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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.
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Cote d'Ivoire

Cote d'Ivoire - US Consular Information Sheet
May 21, 2007
COUNTRY DESCRIPTION: Cote d'Ivoire (Ivory Coast) is a developing country on the western coast of Africa.
The official capital is Yamoussoukro, but Abidjan is the largest city, the
ain commercial center, and where the Ivorian government and the U.S. Embassy are located.
Cote d'Ivoire is a republic whose constitution provides for separate branches of government under a strong president.

The country has been divided since a 2002 coup attempt developed into a civil war.
Despite several peace agreements and the establishment of a transitional government, key issues remain unresolved, elections have been delayed, and tensions persist throughout the country.

Tourist facilities in and near Abidjan, the commercial capital, are good; accommodations in many other locations are limited in quality and availability.
Read the Department of State Background Notes on Cote d’Ivoire for additional information.

ENTRY/EXIT REQUIREMENTS:
A passport is required, but U.S. citizens traveling to Cote d'Ivoire for business or tourism do not require visas for stays of 90 days or less.
To stay longer than 90 days, the visitor may still enter without a visa, but then must apply for a "carte de sejour" within 90 days of arrival.
(Note: "Cartes de sejour" are not issued to children under the age of 16, who are documented on their parents' visas).
An international health certificate showing current yellow fever immunization is required for entry into Cote d'Ivoire.
Without it, the traveler may be required to submit to vaccination at the airport health office before clearing immigration, at a cost of 5,000 CFA (a little less than $10).

Travelers may obtain the latest information and details on entry requirements from the Embassy of the Republic of Cote d'Ivoire, 3421 Massachusetts Avenue, NW, Washington, D.C. 20007, telephone (202) 797-0300.
There are honorary consulates for Cote d'Ivoire in San Francisco, Stamford, Orlando, Houston and Detroit.
Overseas, travelers should inquire at the nearest Ivorian embassy or consulate.
See our Foreign Entry Requirements brochure for more information on Cote d’Ivoire and other countries.
Visit the Embassy of Cote d'Ivoire web site at http://www.cotedivoireembassy.com/ for the most current visa information.

Foreign travelers are sometimes approached at ports of entry by individuals with offers to expedite passport control and customs, and are then asked to pay an exorbitant fee, both for the service and for the passport and customs officers.
Travelers to Cote d'Ivoire are advised that there is no need to pay a police officer or customs officer at the airport for any service rendered during an arrival or departure, and they should not surrender their passports or other important documents to anyone except easily identifiable government officials in uniform.

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

SAFETY AND SECURITY:Cote d'Ivoire has been unstable since the coup in 1999, and territorially divided since 2002.
The New Forces control the northern and some western parts of the country.
There are many road checkpoints manned by security forces and militia in both the government-controlled and New Forces-controlled portions of the country.
Soldiers and militia members check documents and frequently demand cash for permission to pass.
Cote d'Ivoire's border with Liberia is open, but border controls are extensive.

Political instability has contributed to economic stagnation and high unemployment, exacerbating social tensions and creating the potential for labor unrest and civil disorder.
There have been recurring episodes of violence, some of them severe.
In November 2004, there was a brief resumption of hostilities between the two sides followed by widespread attacks against people and property in Abidjan and elsewhere.
Many of these attacks were directed against French and other expatriates, and thousands fled the country.
Americans should avoid crowds and demonstrations, be aware of their surroundings, and use common sense to avoid situations and locations that could be dangerous.
While diplomatic efforts to end the crisis are ongoing, further civil unrest, coup attempts or the resumption of hostilities are possible.

Swimming in coastal waters is dangerous and strongly discouraged, even for excellent swimmers.
The ocean currents along the coast are powerful and treacherous, and numerous people drown each year.

For the latest security information, Americans traveling abroad should regularly monitor the Department’s Internet web site where the current Travel Warnings and Public Announcements, including the Worldwide Caution Public Announcement, can be found.

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

The Department of State urges U.S. 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 continues to be a major security threat for Americans living in Cote d'Ivoire.
Grab-and-run street crime and pick pocketing in crowded areas are widespread.
Armed carjacking, robberies of businesses and restaurants, and home invasions are common, and they often target expatriate residents who are perceived as wealthy.
Armed criminals use force when faced with resistance.
Travelers displaying jewelry and carrying cameras are especially at risk.
Travelers are advised to carry limited amounts of cash and only photocopies of key documents.
While there have been relatively few reported cases of sexual assault, given the general climate of criminality, the actual rate of assault may be much higher than that which is reported.
There were allegations of sexual assaults during the November 2004 civil strife.
Given the strong anti-French sentiment, people of non-African appearance may be specifically targeted for violence.
Avoid large gatherings and political demonstrations, as they can turn violent quickly.

Travel outside of Abidjan or at night is strongly discouraged, and it is particularly dangerous to visit Abidjan's Treichville, Adjame, Abobo, and Plateau districts after dark.
The DeGaulle and Houphouet-Boigny bridges in Abidjan are dangerous areas for pedestrians.
Inadequate resources and training limit the ability of the police to combat crime.
Many hotels, restaurants, nightclubs and supermarkets provide security guards to protect clients and vehicles.

Travelers should take the same common sense precautions in Abidjan that they would in any metropolitan area in the United States.
Travelers should stay in well-lit areas and walk confidently at a steady pace on the side of the street facing traffic close to the curb.
Travelers should avoid crowds, mass transit, doorways, bushes, alleys and sparsely populated areas.
Travelers who need transportation at night should take an Orange metered taxi.
Travelers should be discreet about your transactions, especially in sight on the street.
Normal spending habits of Westerners appear extravagant.

Credit card use in Cote d'Ivoire is limited, particularly outside Abidjan, but credit card fraud is an increasing problem.
Travelers should not use credit cards in paper transactions unless the credit card transaction is electronically performed in view of the individual.

Business fraud is rampant and the perpetrators often target foreigners, including Americans.
Schemes previously associated with Nigeria are now prevalent throughout West Africa, including Cote d'Ivoire, and pose a danger of grave financial loss.
Typically these scams begin with unsolicited communication (usually e-mails) from strangers who promise quick financial gain, often by transferring large sums of money or valuables out of the country, but then require a series of "advance fees" to be paid, such as fees for legal documents or taxes.
Of course, the final payoff does not exist; the purpose of the scam is simply to collect the advance fees.
A common variation is the scammer’s claim to be a refugee or émigré of a prominent West African family, or a relative of a present or former political leader who needs assistance in transferring large sums of cash.
Still other variations appear to be legitimate business deals that require advance payments on contracts.
Sometimes victims are convinced to provide bank account and credit card information and financial authorization that drains their accounts, incurs large debts against their credit, and takes their life savings.

The best way to avoid becoming a victim of advance-fee fraud is common sense — if a proposition looks too good to be true, it probably is a scam, particularly if one has never met the correspondent.
Travelers should carefully check and research any unsolicited business proposal before committing any funds, providing any goods or services, and undertaking any travel.
A good clue to a scam is the phone number given to the victim; legitimate businesses and offices provide fixed line numbers, while scams typically use only cell phones.
In Cote d'Ivoire, all cell phone numbers start with zero.

It is virtually impossible to recover money lost through these scams.
For additional information please consult the Department of State's brochure Advance Fee Business Scams.

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

See our information on Victims of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION:
Abidjan has privately-run medical and dental facilities that are adequate but do not fully meet U.S. standards.
Good physician specialists can be found, though few speak English.
While pharmacies are well stocked with medications produced in Europe, newer drugs may not be available.
Medical care in Cote d'Ivoire outside of Abidjan is extremely limited.
Malaria is a serious health problem in Cote d’Ivoire.
For more information on malaria, including protective measures, see the Centers for Disease Control Travelers’ Health web site at http://www.cdc.gov/malaria/.

The avian influenza or “Bird Flu” virus (H5N1) has been confirmed in animals in Cote d’Ivoire as of June 2006.
For more information regarding Avian Influenza, please visit the CDC’s internet site at http://www.cdc.gov/travel/other/avian_flu/ and the State Department’s Avian Influenza Fact Sheet.

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

MEDICAL INSURANCE:
The Department of State strongly urges Americans to consult with their medical insurance company prior to traveling abroad to confirm whether their policy applies overseas and whether it will cover emergency expenses such as a medical evacuation.
Please see our information on medical insurance overseas.
TRAFFIC SAFETY AND ROAD CONDITIONS:
While in a foreign country, U.S. citizens may encounter road conditions that differ significantly from those in the United States.
The information below concerning Cote d’Ivoire is provided for general reference only, and may not be totally accurate in a particular location or circumstance.

Serious traffic accidents, one of the greatest threats to U.S. citizens in Cote d’Ivoire, occur regularly in Abidjan.
Unsafe road conditions, unskilled drivers, and poorly maintained and overloaded vehicles create very poor driving conditions.
Speed limits, signals, and yielding for pedestrians and cyclists are not respected.
Travelers should drive defensively, watch out for public transportation vehicles that stop and start without warning, and be especially cautious at intersections because traffic lights often malfunction.
Travelers who must travel at night should beware of vehicles without headlights and/or taillights, and pedestrians and bicycles along the roadside.
In case of an accident, travelers are advised not to move their vehicle until a police officer authorizes.
Travelers should go to the nearest hospital or police station if there is no other vehicle to take the injured to a hospital, or if there is reason to believe that their life is in danger from others at the site of the accident.

Abidjan has a poor public transportation system; if traveling by bus, use only the “Express” line.
In Abidjan, taxis are readily available, inexpensive (metered), but poorly maintained and notorious for not respecting the rules of the road.
Communal taxis (“woro-woros”), used only within the limits of each commune, are not metered and are dangerous.
Local vans ("Gbaka") should not be used because they are frequently involved in accidents.

Criminals usually steal vehicles when the driver is in or near the vehicle, so car doors and windows should be kept locked.
While stopped in traffic, travelers should remember to allow enough room between your car and the one in front to maneuver out if needed.
Travelers should look around to see if there is anyone paying unusual attention or if someone appears to be watching, before entering their vehicles. Travelers should not attempt to enter their vehicles, and should go get assistance.
Travelers should enter and exit their vehicles as quickly as possible, to limit their vulnerability to carjacking.

Victims of carjacking should not resist.
Victims should try to remain calm and give the carjackers what they want, which is usually the vehicle and any valuables.
Experience shows that criminals usually don’t use violence unless they are confronted with resistance.
Furthermore, it is not uncommon to take an occupant, usually a woman or child, as hostage to ensure their safe escape; the hostage is usually released unharmed.
This is a very difficult situation; victims should use their best judgment in deciding a course of action.

A newer phenomenon is the staged accidental "bumping" accident.
If your vehicle is "bumped" from the rear or the side, stay locked inside because this ruse is used to get the driver out and leave the vehicle free for carjacking.
Travelers with cell phones should call for assistance.
Victims should report the accident at the nearest police station as soon as possible if they feel their safety is in jeopardy and try to get the license number for any other vehicle involved.

Emergency services such as ambulance service (SAMU) exist in Abidjan and larger towns.
Call 185 or 22-44-55-53.
In smaller towns there is usually no ambulance service available, but ambulances will be dispatched from larger towns

Please refer to our Road Safety page for more information.

AVIATION SAFETY OVERSIGHT: The U.S. Federal Aviation Administration (FAA) has assessed the Government of Cote d'Ivoire’s Civil Aviation Authority as not being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for the oversight of Cote d'Ivoire's air carrier operations.
For more information, travelers may visit the FAA’s internet web site at http://www.faa.gov/safety/programs_initiatives/oversight/iasa.

SPECIAL CIRCUMSTANCES:
Ivorian customs authorities encourage the use of an ATA (Admission Temporaire/Temporary Admission) Carnet for the temporary admission of professional equipment, commercial samples, and/or goods for exhibitions and fair purposes.
ATA Carnet Headquarters, at the U.S. Council for International Business, 1212 Avenue of the Americas, New York, NY 10036, issues and guarantees the ATA Carnet in the United States.
For additional information, call (212) 354-4480, e-mail atacarnet@uscib.org, or visit http://www.uscib.org.

If traveling to another West African Economic and Monetary Union (WAEMU) country, expatriate residents leaving Cote d’Ivoire must declare the amount of currency being taken out of the country; if going to any other country, tourists are prohibited from taking more than 500,000 CFA francs (approximately $1,000), and business operators two million CFA francs (approximately $4,000), without government approval.
Even with authorization, there is a cash limit of $4,000 for tourists and $5,500 for business people, with any surplus in travelers or bank checks.

Travelers should carry a photocopy of your U.S. passport, visa, and entry stamps.
Travelers should also, carry their international driver's licenses if planning to drive.

Government corruption remains a serious problem in Cote d'Ivoire, and has an impact on judicial proceedings, contract awards, customs, and tax issues.
Security forces (police, military, gendarmes) routinely stop vehicles for traffic violations and security checks. Travelers should politely present identification if stopped.
Travelers who are stopped at one of these check points for any reason and asked to pay a "fine" to these uniformed officials, should politely refuse and present a photocopy of their U.S. passport, visa, and entry stamp.

Taking pictures is prohibited near sensitive installations, including military sites, government buildings such as the radio and television stations, the Presidency building, the airport, and the DeGaulle and Houphouet-Boigny bridges in Abidjan.

Cote d’Ivoire recognizes dual nationality if acquired at birth.
Americans who also are Ivorian nationals may be subject, while in Côte d'Ivoire, to certain aspects of Ivorian law that impose special obligations on citizens of that country.
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 Cote d'Ivoire's laws, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in Cote d'Ivoire 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 Criminal Penalties.

CHILDREN'S ISSUES:
For information on international adoption of children and international parental child abduction, see the Office of Children’s Issues web site.

REGISTRATION / EMBASSY LOCATION:
Americans living or traveling in Cote d'Ivoire are urged to register with the nearest U.S. Embassy or Consulate through the State Department’s travel registration website and to obtain updated information on travel and security within Cote d’Ivoire.
Americans withoutInternet access may register directly with the nearest U.S. Embassy or Consulate.
By registering, American citizens make it easier for the Embassy to contact them in case of emergency.
The U.S. Embassy is located in the Riviera Golf neighborhood of the Cocody section of Abidjan, east of the downtown area.
The Embassy's postal address is 01 B.P. 1712 Abidjan 01, and the main telephone number is 22-49-40-00.
The Consular Section fax number is 22-49-42-02, and more information is on the Consular pages of the Embassy's web site at http://Abidjan.usembassy.gov/
*

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*
This replaces the Consular Information Sheet dated November 21, 2006, with no major changes.

Travel News Headlines WORLD NEWS

Date: Tue, 27 Aug 2019 15:33:42 +0200 (METDST)

Bouake, Ivory Coast, Aug 27, 2019 (AFP) - The main market in Bouake, Ivory Coast's second biggest city, was largely destroyed Tuesday in an overnight blaze, although there were no known casualties, an AFP correspondent reported.   The fire broke out around 2:00 am (0200 GMT) and spread fast, market watchmen said.   It took around seven hours to bring under control, mobilising several hundred firefighters, police and troops, partly to put out the blaze but also to secure the area.   "This tragedy has most fortunately caused no loss of life," Bouake mayor Nicolas Djibo said, adding though that he was "dumbstruck by the scale of the damage".

Djibo said the fire had begun in the butchers' area of the market, which hosts hundreds of stalls and is a hub of social activity in Bouake, a city of one million people in the centre of Ivory Coast.   Some traders had been able to remove their wares in time but others wept at the sight of their loss.   Koffi Rachelle, who sold children's toys and various gadgets, told AFP she had lost everything. "I can"t even get into my shop, the fire has destroyed everything over there," she said in tears.

An inquiry into the fire has been opened, according to a police source who asked not to be named.   The market, which had an area of between eight and nine hectares (about 22 to 22 acres), had been razed by a fire in 1998.   Experts had been studying a proposal to house the stalls in a large modern building before the latest blaze.
Date: Tue, 30 Jul 2019 21:28:27 +0200

Abidjan, July 30, 2019 (AFP) - Eighty-nine people have contracted yellow fever and one person has died in recent weeks during an outbreak in Ivory Coast, the health ministry said Tuesday.   Most of the confirmed cases were in the West African country's economic capital Abidjan, the ministry said in a statement.

It recommended that any unvaccinated people be vaccinated against yellow fever.   "The outbreak occurs in the context of a dengue outbreak," the ministry said, adding that dengue and yellow fever are viral diseases transmitted by the same mosquito.    "The vector control measures that have been implemented to deal with dengue also work for the yellow fever outbreak."   In early June, 130 cases of dengue were reported including two deaths, with the authorities launching a major mosquito-control campaign.   Abidjan is going through the end of its rainy season, which spurs mosquito breeding.

Symptoms of yellow fever -- including high fever, vomiting and muscle aches -- usually manifest themselves three to six days after a person is bitten by an infected mosquito.   The infection caused by yellow fever is usually mild, but in some cases can be life-threatening and result in kidney and liver failure.   Yellow fever is found only in parts of South America and Africa.
Date: Tue 30 Jul 2019
Source: Medical Xpress [edited]

In recent weeks, 89 people have contracted yellow fever, and one person has died during an outbreak in Ivory Coast, the health ministry said Tuesday [30 Jul 2019].

Most of the confirmed cases were in the West African country's economic capital Abidjan, the ministry said in a statement. It recommended that any unvaccinated people be vaccinated against yellow fever.  "The outbreak occurs in the context of a dengue outbreak," the ministry said, adding that dengue and yellow fever are viral diseases transmitted by the same mosquito.

"The vector control measures that have been implemented to deal with dengue also work for the yellow fever outbreak."  In early June [2019], 130 cases of dengue were reported, including 2 deaths, with the authorities launching a major mosquito-control campaign.  Abidjan is going through the end of its rainy season, which spurs mosquito breeding.

Symptoms of yellow fever -- including high fever, vomiting and muscle aches -- usually manifest themselves 3-6 days after a person is bitten by an infected mosquito.  The infection caused by yellow fever is usually mild, but in some cases can be life-threatening and result in kidney and liver failure.  Yellow fever is found only in parts of South America and Africa.
=====================
[Yellow fever (YF) is a serious disease and has a case fatality rate of about 30%. It is surprising that there has been only one death so far among the 89 infected individuals. It is not stated that all 89 individuals were laboratory confirmed YF cases. The above report does not indicate the proportion of the population that has been vaccinated against YF.

YF virus can spread rapidly in a largely unvaccinated population, as it did in Angola in 2016. _Aedes aegypti_ vector control is of limited effectiveness in the face of a YF outbreak. Vaccination is the best preventive measure.

There have been YF cases in Cote d'Ivoire in the past, the most recent in 2011. At that time, more than 700 000 people were vaccinated against yellow fever [YF] in an emergency campaign in the country. There were YF cases in Abidjan in 2008, when the estimated vaccination coverage of the population was around 60 percent after a vaccination campaign. Now, time is of the essence to quickly halt the spread of YF, as it rapidly did in Angola and the DR Congo in that large outbreak. - ProMED Mod.TY]

[Maps of Cote d'Ivoire can be accessed at <http://bit.ly/2uHz53s>
and <http://healthmap.org/promed/p/52>.]
Date: Fri, 14 Jun 2019 06:02:40 +0200
By Clotilde RAVEL

Abidjan, June 14, 2019 (AFP) - "Cover your goods," Diakaria Fofana, a doctor of public health, warns food vendors as a thick cloud of insecticide spray wafts down a street in Abidjan, Ivory Coast's economic capital.   Men in protective clothes, goggles and masks are disgorging plumes of mosquito-killing chemicals in a bid to roll back an outbreak of dengue.   Two people have died and 130 have fallen ill since the fever returned to the West African state last month.

The toll, so far, is tiny compared with other tropical countries, especially in Southeast Asia, where the painful and sometimes deadly disease is an entrenched peril.   But tackling the outbreak is a major challenge for Ivory Coast, a poor country that is having to resort to time-honoured, labour-intensive methods of spraying and neighbourhood awareness campaigns to prevent its spread.   Female mosquitoes carrying the dengue virus transfer the pathogen when they tuck into a blood meal from someone. 

A vaccine does exist, but is not available in Ivory Coast because "it has many secondary effects (and) it's expensive"," explained Joseph Vroh Benie Bi, director of the National Institute for Public Hygiene (INHP).    Developed by French pharmaceutical group Sanofi Pasteur, the vaccine is recommended for use in people aged nine and older, and only for individuals who have already been infected.    Usually accompanied by flu-like symptoms, dengue makes some people very sick indeed, developing into a haemorrhagic fever that can cause difficulty breathing, heavy bleeding or even organ failure. While a first bout of dengue is rarely fatal, subsequent infections are usually worse.

- 'Fighting the mosquito' -
The UN's World Health Organization (WHO) says there are up to 100 million cases of dengue worldwide every year, and almost half the world's population lives in countries where the disease is endemic.   It kills more than 20,000 people each year. Southeast Asia and the Western Pacific are the worst-hit areas.   There is no cure, and the WHO recommends that patients take paracetamol, rest and drinking plenty of fluids.   Five new vaccines are in development, but in the meantime Fofana says: "The only effective means of fighting (dengue) is fighting the mosquito."   In Ivory Coast, most recorded cases have occurred in Abidjan.

Health workers are striving to enlist the public in tackling the mosquito, targeting its life cycle.   "The larvae multiply in stagnant water, for example inside used tyres," said Fofana, deputy director of the vector control unit at the INHP.   "People should never store water in buckets in the open air and they should regularly throw out the water in plates under houseplants."   But he faces an uphill job in a sprawling port city of 4.4 million people in the middle of the rainy season.   What's more, people who are infected, even without knowing it, and can bring the virus to new areas when they are bitten by local mosquitoes.    The WHO has set a goal to halve the number of dengue deaths by 2020, but incidence of the disease has increased 30-fold in the last 50 years.   "Before 1970, only nine countries had experienced severe dengue epidemics. The disease is now endemic in more than 100 countries," it says.

- 'Malaria's big brother' -
In Ivory Coast, where malaria accounts for a third of all medical consultations, many people self-medicate when they experience symptoms such as high fever, vomiting, nausea or aches and pains.   "This is a real problem, because the symptoms of malaria, dengue, typhus and yellow fever are similar. Doing a blood test is absolutely indispensable," said Fofana.   Treatment with the wrong medicines can worsen the situation, he stressed -- aspirin or ibuprofen can increase the risk of bleeding, for example.   In the meantime, the spraying goes on.    "We know the risks," said Bamba Segbe, an Abidjan resident watching the masked men in action. "It's not for nothing that we call dengue malaria's big brother."
Date: Mon 18 Mar 2019
Source: Abidjan.net [in French, trans. ProMED Corr.SB, edited]

Two people, including a 70-year-old woman, died on [Sun 17 Mar 2019] in the village of Yrouzon and 4 other people were admitted to the general hospital of Duekoue (West, region of Guemon), after having consumed a decoction of herbal tea, supposed to cure malaria.

According to information collected from the victims, a decoction of herbal tea was prepared the day before by the wife of the young -30 years old- BN, that passed away instantly. [BN may have been trying to relieve the pain of what he believed to be chronic malaria]. BN, affected with chromatic [chronic?] malaria took a sip of the product with the hope of relieving his pain.

Also, his family members of who came to visit him, each took a sip, which was supposed to mitigate their "palu" [pain]. But unfortunately, the following events were; BN, having consumed the first liquid, lost consciousness and died during his evacuation. The old woman, aged about 70, fell on her way home and died on the spot. The other 4 affected people were fortunate enough to be admitted to the general hospital.  An investigation is opened to determine the causes of the tragedy.
======================
[Herbs can be healing, or dangerous. They become dangerous when the plant is misidentified, or mistaken. When a toxic plant is incorrectly identified as non-toxic beneficial herb, then disastrous consequences can follow. - ProMED Mod.TG]

[HealthMap/ProMED map available at:
More ...

Georgia

Georgia US Consular Information Sheet
COUNTRY DESCRIPTION:
Georgia is a constitutional republic with a developing economy.
Tourist facilities outside of Tbilisi are not highly developed, and many of the goods and services taken for granted
in other countries are not yet available.
Read the Department of State Background Notes on Georgia for additional information.
ENTRY/EXIT REQUIREMENTS:
A passport is required.
U.S. citizens visiting for 90 days or less do not need a visa to enter Georgia.
For further information, please contact the Embassy of Georgia at 2209 Massachusetts Avenue NW, Washington DC, 20008 tel. (202) 387-2390, fax: (202) 393-4537.
Visit the Embassy of Georgia web site at http://embassy.mfa.gov.ge/index.php?lang_id=GEO&sec_id=2&lang_id=ENG for the most current visa information.

Information on 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:
As a result of civil wars in the 1980s and early 1990s, there are two separatist regions in Georgia that are not under the control of the Government of Georgia:
South Ossetia, in north-central Georgia; and Abkhazia, in northwest Georgia.
Although armed conflict between the separatist regions and the central government has ceased, episodes of violence continue and political relations are tense. Political developments have the potential to result in open hostilities.
Due to the volatility of the political situation, high levels of crime, and inability of Embassy personnel to travel to Abkhazia or South Ossetia, the U.S. Embassy advises American citizens not to travel to these separatist-controlled areas.
Because of the restricted access of U.S. officials to Abkhazia and South Ossetia, the ability of the U.S. Government to assist American citizens in these regions is extremely limited, even in emergencies.
All travelers to these regions, regardless of purpose, should register with the U.S. Embassy. The U.S. Embassy recommends that Americans regularly monitor warden messages on the Embassy web site for the latest information on the security situation throughout Georgia.

Political tensions remain high between the Georgian Government and the South Ossetia separatist regime, based in Tskhinvali.
This situation culminated in sniper and mortar exchanges between South Ossetian and Georgian troops in 2004.
Although the fighting did not escalate into an all-out war, low-level violence continues between the two sides, periodically resulting in deaths, and underscoring the potential for instability in the region.
A tense truce also exists between the Georgian Government and the separatist de facto government of Abkhazia; since April 2008, several incidents have increased the tension to a point where cross-border military actions are a possibility.
Over the past several years, a number of attacks, criminal incidents, and kidnappings have occurred in Abkhazia.
While Abkhaz "border officials" may demand that travelers entering the region purchase "visas" from the so-called "Ministry of Foreign Affairs of Abkhazia," the U.S. Government recognizes the territorial integrity of Georgia.
American citizens in areas of western Georgia, near Abkhazia, are advised to be aware of their surroundings at all times and to avoid straying off main roads or traveling after dark.

American citizens should be aware that they cannot legally cross by land, air, rail, or sea between Russia and Georgia, even if in possession of valid Russian or Georgian visas.
In July 2006, the Russian Government closed the only border crossing between Georgia and Russia under the control of both governments (the only other crossings are through Georgia’s separatist regions).
Russian authorities said the closure, at Verkhny Lars, would be temporary, pending necessary repairs at the crossing, although it remains closed as of June 2008.
On August 6, 2007, a missile was fired from an aircraft near a village between the city of Gori and the separatist region of South Ossetia.
Although this was an isolated incident, it serves as a reminder that the situation near the separatist areas remains unpredictable.

Georgia's armed forces have periodically conducted operations against suspected international terrorists, Chechen fighters, and criminals who have taken refuge in the Pankisi Gorge.
American citizens should avoid all travel to the Pankisi Gorge, north of the city of Akhmeta.
American citizens are also advised to exercise caution when traveling in the northern mountainous areas of Georgia bordering the Russian Federation, especially the Chechnya and Dagestan sectors.

Political demonstrations take place from time to time in the capital city, Tbilisi, and normally take place in front of the Parliament building on Rustaveli Avenue.
While these demonstrations are normally peaceful, confrontational demonstrations have occurred, and we wish to remind all Americans that even demonstrations intended to be peaceful can turn confrontational and possibly escalate into violence.

Regardless of the region in Georgia one is planning to visit, American citizens are urged to review their personal security precautions, increase their levels of awareness, register with the consular section and as appropriate, take increased security measures.

In the past, religious minorities in Georgia have been targets of violent attacks.
The victims were primarily Jehovah's Witnesses, but also include Pentecostals, Baptists, and members of the Assembly of God.
Incidents included the burning of literature, the destruction of private property and the beating (sometimes severe) of believers, including American citizens.
Although Georgian authorities arrested, convicted and imprisoned the ringleader of the group responsible for these attacks in 2005, American citizens should remain cautious when engaging in missionary activity in Georgia.

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

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

The Department of State urges American citizens to take responsibility for their own personal security while traveling overseas.
For general information about appropriate measures travelers can take to protect themselves in an overseas environment, see the Department of State’s pamphlet A Safe Trip Abroad.
CRIME:
Crime is a very serious problem in Georgia.
There is a great disparity in affluence between foreigners and most Georgians.
Americans in particular are perceived as being wealthy, and are therefore specifically targeted for economic- and property-based crimes.
Incidents such as residential break-in, carjacking, car theft, petty theft, and armed robbery account for most of the crimes involving Americans that are reported to the Embassy.
Petty street crime, such as pick pocketing, purse snatching, and cell phone theft, is also common throughout the country. Furthermore, violent attacks have become more commonplace.
Because illegal firearms are readily available in Georgia, assailants are likely to be armed with firearms and other weapons.

Crime remains a particularly serious issue in Tbilisi, where criminal activity against foreigners remains at levels disproportionate to other metropolitan areas in Europe and the United States.
Many robberies and assaults have occurred in areas frequented by American citizens and foreigners, such as on side streets near Tbilisi’s city center; trouble spots include areas off the main avenues in the Vake and Vera districts, and Chavchavadze and Rustaveli avenues, as well as the Saburtalo region of Tbilisi.
These crimes often occurred when the victim was alone, after dark, and in unfamiliar surroundings.

Petty theft is also a problem on the Tbilisi metro system and in minivans, or “marshrutkas” used for public transport.
American citizens are advised to use personal vehicles or use taxis from established companies that carry passengers door-to-door.
While the security of overland travel in Georgia has improved, vehicular and rail traffic remains vulnerable to robbery.

The threat of kidnapping exists both within and outside of Tbilisi.
In the past, foreign businessmen have been abducted for ransom, and Americans in the Tbilisi area have received kidnapping threats.
The possibility of similar risk to Americans elsewhere in the country cannot be discounted.

Outside of Tbilisi, criminal activity is also a problem, especially in the separatist regions of Abkhazia and South Ossetia, due to the reduced capacity of law enforcement in those areas.
Other regions of concern include:
upper Svanetia, Samtskhe-Javakheti, the administrative border with Abkhazia (including Zugdidi city), and areas along the border with Russia.
When visiting or traveling through these regions, American citizens are urged to increase their vigilance, review their personal security precautions, and take appropriate security measures, e.g. traveling with a native Georgian escort familiar with the local area.

Despite much progress in the Georgian Government’s efforts to reform police and fight internal corruption, serious concerns remain as to the police’s ability to deter criminal activity or conduct effective post-incident investigations.
Although police emergency response is good (see below for contact information), criminals continue to have freedom of movement throughout Tbilisi day or night.

In light of the serious crime situation, all American citizens visiting Georgia are again strongly advised to exercise basic security precautions. American travelers should vary times and routes, especially from places of residence to work locations. Americans should maintain a low profile by not carrying large amounts of cash, not wearing excessive amounts of jewelry, and not behaving in a manner that would draw unnecessary attention.
Additionally, Americans should be aware of their surroundings, travel in pairs or groups, and stay on main streets and routes.
The Embassy recommends that those traveling throughout the country do so during daylight hours only and provide a travel itinerary and contact telephone numbers to a friend or business colleague.
Also, Americans should not hesitate to report any unusual incidents or suspicious vehicles or individuals to the Georgian authorities as soon as possible.
Finally, those that do become a victim of crime should not resist their assailant and should cooperate with the assailant as best they can.
Assailants are most interested in money and/or property; cooperation reduces the chance of being assaulted and/or injured.

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

The Georgian Ministry of Internal Affairs (MOIA) has established a police emergency hotline.
This service is currently limited to larger cities, but the MOIA is planning to expand this service countrywide.

The local “911” equivalent to contact police in an emergency is: “022”.
Please note that the police dispatcher speaks only Georgian or Russian.

See our information on Victims of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION:
Medical care in Georgia is limited.
There is a severe shortage of basic medical supplies, including disposable needles, anesthetics, and antibiotics.
Elderly travelers and those with pre-existing health problems may be at risk due to inadequate medical facilities.
It is recommended that travelers who intend to visit Georgia for at least two weeks get the hepatitis A vaccine and a pre-exposure rabies vaccine.
Travelers are also encouraged to bring medicine to treat diarrhea, which regularly afflicts newcomers.
Georgian doctors and hospitals often expect immediate cash payment before rendering medical services.

Medical Information: Tuberculosis (TB) is an increasingly serious health concern in Georgia.
For further information, please consult the Centers for Disease Control and Prevention’s (CDC) Travel Notice on TB http://wwwn.cdc.gov/travel/yellowBookCh4-TB.aspx
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 (CDC) hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747) or via the CDC 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 before traveling abroad to confirm whether their policy applies overseas and if 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 Georgia is provided for general reference only, and may not be totally accurate in a particular location or circumstance.

As in the United States, vehicular traffic in Georgia moves along the right side of roadways.
Speed limits range from 80 to 100 km/hr on highways, and from 30 to 60 km/hr on urban thoroughfares.
Motorists are not permitted to make right turns on red traffic lights.
While legislation mandating seat belt use has yet to be enacted, drivers and passengers are nevertheless strongly advised to buckle up on Georgian roads.
Georgian law requires that children under seven (7) years of age be restrained in child-safety seats.
A driver with any blood alcohol concentration exceeding 0.00% is considered to be driving under the influence of alcohol.

Motorists should exercise extreme caution when driving in Georgia, as many local drivers do not operate their vehicles in accordance with established traffic laws.
Traffic signals and rules of the road are often completely ignored.
Motorists drive erratically, often recklessly, and at excessive speeds.
Motorists may frequently encounter oncoming high-speed traffic attempting to pass other vehicles at blind turns or over hilltops.
Pedestrians enjoy no right-of-way and need to be extremely careful when crossing streets.
The Georgian Patrol Police, who come under the authority of the Ministry of Internal Affairs, are responsible for maintaining traffic safety in Georgia, but enforcement of traffic regulations is haphazard.

Undivided two-lane roads connect most major cities in Georgia.
Roads are generally in poor condition and often lack shoulder markings and centerlines.
In addition, traffic signals may not work because of power outages or poor maintenance.
Driving at night can be especially dangerous.
Travel on mountain roads is treacherous in both rain and snow, and during winter, heavy snowfalls may make some roads impassable.

Please refer to our Road Safety page for more information.
Visit the web site of the country’s national tourist office and national authority responsible for road safety at http://tourism.gov.ge/start.php
AVIATION SAFETY OVERSIGHT: As there is no direct commercial air service to the United States by carriers registered in Georgia, the U.S. Federal Aviation Administration (FAA) has not assessed Georgia’s Civil Aviation Authority for compliance with International Civil Aviation Organization (ICAO) aviation safety standards.
For more information, travelers may visit the FAA’s web site at http://www.faa.gov/safety/programs_initiatives/oversight/iasa.

Travelers on regional airlines among the countries of the South Caucasus may experience prolonged delays and sudden cancellations of flights.
In addition to frequent delays, flights are often overcrowded or overbooked.
Basic safety features such as seat belts are sometimes missing.
Air travel to Georgia on international carriers via Europe is typically more reliable.
Ticketed passengers on flights departing from Georgia should reconfirm reservations with the airline 24 hours prior to departure.

SPECIAL CIRCUMSTANCES:
Georgia has been subject to energy crises in the last few years.
During the winter months, frequent and prolonged power outages are common, especially outside of Tbilisi.
The lack of lighting in public places, even when electricity is available, heightens vulnerability to crime (please see the Crime section above for details).

Georgia’s customs authorities may enforce strict regulations concerning the temporary import into or export from Georgia of items such as alcohol, tobacco, jewelry, religious materials, art or artifacts, antiquities, and business equipment.
Only personal medicines with a doctor’s statement can be imported without the permission of the Georgian Drug Agency section of the Ministry of Health.

American citizens may not import firearms into Georgia; however, hunting weapons may be brought into the country for a two-week period, based on valid Georgian hunting licenses.
While there is no limit to the amount of currency that can be imported, if more money is exported than was declared at the time of entry, the traveler is obligated to prove it was legally obtained.
There are limits on the amount of Georgian currency that may be exported.

American citizens should exercise extreme caution in purchasing property in Abkhazia.
Land for sale in that region rightfully may belong to internally displaced persons forced to leave Abkhazia in the early 1990s and may have improperly been placed on the market by the de facto authorities in Abkhazia.
In such cases, the government of Georgia considers the sale of property in Abkhazia illegal under Georgian law and the property could be reclaimed by original owners at a future date.

The Ministry of Culture, Department of Expertise and Evaluation must license any valuables such as artwork, antiques, jewelry, paintings, etc.
This license describes the object, assesses its value, and provides permission to export it from Georgia.
The U.S. Embassy in Tbilisi can provide more specific information on quantities of items that can be imported duty-free, as well as duties excised for specific items.
It is also advisable to contact the Embassy of Georgia in Washington, DC for specific information regarding customs requirements.
Please see our information on Customs Regulations.

While the Georgian lari is the only legal tender, dollars can be freely exchanged for laris at market rates.
ATMs are also becoming more widespread, but only within the city of Tbilisi.
Credit cards are rarely accepted outside of upscale hotels and restaurants, and travelers’ checks are difficult to cash.
American citizens in Georgia have reported incidents of credit card fraud and identity theft.

CRIMINAL PENALTIES:
While in a foreign country, an American citizen is subject to that country's laws and regulations, which sometimes differ significantly from those in the United States and may not afford the protections available to the individual under U.S. law.
Penalties for breaking the law can be more severe than in the United States for similar offences.
Persons violating Georgian laws, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in Georgia 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 Georgia are strongly encouraged to register with the nearest U.S. Embassy or Consulate through the State Department's travel registration web site, https://travelregistration.state.gov, and to obtain updated information on travel and security within Georgia.
Americans without Internet access may register directly with the nearest U.S. Embassy or Consulate.
By registering, American citizens make it easier for the Embassy or Consulate to contact them in case of emergency.
The U.S. Embassy in Tbilisi is located at 11 George Balanchine Street.
Office hours from American Citizens Services are from 2 to 5 pm on weekdays; no appointment is necessary.
The telephone number is (995) (32) 27-70-00, which can also be reached after hours, and the fax number is: (995) (32) 53-23-10.
The U.S. Embassy in Tbilisi’s web site is http://georgia.usembassy.gov/.
*
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This replaces the Country Specific Information dated October 3, 2007 to update the section on Entry and Exit Requirements, Safety and Security, Crime, Information of Victims of Crime, ion, Traffic Safety and Road Condition, Special Circumstances, and Aviation Safety Oversight.

Travel News Headlines WORLD NEWS

Date: Sat, 22 Jun 2019 21:45:46 +0200
By Anna SMOLCHENKO with Irakli METREVELI in Tbilisi

Moscow, June 22, 2019 (AFP) - Russia's government on Saturday banned Georgian airlines from flying into its territory, extending restrictions imposed by President Vladimir Putin as part of growing tensions between Moscow and its ex-Soviet neighbour.   Putin had signed a decree late Friday banning Russian airlines from flying to pro-Western Georgia from July 8 in response to anti-Moscow rallies in the Georgian capital Tbilisi.

The protests broke out after a Russian lawmaker addressed parliament from the speaker's seat earlier this week, a hugely sensitive move for two countries whose relations remain tense after a brief war in 2008.   The rallies have morphed into a broader movement against the Georgian authorities while the Kremlin has branded them a "Russophobic provocation".   On Saturday, protesters took to the streets of the Georgian capital for a third day of rallies, with some 3,000 demanding snap elections and electoral reform.   The crowd sang a profanity-laced, anti-Putin chant and some of the demonstrators held up placards insulting the Russian president.   Demonstrators also shot paper airplanes into the sky in response to the Russian bans.

Russia's transportation ministry said that from July 8 two Georgian airlines would be banned from flying to Russia, citing the need to ensure "aviation safety" and debt owned by the Georgian companies.   The Kremlin has said the ban against travel to Georgia was to "ensure Russia's national security and protect Russian nationals from criminal and other unlawful activities."

Authorities recommended travel companies stop selling holiday packages to Georgia and advised Russian tourists to return home.   Russia's travel industry and ordinary Russians hit out at the decision by the Kremlin, saying it was a politically motivated move that has little to do with safety concerns.   "Tourism in Georgia is on the rise, and the decision has shocked the whole industry," Aleksan Mkrtchyan, head of Pink Elephant, a chain of travel agencies, said in a statement.

- 'This is politics' -
The ban during high season is expected to hit the travel industry in both countries hard and become a major nuisance for Russian holidaymakers.   Russia and Georgia fought a brief but bloody war in 2008 and tensions between the two governments remain high.   But Georgia -- known for its picturesque Black Sea resorts, rich national cuisine and generous hospitality -- has emerged as one of the most popular destinations for Russian tourists over the past few years, with more than 1.3 million visiting last year.

Irina Tyurina, a spokeswoman for the Russian Tourism Union, said that most in the industry believed that Georgia was not a dangerous destination.   "Georgians have traditionally treated Russians well," Tyurina told AFP.    It was too early to estimate potential industry losses from the ban, she said.   More than 7,000 people have signed a petition calling on Moscow to resume flights.

Russian tourists in Tbilisi expressed regret at the restrictions.   "We are against the ban," Nina Guseva told AFP in the Georgian capital. "We are not guilty and we do not have to suffer."   Fellow traveller Mikhail Strelkov added: "This is politics and has nothing to do with people on holidays."   In Russia, many struck a similar note.   Elena Chekalova, a prominent chef and culinary blogger, said the latest Kremlin move "shocked" her.   "Why are they deciding for us what we cannot eat, where we cannot fly, who we cannot be friends with?" she wrote on Facebook.

- Simmering discontent -
Moscow has suspended flights to Georgia before -- during a spike in tensions in October 2006 and in August 2008 following the outbreak of the five-day war over the breakaway regions of Abkhazia and South Ossetia.   "Putin decided to punish Georgia because there are street protests there," opposition leader Alexei Navalny said on Twitter.   A senior government official in Tbilisi said the Kremlin ban was politically motivated.   "Putin's decision is of course political and has nothing to do with safety concerns," the official told AFP on condition of anonymity.

Analysts say the latest restrictions may further fuel simmering discontent with Kremlin policies.   Since 2014, Russians have been chafing under numerous rounds of Western sanctions over Moscow's role in Ukraine and other crises, with real incomes falling for the fifth year in a row.    During an annual phone-in with Russians this week, Putin dismissed calls to "reconcile" with the West to alleviate economic hardship, saying Moscow needed to protect its interests and "nothing" would change anyway.
Date: Thu, 6 Jun 2019 11:24:00 +0200

Tbilisi, June 6, 2019 (AFP) - Three people died on Thursday when a helicopter owned by one of Georgia's top luxury hotels crashed in a northern mountainous region of the country, emergency services said.   A chopper belonging to the Rooms luxury hotel "crashed in an unpopulated area near the Qulo mountain in the Kazbegi municipality," the spokesman of Georgia's emergency situations department, Rati Mujiri, told AFP.   "All three people onboard have died," he said.  "The helicopter pilot and two staff members of the Adjara Group (which owns Kazbegi Rooms hotel) have been killed in the accident," the company said in a statement.

The Rooms hotel operates Bell 505 Jet Ranger helicopters, according to the hotel's website.   Famed for its spectacular landscapes with snow-capped peaks of the Greater Caucasus mountain range, dramatic rocky gorges, and medieval churches, Kazbegi is a popular tourist destination.
Date: Thu 2 May 2019
Source: PLoS One [edited]

Citation
--------
Rao S, Traxler R, Napetavaridze T, et al. Risk factors associated with the occurrence of anthrax outbreaks in livestock in the country of Georgia: A case-control investigation 2013-2015. PLoS One. 2019;14(5):e0215228. doi: 10.1371/journal.pone.0215228

Abstract
--------
Introduction
Anthrax is considered endemic in livestock in Georgia. In 2007, the annual vaccination became the responsibility of livestock owners, while contracting of private veterinarians was not officially required. Six years later, due to increase in human outbreaks associated with livestock handling there is a need to find out the risk factors of livestock anthrax in Georgia.

Objective
To identify exposures and risk factors associated with livestock anthrax.

Methods
A matched case-control study design was used to recruit the owners of individual livestock anthrax cases that occurred between June 2013 and May 2015, and owners of unaffected livestock from within ("village control") and outside the village ("area control"). We collected data about the case and control livestock animals' exposure and risk factors within the one-month prior to the disease onset of the case livestock (or matched case for the controls). We used logistic regression analysis (univariate and multivariable) to calculate the odds ratios of exposures and risk factors.

Results
During the study period, 36 anthrax cases met the case definition and were enrolled in the study; 67 matched village control livestock and 71 matched area control livestock were also enrolled. The findings from multivariable logistic regression analysis demonstrate that vaccination within the last 2 years significantly reduced the odds of anthrax in cattle (OR = 0.014; 95% Confidence interval = or less 0.001, 0.99). The other factors that were significantly protective against anthrax were 'animals being in covered fence area/barn' (OR = 0.065; p-value = 0.036), and 'female animal being pregnant or milking compared to heifer' (OR = 0.006; p-value = 0.037).

Conclusions
The information obtained from this study has involved and been presented to decision makers, used to build technical capacity of veterinary staff, and to foster a One Health approach to the control of zoonotic diseases which will optimize prevention and control strategies. Georgia has embedded the knowledge and specific evidence that vaccination is a highly protective measure to prevent anthrax deaths among livestock, to which primary emphasis of the anthrax control program will be given. Education of livestock keepers in Georgia is an overriding priority.
------------------------------------------------------
Communicated by
Debby Reynolds
===============================
[The major benefits of this research project were not scientific but instructional in bringing home to all concerned at all levels that livestock anthrax is not inevitable but extremely preventable with many benefits in both animal health and public health. The article conclusions needed to be emphasised: "The control strategies that were recommended for anthrax included a combination of vaccination, quarantine, and proper carcass handling and disposal. Overall, the information obtained from this study has involved and been presented to decision makers, used to build technical capacity of regional and national veterinary staff, and fostered a One Health approach to the control of zoonotic diseases like anthrax, which will optimize prevention and control strategies. For example, a multi-agency anthrax One Health team was established to investigate cases and co-develop educational materials for farmers.

"The investigation process involved a series of trainings and workshops for participants and stakeholders to promote an understanding of epidemiological investigations and the economics of disease control with anthrax as a model. Georgia now has embedded the knowledge and specific evidence that vaccination is a highly protective measure to prevent anthrax deaths among livestock. Hence, primary emphasis for disease prevention will be given to vaccination, with a specific mark/tag for vaccination being desirable. Alternatively, a formal vaccination record given to the owner, or livestock registration is recommended. Education of livestock keepers in Georgia on the importance of vaccination is an overriding priority. Vaccination teams can play an increased role with more attention paid to delivery of standard memorable messages at the time of vaccination and to disseminating public announcements. It is overwhelmingly the case that vaccination of livestock against anthrax is protective and is an effective risk mitigation for anthrax in Georgia."

And if the Georgians can do it, anybody anywhere can do it. And you will note that their last outbreak was in 2017. Our thanks to Debby for forwarding this article. - ProMED Mod.MHJ]

[Maps of Georgia can be seen at
Date: Fri, 16 Mar 2018 16:59:07 +0100

Tbilisi, March 16, 2018 (AFP) - At least eight tourists, including a pregnant woman from Sweden, were injured on Friday when a chair lift ran out of control in the Georgian ski resort of Gudauri, officials said.   Video of the accident showed skiers being flung out of their chairs as they
turned a bend as other resort visitors screamed in terror. 

An emergency stop led to the chairs sliding back at high speed, Economy Minister Dimitry Kumsishvili told journalists, adding that the incident was "allegedly caused by an electricity outage".   "The interior ministry has launched a criminal probe into alleged violation of safety norms," he added.   Health Minister David Sergeenko said the tourists -- who were Georgiain, Russian, Swedish and Ukrainian -- did not suffer serious injuries.

"Two of them - including a pregnant woman from Sweden -- were airlifted to a hospital in (the Georgian capital) Tbilisi," he added.   Video footage (https://www.facebook.com/yanshyn/videos/10210410103119989/) of the accident posted on Facebook has been viewed more than 600,000 times.   The Caucasus nation of Georgia is an emerging ski destination.
Date: Wed 8 Nov 2017 8:36 PM GET
Source: KyivPost, Interfax-Ukraine report [edited]

Georgia's 2nd anthrax fatality this year [2017] has been confirmed. A Poti [Samegrelo-Zemo Svaneti region] resident, aged 28, died from exposure to anthrax, Maka Gabunia, an epidemiologist of the Georgian Healthcare Ministry's Poti regional laboratory, told reporters on [8 Nov 2017].

The tentative cause of death is that the woman sought medical aid too late, Gabunia said. The patient was showing symptoms of the disease when she was admitted to a hospital, she said. "The appropriate medical assistance was provided to the patient, but, unfortunately, doctors were unable to save her," Gabunia said.

Laboratory tests confirmed the diagnosis of anthrax exposure, she said. She said she believes that there are no reasons for panic among residents of Poti.

The 1st anthrax fatality this year [2017] was recorded in Adjara, Georgia, in September. A 58-year-old resident of the village of Akhalsopeli in the Khelvachauri district died following exposure to an infected animal, the Georgian National Center for Disease Control and Public Health told reporters.

The last time an anthrax fatality was recorded in Georgia was in 2013.
****************************
Date: Thu 9 Nov 2017
Source: Rosbalt.ru [in Russian, trans., edited]

A young Poti resident died of anthrax infection. The citizen turned to the doctors late, the Ministry of Health of Georgia informed. The 28-year-old woman died, despite the help she received from epidemiologists.

In September [2017], a man died from anthrax in Adjara.
------------------------------
Communicated by:
Sabine Zentis
Castleview English Longhorns
Gut Laach
D-52385 Nideggen
Germany
**************************
Date: Fri 10 Nov 2017
From: Ana Kasradze [edited]

Anthrax is an endemic zoonotic disease in Georgia. The majority of cases are cutaneous, generalized forms of the disease are rare; 1-2 gastrointestinal tract anthrax cases were registered in total. From August [2017], the human anthrax cases in the west part of Georgia were related to ongoing epizootics in one of the regions.

In the beginning of November 2017, a 28-year-old female was admitted to the hospital in the west part of the country with high temperature, severe sore throat, neck swelling, predominantly unilateral. Lymph nodes were swollen and a pseudomembranous plaque in the mouth -- predominantly on the right side -- was observed. The hospital suspected diphtheria and notified. For a bacteriological study, the sample was sent to NCDC's [National Center for Disease Control and Public Health] Regional Laboratory. The patient was transferred to the referral hospital in the same city, where the laboratory is located. After 24 hours, the culture was identified as anthrax.

Additional laboratory testing was conducted in the center of Lugar, and the bronchial aspirate sample was PCR positive for anthrax.

The condition of the patient was severe, and despite the specific treatment, she died on the 6th day of hospitalization.

Diagnosis: anthrax, oropharyngeal form.

The case was defined as unusual for Georgia, as no oropharyngeal anthrax cases had been identified before in the country. The suspected source of infection is minced meat, that case bought in the local market. Because of her severe condition, we were not able to interview her, but most likely she tasted the raw minced meat before cooking. The person selling the meat at the local market is a private merchant and the meat is not sold in the food chain. National Food Agency was notified. Environmental samples were collected from the slaughterhouse.
-------------------------------
EpiCore Global Surveillance Project member
Ana Kasradze
National Center for Disease Control and Public Health
=================
[Maps of Georgia can be seen at
and <http://healthmap.org/promed/p/63383>.

According to Wikipedia (<https://en.wikipedia.org/wiki/Poti>) Poti is a port city in Georgia, located on the eastern Black Sea coast in the region of Samegrelo-Zemo Svaneti in the west of the country. The city has become a major port city and industrial center since the early 20th century. It is also home to a main naval base and the headquarters of the Georgian navy. Adjacent to the Poti port area is the RAKIA owned Free Industrial Zone.

Poti, a busy city, is distant from the usual rural areas afflicted with livestock anthrax. As the third report notes the patient was confirmed to have oropharyngeal anthrax which is rare in humans though not uncommon in certain livestock. The suggestion that she had sampled the rare minced meat is logical, as we know from hamburgers such is very easy to cook and the cooked surface would have been sterile. The less cooked interior, if eaten, would have possibly resulted in an enteric infection. If the meat had been mixed with some fibrous matter it would have increased the chance of scratching the throat and have facilitated spore entry. Our thanks to Dr Kasradze for her very quick response. - ProMED Mod.MHJ]
More ...

Congo, Democratic Republic

Democratic Republic of the Congo US Consular Information Sheet
23rd September 2008
COUNTRY DESCRIPTION: The Democratic Republic of the Congo (Congo-Kinshasa) located in central Africa, is the third largest country on the continent. The capital
s Kinshasa. French is the official language. Years of civil war and corruption have badly damaged the country's infrastructure. Read the Department of State Background Notes on the Democratic Republic of the Congo (DRC) for additional information.
ENTRY/EXIT REQUIREMENTS:
A passport, visa and evidence of yellow fever vaccination are required for entry. Some travelers arriving in the DRC without proper proof of yellow fever vaccination have been temporarily detained, had their passports confiscated, or been required to pay a fine. Information about yellow fever vaccination clinics in the U.S. may be found at http://www2.ncid.cdc.gov/travel/yellowfever/.
Visas must be obtained from an embassy of the DRC prior to arrival.
Travelers to the DRC frequently experience difficulties at the airport and other ports of entry, such as temporary detention, passport confiscation and demands by immigration and security personnel for unofficial “special fees.”
All resident foreigners, including Americans, are required to register at the office of the Direction General de Migration (DGM) in the commune of their place of residence.
Visitors who wish to travel in any mining areas must first obtain government approval from various government agencies or ministries, an often cumbersome and time consuming process.
Dual nationals arriving in the DRC should carefully consider which passport they use to enter the DRC. For departure from the DRC, airlines will require a valid visa for all destination countries before they will issue a ticket or allow a passenger to board. Airlines also require that the passenger have the correct entry stamp in the passport they wish to use to exit the country. Passengers who are unable to leave the country on the passport they used to enter the DRC may not be able to continue on their travel itinerary.
Additional information about visas may be obtained from the Embassy of the Democratic Republic of the Congo, 1726 M Street NW, Washington, DC 20036, tel. (202) 234-7690, or the DRC's Permanent Mission to the UN, 866 United Nations Plaza, Room 511, New York, NY 10017, tel. 212-319-8061, fax: 212-319-8232, web site http://www.un.int/drcongo. Overseas, inquiries should be made at the nearest Congolese embassy or consulate. 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:
See the Department of State’s Travel Warning for the Democratic Republic of the Congo.

Though the DRC is now significantly more stable than it has been over the past decade, security remains problematic. The first democratic elections in more than forty years were held in 2006, and a new government is now in place. Post-election disturbances occurred as recently as March 2007 in Kinshasa, resulting in deaths of civilians and military personnel. During civil disturbances in 2007 there were incidents of hostility towards U.S. citizens and other expatriates.

Both inside and outside Kinshasa, there can be roadblocks, especially after dark. Vehicles are often searched for weapons and valuables, and travelers are checked for identity papers. Security forces regularly seek bribes. If confronted with such a situation, it is suggested that U.S. citizens remain courteous and calm. If detained, report the incident to the U.S. Embassy in Kinshasa as soon as possible.

The United Nations has its largest peacekeeping operation in the world in the DRC. Known by its French acronym of MONUC, it has close to 17,000 peacekeepers deployed in the country – primarily in the east. Violence nevertheless persists in the eastern DRC due to the presence of several militias and foreign armed groups, with sporadic outbreaks occurring in North Kivu, South Kivu, and northern Katanga provinces, as well as in the Ituri District of Orientale province. Members of the Lord’s Resistance Army entered into northeastern DRC from Sudan in 2005, and have camps in an isolated region of the DRC, Garamba National Park, where they killed eight MONUC peacekeepers in January 2006.

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 overseas callers, a regular toll line at 1-202-501-4444.
These numbers are available from 8:00 a.m. to 8:00 p.m. Eastern Time, Monday through Friday (except U.S. federal holidays).

The Department of State urges American citizens to take responsibility for their own personal security while traveling overseas.
For general information about appropriate measures travelers can take to protect themselves in an overseas environment, see the Department of State’s pamphlet A Safe Trip Abroad.
CRIME:
In the DRC, poor economic conditions continue to foster crime, especially in urban areas. Travel in many sections of Kinshasa, Kisangani, Lubumbashi and most other major cities, is generally safe during daylight hours, but travelers are urged to be vigilant against criminal activity which targets non-Congolese, particularly in highly congested traffic and areas surrounding hotels and stores. Outlying, remote areas are less secure due to high levels of criminal activity and the lack of adequate training, supervision, and salary payments to the security forces present.

Vehicle thefts, burglaries, and armed robbery occur throughout the country; there have been recent reports of after-dark carjackings, resulting in deaths in the North Kivu area. It is recommended to drive with doors locked and windows closed at all times. If confronted by members of the military or security forces, visitors should not permit soldiers or police officers to enter their vehicles nor get into the vehicle of anyone purporting to be a security official. It is recommended that in such instances U.S. citizens remain courteous and calm and, if threatened, not resist. All incidents should be reported to the U.S. Embassy in Kinshasa.

Consistency in administering laws and regulations is notably absent. Travelers should note that in cases of theft and robbery, legal recourse is limited. Therefore, valuable items may be safer if kept at home or another secure location.

Security officials and/or individuals purporting to be security officials have detained and later robbed American citizens and other foreigners in the city of Kinshasa. This type of crime has increased in recent months, but generally occurs more frequently during the Christmas and New Year's holidays.

Travelers using public transportation or visiting high pedestrian traffic areas of any type are advised to be vigilant against robbery and pick-pocketing which is a persistent problem in all major cities in the DRC. The presence of “street children”, who can be persistent and sometimes aggressive, remains a problem particularly in Kinshasa.
INFORMATION FOR VICTIMS OF CRIME:
The loss or theft abroad of a U.S. passport should be reported immediately to the local police and the nearest U.S. Embassy or Consulate.
If you are the victim of a crime while overseas, in addition to reporting to local police, please contact the nearest U.S. Embassy or Consulate for assistance.
The Embassy/Consulate staff can, for example, assist you to find appropriate medical care, contact family members or friends and explain how funds could be transferred.
Although the investigation and prosecution of the crime is solely the responsibility of local authorities, consular officers can help you to understand the local criminal justice process and to find an attorney if needed.
See our information on Victims of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION:
In the DRC, medical facilities are severely limited, and medical materials are in short supply. Travelers should carry properly labeled prescription drugs and other medications with them and should not expect to find an adequate supply of prescription or over-the-counter drugs in local stores or pharmacies. Payment for any medical services required is expected in cash, in advance of treatment.

Malaria is common throughout the DRC and outbreaks of cholera, typhoid, yellow fever, the Ebola virus, and hemorrhagic fever occur.
Travelers should take appropriate precautions to prevent the spread of HIV/AIDS.
Tuberculosis is an increasingly serious health concern in the DRC.
For further information, please consult the CDC's Travel Notice on TB at: http://wwwn.cdc.gov/travel/yellowBookCh4-TB.aspx.
The U.S. Department of State is unaware of any HIV/AIDS entry restrictions for visitors to or foreign residents of the DRC.

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:
For planning purposes, the minimum estimated cost of medical air evacuation to the nearest suitable health care facility (in South Africa) is $35,000.

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

TRAFFIC SAFETY AND ROAD CONDITIONS:
While in a foreign country, U.S. citizens may encounter road conditions that differ significantly from those in the United States. The information below concerning the DRC is provided for general reference only, and may vary according to location or circumstance.

Inter-city roads are scarce, and throughout the DRC roads are generally in poor condition, and often impassable in the rainy season. When driving in cities, keep windows up and doors locked. At roadblocks or checkpoints, documents should be shown through closed windows. In the event of a traffic incident involving bodily injury to a third party or pedestrian, do not stop to offer assistance under any circumstances. Proceed directly to the nearest police station or gendarmerie to report the incident and request official government intervention. Attempting to provide assistance may further aggravate the incident, resulting in a hostile mob reaction such as stoning or beating.

Presidential and other official motorcades pose serious risks to drivers and pedestrians in Kinshasa. When hearing sirens or seeing security forces announcing the motorcade's approach, drivers should pull off the road as far as possible, stop their vehicles, and extinguish headlights. Vehicles should not attempt to move until the entire motorcade has passed by; the security forces will physically indicate when this has occurred. Failure to comply may result in arrest, and/or vehicle damage with possible personal injury.

Public transportation of all forms is unregulated and is generally unsafe and unreliable. Taxis, mini-buses, and trains are in poor mechanical condition and are invariably filled beyond capacity.

Visitors who wish to travel in any mining areas must first obtain government approval from various government agencies or ministries, an often cumbersome and time consuming process.

Drivers should stop their cars and pedestrians should stand still when passing a government installation during the raising and lowering of the Congolese flag. This ceremony occurs at roughly 7:30 a.m. and 6:00 p.m.
Please refer to our Road Safety page for more information.

AVIATION SAFETY OVERSIGHT:
The U.S. Federal Aviation Administration (FAA) has assessed the Government of the DRC’s Civil Aviation Authority as not being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for the oversight of the DRC’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.
Civil aviation in the DRC continues to experience air incidents and accidents; more than a dozen crashes and in-flight accidents resulted in more than 300 fatalities between 2000 and August 2008. Incidents included hard landings, engine failures, collapsed landing gear, and planes veering off the runway.
In-country air travel schedules are unreliable and planes are frequently overloaded with passengers and/or cargo.
The U.S. Embassy in the DRC has prohibited official travel by U.S. government employees and contractors on all DRC-owned and -operated commercial air transportation services due to concerns regarding safety and maintenance.
International flights on foreign-owned and -operated carriers are not affected by this notice.
SPECIAL CIRCUMSTANCES:
Photography: Travelers should note that photography in public places in Kinshasa and around any public or government building or monument in the DRC is strictly forbidden. Persons caught photographing such sites will likely have their photographic equipment confiscated and risk detention and possible arrest.

Travel to and from Congo-Brazzaville (Republic of Congo): Ferry service to and from Kinshasa and Brazzaville stops running in the late afternoon, does not operate on Sundays, and may close completely with minimal notice. If ferry service is functioning, a special exit permit from the DRC's Immigration Service and a visa from the Republic of the Congo (Congo-Brazzaville) are required for U.S. citizens to cross the Congo River from Kinshasa to Brazzaville.

Ferry and riverboat service to the Central African Republic is suspended due to rebel control of the Ubangui River.
Phone Service: In the DRC, cellular phones are the norm, as other telephone service is unreliable. Depending on the type of phone, it may be possible to locally purchase a SIM card to use an American-compatible cell phone in the DRC.

Currency: U.S. currency is widely accepted in the urban areas, but most vendors and banking institutions will accept only Series 1996 bills or newer, with the large, off-center portraits, that provide stronger protection against counterfeiting. In addition, bills must be in near perfect condition; even those with minor stains or small tears will be rejected. One dollar bills are rarely accepted, even if in mint condition. U.S. bills should be examined before they are accepted to ensure that they are legitimate, as counterfeit currency is widely circulated. It is recommended that currency exchange be conducted at reputable banks and not on the street where several schemes exist to either short-change the unwitting customer or to pass counterfeit bills.

CRIMINAL PENALTIES:
While in any 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. 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.

Penalties for breaking the law can be more severe in the DRC than in the United States for similar offenses.
Persons violating Congolese laws, even unknowingly, may be expelled, arrested or imprisoned. Penalties for possession, use, or trafficking in illegal drugs in the DRC are severe, and convicted offenders can expect long jail sentences and heavy fines. Accusations of engaging in crimes against the security of the State, which are loosely defined, often result in detention for prolonged periods without being formally arrested. The DRC’s justice system remains plagued by corruption and uneven application of the law. Attorney fees can be expensive and are expected to be paid in advance of services rendered.

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 the DRC 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 the Congo. 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 310 Avenue des Aviateurs; tel. 243-081-225-5872 (do not dial the zero when calling from abroad). Entrance to the Consular Section of the Embassy is on Avenue Dumi, opposite the Ste. Anne residence. The Consular Section of the Embassy may be reached at tel. 243-081-884-6859 or 243-081-884-4609; fax 243-081-301-0560 (do not dial the first zero when calling from abroad).
*

*

*
This replaces the Country Specific Information for the Democratic Republic of the Congo, dated April 29, 2008, to update sections on Entry/Exit Requirements and Medical Facilities and Health Information.

Travel News Headlines WORLD NEWS

Date: Sun, 13 Oct 2019 23:31:57 +0200 (METDST)

Kinshasa, Oct 13, 2019 (AFP) - Doctors will use a second Ebola vaccine from November in three eastern provinces in the Democratic Republic of Congo to fight the deadly virus, medical officials said Sunday.   "It's time to use the new Ad26-ZEBOV-GP vaccine, manufactured by Johnson & Johnson's Belgian subsidiary," said Dr. Jean-Jacques Muyembe, who leads the national anti-Ebola operation in the DRC.    It will arrive in the eastern city of Goma, in North Kivu province, on October 18 and be used from the beginning of next month, he added.   DRC's latest Ebola epidemic, which began in August 2018, has killed 2,144 people, making it the second deadliest outbreak of the virus, after the West Africa pandemic of 2014-2016.

Muyembe said the communes of Majingo and Kahembe had been selected to receive the vaccine as they were considered the epicentres of the epidemic.   "We will extend this vaccination to our small traders who often go to Rwanda to protect our neighbours," he added.   "If it works well, we will expand vaccination in South Kivu and Ituri."   DR Congo's eastern provinces of Ituri, North Kivu and South Kivu sit on the borders with Uganda, Rwanda and Burundi.   The Belgian laboratory will send a batch of 200,000 doses to neighbouring Rwanda and 500,000 doses in the DRC, Muyembe said.   More than 237,000 people living in active Ebola transmission zones have received a vaccination produced by the pharma company Merck Sharpe and Dohme since August 8, 2018. 

The J&J vaccine had been rejected by DRC's former health minister Oly Ilunga, who cited the risks of introducing a new product in communities where mistrust of Ebola responders is already high.   But Ilunga's resignation in July appears to have paved the way for approval of the second vaccine. He currently faces charges that he embezzled funds intended for the fight against Ebola.   In his letter of resignation Ilunga said "actors who have demonstrated a lack of ethics" want to introduce a second vaccine, but did not elaborate.    Muyembe, who took over the Ebola fight in the DRC in July, said "The Johnson & Johnson vaccine has the most science-based data."
Date: Wed, 9 Oct 2019 22:01:17 +0200 (METDST)

Kinshasa, Oct 9, 2019 (AFP) - Six people were killed in the Democratic Republic of Congo after torrential rains hit the capital Kinshasa, flooding several neighbourhoods. a local official said.    The bodies were found between Tuesday night and Wednesday morning.    Five people were killed in the capital's Selembao municipality where around 30 houses collapsed, local mayor Augustin Mankesi told Top Congo radio station.   One woman died in the Pelende district after she was electrocuted, he added.    "Our community is stricken," Mankesi added, calling on the Congolese authorities for help.   Fatal floods and rains are frequent in Kinshasa. In January last year 48 people were killed in landslides, floods and after houses collapsed, according to authorities.    Residents told AFP the road from the sea port district of Matadi to the Kinshasa turnoff has been closed due to erosion caused by the rain.    The passage is Kinshasa's main supply route for imported goods and also serves as an exit point for exports.
Date: Wed 9 Oct 2019
Source: Provinces 26 RDC [in French, trans. Google, abridged, edited]

Measles killed 246 children in one month in the Basankusu health zone. The epidemic is currently raging in 12 health zones in [Equateur]. Civil society organizations are launching an SOS in the face of the scale of this epidemic.

The coordinator of the citizen movement ECCHA / Basankusu, Christian Boketsu, says that after his visit Mon 7 Oct 2019 through hospitals and health institutions, he noted "a total of 246 deaths in this territory. Patients are abandoned because of lack of medication."

Provincial health minister / Equateur, Bruno Efoloko, confirms that this measles outbreak has been reported since the 36th week in 12 health zones in the province. He said that as far as Basankusu was concerned, "WHO is planning to go down there soon in its 2nd phase of intervention." This includes the "free measles care, but also the strengthening of routine vaccination with a double dose of vaccine."

Dr. Bruno Efoloko lamented the fact that "many parents were hiding their children, saying that measles cannot be cured in the hospital. This caused this high mortality."
=======================
[Also see <https://www.apnews.com/f45e17d506f842f3ad10f3080d57ed48>. More than 4000 people have died in Congo this year [2019] in the world's largest measles outbreak, the UN's children's agency said Wednesday [9 Oct 2019]. Since January [2019], more than 200,000 cases of measles have been reported across Congo, UNICEF said. More than 140,000 involve children under 5, who also make up nearly 90% of deaths. UNICEF said health workers were rushing additional medical kits to help care for more than 110 000 people infected with the measles, a highly contagious and potentially deadly virus. More than 1.4 million children have been vaccinated this year [2019]. - ProMED Mod.LK]
Date: Thu 19 Sep 2019
Source: Wellcome Trust Sanger Institute [edited]

The 1st extensively drug-resistant (XDR) strains of _Salmonella_ Typhimurium, a pathogen which is responsible for millions of bloodstream infections per year in sub-Saharan Africa, have been identified in the Democratic Republic of Congo (DRC). Drug-resistance has increased in successive groups of _S._ Typhimurium over time. These new strains are resistant to all but one of the commonly available drugs in the DRC, with one sample showing reduced susceptibility to this final antimicrobial.

The study, published today (19 Sep 2019) in Nature Communications, was conducted by researchers from the Institute of Tropical Medicine (ITM) in Antwerp, the Institut National de Recherche Biomedicale (INRB) in the DRC, the Wellcome Sanger Institute, the University of Cambridge and their collaborators. The findings suggest that _S._ Typhimurium has evolved in sub-Saharan Africa in the past decades and continues to do so. A multifaceted approach will be needed to track and control the spread of XDR _Salmonella_, including further microbiological and genomic surveillance.

Most _Salmonella_ infections result in symptoms associated with food poisoning. While unpleasant, symptoms are not life-threatening in the vast majority of cases. But in sub-Saharan Africa, _Salmonella_ such as _S._ Typhimurium can cause infections of the blood, known as invasive non-typhoidal _Salmonella_ (iNTS) infections. Every year, iNTS infections are estimated to affect 3.4 million people and result in 681 316 deaths globally*, of which the majority are caused by _S._ Typhimurium. The containment and treatment of iNTS infections in places like the DRC is complicated by limited access to healthcare, infrastructure challenges and weakened immunity, with children under 5 years of age particularly at risk.

It is known that iNTS infections in sub-Saharan Africa are dominated by a type of _S._ Typhimurium known as ST313, which is associated with antimicrobial resistance. Two groups of ST313 (named lineage I and II) split off independently and subsequently spread over the African continent. Antimicrobial resistance has been growing over time, with lineage II now the primary cause of iNTS infections.

Now a global research partnership is working to understand how _Salmonella_ ST313 continues to evolve and develop drug resistance. Working on blood samples collected in DRC hospitals from people with suspected bloodstream infections, researchers from the INRB and ITM observed antimicrobial resistance levels never seen before in _S._ Typhimurium causing bloodstream infections, including resistance to the antimicrobial azithromycin, a drug normally held in reserve in case others prove ineffective**.

To better understand these findings, these strains were genome sequenced and analyzed, including bioinformatics analyses and laboratory experiments at ITM and the Wellcome Sanger Institute, and machine learning analyzes at the Centre for Genomic Pathogen Surveillance (CGPS). Analysis of these _S._ Typhimurium genomes identified a new sub-group that is branching off from ST313, named lineage II.1. Estimated to have emerged in 2004, this new group exhibits extensive drug resistance (XDR).

Dr Sandra Van Puyvelde, 1st author of the study from the Institute of Tropical Medicine and Visiting Scientist at the Wellcome Sanger Institute, said: "All antibiotic resistance genes contributing to XDR are present on the same plasmid. This is worrying because a plasmid is a mobile genetic element that could be transferred to other bacteria. While accumulating more antibiotic resistance, we discovered that the novel _Salmonella _ Typhimurium line is also showing further genetic and behavioral changes, which suggest ongoing evolution of the bacteria towards bloodstream infections."

The researchers also studied the way _S._ Typhimurium is adapting to an invasive lifestyle, moving away from the forms of _Salmonella_ that cause gastrointestinal illness towards the types that cause dangerous invasive bloodstream infections in sub-Saharan Africa. In addition to lab experiments, the samples were tested with a machine learning algorithm designed to look for characteristic patterns in the DNA of _Salmonella_ that indicate the potential to cause dangerous invasive infections.

Dr Nicole Wheeler, a bioinformatician at the Centre for Genomic Pathogen Surveillance, based at the Wellcome Sanger Institute, said: "In the lab, we've observed changes in this new group of _Salmonella_ Typhimurium_ that we've seen in other invasive salmonella. What's interesting as a bioinformatician is that we've been able to pick up these changes using machine learning. The hope is that in the near future, we'll be able to deploy machine learning in a more predictive role to help control the emergence and spread of drug-resistant strains of bacteria such as _S._ Typhimurium."

INRB and ITM have established bloodstream infection surveillance in the past 10 years which has been pivotal in the early detection of the XDR _S._ Typhimurium. Professor Octavie Lunguya of INRB in the DRC, said: "We isolated the organism from patients in hospitals across the Democratic Republic of Congo during our bloodstream infection surveillance activities. It is now crucial that we closely monitor the bacteria and their progression."

Professor Gordon Dougan, from the University of Cambridge, said: "Studies like this are unique, as we are making the bridge between the most important health issues observed in hospitals across the world with in-depth biological research for which we apply cutting edge technologies. Collaborations like this are key and will be important in the future to gain further insights on emerging diseases."
=====================
[The publication discussed is:
Van Puyvelde S, Pickard D, Vandelannoote K, Et al: An African Salmonella Typhimurium ST313 sublineage with extensive drug-resistance and signatures of host adaptation. Nat Commun. 2019 Sep 19;10(1):4280. doi: 10.1038/s41467-019-11844-z.

Abstract:
Bloodstream infections by Salmonella enterica serovar Typhimurium constitute a major health burden in sub-Saharan Africa (SSA). These invasive non-typhoidal (iNTS) infections are dominated by isolates of the antibiotic resistance-associated sequence type (ST) 313. Here, we report emergence of ST313 sublineage II.1 in the Democratic Republic of the Congo. Sublineage II.1 exhibits extensive drug resistance, involving a combination of multidrug resistance, extended spectrum B-lactamase production and azithromycin resistance. ST313 lineage II.1 isolates harbour an IncHI2 plasmid we name pSTm-ST313-II.1, with one isolate also exhibiting decreased ciprofloxacin susceptibility. Whole genome sequencing reveals that ST313 II.1 isolates have accumulated genetic signatures potentially associated with altered pathogenicity and host adaptation, related to changes observed in biofilm formation and metabolic capacity. Sublineage II.1 emerged at the beginning of the 21st century and is involved in on-going outbreaks. Our data provide evidence of further evolution within the ST313 clade associated with iNTS in SSA.

The combination of an extensively drug resistance phenotype with increased invasiveness is a very problematic combination. - ProMed Mod.LL]

[HealthMap/ProMED map available at:
Date: Fri 4 Oct 2019
From: Dr. Pascal Adroba, Dr. Anne Laudisoit, and Dr. William Karesh [edited]

On 25 Sep 2019, a rodent and guinea pig die-off was reported to the health authorities of the Aru Health Zone, Ituri Province, DRC, in the village of Omeyi in the Ongoyi health area. Subsequently a family cluster of 4 cases with the clinical symptoms consistent with the definition of bubonic plague was reported. Symptoms were high fever in 3 patients and high fever with a painful inguinal swollen lymph node in the 15-year-old patient. This family was admitted at the health center of Ekanga on 25 Sep 2019; unfortunately, the 15-year-old boy died on 26 Sep 2019. The other 3 patients were treated with doxycycline (200 mg/day for 5 days).

The DRC health zone team arrived on 27 Sep 2019 to spray the houses with deltamethrin, take human and wildlife samples, and raise community awareness of the measures to be taken. In response to this situation, the head of the Health Center of Ekanga alerted the Central Office of the health zone, and 225 villagers were given doxycycline preventively (single 200-mg dose for adults and children ). A plague rapid diagnostic test (RDT) was performed on the 3 other patients but only one was weakly positive, possibly due to antibiotic treatment. Two samples taken on the dying guinea pigs (lymph node aspirate) were strongly positive with the same RDT.

In total, 12 suspected plague cases (4 male, 8 female) and 3 deaths have been reported since 27 Sep 2019: 7 cases and 3 deaths from Omeyi, 3 cases from Ongoyi, 1 case from Doro and 1 case from Alembele village.

The provincial division of health is closely monitoring the situation and should send a team to the outbreak site on 7 Oct 2019. Rodent samples have been stored in ethanol for PCR diagnostic confirmation of bubonic plague.

The location of the village in proximity with the Ugandan border (20 km [12.4 mi] maximum) and with people seeking treatment in Uganda presents an additional risk of transborder outbreak as earlier this year [2019]. In March 2019, a 35-year-old woman died of pneumonic plague in Uganda after spending time in Atungulei village in DRC's Ituri province, and where her 4-year-old child had died days before. Further investigation revealed that finding her sick at her child's burial, her relatives took her to Uganda for treatment.
------------------------------------------
Dr. Pascal Adroba
Caritas, Bunia, Ituri Province, DRC
with additional details from
Dr. Anne Laudisoit
EcoHealth Alliance
<laudisoit@ecohealthalliance.org>
William B. Karesh, DVM
Executive Vice President for Health and Policy
EcoHealth Alliance
=======================
[ProMED is grateful to Drs. Adroba, Laudisoit, and Karesh for reporting this cluster of rodent and human plague occurring in Ituri, DRC. Although rodents and their fleas are the source of human plague, we don't often identify ill and dying animals in proximity and in advance of human cases.

From ProMED Mod.LL: "Most cases are due to bubonic plague following the bite of an infected rodent flea causing a swollen and very tender lymph gland. The swollen gland is called a 'bubo'. Bubonic plague should be suspected when a person develops a swollen gland, fever, chills, headache, and extreme exhaustion, and has a history of possible exposure to infected rodents, rabbits, or fleas. A person usually becomes ill with bubonic plague 2 to 6 days after being bitten.

"When bubonic plague is left untreated, plague bacteria invade the bloodstream. As the plague bacteria multiply in the bloodstream, they spread rapidly throughout the body and cause a severe and often fatal condition. Infection of the lungs with the plague bacterium causes the pneumonic form of plague, a severe respiratory illness. The infected person may experience high fever, chills, cough, and breathing difficulty and may expel bloody sputum. If plague patients are not given specific antibiotic therapy, the disease can progress rapidly to death."

Plague is endemic in this region of DRC, and this outbreak adds to the woes of a region where Ebola virus disease and measles have been occurring. Moreover, symptoms and signs of plague may overlap with those of Ebola and complicate diagnosis and provision of appropriate medical care. ProMED reported plague in an adjacent region of Uganda in March 2019 (Archive number http://promedmail.org/post/20190312.6363171). - ProMED Mod.LM]

[HealthMap/ProMED-mail map:

HealthMap/ProMED map available at:
Ituri, Democratic Republic of the Congo:
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World Travel News Headlines

Date: Wed, 16 Oct 2019 18:45:39 +0200 (METDST)

Manila, Oct 16, 2019 (AFP) - A child was killed in a strong 6.4-magnitude quake that hit the southern Philippines on Wednesday, a local mayor said, as houses collapsed, power was knocked out and a shopping mall burst into flames.   Residents evacuated homes and buildings across the Mindanao region including a mall that caught fire in the city of General Santos shortly after the quake struck in the evening, officials said.   The child died in a house collapse in the town of Datu Paglas, while four residents of nearby Tulunan town were injured when at least two other houses fell down, Tulunan Mayor Reuel Limbungan told AFP.   "The child was crushed by a collapsed house wall" and pronounced dead in hospital, Limbungan said, adding that he had visited the medical facility and spoken to its director.

Rescue and local officials said there were no immediate reports of deaths elsewhere in Mindanao, and rescue official Anthony Allada told local television that 20 people were treated for injuries in the town of Magsaysay, near the epicentre.   Three other people were hurt in the town of M'lang, added its vice-mayor, Joselito Pinol.   The quake was 14 kilometres (8.7 miles) deep and was followed by at least two aftershocks, according to the United States Geological Survey (USGS).   "It was the most powerful earthquake I have ever experienced," Sara Duterte, mayor of the largest Mindanao city of Davao, and daughter of President Rodrigo Duterte, told local television.

- Falling debris -
The Philippines is part of the Pacific "Ring of Fire", an arc of intense seismic activity that stretches from Japan through Southeast Asia and across the Pacific basin.   An elderly man was treated for injuries after being struck by a falling object during the evacuation of a Davao mall, local TV reported.   Jerome Barranco, civil defence officer for the region, said several people were also injured in the city of Kidapawan "as a result of falling debris".   In General Santos, television footage showed firemen battling a blaze that engulfed the three-storey Gaisano shopping mall.   It was not known if there were still people inside the building, which was evacuated as the quake struck.   The blaze was still raging more than three hours later despite the efforts of nearly 100 firemen, fire officer Redentor Batulan told AFP.

Coastal residents of Davao fled their homes in fear of a tsunami, but rescue workers were trying to convince them to return as no warning was issued, city civil defence chief Rodrigo Bustillo told local television.   "Our volunteers are out to calm the people and tell them there is no tsunami," Bustillo added.   Chief Philippine government seismologist Renato Solidum said there was no risk of a tsunami because the quake occurred inland, but he advised residents to check their homes for possible damage.   "We ran out of the police station, and we also let the inmates at the municipal jail out," patrolwoman Celina Sarte told AFP by telephone from the town of Bansalan.   She said the 10 prisoners were put in handcuffs outside moments later.
Date: Tue, 15 Oct 2019 20:35:37 +0200 (METDST)

Addis Ababa, Oct 15, 2019 (AFP) - Rescue workers on Tuesday used excavators to dig out bodies after a landslide in southern Ethiopia washed away homes and killed more than 20 people, a local official said.    The landslide in the remote district of Konta occurred Sunday following 10 hours of heavy rains, said the official, Takele Tesfu.   "There are 22 people dead and we have only been able to dig up 17 using manpower and machine power," Takele told AFP.   "So far, we cannot get the others, so tomorrow we will continue to dig."     He said the victims included nine women and six children.

While the district -- located in Ethiopia's Southern Nations, Nationalities, and Peoples' Region -- sees landslides with some regularity, Takele said this was the deadliest he could remember.    "The area where this occurred is very mountainous, and this means the landslide was very dangerous," he said.    Ethiopia is nearing the end of its rainy season, but security forces are nonetheless relocating some families for fear that more rain in the coming days could lead to similar disasters, Takele said.
Date: Tue, 15 Oct 2019 10:00:23 +0200 (METDST)

New Delhi, Oct 15, 2019 (AFP) - New Delhi banned the use of diesel generators on Tuesday as pollution levels in the Indian capital exceeded safe limits by more than four times.   Every winter, New Delhi is enveloped in a noxious blanket of smog of car fumes, industrial emissions and smoke from stubble burning at farms outside the megacity of 20 million people.   The ban on generators is part of the Graded Response Action Plan (GRAP) that entered into force on Tuesday.   Other measures that will come into effect as smog levels rise, particularly following the Diwali festival in late October, include banning trucks and setting up a "war room".

From November 4-15, a road-rationing scheme will come into force, meaning cars with odd and even plates would be allowed on alternate days in that period.   "We will hand out anti-pollution masks to schoolchildren next week but the date is yet to be decided," the official told AFP.   Indian authorities have also sought to reduce the burning of stubble by farmers in areas surrounding Delhi.   According to government data, concentrations of particles measuring less than 2.5 microns across -- which can penetrate the lung barrier and enter the blood -- hit 108 icrograms per cubic metre on Tuesday.   This was more than four times the recommended World Health Organization safe daily maximum of 25. In previous years, the level has regularly exceeded 400.   Last year, a UN report found 14 of the world's 15 most polluted cities were in India, with one US study saying it kills a million people prematurely every year.
Date: Tue, 15 Oct 2019 09:50:21 +0200 (METDST)
By Kyoko HASEGAWA

Tokyo, Oct 15, 2019 (AFP) - Rescuers in Japan were working around the clock Tuesday in an increasingly desperate search for survivors of a powerful weekend typhoon that killed nearly 70 people and caused widespread destruction.   Hagibis slammed into Japan on Saturday night, unleashing fierce winds and unprecedented rain that triggered landslides and caused dozens of rivers to burst their banks.   By Tuesday afternoon, local media put the toll at nearly 70, with around a dozen people missing. The government's tally was lower, but it said it was still updating information.   Prime Minister Shinzo Abe said there was no plan to slow rescue operations, with around 110,000 police, coast guard, firefighters and military troops involved.   "Currently in damaged areas rescue work and searches for the missing are continuing around the clock," Abe told parliament.   "Where rivers flooded, work is ongoing to fix spots where banks broke, and water is being pumped out where floods occurred," he added.   The prime minister's office said more than 3,000 people have been rescued in the wake of the disaster, which affected 36 of the country's 47 prefectures.   The defence ministry has called up several hundred reserve troops in addition to active duty soldiers for the first time since the 2011 earthquake and tsunami.

- Rain prompts new warnings -
Government officials warned that more rain was expected throughout the day Tuesday in several parts of the country affected by the typhoon.   "We ask people not to drop their guard and to remain fully alert," chief cabinet secretary Yoshihide Suga. told reporters.   Hagibis crashed into land packing gusts up to 216 kilometres (134 miles) per hour, but it was the storm's heavy rain that caused the most damage.   At least 176 rivers burst their banks, including in central Nagano, where a levee breach sent water from the Chikuma river gushing into residential neighbourhoods and submerging bullet trains in a depot up to their windows.   Deaths were reported across many prefectures and included a man whose apartment was flooded, a municipal worker whose car was caught in rising waters and at least seven crew aboard a cargo ship that sank in Tokyo bay on Saturday night.   By Tuesday morning, some 34,000 households were still without power, and 133,000 homes had no water.   Tens of thousands of people spent Monday night in government shelters, with many unsure when they would be able to return home.   "My frightened daughter can't stop shaking. We want to go home quickly," Rie Nishioka, 39, told Kyodo News agency in Miyagi prefecture.

- Government pledges aid -
The government pledged financial support to affected regions without specifying how much aid it would set aside.   "Support for the victims of the disaster is an urgent task," Abe said.   "There are concerns that the impact on daily life and economic activities may be long-lasting."   Another area affected by the storm was Fukushima, where several bags containing soil and plants collected during nuclear decontamination efforts were washed away.   "Ten bags out of 2,667 were swept into a river during the typhoon, but six of them were recovered yesterday," environment ministry official Keisuke Takagi told AFP, adding that the remaining four bags had been found and would be collected soon.   "Residents must be worried about the environment, but there are no reports that the bags were broken, so there will be nothing to worry about once they have been recovered safely," he said.   Hagibis caused transport chaos over a holiday weekend in Japan, grounding flights and halting train services.   By Tuesday, things were largely back to normal, though some flights were cancelled and train services partially disrupted where tracks or train stock were damaged by the storm.   The typhoon also caused disruption to sporting events, delaying Japanese Grand Prix qualifiers and forcing Rugby World Cup organisers to cancel three matches.   A crunch fixture pitting the hosts against Scotland went ahead on Sunday night, with Japan winning its first-ever quarter final spot.
Date: Mon, 14 Oct 2019 17:55:47 +0200 (METDST)

Harare, Oct 14, 2019 (AFP) - Striking Zimbabwe doctors on Monday defied a court order to return to work, saying a pay rise offered by the government failed to meet everyday costs.   Doctors remained home for a 43rd consecutive day, striking for better pay after their salaries were eroded by the country's spiralling inflation.   Zimbabwe's labour court ruled the action "unlawful" on Friday and ordered the medics back to their wards within 48 hours.

The Zimbabwe Hospital Doctors Association (ZHDA) announced Sunday it would appeal to the Supreme Court.    "We noted the court order but unfortunately we don't have the means by which to comply," said ZHDA spokesman Masimba Ndoro on Monday.   "We remain incapacitated... There is nothing we can do when we don't have the means to go to work and to meet our basic needs," he told AFP.   The doctors say the value of their pay shrank 15-fold over the past year -- a legacy of hyperinflation caused by economic mismanagement under ex-president Robert Mugabe.   His successor Emmerson Mnangagwa has so far failed to redress the situation.    Fuel prices have increased by more than 400 percent since the start of the year, and the ZHDA said that doctors had to use their savings just to show up to hospital each morning.

Negotiations with the government have been deadlocked since the ZHDA rejected a 60-percent salary rise offer.   With pay slips worth less than the equivalent of $100 (91 euros) in some cases, they are demanding doctors' salaries be pegged to the US dollar and have appealed to international bodies to supplement their wages.   "While doctors would want nothing more than to return to work in service of their patients, they continue to be incapacitated and lack the resources to comply with the Labour Court judgement," the ZHDA said in a statement on Sunday.   Nurses joined in the action last week.   "We have reduced the number of days we are coming to work initially to three days a week now we are down to two days," Zimbabwe Nurses Association spokesman Enoch Dongo told AFP.   "If the issue of salaries is not urgently addressed we will soon have a situation where nurses will no longer be able to come to work," he said, adding that nurses were "taking turns" in coming to hospital.      Rural teachers also embarked on strike action on Monday with a stay-at-home protest "against underpayment".   "We urge the government to respect our right to engage in job actions and peacefully protest demanding a living wage," the Amalgamated Rural Teachers Union of Zimbabwe posted on Twitter.
Date: Mon, 14 Oct 2019 16:33:26 +0200 (METDST)
By Daniel BOSQUE

Barcelona, Oct 14, 2019 (AFP) - "I feel fury and a sense of powerlessness," said Joan Guich, a 19-year-old student protesting in Barcelona after Spain's Supreme Court jailed nine Catalan leaders jailed over a failed independence bid.   "They have been convicted for an ideology which I agree with."   Within minutes of the ruling demonstrators had poured onto the streets of the Catalan capital, waving flags and blocking traffic over the conviction of the separatist leaders who organised a 2017 referendum banned by Madrid.   "We have to mobilise and stick up for them ... in a way that has an impact, closing airports, stations, but always avoiding violence," Guich said. "Or at least, it won't be us that provokes it."

Workers rallied outside their offices, university students walked out of classes and regional lawmakers demonstrated inside Catalonia's parliament, where most of the defendants had held a senior role.   "Today is going to be historic, you can feel it in the atmosphere. Serious things are happening, we can't stay home," said Oscar Quiles, a 47-year-old real estate entrepreneur.   News of the verdict reached him as he arrived at the office and he immediately called his mother to join him at a protest in Plaza Cataluna in the centre of Barcelona.   By noon the square was packed with thousands of demonstrators, many waving yellow, red and blue Catalan separatist flags or banners reading "We would do it again" and "Freedom for political prisoners".   The protesters then set off walking towards Barcelona's airport, Spain's second busiest, in the hope of blocking it, just as pro-democracy activists have done recently in Hong Kong.

- 'Weeks of mobilisation' -
Tension gripped Barcelona on Monday morning ahead of the ruling, with a heavy police presence outside the courts, the airport and the city's main train station, as a helicopter flew overhead.    Democratic Tsunami, a group advocating more active forms of civil disobedience, had urged demonstrators to hit the streets as soon as the verdicts were announced.   "Tomorrow everyone ready! When the verdict is out, the response will be immediate," said the group in a message to its roughly 150,000 followers on mobile messaging service Telegram.   Juli Cuellar, a 44-year-old office worker, said he believed the verdict was politically motivated.    "Now all we have left is a life of civil and institutional disobedience," he told AFP, predicting "weeks of mobilisation".   The Catalan National Assembly (ANC) and Omnium Cultural, the region's two biggest grassroots pro-independence groups, have also called supporters to attend an evening rally. They have organised some of the largest separatist protests in recent years.   Several more protests are scheduled over the next few days across Catalonia, as well as a general strike on Friday.

- 'Felt like crying' -
Democratic Tsunami, the group that called the gathering in Plaza Cataluna, only emerged in recent weeks. It says it does not depend on Catalan separatist parties or civil associations for support.   Its leaders remain unknown, keeping in touch with each other through encrypted messaging apps such as Wire.   But supporters tend to be kept in the dark until the last minute.   "We don't know exactly what we have to do," said Arnau Font, a 22-year-old shop assistant who took the week off to protest.   "We have to get involved. Right now I feel really powerless in light of the verdicts," he told AFP.    "When I found out, I felt like crying."   The uncertainty was over a few minutes later when a Telegram message arrived urging everyone to "go to the airport", a 15-kilometre (nine-mile) walk from the city centre.    "The time has come to make our voice felt around the world. The goal: stop the activity of Barcelona's airport," it said.   Spain's airport operator Aena said no flights were disrupted, but many passengers got stuck in traffic jams leading to the airport.
Date: Mon, 14 Oct 2019 14:09:03 +0200 (METDST)

Frankfurt am Main, Oct 14, 2019 (AFP) - German cabin crew union UFO urged members Monday to walk off their jobs at airline giant Lufthansa on October 20, although the carrier contests its right to represent workers.   "We call on all cabin crew... not to show up to work" between six and eleven am (0400 to 0900 GMT) at Germany's two busiest hubs Frankfurt and Munich, Ufo chairman Daniel Flohr said in a video message to staff.   At least five of the Lufthansa group's airlines -- Lufthansa, Eurowings, Germanwings, Cityline and Sunexpress -- would be hit by strikes for higher pay in the coming weeks, Flohr added.

Lufthansa told AFP it would "maintain its entire timetable", calling UFO's call to strike "illegal".   Bosses at the airline group believe UFO may no longer have the legal right to speak for workers and have challenged its status in court.   Internal disputes at the union have cost it members and support among cabin crew, some of whom have now turned to other representative organisations.   Berlin daily Tagesspiegel on Monday called UFO a "half-dead" outfit.   "UFO is battling for its life," agreed business daily Handelsblatt.   "With its far-reaching call for strikes, it wants to show members it remains capable of acting and is representing cabin crew interests."   Lufthansa could also contest before a court whether UFO has the right to initiate a strike -- potentially leaving the worker representatives on the hook for any resulting costs.
Date: Mon, 14 Oct 2019 11:08:10 +0200 (METDST)

Manila, Oct 14, 2019 (AFP) - Parents lined up from sunrise holding sleeping infants as the Philippines launched a campaign on Monday to vaccinate millions of children against polio, which has re-emerged nearly two decades after the nation's last cases.   Years of falling vaccination rates, made worse by the botched rollout of a dengue vaccine, culminated in an outbreak of the preventable disease in September.   "This is for the welfare of my child," Ruth Miranda told AFP after the vaccine was squirted into her child's mouth at the Manila slum they call home.

Miranda's child is among scores who are unprotected in the capital of about 13 million people, where vaccination rates of young children plunged from 77 percent in 2016 to a mere 24 percent in June.   The atmosphere at the event in Manila was festive -- with ice cream vendors and music -- but the stakes for the campaign are high.

Polio, which can cause paralysis and can be fatal in rare cases, has no cure and can only be prevented with several doses of oral and injectable vaccines.   Two cases were detected in September, the first polio infections in the Philippines since 2001, adding to the woes of a country already hit by deadly measles and dengue epidemic.   The risk of the disease spreading within the Philippines is high, according to World Health Organization, due to low immunisation coverage partly blamed to a dengue vaccine scandal.

The Philippines was the first nation to use Dengvaxia in a mass programme in 2016, but a botched rollout led to claims that children had died after being vaccinated.   A dramatic drop in vaccine confidence followed, with trust plunging from 93 percent in 2015 to 32 percent in 2018, according to a study led by the London School of Hygiene and Tropical Medicine.   The Philippines polio outbreak has been traced back to the weakened form of the virus used in vaccines, which is excreted by people for a time after they receive it.   According to the WHO, that form can mutate and spread in the surrounding community when immunisation rates get too low.
Date: Mon, 14 Oct 2019 10:25:38 +0200 (METDST)
By Shingo ITO, Sara HUSSEIN

Tokyo, Oct 14, 2019 (AFP) - Tens of thousands of rescue workers in Japan battled on Monday to find survivors of a powerful typhoon that killed at least 43 people, as fresh rain threatened to hamper efforts.   Typhoon Hagibis crashed into the country on Saturday night, unleashing high winds and torrential rain across 36 of the country's 47 prefectures, and triggering landslides and catastrophic flooding.   "Even now, many people are still unaccounted for in the disaster-hit area," Prime Minister Shinzo Abe told an emergency disaster meeting on Monday.   "Units are trying their best to search for and rescue them, working day and night," Abe said.

But even as rescuers, including troops, combed through debris, the country's weather agency forecast rain in central and eastern Japan that it warned could cause further flooding and new landslides.   "I would like to ask people to stay fully vigilant and continue watching for landslides and river flooding," Chief Cabinet Secretary Yoshihide Suga told a news conference.   In Nagano, one of the worst-hit regions, rain was already falling and was expect to intensify.   "We are concerned about the impact of the latest rain on rescue and recovery efforts," local official Hiroki Yamaguchi told AFP.   "We will continue operations while watching out for secondary disasters due to the current rain."

- 43 dead, 16 missing: NHK -
By late Monday afternoon, national broadcaster NHK said the toll had risen to 43 dead, with 16 others missing and over 200 people injured. The government gave lower figures but was continuing to update its information.   The dead included a municipal worker whose car was overcome by floodwaters and at least seven crew from a cargo ship that sank in Tokyo Bay on Saturday night, a coast guard spokesman said.   Four others, from China, Myanmar and Vietnam, were rescued when the boat sank and the coast guard was still searching for a last crew member.   While Hagibis, one of the most powerful storms to hit the Tokyo area in decades, packed wind gusts of up to 216 kilometres (134 miles) per hour, it was the heavy rains that caused most damage.

A total of 142 rivers flooded, mainly in eastern and northern Japan, with river banks collapsing in two dozen places, local media said.   In central Nagano, a levee breach sent water from the Chikuma river gushing into residential neighbourhoods, flooding homes up to the second floor.   As water slowly receded Monday, television footage showed patients being transferred by ambulance from a Nagano hospital where some 200 people had been cut off by flooding.   Elsewhere, rescuers used helicopters to winch survivors from roofs and balconies, or steered boats through muddy waters to reach those trapped.

- Japan dedicates rugby win to victims -
By Monday afternoon, some 75,900 households remained without power, with 120,000 experiencing water outages.   The disaster left tens of thousands of people in shelters, with many unsure when they would be able to return home.   "Everything from my house was washed away before my eyes, I wasn't sure if it was a dream or real," a woman in Nagano told NHK.   "I feel lucky I'm still alive."   The storm brought travel chaos over the holiday weekend, grounding flights and halting commuter and bullet train services.

By Monday, most subway trains had resumed service, along with many bullet train lines, and flights had also restarted.   The storm also brought havoc to the sporting world, forcing the delay of Japanese Grand Prix qualifiers and the cancellation of three Rugby World Cup matches.   But a crucial decider pitting Japan against Scotland went ahead, with the hosts dedicating their stunning 28-21 win to the victims of the disaster.   "To everyone that's suffering from the typhoon, this game was for you guys," said Japan captain Michael Leitch.
Date: Sun, 13 Oct 2019 23:31:57 +0200 (METDST)

Kinshasa, Oct 13, 2019 (AFP) - Doctors will use a second Ebola vaccine from November in three eastern provinces in the Democratic Republic of Congo to fight the deadly virus, medical officials said Sunday.   "It's time to use the new Ad26-ZEBOV-GP vaccine, manufactured by Johnson & Johnson's Belgian subsidiary," said Dr. Jean-Jacques Muyembe, who leads the national anti-Ebola operation in the DRC.    It will arrive in the eastern city of Goma, in North Kivu province, on October 18 and be used from the beginning of next month, he added.   DRC's latest Ebola epidemic, which began in August 2018, has killed 2,144 people, making it the second deadliest outbreak of the virus, after the West Africa pandemic of 2014-2016.

Muyembe said the communes of Majingo and Kahembe had been selected to receive the vaccine as they were considered the epicentres of the epidemic.   "We will extend this vaccination to our small traders who often go to Rwanda to protect our neighbours," he added.   "If it works well, we will expand vaccination in South Kivu and Ituri."   DR Congo's eastern provinces of Ituri, North Kivu and South Kivu sit on the borders with Uganda, Rwanda and Burundi.   The Belgian laboratory will send a batch of 200,000 doses to neighbouring Rwanda and 500,000 doses in the DRC, Muyembe said.   More than 237,000 people living in active Ebola transmission zones have received a vaccination produced by the pharma company Merck Sharpe and Dohme since August 8, 2018. 

The J&J vaccine had been rejected by DRC's former health minister Oly Ilunga, who cited the risks of introducing a new product in communities where mistrust of Ebola responders is already high.   But Ilunga's resignation in July appears to have paved the way for approval of the second vaccine. He currently faces charges that he embezzled funds intended for the fight against Ebola.   In his letter of resignation Ilunga said "actors who have demonstrated a lack of ethics" want to introduce a second vaccine, but did not elaborate.    Muyembe, who took over the Ebola fight in the DRC in July, said "The Johnson & Johnson vaccine has the most science-based data."