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Angola

Angola - US Consular Information Sheet
June 20, 2008
COUNTRY DESCRIPTION:
Angola is a large, developing country in south-west central Africa.
The capital city is Luanda.
Portuguese, the official language, is widely spoken through
ut the country.
Despite its extensive oil and mineral reserves and arable land suitable for large-scale production of numerous crops, Angola has some of the world's lowest social development indicators.
Development was severely restricted by a 27-year long civil war that broke out upon independence in 1975, which destroyed the majority of the country's infrastructure.
Since the conflict's conclusion in 2002, the government has initiated extensive infrastructure reconstruction and development projects, and there are growing signs of economic recovery.
However, Angola still faces challenges with its infrastructure and with providing government services, especially in basic social services, aviation and travel safety, accommodation availability and quality and communications. Facilities for tourism, particularly outside the capital of Luanda, are often rudimentary. Read the Department of State Background Notes on Angola for additional information.
ENTRY/EXIT REQUIREMENTS:
A passport and visa are required and must be obtained in advance.
An International Certificate of Vaccination is required.
Visitors should allow several weeks for the processing of their visa application.
Angola does not issue airport visas.
Persons arriving without visas are subject to arrest or exclusion.
Travelers may also encounter delays if they do not have at least one completely blank visa page in their passports for entry stamps.
As of November 1, 2007, Angola no longer requires travelers to have an exit visa.
Travelers whose international immunization cards do not show inoculations against yellow fever within the past ten years may be subject to exclusion, on-the-spot vaccination, and/or heavy fines.
Visitors remaining in Angola beyond their authorized visa duration are subject to fines and arrest.
It is illegal to attempt to carry local currency out of Angola and persons found attempting to carry local currency out of Angola are subject to having this currency confiscated by customs officers.
Current information on entry requirements may be obtained from the Embassy of Angola at 2100-2108 16th Street NW, Washington, DC, tel. (202) 785-1156, fax (202) 785-1258. See our information on dual nationality, the prevention of international child abduction and customs regulations.
SAFETY AND SECURITY:
The overall security situation in Angola has improved markedly since the end of the civil war; however, Americans should still exercise caution when traveling in Angola.
Although the war has ended, ground travel throughout Angola can be problematic due to land mines, which were used extensively during the war.
Travelers should not touch anything that resembles a mine or unexploded ordinance.
Frequent checkpoints and poor infrastructure contribute to unsafe travel on roads outside of the city of Luanda.
Police and military officials are sometimes undisciplined, but their authority should not be challenged.
Travel in many parts of Luanda is relatively safe by day, but car doors should be locked, windows rolled up, and packages stored out of sight.
Visitors should avoid travel after dark, and no travel should be undertaken on roads outside of cities after nightfall.

Americans located in, or planning to visit, the northern province of Cabinda should be aware of threats to their safety outside of Cabinda city.
In 2007 and 2008 armed groups specifically targeted and attacked expatriates in Cabinda; these armed attacks resulted in the rape, robbery and murder of a small number of expatriates working in Cabinda.
Those responsible have declared their intention to continue attacks against expatriates.
Occasional attacks against police and Angolan Armed Forces (FAA) convoys and outposts also continue to be reported.
These incidents, while small in overall numbers, have occurred with little or no warning.
American citizens are, therefore, urged to exercise extreme caution when traveling outside of Cabinda city and limit travel to essential only.

Americans are advised to undertake only essential travel to Lunda North and South provinces.
As the government of Angola is sensitive to the travel of foreigners in the diamond producing areas of the provinces, proper permission and documentation is required to frequent these areas.
One can be subject to restriction or detention.
There have been reports of crime or banditry in these areas, especially on roads leading into these areas.

Visitors to Angola are advised not to take photographs of sites and installations of military or security interest, including government buildings, as this can result in fines and possibly arrest.

For the latest security information, Americans traveling abroad should regularly monitor the Department’s web site, where the current Travel Warnings and Public Announcements, including the Worldwide Caution, can be found.
Up-to-date information on 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 AM to 8:00 PM Eastern Standard Time, Monday through Friday (except on U.S. federal holidays).

The Department of State urges American citizens to take responsibility for their own personal security while traveling overseas.
For general information about appropriate measures travelers can take to protect themselves in an overseas environment, see the Department of State’s pamphlet A Safe Trip Abroad.
CRIME:
Crime is a serious problem throughout Angola.
While most violent crime occurs between Angolans, foreigners have occasionally been attacked as well.
Street crime is a regular occurrence in Luanda.
The most common crimes are pick-pocketing, purse-snatching, vehicle theft, and vehicle break-ins.
Armed muggings, robberies, and carjacking involving foreigners are not frequent but do occur.
Americans are advised to avoid Roque Santeiro and Rocha Pinto, and to only travel the “Serpentine Road” in front of the U.S. Embassy by car.
In general, movement around Luanda is safer by day than by night.
Touring after dark should be avoided.
Police and military officials are sometimes undisciplined, but their authority should not be challenged.
Air travelers arriving in Luanda are strongly advised to arrange reliable and secure ground transportation in advance; there is no regular taxi service.
American citizens are advised to avoid the use of the public transportation known as “candongueiros” or “taxistas”; these multi-passenger vans are largely unregulated and often dangerous.

Motorists should stop at all police checkpoints if so directed.
Police officers may solicit bribes or request immediate payment of "fines" for alleged minor infractions.
American citizens asked for bribes by the police should politely ask the traffic police to write them a ticket if the police allege a moving violation.
If the police officer writes the ticket, then the motorist would pay the fine at the place indicated on the ticket.
If no moving violation is alleged and the officer is asking for a bribe, the motorist should, without actually challenging the officer's authority, politely ask the officer for his/her name and badge number.
Officers thus engaged will frequently let motorists go with no bribe paid if motorists follow this advice.
Motorists are reminded to have all proper documents in the vehicle at all times (i.e. vehicle registration, proof of insurance, and driver's license), as the lack of documentation is a violation and can also be a reason an officer would solicit a bribe.
Local law requires that every driver in Angola have the proper permission to drive.
Further information on driving in Angola can be obtained from the Embassy of Angola.
Police are not always responsive to reports of crime or requests for assistance.
Most police are on foot and are assigned to designated stationary posts.
The Rapid Intervention Police (PIR) unit is frequently seen patrolling various areas of the city.
This unit, which is well trained and organized, will respond to major criminal incidents.

There have been police operations against illegal aliens and private companies resulting in deportation of illegal resident foreign nationals and loss of personal and company property.
Independent entrepreneurs in Angola should carry relevant immigration and business documents at all times.

Travelers should be alert to fraud occasionally perpetrated by Luanda airport personnel.
Immigration and customs officials sometimes detain foreigners without cause, demanding gratuities before allowing them to enter or depart Angola.
Airport health officials sometimes demand that passengers arriving without proof of current yellow fever vaccination accept and pay for a vaccination at the airport.
Travelers are advised to carry their yellow fever vaccination card and ensure their yellow fever vaccine is up-to-date.
If travelers forget to bring their yellow fever vaccination card and do not wish to receive the vaccine offered at the airport, they should be prepared to depart the country on the next available flight.
Searches of travelers' checked baggage is common; travelers are advised to take precautions against this possibility.
Travelers should also be aware that criminals sometimes attempt to insert items into baggage at the airport, particularly for flights from Luanda to South Africa.
It is important that travelers maintain control of their carry-on baggage at all times, and if they believe something has been inserted into their baggage, they should report the incident immediately to airport authorities.
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 crimes 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.

In addition to reporting crime to local police and the U.S. Embassy in Angola, victims of crime who are residing in Angola are also encouraged to report the crime to the security department of their employer.
Short-term visitors are encouraged to report the crime to the management of the hotel where they are staying if the crime occurred in or near the hotel.
The local equivalent to the “911” emergency line in Angola for police is 113; for fire fighters: 115, and for ambulance services: 112.
Please be advised that the emergency numbers listed may or may not have an English speaking operator available.
See our information on Victims of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION:
Medical facilities and services are available in Angola, but are limited and often do not meet U.S. standards.
Adequate care for medical emergencies is limited to Luanda, where there are some good private clinics that usually have a 24-hour service provided by a general practice physician and with specialists on call.
A list of such facilities can be found at http://angola.usembassy.gov/medical_information.html.
Routine operations such as appendectomies can be performed.
Local pharmacies provide a limited supply of prescriptions and over-the-counter medicines/drugs.
Travelers are, therefore, urged to carry with them an adequate supply of properly-labeled medications they routinely require for the duration of their projected stay in Angola.
Malaria is endemic in most areas of Angola.

An outbreak of Marburg hemorrhagic fever, a severe and often fatal disease, occurred in Uige province in the spring of 2005; however, on November 7, 2005, the Ministry of Health of the Republic of Angola and the World Health Organization (WHO) declared that the Marburg outbreak in Angola had ended.
This announcement came after 45 consecutive days without a new case of the illness.

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

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

TRAFFIC SAFETY AND ROAD CONDITIONS:
While in a foreign country, U.S. citizens may encounter road conditions that differ significantly from those in the United States.
The information below concerning Angola is provided for general reference only, and may not be totally accurate in a particular location or circumstance.
Since the end of the civil war in 2002, overland access to the interior has increased.
However, fighting in most of the country damaged or destroyed many roads and bridges, and services for motorists outside urban areas cannot be counted on.

Road travel can be dangerous, especially during the rainy season (October - March), which can cause large potholes and erosion and due to the presence of landmines.
Road conditions vary widely outside the capital from acceptable paved surfaces to virtually impassable dirt roads, particularly secondary routes.
Many secondary roads, including secondary roads in urban areas, are impassable during the rainy season.
Overloaded, poorly marked, and disabled vehicles, as well as pedestrians and livestock, pose hazards for motorists.
Ground travel in rural areas should be undertaken during daylight hours only.
Landmines also pose a continuing hazard to travelers.
Many areas were heavily mined during the war, including roads, bridges, and railroad tracks.
Areas with suspected landmines are generally clearly marked and travelers should heed these warnings.
Primary roads are considered to be landmine free in most provinces, but travelers should not venture far from the margins of the road.
Extensive government, commercial, and NGO demining projects continue throughout the country.

Traffic in Luanda is heavy and often chaotic, and roads are often in poor condition.
Few intersections have traffic lights or police to direct vehicles.
Drivers often fail to obey traffic signals and signs, and there are frequent vehicle breakdowns.
Itinerant vendors, scooters and pedestrians often weave in and out of traffic, posing a danger to themselves and to drivers.
Most public transportation, including buses and van taxis, should be avoided as the vehicles are generally crowded and may be unreliable.
Please refer to our Road Safety page for more information.

AVIATION SAFETY OVERSIGHT:
As there is no direct commercial air service to the United States by carriers registered in Angola, the U.S. Federal Aviation Administration (FAA) has not assessed Angola’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 www.faa.gov/safety/programs_initiatives/oversight/iasa/. The U.S. Embassy in Luanda prohibits its employees from using TAAG, Angola’s national airline, for domestic or international flights due to concerns regarding safety and maintenance.
SPECIAL CIRCUMSTANCES:
Customs Regulations:
Angolan customs authorities may enforce strict regulations concerning temporary importation into or export from Angola of sensitive items including firearms, antiquities, and currency.
It is advisable to contact the Embassy of Angola in Washington, DC or one of Angola's consulates in the United States for specific information regarding customs requirements.

Financial Transactions:
Angola is generally a cash-only economy; neither traveler’s checks nor credit cards are used outside the capital of Luanda.
In Luanda, credit cards are accepted in extremely limited circumstances, namely large hotels.
Although, in April 2007 a major campaign was launched to expand credit card acceptance this effort has yet to expand beyond the capital city.
In general, Automated Teller Machine’s (ATM’s) are only accessible to those individuals who hold accounts with local banks.
Dollars are generally accepted in all provincial capitals; travelers should carry a sufficient supply of U.S. dollars with them.
Only the newer series U.S. dollar bills (with large faces) are accepted.
U.S. dollars can be converted to local currency at exchange businesses authorized by the Angolan government.
Angolan currency (the Kwanza) may not be taken out of the country and travelers, who attempt to carry currency out of Angola, are subject to having the currency confiscated.

Personal Identification: U.S. citizens are encouraged to carry a copy of their U.S. passports with them at all times so that, if questioned by local officials, proof of identity and U.S. citizenship is readily available.
The Consular Section of the U.S. Embassy in Luanda can prepare copies of American passports at no charge for individuals who register with the Embassy.
To avoid the risk of theft of or confiscation of original documentation, the U.S. Embassy recommends that Americans keep their passport in a secure place and carry a copy to avoid the possibility of authorities confiscating identity and travel documents.

Labor Disputes: American performers traveling to Angola to perform in concerts and/or other events should be aware that there have been several serious allegations made against talent agencies making arrangements for foreign performers.
These allegations include, among other things, several charges of breach of contract and the forcible retention of passports and persons.
Performers should assure themselves of the reputation of any agency they may contract with before traveling.
Many find it useful to contact performers who have previously worked in Angola and are familiar with agencies in Angola.
Persons experiencing any incidents of this nature in Angola should report these to the local Angolan police and the U.S. Embassy.

Long Delays in Renewal of Visas: U.S. citizens who opt to renew their work or other visa while in Angola should expect delays of 2-10 weeks or more, during which time the Angolan immigration authorities will retain one's passport and one will not be able to travel.
U.S. citizens are advised to plan accordingly, and if travel during this time cannot be avoided, one should apply for a second U.S. passport PRIOR to turning over the primary passport to Angolan authorities for visa renewal.
To apply for a second U.S. passport, you must write a letter explaining the need for the second passport, as well as meet all the requirements for a normal application for passport renewal, including being able to show a current valid passport.
Receiving a second passport will take 7-10 business days.
Expatriates who stay beyond their visa expiration date are subject to steep fines.

Hotel Availability:
Hotels are limited in Angola, and demand for the limited number of rooms is high.
Hotels are often booked months in advance, especially in the capital city of Luanda.
Only a few large hotels in Luanda accept credit cards; hotels in the provinces generally do not accept credit cards.
Adequate hotels are found in most provincial capitals, but some provide limited amenities.
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 offenses.
Persons violating Angolan laws, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession or use of, or trafficking in illegal drugs in Angola are severe, and convicted offenders can expect long jail sentences and heavy fines.
Engaging in sex 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 Angola 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 Angola.
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 Consular Section is located at the American Embassy Complex, Rua Houari Boumedienne #32, in the Miramar area of Luanda, P.O. Box 6468, tel. (244) 222-641-000,
(244) 222-447-028, (244) 222-445-481, (244) 222-446-224; 24-hour duty officer (244) 923-404-209; fax (244) 222-641-259.
The Consular Section may be contacted by e-mail at consularluanda@state.gov.
Further information on travel to Angola is also available at the Embassy web site at http://angola.usembassy.gov/.
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This replaces the Consular Information Sheet dated April 29, 2008, to update the Country Description, Entry/Exit Requirements, Safety and Security, Crime, Traffic Safety and Road Conditions, Aviation Safety Oversight, and Special Circumstances.

Travel News Headlines WORLD NEWS

26th December 2018

Angola (Cunene province). 29 Nov 2018. (reported) 25 cases of microcephaly. Samples sent to the central laboratory in Luanda to determine if they are Zika virus related. There were no cases of microcephaly during the same period in 2017.

[HealthMap/ProMED-mail map Angola:
Date: Sat 11 Aug 2018
Source: World Health Organization [edited]
<http://www.who.int/neglected_diseases/news/Surveillance-presence-of-dracunculiasis-in-Angola/en/>

Disease surveillance confirms the presence of dracunculiasis in Angola. The World Health Organization (WHO) has received confirmation of a human case (29 Jun 2018) of dracunculiasis (guinea worm disease) in Angola -- a country not known to have had any cases in the past. "The patient is an 8 year old girl from Cunene Province.

Signs of worm emergence in April this year [2018] were characteristic of guinea worm disease and the worm appeared identical to _Dracunculus medinensis_," said Dr Maria Cecília de Almeida of the Angolan Guinea Worm Eradication Programme and who is also director of Control Programmes for Neglected Tropical Diseases, Ministry of Health. "The case-management protocol was observed, including the preservation of the worm specimen, and we are investigating further to determine the extent of transmission and burden of the disease." The case was detected through a nationwide guinea worm case search during the national immunization campaign against measles and rubella.

The specimen was sent to the WHO Collaborating Center for Dracunculiasis Eradication at the US Centers for Disease Control and Prevention, where a polymerase chain reaction (PCR) [1] test confirmed the worm as _Dracunculus medinensis_ [2]. "This is the first confirmed case of human infection in Angola. The discovery is part of measures taken by the Ministry of Health, following a WHO evaluation mission to Angola in 2016 to assess the country's level of readiness to finalize its dossier requesting a WHO certification," said Dr Dieudonné Sankara, team leader of WHO's guinea worm eradication programme.

After the evaluation mission of 2016, the International Commission for the Certification of Dracunculiasis Eradication recommended that Angola should use all available opportunities to gather robust evidence of absence of guinea worm disease in the country before submitting its certification request. WHO is supporting Angola through all 3 of its operating levels -- Country Office, Regional Office and Headquarters -- to implement its roadmap for certification of dracunculiasis-free status. "With the discovery of this new case, measures are being put up to strengthen surveillance, reporting and investigation of all suspicious cases through the country's Integrated Disease Surveillance and Response," said Dr Nzuzi Katondi, field officer, WHO Country Office, Angola. "Intelligence and alerts are being reported and rumours are being followed up and investigated."

Efforts are also being made through the country's broader mapping exercise of other neglected tropical diseases. To achieve global certification of dracunculiasis eradication, WHO must formally certify every individual country even if no transmission has ever taken place in that particular country. Confirmation of the 1st case in Angola comes as the global guinea worm eradication programme is tackling _Dracunculus medinensis_ infection in both humans and dogs, mainly in Chad. From 1 Jan to 31 May 2018, Chad reported 3 human cases and 534 infected dogs. Ethiopia and Mali, 2 other countries with recent cases, reported zero human cases.

South Sudan, which reported its last human case in November 2016, declared interruption of dracunculiasis transmission in March 2018. The latest confirmation from Angola brings the global total, so far this year [2018], to 4 human cases. Dracunculiasis is a crippling parasitic disease caused by a long threadlike worm. The infection is transmitted mostly when people drink water contaminated with parasite-infected water fleas. When the eradication campaign began in 1986, there were an estimated 3.5 million cases.  PCR is a technique used in medical and biological research laboratories. It is used in the early stages of processing DNA for sequencing, for detecting the presence or absence of a gene to help identify pathogens during infection, and when generating forensic DNA profiles from tiny samples of DNA.  _Dracunculus medinensis_, a nematode (worm), is the causative agent of guinea worm disease.
============================
[According to the latest guinea worm update from WHO (Weekly Epidemiology Report 2018;32:409-16. 10 Aug 2018; <http://apps.who.int/iris/bitstream/handle/10665/273782/WER9332.pdf>) the reported numbers for other countries in 2018 are Chad, 5544; Ethiopia, 5044; Mali, 91; Sudan, 0. South Sudan did not file a report. Even though this is just a single case, the finding indicates that there is a focus. - ProMED Mod.EP]

[Cunene province is in the south of Angola bordering Namibia (<https://en.wikipedia.org/wiki/Cunene_Province>).

HealthMap/ProMED map available at: Angola: <http://healthmap.org/promed/p/165>.]
Date: Tue 8 May 2018
Source: AllAfrica.com [edited]

A total of 21 positive cases of sleeping sickness were diagnosed in the last 2 weeks in the municipality of Banga, Kwanza Norte province, during the prospecting campaign held by the Provincial Department of the Institute of Combat and Control of Trypanosomiasis (Icct).

Angelino Francisco Correia, the supervisor of the campaign, said that 2800 had been examined, and 21 cases were diagnosed, of which 5 were confirmed as sleeping sickness patients.

The official called the active participation of the population in the campaigns of prospection of the disease.
=====================
[A review of human trypanosomiasis (sleeping sickness) in Africa (Fevre EM, Wissmann Bv, Welburn SC, Lutumba P (2008) The Burden of Human African Trypanosomiasis. PLoS Negl Trop Dis 2(12): e333. <https://doi.org/10.1371/journal.pntd.0000333>) found that Angola is a highly endemic country with more than a 1000 cases annually. For background information on human trypanosomiasis in Africa see the ProMED posting "Trypanosomiasis - Angola http://promedmail.org/post/20110709.2081".

A map of Kwanza Norte Province, Angola:
Monday 16th April 2018

- Ndalatando. 11 Apr 2018. At least 78 suspected cases recorded in the period 4-9 Apr 2018 in northern Cuanza Norte Province.
Date: Wed, 7 Mar 2018 04:20:53 +0100
By Daniel GARELO PENSADOR

Luanda, March 7, 2018 (AFP) - Heavy rains, filthy conditions, medicine shortages and endemic corruption have combined to make a lethal malarial cocktail for Angola.   Since the start of the year more than 300,000 cases of the disease have been reported across the country, leading to at least a thousand deaths.   The toll, say experts, is a clear sign of the poverty and failings of governance in a country which, paradoxically, is one of Africa's top oil producers.   "The number is frightening," said Jose Antonio, the director of public health in Kilamba Kiaxi, a poor neighbourhood of the capital.  

Luanda province, which includes the capital, has been the hardest hit with more than 75,225 cases and 117 deaths followed by Benguela in the west of the country where 43,751 cases and 213 deaths have been reported.   In 2017, 7,000 people died from the disease.   Sub-Saharan Africa accounts for 90 percent of malaria cases worldwide and 92 percent of deaths caused by the condition that is spread by infected mosquitoes. Malaria remains one of the leading causes of premature death in Angola and every year public hospitals are deluged with patients battling the disease.

- 'She is dead' -
In the Cajueiros clinic, in the heart of the densely populated Cazenga neighbourhood in Luanda, dozens of mothers and their children queued for medical consultations.   "Every day we record at least 15 to 20 cases of malaria in our hospital," said paediatrician Miguel Sebastiao. That compared to just one or two in the dry season.   "They don't give us any medicine here. You can have a free consultation but they just give you a prescription to go and buy drugs at a pharmacy," complained Rosa Eduarte, who had come to seek a diagnosis for her five-year-old daughter.

Because of her precarious financial position, she had no other choice than to visit a public hospital, which typically lacks even basic supplies like cotton wool, syringes, latex gloves and, crucially, medicines.   "We don't have any tablets here," said Marcelina Paulina, a nurse at the Palanca Dona Paulina hospital in Luanda.   Ana Joaquina lost her sister at the end of February.   "The doctors diagnosed malaria. The hospital didn't have any money to buy medicines. She is dead," said Joaquina matter-of-factly.

Like all of Angola's other public services, health care has been starved of resources by the economic crisis that has plagued the country since oil prices collapsed in 2014.   In 2016 an outbreak of yellow fever killed almost 400 people and shone a light on the risible state of government-run healthcare.   The system has also suffered from chronic corruption, according to doctors and opposition politicians.

- 'Easier to buy luxury cars' -
"It's easier to buy luxury cars for the hospital managers than it is to buy medical supplies," said Maurilio Luyele, a medical doctor who is also a lawmaker for the opposition Unita party.   Last month, three senior officials were sentenced to eight years imprisonment after embezzling $2 million (1.6 million euros) that was intended for the fight against malaria.   Even if Angola had the "best medicine in the world," the issue of malaria will persist "while we don't resolve the problem of rubbish piling up in the streets, of stagnant water and a lack of hygiene," said Sebastiao, the paediatrician.   Refuse collectors have not visited some parts of Luanda for months, another service that is also afflicted by corruption.

Some quarters of Luanda have been transformed into open-air dumps as local authorities grapple with limited budgets and the small number of companies providing refuse services.   During the rainy season from September to May, roads and public spaces are transformed into marshes with floating detritus -- a paradise for mosquitoes.    Faced with a growing crisis, the government of new president Joao Lourenco who took office in September last month launched an emergency plan to fight the malaria epidemic with mass insect fumigation and the distribution of mosquito nets.
More ...

Uruguay

Uruguay - US Consular Information Sheet
May 01, 2008
COUNTRY DESCRIPTION:
Uruguay is a constitutional democracy with a large, educated middle class and a robust developing economy.
The capital city is Montevideo .
Tourist facilit
es are generally good with many 5-star accommodations at resort destinations such as Punta del Este and Colonia de Sacramento.
The quality of tourist facilities varies according to price and location.
Travelers are encouraged to seek travel agency assistance in making plans to visit Uruguay .
Read the Department of State Background Notes on Uruguay for additional information.

ENTRY/EXIT REQUIREMENTS:
All United States citizens entering Uruguay for business or pleasure must have a valid passport.
U.S. citizens traveling on a regular passport do not need a visa for a visit of less than three months.
U.S. citizens traveling on diplomatic or official passports require a visa.
Air travelers are required to pay an airport tax upon departure.
This fee may be paid in U.S. dollars or in Uruguayan pesos.
For further information on entry requirements, contact the Embassy of Uruguay at 1913 “Eye” Street NW, Washington, DC 20006, tel. (202) 331-4219; e-mail: conuruwashi@uruwashi.org.
Travelers may also contact the Consulate of Uruguay in New York, Miami, Chicago, Los Angeles, and Puerto Rico.
Visit the Embassy of Uruguay web site at http://www.uruwashi.org/ for the most current visa information.

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

SAFETY AND SECURITY:
Regular protests, some with an anti-American flavor, take place outside Congress, City Hall and the “University of the Republic.”
U.S. citizens visiting or residing in Uruguay are advised to take common-sense precautions and avoid any large gatherings or any other event where crowds have congregated to demonstrate or protest.
If travelers encounter a protest they should walk the other way or enter a commercial establishment until the protest passes.
Taking pictures of protesters is not a good idea.

Although there have been no past instances of violence directed at U.S. citizens from cross-border extremist groups, U.S. citizens traveling or residing in the more remote areas of Uruguay near the border with Argentina and Brazil are urged to exercise caution.

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

Up to date information on safety and security can also be obtained by calling 1-888-407-4747 toll free in the 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:
Petty street crime is prevalent in Montevideo .
The criminals tend to be non-violent.
However, criminals often resort to violence if the victims resist.
Travelers should exercise reasonable caution to minimize their exposure to crime.
Criminals prey on the unaware, particularly those carrying cameras, pocketbooks, laptops, or backpacks.
Travelers are advised to lock most valuables in secure hotel safes and to download their wallets of excess credit cards and cash.
If dining at an outdoor restaurant take extra care with pocketbooks or bags.
There are no “off limits” areas of the city and parts of “Ciudad Vieja” are popular tourist attractions.
However the only sections of Ciudad Vieja with continual police patrols are Plaza Independencia, the pedestrian street Sarandi, and the Mercado del Puerto.
Mugging is common in other parts of Ciudad Vieja - particularly for travelers walking alone, or couples walking at night.
A smart alternative is to call for a taxi for evening travel between restaurants, bars, and hotels.

Victims are usually foreign tourists, individuals openly carrying valuable items, and motorists in unlocked vehicles stopped at busy intersections, particularly on Montevideo 's riverfront road known as the Rambla. Drivers should keep all car doors locked, the driver's window open only one inch, and purses, bags, briefcases and other valuables out of sight on the floor or in the trunk. Parked cars, particularly in the Carrasco neighborhood, are also increasingly targeted for break-ins. During the summer months (December-March), beach resort areas such as Punta del Este attract tourists, and petty street crimes and residential burglaries--similar to those that occur in Montevideo --rise significantly. Visitors are advised to exercise common sense in the conduct of their activities around Montevideo and in Uruguayan resort areas. They should be very attentive to personal security and their surroundings in the aforementioned areas.

Those planning to live in Montevideo should note that burglaries and attempted burglaries seem to be on the rise in upscale neighborhoods.
The perpetrators are mostly non-confrontational but determined teenagers.
A combination of preventive measures including rigorous use of locks and alarms, strong grillwork on all windows, guard dogs, keeping a residence occupied as much as possible, and using a security service is highly recommended.

Montevideo continues to experience armed robberies of patrons at crowded restaurants in the Pocitos neighborhood.
Most of these crimes have occurred very late at night.
Restaurant patrons should exercise extreme caution for late night dining.

Uruguayan law enforcement authorities have increased the number of uniformed policemen on foot in areas where criminal activity is concentrated and the number of patrol cars in residential areas. The clearly marked patrol cars are equipped with cellular phones and the phone numbers are conspicuously painted on the vehicles.

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 U.S. Embassy or Consulate for assistance.
The Embassy/Consulate staff can, for example, assist you to find appropriate medical care, contact family members or friends and explain how funds could be transferred.
Although the investigation and prosecution of the crime is solely the responsibility of local authorities, consular officers can help you to understand the local criminal justice process and to find an attorney if needed.

See our information on Victims of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION:
Facilities for medical care are considered adequate. Serious medical problems requiring hospitalization and/or medical evacuation to the United States can cost tens of thousands of dollars.


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

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

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

The Uruguayan Ministry of Transportation is responsible for maintaining safe road conditions countrywide. The Uruguayan Ministry of Interior highway police (tel. 1954) are responsible for traffic safety on highways and other roads beyond city limits. In urban and suburban areas, transit police and municipal employees share road safety responsibilities.

Driving is on the right-hand side of the road. Wearing seat belts and using headlights on highways and other inter-city roads 24 hours a day are mandatory. Children under 12 must ride in the back seat. Motorcyclists must wear helmets. The use of cellular phones while driving is prohibited. Right turns on red lights and left turns at most intersections marked with a stoplight are not permitted. Drivers approaching an intersection from the right or already in traffic circles have the right of way.
Flashing high beams indicate intent to pass or continue through unmarked intersections.
Many drivers ignore speed limits and traffic signs.
If you plan to drive, use extreme caution and drive defensively.

For driving under the influence, violators are fined and confiscated licenses may be retained for up to six months. In accidents causing injury or death, drivers are brought before a judge who decides if incarceration is warranted.

Inter-city travel is via bus, taxi, car service (remise), car, and motorcycle. Speed limits are posted on highways and some main roads. Most taxis have no seat belts in the back seat. Cycling outside the capital or small towns is hazardous due to a scarcity of bike paths, narrow road shoulders and unsafe driving practices.

Illumination, pavement markings, and road surfaces are sometimes poor. Route 1, which runs between Montevideo and Colonia or Punta del Este, and Route 2, between Rosario and Fray Bentos, are particularly accident-ridden because of heavy tourist traffic. Road accidents rise during the austral summer beach season (December to March), Carnaval (mid-to-late February), and Easter Week.

Within Montevideo , the emergency number to contact the police, fire department, rescue squad, or ambulance service is 911. In the rest of the country, dial 02-911 to connect with the Montevideo central emergency authority, which will then contact the local emergency service. The Automobile Club of Uruguay responds to emergency calls for roadside assistance at 1707, “Car Up” at 0800-1501 and the Automobile Center of Uruguay at 2-408-6131/2091. SEMM (tel. 159) and UCM (tel. 147), Montevideo-based ambulance services manned by doctors, have agreements with emergency medical units in other cities.

Please refer to our Road Safety page for more information.
You may also telephone Uruguay ’s national tourist office and national authority responsible for road safety in Miami at (305) 443-7431.

AVIATION SAFETY OVERSIGHT:
The U.S. Federal Aviation Administration (FAA) has assessed Uruguay ’s Civil Aviation Authority as not being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for oversight of Uruguay ’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:
Uruguay 's customs authorities may enforce strict regulations concerning temporary importation into or export from Uruguay of items such as precious jewels, gold, firearms, pornography, subversive literature, inflammable articles, acids, prohibited drugs (medications), plants, seeds, and foodstuffs as well as some antiquities and business equipment. It is advisable to contact the Embassy of Uruguay in Washington, D.C., or one of Uruguay 's consulates in the U.S. for specific information regarding customs requirements. Note: Travelers entering Uruguay with precious jewels or gold worth more than $500.00 ( U.S. ) must declare them to customs officers at the port of entry or face possible detention or seizure of the goods and charges of contraband or evasion of customs controls. Visitors are expected to comply with local law and regulations by approaching a customs officer before routine inspection of all incoming baggage, conducted on standard security equipment.
Please see our Customs Information.

CRIMINAL PENALTIES:
While in a foreign country, a U.S. citizen is subject to that country's laws and regulations, which sometimes differ significantly from those in the United States and may not afford the protections available to the individual under U.S. law.
Penalties for breaking the law can be more severe than in the United States for similar offenses.
Persons violating Uruguay ’s laws, even unknowingly, may be expelled, arrested, or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in Uruguay 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.

The Uruguayan Ministry of Agriculture and Fishing strictly enforces all regulations regarding hunting permits, as well as seasonal and numerical limits on game. Visitors who contravene local law have been detained by the authorities and had valuable personal property (weapons) seized. Under Uruguayan law, seized weapons can only be returned after payment of a sum equivalent to the value of the property seized. Hunters are also subject to stiff fines for practicing the sport without all appropriate permits.

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

REGISTRATION / EMBASSY LOCATION:
Americans living or traveling in Uruguay 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 Uruguay .
Americans without Internet access may register directly with the U.S. Embassy.
By registering, American citizens make it easier for the Embassy to contact them in case of emergency. The U.S. Embassy is located at Lauro Muller 1776; telephone (598) (2) 418-7777; fax (598) (2) 418-4110 or -8611. Internet: http://uruguay.usembassy.gov/, email: MontevideoACS@state.gov. Consular Section hours for American Citizen Services are Monday to Thursday, 9:00 a.m. to 11:00 p.m. and 2:00 p.m. to 4:00 p.m., except U.S. and Uruguayan holidays.
* * *
This replaces the Consular Information Sheet dated August 28, 2007 to update Sections on Entry/Exit Requirements, Safety and Security, Crime, Aviation Safety Oversight, Children’s issues, and Registration/Embassy Location.

Travel News Headlines WORLD NEWS

Date: Tue 12 Mar 2019
Source: Carmelo Portal [in Spanish, trans. Mod. TY, edited]

The departmental health director, Dr Jorge Mota, confirmed for Carmelo Portal the death in our city of a young 17 year old girl from [a] hantavirus [infection]. "In Colonia department, there are on average 3 cases per year. The evolution of the disease is in thirds. One-third of the [infected] people do not have notable symptoms; another third have serious symptoms, especially respiratory symptoms and ones in all the systems, but with adequate treatment, [the infected people] survive, sometimes with sequelae. There is another third that die. It is those few with the virus that die with an evolution so drastic, such as is the case of this girl, sadly," Dr Mota stated.

The department health director said that hantaviruses are not contagious person-to-person. "It is transmitted from an intermediate animal, the field mouse. Only 3% of these mice have [a] hantavirus. To become infected, one must be in contact with an [infected] mouse's secretions that have dried, are mixed with dust, and are in a closed space, away from sunlight and ventilation. A spa, a shed, or a wood pile [are examples of such a space]. The person had to have been moving around there and inhaled the dust," he explained.

Dr Mota spoke about the epidemiological surveillance that is carried out. "We tracked places where the person was, even those that could be identified 2 months before contracting the virus; sometimes we found the place, but sometimes not." As a preventive measure, Mota stated that in these cases, ventilate these closed spaces for at least half an hour. Wet down floors and shelves with water [with 10% bleach]. Use masks [and gloves].
==========================
[The report above does not mention the circumstances under which the infection might have been acquired nor which hantavirus was responsible for this or earlier cases in Uruguay. Hantaviruses that cause hantavirus pulmonary syndrome (with rodent hosts found in Uruguay) include Laguna Negra virus (_Calomys laucha_), Maciel virus (_Necromys benefactus_), Central Plata virus, Lechiguanas virus (_Oligoryzomys flavescens_, complex of rodents), and Anajatuba virus and Juquitiba virus (_Ologoryzomys fornesi_).

The rodent reservoir hosts shed the virus in its saliva, urine, and faeces, contaminating the environment in which they live and breed.

A HealthMap/ProMED-mail map showing the location of Uruguay in South America can be accessed at
<http://healthmap.org/promed/p/28995>.

A map of Colonia department in southern Uruguay is available at
<https://en.wikipedia.org/wiki/Colonia_del_Sacramento>
and <http://healthmap.org/promed/p/27367>. - ProMED Mod.TY]
Date: Thu, 19 Jul 2018 03:23:55 +0200
By Lucia LACURCIA

Montevideo, July 19, 2018 (AFP) - Enrique Curbelo is delighted. Selling cannabis has allowed the affable 76-year-old to keep his privately owned pharmacy in Montevideo open in a market dominated by big chains.   "I had to sell what they didn't sell," he told AFP. "For me it's like selling aspirin."   It's been this way for a year now.   Every Wednesday, Ismael Fernandez receives a WhatsApp message from his local pharmacist telling him a new stock of cannabis has arrived.   After leaving work, he heads there and buys the 10 grams that Uruguayan law permits, costing 400 pesos, around $13.

Fernandez then heads home and rolls a joint "to relax" with his partner Stefania Fabricio.   No longer do they need to surreptitiously contact a dealer and pay more for Paraguayan or Brazilian marijuana that's been "pressed, mixed (and is) sometimes very bad and full of chemicals."   "Now it's much easier than when it started," Fernandez, a 31-year-old who works for a cleaning company, told AFP.   It has been four and a half years since marijuana use became legal in Uruguay and a year since it has been sold in pharmacies -- up to 40 grams a month per person.

Initially, there was insufficient supply, leaving people standing in long queues as stocks sometimes ran out. Pharmacies are better prepared now.   "They send you a message with a number which you use later to go and collect it, and in my pharmacy you can order it online," added Fernandez, the father of a three-year-old.   Hairdresser Fabricio, also 31, says "it's good quality," but not too strong.   "It doesn't send your head spinning, but it's not meant to. You get a hit but you can still do things perfectly."   - 'Privileged' -   She says she feels "privileged" to live in a country that enacted a law to "get tons of people out of the black market."   As a result, she said, the stigma attached to those who smoke pot is changing, "albeit slowly."

The system is simple: to buy cannabis in a pharmacy you must be at least 18, live in Uruguay and sign up as a "buyer" at the post office.   An initial stumbling block arose when banks refused to work with establishments selling cannabis due to international rules against drug-trafficking.   But the country plowed on, and last year it became the first in the world to fully legalize its sale.   But Enrique Curbelo had to get over his own prejudices before deciding to join the select band of pharmacies selling the plant.   There are 14, half of them in the capital, serving the 24,812 registered buyers.

- 'Normal people' -
Users can choose between two brands and two types of cannabis -- sativa and indica -- both provided by an official distributor.   Customers are generally not the stereotypical grubby-looking student or idle waster.    On this day in Curbelo's store they include two young women, a man in his 50s and an older lady -- "normal people," says the pharmacist.   Official statistics say 70 percent of buyers are male and 49 percent are between the ages of 18 and 29.

To keep anyone from exceeding their monthly allowance, a fingerprint machine is used to register every sale.   Along with the ability to purchase cannabis in a pharmacy, Uruguayans have the right to grow their own -- up to a six-plant maximum -- or to join a cannabis club, which can have up to 45 members and 99 plants.   Federico Corbo, a 41-year-old gardener, grows cannabis in his garden on the outskirts of Montevideo. He experiments by crossing species in an attempt to improve quality and optimize the flowering period.   Corbo is not impressed with the quality on offer in pharmacies.   "It's not the worst, but it's low," he said, insisting quality control needs to be improved.   "Marijuana that doesn't reach the minimum standards -- with crushed flowers, no aroma, low quality -- shouldn't be sold in the pharmacy.   "Maybe, as I'm a grower, I'm very demanding, but there is a cost associated to the product and it must be offered to the public in the best way possible."

According to the Institute of Cannabis Regulation and Control (Ircca), an average cultivator or club member supplies cannabis to two other people, while those who buy it in a pharmacy share it with one other.   "Approximately half of marijuana users have access to regulated cannabis," says Ircca.   The rest prefer to continue buying the drug on the black market, put off by the need to register as a user.   "It's wrong -- if they legalize it they have to do so in a way in which the state doesn't keep a paternalistic role in overseeing how much you smoke or stop smoking," one clandestine user, who wished to remain anonymous, told AFP.   This 48-year-old lawyer simply doesn't trust the authorities. He pointed to the danger a change of government could bring, or even the return of dictatorship.   "Right now that seems impossible," he said, "but you can never discount it."
Date: Thu 1 Feb 2018 23:02hs UYT
Source: LaRed 21 [in Spanish, machine trans. edited]

The Ministry of Public Health (MSP) issued a statement through which it reports that it has detected cases of infection by the bacterium _Vibrio vulnificus_ in Montevideo, Canelones, and Maldonado [departments]. The State Secretariat assured that every year there are cases of this bacterium, but so far in 2018, 4 serious cases have been reported, of which 3 died. All of them had underlying illnesses.

"90 percent of these cases, in the world, are associated with the consumption of undercooked or raw seafood. Infrequently, the infection can be acquired when entering the sea with open wounds, especially in elderly people or people with diseases that affect the immune system," explained the MSP. It is an event "extremely rare in our country," said the State Secretariat. It also indicated that fewer than 10 cases per year are registered per year for this bacterium.

It is an infection that "can be serious and in some cases fatal, so it is recommended to avoid the consumption of undercooked or raw sea products (as well as their handling without protection measures) and in the same way, avoid entering the sea with wounds or cuts on the skin." The bacteria can be found in coastal marine waters and estuaries in areas of tropical and subtropical climates that have a moderate degree of salinity and temperatures that usually exceed 18 C [64.4 F].
====================
[The following is extracted from the previous edition of the "Bad Bug Book," Center for Safety and Applied Nutrition, US FDA (Food and Drug Administration). The newest version is available at:  <https://www.fda.gov/downloads/Food/FoodborneIllnessContaminants/UCM297627.pdf>:

"_Vibrio vulnificus_, a lactose-fermenting, halophilic, Gram-negative, opportunistic pathogen, is found in estuarine environments and associated with various marine species such as plankton, shellfish (oysters, clams, and crabs), and finfish. Environmental factors responsible for controlling numbers of _V. vulnificus_ in seafood and in the environment include temperature, pH, salinity, and amounts of dissolved organics. It may be normal flora in salt water, and acquiring this organism from shellfish or water exposure does not imply that the water is contaminated by sewage.

"Wound infections result either from contaminating an open wound with sea water harbouring the organism, or by lacerating part of the body on coral, fish, etc., followed by contamination with the organism. The ingestion of _V. vulnificus_ by healthy individuals can result in gastroenteritis."

The "primary septicaemia" form of the disease follows consumption of raw seafood containing the organism by individuals with underlying chronic disease, particularly liver disease. The organism can also enter through damaged skin. In these individuals, the microorganism enters the blood stream, resulting in septic shock, rapidly followed by death in many cases (about 50 percent). Over 70 percent of infected individuals have distinctive bullous skin lesions (shown at <http://safeoysters.org/medical/diagnosis.html>).

There are 2 points to be emphasized: that vibrios are normal flora in warm saltwater (not indicative of any sewage contamination) and that most of the life-threatening illnesses occur in individuals with underlying medical illnesses, including immunocompromised states, chronic liver disease, and diabetes. So-called normal individuals often just develop gastroenteritis. The range of disease due to _V. vulnificus_ can involve more northern geographical areas as overall global warming takes effect. - ProMED Mod.LL]

Date: Mon 29 Jan 2018
Source: Monte Carlo [in Spanish, trans. ProMED Mod.TY, edited]

Personnel of the Ministry of Public Health are investigating the death of a young --28-years old -- agronomist caused by [a] hantavirus [infection]. After completion of the specific studies, which could take 48 hours, they will be able to determine if the young woman died as a consequence of the virus [infection].

The disease is contracted by the inhalation of excretions or secretions of rodents infected by the hantavirus.

As a preventive measure, personnel of the Department of Epidemiology of the Ministry of Health will go to the rural area in Canelones, where the young woman resided.  [Byline: Enrique Puig]
====================
[No information is given about the symptoms that the young woman experienced prior to her death, nor the date of her illness and death. Presumably, the diagnosis of a suspected hantavirus infection leading to death was hantavirus cardiopulmonary syndrome (HPS).

The report above does not mention which hantavirus was responsible for this or earlier cases in Uruguay. Central Plata hantavirus could be the etiological agent responsible (for this and previous HPS cases). Its rodent host is the yellow pygmy rice rat, _Oligoryzomys flavescens_, complex of rodents. This rodent reservoir host sheds the virus in its saliva, urine and faeces, contaminating the environment in which it lives and breeds.

An image of this rodent can be accessed at

A HealthMap/ProMED-mail map showing the location of Uruguay in South
America can be accessed at: <http://healthmap.org/promed/p/28995> and
Canelones department in southern Uruguay at
Date: Wed, 19 Jul 2017 22:41:35 +0200
By Mauricio RABUFFETTI

Montevideo, July 19, 2017 (AFP) - Pharmacies in Uruguay started selling marijuana Wednesday under a four-year-old law that has made the small South American country the first in the world to legalize pot from production to sale.   At a pharmacy in Montevideo's Old Town, five customers were waiting to buy when the store shutters went up at the start of the day, and lines grew longer as the day went on.   "I've been smoking since I was 14. Let's give it a try," said a 37-year-old man who would not give his name.   "It's funny," a pharmacy employee told AFP on grounds of anonymity. "In two hours we filled only three prescriptions, but 30 people came to buy marijuana."

Some pharmacies saw as many as 20 people lining up to make their first legal pot purchase.    "We did not expect this kind of movement," said Sebastian Scafo, 33, a pharmacy manager.    In all, 16 pharmacies have been authorized to sell marijuana under state controls, barely enough to cover a country of 3.5 million people.   No major pharmacy chain has agreed to sell the drug.   Many pharmacies have been unwilling to participate in the scheme because of concerns about security and doubts that the small market of registered users is worth the trouble.   Only about 5,000 people, most of them age 30 to 44, have signed up as prospective buyers since Uruguay's state registry opened in early May.   Walk-in sales are not allowed under the law, and only residents of Uruguay can register to buy pot -- thereby preventing marijuana tourism.

-- Blow to drug-dealers? --
Among those trying the new legal distribution system was Xavier Ferreyra, a 32-year-old city employee, who was making his first purchase at a pharmacy in Montevideo's Old Town.    He said he saw two main advantages to the new approach: "safety and the quality" of the drug, adding, "I no longer have to go buy it in some slum."   Pharmacy sales are the last of three phases set out under the 2013 law.   Under the early phases, nearly 7,000 people registered to grow weed at home, and more than 60 smokers' clubs were authorized.   Only two companies were authorized to produce marijuana for pharmacies -- under military protection, and with no public access.

The state Institute for the Regulation and Control of Cannabis (IRCC) has authorized the sale of two types of marijuana, to be sold in five-gram packets.   On Monday, the National Drugs Council tweeted an image of what the packages would look like: blue-and-white sealed sachets that look something like condom packets.   An "Alfa I" package contains "Alfa I variety cannabis hybrid with Indica predominant."    Another sort has "Beta I variety cannabis" with Sativa. The levels of THC -- the psychotropic constituent in cannabis -- are given on the outside, for consumer information.   The packets also bear a "Warnings" section about the risks of consuming marijuana and recommendations on how to do it more safely.

-- 'A marvelous plant' --
The buyers who talked to AFP reporters all said they had bought 10 grams of pot, a packet of each variety on sale.   The packets are being retailed at $6.60 each, according to the IRCCA.   Customers are identified through a digital fingerprint reader, which allows them to buy without having to show other forms of identification in the store.   Uruguay's goal in legalizing the sale of marijuana for recreational use is to cut down on illegal smuggling.   Camila Berro, a 24-year-old business student, walked out of a pharmacy smiling, two packets of pot in hand.    "I feel very lucky to be able to get it legally," she said. "I have friends in other countries who were imprisoned for smoking a joint."   To Ferreyra, the municipal worker, "Uruguay has taken a very big step... I hope one day they can legalize a lot more drugs."   And former President Jose Mujica, who enacted the marijuana reforms while in office from 2010 to 2015, said that while "no addiction is good," it was "horrible to condemn a marvelous plant."    Uruguay, he added, is "trying a new path."
More ...

World Travel News Headlines

Date: Fri, 15 Mar 2019 19:08:37 +0100
By Joaquim Nhamirre

Maputo, March 15, 2019 (AFP) - Tropical cyclone Idai battered Mozambican coastal city Beira Friday, leaving half a million people virtually cut off after power lines crashed, airport shut and roads were swamped by flooding that killed 66 people nationwide.   "There is no communication with Beira. Houses and trees were destroyed and pylons downed," an official at the National Institute of Disaster Management (NIDM) told AFP.   Authorities had to close Beira international airport after the air traffic control tower, the navigation systems and the runways were damaged by the storm.   "Unfortunately there is extreme havoc," said the official.   "Some runway lights were damaged, the navigation system is damaged, the control tower antennas and the control tower itself are all damaged.    "The runway is full of obstacles and parked aircrafts are damaged."

Late on Wednesday, the national carrier LAM cancelled all flights to Beira and Quelimane, which is also on the coast, as well as to Chomoio, which is inland.    Power utility Electricidade de Mocambique said in a statement that the provinces of Manica, Sofala and parts of Inhambane have been without power since Thursday.   Officials did not report any confirmed deaths, but local Beira station STV reported a child had died in Manica province west of the city, apparently the victim of a falling roof.   "There was no tsunami-type storm but Beira and Chinde (400 kilometres, 250 miles northeast of Beira on the coast) were badly hit," added the NIDM official.

Another official, Pedro Armando Alberto Virgula, in Chinde, said a hospital, police station and seven schools there lost their roofs and four houses were destroyed.   Virgula added that efforts were under way to assess the damage caused after Idai made landfall late on Thursday.   Local officials said that this week's heavy rains claimed 66 lives, injured 111 people and displaced 17,000 people.   The World Food Programme (WFP) said it would move 20 tonnes of emergency food aid to the affected areas.   The UN Office for the Coordination of Humanitarian Affairs (OCHA) had warned that the storm could pack winds of up to 190 kilometres per hour (118 miles per hour).

- 'Devastation' -
At least 126 people were killed by the downpour that has struck parts of Mozambique, Malawi and South Africa over the past week, officials said.   Heavy rains in neighbouring Malawi have affected almost a million people and claimed 56 lives, according to the latest government toll.   Authorities there have opened emergency relief camps where malaria and shortages of supplies have led to dire conditions, according to AFP correspondents.

Malawian President Peter Mutharika this week declared a natural disaster.   Mozambique's weather service has warned that heavy rain will continue to batter Beira and surrounding areas until Sunday.   The UN warned of damage to crops, "including about 168,000 hectares (415,000 acres) of crops already impacted by flooding in early March, which will undermine food security and nutrition".   Mozambique and Malawi, two of the poorest countries in the world, are prone to deadly flooding during the rainy season and chronic drought during the dry season.   In neighbouring Zimbabwe, weather services have warned that violent thunderstorms, lightning and strong winds will be experienced in the eastern regions of the country.
Date: Fri, 15 Mar 2019 19:00:39 +0100

Niamey, March 15, 2019 (AFP) - Health authorities in Niger said Friday they had found a fake version of a meningitis vaccine after the country had launched a campaign to innoculate millions of children against the disease.   In a statement, the health ministry asked doctors to be vigilant over a "counterfeit" version of a vaccine called Mencevax ACWY.   The fake drug is marked as having been manufactured in December 2016, with an end-date for use by November 2021, it said.   Niger launched a week-long campaign on March 5 to vaccinate six million children against meningitis, which killed nearly 200 people two years ago.   The country lies in the so-called "meningitis belt" stretching from Senegal in the west to Ethiopia in the east, where outbreaks of the disease are a regular occurrence. 

The vaccination programme is against meningitis A, one of the six groups of meningitis bacteria that can cause epidemics.   The ministry's spokesman told AFP the bogus drug had been discovered during a "routine inspection" of a privately-owned pharmacy in the capital Niamey.   An investigation is underway to try to ascertain how many of the fake vaccines have been used, the spokesman said.   Health workers administering meningitis jabs are being asked to take special care about their supply source, and the public are being urged to scrutinise vaccines clearly, even if they buy them in "licensed" pharmacies.   Fake drugs -- medications that are outright counterfeits or whose active ingredients have been diluted -- are a major problem in West Africa.

In the 2017 outbreak, and in an epidemic in 2015 in which nearly 500 people died, Niger sounded the alarm over purported vials of vaccine that just contained water.   Meningitis is transmitted between people through coughs and sneezes, close contact and cramped living conditions.   The illness causes acute inflammation of the outer layers of the brain and spinal cord, with the most common symptoms being fever, headache and neck stiffness.
Date: Fri, 15 Mar 2019 02:55:29 +0100
By Khaliun Bayartsogt

Bornuur, Mongolia, March 15, 2019 (AFP) - In the world's coldest capital, many burn coal and plastic just to survive temperatures as low as minus 40 degrees -- but warmth comes at a price: deadly pollution makes Ulaanbataar's air too toxic for children to breathe, leaving parents little choice but to evacuate them to the countryside.   This exodus is a stark warning of the future for urban areas in much of Asia, where scenes of citizens in anti-pollution masks against a backdrop of brown skies are becoming routine, rather than apocalyptic.   Ulaanbaatar is one of the most polluted cities on the planet, alongside New Delhi, Dhaka, Kabul, and Beijing. It regularly exceeds World Health Organisation recommendations for air quality even as experts warn of disastrous consequences, particularly for children, including stunted development, chronic illness, and in some cases death.

Erdene-Bat Naranchimeg watched helplessly as her daughter Amina battled illness virtually from birth, her immune system handicapped by the smog-choked air in Mongolia's capital.   "We would constantly be in and out of the hospital," Naranchimeg told AFP, adding that Amina contracted pneumonia twice at the age of two, requiring several rounds of antibiotics.   This is not a unique case in a city where winter temperatures plunge towards uninhabitable, particularly in the districts that rural workers moved to in search of a better life.   Here row upon row of the traditional tents -- known as gers -- are warmed by coal, or any other flammable material available. The resulting thick black smoke shoots out in plumes, blanketing surrounding areas in a film of smog that makes visibility so poor it can be hard to see even a few metres ahead.   Hospitals are packed and young children are vulnerable, common colds can quickly escalate into life-threatening illness.

- Birth defects -
The situation was so bad that doctors told Naranchimeg the only solution was to send her little girl to the clean air of the countryside.   Now aged five, Amina is thriving. She lives with her grandparents in Bornuur Sum, a village 135 kilometres away from the capital.   "She hasn't been sick since she started living here," said Naranchimeg, who makes the three-hour round trip to see Amina every week.   "It was very difficult in the first few months," she said. "We used to cry when we talked on the phone."   But like many parents in Ulaanbaatar, she felt the move was the only way to protect her child.

The levels of PM2.5 -- tiny and harmful particles -- in Ulaanbaatar reached 3,320 in January, 133 times what the World Health Organisation (WHO) considers safe.   The effects are terrible for adults but children are even more at risk, in part because they breathe faster, taking in more air and pollutants.   As they are smaller, children are also closer to the ground, where some pollutants concentrate, and their still-developing lungs, brains, and other key organs are more vulnerable to damage.   Effects to prolonged exposure range from persistent infections and asthma to slowed lung and brain development.   The risks apply in utero, too, because gases and fine particles can enter a mother's bloodstream and placenta, causing miscarriage, birth defects and low birth weights, which can also affect a child for the rest of their lives.   Researchers are now investigating whether pollution, like exposure to tobacco smoke, has health effects that could even be passed down to the next generation.

- 'Terribly afraid' -
Buyan-Ulzii Badamkhand and her husband need to stay in capital for work, but they have decided to send their two-year-old son Temuulen more than 1,000 kilometres away.   The 35-year-old mother-of-three struggled with the decision, even moving from one ger district to another in the hope her son's health would improve.   But successive bouts of illness, including bronchitis that lasted a whole year, finally convinced her to send Temuulen to his grandparents.   Hours after he arrived, she called her mother-in-law to discuss her son's medicines.   "But my mother-in-law asked me 'does he still need medicine? He isn't coughing anymore," she said.   "I tell myself that it doesn't matter that I miss him and who raises him, as long as he is healthy, I am content."   Respiratory problems are the most obvious effect of air pollution, but research suggests dirty air can also put children at greater risk for diabetes and cardiovascular disease later in life.   And the WHO links it to leukaemia and behavioural disorders.   When air pollution peaks in winter, Ulaanbaatar's playgrounds empty and those who are able to are increasingly travelling abroad to wait out the smog.

In desperation, Luvsangombo Chinchuluun, a civil society activist, borrowed money to take her granddaughter to Thailand for all of January.   "We can't let her play outside (in Ulaanbaatar) because of the air pollution, so we decided to leave," she said.   The persistent smog has caused tensions in the city, with those living in wealthier areas blaming the ger residents for the pollution and even calling for the tent districts to be cleared.   But the ger residents say coal is all they can afford.   "People come to the capital because they need sustainable income," said Dorjdagva Adiyasuren, a 54-year-old mother of six.   "It's not their fault," she added.    In a bid to tackle the problem, the local government banned domestic migration in 2017, and a ban on burning coal comes into force from May.   But it is unclear whether the moves will be enough to make a difference.   For Naranchimeg, the problems are serious enough to make her consider whether she wants more children.    She explained: "Now, I am terribly afraid of to give birth again. It is risky to carry a child and what will happen to the child after it is born in this amount of pollution?"
Date: Thu, 14 Mar 2019 18:17:56 +0100

Reykjavik, March 14, 2019 (AFP) - Iceland has blocked the millions of tourists who descend upon the volcanic island each year from visiting a canyon that has been overrun since it was featured in a Justin Bieber music video.   An influx of tourists and a humid winter have disrupted the Fjadrargljufur canyon's fragile ecosystem, so the Environment Agency of Iceland has closed the site to the public until June 1.   "During periods of thaw, the path is completely muddy and is practically unusable for hikers," agency advisor Daniel Freyr Jonsson told AFP on Thursday.   "Because the mud is so thick, visitors step over the fences and walk parallel to the path, which rapidly damages the plant life," he added.

Fjadrargljufur is a gorge about 100 meters (yards) deep and two kilometres (1.25 miles) long, with steep green walls and a winding riverbed. The canyon was created by progressive erosion from water melting from glaciers 9,000 years ago.   The canyon was little known to foreigners until the end of 2015, when Canadian singer Justin Bieber featured the site in his song "I'll Show You".   "Visits to the site have risen by 50 to 80 percent per year since 2016," said Daniel Freyr Jonsson, estimating that around 300,000 people visited the canyon in 2018.   A growing number of tourist sites in Iceland have been closed in a bid to
preserve them.

The popular Reykjadalur valley and its hot springs were temporarily closed in April 2018 and a hiking trail overlooking the Skogafoss waterfall is currently shut.   "The infrastructure is not set up to accomodate so many visitors," said Daniel Freyr Jonsson.    "Tourism in winter and spring, the most sensitive periods for wildlife in Iceland, (was previously) almost unheard of in Iceland."   Since 2010 and the eruption of the Eyjafjallajokull volcano -- which generated a lot of publicity for the island -- the number of visitors has grown by 25 percent per year on average.   Last year, a record 2.3 million people visited Iceland.
Date: Thu, 14 Mar 2019 16:50:58 +0100

Geneva, March 14, 2019 (AFP) - The deadly Ebola outbreak raging in eastern Democratic Republic of Congo should be over within six months, the head of the World Health Organization said Thursday.   Seven months since the outbreak erupted in DRC's violence-torn North Kivu province, WHO Director-General Tedros Adhanom Ghebreyesus told reporters there were clear signs the spread of the virus was "contracting".   "Our target is now to finish it in the next six months," he told reporters in Geneva, warning though that increased unrest in the affected area could reverse the progress being made.   "It's always good to plan beyond the horizon to prepare for any eventualities," he said, while voicing optimism that massive efforts to rein in the outbreak are working.

The ongoing Ebola outbreak, the 10th in DRC's history, emerged in North Kivu in August 2018 and then spread to neighbouring Ituri province.    It has claimed 584 lives out of nearly 1,000 believed to have been infected, WHO said.   Security in eastern DRC, a region rampant with rebel fighters, has dramatically complicated the response, with numerous attacks on Ebola treatment centres.   The Doctors Without Borders (MSF) medical charity has also sounded the alarm over increasingly "toxic" relations with local communities, whose resistance to Ebola response efforts have also fuelled the spread.   MSF pointed out that 40 percent of deaths from the extremely contagious virus are occurring in communities rather than in Ebola treatment centres.

- 'Contracting' -
"The Ebola response is failing to bring the epidemic under control," MSF chief Joanne Lieu told reporters in Geneva last week.   But Tedros denied Thursday that this was the case.   "That's not true," he said. "You cannot say it's failing when the outbreak is contracting. It's contracting."   He stressed that over the past seven months, the virus had been contained to North Kivu and Ituri.

"It hasn't spread to other parts of the country and it hasn't spread to neighbouring countries," he said, adding that transmission had been halted in a number of places, including in Beni and Mangina.   "So the cases are now shrinking in certain geographic areas," he said.   Tedros also stressed that the number of new cases had been cut in half since January, with an average of 25 new cases reported each week now compared to 50 at the beginning of the year.   He acknowledged though that violence, unrest and community resistance remained a challenge in Butembo especially, which along with Katwa is where the spread of the virus is now concentrated.   "I don't want to undermine the risk, because it may again (resurge) if the security situation continues to deteriorate," he said, acknowledging that there is still a chance Ebola could spread to other parts of DRC and neighbouring countries.
Date: Thu, 14 Mar 2019 03:42:36 +0100

Kuala Lumpur, March 14, 2019 (AFP) - Over 100 schools in Malaysia have been closed after the dumping of toxic waste into a river caused hundreds of people to fall ill, including many children, authorities said.   A lorry is believed to have dumped the waste in southern Johor state last week, sending hazardous fumes across a wide area and causing those affected to display symptoms of poisoning such as nausea and vomiting.

Over 500 people, many of them school pupils, have received medical treatment after inhaling the fumes, with over 160 admitted to hospital, according to official news agency Bernama.    It was unclear what type of poisonous gas had been emitted near the industrial town of Pasir Gudang.   Education Minister Maszlee Malik initially ordered the closure of 43 schools in the area Wednesday, but later announced that figure had more than doubled.

"The ministry of education has decided to close all 111 schools in the Pasir Gudang area immediately," he said in a statement.    "The education ministry is requesting that all parties take precautions."   Three men were arrested earlier this week over the toxic waste dumping. One is expected to be charged in court soon and could face up to five years in jail if found guilty of breaking environmental protection laws.
Date: Tue 12 Mar 2019
Source: Carmelo Portal [in Spanish, trans. Mod. TY, edited]

The departmental health director, Dr Jorge Mota, confirmed for Carmelo Portal the death in our city of a young 17 year old girl from [a] hantavirus [infection]. "In Colonia department, there are on average 3 cases per year. The evolution of the disease is in thirds. One-third of the [infected] people do not have notable symptoms; another third have serious symptoms, especially respiratory symptoms and ones in all the systems, but with adequate treatment, [the infected people] survive, sometimes with sequelae. There is another third that die. It is those few with the virus that die with an evolution so drastic, such as is the case of this girl, sadly," Dr Mota stated.

The department health director said that hantaviruses are not contagious person-to-person. "It is transmitted from an intermediate animal, the field mouse. Only 3% of these mice have [a] hantavirus. To become infected, one must be in contact with an [infected] mouse's secretions that have dried, are mixed with dust, and are in a closed space, away from sunlight and ventilation. A spa, a shed, or a wood pile [are examples of such a space]. The person had to have been moving around there and inhaled the dust," he explained.

Dr Mota spoke about the epidemiological surveillance that is carried out. "We tracked places where the person was, even those that could be identified 2 months before contracting the virus; sometimes we found the place, but sometimes not." As a preventive measure, Mota stated that in these cases, ventilate these closed spaces for at least half an hour. Wet down floors and shelves with water [with 10% bleach]. Use masks [and gloves].
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[The report above does not mention the circumstances under which the infection might have been acquired nor which hantavirus was responsible for this or earlier cases in Uruguay. Hantaviruses that cause hantavirus pulmonary syndrome (with rodent hosts found in Uruguay) include Laguna Negra virus (_Calomys laucha_), Maciel virus (_Necromys benefactus_), Central Plata virus, Lechiguanas virus (_Oligoryzomys flavescens_, complex of rodents), and Anajatuba virus and Juquitiba virus (_Ologoryzomys fornesi_).

The rodent reservoir hosts shed the virus in its saliva, urine, and faeces, contaminating the environment in which they live and breed.

A HealthMap/ProMED-mail map showing the location of Uruguay in South America can be accessed at
<http://healthmap.org/promed/p/28995>.

A map of Colonia department in southern Uruguay is available at
<https://en.wikipedia.org/wiki/Colonia_del_Sacramento>
and <http://healthmap.org/promed/p/27367>. - ProMED Mod.TY]
Date: Wed 13 Mar 2019
Source: Outbreak News Today [abridged, edited]

The number of measles deaths has topped 1100 in Madagascar. In an update on the measles epidemic in Madagascar, UN health officials report 6607 cases of measles, including 41 deaths, in the week ending 24 Feb [2019]. Cases are reported in children aged 1 to 14 years. Of 114 districts in all 22 regions, 104 are in the epidemic phase, officials report.
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[The number of cases and deaths from measles in Madagascar is horrifying, even more so since the disease is vaccine-preventable. There is no information on how the health sector in the country is responding, but clearly the clinics are overburdened during this devastating outbreak. - ProMED Mod.LK]

[HealthMap/ProMED-mail map of Madagascar:
Date: Mon 11 Mar 2019
Source: Focus Taiwan [abridged, edited]

A Taipei resident in her 20s has been confirmed to be infected with measles and is suspected of having had contact with 247 people during the incubation period, according to the Centers for Disease Control (CDC). The woman, who works at a restaurant in the ATT 4 Fun shopping centre in Taipei's Xinyi District might have been infected through coming into contact with foreign tourists in her workplace, said CDC deputy director-general Lo Yi-chun in a statement issued on Mon [11 Mar 2019].

To date, 247 people considered to have had contact with the patient, including her family, colleagues and health care personnel, have been traced. The contact tracing will continue until 27 Mar [2019]. The CDC alerted people who used the same bus and had been to the same places the patient visited to beware of possible exposure to the measles virus. It asked those who might have had contact with the woman to conduct self-health management for 18 days.

The reported new case has brought the total number of confirmed measles cases in Taiwan to 29 since the beginning of this year [2019], 16 contracted at home and 13 from abroad. Among the 16 indigenous cases, 8 have been linked to imported cases, the CDC said.

Lo reminded the public that measles is highly contagious and now is the peak transmission season. Outbreaks in some Asian countries have been growing, including the Philippines, Vietnam, Thailand, China, India and Indonesia, he said. As of 24 Feb [2019], the number of measles cases in Japan has risen to 258, the highest in the same period since 2009, Lo added.  [byline: Chang Ming-hsuan and Evelyn Kao]
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[HealthMap/ProMED-mail map of Taiwan:
Date: Thu 14 March 2019
Source: South China Morning Post [abridged, edited]

Health authorities seek passengers on Cathay Pacific Hong Kong-Tokyo flight [1 Mar 2019] after a man [said to be a Cathay Pacific flight attendant] contracted measles, a contagious disease. The man tested positive for the immunoglobulin M antibody that confirms a measles infection. He was admitted to St Paul's Hospital in Causeway Bay after he returned to Hong Kong. He was later declared to be in a stable condition and discharged.

This is the 11th case of measles confirmed in city this year [2019] with at least 7 infections imported. Authorities seek passengers on the Cathay Pacific flight who might have had contact with the 23 year old man.  [byline: Danny Mok]
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[HealthMap/ProMED-mail map of Hong Kong: