and his six-month-old baby.   The infant needs his second MMR vaccine. "It's important!" pleads the father. The child will get his jab.   Tchere returns to his clinic in Hilouta. There is no water or electricity. Two local people are awaiting him in the gloom, desperate for a medical consultation.    "The working day is long," he sighs, as he welcomes them in.
More ...

World Travel News Headlines

Date: Thu, 20 Feb 2020 16:20:39 +0100 (MET)

Damascus, Feb 20, 2020 (AFP) - A bomb explosion wounded two people in Damascus Thursday, the state news agency reported, the latest of several such attacks in the Syrian capital.   "An explosive device planted on a pickup truck went off in the Marjeh area" in central Damascus, SANA said, adding that two civilians were wounded by the blast.

The Syrian Observatory for Human Rights war monitor said the device was a "sticky bomb" planted on a military vehicle, although it was not immediately clear what the target was.   There was no immediate claim of responsibility for the blast, nor for a similar explosion that wounded five people in another neighbourhood of Damascus on Tuesday. The Syrian capital was routinely targeted by major car bomb attacks in the course of the nine-year-old conflict but blasts have been less frequent since regime forces reclaimed full control of the Damascus region in 2018.
Date: Thu, 20 Feb 2020 15:40:35 +0100 (MET)
By Laurent Thomet, with Miwa Suzuki in Tokyo

Beijing, Feb 20, 2020 (AFP) - China on Thursday touted a big drop in new virus infections as proof its epidemic control efforts are working, but the toll grew abroad with deaths in Japan and South Korea.   Fatalities in China hit 2,118 as 114 more people died, but health officials reported the lowest number of new cases in nearly a month, including in hardest-hit Hubei province.

More than 74,000 people have been infected by the new coronavirus in China, and hundreds more in over 25 countries.   The number of deaths outside mainland China climbed to 11.   Japan's toll rose to three as a man and a woman in their 80s who had been aboard a quarantined cruise ship died, while fears there mounted about other passengers who disembarked the Diamond Princess after testing negative.

South Korea reported its first death, and the number of infections in the country nearly doubled Thursday to 104 -- including 15 at a hospital in Cheongdo county.   The mayor of Daegu -- South Korea's fourth-largest, with 2.5 million people -- advised residents to stay indoors, while commanders at a major US military base in the area restricted access.   Iran reported two deaths on Wednesday, the first in the Middle East. Deaths have previously been confirmed in France, the Philippines, Taiwan and Hong Kong.

Chinese officials say their drastic containment efforts, including quarantining tens of millions of people in Hubei and restricting movements in cities nationwide, have started to pay off.   "Results show that our control efforts are working," Foreign Minister Wang Yi said at a special meeting on the virus with Southeast Asian counterparts in Laos, citing the latest data.   Wang said the situation was "significantly improving" in Hubei and Wuhan, but an official in a central government team dealing with the epidemic said it was still "very severe".

- 'Not turning point' -
Although more than 600 new infections were reported in Hubei's capital Wuhan, it was the lowest daily tally since late January and well down from the 1,749 new cases the day before.   The national figure has now fallen for three straight days.   Chinese authorities placed the city of 11 million under quarantine on January 23 and quickly locked down the rest of the province in the days that followed.

Wuhan authorities this week carried out a three-day, door-to-door check on residents, with the local Communist Party chief warning that officials would be "held accountable" if any infections were missed.   Cities far from the epicentre have limited the number of people who can leave their homes for groceries, while rural villages have sealed off access to outsiders.   Richard Brennan, a World Health Organization official, said in Cairo that China was making "tremendous progress" and "trends are very encouraging, but we are not at a turning point yet".

- 'Chaotic' cruise quarantine -
While China has boasted progress in its fight against the COVID-19 epidemic, Japan's government has been criticised for the quarantine measures it placed on the Diamond Princess.   The huge vessel moored in Yokohama is easily the biggest coronavirus cluster outside the Chinese epicentre, with 634 cases confirmed among passengers and crew.   Another 13 people on board the ship were diagnosed with the virus Thursday, Japan's health ministry said.   Still, passengers were disembarking after negative tests and having completed a 14-day quarantine period -- packing into yellow buses and leaving for stations and airports.

Questions were asked over the wisdom of allowing them to mingle in Japan's crowded cities.   "Is it really safe to get off?" screamed a headline in the Nikkan Sports tabloid.   The paper quoted one passenger who said he was tested on February 15, but only left four days later.   "I thought I could be infected during the four days. I thought 'Is it really OK'?"

A specialist in infectious diseases at Kobe University slammed as "completely chaotic" the quarantine procedures on board in rare criticism from a Japanese academic.   "The cruise ship was completely inadequate in terms of infection control," said Kentaro Iwata in videos he has since deleted.

South Korea, meanwhile, announced 51 new cases, with more than 40 in a cluster centred on the Shincheonji Church of Jesus, an entity often accused of being a cult.  The infections apparently came from a 61-year-old woman who first developed a fever on February 10 and attended at least four services before being diagnosed.   Local media said she had twice refused to be tested for the coronavirus on the grounds she had not recently travelled abroad.   Authorities were investigating whether she might have visited the hospital where a long-term patient contracted the virus and later died.

Some 15 other patients have now been found to have the virus.   Shincheonji claims its founder, Lee Man-hee, has donned the mantle of Jesus Christ and will take 144,000 people with him to heaven on the day of judgement.   A man in his 60s tested positive for the coronavirus after dying Wednesday following symptoms of pneumonia, South Korean authorities said.
Date: Thu, 20 Feb 2020 10:28:16 +0100 (MET)

Lagos, Feb 20, 2020 (AFP) - An outbreak of Lassa in Nigeria has killed 103 people this year, health authorities said, as the first confirmed case was reported in the economic hub Lagos.    "Cumulatively from week 1 to week 07, 2020, 103 deaths have been reported with a case fatality rate of 17.6%," said the Nigeria Centre for Disease Control (NCDC) in its latest statistics on the virus released on Wednesday.    The overall number of confirmed cases rose by 115 last week to a total of 586 across the country.

Separately, health authorities in Lagos, Nigeria's most populous city with 20 million inhabitants, said an infected person was diagnosed there on February 17 and being treated in isolation in hospital.    "Sixty-three people that may have been in contact with the patient and who may have been infected in the process have been identified and are being monitored," the state government wrote on Twitter on Thursday.

Endemic to Nigeria, Lassa fever belongs to the same family as the Ebola and Marburg viruses, but is much less deadly.   The disease is spread by contact with rat faeces or urine or the bodily fluids of an infected person.    The majority of those infected do not show symptoms but the disease can go on to cause severe bleeding and organ failure in about 20 percent of cases.

An outbreak of Lassa fever killed some 170 people around Nigeria last year.     The number of cases usually climbs around the start of the year linked to the dry season.   While the overall number of confirmed cases and deaths is up this year on the same period in 2019, the mortality rate is lower.    Twenty health workers across the country have been confirmed as contracting the disease so far in 2020.    The virus takes its name from the town of Lassa in northern Nigeria, where it was first identified in 1969.
Date: Thu, 20 Feb 2020 09:58:17 +0100 (MET)
By Nicolas DELAUNAY

Les Mamelles, Seychelles, Feb 20, 2020 (AFP) - On a plain suburban street in Seychelles, far from the idyllic coastline and luxury resorts pampering honeymooners and paradise-seekers, heroin addicts queue anxiously for their daily dose of methadone.   It is a scene few outsiders would associate with the tropical nirvana adrift in the Indian Ocean, and one rarely, if ever, glimpsed by tourists as they shuttle from the airport to five-star luxury on white-sand beaches.

But life for many Seychellois is far from picture perfect: the tiny archipelago nation is battling what officials say are the world's highest rates of heroin addiction.   Nearly 5,000 people are hooked, government figures show, equivalent to nearly 0 percent of the national workforce -- a statistic that has startled the government into action.

In comparison, 0.4 percent of the global population consumed opioids in 2016, half of them in Asia, according to a United Nations report that puts Seychelles among the top consumers alongside producing countries such as Afghanistan.   The Seychelles' heroin boom, which took off over the past decade, gripped young and old alike and cut across class lines.   Among those queueing in the town of Les Mamelles for methadone -- a substitute narcotic used to wean users off heroin -- are parents with young children, an old man leaning on a cane and a taxi driver between shifts.

Graham Moustache, a 29-year-old father of two, described how the arrival of affordable and high-quality heroin in Seychelles swept up his entire family.   "I have four brothers and two sisters, and we have all been heroin addicts at one point," he told AFP, tracing his fingers over the needle scars on his arms.   "I've been to prison twice," he said, adding his mother had turned him in as "she didn't know what to do any more".   "Sometimes, I didn't have enough to eat and I had to choose between eating and buying heroin. I chose heroin."

- Soaring addiction -
The rise of new trafficking routes through East Africa in the late 2000s, coupled with porous borders and relatively high purchasing power among Seychellois, flooded the paradisal islands with heroin.   The average salary in the archipelago is $420 (390) -- high compared to other African nations.   The World Bank considers the Seychelles the only high-income country on the continent, thanks to the growing tourism industry.    But around 40 percent of the population still lives in poverty.

By 2011, around 1,200 people were addicted, prompting a punitive crackdown.   "We did not make a difference between the victim and the trafficker," said Patrick Herminie, director of the state-run Agency for Drug Abuse Prevention and Rehabilitation (APDAR).   By 2017, addiction had risen four-fold, placing Seychelles among the world's most drug-dependent nations.   The government, realising its war on drugs had failed, changed tack and declared a public health emergency.   "The magnitude of the problem is simply because we reacted a bit late," Herminie said.

Money has poured into combating the scourge, with state funds for drug prevention and rehabilitation programmes soaring to 75 million Seychelles rupees ($5.5 million) in 2020 -- almost 10 times the 2016 budget.    APDAR, a specialist drug agency created in 2017 to tackle the problem, employs four times as many staff as the body that preceded it.   A state-run methadone programme has reached 2,500 people, with medical follow-ups helping to track their progress.    But the free availability of methadone has also prompted drug dealers to lower their prices.

Mobile clinics drive around offering methadone to addicts and providing free health checks and advice.    "I've been clean for more than a year. I found a job as a fisherman, and I can see my two kids," said Moustache proudly, as he queued at the white methadone van staffed with healthcare workers.   Others have struggled to stay the course.   "Methadone helps me a lot, but it's difficult not to take heroin at all," said Gisele Moumou, an emaciated 32-year-old addict, drawing ragged breaths and sweating as she waits for her small cup of methadone.

- Stopping the scourge  -
Schoolchildren are being taught about the damage done by drugs through awareness campaigns and billboards in classrooms.    But there is much work to be done, especially among children from families affected by drug use, says Noellie Gonthier from CARE, a local harm-reduction charity.   "Sometimes, four- or five-year-olds at school mimic injecting heroin," she said.   "Our challenge is to make them understand that what they consider normal -- because of their family context -- actually isn't at all."   On Mahe, a small, mountainous island with lush vegetation, most of the population lives near the water. Life is quiet here, without traffic, and the streets are mostly clean.

Poverty is largely hidden, concentrated in a few neighbourhoods behind faded walls or in the hills.   So why do so many Seychellois take drugs? The authorities admit they haven't quite figured it out, but say it appears that while poverty does not quite allow people to live well, it allows them enough money to buy drugs to forget their woes.   "The root of the cause, we're still working on it," said Herminie.   Early studies show that health and social problems associated with heroin use have declined since the government switched its response from punishment to prevention, officials say.

Crime has nearly halved and annual cases of new hepatitis C infections have fallen 60 percent.    Youth unemployment, meanwhile, has shrunk from 6.5 percent to 2.1 percent in recent years.   One recovering addict, a taxi driver who did not want to be named, offered a bleak assessment as he waited for his daily methadone in an empty car park in Les Mamelles.    "We're a small island in the middle of the ocean. What else is there to do here?" he said.
Date: Wed, 19 Feb 2020 16:12:54 +0100 (MET)
By Michael O'HAGAN

Otuke, Uganda, Feb 19, 2020 (AFP) - Under a warm morning sun scores of weary soldiers stare as millions of yellow locusts rise into the northern Ugandan sky, despite hours spent spraying vegetation with chemicals in an attempt to kill them.   From the tops of shea trees, fields of pea plants and tall grass savanna, the insects rise in a hypnotic murmuration, disappearing quickly to wreak devastation elsewhere.   The soldiers and agricultural officers will now have to hunt the elusive fast-moving swarms -- a sign of the challenge facing nine east African countries now battling huge swarms of hungry desert locusts.

They arrived in conflict-torn South Sudan this week, with concerns already high of a humanitarian crisis in a region where 12 million are going hungry, according to the UN's Food and Agriculture Organization (FAO).    "One swarm of 40 to 80 million can consume food" for over 35,000 people in a day, Priya Gujadhur, a senior FAO official in Uganda, told AFP.

In Atira -- a remote village of grass-thatched huts in northern Uganda -- some 160 soldiers wearing protective plastic overalls, masks and goggles sprayed trees and plants with pesticide from before dawn in a bid to kill the resting insects.   But even after hours of work they were mostly able to reach only lower parts of the vegetation.   Major General Kavuma sits in the shade of a Neem Tree alongside civilian officials as locusts sprayed with pesticide earlier that morning fall around them, convulsing as they die.   An intense chemical smell hangs in the air.

- 'They surrounded me' -
Zakaria Sagal, a 73-year-old subsistence farmer was weeding his field in Lopei village some 120 kilometres (75 miles) away, preparing to plant maize and sorghum, when without warning a swarm of locusts descended around him.   "From this side and this side and this side, they surrounded me," Sagal said, waving his arms in every direction.    "We have not yet planted our crops but if they return at harvest time they will destroy everything. We are not at all prepared."

East Africa's regional expert group, the Climate Prediction and Applications Centre (ICPAC), warned Tuesday that eggs laid across the migratory path will hatch in the next two months, and will continue breeding as the rainy season arrives in the region.   This will coincide with the main cropping season and could cause "significant crop losses... and could potentially worsen the food security situation", ICPAC said in a statement.

- 'Panic mode' -
Since 2018 a long period of dry weather followed by a series of cyclones that dumped water on the region created "excessively ideal conditions" for locusts to breed, says Gujadhur.    Nevertheless, governments in East Africa have been caught off guard and are currently in "panic mode" Gujadhur said.   The locusts arrived in South Sudan this week after hitting Ethiopia, Somalia, Kenya, Djibouti, Eritrea, Tanzania, Sudan and Uganda.   Desert locusts take over on a dizzying scale.

One swarm in Kenya reached around 2,400 square kilometres (about 930 square miles) -- an area almost the size of Moscow -- meaning it could contain up to 200 billion locusts.   "A swarm that size can consume food for 85 million people per day," said Gujadhur.   Ugandan authorities are aware that subsequent waves of locusts may pose problems in the weeks to come, but in the meantime they are attempting to control the current generation.

Gujadhur is quick to praise the "quite strong and very quick" response from the Ugandan government but is concerned that while the army can provide valuable personnel, a military-led response may not be as effective as is necessary.    "It needs to be the scientists and (agriculture officials) who take the lead about where the control operations need to be and how and when and what time," she said.

- 'They eat anything green' -
The soldiers have been working non-stop for two days, criss-crossing the plains on the few navigable roads, trying to keep up with the unpredictable swarms.    Major General Kavuma recognises that the biggest threat is from the eggs which are yet to hatch but is confident the army will be able to control this enemy.   "We have the chemicals to spray them, all we need is to map the places they have been landing and sleeping," he said.   "In two weeks time we will come back and by that time they will have hatched and that will be the time to destroy them by praying."

Back in Lopei village, Elizabeth Namoe, 40, a shopkeeper in nearby Moroto had been visiting family when the swarm arrived.   "When the locusts settle they eat anything green, the animals will die because they have nothing to feed on, then even the people (will suffer)," she said.   "The children will be affected by hunger and famine since all life comes from all that is green. I fear so much."
Date: Wed, 19 Feb 2020 12:55:06 +0100 (MET)

Beijing, Feb 19, 2020 (AFP) - China's President Xi Jinping called Wednesday for greater protection of medical staff fighting the new coronavirus after the deaths of prominent doctors sparked national anger at the government's handling of the outbreak.   At least seven medical workers have died from the virus, while 1,716 have been confirmed as infected, most at the epicentre of the epidemic in central Hubei province where hospitals have dealt with a huge influx of patients.

Staff have faced shortages of masks and protective bodysuits, with some even wearing makeshift suits and continuing to work despite showing respiratory symptoms, health workers have told AFP.   Xi said China must "strengthen efforts to relieve the stress of medical workers, provide them with daily necessities, arrange time for their rest and give them encouragement", the official Xinhua news agency reported.   Liu Zhiming, the director of Wuchang Hospital in Hubei's capital Wuhan, died Tuesday, more than a week after the death of whistleblowing ophthalmologist Li Wenliang in the same city prompted nationwide mourning and calls for political reforms.

- 'Majestic spirit' -
A paper published by China's Center for Disease Control and Prevention said an additional 1,300 health workers may have been infected but have yet to receive a diagnosis.   Xi said China must ensure medical teams in Hubei and Wuhan "carry out work in a safe, orderly, coordinated, effective and swift manner", Xinhua reported.   The deaths of frontline medical workers "reflected doctors' humane and majestic spirit", Xi said.   The death toll from the virus jumped past 2,000 on Wednesday, while 74,185 cases of infection have been confirmed in mainland China.
Date: Wed, 19 Feb 2020 12:19:59 +0100 (MET)

Tehran, Feb 19, 2020 (AFP) - Two people in Iran tested positive Wednesday for the deadly new coronavirus, the health ministry said, in the Islamic republic's first cases of the disease.   Kianoush Jahanpour, a ministry spokesman, said the cases were detected in the holy city of Qom, south of the Iranian capital.   "In the past two days, some suspect cases of the new coronavirus were observed in Qom city," he said, quoted by state news agency IRNA.

"Teams were dispatched after receiving the reports, and based on the existing protocols the suspect cases were isolated and tested," said Jahanpour.   "Out of the samples sent, a laboratory tested two of them as positive for coronavirus just minutes ago and some of the other samples were type B influenza."

The health ministry spokesman said additional tests were being done on the two cases and final results would be announced "as soon as possible".   The new coronavirus epidemic has killed more than 2,000 people in China and infected more than 74,000. It has spread to at least two dozen countries.   The United Arab Emirates was the first country in the Middle East to report cases of coronavirus last month.
Date: Tue 18 Feb 2020
Source: CIDRAP (Center for Infectious Disease Research & Policy) News [edited]

The WHO's African regional office said that both Chad and the Central African Republic (CAR) are in the midst of measles outbreaks, with both countries reporting increasing case counts since [1 Jan 2020].

In Chad, 1276 cases, including 14 deaths have been reported since 1 Jan 2020, with 352 suspected measles cases and 4 deaths reported in the week ending on 9 Feb 2020.  "Most, 78%, of the investigated cases never received any vaccination against measles," the WHO said. "60% of the investigated cases were under 5 years of age while 19% were between 5 and 14 years and 14% were 15 years and above."

In CAR, a total of 1498 suspected measles cases, including 15 deaths, have been recorded since [1 Jan 2020]. The outbreak has been ongoing since early 2019. From 1 Jan 2019, through 9 Feb 2020, a total of 5724 suspected measles cases, including 83 deaths (case fatality rate, 1.45%) have been reported in 13 health districts.  Almost 3/4 of the cases (72%) are in children under the age of 5.
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[HealthMap/ProMED-mail maps
Central African Republic: <http://healthmap.org/promed/p/6>]
Date: Wed 19 Feb 2020
Source: Circular/News, Veterinary Services, Israel's Ministry of Agriculture [in Hebrew, trans. Mod.AS, edited]

Rabies, Case No. 6 for 2020, dog, Ramot Naftali, Upper Galilee. Reference: Kimron Vet Institute [KVI] Laboratory Test No. A00373420, dated 19 Feb 2020
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On 17 Feb 2020, a dead dog was brought for examination to the KVI [at Beit-Dagan]. The dog died while being transported to a rabies observation kennel since, as reported, it had attacked grazing cattle and attempted to attack people.  It was also reported that the dog had bitten itself. The tested animal has been diagnosed rabies positive.  [Byline: Dr. Avi Wasserman Head, Field Veterinary Services (acting)]
====================
[The above and 5 earlier rabies cases in Israel since 1 Jan 2020 are located within a small region along the Lebanese border, facing Lebanon's governorate A-Nabatieh. See the rabies map (2020) at <https://moag.maps.arcgis.com/apps/webappviewer/index.html?id=a6d8aae5cbc04c958d5efefd2724318f>.

The 2019 map, presenting a total of 17 cases, is available at

The 6 cases during 2020 are: 3 jackals, 2 dogs, 1 cow. Most likely, rabies is currently circulating within the Lebanese side of the border.

It would be interesting to note whether the rabid dog was owned and, in case affirmative, whether and when this dog was last vaccinated against rabies, as prescribed by law. Israel's owned dogs are included in the national dog registry, currently counting more than 400,000 dogs. - ProMED Mod.AS]
Date: Tue 18 Feb 2020
Source: Qatari Ministry of Public Health [edited]

The Ministry of Public Health (MOPH) declared that a case of Middle East respiratory syndrome (MERS) has been confirmed. The case is a male citizen aged 65 years who has been suffering from several chronic diseases. The patient has been admitted to the hospital to receive the necessary medical care in accordance with the national protocol to deal with confirmed or suspected cases of the disease.

The Ministry of Public Health, in cooperation with the Ministry of Municipality and Environment, is taking all necessary preventive and precautionary measures to control the disease and prevent it from spreading.

MERS is a viral respiratory disease that is caused by one of the coronaviruses (MERS-CoV), but it differs from the novel coronavirus, known as COVID-19, which has recently spread in several countries. Both viruses differ in terms of the source of infection, mode of transmission, and the disease severity. The Ministry of Public Health confirms that no cases of the novel coronavirus (COVID-19) have been diagnosed in Qatar so far.

Only 3 cases of MERS-CoV were registered in Qatar during the past 2 years. The Ministry of Public Health calls on all members of public, and especially people with chronic diseases or those with immunodeficiency disorders, to adhere to public hygiene measures. This includes washing the hands regularly with water and soap, using hand sanitizers, as well as avoiding close contact with camels and seeking medical advice when experiencing symptoms of fever, cough, sore throat, or shortness of breath.

The Rapid Response Team of the Health Protection and Communicable Disease Control is available round-the-clock to receive notifications or inquiries related to communicable diseases on its hotline numbers 66740948 or 66740951.
======================
[In early December 2019, Qatar reported 3 cases of MERS-CoV infection, a fatal case and 2 asymptomatic contacts of the fatal case. The fatal case denied a history of contact with camels or recent travel. She did have a history of underlying medical conditions (which may have led to contact with the health sector in the 2 weeks prior to onset of illness). Prior to these cases, the most recent report of a case of MERS-CoV infection in Qatar was in 2017 when there were 3 cases reported (see prior ProMED-mail posts listed below.)

The location of residence of this patient was not available, nor were other epidemiological variables, including possible high risk exposures.

The HealthMap/ProMED-mail map of Qatar is available at