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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: 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
Date: Sun 8 Sep 2019
Source: Irish Mirror [abridged, edited]

A TD [member of the Irish Parliament] has warned of "serious repercussions" after it was revealed the child vaccination uptake has dropped into the World Health Organisation (WHO) red zone. Statistics from the Health Protection Surveillance Centre show up to 25% of infants and toddlers are not receiving shots in parts of Ireland.

Sinn Fein spokeswoman Louise O'Reilly said: "We need to get past all the misinformation on social media and the anti-vaxxers and talk to parents face to face."

Fears are growing that highly contagious diseases such as measles could run rampant again, with experts warning of a possible epidemic.

Officials from the European Centre for Disease Prevention and Control have recorded 10,958 cases of the illness -- which can prove fatal -- across the continent from January to [14 Jul] this year [2019]. It is the worst performance in over a decade and the 1st time the country has been in the range since the anti-vax movement began.

EU countries worst affected are France, Bulgaria, Italy, Poland and Lithuania -- but the slump in Ireland means we could soon be facing an epidemic of our own. The number of measles cases reported tripled last year [2018] with 77 cases -- up from just 25 in 2017.  [Byline: Ailbhe Daly]
Date: Fri 17 May 2019 16:33 IST
Source: Breaking News Irish Examiner Reporter [abridged, edited]

There have been 58 reports of measles recorded so far this year [2019], according to the HSE's [Health Service Executive] Health Protection Surveillance Centre [HPSC].

Another 2 cases were reported to the HPSC in the past week -- one from the Eastern Regional Health Authority and the other from the Southern Health Board. The 2 people affected were both female and aged between 15 and 34 years.

The HSE's assistant national director of health protection, Dr Keven Kelleher, has warned that cases of measles are set to rise over the summer [2019].

There has been an increase in measles, an acute viral disease, throughout the world and cases are spreading because people are travelling more.

Dr Kelleher said measles is very active throughout southern Europe.

Current vaccination rates are not good enough currently, with take-up rates up to 8% below what they should in some parts of the country.  [Byline: Evelyn Ring]
========================
[HealthMap/ProMED-mail map of Ireland:
Date: Wed 17 Apr 2019
Source: Leitrim Observer [abridged, edited]

The HSE [Ireland's national health service] says it "had not seen diseases like measles in Donegal, Sligo or Leitrim for a number of years, because 95% of children were vaccinated against them. Last year [2018], the uptake of childhood vaccinations dropped slightly in Donegal, and this resulted in an outbreak of measles in January this year [2019]."

The HSE says "There is also an ongoing mumps outbreak across Donegal, Sligo and Leitrim. The HSE has been notified of 116 cases so far.

"As soon as vaccination rates fall, diseases like measles and mumps return. Fortunately, the majority of people in Donegal, Sligo and Leitrim are protecting their children with vaccination. The most recent figures for 2018 show that 90% of children in Donegal received the MMR and 93% of children in Sligo and Leitrim received it.

"However, over 95% of children need to be vaccinated with the MMR in order to prevent the spread of measles in our community. This is the goal for 2019, as it is really important for 'herd immunity'. In this way, we can protect new-borns and vulnerable children, including those with cancer or immune problems who can't get vaccinated, from coming in contact with measles and other diseases like meningitis."

This year [2019] European Immunisation Week runs 24-30 Apr. The goal is to raise awareness of the benefits of vaccination and to celebrate the vaccine heroes who contribute to protecting lives through vaccination. Vaccine heroes include health workers who administer vaccines, parents who choose vaccination for their children, and everyone who promotes vaccination.

"Every parent wants to protect their child and do what's right for them. Sometimes it can be difficult to know what to do, now that there is so much false and misleading information on the internet and social media when it comes to vaccination," says Dr. Laura Heavey, Specialist Registrar in Public Health Medicine in HSE North West, "I would really encourage parents to look for information in the right places. Two good sources of reliable, evidence-based information are <www.immunisation.ie> and the Vaccine Knowledge Project at <http://vk.ovg.ox.ac.uk/>. Essentially all of the vaccines on the infant, child and adolescent schedule in Ireland are backed up with years of data on their safety."

Another goal for the HSE in 2019 is to continue to increase the uptake of the HPV vaccine in teenagers. In 2018, 70% of teenage girls in Ireland got the vaccine. In Scotland, where HPV vaccination started over 10 years ago and 90% of teenage girls get the HPV vaccine, researchers have found that the vaccine has nearly wiped out cases of cervical pre-cancer in young women. We want to see as many Irish teenagers as possible getting vaccinated in 2019, so that we can see those same results here. This year [2019], the vaccine will also be offered to teenage boys. If all our young people receive the vaccine, cervical cancer could be eliminated in Ireland in the future.
========================
[HealthMap/ProMED-mail map of Ireland:
Date: Wed 27 Feb 2019
Source: The Times [abridged, edited]

A total of 384 cases mumps have been reported this year [2019] from Irish Universities, HSE figures have shown.

There were 64 new cases reported last week, bringing the total to 384 since the start of the year [2019]. The number of cases has been rising steadily in recent weeks, with 278 in the 1st 6 weeks of the year. Last year [2018] there had been 52 cases by the end of February. There were 576 cases in total last year [2018].  [Byline : Catherine Sanz]
===================
[Also see ProMED-mail Mumps update (02): USA (CO, TX), Europe (Ireland) http://promedmail.org/post/20190221.6329434 for more on the outbreak in Ireland. - ProMED Mod.LK]

["Before the U.S. mumps vaccination program started in 1967, about 186,000 cases were reported each year, but the actual number of cases was likely much higher due to underreporting. Since the pre-vaccine era, there has been a more than 99% decrease in mumps cases in the United States. Since the 2-dose vaccination program was introduced in 1989, mumps cases have ranged year to year from a couple of hundred to several thousand.

However, in recent years, there has been an increase in the number of reported cases, from 229 cases in 2012 to 6366 cases in 2016. The recent increase has been mainly due to multiple mumps outbreaks reported across the country in settings where people often have close contact with one another, like college campuses." CDC (<https://www.cdc.gov/mumps/outbreaks.html>). - ProMED Mod.LK]
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
*

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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: 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".

7 May 2019, Cairo, Egypt: The World Health Organization (WHO) strongly condemns continuing attacks on health facilities in north-western Syria. Since 29 April, in just nine days, twelve health structures have been hit. 

On 5 May, three facilities were struck in one day alone, including two major hospitals that provide secondary healthcare in the area.  One of the structures, a surgical unit, was supported by WHO. Three health care workers lost their lives as a result of these attacks.  There are now no functioning hospitals in northern Hama, and emergency care is provided by only three surgical units supported by WHO.  Close to 300,000 civilians are affected.   

“These attacks against health facilities and other civilian infrastructure are a grave and totally unacceptable development,” said Dr. Ahmed Al-Mandhari, WHO Regional Director for the Eastern Mediterranean Region. “International humanitarian law safeguards civilians, even in the most violent of conflicts. And according to the Geneva Convention, health facilities and civilians – especially the most vulnerable – must be protected.  Parties to the conflict in northern Hama and in Idleb are flagrantly disregarding those rules; and it is women, children, the elderly and other vulnerable groups who are suffering as a result.”   

The health facilities that were hit in northern Hama and southern Idleb provided a total of 30,000 consultations, 860 hospital admissions and 700 surgeries per month to a highly vulnerable population. 

“We are also deeply concerned about the people who have had to flee their homes and now have no access to basic health services. Over 150,000 people were displaced from northern Hama and southern Idleb in between 29 April and 4 May, doubling the total number of people displaced in the area in the last three months. Saving their lives is our main priority and this requires further strengthening available health services. What is of particular concern is the increasing risk for infectious disease outbreaks due to overcrowding in temporary settlements,” Dr Al-Mandhari added.

WHO continues – with health partners – to ensure the provision of key primary and secondary healthcare and has released emergency health supplies for almost 92,200 treatment courses, including for surgical and trauma care, secondary healthcare, and primary healthcare.

As the conflict in north-western Syria intensifies, WHO reminds all parties to the conflict that attacks on health facilities are a blatant violation of international humanitarian law. Health facilities must never be attacked or damaged, and health workers should be allowed to provide medical treatment and services to all people in need wherever they are.

Date: Tue, 2 Apr 2019 18:54:39 +0200

Beirut, April 2, 2019 (AFP) - More than 40,000 displaced people in north-western Syria have seen their camps flooded by heavy rains in the past three days, a United Nations spokesman said Tuesday.   Around 14 camps were affected in the north-western province of Idlib, David Swanson of the UN Office for the Coordination of Humanitarian Affairs told AFP.

The Idlib region, controlled by Syria's former Al-Qaeda affiliate, is home to more than 3 million people -- more than half of them displaced by the country's eight-year war.   Civil defence workers known as the White Helmets have been working to save people and their scant belongings from the rising muddy waters.   "For the second day in a row, White Helmets... continue to respond to the catastrophic situation in the northern Syria camps," they said on Twitter late Monday.

One video posted by the group on Sunday showed brown water cascading out of a flooded tent.   In another published the same day, civil defence workers clung on to a rope as they waded through a brown torrent above knee level.   The downpour has affected tens of thousands of civilians, displaced persons, crops and livestock in Idlib, as well as in the Aleppo and Hasakeh provinces since Saturday, Swanson said.

In Aleppo province, tents were destroyed in several camps for the displaced and a hospital in the countryside had to shut down due to the flooding.   Syria's war has killed more than 370,000 people and displaced millions since starting in 2011 with the brutal repression of anti-government protests.   Tens of thousands of displaced Syrians in the north of the country depend on handouts from humanitarian aid groups, including food, blankets and heating fuel for the winter months.

Thursday 7th March 2019
http://www.emro.who.int/syr/syria-news/unexploded-mines-pose-daily-risk-for-people-in-northern-syria.html

6 March 2019 - Um Hassan, from rural Aleppo, was collecting truffles in the countryside to sell in local markets. At the end of a long day of backbreaking work in harsh winter conditions, she and her children climbed into a crowded lorry to begin their journey home. Half-way through their trip, the lorry drove over an unexploded mine. Um Hassan’s 10-year old daughter Lolo was killed instantly and two of her other children were seriously injured.

Lolo was one of six people killed in the explosion. Another 15 people were rushed to the WHO-supported University Hospital in Aleppo. Um Hassan’s husband was frantic with worry when his family did not return home. He had no way of getting in touch with his wife and she was unable to get in touch with him. Like many people living in poverty in rural areas of Syria, the family has no mobile phone or landline.

“This is such a tragic event,” said Elizabeth Hoff, WHO Representative in Syria. “Although the security situation in the north has improved recently, tens of thousands of landmines and other unexploded devices continue to pose a severe threat to millions of innocent people. WHO is working to strengthen trauma care and emergency services in Aleppo and other northern governorates, but the underlying problem remains. Sustained efforts must be made to clear mines and other hazards from former conflict areas. Until then, people like Um Hassan and her family will be at risk of similar incidents.”

For Um Hassan and many others like her, there is no choice but to continue working every day, despite the risks. “Life is difficult and we have to keep working in our fields, no matter how hard,“ said Um Hassan. “Our survival depends on it.”

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Falkland Islands

No Profile is available at present

Travel News Headlines WORLD NEWS

Date: Wed, 30 Oct 2019 02:46:41 +0100 (MET)
By Barnaby CHESTERMAN

Stanley, Falkland Islands, Oct 30, 2019 (AFP) - Waddling up the beach in single file, their heads held high with an almost self-important demeanor, king penguins are a major draw in the Falkland Islands' tourism industry.   Their fluffy brown chicks are nearly fearless of humans, meaning tourists at Volunteer Point, a peninsula on East Falkland Island, might get almost close enough to touch one.    "We're the furthest location north in the world that you can see king penguins," said Tony Heathman, a former sheep farmer who has spent the last 16 years taking tour groups to Volunteer Point, where a thousand pairs of the islands' signature species go to breed.   "We get lots and lots of people who... love to come here and get as close to the king penguins as they possibly can," the 70-year-old told AFP.

Kings are just one of five penguin species in the Falklands, alongside the wacky-looking rockhoppers which have yellow tassels sprouting from the side of their heads, gentoos, macaronis and the burrowing magellanics.    The Falklands have incredibly rich biodiversity, including more than 25 species of whales and dolphins, but it is the guaranteed ability to get up close with penguins that makes it a particularly enticing destination.  Tourism is a growing industry in the Falklands despite their remote location in the South Atlantic some 480 kilometers (300 miles) off Argentina and occasional political and economic hostility from Buenos Aires.

In 2018, there was a 6.3 percent increase in tourist arrivals and a 29.4 percent surge in tourist expenditure to almost £8.8 million ($11.3 million).    "One of the key attractions for us was the king penguins at Volunteer Point, so we saw plenty of those," said Flavia Tang, 29, from London, who came for a week with her partner.    Volunteer Point is one of the islands' most popular destinations, accessible from the capital Stanley by a three-hour ride in a four-wheel drive vehicle, including 11 miles of bumpy, boggy, off-road track.   The peninsula is also home to gentoos and magellanic penguins -- known locally as jackasses because of their braying-like call -- as well as oystercatchers, South American terns and ruddy-headed geese.

- Like a Hitchcock film -
Another of the Falklands' stunning locations for wildlife watching is Kidney Island, where rockhoppers use their claws and beaks to help them get to the top of cliffs where they will mate.   In order to see the birds, visitors must trek a half hour through tall, three-meter (10-foot) tussac grass while avoiding ground bird nests.   But a bird called the sooty shearwater is what makes the island truly unique.   "Kidney Island is home to 140,000 breeding pairs of sooty shearwaters that are just rafting off the coast here ready to come in," Denise Blake, the Falklands government's environmental officer, told AFP during a visit to the outlying island.  "So as night falls you really see them swooping in over the heads a bit like the Hitchcock movie where all the birds start circling in: It's incredible for that."

While many nature-lovers head to places such as Antarctica and South Georgia, an island in the South Atlantic, Sally Ellis, the manager at International Tours and Travel, feels the Falklands are a better option.   "Antarctica and South Georgia are nothing compared to the variety and accessibility of wildlife in the Falkland Islands and it costs about a quarter," she said, adding that there was nearly a "guarantee" to see whatever wildlife is desired.   Beyond birds the endangered sei whale is found off the coast of the Falklands while the distinctive black and white Commerson's dolphins swim near Yorke Bay and Gypsy Cove.

- 'Leap of faith' -
In addition to nature watching, adventure tourism is also growing on the islands, where enterprising locals are branching into the industry.   Tom and Jane Chater recently launched a business offering helicopter trips and tours.    The married couple is hoping to attract some of the 60,000 people a year who arrive in the Falklands from cruise ships by offering the chance to explore the islands from their four-seater Robinson R-44 helicopter.    "It's been a very busy and exciting time for us," said Tom Chater, 43.    "It's something we thought about for a long time," added 46-year-old Jane. "It's a leap of faith but we're keen to see how it works out."
Date: Mon, 25 Nov 2013 09:47:39 +0100 (MET)

WASHINGTON, Nov 25, 2013 (AFP) - A powerful 7.0 magnitude earthquake struck in the south Atlantic ocean 314 kilometers (195 miles) southeast of Stanley, the main city on the Falkland Islands, the US Geological Survey said early Monday.  The underwater quake struck at 0627 GMT at a depth of 10 kilometers in the lightly populated area, the USGS said. The epicenter was also 877 kilometers east of Ushuaia, Argentina, the USGS said.   There were no initial reports of damage or casualties.   The Hawaii-based Pacific Tsunami Warning Center issued a bulletin stating that, despite the power of the quake, "a destructive widespread tsunami threat does not exist."   The Tsunami Warning Center however did say that there was a "small possibility of a local or regional tsunami" that could affect coastlines "located usually no more than a few hundred kilometers from the earthquake epicenter."   The USGS initially said that it was a magnitude 6.6 earthquake, but later revised the quake's strength.
Date: Sun, 13 Jan 2013 00:01:52 +0100 (MET)

LONDON, Jan 12, 2013 (AFP) - British-American owned cruise firm P&O on Saturday announced it would not be stopping at three Argentinian ports due to the continuing row over the Falkland Islands. "As a British cruise company we cannot allow ourselves to be the subject of any political dispute or put our customers and crew into any situation where their enjoyment may be compromised," said a spokesman for the company. "With this in mind, we have had to take the difficult decision to remove all Argentinian ports of call from the itinerary." Its Arcadia and Adonia vessels will now not dock in Buenos Aires, Puerto Madryn or Ushuaia during their round-the-world cruises.

Argentinian port officials have previously turned away liners that have been to the Falklands. President Cristina Kirchner said earlier this month that Argentina was forcibly stripped of the Falklands by Britain in "a blatant exercise of 19th-century colonialism" and demanded they be handed over to Argentina. British Prime Minister David Cameron replied that the 3,000 residents of the Falklands had a strong desire to remain British and would have a chance to express their views in a referendum on their political status to be held in March. The islanders are expected to vote strongly in favour of continued union with Britain.

Argentina invaded the Falklands in 1982, prompting Britain's then prime minister Margaret Thatcher to send a naval taskforce to successfully reclaim the islands in a war that claimed the lives of 255 British and 649 Argentinian soldiers. British defence officials have prepared plans for dealing with aggressive action by Argentina towards the disputed islands, according to a report on the Sunday Telegraph website. A senior defence source told the paper: "Britain needs to be in a situation to respond very quickly to a whole series of threats -- that is why we have contingency plans. Our posture has not changed but neither are we complacent."
Date: Tue, 28 Feb 2012 01:19:14 +0100 (MET)

BUENOS AIRES, Feb 27, 2012 (AFP) - Two British cruise ships that visited the Falkland Islands were refused entry to an Argentine port on Monday, amid tension over the disputed archipelago.  The Adonia, owned by P&O cruises, and the Princess Cruises vessel Star Princess were both blocked from entering Ushuaia in southern Argentina after both ships stopped at the Falklands on Saturday. "We are very concerned to hear the Adonia and Star Princess have been refused access to the port of Ushuaia," a spokesman for Britain's Foreign Office said in London. "There can be no justification for interference in free and legitimate commerce. "British diplomats in Argentina are urgently seeking to clarify the circumstances surrounding this incident, and we are in contact with the company concerned." Tensions are running high between Britain and Argentina over the Falklands, which London controls but Buenos Aires claims, ahead of the 30th anniversary in April of the start of the war between the two nations over the South Atlantic islands.

Argentina has also reacted angrily to the deployment of Prince William to the Falklands as part of his job as a Royal Air Force search and rescue pilot, and to a planned fact-finding trip by British lawmakers next month. The Argentine province of Tierra del Fuego said they "applied the law" in denying port access to the Carnival Corporation ships the Star Princess and the Adonia.  "The Governor of Tierra del Fuego, Antarctica and the South Atlantic Islands, Fabiana Rios, decided not to allow the docking in the port of Ushuaia (3,200 km south of Buenos Aires)" of the two ships, Tierra del Fuego authorities said in a statement. "We've never had a ship stopped from coming into an Argentine port before," Julie Benson, spokeswoman for Carnival affiliate Princess Cruises, told AFP.

Carnival UK, which owns both P&O and Princess Cruises, said in a statement the Adonia was now sailing towards Punta Arenas in Chile, its next port of call on an 87-night tour of South America. The Star Princess was on a 14-night South America cruise which started in Rio de Janeiro on February 18. The Falklands, located off the southern coast of Argentina, have been under British control since 1833. A brief 74-day war in 1982 cost the lives of 649 Argentine troops, 255 British troops and three Falkland Islanders, with Britain retaining control. The United Nations has called on Britain to start talk on decolonization, but London has refused to do so.
Date: Tue, 5 Jan 2010 07:03:15 +0100 (MET)

WASHINGTON, Jan 5, 2010 (AFP) - A major 6.7-magnitude earthquake struck the southern Atlantic ocean early Tuesday east of South Georgia and the South Sandwich Islands, a sparsely populated British territory, a US monitor said.

The quake struck at 3:55 am (04:55 GMT) in waters 685 kilometers (425 miles) east of Bristol Island, part of an chain inhabited mainly by scientists on a series of bases, the US Geological Survey reported.   The earthquake, about 2,800 kilometers (1,740 miles) east of the Falkland Islands, occurred at a depth of 10 kilometers (six miles) according to USGS.

The Pacific Tsunami Warning Center issued an alert stating there was no threat of a destructive widespread tsunami, but warned "there is the small possibility of a local or regional tsunami that could affect coasts" near the epicenter.
More ...

Oman

Oman US Consular Information Sheet
February 11, 2009
COUNTRY DESCRIPTION: The Sultanate of Oman, a land of great natural beauty on the southeast corner of the Arabian Peninsula, has a long and proud heritage.
Oman has seen rapid economic a
d social development in the past three decades.
The Government of Oman estimated its population at 2,340,815 in its 2003 census, but the current number is likely to be significantly higher due to an influx of expatriate workers in numerous sectors of the economy.
The CIA World Factbook estimates Oman’s population to be 3,311,640 in its latest on-line update as of December 18, 2008.
A monarchy governed by Sultan Qaboos bin Said, the country does not have political parties or a legislature, although a bicameral representative body (the lower house of which is directly elected) provides the government with advice and reviews draft legislation.
While Oman is traditionally Islamic and Islam is the state religion, Omanis have for centuries lived with people of other faiths.
Non-Muslims are free to worship at churches and temples built on land donated by the Sultan.
The economy is largely dependent on the production and export of oil and natural gas, but is becoming increasingly diversified.
Excellent tourist facilities are available in the major cities of Muscat, Salalah, Sohar, and Nizwa and can increasingly be found elsewhere in the country.
Travelers may wish to visit the Sultanate’s tourism web site at http://www.omantourism.gov.om/ for more information.
Travelers may also wish to read the Department of State Background Notes on Oman for additional information.
ENTRY/EXIT REQUIREMENTS:
A valid passport and visa are required for entry into Oman.
Omani embassies and consulates issue multiple-entry tourist and/or business visas valid for up to two years.
Omani immigration officials at the port of entry determine the length of stay in Oman, which varies according to the purpose of travel.
Alternatively, U.S. citizens may obtain a 30-day visa by presenting their U.S. passports on arrival at all Oman land, sea, and air entry points.
Note: The validity period of the applicant's passport should not be less than six months.
Adequate funds and proof of an onward/return ticket, though not required, are strongly recommended.
The fee is Rials Omani 6.00 (approximately USD 16.00).
This visa can be extended for an extra 30 days only; a completed extension application form and the fee of Rials Omani 6.00 (USD 16.00) should be submitted to the Directorate General of Passports and Residence or to its branches at regional Royal Omani Police offices.
Other categories of short-term visit/business/work contract visas are available, but these must be arranged in advance through an Omani sponsor.
To obtain a visa or for details on entry and travel requirements, please contact the Embassy of the Sultanate of Oman, 2535 Belmont Road NW, Washington, DC
20008, telephone (202) 387-1980/2.
Evidence of yellow fever immunization is required if the traveler enters from an infected area.
Visit the Embassy of Oman web site 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.
Forbidden items:
The Sultanate prohibits pornographic materials and firearms from entering Oman.
Local law limits each traveler to two bottles of alcohol.
Items subject to confiscation at the airport due to content considered culturally inappropriate include, but are not limited to, compact discs, digital video discs, and video and audiocassettes.
Please refer to our Customs Information to learn more about customs regulations.
SAFETY AND SECURITY:
There have been no instances in which U.S. citizens or facilities in Oman have been subject to terrorist attacks.
However, the Department of State remains concerned about the possibility of terrorist attacks against United States citizens and interests throughout the region.
American citizens in Oman are urged to maintain a high level of security awareness.
The State Department suggests that all Americans in Oman maintain an unpredictable schedule and vary travel routes and times whenever possible.
Americans are also urged to treat mail or packages from unfamiliar sources with suspicion.
Unusual mail or packages should be left unopened and reported to local authorities.
U.S. citizens with security concerns are encouraged to contact local authorities and the Consular Section of the U.S. Embassy in Muscat.
For the latest security information, Americans traveling abroad should regularly monitor the Department’s web site, where the current Worldwide Caution, Travel Warnings and Travel Alerts 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 information on A Safe Trip Abroad.
CRIME:
The incidence of street crime is low in Oman; violent crime is rare by U.S. standards, but can occur.
Crimes of opportunity remain the most likely to affect visitors.
Visitors to Oman should, therefore, take normal precautions, such as avoiding travel in deserted or unfamiliar areas and after dark.
Visitors should also protect personal property from theft.
In particular, valuables and currency should not be left unsecured in hotel rooms.
Common sense and caution are always the best methods for crime prevention.

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

The local equivalent to the “911” emergency line in Oman is:
9999
See our information on Victims of Crime.
SPECIAL CIRCUMSTANCES: By Omani custom and law, expressing frustration either verbally or through otherwise innocuous hand gestures is considered insulting and abusive.
Any individual, regardless of citizenship and residency status, may file a personal defamation charge, and accusation of wrongdoing is sufficient to initiate a legal process.
While not commonplace, the incidence of American citizens charged with personal defamation has been on the rise in recent months.
These cases are normally resolved by a formal apology and a payment of damage to the aggrieved party, but one American citizen’s case went to trial in 2008.
Omani law typically does not permit a foreigner accused of a crime, including defamation, to depart the country while legal proceedings are ongoing.
Confrontations leading to defamation charges occur mostly on Oman’s roads, and visitors should exercise caution when dealing with difficult drivers.
Omani employers often ask that expatriate employees deposit their passports with the company as a condition of employment.
While to an extent still customary, this practice is contrary to Omani law.
The U.S. Embassy in Muscat advises Americans to exercise caution on the issue of permitting an employer to hold their passports, since this can operate as a restraint on travel and could give undue leverage to the employer in a dispute.
U.S. passports are the property of the U.S. government.
Islamic ideals provide the conservative foundation of Oman's customs, laws, and practices.
Foreign visitors are expected to be sensitive to Islamic culture and not dress in a revealing or provocative style, including the wearing of sleeveless shirts and blouses, halter-tops and shorts.
Athletic clothing is worn in public only when the wearer is obviously engaged in athletic activity.
Western bathing attire, however, is the norm at hotel pools and beaches.

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 Omani laws, even unknowingly, may be expelled, arrested, or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in Oman 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.

MEDICAL FACILITIES AND HEALTH INFORMATION:
There are a number of modern medical facilities in Oman.
Local medical treatment varies from quite good to inadequate, depending in large part on location.
Many Western pharmaceuticals can be found in Oman.
Hospital emergency treatment is available.
Doctors and hospitals often expect 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 the CDC’s web site.
For information about outbreaks of infectious diseases abroad consult the World Health Organization (WHO).
Further health information for travelers is available from the WHO.

Some HIV/AIDS entry restrictions exist for visitors to and foreign residents of Oman.
Oman requires persons seeking work or residence visas to take an HIV/AIDS test after arriving in the country; U.S. HIV/AIDS tests are not accepted.
Please verify this information with the Embassy of Oman at (202) 387-1980/2 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 Oman is provided for general reference only, and may not be totally accurate in a particular location or circumstance.
Road Conditions and Hazards: Road conditions, lighting, and traffic safety in cities and on major highways are good.
The condition of rural roads varies from good to poor.
Travel between cities, especially at night, may be dangerous due to poor or no lighting, wandering livestock, and speeding drivers.
The safety of public transportation is generally good.
Taxis, minivans, and small buses may swerve to the side of the road to pick up passengers with little notice or regard for other vehicles.

Local Laws and Practices:
Traffic laws in Oman are strictly enforced and the consequences for violating them may be severe by U.S. standards.
For example, running a red light results in a mandatory, non-bailable detention period of 48 hours, followed by confiscation of one’s driver’s license, vehicle registration, and car registration plate until the Omani judicial process is concluded, which may take as long as several months.
Other common traffic violations that carry strict penalties, up to and including jail sentences, fines, and/or deportation, include: driving without a license, driving under the influence of alcohol, failure to wear a seat belt, talking on cellular telephones while driving (other than using hands-free technology), speeding excessively, overtaking another vehicle, screeching a car’s tires or failing to keep one’s car clean.
In the event of a traffic violation and fine, drivers should cooperate with police officers and should not attempt to pay or negotiate payment at the time of the traffic stop.

Effective June 1, 2007, the Royal Oman Police (ROP) introduced new procedures for minor Road Traffic Accidents (RTA) to reduce traffic jams.
According to the ROP, the new procedure is currently in force in the Governorate of Muscat area and will eventually be implemented in the other governorates and regions of the Sultanate.
American citizens considering driving in Oman are advised to familiarize themselves with the new procedures available on the ROP web site under “Minor Road Traffic Accidents.”
Note:
Minor RTA are accidents that cause minor damage to one or more vehicles but do not result in injuries, deaths, or material damage to public/private properties.
Parties involved in such accidents should immediately move their vehicles to the side of the road.

American citizens involved in accidents outside of the Muscat area are advised not to move their vehicles from the accident location until the ROP gives them permission; moving a vehicle may be interpreted as an admission of guilt.

The use of European-style traffic circles is prevalent in Oman.
However, unlike European traffic practice, the driver on the inside lane always has priority.
A driver flashing his/her high beams is generally asking for a chance to pass.
Turning right on a red traffic signal is prohibited.
Visitors should not drive without a valid license.
Short-term visitors in possession of a valid U.S. driver's license may drive rental vehicles, but residents must have an Omani driver's license.
To obtain an Omani license, a U.S. citizen must have a U.S. license that has been valid for at least one year or must take a driving test.
Visitors hiring rental cars should insure the vehicles adequately against death, injury and loss or damage.
Residents may insure their vehicles outside the Sultanate; however, third party liability insurance must be purchased locally.

Emergency Services:
A modern ambulance service using American equipment and staff trained in the U.S. was instituted in 2004 and has been assessed as very good.
The service currently serves only certain urban locations in Oman, including the capital area, but is eventually expected to provide coverage for motor vehicle accident victims throughout the entire Sultanate.
For all traffic-related emergencies, the Royal Omani Police can be contacted by dialing "9999."
Please refer to our Road Safety page for more information.
Visit the web site of Oman’s national tourist office for further information.
AVIATION SAFETY OVERSIGHT:
The U.S. Federal Aviation Administration (FAA) has assessed the Government of Oman’s Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for oversight of Oman’s air carrier operations.
For more information, travelers may visit the FAA’s web.

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 Oman are encouraged to register with the U.S. Embassy in Muscat through the State Department’s travel registration web site and to obtain updated information on travel and security within Oman.
Americans without Internet access may register directly with the U.S. Embassy in Muscat.
By registering, American citizens make it easier for the Embassy to contact them in case of emergency.

The U.S. Embassy is located on Jamiat A’Duwal Al Arabiya Street, Al Khuwair Area (Shatti Al-Qurum), in the capital city of Muscat.
The mailing address is: PO Box 202, Medinat Al Sultan Qaboos 115, Sultanate of Oman, telephone: (968) 24-643-400, fax: (968) 24-643-535.
The Embassy’s Consular e-mail address is ConsularMuscat@state.gov.
American Citizens Services are available on a walk-in basis from 10:30 a.m. to 12:30 p.m. every Saturday, Monday, Tuesday and Wednesday.
The U.S. Embassy is closed on Omani and American holidays.
In the event of an emergency outside of normal office hours, American citizens may call the number above for assistance.
* * *
This replaces the Country Specific Information for Oman dated December 3, 2007 to update the sections on Country Description, Entry/Exit Requirements, Safety and Security, Information for Victims of Crime, Special Circumstances, Medical Facilities and Health Information, Traffic Safety and Road Conditions, and Registration/Embassy Location.

Travel News Headlines WORLD NEWS

Date: Thu 14 Feb 2019
Source: Muscat Daily [edited]

The Ministry of Agriculture and Fisheries (MoAF) has announced that it has imposed veterinary quarantine on a farm in the wilayat [district] of Shinas in North Batinah [governorate] after it registered a case of Crimean-Congo haemorrhagic fever (CCHF) in a citizen. MoAF has also confirmed that the citizen infected is undergoing treatment at Sohar Hospital and his condition is stable.

Experts took samples of tick insects, a carrier of the disease from the animals at the citizen's farm and other animals in the area and sent them to the laboratory for examination. MoAF elaborated that experts are guiding the citizen's family on how to handle animals. CCHF is caused by a virus carried by ticks.

Animals like sheep, goats, and cows become carriers after they are bitten by the infected ticks. Humans get infected either by tick-bites or through direct contact with the infected animal's blood and tissues during or after slaughtering. Human-to-human transmission can occur resulting from close contact with blood, secretions, organs, or other bodily fluids from infected persons, the ministry said.
=====================
[CCHF virus has the greatest geographic range of any tick-borne virus and there are reports of viral isolation and/or disease from more than 30 countries in Africa, Asia, Eastern and Southern Europe, and the Middle East. Numerous domestic and wild animals, such as cattle, goats, sheep, and small mammals, such as hares and rodents, serve as asymptomatic hosts for amplification of the virus, which is transmitted through _Ixodid_ ticks, especially _Hyalomma_ spp that act as both reservoirs and vectors  (<https://www.biorxiv.org/content/biorxiv/early/2018/12/20/502641.full.pdf>).

Oman is situated in the south-eastern corner of the Arabian Peninsula, bordering the Kingdom of Saudi Arabia, United Arab Emirates, and Yemen. Cases of CCHF were first detected in Oman in 1995 with 3 unrelated sporadic cases, and another in 1996. A 1996 survey in Oman revealed asymptomatic seropositivity for CCHFV in 1/41 (2.4 percent) of Omanis compared to 73 (30.3 percent) of 241 non-Omani citizens with occupational animal contact. No further human cases of CCHF were reported in Oman until 2011 and there has been a steady increase in cases since then. Asia lineage 1 (clade IV) of CCHF virus has been identified in one of 1996 confirmed cases from Oman. Al-Abri et al have published a detailed report on CCHF cases from Oman from 2011-17 and describe a higher mortality rate of over 36 percent in their study (<http://dx.doi.org/10.1101/502641>).

The Oman MoH has undertaken a number of activities and initiatives to educate and inform the public about the risks of CCHF infection associated with slaughtering. A joint strategic initiative was developed in collaboration with the Ministry of Agriculture and Fisheries and the Ministry of Regional Municipalities and Water Resources. Education and information on prevention of CCHF in different languages has been targeted at those involved in slaughtering and handling animals. In addition, guidelines have been produced for culturally acceptable safe burials. - ProMED Mod.UBA]

[HealthMap/ProMED-mail map of Oman:
Date: 28 Jan 2019
Source: Times of Oman [edited]

Four new cases of Middle East respiratory syndrome (MERS) coronavirus have been detected in Oman, according to the Ministry of Health. "This brings the total number of recorded cases from various governorates in the Sultanate to 18 since 2013," the ministry said in a statement. The new cases are receiving necessary medical care at one of the hospitals.

"The ministry affirms its continued effort to monitor and control the disease through the effective Epidemiological Surveillance System," the ministry added. "All hospitals are capable of dealing with such cases," the ministry said, "We urge all citizens and residents to comply with preventative measures to control infection and to maintain hygiene when sneezing and coughing."

MERS is a viral respiratory disease caused by a novel coronavirus (Middle East respiratory syndrome coronavirus, or MERS-CoV) that was 1st identified in Saudi Arabia in 2012. Coronaviruses are a large family of viruses that can cause diseases ranging from the common cold to severe acute respiratory syndrome (SARS).

Symptoms: "Typical MERS symptoms include a fever, cough and shortness of breath. Pneumonia is common, but not always present. Gastrointestinal symptoms, including diarrhoea, have also been reported. Some laboratory-confirmed cases of the MERS-CoV infection are reported as asymptomatic, meaning that they do not have any clinical symptoms, yet they are positive for a MERS-CoV infection following a laboratory test. Most of these asymptomatic cases have been detected following aggressive contact tracing of a laboratory-confirmed case," the World Health Organization (WHO) said. Approximately 35 per cent of patients reported to be infected with MERS-CoV have died.

"Although most human cases of MERS-CoV infections have been attributed to human-to-human contact in health care settings, current scientific evidence suggests that dromedary camels are a major reservoir host for MERS-CoV and an animal source of MERS infection in humans. However, the exact role of dromedaries in the transmission of the virus and the exact route(s) of transmission are unknown. "The virus does not seem to pass easily from person to person unless there is close contact, such as when providing unprotected care to a patient. Health care associated outbreaks have occurred in several countries, with the largest outbreaks seen in Saudi Arabia, the United Arab Emirates, and the Republic of Korea," the WHO added.
=======================
[According to the above media report (and the MOH press release available at: <https://www.moh.gov.om/en/-/---951>, this now brings the total number of MERS-CoV infected individuals occurring in Oman to 18. According to prior reports, as of the date of the last reported case of MERS-CoV infection by Oman in March 2018, there had been a total of 11 cases reported by Oman (see MERS-CoV (10): Oman, Saudi Arabia, WHO http://promedmail.org/post/20180315.5690014). The addition of these 4 newly confirmed/reported cases would bring the total to 15, unless there were 3 previously reported cases that we have missed. Another explanation might be the addition of 3 Omanis who were diagnosed to have MERS-CoV infection after travelling to other countries. There were 2 reported Omani travelers to Thailand confirmed to have MERS-CoV infections in 2015 and 2016 (MERS-CoV (70) - Thailand ex Oman, 1st report, RFI http://promedmail.org/post/20150618.3447631, and MERS-COV (08): Thailand ex Oman, Saudi Arabia corr http://promedmail.org/post/20160124.3962172) and an Omani confirmed to have a MERS-CoV infection in the United Arab Emirates in 2013 (MERS-CoV - Eastern Mediterranean (81): Saudi Arabia, UAE ex Oman, RFI http://promedmail.org/post/20131108.2044846). Clarification of this would be greatly appreciated. In addition, more information on the newly confirmed cases including age, gender, governorate of presumed exposure, dates of onset of illness, and history of possible high-risk exposures (direct or indirect camel contact, consumption of raw camel products, contact with other confirmed cases of MERS-CoV infection) would be greatly appreciated. Are the 4 newly reported cases a defined cluster with common contacts?

The HealthMap/ProMED map of Oman: <http://healthmap.org/promed/p/124>  - ProMED Mod.MPP]
Date: 15 Mar 2018
Source: WHO Emergencies preparedness, response, Disease Outbreak News (DONs) [edited]

Middle East respiratory syndrome coronavirus (MERS-CoV) - Oman 15 Mar 2018
--------------------------------------------------------------------------
On [4 Mar 2018], the National IRH focal point of Oman reported 1 additional case of Middle East respiratory syndrome coronavirus (MERS-CoV).

The patient was a 74-year-old male Omani national, living in Batinah, who had symptom onset on [23 Feb 2018]. The patient had neither recently travelled nor had any contact with any person with respiratory symptoms or with a known MERS-CoV case. The patient took care of camels that were reportedly ill. The investigation of the patient's exposure in the 14 days prior to the onset of symptoms is still ongoing.

Prior to this patient, the last laboratory-confirmed case of MERS-CoV from Oman was reported in November 2017.

Globally, 2144 laboratory-confirmed cases of MERS-CoV, including at least 750 related deaths, have been reported to WHO.
==================
[This is the 1st laboratory confirmed case of MERS-CoV infection reported by Oman in 2018, bringing the total number of laboratory confirmed cases reported by Oman to 11. During 2017, there were 2 cases reported by Oman. One on 5 Nov 2018 (see MERS-CoV (69): Oman, Saudi Arabia (RI, QS) RFI http://promedmail.org/post/20171105.5425993) and one reported to WHO on 30 Aug 2017, and reported by WHO on 12 Oct 2017 (see MERS-CoV (59): Oman, Saudi Arabia, WHO http://promedmail.org/post/20170913.5313874). In addition, there have been 2 cases reported in Omani citizens travelling to Thailand and confirmed by Thailand. A common observation in the cases reported by Oman is a history of contact with camels in the 14 days preceding onset of illness.

In total, there have been 2144 laboratory-confirmed cases of MERS-CoV reported to WHO since September 2012, including at least 750 related deaths (reported case fatality rate 35.0 percent). (This total includes cases reported by Saudi Arabia up through 11 Jan 2018).

The HealthMap/ProMED map of Oman can be found at:
Date: Thu 15 Feb 2018
Source: Muscat Daily [summarised, edited]

A study conducted by Sultan Qaboos University (SQU) shows that goats and other [livestock] in Jebel Akhdar, Saham and some areas in Dhofar are infected by brucellosis - a disease caused by [the] bacteria Brucella.

The study titled, 'A Novel Molecular Approach to Study Brucellosis in Cattle, Sheep, Goats and Camels in the Sultanate of Oman' shows that cattle in the area have been infected by brucellosis. In Jebel Akhdar, 11.4 per cent goats were found infected and in Saham one per cent cattle and one per cent sheep were infected.

Speaking to Muscat Daily, Dr Yasmin el Tahir, assistant professor at the Department of Animal and Veterinary at the College of Agriculture and Marine Sciences in SQU said that brucellosis is a major bacterial zoonosis - a disease that can be transmitted to humans from animals.

The study which started in 2014 will be concluded by April 2018.

In Dhofar, blood samples were randomly collected from 50 farms during March and April 2015.

"In Batinah, the study was carried out to determine the sero-prevalence of brucellosis in livestock including sheep, goats and camels in different areas from March to April 2015. Blood samples of 248 animals (102 goats, 104 sheep and 42 camels) were tested for brucellosis."

Elaborating on who can be affected by it, Dr Yasmin said, "Different mammals including man, cattle, sheep, goats, camels, swine, rodents and marine mammals can be carriers. In the host species, the disease primarily affects the reproductive system with concomitant loss in productivity of animals. In human beings, infection is associated with a spectrum of non-pathognomonic symptoms which are often misdiagnosed resulting in serious and debilitating manifestations," she added.

In order to control brucellosis, comprehensive surveillance, pre and post-import testing is of paramount importance, Dr Yasmin said. "The overall aim of this study is firstly to determine the seroprevalence of brucellosis in the most common domestic animals in Oman. It seeks to identify the risk factors associated with the disease, determine the prevalence of brucellosis in different regions of the sultanate, and above all shed light on the important reservoirs that serve to transmit brucella. This information will facilitate development of suitable control strategies to reduce the risk of this malady in man and animals," she added.

A French team comprising, Dr Jay Maryne, Dr Virginie Mick and Corde Yannick from the Brucellosis Reference Laboratory in Paris has also approved the study, said Dr Yasmin.
==================
[_Brucella melitensis_ is endemic in Oman, as in most if not all Near Eastern countries, with serious zoonotic impact. The species mostly affected are sheep and goats, but as indicated in the above report, camels and cattle may be affected as well.

During 2016, 23 outbreaks in small ruminants were reported to the OIE; during the 1st 6 months of 2017, 12 outbreaks were reported. Later information on the disease in animals is not yet available.
        
The brucellosis situation in humans is presented by the following numbers of human cases, as reported to the OIE: 2012 (148 cases), 2013 (192), 2014 (217), 2015 (379), 2016 (416). In humans, children constitute the most vulnerable sector.

These statistics may be indicative of a deteriorating situation. An example, addressing a cluster of 55 brucellosis cases identified during the period May to July 2016 from the coastal area in the North Batinah Governorate, was described in an Aug 2016 posting (http://promedmail.org/post/20160809.4404332). This concerning situation should not surprise in view of the vaccination coverage, as reported for the year 2016 (most recent available):
        
species/doses used/population   
Goats/  12 681/ 2 212 839
Sheep/  937/    581 787

A 2011 review on Brucellosis in Oman is available in ref 1. For a recent (2017) review on _B. melitensis_, worldwide, see ref 2.

References:
1. Yeh El Tahir, RR Nair. (2011). Prevalence of brucellosis in the Sultanate of Oman with reference to some Middle East countries. Vet Res,4 (3), 71-76.

2. Rossetti CA, Arenas-Gamboa AM, Maurizio E (2017) Caprine brucellosis: A historically neglected disease with significant impact on public health. PLoS Negl Trop Dis 11(8): e0005692.

A map of (Dhofar Governorate, Oman):
Date: Sat, 23 Dec 2017 04:18:14 +0100
By Khaled Orabi

Haima, Oman, Dec 23, 2017 (AFP) - The Gulf sultanate of Oman is looking to carve itself a new niche in ecotourism by opening up a sanctuary for one of the desert's most fabled creatures -- the Arabian oryx.   Once extinct in the wild, the rare member of the antelope family famed for its elegant horns has been dragged back from the precipice in a sprawling reserve fenced off for decades from the public.

That changed last month when authorities for the first time officially opened the sanctuary to visitors -- part of a broader bid by Oman to boost tourism as oil revenues decline.   On a recent outing, wildlife rangers in SUVs patrolled the sandy plains of the reserve in central Oman's Haima province, spotting groups of grazing oryx and other indigenous species.

For years, the main goal has been a basic one -- ensuring the oryx can survive by focusing on "helping the animals here reproduce and multiply", said sanctuary spokesman Hamed bin Mahmoud al-Harsousi.   But now, as numbers have ticked up from just 100 some two decades ago to almost 750 today, the authorities began eyeing another role for the reserve.    "There has been more interest in its tourism potential -- to take advantage of its uniqueness and rare animals," Harsousi told AFP.

- 'Arabian unicorn' -
The story of the Arabian oryx -- sometimes referred to as the Arabian "unicorn" due to its distinctive profile -- is one of miraculous survival.    Hunted prolifically, the last wild member of the species was killed in Oman by suspected poachers in 1972.    The species only clung to existence thanks to a programme to breed them in captivity and in the early 1980s a batch of 10 were released into Oman's Arabian Oryx Sanctuary.   Since then, regenerating the oryx has been an often precarious process.

The Omani sanctuary sprawls over 2,824 square kilometre (1,100 sq miles) of diverse terrain -- from flat plains to rocky slopes and sandy dunes.   Its own fate has been nearly as tortured as that of the oryx it houses.   In 2007, the sanctuary became the first place ever to be removed from UNESCO's World Heritage list as the government of Oman turned most of it over to oil drilling.

- On guard against poachers -
Now, as oil prices have plunged over the past few years, it is the wildlife once again that has become an increasing priority for the authorities.   Harsousi puts the current number of Arabian oryx in the sanctuary at 742 and says that other species are flourishing there too.    "In the past three years, we have been able to increase the number of the Arabian gazelle, known as sand gazelles, from 300 to about 850," he added.   In addition to the animals, there are 12 species of trees that provide a habitat for diverse birds.   Oman has been on a push to transform itself into a tourist draw -- pitching its beach resorts to luxury travellers and desert wilderness to the more adventurous.

Officials in the sultanate told AFP that a major tourism plan would be announced within a matter of weeks.   Those working at the oryx sanctuary hope that it can help play a lead role in luring visitors to the country.   But there are also fears that greater openness could see the return of an old foe -- hunters.    With that in mind security is being kept tight, said Abdullah Ghassab Obaid, a wildlife guard at the reserve.   "Thirty guards and a police patrol are working to provide security in the reserve to prevent any infiltration."
More ...

Travel News Headlines WORLD NEWS

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Argentina

Irish Diplomatic and Consular Information for Argentina
**********************************************************************
Address:
Embassy of Ireland
Suipacha 1380
2nd Floor
1011 Buenos Aires
Telephone:
+54-1
-4325-8588 / 4325-0849
Fax:
+54-11-4325-7572
Email:

Ambassador:
Her Excellency Paula Ní Shlattara
Secretary:

Jonathan Conlon
***************************************
Argentina - US Consular Information Sheet
October 02, 2008
COUNTRY DESCRIPTION:
Last year, Argentina's charm, natural beauty and diversity attracted more than 400,000 American citizen visitors, and this year's total is expected to be even higher. Buenos Aires and other large cities have well-developed tourist facilities and services, including many four- and five-star hotels. The quality of tourist facilities in smaller towns outside the capital varies. The country suffered a major financial crisis in 2001-2002. While it has made a dramatic recovery, continued economic hardship has been linked to a rise in street crime. Read the Department of State Background Notes on Argentina for additional information.

ENTRY/EXIT REQUIREMENTS: A valid passport is required for U.S. citizens to enter Argentina. U.S. citizens do not need a visa for visits of up to 90 days for tourism and business. U.S. citizens who arrive in Argentina with expired or damaged passports may be refused entry and returned to the United States at their own expense. The U.S. Embassy cannot provide guarantees on behalf of travelers in such situations, and therefore encourages U.S. citizens to ensure their travel documents are valid and in good condition prior to departure from the United States. Different rules apply to U.S. citizens who also have Argentine nationality, depending on their dates of U.S. naturalization. For more information, check the Argentine Ministry of the Interior web site at www.mininterior.gov.ar/migraciones/. Most dual nationals are permitted 60-day visits. Dual nationals who stay beyond their permitted time are required to depart on an Argentine passport.
The application process for an Argentine passport is lengthy, and the U.S. Embassy is not able to provide assistance in obtaining Argentine passports or other local identity documents. Children under 21 years of age who reside in Argentina, regardless of nationality, are required to present a notarized document that certifies both parents' permission for the child's departure from Argentina when the child is traveling alone, with only one parent, or in someone else's custody (click on the "international child abduction" link below for more information). An airport tax is collected upon departure, payable in dollars or Argentine pesos.

American citizens wishing to enter Brazil are required to obtain a visa in advance from the Brazilian Embassy or consulate nearest to the traveler's place of residence. The U.S. Embassy in Buenos Aires cannot assist travelers to obtain Brazilian visas. For more information, see the Country Specific Information for Brazil.
Visit the Embassy of Argentina’s web site at http://www.embassyofargentina.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:
Traffic accidents are the primary threat to life and limb in Argentina. Pedestrians and drivers should exercise caution. Drivers frequently ignore traffic laws and vehicles often travel at excessive speeds. The rate and toll of traffic accidents has been a topic of much media attention over the past year. The Institute of Road Safety and Education, a private Buenos Aires organization dedicated to transportation safety issues, reports that Argentina has the highest traffic mortality rate in South America per 100,000 inhabitants.

Care should be exercised when traveling in Brazil and Paraguay, near the Argentine border, where criminal entities are known to operate. These organizations are involved in the trafficking of illicit goods, and some individuals in the area have been designated by the U.S. Treasury Department for financially supporting terrorist organizations.
The U.S. government is supportive of coordinated efforts by Argentina, Brazil, and Paraguay to combat illegal activity in that region. Americans crossing from Argentina into Paraguay or Brazil may wish to consult the most recent Country Specific Information for those countries.

Demonstrations are common in metropolitan Buenos Aires and occur in other major cities as well. Protesters on occasion block streets, highways, and major intersections, causing traffic jams and delaying travel. While demonstrations are usually nonviolent, hooligans in some of the groups sometimes seek confrontation with the police and vandalize private property. Groups occasionally protest in front of the U.S. Embassy and U.S.-affiliated businesses. U.S. citizens should take common-sense precautions and avoid gatherings or any other event where crowds have congregated to protest. Information about the location of possible demonstrations is available from a variety of sources, including the local media. Additional information and advice may be obtained from the U.S. Embassy at the telephone numbers or email address listed at the end of this document.

Domestic flight schedules can be unreliable. Occasional work stoppages, over-scheduling of flights and other technical problems can result in flight delays, cancellations, or missed connections. Consult local media for information about possible strikes or slow-downs before planning travel within Argentina.
Public transportation is generally reliable and safe. The preferred option for travel within Buenos Aires and other major cities is by radio taxi or "remise" (private car with driver). The best way to obtain safe taxis and remises is to call for one or go to an established stand, rather than hailing one on the street. Hotels, restaurants, and other businesses can order remises or radio taxis, or provide phone numbers for such services, upon request. Passengers on buses, trains, and the subway should be alert for pickpockets and should also be aware that these forms of transport are sometimes interrupted by strikes or work stoppages.

Argentina is a geographically diverse country with mountains, forests, expansive deserts, and glaciers, making it a popular destination for outdoor and adventure sports. Despite the best efforts of local authorities, assisting visitors lost or injured in such remote areas can be problematic. American citizens have been killed in recent years while mountain climbing, skiing, trekking, and hunting. Travelers visiting isolated and wilderness areas should learn about local hazards and weather conditions and always inform park or police authorities of their itineraries. Reports of missing or injured persons should be made immediately to the police so that a search can be mounted or assistance rendered.

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, 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 pamphlet A Safe Trip Abroad.

CRIME: Most American citizens visit Argentina without incident. Nevertheless, street crime in the larger cities, especially greater Buenos Aires and Mendoza, is a problem for residents and visitors alike. As in any big city, visitors to Buenos Aires and popular tourist destinations should be alert to muggers, pickpockets, scam artists, and purse-snatchers on the street, in hotel lobbies, at bus and train stations, and in cruise ship ports. Criminals usually work in groups and travelers should assume they are armed. Criminals employ a variety of ruses to distract and victimize unsuspecting visitors.
A common scam is to spray mustard or a similar substance on the tourist from a distance. A pickpocket will then approach the tourist offering to help clean the stain, and while doing so, he or an accomplice robs the victim. Thieves regularly nab unattended purses, backpacks, laptops, and luggage, and criminals will often distract visitors for a few seconds to steal valuables. While most American victims are not physically injured when robbed, criminals typically do not hesitate to use force when they encounter resistance. Visitors are advised to immediately hand over all cash and valuables if confronted. Thieves will target visitors wearing expensive watches or jewelry.

Your passport is a valuable document and should be guarded. Passports and other valuables should be locked in a hotel safe, and a photocopy of your passport should be carried for identification purposes. The U.S. Embassy has observed a notable rise in reports of stolen passports in the past year. Some travelers have received counterfeit currency in Argentina. Unscrupulous vendors and taxi drivers sometimes pretend to help tourists review their pesos, then trade bad bills for good ones. Characteristics of good currency can be reviewed at the Argentine Central Bank web site at www.bcra.gov.ar.
Along with conventional muggings, so-called express kidnappings continue to occur. Victims are grabbed off the street based on their appearance and vulnerability. They are made to withdraw as much money as possible from ATM machines, and then their family or co-workers are contacted and told to deliver all the cash that they have on hand or can gather in a couple of hours. Once the ransom is paid, the victim is usually quickly released unharmed. There have been some foreign victims. Visitors are particularly advised not to let children and adolescents travel alone.
Travelers worldwide are advised to avoid packing valuables in their checked baggage. In Argentina, officials have publicly acknowledged the systematic theft of valuables and money from checked baggage at Buenos Aires airports. Authorities are working to resolve the problem and have made a number of arrests, but travelers should exercise continued care and caution. In many countries around the world, counterfeit and pirated goods are widely available. Transactions involving such products may be illegal under local law. In addition, bringing them back to the United States may result in forfeitures and/or fines. More information on this serious problem is available at http://www.cybercrime.gov/18usc2320.htm
INFORMATION FOR VICTIMS OF CRIME: The loss or theft abroad of a U.S. passport should be reported immediately to the local police and the nearest U.S. Embassy or Consulate. If you are the victim of a crime while overseas, in addition to reporting to local police, please contact the nearest U.S. Embassy or Consulate for assistance. The Embassy/Consulate staff can, for example, assist you to find appropriate medical care, contact family members or friends and explain how funds can 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 Argentine Federal Police have established a special Tourist Police Unit to receive complaints and investigate crimes against tourists. The unit, located at Corrientes 436 in Buenos Aires, responds to calls around the clock at 4346-5748 or toll-free 0800-999-5000 from anywhere in the country. The local equivalent to the "911" emergency line in the city of Buenos Aires or in the surrounding Province of Buenos Aires is 911 for police assistance. In the city of Buenos Aires, dial 100 in case of fire and 107 for an ambulance. In the Province of Buenos Aires, fire and ambulance numbers vary by location. See our information for Victims of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION: The public health system in Argentina provides emergency and non-emergency services free of charge to all, regardless of nationality or immigration status. However, the quality of non-emergency care in public hospitals is generally below U.S. standards. Medical care in private hospitals in Buenos Aires is generally good, but varies in quality outside the capital. Serious medical problems requiring hospitalization in private facilities and/or medical evacuation to the United States can cost thousands of dollars or more. Private physicians, clinics, and hospitals often expect immediate cash payment for health services.
HIV/AIDS restrictions. The U.S. Department of State is unaware of any HIV/AIDS entry restrictions for visitors to or foreign residents of Argentina.
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 Preventions hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747) or via the CDC's Internet site at http://wwwn.cdc.gov/travel/default.aspx. For information about outbreaks of infectious diseases abroad, consult the World Health Organization (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 policies apply overseas and will cover prior conditions and emergency expenses such as a medical evacuation, which could cost tens of thousands of dollars. If not covered, visitors are encouraged to consider purchasing travel insurance. No Medicare benefits are available abroad. 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 Argentina is provided for general reference only, and may not be totally accurate in a particular location or circumstance.
Driving in Argentina is generally more dangerous than driving in the United States. By comparison, drivers in Argentina tend to be very aggressive, especially in the capital city of Buenos Aires, and frequently ignore traffic regulations. U.S. driver's licenses are valid in the capital and the province of Buenos Aires, but Argentine or international licenses are required to drive in the rest of the country. For further information, please contact the Argentine Automobile Club, Av. Libertador 1850, 1112 Capital Federal, telephone (011) (54)(11) 4802-6061, or contact the Embassy of Argentina as listed in the above section on Entry Requirements. Please refer to our Road Safety page for more information. Visit the websites of Argentina's national tourist office and national roadways office at www.turismo.gov.ar and www.vialidad.gov.ar.

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

SPECIAL CIRCUMSTANCES: In addition to being subject to all Argentine laws affecting U.S. citizens, dual nationals may also be subject to other laws that impose special obligations on Argentine citizens. In some instances, dual nationality may hamper U.S. Government efforts to provide protection abroad. 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 also be more severe than in the United States for similar offenses. Persons violating Argentina's laws, even unknowingly, may be expelled, arrested or imprisoned. Penalties for possession, use, or trafficking in illegal drugs in Argentina are strict, and convicted offenders can expect lengthy jail sentences and fines. Engaging in sexual conduct with children and using or disseminating child pornography in a foreign country are crimes 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 Argentina are encouraged to register with the U.S. Embassy through the State Department’s travel registration web site, so that they can obtain updated information on travel and security within Argentina. Americans without Internet access may register directly with the U.S. Embassy. By registering, American citizens make it much easier for the Embassy or Consulate to contact them in case of emergency. The U.S. Embassy is located at Avenida Colombia 4300 in the Palermo neighborhood of Buenos Aires (near the Plaza Italia stop on the "D" line subway). The main Embassy switchboard telephone is (54) (11) 5777-4533. Recorded consular information, including instructions on whom to contact in case of an American citizen emergency, is available at tel. (54) (11) 4514-1830. The Consular Section fax is (54) (11) 5777-4293. The Consular Section is open to the public from 8:30 a.m. to noon and 2:30 p.m. to 4 p.m. Monday through Friday, except on American and Argentine holidays. Additional information on Embassy services is available on the Internet at http://argentina.usembassy.gov or by e-mail: BuenosAires-ACS@state.gov
* * *
This replaces the Country Specific Information December 28, 2007 to update Sections on Country Description, Safety and Security, Information for Victims of Crime, Medical Facilities, Traffic Safety and Road Conditions, and Registration/Embassy Locations.

Travel News Headlines WORLD NEWS

Date: Sun 22 Sep 2019
Source: La Voz [in Spanish trans. Mod.TY, edited]

Viruses transmitted by mosquitoes are emerging in the Americas. To historic dengue in recent years have been added Zika and chikungunya [viruses], 2 pathogens that before were restricted only to Africa. Madariaga has now been added to that list [of viruses new in the Americas].

Researchers from the Instituto de Medicina Regional of the Universidad Nacional del Nordeste (IMR-Unne) and from the Instituto de Virologia, and J. M. Vanella of the Universidad Nacional de Cordoba (Inviv, UNC) detected its presence in mosquitoes captured in the Chaco. "Madariaga is a virus that causes disease in equine animals and is of low pathogenicity for humans, but in 2010 caused an outbreak in humans in Panama with 10 cases," said Marta Contigiani, who works in the UNC laboratory. It was also isolated in 2015 and 2016 from human samples in Haiti.

Ornella Stechina, of the IMR-Unne, was the person who detected presence of the virus in the mosquitoes. The work was done with the financial support of this institution with Mariana Stein, a researcher from CONICET [the national science agency] as the person in charge.

Contigiani explained that there have been no subsequent cases in horses since 1988. "In other provinces in the country, serological studies have detected [Madariaga] virus infections. There is a vaccine for equine animals, but its application is not obligatory," she said.

However, she warned that global climate change (including deforestation in the Amazon Basin) influences the geographic distribution and emergence of diseases, with appearance of new environments that are favorable for the development of vectors and that favor the development of the [transmission] cycle.

"To this we must add the genetic changes that are observed in these viruses," she stated.

For some time, experts have been issuing alerts about the emergence and reemergence of arboviruses, pathogens that are transmitted by insects.

"West Nile virus rapidly invaded North America, and now cases are being found in Central and South America. Also, Mayaro and eastern equine encephalitis viruses have increased their activity and have been found in new regions," said Raquel Gleiser, a researcher at the Instituto Multidisciplinario de Biologia Vegetal of the UNC (Imbiv) in an article published in the Journal of Medical Entomology.

Madariaga virus is a strain of eastern equine encephalitis virus, which was early on detected in Argentina. Contigiani did not discard the possibility that a variant that had greater capacity to replicate, the proliferation of competent vectors, and propitious environmental conditions could cause an outbreak in the region.

The evidence for warning about Madariaga virus is not at the same level as for chikungunya [virus], although they are in the same family (Togaviridae). "For now, the epidemiological behavior is different. Chikungunya virus has _Aedes aegypti_ as its vector, whereas the vector of Madariaga virus is within the _Culex_ genus," she said.

This study detected the virus in mosquitoes of the _Culex_ genus in wildland areas in Choco province. Thus, they identified this vector in Argentinian territory for the 1st time.

Although the mosquito species or species that had the virus could not be detected, the genus _Culex_ has more than 1000 species, many of which are of urban habits such as _Culex pipiens_ that we hear buzzing at night.

Madariaga virus can infect various mammals that could serve as hosts, such as rats and bats, as well as birds.

In Argentina, it was found for the 1st time in animals in the decade of the 1930s. The strain found in the Chaco belongs to the same lineage discovered in those years, which indicates that the virus is endemic in the region.

For now, the infections studied in humans has been for the most part mild and asymptomatic.

Adrian Diaz of the Cordoba Institute, Griselda Oria (IMR-Unne), and Carolina Torres of the Universidad de Buenos Aires participated as part of the work that was published a week ago in the American Journal of Tropical Medicine and Hygiene [reference below].

The researchers suggest that more epidemiological studies be done to determine the vectors and potential hosts and do deeper studies about the genetic characteristics of the [virus] strains that circulate in the country in order to know whether this virus is endemic in the region or is reintroduced.

"Ideally, studies will be done [in the field] with sentinel animals to detect virus circulation as well. In other countries, they use sentinel chickens for these types of studies," Contigiani commented, and clarified that in case [virus] circulation was detected, animal health officials must take relevant measures.

"There is no human vaccine, so [human] health officials must indicate measures [needed] for prevention and control," she added.

The vector is the most common, _Culex_. However, there is no virus circulation in Cordoba.

_Culex_ is a genus of hematophagous mosquitoes in the Culiidae family, many species of which act as vectors of important diseases, such as West Nile, filariasis, virus encephalitis (Japanese, Venezuelan, equine, and St. Louis) and avian malaria, as well as Madariaga virus. There are more than 80 varieties [of what?].  [Byline: Lucas Viano]
=================
[The isolation of Madariaga virus from Culex mosquitoes in northern Argentina is interesting, but, as the authors point out, merits additional studies to determine whether it is a human or animal (especially equine) pathogen of importance for human or animal health in Argentina. Studies of the Culex species involved in transmission of the virus and determination of the animal hosts are essential to understand cycles of transmission.

Reference:
Ornela Sofia Stechina, Griselda Ines Oria, Carolina Torres, Luis Adrian Diaz, Marta Contigiani and Marina Stein. First Detection of Madariaga virus in Mosquitoes Collected in a Wild Environment of Northeastern Argentina. 2019. Am. J. Trop. Med. Hyg., 00(0), 2019, pp. 1-3 DOI: <https://doi.org/10.4269/ajtmh.19-0475>.

Chaco province is in the far north of Argentina. - ProMED Mod.TY]

[HealthMap/ProMED map available at:
Chaco Province, Argentina: <http://healthmap.org/promed/p/54342>]
Date: Sun 4 Aug 2019
Source: Diario Uno [in Spanish, trans. ProMED Mod.JG, edited]

A family living in El Borbollon, Las Heras, ate ham and sausages after fixing pork at their home, but after this, 11 persons needed medical attention because of the occurrence of symptoms related to trichinellosis.

It was reported that the Provincial Livestock Direction confiscated homemade ham and sausages after receiving an alert from the Epidemiology Area of Lagomaggiore Hospital, which stated they received and attended (infected) people with symptoms of thichinellosis.

The operation was carried out last Friday in a household located in El Borbollon, which was pointed out as the infection source after 3 persons (2 of them less than legal age) were brought to Lagomaggiore Hospital seeking medical care. As days went by, 8 additional compatible cases -- presenting with similar symptoms -- were reported in Lencinas Hospital.

Once the protocol involving Food Hygiene, Zoonoses, Livestock Farming, and Epidemiology local departments and also the local municipality was activated, 2 pieces of ham, 2 pork shoulders, one piece of pork tenderloin, dry sausages and Bondiola pork were confiscated. Considering the size of these pieces, it is thought a large animal was involved.

Laboratory tests were immediately performed, and because of positive results, the meat products were destroyed and properly disposed of in a local slaughterhouse, aiming to prevent the dissemination of this disease.

Trichinellosis is a parasitic disease caused by ingesting _Trichinella spiralis_ larvae located in muscles (meat). This condition is characterized by high fever, muscle pain and vomiting or diarrhoea. The disease affects humans and many mammals. This condition is acquired by eating infected pork meat.

Common symptoms are diarrhoea, abdominal pain, fatigue, nausea, vomiting, and in severe cases also fever.
=====================
[Trichinellosis caused by _Trichinella spiralis_ is common in Argentina, especially in northern Argentina (see ProMED reports below). The source of meat is pigs from small farms or even "backyard pigs" slaughtered and processed without proper veterinary control. - ProMED Mod.EP]

[HealthMap/ProMED map available at:
Mendoza, Mendoza, Argentina: <http://healthmap.org/promed/p/5900>]
Date: Wed 24 Jul 2019
Source: Jujuy al Momento [in Spanish, trans. ProMED Mod.TY, edited]

The disease [virus], transmitted by rodents, has now taken the life of a man, and there are 18 confirmed cases [of hantavirus infection]. There is concern in the health sector because of the lack of environmental policies to confront the problem of trash dumps, one of the environments where these animals [rodents] proliferate.

- There are now 18 confirmed cases of hantavirus [infections].
- There are 372 suspected cases.
- The increase in the number of trash dumps in the whole province contributes to aggravation of the situation.

The Ministry of Health indicated that there are 372 suspected cases of hantavirus [infections] in Jujuy, with 18 confirmed cases. An adolescent died in the Talar locality, and 17 patients are recuperating favorably.

The majority of the cases are registered in Palma Sola and San Pedro with 4 in each locality.

There was also a case of hantavirus [infection] very close to San Salvador that occurred in the Palpala rural area. This city is one of those with evidence of the greatest increase in trash dumps, to the point that several of them begin to increase in proximity to the plazas and urban neighborhoods.

_Hantavirus_ is a genus that groups various RNA viruses that are transmitted by rodents and, in humans, generally produces 2 types of afflictions: a type of viral hemorrhagic fever, a hemorrhagic fever with renal syndrome; or hantavirus pulmonary syndrome, a very serious affliction.

The disease has a strict relationship to trash deposits since this is where these [reservoir] animals eat and reproduce. Despite this, the Ministry of the Environment, headed by Maria Ines Zigaran, still has not recognized policies to attack the problem.
=====================
[Cases of hantavirus infections have been increasing in Jujuy province since early April 2019. The number of confirmed hantavirus infections in Jujuy province has increased from 11 cases reported on 8 Apr 2019, in the localities of San Pedro, Palma Sola, Libertador General San Martin, and Calilegua, to 15 cases on 10 May 2019, and now to 18 cases reported above. The above report of 372 suspected cases is a surprisingly large number. It will be interesting to learn how many of these cases are ultimately confirmed as hantavirus infections. The confirmed cases are from a variety of locations, indicating that the virus and its reservoir rodent hosts are widespread in the province. The public is well advised to follow the Ministry's recommendations for avoidance of infection.

The hantaviruses responsible for these 18 confirmed cases are not stated in the earlier reports or the one above. An earlier report from Jujuy province this year (2019) apparently presumed that the hantavirus involved in that case was Laguna Negra, although it is not stated that this virus had been laboratory confirmed. As noted in ProMED-mail archive no. http://promedmail.org/post/20110430.1348, several hantaviruses have been associated with human infection and hantavirus pulmonary syndrome in Argentina: Andes virus (in western Argentina, in the long-tailed pygmy rice rat host, _Oligoryzomys longicaudatus_); related Andes-like viruses Hu39694 (in central Argentina; rodent host unknown); Lechiguana (in central Argentina, in the yellow pygmy rice rat, _O. flavescens_); Oran (in northwestern Argentina, in _O. longicaudatus_); Bermejo (in western Argentina, in _O. flavescens_); and Laguna Negra (in northern Argentina, in _Calomys laucha_). Seoul virus with its brown rat (_Rattus norvegicus_) host (a frequenter of trash dumps) is another possibility. Without laboratory confirmation, it is not possible to say with certainty which hantavirus was involved. Andes virus seems unlikely in these cases in Jujuy province. - ProMED Mod.TY]

[Map of Argentina:

HealthMap/ProMED-mail map:
Jujuy province, Argentina: <http://healthmap.org/promed/p/53166>]
Date: Sat 29 Jun 2019 10:38 ART
Source: La Voz, Argentina [in Spanish, trans. Rapp. Kathryn Soderholm, abridged, edited]

The Ministry of Health of San Luis issued an epidemiological alert after 3 cases of trichinosis were confirmed by laboratory. The cases are one child, his father, and his mother. Another 12 probable cases are under investigation, all from the distant towns of Concaran and Villa Mercedes, 163 [101 mi] and 100 kilometres [62 mi], respectively, from the provincial capital [San Luis].

The affected patients would have contracted the disease after consuming sausages purchased in La Punilla at the beginning of June [2019], and the symptoms were detected 48 hours ago, the News Agency of the provincial state declared.

The head of Epidemiology, Rodrigo Verdugo, confirmed that the analyses were performed last [Thu 27 Jun 2019] after the suspected cases were referred on [26 Jun 2019].

The other 12 cases are being investigated and will be confirmed by blood sample.

The boy, who is 8 years old, remains hospitalized in the San Luis Hospital; another patient hospitalized in Merlo and another in Villa Mercedes.

Representatives from the department of Epidemiology with the Sanitary and Fiscal Control Program (Cosafi) toured La Punilla and Concaran, where the other cases originated, making visits to the premises that may have samples of these foods, explained Claudia Olarte, head of the Epidemiological Surveillance Service.

Verdugo noted that "this is the 1st outbreak" of this year [2019] and recalled that in 2018, 3 cases were detected, one of which also originated in La Punilla, so the Health department is also investigating in nearby towns such as Papagayos and Villa del Carmen.
=====================
[La Punilla is approximately 200 km [about 125 mi] south of Cordoba, in San Luis province. Trichinellosis has been reported often from Argentina. The source is homemade sausages from backyard pigs, slaughtered and used or sold at local markets without veterinary control. - ProMED Mod.EP]

[HealthMap/ProMED-mail map of Argentina:
Date: Sat 18 May 2019
Source: Food Safety News [edited>

Two cases of foodborne botulism linked to hummus have been confirmed by Argentinian health authorities. The National Administration of Drugs, Foods and Medical Devices (ANMAT) reported that an investigation confirmed the botulism cases and results of an epidemiological survey determined illness was associated with a hummus product. Hummus was sold under the brand Tsuki Macro Vegan, which is based in Palermo, Buenos Aires.

The general directorate of hygiene and food safety and ANMAT inspected the processing establishment where the product was made and imposed a ban on processing and marketing. It was also detected that the product did not have the relevant sanitary authorization. The processing firm was asked to carry out an immediate withdrawal from the national market of all units of the implicated branded hummus.

ANMAT advised the public to refrain from consuming the product and to keep the containers closed and separated from other foods. The agency also told those who sell the products to stop marketing it.

Botulism is a rare but life-threatening condition caused by toxins produced by _Clostridium botulinum_ bacteria. In foodborne botulism, symptoms generally begin 18-36 hours after eating a contaminated food. However, they can start as soon as 6 hours after, or up to 10 days later. Botulism can cause symptoms including general weakness, dizziness, double vision, and trouble with speaking or swallowing. Difficulty in breathing, weakness of other muscles, abdominal distension, and constipation may also occur. People experiencing these problems should seek immediate medical attention.

The latest incident follows a different outbreak in Rancul, a town in the La Pampa province of Argentina, at the start of May 2019 with 4 suspected cases. Health authorities in La Pampa reported that 4 people older than 57 years old were in a serious condition and needed hospital treatment. The poisoning was a result of a meal shared by 7 friends in Rancul. The suspected source is preserves such as peppers that were prepared in a homemade way by one of the people who fell ill.
===================
[Hummus is an unusual source of botulism but has been reported, also from a commercially produced product.

Mad'arova L, Dorner BG, Schaade L, et al.: Reoccurrence of botulinum neurotoxin subtype A3 inducing food-borne botulism, Slovakia, 2015. Euro Surveill. 2017 Aug 10; 22(32): pii: 30591. doi: 10.2807/1560-7917.ES.2017.22.32.30591.

Abstract
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A case of foodborne botulism occurred in Slovakia in 2015. _Clostridium botulinum_ type A was isolated from 3 nearly empty commercial hummus tubes. The product, which was sold in Slovakia and the Czech Republic, was withdrawn from the market, and a warning was issued immediately through the European Commission's Rapid Alert System for Food and Feed (RASFF). Further investigation revealed the presence of botulinum neurotoxin (BoNT) subtype BoNT/A3, a very rare subtype implicated in only one previous outbreak (Loch Maree in Scotland, 1922). It is the most divergent subtype of BoNT/A with 15.4% difference at the amino acid level compared with the prototype BoNT/A1. This makes it more prone to evading immunological and PCR-based detection. It is recommended that testing laboratories are advised that this subtype has been associated with foodborne botulism for the 2nd time since the 1st outbreak almost 100 years ago, and to validate their immunological or PCR-based methods against this divergent subtype. - ProMED Mod.LL]

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World Travel News Headlines

Date: Tue, 12 Nov 2019 13:10:01 +0100 (MET)
By Holly ROBERTSON, Andrew BEATTY, with Daniel De Cartert in Hillville

Sydney, Nov 12, 2019 (AFP) - Bushfires raging across eastern Australia singed Sydney's suburbs on Tuesday, with firefighters scrambling planes and helicopters to douse a built-up neighbourhood with water and red retardant.   Experts have described the conditions as the worst on record, as spring temperatures climbed toward 40 degrees Celsius (104 Fahrenheit) and winds topped 80 kilometres (50 miles) per hour across a zone which has been plagued by persistent drought.   Although the bushfire season is in its infancy, scientists predict it to be one of Australia's toughest ever, with climate change and unfavourable weather cycles helping created a tinderbox of strong winds, low humidity and high temperatures.

Twin blazes in the north shore suburb of Turramurra -- around 15 kilometres (nine miles) from the centre of Australia's largest city -- tore through a eucalypt forest park and sparked spot fires in homes, before eventually being brought under control.   As night fell, authorities said they were bringing another "clearly suspicious" blaze in a national park in the city's southern suburbs under control.    Throughout the day, more than 300 bushfires burned up and down Australia's east coast, fanned by gale-force winds, scorching temperatures and tinder-dry bushland that has brought some of the most dangerous conditions the country has seen.

In Turramurra, gardens smouldered, thick smoke hung heavy in the air and cars, houses and roads were caked in raspberry-red retardant as if hit by a giant paintball.   "It was the embers that floated up that actually went across and set off spot fires in the front yards" resident Nigel Lush told AFP, adding that one roof had been set alight.   Another resident, Julia Gretton-Roberts, said the blaze spread shockingly quickly.   "Next thing I know the fire was opposite our house and it was massive and the police came and grabbed our kids and took them away," she said.   "My daughter is pretty freaked out."   Firefighter Andrew Connon told AFP "a number of homes were threatened but it was contained by the aerial bombing".

- 'Catastrophic conditions' -
From early morning thousands of firefighters spread out across New South Wales in anticipation of what they called "off the scale" fire risk and "catastrophic" conditions.   They were unable to prevent several bushfires from breaching containment lines and trapping residents who had not already evacuated.   New South Wales Rural Fire Service Commissioner Shane Fitzsimmons said so far only a dozen buildings had been damaged Tuesday and a handful non-life-threatening injuries were reported, but the crisis was far from over.

Firefighters will be "working on these fires for days and weeks given the enormity of the firegrounds," he said.    Even before unfavourable weather hit, days of fires had killed three people and destroyed at least 150 homes.   "The conditions are expected to get worse," Fitzsimmons said, warning residents in adjacent areas to stay alert.   "Complacency kills," he added.   Up to 600 schools were closed, as well as many national parks, a total fire ban was introduced for the affected area and Rally Australia -- due to be held in Coffs Harbour at the weekend -- was cancelled.   The military pitched in, helping firefighters with logistics and water-dropping sorties using more than 100 aircraft.

- 'We'll fight it first' -
In the town of Hillville a fire that has ripped through an area the size of 25,000 soccer fields approached the home of Daniel Stevens.   Like many, his family -- including his mother nursing a broken leg -- have packed their bags, but have resisted leaving their house and everything they own.    "We'll fight it first," he told AFP, "but if it jumps the fence line into the paddock, we'll go."

In the nearby town of Taree, dozens of people have already moved to a showground that has become a makeshift evacuation centre.   Fifty-nine-year-old Caroline Watson arrived last night with her husband and their dog.    "The fires are just rife. They are absolutely everywhere" she told AFP. "They didn't ask us to get out, but we figured it was coming."

Further south in the Blue Mountains on the outskirts of Sydney, veteran Winmalee firefighter Alan Gardiner said locals were "terrified and on edge".    The town still bears the scars of a 2013 blaze that destroyed 200 homes, and residents are acutely aware that with few roads in and out of the mountains, a decision to leave late can be fatal.   Efforts to burn fuel in a controlled way have been limited by months of drought-like conditions that made it too dangerous.
Date: Tue, 12 Nov 2019 10:03:07 +0100 (MET)

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

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

After a string of embarrassing incidents by tourists, Bali officials recently warned that boorish visitors may be kicked off the island, which attracts millions annually to its palm-fringed beaches, colourful nightlife and ancient temples.   Australian professional rugby league player David Fifita returned home this week after he was briefly arrested in Bali for assaulting a nightclub security guard.   Several days after Carr's arrest, a Czech couple who were slammed for disrespecting a Balinese temple took part in a ritual purification ceremony.
Date: Mon, 11 Nov 2019 16:19:54 +0100 (MET)

Lyon, Nov 11, 2019 (AFP) - An unusually strong earthquake hit south-eastern France on Monday, injuring four people, one of them seriously, authorities said.   A physicist at a geophysics institute the IPGP said that quakes of this strength are rare in that region, but warned of possible aftershocks and said people should leave fragile buildings.   The quake, with a magnitude of 5.4, was felt in a vast area between the cities of Lyon and Montelimar which are about 150 kilometres (93 miles) apart, the national seismological office said.   "I was leaning against the oven in my mother's bakery when I felt the tremor," said Victoria Brielle, a resident in Privas, some 25 kilometres from the quake's epicentre.   "A customer said her sideboard had moved and all her crockery was broken,"  she said.

Another resident in the area, Didier Levy, who lives in a 15th century castle, told AFP that "chandeliers were still trembling" several minutes after the quake.   Levy, who said his dog starting barking even before humans felt the tremors, added: "I have never experienced anything like it, I could feel the trembling even though these wall are one metre thick."   One person was seriously hurt when some scaffolding collapsed, the regional prefect's office said.   Three other people in the neighbouring Ardeche region were slightly injured.

Quakes in this region are rarely higher than Magnitude 5, said Mustapha Meghraoui of the IPGP's office in Strasbourg.   "We can say that this is a rare one," he added. But he said there might be an aftershock of around 4.5.   "If people are in a fragile house, they would be better leaving it" for something more robust for a while, he said.   The scale of the damage suggested the quake happened at a depth of between five and 10 kilometres, he added. But they were working on a more accurate reading.
Date: Mon, 11 Nov 2019 13:19:54 +0100 (MET)

Goma, DR Congo, Nov 11, 2019 (AFP) - A local radio station that has been involved in the fight against Ebola in eastern DR Congo said Monday it was closing down after one of its broadcasters was murdered.   Joel Musavuli, head of Lwemba radio in Mambasa in Ituri province, told AFP that the station had been targeted by armed groups hostile to the campaign to roll back the Ebola epidemic.

"Each of us have received threats since last month. We have now decided to stop broadcasting, Musavuli said, adding that he himself had escaped two kidnap attempts.   "We are victims of our commitment to the awareness campaign about the spread of Ebola virus disease. We don't know why the militiamen are targeting us."   Nearly 2,200 people have died since the notorious haemorrhagic disease erupted in eastern Democratic Republic of Congo in August 2018, according to the latest official figures.

The fight against the outbreak has been hampered by local fears and superstititions, exploited by militia groups that are rampant in the remote region.   Several health workers have been killed and media that have supported the campaign have received threats.

Several radio stations in the Mambasa area say they have stopped broadcasting anti-Ebola messages because of intimidation.   On November 2, Lwemba broadcaster Papy Mahamba was killed at his home by unidentified men. His wife was injured and their house set ablaze.    The station said the authorities had failed to take action against the threats. It said it would resume broadcasts after "the state has restored authority in the area".
Date: Mon, 11 Nov 2019 11:38:15 +0100 (MET)

Kuwait City, Nov 11, 2019 (AFP) - Hundreds of workers at Kuwait's international airport held a one-hour strike Monday to demand better working conditions, threatening to stage longer walkouts in the coming days.    Ahmed Mohammed al-Kandari, a union representative, said workers were calling for improved treatment and to be compensated for daily exposure to pollution and noise.  Monday's strike by Kuwaiti staff did not affect flights, officials said.   The right to strike is guaranteed for citizens in Kuwait, but such actions remain rare in the Gulf country.

Foreign workers do not have the right to strike.  "Airport traffic is very normal," Sheikh Salman Al-Hamoud Al-Sabah, head of the General Directorate of Civil Aviation, told AFP.    Another official, Saleh Al-Fadaghi, the airport's director of operations, also said flights were not affected. "During the one-hour strike, 19 flights were operated as scheduled. There were five departures and 14 arrivals," he told AFP.

Kandari said the purpose of the strike was not to disrupt operations but "to make our voices heard". He added that Kuwaiti workers would hold a further two-hour strike on Wednesday and a 24-hour strike on Sunday if their demands are not met.    Of 4,500 civil aviation employees, 1,500 took part in Monday's strike, he said.
Date: Mon, 11 Nov 2019 10:39:09 +0100 (MET)

La Jonquera, Spain, Nov 11, 2019 (AFP) - Catalan separatist activists blocked traffic on Monday on a motorway linking Spain and France, in a fresh protest against the sentencing last month of nine of their leaders to lengthy jail terms.   Demonstrators cut the AP7 motorway at La Jonquera near the city of Girona in eastern Spain, a day after a repeat general election in which Prime Minister Pedro Sanchez's Socialist emerged as winners but weakened, while far-right party Vox surged to third place on the back of its hardline stance against separatism.   Dozens of vehicles blocked the motorway near the border with France while some 300 people set up a barricade, according to an AFP photographer at the scene.   Some demonstrators began to set up a stage and speakers which they brought to the scene in vans.   Catalonia's regional road department confirmed the motorway was cut in both directions at La Jonquera.

The protest was called by a new, mysterious organisation called "Democratic Tsunami" which last month sent thousands of people to block access to Barcelona airport in a protest which ended in clashes between demonstrators and police.   "This mobilisation is a cry to the international community so that it makes the Spanish state understand that the only possible path is to sit down and talk," the group said in a message sent to its followers on encrypted messaging service Telegram.   Radical separatist group CDR also called on its supporters to head to La Jonquera to block the highway.   Catalonia was rocked by days of mass, sometimes violent, pro-independence rallies after Spain's Supreme Court on October 14 sentenced nine politicians and activists to jail for up to 13 years for their role in a failed secession bid in 2017.   Demonstrators have frequently cut road and rail links between Spain and France while many shops in downtown Barcelona have been shut during the rallies and there are growing concerns about the impact of the unrest on business in Spain's second largest city.
Date: Sat, 9 Nov 2019 18:59:25 +0100 (MET)

MOUSOUNI ISLAND, India, Nov 9, 2019 (AFP) - Cyclone Bulbul hit India and southern Bangladesh on Saturday, leaving two dead as authorities in the countries ordered more than two million people to get out of the path of the storm.   The cyclone, packing winds of up to 120 kilometres (75 miles) per hour, has "weakened" and "started crossing" India's West Bengal and Bangladesh's Khulna coast at about 9:00 pm (1500 GMT), Dhaka's Meteorological Department said in a special bulletin.   "It is likely to move in a northeasterly direction" and "weaken gradually, and may complete crossing West Bengal-Khulna coast by midnight tonight," the department said.     Airports and ports were shut down and the deaths were reported before the full force of the cyclone had hit.   One person was killed by an uprooted tree in Kolkata and another by a wall that collapsed under the force of the winds in Odisha state, authorities said.

More than 60,000 people were moved away from the coast on the Indian side of the border.   Bangladesh disaster management secretary Shah Kamal told AFP that "2.028 million" have been evacuated and moved to more than 5,500 cyclone shelters.   He said there was no reports of casualties and rejected reports in local media that dozens of local fishermen were missing on the southern coast.    Bangladeshi troops were sent to some villages, while about 55,000 volunteers went door-to-door and making loudspeaker announcements in the streets to get people away from the danger zone in villages, many of which were below sea level.

- Ports closed, flights halted -
A storm surge up to two metres (seven feet) was predicted along the coast, Bangladesh's Meteorological Department said.   About 1,500 tourists were stranded on the southern island of Saint Martin after boat services were suspended due to bad weather.   Bangladesh's two biggest ports, Mongla and Chittagong, were closed because of the storm, and flights into Chittagong airport were halted.   In India, flights in and out of Kolkata airport were suspended for 12 hours because of the storm.   On the West Bengal island of Mousouni, which lies in the path of the storm, frightened residents took shelter in schools and government buildings because they had not been able to escape.   Military planes and ships have been put on standby to help in emergencies, Indian authorities said.

Bulbul hit the coast at the Sundarbans, the world's largest mangrove forest, which straddles Bangladesh and part of eastern India, and is home to endangered species including the Bengal tiger and the Irrawaddy dolphins.   Bangladesh's low-lying coast, home to 30 million people, is regularly battered by cyclones that leave a trail of destruction.   Hundreds of thousands of people have been killed in cyclones in recent decades.   While the frequency and intensity have increased, partly due to climate change, the death tolls have come down because of faster evacuations and the building of 4,000 cyclone shelters along the coast.   In November 2007, Cyclone Sidr killed more than 3,000 people. In May this year, Fani became the most powerful storm to hit the country in five years, but the death toll was about 12.
Date: Sat, 9 Nov 2019 14:18:27 +0100 (MET)

Beirut, Nov 9, 2019 (AFP) - Several petrol stations in protest-hit Lebanon stopped services Saturday, as reserves ran dry due to a shortage of US dollars to pay suppliers, a syndicate head said.   The shuttering of petrol stations came as demonstrators again took to the street across the country, keeping up their three-week-long movement against a political class regarded as inefficient and corrupt.    "The petrol stations that opened today are the ones that still have reserves. They will close down as soon as supply runs out," said Sami Brax, the head of the Syndicate of Gas Station Owners.   He said if officials do not facilitate access to dollars by Tuesday, "we will be forced to stop imports and close down all petrol stations."

Petrol stations receive payment from customers in Lebanese pounds but have to pay importers and suppliers in dollars.    For two decades, the Lebanese pound has been pegged to the US dollar, with both currencies used interchangeably in daily life.   But banks have been reducing access to dollars since the end of the summer, following fears of a shortage in central bank dollar reserves.   In recent days, banks halted all ATM withdrawals in dollars and severely restricted conversions from Lebanese pounds.   Many Lebanese have had to instead buy dollars from money changers at a higher exchange rate, in what amounts to a de-facto devaluation of the local currency that has sparked price hikes.

The official exchange rate has remained fixed at 1,507 Lebanese pounds to the dollar, but the rate in the parallel market has surpassed 1,800.   "The banks are under pressure from people, both inside Lebanon and abroad," said economist Naseeb Ghabreel, after many rushed to withdraw their dollar savings or convert Lebanese pound accounts.   Since September, petrol station owners have accused banks of failing to provide them with the dollars they need and threatened strikes.    In response, the central bank last month pledged to facilitate access to the greenback for importers of petroleum products, wheat and medicine.   But the measure has not yet gone into effect.

Lebanon has since October 17 witnessed an unprecedented popular uprising against everything from power cuts and poor social security to alleged state corruption.   The government yielded to popular pressure and stepped down last month, with the World Bank urging for the quick formation of a new cabinet to prevent the economy from further deteriorating.
Date: Fri, 8 Nov 2019 19:25:02 +0100 (MET)

Madrid, Nov 8, 2019 (AFP) - Spanish health authorities confirmed Friday a case of a man spreading dengue through sex, a world first for a virus which until recently was thought to be transmitted only by mosquitos.   The case concerns a 41-year-old man from Madrid who contracted dengue after having sex with his male partner who picked up the virus from a mosquito bite during a trip to Cuba, said Susana Jimenez of the Madrid region's public health department.

His dengue infection was confirmed in September and it puzzled doctors because he had not travelled to a country where the disease, which causes severe flu-like symptoms such as high fever and body aches, is common, she added.   "His partner presented the same symptoms as him but lighter around ten days earlier, and he had previously visited Cuba and the Dominican Republic," Jimenez said.   "An analysis of their sperm was carried out and it revealed that not only did they have dengue but that it was exactly the same virus which circulates in Cuba."

A "likely' case of sexual transmission of dengue between a man and a woman was the subject of a recent scientific article in South Corea, Jimenez said.   In an e-mail sent to AFP, the Stockholm-based European Centre for Disease Prevention and Control (ECDC), which monitors health and disease in Europe, said this was "to our knowledge, the first sexual transmission of the dengue virus among men who have sex with men."

According to the World Health Organization's website, dengue is transmitted mainly by the Aedes Aegypti mosquito, which thrives in densely-populated tropical climates and breeds in stagnant pools of water.    It is most serious -- and deadly -- in children, especially young girls though scientists don't know why.

Dengue is most commonly caught by people travelling to hotter climates such as southeast Asia, Africa, Australia, the Caribbean and South and Central America.
Date: Sun 10 Nov 2019
Source: The News [abridged, edited]

Another young man is awaiting death in an isolation ward of the Jinnah Postgraduate Medical Centre (JPMC) after developing full-blown rabies, as he was bitten by a rabid dog some 3 months ago but was not administered the rabies vaccine, officials said on Saturday [9 Nov 2019].

"18-year-old Z.K., a resident of Jeva Khan Goth in the Nooriabad area of District Jamshoro, has been brought to the casualty ward of the JPMC with full-blown rabies," Dr Seemin Jamali, the hospital's executive director, told The News.

"According to his family members, the teenager was bitten by a stray dog on the leg around 3 months ago. Unfortunately, neither did the family know about vaccination nor did anybody tell them to get the teenager vaccinated, which resulted in the development of the lethal disease."

Sindh Health Department officials said that this is the 22nd case of rabies in the province this year [2019].

M.K., the ill-fated youngster's father, said that after his son was bitten on the leg, he was taken to a local doctor, who had dressed the wound and given him some medicines but had not asked for the teenager to be vaccinated or referred him to a tertiary-care hospital.

Officials said that right now, dog-bite incidents are on the rise in Karachi as well as in other districts of Sindh, with so far more than 200 000 people falling victim to canine attacks.

They added that the population of rabid dogs is also on the rise, and the animals are not only transmitting the disease to their own species but also attacking humans throughout the province.

Dr Seemin said: "These days any person who is bitten by a dog should be given immunoglobulin as well as the full course of the rabies vaccine to prevent the victim from a painful death. Once rabies is developed in a person, there is no cure for their condition."

She deplored the fact that on the one hand incidents of dog-bite are on the rise and on the other, hospitals in the entire province are facing a shortage of the rabies vaccine, due to which the cases are being referred to the JPMC in Karachi.

"Even the Abbasi Shaheed Hospital, which is considered to be a tertiary-care hospital, is referring dog-bite victims to the JPMC after administering one dose of the vaccine," she said.

"As we don't know the status of their vaccination, we have to vaccinate these patients from zero, but this practice is extremely unprofessional, and it can result in the loss of a precious life."

On the other hand, the shortage of rabies vaccine is becoming a serious issue in Pakistan, especially in Sindh, which requires hundreds of thousands of doses to prevent the people from developing rabies encephalitis.

Pakistan used to get most of its rabies vaccine supplies from Indian biotechnology giants and pharmaceutical companies, but after the deterioration of relations between the 2 countries, Pakistan's next-door neighbour reduced those supplies, while production at the NIH is insufficient to meet the local requirements.

In this scenario, experts say there is an urgent need to control the population of stray dogs in the country by hook or by crook. They believe that at a time when there is not enough rabies vaccine available, the authorities should take measures to save people from canine attacks by reducing the dog population by any means.  [Byline: M. Waqar Bhatti]
=====================
[We have received recently several reports from Pakistan, describing human rabies cases; e.g.
(published 7 Nov 2019),
(published 3 Nov 2019),
(published 15 Oct 2019].

Hopefully, this post will help the professionals involved in getting due attention and required means from the health and municipal authorities for immediate measures undertaken, including timely supply of the required medical preparations.

According to Pakistan's Health Minister, Dr Azra Fazal Pechuho, (on Fri 8 Nov 2019), dog-bite cases were "mishandled" by citizens, as the victims were often brought to hospitals quite late, and the delay caused their deaths (see <https://www.dawn.com/news/1515803>).

WHO's most recent available position paper addressing rabies vaccines and immunoglobulins is available at

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