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Antartica

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

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

Travel News Headlines WORLD NEWS

Date: Thu, 17 May 2018 09:57:07 +0200

Buenos Aires, May 17, 2018 (AFP) - Tourism regulation in Antarctica has become an urgent matter due to environmental threats, officials from the 53 member countries of the Antarctic Treaty warned at their annual meeting, held this week in Buenos Aires.

In the absence of rules, travel agencies offer trips to the region on boats sometimes equipped with helicopters or submarines, according to Segolene Royal, French ambassador for the Arctic and Antarctic poles.   "This activity creates considerable disturbance ... we are witnessing a race toward large-scale tourism that is dangerous for ecosystems," she said at the assembly on Wednesday.

During the austral summer of 2016/2017, around 44,000 tourists set off for Antarctica, compared with just 9,000 in 1995/1996, according to French authorities.   However, the push for regulation is not about banning tourism, former environmental minister Royal said, but rather about ensuring it is managed in compliance with the treaty and its environmental protection protocol.

In Buenos Aires, the Antarctic Treaty Consultative Meeting  -- whose mission is to regulate human activity on the continent -- also sought to encourage scientific cooperation between countries that have collectively set up around 100 research bases across the ice.   Also up for analysis is China's proposed fifth permanent scientific station in Antarctica, which would be located in the Ross Sea area south of New Zealand.
Date: Wed, 5 Jul 2017 13:01:49 +0200
By Marlowe HOOD

Paris, July 5, 2017 (AFP) - A chunk of ice bigger than the US state of Delaware is hanging by a thread from the West Antarctic ice shelf, satellite images revealed Wednesday.   When it finally calves from the Larsen C ice shelf, one of the biggest icebergs in recorded history will be set adrift -- some 6,600 square kilometres (2,550 square miles) in total, according to the European Space Agency (ESA).

The iceberg's depth below sea level could be as much as 210 metres (almost 700 feet), or about 60 storeys, it said.   "The crack in the ice is now around 200 kilometres (125 miles) long, leaving just five kilometres between the end of the fissure and the ocean," the ESA said in a statement.   "Icebergs calve from Antarctica all the time, but because this one is particularly large its path across the ocean needs to be monitored as it could pose a hazard to maritime traffic."

Scientists tracking the berg's progression expect it to break of within months.    The Larsen C shelf will lose more than 10 percent of its total surface area.   The massive ice cube will float in water and by itself will not add to sea levels when it melts.   The real danger is from inland glaciers.   Ice shelves float on the sea, extending from the coast, and are fed by slow-flowing glaciers from the land.    They act as giant brakes, preventing glaciers from flowing directly into the ocean.   If the glaciers held in check by Larsen C spilt into the Antarctic Ocean, it would lift the global water mark by about 10 centimetres (four inches), researchers have said.

The calving of ice shelves occurs naturally, though global warming is believed to have accelerated the process.   Warming ocean water erodes the underbelly of the ice shelves, while rising air temperatures weaken them from above.   The nearby Larsen A ice shelf collapsed in 1995, and Larsen B dramatically broke up seven years later.   The ESA is keeping an eye on Larsen C with its Copernicus and CryoSat Earth orbiters.

Man-made global warming has already lifted average global air temperatures by about one degree Celsius (1.8 degrees Fahrenheit) since pre-industrial levels.    Antarctica is one of the world's fastest-warming regions.   The world's nations undertook in the Paris Agreement, inked in 2015, to cap average global warming at "well under" 2 C.
Date: Wed, 22 Jun 2016 21:35:09 +0200
By Jean-Louis SANTINI

Washington, June 22, 2016 (AFP) - Two sick workers were evacuated from a remote US research station near the South Pole on Wednesday in a risky rescue mission carried out in the dead of Antarctica's winter, a US official said.   A Twin Otter turboprop plane flew in dark and cold conditions to pick up the workers from the Amundsen-Scott station, about 250 meters from the geographic South Pole, a spokesman for the US National Science Foundation (NSF), Peter West told AFP.

The plane's crew and a medical team had made the 10-hour journey to the South Pole in the middle of Antarctica's 24-hour winter on Tuesday night to reach the unidentified patients, who could not be treated on site.   The NSF -- the US research agency that operates the Amundsen-Scott Station -- organized the rescue mission last week given the condition of the first patient, which was not disclosed for privacy reasons.   "It was really an emergency," West said.   It later became apparent that the second worker also needed to be evacuated.

The sick workers -- employees of the US company Lockheed Martin who worked on base logistics -- were then taken to the Rothera base, a British research station some 2,200 kilometers (about 1,365 miles) away, the spokesman said.   The pair, who were not identified, were then to be transferred to a hospital in South America, West said, without giving further details.   The Amundsen-Scott base was home to 48 people -- 39 men and nine women -- who work on-site throughout the austral winter, which spans February through October.

- Rare rescue mission -
Near the world's southernmost point, workers spend this period withstanding nearly complete darkness and dramatically low temperatures -- on Tuesday, the thermometer dropped to -60 degrees Celsius (-76 degrees Fahrenheit).   It was only the third time that an emergency rescue operation has been launched in the middle of winter.   In 2001, the only doctor at the Amundsen-Scott station was suffering from a life-threatening pancreatic condition and required urgent evacuation. A second medical evacuation was carried out that year.

In 1999, the US station's doctor Jerri Nielsen, who was self-treating her own breast cancer, required medical evacuation but weather conditions were more favorable, as the mission took place in the spring.  The Twin Otter plane, operated by the Canadian company Kenn Borek Air, is specially designed to operate in extremely cold temperatures.

Research projects at the Amundsen-Scott station include monitoring long-term levels of carbon dioxide (CO2) in the atmosphere.     The station also operates two telescopes that observe "cosmic microwave background" radiation -- the faint light signature left by the Big Bang -- to study the origins of the universe, dark energy and dark matter.
Date: Wed, 18 Jun 2014 09:04:56 +0200 (METDST)
by Martin PARRY

SYDNEY, June 18, 2014 (AFP) - Antarctic scientists warned Wednesday that a surge in tourists visiting the frozen continent and new roads and runways built to service research facilities were threatening its fragile environment.   Tourist numbers have exploded from less than 5,000 in 1990 to about 40,000 a year, according to industry figures, and most people go to the fragmented ice-free areas that make up less than one percent of Antarctica.   A growing number of research facilities are also being built, along with associated infrastructure such as fuel depots and runways, in the tiny ice-free zones.

It is these areas which contain most of the continent's wildlife and plants, yet they are among the planet's least-protected, said a study led by the Australian government-funded National Environmental Research Programme (NERP) and the Australian Antarctic Division.   "Many people think that Antarctica is well protected from threats to its biodiversity because it's isolated and no one lives there," said Justine Shaw from the NERP of the study published in the journal PLoS Biology.   "However, we show that there are threats to Antarctic biodiversity.   "Most of Antarctica is covered in ice, with less than one percent permanently ice-free," she added.   "Only 1.5 percent of this ice-free area belongs to Antarctic Specially Protected Areas under the Antarctic Treaty System, yet ice-free land is where the majority of biodiversity occurs."   Five of the distinct ice-free areas have no protection at all while all 55 of the continent's protected zones are close to sites of human activity.

- Fragile ecosystems -
Steven Chown of Monash University, another collaborator in the study, said the ice-free areas contain very simple ecosystems due to Antarctica's low species diversity.   This makes its native wildlife and plants extremely vulnerable to invasion by outside species, which can be introduced by human activity.   "Antarctica has been invaded by plants and animals, mostly grasses and insects, from other continents," he said.    "The very real current and future threats from invasions are typically located close to protected areas.    "Such threats to protected areas from invasive species have been demonstrated elsewhere in the world, and we find that Antarctica is, unfortunately, no exception."

The study said the current level of protection was "inadequate by any measure" with Shaw saying more was needed to guard against the threat posed by the booming tourism industry.   "(We need) to protect a diverse suite of native insects, plants and seabirds, many of which occur nowhere else in the world," she said.   "We also need to ensure that Antarctic protected areas are not going to be impacted by human activities, such as pollution, trampling or invasive species."   Antarctica is considered one of the last frontiers for adventurous travellers.   Most travel by sea, some paying in excess of US$20,000 for a luxury cabin in the peak period from November to March. There is also a healthy market for sightseeing flights.

Approximately 30 nations operate permanent research stations on the continent including the US, China, Russia, Australia, Britain, France and Argentina, and more are on the way.   China's state media said in December that the country was building its fourth base and a fifth was being planned.   Fellow study author Hugh Possingham, from NERP, said that without better protection "this unique and fragile ecosystem could be lost".   "Although we show that the risks to biodiversity from increasing human activity are high, they are even worse when considered together with climate change," he added.    "This combined effect provides even more incentive for a better system of area protection in Antarctica."
Date: Sun, 17 Nov 2013 12:27:56 +0100 (MET)

WASHINGTON, Nov 17, 2013 (AFP) - A powerful 7.8 magnitude undersea earthquake struck in the Scotia Sea, a remote region in the far south Atlantic near Antarctica, US earthquake monitors reported Sunday.   The quake struck at 0904 GMT in the ocean some 893 kilometers (550 miles) southwest of Grytviken, South Georgia, and 1,140 kilometres (710 miles) southeast of Ushuaia, Argentina, said the US Geological Survey, which monitors earthquakes worldwide.   The epicenter was at a depth of 10 kilometers (6.2 miles), and was near that of a 6.8 magnitude undersea earthquake that the USGS registered in the Scotia Sea some 30 hours earlier.

The quake occurred at the boundary between the Antarctic tectonic plate and the Scotia Sea plate, said geophysicist Randy Baldwin at the National Earthquake Information Center in Golden, Colorado.   "They're sliding past one another horizontally, it's not a subduction zone," Baldwin told AFP. "There will be aftershocks probably for weeks."   There were no tsunami warnings since there were no vertical movements in the seafloor as occur in a subduction quake, when one tectonic plate moves under another one, Baldwin said.   Yet despite the enormous energy unleashed the area is so remote that there is little or no impact to humans, he said.   "You couldn't pick a more remote area for an earthquake," he said.
More ...

Switzerland

Switzerland US Consular Information Sheet
December 01, 2008
COUNTRY DESCRIPTION:
Switzerland is a highly developed democracy.
Liechtenstein is a democratically run constitutional monarchy.
Read the Department of State Background
otes on Switzerland for additional information.

ENTRY/EXIT REQUIREMENTS:
A passport is required for travel to both Switzerland and Liechtenstein.
A visa is not required for stays up to 90 days in either country.
For more information on entry requirements for both countries, travelers may contact the Embassy of Switzerland at 2900 Cathedral Avenue, NW, Washington, DC 20008, telephone (202) 745-7900, or the nearest Swiss Consulate General in Atlanta, Chicago, Los Angeles, New York, or San Francisco.
Visit the Embassy of Switzerland’s web site at http://www.swissemb.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:
Although there have been no recent terrorist attacks in Switzerland, violence by anti-globalization, anti-Semitic, and anti-establishment (anarchist) groups does occur from time to time.
This violence is typically in the form of property damage and clashes between these groups and the police.
The potential for specific threats of violence involving American citizens in Switzerland is remote.
Nevertheless, the Consular Agencies in Zurich and Geneva may close periodically to assess their security situation.
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:
Switzerland has a low rate of violent crime.
However, pick-pocketing and purse snatching do occur in the vicinity of train and bus stations, airports, and some public parks, especially during peak tourist periods (such as summer and Christmas) and when conferences, shows, or exhibits are scheduled in major cities.
Liechtenstein has a low crime rate.
Travelers may wish to exercise caution on trains, especially on overnight trains to neighboring countries.
Thieves, who steal from passengers while they sleep, can enter even locked sleeping compartments.
Thieves have been known to work in pairs to target train passengers; while one member of the pair creates a diversion at a train window or on a platform, the other steals items left briefly unattended.

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.

Switzerland, through its 26 cantons (states), has programs to assist victims of crime and their immediate relatives.
Medical, psychological, social, financial, and legal assistance are available throughout the country.
These programs also protect the rights of the victim during criminal proceedings.
The victim may receive compensation for some damages, if requested during the criminal procedure.
Information is available at the Swiss Department of Justice located on Bundesrain 20, 3003 Bern, telephone: 41-31-322-4750, as well as on the Internet at http://www.bj.admin.ch/bj/en/home.html
The local equivalent to the “911” emergency line in Switzerland is fire 118; police 117; medical 144.
For additional assistance, including possible U.S. compensation, see our information for Victims of Crime.

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

The U.S. Department of State is unaware of any HIV/AIDS entry restrictions for visitors to or foreign residents of Switzerland.
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 Switzerland is provided for general reference only, and may not be totally accurate in a particular location or circumstance.
Although many roads are mountainous and winding, road safety standards are high.
In some mountain areas, vehicle snow chains are required in winter.
Road travel can be more dangerous during summer, winter holidays, the Easter break, and Whitsunday weekend (late spring) because of increased traffic.
Travel on expressways (indicated by green signs with a white expressway symbol) requires purchase of a sticker or “vignette,” which must be affixed to the car’s windshield.
Vignettes can be purchased at most border crossings points, gas stations and at Swiss post offices.
Drivers using the highway system without a vignette are subject to hefty fines levied on the spot.
Public transportation in Switzerland and Liechtenstein is excellent.

Please refer to our Road Safety page for more information.
Visit the website of Switzerland’s national tourist office at http://www.myswitzerland.com/en.cfm/home.

AVIATION SAFETY OVERSIGHT:
The U.S. Federal Aviation Administration (FAA) has assessed the Government of Switzerland’s Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for oversight of Switzerland’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:
Travelers who plan to participate in mountain activities (summer and winter) are strongly encouraged to buy mountain search and rescue insurance. Costs of search and rescue operations are the responsibility of the victim. Search and rescue insurance is available inexpensively in Switzerland and may be purchased at many Swiss post offices.
Information can be obtained from the Swiss National Tourist Office, at http://www.myswitzerland.com, at most tourist information offices or with the Swiss Air Rescue Organization at http://www.rega.ch/en/start_en.aspx .
Such insurance has proved useful as uninsured rescues can easily cost $25,000.

Switzerland’s customs authorities encourage the use of an ATA (Admission Temporaire/Admission) Carnet for the temporary admission of professional equipment, commercial samples, and/or goods for exhibitions and fair purposes.
ATA Carnet Headquarters located at the U.S. Council for International Business, 1212 Avenue of the Americas, New York, N.Y. 10036, and issues and guarantees the ATA Carnet in the United States.
For additional information call (212) 354-4480, send an email to atacarnet@uscib.org, or visit http://www.uscib.org for details.
Please see our information on 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 Switzerland’s laws, even unknowingly, may be expelled, arrested, or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in Switzerland 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 Switzerland are encouraged to register with the U.S. Embassy in Bern, with the Consular Agencies in Geneva or Zurich, or through the State Department’s travel registration web site, and to obtain updated information on travel and security within Switzerland and Liechtenstein.
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, Consulate, or Consular Agent to contact them in case of emergency.
The U.S. Embassy is located at Sulgeneckstrasse 19, 3007 Bern; Tel. (41)(31) 357-7011 (2 p.m. – 5 p.m.); fax (41)(31) 357-7280.
The Embassy’s email address is bernacs@state.gov.
The U.S. Embassy website at http://bern.usembassy.gov answers many questions of interest to Americans visiting and residing in Switzerland.

The U.S. Consular Agency in Zurich is located at the American Center of Zurich, Dufourstrasse 101, 8008 Zurich; Tel: (41)(43) 499-2960 (10 a.m. – 1 p.m.), fax (41)(43) 499-2961.
The U.S. Consular Agency in Geneva is located at rue Versonnex 7, CH-1207 Geneva, Tel: 022-840-51 60 (10 a.m. – 1 p.m.); fax 022-840-51 62.
There is no U.S. Embassy or Consulate in Liechtenstein.
For assistance and information on travel and security in Liechtenstein, U.S. citizens may contact or register at the U.S. Embassy in Bern at the address above.
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*
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This replaces the Consular Information Sheet dated March 3, 2008 with changes to the sections on Crime and Registration/Embassy Location.

Travel News Headlines WORLD NEWS

Date: Mon 22 Jul 2019
Source: Swissinfo [edited]

Cases of tick-borne diseases, including encephalitis and Lyme disease, almost halved in Switzerland in the 1st 6 months of 2019 compared with the same period last year [2018].

Figures for 2019 so far show 127 cases of meningoencephalitis [the graph shows approximately 75 cases - ProMED Mod.TY], compared with 218 for the 1st half of 2018. Those showing symptoms of Lyme disease fell from 10 000 to 3600.

But Daniel Koch, head of communicable diseases at the Federal Office for Public Health (FOPH), told the Keystone-SDA news agency that while the numbers mark a big fall from 2018, they are closer to the average over a longer time period. Indeed, since 2000, numbers of tick-borne encephalitis declared in the 1st 6 months of the year varied between 24 and 120, FOPH figures show. In 2018, the number was 206.

If the cause of last year's [2018's] peak remains unclear, the subsequent drop in 2019 is also difficult to explain, though it has coincided with a concerted campaign by authorities to encourage vaccination among the population. Tick-borne encephalitis, a debilitating and potentially fatal disease that attacks the nervous system, is preventable through a jab.

To reduce the risk of picking up tick-borne diseases, authorities recommend avoiding particularly at-risk areas -- for example, bushes and tall grass -- as well as using an insect repellent and wearing clothing that covers the arms, legs, and feet.  [Byline: Laurent Gillieron]
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[The Swiss government has had a proactive tick-borne encephalitis (TBE) vaccination program this year (2019), beginning early in the year. In a press release [<https://www.admin.ch/gov/fr/accueil/documentation/communiques.msg-id-73873.html>], the office repeated the call for anybody who may be exposed to ticks -- for example walkers, especially in forests -- to be vaccinated. Residents of Geneva or Ticino travelling outside their canton for such activities should also get the jab, it said. The optimum time for vaccination is in winter, the office wrote, so that walkers and hikers are protected once the good weather and riskiest period (from April to October) rolls around.

As cited earlier, according to government information, the most widespread TBE vector tick species in Switzerland is the wood tick (_Ixodes ricinus_, commonly known as the castor bean tick or sheep tick). It prefers deciduous woods with abundant undergrowth, the edge of the forest, and forest paths and waits on low-growing plants until a warm-blooded host (a person or animal) brushes against the plant.

In a previous comment in 2017 concerning TBE in Switzerland, Dr Ivo M Foppa indicated that the incidence of TBE in Switzerland has increased markedly, roughly about 50%, since 2000. The reason for the increase of TBE incidence in Central/Western/Northern Europe is unknown.

TBE is a virus infection caused by one of 3 TBE virus subtypes belonging to the Flaviviridae family: Central European, Siberian, and Far Eastern (formerly known as Russian spring-summer encephalitis). It is transmitted to humans through the bite of infected _Ixodes_ ticks. - ProMED Mod.TY]

[Maps of Switzerland:
Date: Sun, 16 Jun 2019 00:19:43 +0200

Geneva, June 15, 2019 (AFP) - A woman has drowned in Lake Geneva when her sightseeing boat sank as a violent storm battered parts of Switzerland on Saturday, police said.   A man who was in the same boat was able to swim to another vessel from where he fired "two flares", Joanna Matta, police spokeswoman for the canton (region) of Geneva, told AFP.   The man told officers that the woman had been "passing through Geneva" and that the storm had taken them "by surprise", Matta said.   Three police boats and emergency services rushed to the scene. Police divers later retrieved the woman's body from the lake.

The victim, whose nationality remains unknown, was then taken to a hospital in Geneva where she was declared dead.   In a separate incident, the storm also damaged some of the 465 boats taking part in the 81st edition of the Bol d'Or, an annual regatta on Lake Geneva, the event's press service said.   Heavy rain and strong winds lashed the participants on Saturday afternoon, causing boats to capsize although nobody was injured.

However, the storm broke the mast of the ultra-fast "Real Team" catamaran, which had been in the lead and was forced to pull out of the race.   The bad weather struck western Switzerland on Saturday afternoon, bringing hail and winds reaching up to 110 kilometres (70 miles) per hour, according to the national forecaster MeteoSwiss.   In the neighbouring French region of Haute-Savoie the storm also caused damage and left a 51-year-old German tourist dead after a tree came down at a campsite.
diDate: Mon 3 Jun 2019
Source: FM1 Today [in German, machine trans., edited]

Several cases of pneumonia have occurred in the Ticino Maggia Valley in recent weeks. Those affected have been infected with Q fever. The situation is, however, under the control of the health authorities.

Q fever is transmitted by a bacterium found in goats. The Ticino health authorities have therefore ordered the vaccination of exposed animals. In addition, the transport of the animals from one farm to another was prohibited.

Infection with goat milk is considered very unlikely. Even from person to person, the disease is not transmitted. Q fever manifests itself with flu-like illnesses, but without a cold or sore throat. In 1-2 percent of cases there are complications.

Q fever is a notifiable disease in Switzerland. Since the beginning of the year [2019] around 50 cases have been reported, 20 of them from Ticino, said Daniel Koch of the Federal Office of Public Health (FOPH).

Therefore, there will be an increase this year [2019] compared to the approximately 40 cases that have occurred on average per year since 2012. In 2012, the disease was again declared as notifiable after 17 cases of illness occurred in the canton of Vaud.

According to Koch, the situation is under control, despite the increased occurrence of illnesses in Ticino. The established monitoring system proved its effectiveness. The last time a major epidemic of Q fever occurred in 1983. At that time, more than 400 people fell ill in Valais.
Date: Sun, 28 Apr 2019 11:34:28 +0200

Geneva, April 28, 2019 (AFP) - Four German hikers have been killed by an avalanche in the Swiss Alps, police in the southern canton of Valais said Sunday.   The accident took place on Friday in the village of Fieschertal, but bad weather prevented rescue services from finding the victim's bodies before Saturday, police said.   All equipped with search beacons, and an investigation into their deaths has been opened, they added.
Date: Mon 1 Apr 2019
Source: Swiss Info [abridged, edited]

The Federal Office of Public Health external link said on Monday [1 Apr 2019] that 55 cases of measles were reported in March [2019], nearly twice the number of cases registered at the beginning of the year [2019].

In all, 97 cases have been recorded in 2019, the office said. This compares to 15 cases during the same 3-month period at the start of last year [2018]. In 2018, there were a total of 48 measles cases, and in 2017, there were 105.

In the World Health Organization external link (WHO)'s European  region, which covers nearly 900 million people, some 82,600 in 47 countries contracted measles last year [2018], the highest number this decade. Of those, 72 cases were fatal. The worst-affected countries were Ukraine (53,000 cases), followed by Serbia (5076), Israel (2919), France (2913), Russia (2256), Italy (2517), Georgia (2203), and Greece (2193). Six of the 53 countries did not report.

The record number in Europe is partly due to a growing number of pockets where parents are refusing vaccination for their children, the WHO said in February [2019]. At the same time, the WHO said, record numbers of children are getting the vaccine, offering hope that the rise in infections may not last.

In 1987, the Swiss Federal Office of Public Health announced a vaccination strategy that it hoped would eradicate measles by the year 2000. To eradicate measles, the WHO advocates a vaccination coverage of 95% of the population. Swiss coverage is currently below this at 87% for 2-year-olds and 93% for 16-year-olds.

In Switzerland, there are large differences between cantons, with more urban cantons reaching a near-100% level, while rural areas score much lower, with the lowest vaccination rate in the tiny canton of Appenzell Inner Rhodes at 82%.
======================
[HealthMap/ProMED map of Switzerland:
More ...

Peru

General Information:
***********************************
The number of Irish holiday makers heading to Peru to complete the Inca Train is increasing. This is partly due to easier travel arrangements but the beauty of this region is also attracti
g many. Overall the majority will remain healthy but some will become sick by exposure to a variety of situations which should be protected against. The Inca Trail is situated in southern Peru and the most commonly visited regions include Lima (the capital), Cusco, Machu Picchu and Lake Titicaca. This includes some high mountainous regions of the country and many of the trekking paths are poorly maintained.
Personal Health:
***********************************
Generally those planning a holiday along the Inca Trail will be trekking for a part of their time abroad. It is essential that these individuals realise that they may reach significant altitude and that this is not a ‘restful’ holiday. Good general health is required and those with heart problems or respiratory conditions may find that they will be unable to complete the journey. Having a general medical check before booking your ticket may be worth considering for any patient with a chronic illness.
Travelling Alone:
***********************************
If you are travelling alone or in a small group it will be essential to take care at all times. In Lima, the level of crime is high and resistance to violent crime often provokes greater violence, while those who do not resist usually do not suffer serious physical harm. Street crime is also prevalent in tourist cities in Peru's interior, including Cusco, Arequipa, Puno and Juliaca, and pickpockets frequent the market areas.
In Cusco, "choke and grab" muggings are common, particularly on streets leading off the main square and in the area around the train station.
Travellers should use only registered taxis in Cusco and should not accept offers of transportation or guide services from individuals seeking clients on the streets.
The number for the tourist police in Lima is (51-1) 225-8698 or 225-8699, or fax 476-7708.
There are also tourist police offices in 15 other cities, including all major tourist destinations such as Cusco, Arequipa, and Puno.
Altitude problems:
***********************************
Along the Inca Trail the elevation above sea level can be significant. For instance Cusco is at 10,000 feet and Lake Titicaca is at 13,000 feet. Those visiting these regions should be aware that it is essential to take time to adjust to the altitude, which can adversely affect blood pressure, digestion and energy level.
In 1999, several U.S. citizens died in Peru from medical conditions exacerbated by the high altitude. (See separate TMB leaflet on Altitude Sickness). Adventure travellers should be aware that rescue capabilities in the region are limited.
In recent years, several hikers have died and others have had to be rescued after serious accidents in the Huaraz region of the Cordillera Blanca mountains, where Peru's highest peaks are located.
Coca Tea:
***********************************
On arriving in many of these regions you will find street vendors and restaurants selling Coca tea to relieve altitude sickness. Generally this is safe providing the water is boiling but take care of the hygiene for the cup which is used to drink from. Advice would usually be to avoid chewing the leaves of the Coca plant.
Avoiding Insect Bites:
***********************************
One of the biggest problems facing travellers to this region is the risk of insect bites. Along the Inca Trail you will often find that many travellers have been bitten significantly by both mosquitoes and sandflys. There are a number of diseases transmitted by these insects in this region and so it is essential to protect yourself. Wearing long sleeved pale coloured clothing and applying good insect repellent (with DEET 30-50% at least) will help. This will be particularly important on the day that you visit Machu Picchu.
Leishmaniasis:
***********************************
This is a parasitic disease transmitted by sandflys. The skin ulcers associated with this condition can take months to heal.
Malaria:
***********************************
Fortunately this dangerous disease does not occur in southern Peru along the Inca Trail. Those visiting the jungle areas east of the Andes will need protection.
Food and Water:
***********************************
It is essential to take care to ensure that all food is fresh and well prepared. Eating from street vendors is a high risk activity and bivalve shellfish should be avoided at all times.
Rabies:
***********************************
The risk of this viral disease occurs throughout the country. Avoid all warm blooded animals and seek adequate medical treatment after any bite, lick or scratch. Dogs, cats and monkeys commonly transmit the disease but it can be from any warm blooded animal.
Vaccines:
***********************************
For entry/exit purposes it is recommended that all travellers receive cover against Yellow Fever. Having cover also against Typhoid, Tetanus and Hepatitis A is well worthwhile for personal protection. Those planning a longer trip or more extensive trekking will need to consider cover against conditions like Hepatitis B and Rabies.
Summary:
***********************************
Make sure you are fit enough for this trip. Trek within your limits and have good shoes and clothing. Bring plenty of insect repellent!
Further Information:
***********************************
Contact the Tropical Medical Bureau at the numbers below. This leaflet must not be used in place of a detailed medical consultation.

Wanderlust April/May 2001
Web. www.wanderlust.co.uk
****************************************
Visiting Machu Picchu is almost a rite of passage for Latinophiles and for the adventurous there is only one way - along the Inca Trail. While romantics and old-timers lament the loss of independent trekking this remains one of the world’s classic walks. If you want to see Machu Picchu and you like trekking, the euphoric jubilation of passing through the Gate of the Sun is close to unbeatable.
The dry season in the highlands runs from May to October and makes for clearer skies and generally better views. Off-season the weather can be risky, but there are far fewer people.
To be fair this is not the only trek in Peru. Scribes from Pizarro to Parris have waxed lyrical about the breathtaking beauty of the Cordilleras Blanca and Huayhuash. Sheer walls of ice and granite hang precariously above scrubby grassland basking in the warm equatorial sun. As one of the most popular trekking areas in South America, the central cordilleras are ideal for hiking, with most activities starting from the mountain-fringed setting of Huaraz at almost 3,lOOm.
Whitewater rafting is also popular and most is based out of Cuzco; a quick and complete drenching in the River Apurimac takes in awesome scenery and exhilarating Class IV rapids. Trips also head to the source of the Amazon and down to the dramatic Colca Canyon which is twice as deep as the Grand Canyon.
Mountain biking is popular in the central cordilleras along with some challenging opportunities through dramatic Andean scenery in the Cuzco area.
Manu National Park in the Amazon lowlands north of Cuzco is one of the continent’s great untouched wildernesses. Set aside for research and ecotourism, Manu is one of the best places to visit the rainforest and sightings of big cats, although not common, are regular. The nearby town of Puerto Maldonado, close to the famous macaw salt lick in the Tambopata-Candamo Reserve, is a popular spot for jungle tours mixing short hikes with river trips; they generally last a few days.
Adventurous independent travellers may want to join the locals and travel down the Amazon in a hammock on a cargo boat from Pucallpa. Short jungle treks and canoe trips from the northern Amazon town of Iquitos explore small tributaries and indigenous villages to help you encounter the natural wonders of the Amazon rainforest face to face.
Peter Hutchison is editor of Footprint’s
Mexico & Central America Handbook 2001
*******************************************************

Travel News Headlines WORLD NEWS

Date: Mon 10 Jun 2019
Source: Peruvian Times [edited]

More than 100 cases of Guillain-Barre syndrome have been reported in Lima and several other regions of the country, prompting the Health Ministry to issue a 90-day emergency health warning and increase the health services budget to cover treatment.

There are 3 fatal cases, 2 in Piura and one in Trujillo on the north coast. The National Institute of Neurological Sciences reported that the current cases show unusual and atypical features that require rapid and immediate treatment.

According to the minister of health, Zulema Tomas, the report of cases is usual at this time of year when cases of influenza and bronchial infections increase. In 2018, the Health Ministry reported 205 cases. Tomas said up to 300 cases may be expected this year [2019].

Guillain-Barre syndrome, GBS, is a rare but serious autoimmune disorder that attacks the peripheral nervous system and leads to weakness, tingling, and numbness, initially in the limbs and expanding to the rest of the body, and can eventually cause paralysis.

Although the precise cause of the disease is unknown, according to the US Centers for Disease Control and Prevention, people who develop GBS do so several days or weeks after they have been sick with diarrhea or a respiratory illness. Although rare, some may develop the symptoms days or weeks after getting a vaccination.
Treatment consists of cleaning or immunizing the blood, according to Dr. Hugo Umeres of the Neurological Service at the Cayetano Heredia university hospital. One of the treatments is plasmapheresis, a procedure that removes the plasma from the blood and replaces it with other fluids. The treatment can cost up to [USD] 15,000, but the increased budget will allow all state hospitals to provide free treatment for GBS cases.

According to the World Health Organization (WHO), symptoms last a few weeks, and most cases recover without any serious or long-term complications.

The Health Ministry has emphasized that GBS is not contagious. It is a virus, and the best prevention is to wash hands frequently, avoid street food, and treat respiratory diseases promptly.
***************************************
Date: Mon 10 Jun 2019
Source: France 24 [edited]

Peru has declared a health emergency in 5 regions, including Lima, after the deaths of at least 4 people linked to Guillain-Barre syndrome, an autoimmune disorder that attacks the nervous system.

Health minister Zulema Tomas said Sunday [9 Jun 2019] that in addition to the deaths there were currently 206 cases of the disease.

"We have an outbreak; there has been a brusque increase" since 5 Jun [2019], Tomas said on state-run TV Peru, adding that health authorities were taking steps to control and contain the disease.

While the syndrome is not contagious, a 90-day health emergency was declared because the current cases "have unusual and atypical characteristics that require rapid or immediate initial treatment," Peru's Institute of Neurological Sciences said.

The precise cause of the disorder is unknown, but most cases develop after a person has been sick with diarrhea or a respiratory infection.

The Centers for Disease Control and Prevention in the US says its research suggests that the syndrome is "strongly associated" with the Zika virus, a mosquito-borne illness.

The regions affected by GBS include 3 on the country's northern coast -- Piura, Lambayeque, La Libertad -- tourist destinations known for their archaeological sites and beaches. Also included was the central region of Junin and Lima, which has 9 million inhabitants.

There are 2 deaths reported in Piura, one in La Libertad, and another in Junin.
=====================
[Guillain-Barre syndrome (GBS) can occur following infections. GBS has also been reported following Zika virus infections in other localities. A report in 2018 described a 2-year clinical course of Zika virus infection-related GBS. In that study, clinical and demographic characteristics of the 18 patients infected during the Colombian Zika epidemic with serologically diagnosed Zika infection with GBS are reported (see Zika virus (09): Americas, Asia, research, observations http://promedmail.org/post/20180909.6016422). No mention is made in the above report about the measures that will be used to contain the occurrence of GBS. - ProMED Mod.TY]

[HealthMap/ProMED-mail maps:
Lambayeque, Lambayeque, Peru: <http://healthmap.org/promed/p/33583>
La Libertad region, Peru: <http://healthmap.org/promed/p/35305>
Date: Mon, 10 Jun 2019 14:24:43 +0200

Lima, June 10, 2019 (AFP) - Peru has declared a health emergency in five regions, including Lima, after the deaths of at least four people linked to Guillain-Barre syndrome, an autoimmune disorder that attacks the nervous system.   Health Minister Zulema Tomas said Sunday that in addition to the deaths there were currently 206 cases of the disease.   "We have an outbreak, there has been a brusque increase" since June 5, Tomas said on state-run TV Peru, adding that health authorities were taking steps to control and contain the disease.

While the syndrome is not contagious, a 90-day health emergency was declared because the current cases "have unusual and atypical characteristics that require rapid or immediate initial treatment," Peru's Institute of Neurological Sciences said.   The precise cause of the disorder is unknown, but most cases develop after a person has been sick with diarrhoea or a respiratory infection.

The Centers for Disease Control and Prevention in the US says its research suggests that the syndrome is "strongly associated" with the Zika virus, a mosquito-borne illness.   The regions affected by GBS include three on the country's northern coast -- Piura, Lambayeque, La Libertad -- tourist destinations known for their archaeological sites and beaches.   Also included was the central region of Junin and Lima, which has nine million inhabitants.   Two deaths were reported in Piura, one in La Libertad and another in Junin.
Date: Tue, 4 Jun 2019 20:24:14 +0200

Lima, June 4, 2019 (AFP) - Peruvian police on Tuesday were searching for a British tourist who went missing last week in the forests of a national park in the centre of the country, officials said.   Mary Elizabeth Orchard disappeared on Friday after entering the Yanachaga-Chemillen national park with her sister and brother-in-law, local media reported.    Orchard got separated from the group, and her sister reported her disappearance, triggering a search by police, firefighters and park rangers.

Locals reported the missing tourist had slipped into a ravine in a remote and hilly area of the park.   Peruvian media reports said a helicopter had been deployed in the search, but had been hampered by dense cloud cover.   Yanachaga-Chemillen is a nature reserve of 122,000 hectares (300,000 acres) known for its cloud forests and diverse flora and fauna, some of which is under threat of extinction.
Date: Mon, 27 May 2019 05:16:24 +0200
By Carlos MANDUJANO

Lima, May 27, 2019 (AFP) - A powerful 8.0-earthquake toppled houses, blocked roads and knocked out power in parts of Peru on Sunday, killing one person and injuring at least 26 others as the shockwave extended into neighbouring Ecuador.   The quake hit in a sparsely populated region of Peru's Amazon basin region but was felt over a wide area. In Lima and other cities, frightened residents rushed into the streets.   "There are many old houses that have collapsed after this strong earthquake," said Hugo Araujo, the mayor of Yurimaguas, a town near the epicentre.

Peru's civil defense coordinator Ricardo Seijas told RPP radio that a man was killed by falling debris in his house in Cajamarca.   Danilo Munoz, the 48-year-old victim, was asleep when the quake struck at 2:41 am (0741 GMT).   Seijas said 11 people were injured in Peru, and more than 50 houses were left uninhabitable.   Reports said 15 people had been hurt in Ecuador.

The quake blocked roads, damaged a bridge and knocked down houses, said Peru's President Martin Vizcarra, adding that it was the most powerful quake to hit the country in 12 years.   "It is an earthquake affecting the entire Peruvian jungle," he said.   "We are working on establishing an air bridge to transport people who have an emergency," he said.   The quake struck about 75 kilometers (45 miles) southeast of the town of Lagunas at a depth of at least 110 kilometres.   The US Geological Survey and Peruvian geophysicists said the quake registered 8.0 in magnitude. They said it lasted just over two minutes.

The mayor of Lagunas, Arri Pezo, said many residents who fled from their homes later stayed in the streets for fear of aftershocks.   "You could not walk at the time of the earthquake, things were falling," Pezo told RPP. Power was knocked out, making it difficult to assess the damage, he said.   One of the most dramatic moments captured on social media happened in Yurimaguas. Video from the police station shows the police chief shouting at his subordinates to quickly open the jail cells and get inmates outside.   "The earthquake is strong!" he is heard yelling. "Open the cells! Help with the detainees, get one each!"

- Power cuts in Ecuador -
The shockwave of Sunday's tremor also extended to neighboring Ecuador, where power cuts were reported in parts of its Amazon basin region.    Peruvian media said the tremor was also felt in parts of Colombia and Venezuela.   Peru lies on the so-called Ring of Fire -- an arc of fault lines that circles the Pacific Basin and is prone to frequent earthquakes and volcanic eruptions.

The South American country records about 200 earthquakes a year, most of them going unnoticed by the public.   In February, a quake measuring 7.5 with its epicenter in Ecuador rattled the coast and Amazon region of northern Peru.   It left nine people injured and caused damage in Ecuador, but Peru was unscathed.
Date: Sat, 11 May 2019 03:17:40 +0200

Lima, May 11, 2019 (AFP) - Peru announced on Friday a two-week restriction to three important areas at Machu Picchu to prevent greater degradation to the iconic Inca citadel.   From May 15-28, access to the Temple of the Sun, Temple of the Condor and Intihuatana Stone will be strictly controlled at the UNESCO World Heritage Site, the government said.   "These measures are necessary to conserve Machu Picchu, given the evidence of deterioration" on stone surfaces caused by visitors to the three areas, the culture ministry said.

Almost 6,000 visitors a day are permitted onto the 15th century site in two waves.   The new plan will give tourists just three hours to visit the three emblematic areas.   Authorities will evaluate the impact of the measures before applying new permanent rules from June 1.

Machu Picchu, which means "old mountain" in the Quechua language indigenous to the area, is at the top of a lush mountain and was built during the reign of the Inca emperor Pachacuti (1438-1471).   It lies around 100 kilometres (60 miles) from the Andean city of Cusco, the old Inca capital in south-eastern Peru.   It was rediscovered in 1911 by the American explorer Hiram Bingham. UNESCO declared it a World Heritage Site in 1983.
More ...

World Travel News Headlines

Date: Tue 17 Sep 2019
Source: Boston Globe [edited]

Rhode Island officials announced Tuesday [17 Sep 2019] that 2 more human cases of eastern equine encephalitis [EEE] were confirmed in the state.

The 2 people -- one a Coventry child younger than 10 and the other a person in their 50s from Charlestown -- have been discharged from the hospital and are recovering, according to a statement from the state's Department of Public Health.

Authorities think the 2 people contracted EEE in late August [2019]. The cases were confirmed by tests done at the Centers for Disease Control and Prevention. There have been 3 confirmed EEE cases in Rhode Island this year [2019]. A West Warwick resident diagnosed with the mosquito-borne illness died this month [September 2019].

All 3 people contracted EEE before areas at critical risk for the disease were aerially sprayed with pesticide, state officials said.

EEE is a rare but potentially fatal disease that can cause brain inflammation and is transmitted to humans bitten by infected mosquitoes, according to federal authorities. About 1/3 of infected people who develop the disease will die, officials have said, and those who recover often live with severe and devastating neurological complications. There is no treatment for EEE.

"This [2019] has been a year with significantly elevated EEE activity, and mosquitoes will remain a threat in Rhode Island until our 1st hard frost, which is still several weeks out," said Ana Novais, the deputy director for the state's health department. "Personal mosquito-prevention measures remain everyone's 1st defence against EEE. If possible, people should limit their time outdoors at sunrise and sunset. If you are going to be out, long sleeves and pants are very important, as is bug spray [repellent]."

EEE was also confirmed in a deer in Exeter this week [week of Mon 16 Sep 2019].

In Massachusetts, 8 human cases of EEE have been confirmed this year [2019]. Last month [August 2019], a Fairhaven woman with EEE died.
========================
[The 1st Rhode Island case died. Now there are 2 additional EEE cases who have recovered sufficiently to have been discharged from the hospital. Although most reported cases of EEE this year [2019] have occurred in horses, there have been several recent human cases as well. Individuals living in areas where human or equine EEE cases have occurred should heed the above recommendations to prevent mosquito bites. Avoidance of mosquito bites is the only preventive measure available. Fortunately, horses can be vaccinated, but there is no vaccine available for humans.

The risk of EEE virus infection for humans and horses will continue in Rhode Island and the other affected states until the 1st killing frosts occur, likely in October (2019). - ProMED Mod.TY]

[HealthMap/ProMED-mail map:
Rhode Island, United States: <http://healthmap.org/promed/p/241>]
Date: Tue 17 Sep 2019
Source: Detroit Free Press [edited]

State health officials said Tuesday [17 Sep 2019] that 3 Michiganders have died from the rare and dangerous mosquito-borne virus eastern equine encephalitis [EEE], and 4 others have been sickened by the disease, amid the biggest outbreak in more than a decade.

Those who live in all 8 of the affected counties -- Kalamazoo, Cass, Van Buren, Berrien, Barry, St. Joseph, Genesee, and Lapeer counties -- are urged to consider canceling, postponing, or rescheduling outdoor events that occur at or after dusk, especially those that involve children, according to the Michigan Department of Health and Human Services. This would include events such as late-evening sports practices or games or outdoor music practices "out of an abundance of caution to protect the public health, and applies until the 1st hard frost of the year [2019]," according to an MDHHS news release.

The 3 people who died were all adults and lived in Kalamazoo, Cass, and Van Buren counties, [respectively], said Bob Wheaton, a spokesman for the Michigan Department of Health and Human Services. The 4 other confirmed cases are in Kalamazoo, Berrien, and Barry counties.

Animals have also been confirmed to have the virus in St. Joseph, Genesee, and Lapeer counties.

The Kalamazoo County Health and Community Services Department also issued a recommendation to local communities and school districts to consider canceling outdoor events at dusk or after dark, when mosquitoes are most active, or move [the events] indoors.  "Michigan is currently experiencing its worst eastern equine encephalitis outbreak in more than a decade," said Dr. Joneigh Khaldun, MDHHS chief medical executive and chief deputy for health. "The ongoing cases reported in humans and animals and the severity of this disease illustrate the importance of taking precautions against mosquito bites."

EEE is one of the deadliest mosquito-borne viruses in the US. One in 3 people who are infected with the virus die. The only way to prevent it is to avoid mosquito bites. The MDHHS says residents should
- apply insect repellents that contain the active ingredient DEET or other US Environmental Protection Agency-registered product to exposed skin or clothing, and always follow the manufacturer's directions for use;
- wear long-sleeved shirts and long pants when outdoors. Apply insect repellent to clothing to help prevent bites;
- maintain window and door screening to help keep mosquitoes outside;
- empty water from mosquito breeding sites around the home, such as buckets, unused kiddie pools, old tires, or similar sites where mosquitoes may lay eggs; and
- use nets and/or fans over outdoor eating areas.

Symptoms of EEE include
- sudden onset of fever, chills;
- body and joint aches, which can progress to a severe encephalitis;
- headache;
- disorientation;
- tremors;
- seizures;
- paralysis; and
- coma.

Anyone experiencing these symptoms should visit a doctor.

[Byline: Kristen Jordan Shamus]
=======================
[The number of human cases remains at 7. However, 3 of these have died since the 6 Sep 2019 report (see Eastern equine encephalitis - North America (18): USA human, horse, deer http://promedmail.org/post/20190910.6667626). However, even among the survivors, there is a significant risk of permanent neurological damage following clinical encephalitis. CDC reports that many individuals with clinical encephalitis "are left with disabling and progressive mental and physical sequelae, which can range from minimal brain dysfunction to severe intellectual impairment, personality disorders, seizures, paralysis, and cranial nerve dysfunction. Many patients with severe sequelae die within a few years" (<https://www.cdc.gov/easternequineencephalitis/tech/symptoms.html>). - ProMED Mod.TY]

[HealthMap/ProMED-mail map:
Michigan, United States: <http://healthmap.org/promed/p/225>
Michigan county map:
Date: Mon 16 Sep 2019
Source: Patch [edited]

The state Department of Public Health is warning that an adult resident of East Lyme has tested positive for eastern equine encephalitis (EEE). This is the 1st human case of EEE identified in Connecticut this season [2019].  The patient became ill during the last week of August [2019] with encephalitis and remains hospitalized. Laboratory tests, which were completed today at the Centers for Disease Control and Prevention (CDC) Laboratory in Ft. Collins, Colorado, confirmed the presence of antibodies to the virus that causes EEE.  "EEE is a rare but serious and potentially fatal disease that can affect people of all ages," said DPH commissioner Renee Coleman Mitchell in a release. "Using insect repellent, covering bare skin, and avoiding being outdoors from dusk to dawn are effective ways to help keep you from being bitten by mosquitoes."  The EEE virus has been identified in mosquitoes in 12 towns and in horses in 2 other towns.

Towns where mosquitoes have tested positive for EEE include Chester, Haddam, Hampton, Groton, Killingworth, Ledyard, Madison, North Stonington, Plainfield, Shelton, Stonington, and Voluntown. Horses have tested positive for EEE virus in Colchester and Columbia this season, and the virus has been detected in a flock of wild pheasants.  Other states throughout the northeast are also experiencing an active season for EEE. In addition to the virus being found in mosquitoes, there have been a total of 8 human cases of EEE infection in Massachusetts and one human case in Rhode Island, with one case in each state resulting in a fatality. "This is the 2nd human case of EEE ever reported in Connecticut," said Dr. Matthew Cartter, director of infectious diseases for the DPH. "The 1st human case of EEE reported in Connecticut occurred in the fall of 2013."

The DPH advises against unnecessary trips into mosquito breeding grounds and marshes, as the mosquitoes that transmit EEE virus are associated with freshwater swamps and are most active at dusk and dawn. Overnight camping or other substantial outdoor exposure in freshwater swamps in Connecticut should be avoided. Even though the temperatures are getting cooler, the DPH is advising that mosquito season is not over, and residents should continue to take measures to prevent mosquito bites, including wearing protective clothing and using repellents.  Although EEE-infected mosquitoes continue to be detected in the south-eastern corner of the state, the numbers are declining, and we are not experiencing the excessively high levels of activity seen in Massachusetts. There are currently no plans to implement widespread aerial pesticide spraying in the state.

Severe cases of EEE virus infection (involving encephalitis, an inflammation of the brain) begin with the sudden onset of headache, high fever, chills, and vomiting. The illness may then progress into disorientation, seizures, and coma. Approximately 1/3 of patients who develop EEE die, and many of those who survive have mild to severe brain damage, according to the DPH.

There is no specific treatment for EEE. Antibiotics are not effective against viruses, and no effective anti-viral drugs have been discovered. Severe illnesses are treated by supportive therapy, which may include hospitalization, respiratory support, IV fluids, and prevention of other infections. It takes 4-10 days after the bite of an infected mosquito to develop symptoms of EEE.

The management of mosquitoes in Connecticut is a collaborative effort involving the Department of Energy and Environmental Protection, the Connecticut Agricultural Experiment Station, and the DPH, together with the Department of Agriculture and the Department of Pathobiology at the University of Connecticut. These agencies are responsible for monitoring and managing the state's mosquito population levels to reduce the potential public health threat of mosquito-borne diseases.

Information on what can be done to prevent getting bitten by mosquitoes and the latest mosquito test results and human infections is available online.  [Byline: Rich Kirby]
===========================
[This has been an active year for EEE virus transmission in the eastern USA from the upper Midwest to the northeastern states and south to Florida. Although historically, EEE human cases in Connecticut have been very rare, the occurrence of a human case in the state this year (2019) is not surprising. There have been equine and/or human EEE cases this summer (2019) in the 3 bordering states: Rhode Island, Massachusetts, and New York. Interestingly, pheasants are mentioned in the above report. They are susceptible and, after being infected with the virus from the bite of an EEE-carrying mosquito, become ill or moribund with viremia titers that can reach 10^9 per ml. Ill or moribund pheasant can be attacked and cannibalized by pen mates that, in turn, are infected orally and may become ill and die as well. As the above report cautions, the only way to avoid infection is for people to avoid mosquito bites. Although the incidence of EEE cases and virus-positive mosquitoes may be declining, there is a risk of infection until the 1st killing frost occurs in autumn, when the mosquitoes are no longer active. - ProMED Mod.TY]

[HealthMap/ProMED-mail map:
Connecticut, United States: <http://healthmap.org/promed/p/210>]
Date: Wed 11 Sep 2019
Source: BBC Afrique [In French, trans. Mod.LXL, edited]

At least 18 people died in 10 days after eating pesticide-contaminated food in 2 localities in Burkina Faso. A dozen still remain under observation in hospitals, according to the Minister of Health.  The 1st cases were reported on [1 Sep 2019] in the town of Didyr in the centre-west of the country, said Professor Claudine Lougue, Minister of Health.  About 15 members of the same families felt unwell after eating local dishes made from bean leaves and small millet seeds, which are actually seed remains. Thirteen died later despite medical care.

On Monday [2 Sep 2019], the ministry received another alert, this time from the central-eastern region. Here again, 14 people from the same family were admitted to the health centres. Five have lost their lives. After analysis, doctors diagnosed massive food poisoning, said the minister. Complementary examinations incriminate pesticides, she said.  "Investigations have been made on samples of biological products such as blood and urine, and we found an unusually high level of pesticides in foods that were consumed. There was an abnormally high level of pesticides, and these pesticides were strongly incriminated," said the minister.

The remains of food have been secured, announced Professor Lougue, who calls on citizens to observe strict hygiene measures in the use of plant leaves for consumption. Pesticides are used for the needs of field work, especially in the countryside during this period of wintering.
Date: Wed, 18 Sep 2019 16:44:19 +0200 (METDST)

London, Sept 18, 2019 (AFP) - British Airways pilots on Wednesday cancelled a strike that had been due September 27, the British Airline Pilots Association union said after two walkouts last week that cost the company dear.   "Someone has to take the initiative to sort out this (pay) dispute and with no sign of that from BA the pilots have decided to take the responsible course," BALPA General Secretary Brian Strutton said in a statement.    The union chief added that the airline's "passengers rightly expect BA and its pilots to resolve their issues without disruption and now is the time for cool heads and pragmatism to be brought to bear.    "I hope BA and its owner IAG show as much responsibility as the pilots," he added.   It was now "time for a period of reflection before the dispute escalates further and irreparable damage is done to the (BA) brand."

However the union added that should the airline "refuse meaningful new negotiations, BALPA retains the right to announce further strike dates".   British Airways, which likes to call itself "the world's favourite airline", flew into turbulence last week as pilots staged a costly and historic two-day strike, tarnishing its global reputation according to aviation analysts.   Pilots walked out for the first time in the company's 100-year history, sparked by a bitter and long-running feud over pay.   BA faced the embarrassment of grounding its entire UK fleet on September 9 and 10, causing the cancellation of about 1,600 flights.   The move sparked travel chaos for about 200,000 passengers who had been due to fly in and out of London's Gatwick and Heathrow airports.

The disruption continued into September 11 because half of BA's 300 aircraft and more than 700 pilots were mostly in the wrong place.   As a result, BA was forced to cancel approximately ten percent of its daily 850 flights in and out of Britain that day.    BALPA and its members are demanding a bigger share of British Airways profits.   The airline has offered a salary increase of 11.5 percent over three years, which it argues would boost the annual pay of some captains to £200,000 ($250,000 or 226,000 euros).   However, the union has rejected the proposal made in July.   BALPA meanwhile estimates that last week's 48-hour strike cost the airline £80 million.   BA is owned by IAG, which was formed in 2011 with the merger of British Airways and Spain's Iberia. IAG has since added other carriers, including Austria's Vueling and Ireland's Aer Lingus.
Date: Wed, 18 Sep 2019 12:26:37 +0200 (METDST)
By Sam Reeves

Kuala Lumpur, Sept 18, 2019 (AFP) - Toxic haze from Indonesian forest fires closed schools and airports across the country and in neighbouring Malaysia Wednesday, while air quality worsened in Singapore just days before the city's Formula One motor race.   Illegal fires to clear land for agriculture are blazing out of control on Sumatra and Borneo islands, with Jakarta deploying thousands of security forces and water-bombing aircraft to tackle them.

Indonesian blazes belch smog across Southeast Asia annually, but this year's are the worst since 2015 and have added to concerns about wildfire outbreaks worldwide exacerbating global warming.   On Wednesday, air quality deteriorated to "very unhealthy" levels on an official index in many parts of peninsular Malaysia, to the east of Sumatra, with the Kuala Lumpur skyline shrouded by dense smog.    Nearly 1,500 schools were closed across Malaysia due to the air pollution, with over one million pupils affected, according to the education ministry.

A growing number of Malaysians were suffering health problems due to the haze, with authorities saying there had been a sharp increase in outpatients at government hospitals -- many suffering dry and itchy eyes.   Indonesian authorities said hundreds of schools in hard-hit Riau province on Sumatra were shut, without providing a precise number, while about 1,300 were closed in Central Kalimantan province on Borneo.    Borneo is shared between Indonesia, Malaysia and Brunei.   Poor visibility closed seven airports in the Indonesian part of Borneo, the transport ministry in Jakarta said. Scores of flights have already been diverted and cancelled in the region in recent days due to the smog.

- Singapore smog race? -
Air quality in Singapore worsened to unhealthy levels and a white smog obscured the striking waterfront skyline, featuring the Marina Bay Sands casino resort with its three towers and boat-shaped top level.    The worsening pollution increased fears that this weekend's Formula One race may be affected. Organisers say the possibility of haze is one of the issues in their contingency plan for Sunday's showpiece night race, but have not given further details.

The city-state's tourism board said spectators would be able to buy masks as protection from the haze if conditions did not improve and assistance would be provided for those who feel unwell, the Today news portal reported.   The fires have sparked tensions between Indonesia and Malaysia.    Indonesia's environment minister initially suggested the haze was from Malaysian fires despite satellite data showing hundreds of blazes in Indonesia and only a handful in its neighbour, prompting anger from her Malaysian counterpart.

Indonesia later sealed off dozens of plantations where it said fires were blazing, including some owned by Malaysia-based firms, deepening the row.   But Prime Minister Mahathir Mohamad, who has struck a diplomatic tone throughout the crisis, said Malaysia may pass legislation forcing its companies to tackle fires on plantations abroad.   Malaysia wants its firms with sites overseas to put out blazes contributing to the haze, he said, adding: "Of course, if we find they are unwilling to take action, we may have to pass a law to make them responsible."

The Indonesian government has insisted it is doing all it can to fight the blazes. But this year's fires have been worsened by dry weather and experts believe there is little chance of them being extinguished until the onset of the rainy season in October.   Indonesia's meteorology, climate and geophysics agency said Wednesday that over 1,000 hotspots -- areas of intense heat detected by satellite that indicate a likely fire -- had been sighted, most of them on Sumatra.
Date: Wed, 18 Sep 2019 12:14:44 +0200 (METDST)
By Aishwarya KUMAR

New Delhi, Sept 18, 2019 (AFP) - India announced on Wednesday a ban on the sale of electronic cigarettes, as a backlash gathers pace worldwide due to health concerns about a product promoted as less harmful than smoking tobacco.   The Indian announcement, also outlawing production, import and distribution, came a day after New York became the second US state to ban flavoured e-cigarettes following a string of vaping-linked deaths.   "The decision was made keeping in mind the impact that e-cigarettes have on the youth of today," Finance Minister Nirmala Sitharaman told reporters in New Delhi.

E-cigarettes do not "burn" but instead heat up a liquid -- tasting of everything from bourbon to bubble gum and which usually contains nicotine -- that turns into vapour and is inhaled.   The vapour is missing the estimated 7,000 chemicals in tobacco smoke but does contain a number of substances that could potentially be harmful.   They have been pushed by producers, and also by some governments including in Britain, as a safer alternative to traditional smoking -- and as a way to kick the habit.

However critics say that apart from being harmful in themselves, the flavours of e-cigarette liquids appeal particularly to children and risk getting them addicted to nicotine.   Some 3.6 million middle and high school students in the United States used vaping products in 2018, an increase of 1.5 million on the year before.   The New York emergency legislation followed an outbreak of severe pulmonary disease that has killed seven people and sickened hundreds.   President Donald Trump's administration announced last week that it would soon ban flavoured e-cigarette products to stem a rising tide of youth users.

- Big E-Tobacco -
Although few Indians vape at present, the Indian ban also cuts off a vast potential market of 1.3 billion consumers for makers of e-cigarettes.   Tobacco firms have been investing heavily in the technology to compensate for falling demand for cigarettes due to high taxes and public smoking bans, particularly in the West.

In 2018 Altria, the US maker of brands such as Marlboro and Chesterfield, splashed out almost $13 billion on a stake in one of the biggest e-cigarette makers, Juul.   A few Indian states have already banned e-cigarettes although the restrictions have been ineffective since online sale of vaping products continue.   The new ban does not cover traditional tobacco products in India.   According to the World Health Organization, India is the world's second-largest consumer of tobacco products, killing nearly 900,000 people every year.

Nearly 275 million people over 15, or 35 percent of adults, are users, although chewing tobacco -- which also causes cancer -- is more prevalent than smoking.   India is also the world's third--largest producer of tobacco, the WHO says, and tobacco farmers are an important vote bank for political parties.   According to the Associated Chambers of Commerce and Industry, an estimated 45.7 million people depend on the tobacco sector in India for their livelihood.   Tobacco is also a major Indian export, and the government holds substantial stakes, directly or indirectly, in tobacco firms including in ITC, one of India's biggest companies.
Date: Wed, 18 Sep 2019 03:56:31 +0200 (METDST)

Washington, Sept 18, 2019 (AFP) - Hurricane Humberto strengthened to a major Category 3 storm on Tuesday and was expected to pass near Bermuda, threatening it with dangerous waves and heavy rain, the US National Hurricane Center said.   "Hurricane conditions are expected to reach Bermuda by Wednesday night and continue into early Thursday morning," the Miami-based NHC said.   "Some fluctuations in intensity are likely during the next day or so, but Humberto should remain a powerful hurricane through Thursday," it said.   As of 8:00 pm (0000 GMT), the storm had maximum sustained winds of 115 miles per hour (185 kilometers per hour) and was moving east-northeast at 12 miles per hour.
Date: Wed, 18 Sep 2019 01:36:21 +0200 (METDST)

Dakar, Sept 17, 2019 (AFP) - Four people died after a boat carrying dozens of tourists capsized during heavy storms in Senegal, authorities and emergency services said Tuesday.   The death toll could rise as three passengers were said to be missing after the accident.  The boat was carrying several Senegalese nationals, six French people, two Germans, two Swedes and one person from Guinea-Bissau, when it turned over Monday in driving rain and a heavy swell, fire department chief Papa Angel Michel Diatta said.   All the dead were Senegalese, officials and emergency services said.

Two worked in a national park, one was a woman and the other victim was a child, Diatta said.   The boat was heading for the Madeleine islands, site of an offshore national park popular with tourists who travel from Dakar, coastal capital of the West African country.   Senegalese President Macky Sall appealed for "greater caution and respect for existing security norms duing the rainy season" in a tweet.

Emergency services continued to look for those missing on Tuesday. AFP journalists saw a dozen divers at the scene. Distressed families were waiting on the shore to get news of their loved ones.    "The gendarmerie called us at 5:00 am (GMT and local time). My brother was on the boat. The worst thing is not knowing," said Aminata Diop, who was among the relatives on the beach.   There are "four dead bodies and between three and four people are missing. Thirty-five people were on the boat. Search and rescue operations are continuing this morning," Interior Minister Aly Ngouille Ndiaye told AFP by telephone.

The causes of the accident were unclear. The interior minister told Senegalese media overnight that several tourists were worried about the heavy rains and wanted to return to the pier but others wanted to stay on the boat.   The survivors spent the night on the island, Ndiaye told local radio on Tuesday. Blankets and food were sent to them and they were to be ferried back to the mainland in the morning, he added.   The rainy season arrived late this year and heavy storms have resulted in several casualties this month.    Two fishermen were killed on their canoe in the same area nearly two weeks ago.
Date: Tue, 17 Sep 2019 15:38:37 +0200 (METDST)

Jakarta, Sept 17, 2019 (AFP) - Massive forest fires in Indonesia that have caused a toxic haze to spread as far as Singapore and peninsular Malaysia are also seriously affecting endangered orangutans and their habitat, a rescue foundation said Tuesday.   Jakarta has deployed thousands of troops as temporary fireman and deployed dozens of water-bombing aircraft to battle blazes that are turning pristine forest into charred landscape in Sumatra and Borneo islands.   The fires -- usually started by illegal burning to clear land for farming -- have unleashed a choking haze across parts of southeast Asia.

The Borneo Orangutan Survival Foundation said Tuesday that the haze was affecting hundreds of great apes in its care at rescue centres and wildlife re-introduction shelters.   "The thick smoke does not only endanger the health of our staff... but also it affects the 355 orangutans we currently care for", the foundation said in a statement, referring to just once cetre in Kalimantan   "As many as 37 young orangutans are suspected to have contracted a mild respiratory infection," it added.   Conditions were so bad at their Samboja Lestari facility in East Kalimantan that outdoor activities for the animals had been restricted to a few hours a day.

Orangutans have been particularly vulnerable to commercial land clearances and have seen their natural habitat shrink dramatically in the last few decades.   The population of orangutan in Borneo has plummeted from about 288,500 in 1973 to about 100,000 today, according to the International Union for Conservation of Nature.   The toxic smoke caused by the forest fires is an annual problem for Indonesia and its neighbours, but has been worsened this year by particularly dry weather.   On Borneo island, which Indonesia shares with Malaysia and Brunei, pollution levels were "hazardous", according to environment ministry data.   Hundreds of schools across Indonesia and Malaysia were shut.