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Antartica

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

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

Travel News Headlines WORLD NEWS

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Indonesia

*****
Information for Bali
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General
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Bali is one of the main tourist destinations for many Irish travellers to Indonesia. The island is well developed for the tourist industry and genera
ly the climate is tropical and humid throughout the year. Many Irish travellers will use the island as a stopover. If this is for only 24 to 28 hours the extent of your jetlag may leave you little time to enjoy the country and its people.
Safety & Security
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Throughout Indonesia there are many regions where it is unsafe to travel. The Parliament in Indonesia may impeach the President in the near future. Civil disturbance with student demonstrations in the capital Jakarta, earthquakes in the island of Sumatra, unrest regarding the independence of Timor and profound warring fractions on the island of Borneo has the potential to spill over into Bali. Nevertheless during the past years Bali has remained stable and there have been few reports of serious disturbances that have affected tourists or business travellers. Lombok is an island close to Bali often visited by tourists. It is regarded as more unstable and recently (Dec 2000) four explosions during fighting between two villages (Bongor & Parampuan). The main tourist region around Senggigi has remained quiet.

Local Customs
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The laws against illegal drugs are severe and travellers should ensure that they carry sufficient well-marked medication that they may require for their time in Indonesia. Travellers are required to show identification at any time and so carrying photocopies of your passport is a wise precaution. Keep all valuable documents in a safe place and do not flaunt personal wealth while travelling around the island.
Night Activities
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The nightlife in Bali is one of the main attractions for many tourists but sensible precautions are required. Travelling alone is unwise. Take care to ensure that your drink could not be spiked at any stage and do not walk at night, use an authorised taxi where possible. The level of HIV infection among the bar workers is high and close personal contact is very unwise.
Medical Facilities
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The level of available health facilities varies greatly through Bali and other parts of Indonesia. In general most of the main hotels will have English speaking doctors but care would be required if your illness requires hospitalisation.
Food and Water
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It is wise to maintain a high level of care with regard to your food and water while in Indonesia. This includes even those in high quality hotels but also particularly for those eating from street vendors. Bivalve shellfish (e.g. oysters, mussels, clams etc) should be avoided at all times due to inadequate cooking. Bottled water should be purchased from your hotel or good quality shops to ensure that it is pure.
Mosquitoes and Insect Bites
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Malaria transmission occurs throughout Indonesia all year but the risk in Bali is so low that prophylaxis is not generally recommended for most tourists. Nevertheless for those visiting Lombok (overnight visits) the risk exists and prophylaxis should be considered. Other mosquito borne diseases also occur throughout Indonesia and care must be taken to avoid insect bites. In Jakarta and other main cities there is a particular problem with a viral disease called Dengue Fever. The mosquito, which transmits this disease, typically bites during the day and in main urban centres.
Sun Exposure
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The strength of the sun in Bali is considerable higher than that experienced in Ireland at any time of the year. Sufficient head covering should be worm when exposed and travellers should ensure that their fluid intake is sufficient. Salt depletion also needs to be replaced in times of significant perspiration.
Swimming
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If swimming in pools, make sure that sufficient chlorination has been used. Take care with small children when close to the deep end of the pool. If sea swimming make sure that there are always others around and that you heed any local advice and warning signs. Never swim soon after alcohol or for an hour after mealtime.
Jet Lag
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The extent of jet lag, which you will experience, depends on the duration of your flight and the amount of rest you were able to get before arrival. Try to rest for the first 24 hours to allow your body to acclimatise and make sure you do not fall asleep beside the swimming pool during this initial period.
Vaccinations for Bali
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There are no essential vaccines or entry to Bali from Western Europe. However for your personal protection travellers are recommended to consider vaccination cover against;
*
Poliomyelitis (childhood booster)
*
Tetanus (childhood booster)
*
Typhoid (food & water disease)
*
Hepatitis A (food & water disease)
Other travellers planning a more rural or extensive trip may need to consider other vaccine cover against diseases like Hepatitis B, Japanese B Encephalitis, Rabies.
Summary
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The majority of those visiting Bali will enjoy the many tourist attractions on the island. However commonsense and care is required to ensure that you do not expose yourself to unnecessary risk. The staff of the Tropical Medical Bureau can be contacted at either of the numbers below if you require further information.

Travel News Headlines WORLD NEWS

Date: Sat, 3 Aug 2019 22:33:09 +0200 (METDST)

Jakarta, Aug 3, 2019 (AFP) - Five people died and several were injured after a powerful undersea earthquake rocked Indonesia's heavily populated Java island, triggering a brief tsunami warning, the national disaster agency said Saturday.   The 6.9 magnitude quake on Friday evening sent residents fleeing to higher ground, while many in the capital Jakarta ran into the streets.

An official from Indonesia's national disaster agency warned the quake could generate a tsunami as high as three metres (10 feet), but the alert was lifted several hours later.   Three people died of heart attacks as the strong quake rocked the region, agency spokesman Agus Wibowo said on Saturday.   Another person fell to his death while trying to flee his house when the jolt happened, he said, while a fifth victim died from a panic attack.   Four more people were injured and more than 200 buildings were damaged, with about 13 houses destroyed, he added.

More than 1,000 people, who had earlier fled to temporary shelters, returned home after authorities convinced them it was safe to do so, Wibowo said.   "There was thundering noise -- it sounded like a plane overhead -- and I was just so scared that I ran," said 69-year-old Isah, who like many Indonesians goes by one name, at an evacuation shelter in Pandeglang at the southwest end of Java.   In December, the area was hit by a volcano-sparked tsunami that killed more than 400 people.

Indonesia experiences frequent seismic and volcanic activity due to its position on the Pacific "Ring of Fire", where tectonic plates collide.   Last year, a 7.5-magnitude quake and a subsequent tsunami in Palu on Sulawesi island killed more than 2,200 people, with another thousand declared missing.   On December 26, 2004, a 9.1-magnitude earthquake struck off the coast of Sumatra and triggered a tsunami that killed 220,000 across the Indian Ocean region, including around 170,000 in Indonesia.
Date: Sun, 14 Jul 2019 12:47:38 +0200

Labuha, Indonesia, July 14, 2019 (AFP) - A major 7.3-magnitude earthquake hit the remote Maluku islands in eastern Indonesia Sunday, sending panicked residents running into the streets, but no tsunami warning was issued.   The shallow quake struck about 165 kilometres (100 miles) south-southwest of the town of Ternate in North Maluku province at 6:28 pm (0928 GMT), according to the US Geological Survey.
 
"The earthquake was quite strong, sending residents to flee outside. They are panicking and many are now waiting on the roadside," said local disaster mitigation official Mansur, who like many Indonesians goes by one name.   Officials were assessing the situation but there were no immediate reports of casualties, he told AFP.

In the town of Labuha, one of the closest to the epicentre, panicked residents took to motorcycles in a bid to flee to higher ground, according to an AFP photographer in town when the earthquake hit.   Local disaster official Ihsan Subur told Metro TV that no damage or casualties had been reported there so far, but residents took to the streets and many evacuated to higher ground.   "Electricity went of during the earthquake, but now it's back to normal," ubur said, adding that at least seven big aftershocks were felt after the initial quake.

The province was also hit by a 6.9-magnitude tremor last week.   Indonesia experiences frequent seismic and volcanic activity due to its position on the Pacific "Ring of Fire", where tectonic plates collide.   Last year, a 7.5-magnitude quake and a subsequent tsunami in Palu on Sulawesi island killed more than 2,200 people, with another thousand declared missing.   On December 26, 2004, a devastating 9.1-magnitude earthquake struck off the coast of Sumatra and triggered a tsunami that killed 220,000 across the Indian Ocean region, including around 170,000 in Indonesia.
Date: Mon, 24 Jun 2019 05:38:33 +0200

Jakarta, June 24, 2019 (AFP) - A powerful magnitude 7.3 quake struck eastern Indonesia on Monday, US seismologists said, but no tsunami warning was issued and there were no immediate reports of major damage or casualties.   The quake hit at a depth of 208 kilometres (129 miles) south of Ambon island in the Banda Sea at 11:53 local time, the US Geological Survey said.

The Pacific Tsunami Warning Center said there was no threat of a tsunami as the quake was too deep.   The strong temblor came hours after a 6.1-magnitude earthquake hit Papua, also in the eastern part of the Southeast Asian archipelago.   That quake hit about 240 kilometres (150 miles) west of the town of Abepura in Papua province, at a relatively shallow depth of 21 kilometres, according to the USGS.

There were also no immediate reports of casualties after the earthquake.   A shallower 6.3-magnitude hit the area last week, but the damage was not extensive.   Indonesia experiences frequent seismic and volcanic activity due to its position on the Pacific "Ring of Fire", where tectonic plates collide.   Last year, a 7.5-magnitude quake and a subsequent tsunami in Palu on Sulawesi island killed more than 2,200 with a thousand more declared missing.   On December 26, 2004, a 9.1-magnitude earthquake struck Aceh province, causing a tsunami and killing more than 170,000.
31st May 2019

A volcano on the Indonesian island of Bali erupted Friday, spewing a plume of ash and smoke more than 2,000 metres (6,500 feet) into the sky. Mount Agung, about 70 kilometres from the tourist hub of Kuta, has been erupting periodically since it rumbled back to life in 2017, sometimes grounding flights and forcing residents to flee their homes.
Mount Agung is about 70 kilometres from the tourist hub of Kuta

The latest shortly before noon on Friday shot a cloud of volcanic ash high into the sky, but caused no disruption to flights, Indonesia's geological agency said.  Agung remained at the second highest danger warning level, and there is a four-kilometre no-go zone around the crater.

Last summer, dozens of flights were cancelled after Agung erupted, while tens of thousands of locals fled to evacuation centres after an eruption in 2017.

The last major eruption of Agung in 1963 killed around 1,600 people.

Indonesia is situated on the Pacific "Ring of Fire", a vast zone of geological instability where the collision of tectonic plates causes frequent quakes and major volcanic activity.

Date: Sat 11 May 2019
Source: The Jakarta Post [edited]

No one really knows what is spreading in the small village of Garonggong in Jeneponto regency, South Sulawesi. However, for the last couple of months, nearly all people living there have been experiencing mysterious symptoms, which started with a fever and pain all over the body, especially in their joints. The unknown disease killed 4 people from a total of 72 people that had experienced similar symptoms. The village administration has declared a health emergency. Several villagers have moved to avoid contagion.  "It has been going on for 2 months. They have experienced the same symptoms, and 4 people have died because of it, including my child, a local, said on Thursday [9 May 2019] as quoted by kompas.com.

The acting head of Jeneponto Health Agency, Syafruddin Nurdin, said it all began in April [2019] when a couple of villagers were infected. By 24 Apr [2019], 17 residents had been admitted to hospitals and community health centers for the same symptoms.  Syafruddin said most of them had experienced similar symptoms, such as a fever, headache, nausea and joint pain. "All of them came from the same village, Garonggong village," Syafruddin told The Jakarta Post on Friday [10 May 2019].

However, the health workers and agency have not been able to identify the disease or the cause of it, or why it had struck many people at the same time.  "The patients gradually lost consciousness. [...] When their blood was tested, all of the suspected diseases such as malaria, dengue fever, Zika, leptospirosis, anthrax, H5N1, were all ruled out. The tests came back negative for all of them," Syafruddin said.

The Health Ministry has yet to provide an explanation on this matter, but the ministry's disease control and prevention director general, Anung Sugihantono, said his side was investigating the outbreak.  A special team consisting of academics, health and environment experts, as well as veterinarians have been deployed to the village to carry out disease surveillance and epidemiology research.

Also, 3 patients have been moved to Makassar, the provincial capital, for further examination and treatment.  "Initial laboratory research had shown indication of typhoid, but further studies are needed," he added. South Sulawesi Health Agency acting head Bachtiar Baso said one of the deceased patients was pregnant. Doctors have been treating the patients using different approaches. "Most doctors treated those admitted to the hospitals for typhoid. Some of them saw their health improve, and some of them did not," he said.

Bachtiar said the investigative team had collected blood samples from the infected patients and animals in the area and had collected soil samples.  The team suspects those affected may have had either leptospirosis, meningitis or the hantavirus, Bachtiar said. "I hope the research results will be revealed soon and the team can gain a better understanding of the disease that has been spreading across Garonggong so we can prepare the necessary medicine and preventative measures," he added.
======================
[A comprehensive laboratory workup is necessary to establish a diagnosis. There is no indication that autopsies were carried out that might provide addition clues about the aetiology. Mention was made of hantaviruses, but no mention was made of supporting laboratory results that might point to Seoul hantavirus infections, but the large number of cases occurring in a single village in a short period of time would be unusual for hantavirus infections or for scrub typhus. There was an outbreak of Japanese encephalitis (JE) in North Sulawesi last year (2018). Although there is no specific mention of encephalitis in these patients, JE should be ruled out.

ProMED-mail would be interested in receiving further information about confirmation of typhus, any new cases, or laboratory results as they become available. - ProMED Mod.TY]

[HealthMap/ProMED map available at:
Sulawesi, Indonesia: <http://healthmap.org/promed/p/535>]
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Cameroon

Cameroon - US Consular Information Sheet
April 02, 2008
COUNTRY DESCRIPTION:
Cameroon is a developing country in central Africa.
Although there are many natural and cultural attractions in Cameroon, facilities catering to Western-styl
tourism are quite limited.
The capital is Yaoundé, though Douala, the country's largest city, is its main port and commercial center.
Official languages are French and English, though French predominates in most of the country.
English may be used in Cameroon's two Anglophone provinces of Southwest and Northwest, and the larger cities.
The staff of major hotels in Cameroon’s large cities is usually bilingual.
In February 2008, social and political unrest led to civil unrest, although the immediate threat of violence has now receded.
For general information on Cameroon, read the Department of State Background Notes on Cameroon.

ENTRY/EXIT REQUIREMENTS:
A valid passport, visa, evidence of yellow-fever vaccination, and current immunization records are required, and travelers may be denied entry if they lack the proper documentation.
Travelers should obtain the latest information and details from the Embassy of the Republic of Cameroon, 2349 Massachusetts Avenue, NW, Washington D.C. 20008, tel: (202) 265-8790, fax: (202) 387-3826.
Visit the Embassy of Cameroon’s web site at http://www.ambacam-usa.org/ for the most current visa information.

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

SAFETY AND SECURITY:
During the week of February 25, 2008, Cameroon experienced significant civil unrest in half of its ten provinces, most notably in the port city of Douala.
Demonstrators clashed violently with police and then military personnel, resulting in the reported deaths of forty persons and arrest of over 1,600 individuals.
The unrest was marked by widespread road blockages, attacks on public and private vehicles, looting, burning of government and other buildings, and roaming crowds of malcontents.
This disturbance created shortages of fuel, food and other supplies throughout the country, and was ended through the deployment of military units and the use of significant force.

Following the restoration of order, some efforts have been made to address fuel and food prices that were among the key grievances of the demonstrators.
However, economic conditions, notably the high unemployment rate, remain difficult without the prospect for rapid improvement.
Political tensions also remain, particularly over a possible amendment to the Constitution that would allow President Biya to serve again.
Although a rapid resumption of violence is considered unlikely, Americans living in or visiting Cameroon are encouraged to stay abreast of local political and social developments that could signal additional difficulties for the country.

Embassy employees have been instructed to refrain from travel outside of city limits after dusk, and to monitor their movements in centrally located areas within cities and towns.
Private American citizens are urged to follow the same guidelines and are strongly advised against nighttime travel.
Armed highway bandits (most notably in border areas); poorly lit roads; hazardous, poorly maintained vehicles; and unskilled, aggressive and/or intoxicated drivers pose a threat to motorists.
Attacks and accidents are most common outside major towns, especially in the provinces bordering Chad and the Central African Republic but occur in all areas of the country.

The U.S. Department of State continues to warn U.S. citizens against travel to neighboring Central African Republic (CAR).
On occasion, conflict between insurgents and government security forces in CAR has spilled across the border into Cameroon, affecting outposts in both Adamawa and East Provinces.
Humanitarian and religious workers in eastern Cameroon are strongly encouraged to coordinate their efforts with the Embassy and the Office of the United Nations High Commission for Refugees (UNHCR) in Yaoundé.

In February 2008, an attack by rebel insurgents on Ndjamena, the capital of Chad, forced the evacuation of the Embassy in Chad and sent up to 50,000 refugees across the border into the town of Kousseri in Cameroon.
Although the attack was ultimately repelled, the possibility of further military action by the rebel forces remains.

In late 2006, inter-ethnic clashes were reported in the town of Kye-Ossi near the Cameroonian border with Gabon.
These confrontations were a result of a discord between moto-taxi drivers and the security forces, which resulted in demonstrations and roadblocks.
According to security authorities, tensions in the area are still high, despite the deployment of a large security force to the region.

Following a ruling from the International Court of Justice defining a section of the Cameroon-Nigeria border, Cameroon assumed administrative control of most of the Bakassi Peninsula, in August 2006, with Nigerian military forces withdrawing across the border.
Although the transition has generally gone smoothly, there was an attack on Cameroonian military forces in November 2007, reportedly by criminal elements from the Niger Delta not connected to the Nigerian government.
It is very difficult to reach Bakassi, but travelers thinking of going near there should exercise extreme caution as there is the potential for violence if tensions rise.

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 Worldwide Caution, Travel Warnings, and Travel Alerts can be found.

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

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

CRIME:
Crime is a serious and growing problem throughout Cameroon and U.S. citizens should exercise caution when traveling in Cameroon.
Internet-based crime is escalating rapidly, and Americans should be extremely skeptical of financial
transactions --
e.g. adoptions, hiring a service worker, such as a nanny, to come to the U.S., or purchasing a pet -- that involve sending money for goods or services not yet delivered (see below).
In February 2008, two European nationals were kidnapped by criminals posing as businessmen seeking to establish a palm oil export business. Although several perpetrators were arrested and the individuals were not harmed, the incident highlights a dangerous new confluence of internet-based and violent crime.
If you have concerns about the legitimacy of a transaction, such as adoption, in Cameroon contact the U.S. Embassy in Cameroon – see Registration/Embassy Location section below.
All foreigners are potential targets for theft with possible attendant violence.
Petty crimes, crimes against persons, thefts from vehicles, and of vehicles are the most common criminal activities.
Armed banditry is a growing problem throughout all ten provinces in Cameroon.
Specifically, incidents of armed highway-robbery have been reported in the North West, West, South West and East provinces.
Armed bandits have erected road barricades on major routes that link rural towns to provincial headquarters, and have taken as many as 100 cars in a single attack.
To curb banditry, security personnel may request persons to show their passport, residence card, driver's license, and/or vehicle registration at random checkpoints.
Certified copies of these important documents should be kept in a secure location separate from the originals.
Security personnel have been known to ask for bribes and may hurt citizens who refuse to pay.
The U.S. Government does not condone bribery or corruption of any kind.

Due to the frequency of criminal incidents involving public transportation, American citizens are advised that use of public taxis can be dangerous.
In April 2007, two American women were assaulted and robbed in a taxi.
Public taxis in Cameroon function more like the U.S. bus system with drivers stopping to pick up additional passengers as long as there is space left in the vehicle.
There have been numerous reports of assaults and robberies committed by "passengers" in shared taxis since crimes – rape and robbery being among the most common – are often a collaborative effort between the driver and "passengers."
If a traveler must use a taxi, the use of a private taxi – or a taxi hired for exclusive use by the individual for that particular trip – where the driver is known to the passenger is a better alternative to the use of shared taxis.
Taxi passengers should be particularly vigilant at night.

The risk of street and residential crime is high, and incidents of violent crime are on the rise throughout the country.
During the last year, the number of carjacking and armed burglary incidents in residences and restaurants, particularly in Yaoundé and Douala, continued to increase.
Carjacking and robbery has also been reported on rural highways, especially in the Northern provinces and regions near Cameroon's border with the Central African Republic.

On March 27, 2006, 11 armed men attacked a group of four U.S. citizens in a private residence (adjacent to a hotel frequented by expatriates) in Kribi, located in the Southern province.
A group of five armed bandits held up and robbed staff and guests of a hotel in Ngaoundere (Adamawa Province) on December 20, 2006.
Similar incidents occurred in the middle of the night at hotels in Bertoua (East Province) on April 22, 2007, and in Yaoundé (Central Province) on May 15, 2007 when assailants broke into hotel rooms and robbed the residents.
Americans were among the victims.
Crimes against property, such as carjacking and burglaries, have often been accompanied by violent acts and have resulted in fatalities.
There were four incidents of armed robberies in the month of April 2007, involving American citizens in or near restaurants in Yaoundé and Bertoua.

In January 2007, a French expatriate was fatally shot in the upscale Bastos neighborhood of Yaoundé.
The woman was dropping off a friend to her residence and interrupted an attempted home invasion.
Upon realizing what was happening, the friend returned to the vehicle and both women attempted to flee the scene.
As they were leaving, an armed bandit shot and fatally wounded the driver of the vehicle.

In September 2007, several expatriates suffered armed attacks.
In one incident, an Israeli citizen giving a ride to a friend was attacked in Bastos by two men with knives.
In the ensuing scuffle, the Israeli was critically wounded.
A Moroccan diplomat was fatally injured while walking near his residence.
Found unconscious by security guards, he was taken to a local hospital where he died the following day.
A Chinese business woman was also robbed and killed outside her home in a neighborhood near Bastos.
All incidents occurred late at night.

In December 2007, a police officer was arrested and jailed in Yaoundé after he and his accomplices surprised a couple returning from Europe and stole a briefcase and jewelry.

In January 2008, three bandits posing as passengers on a bus to Douala – and carrying locally made guns - were intercepted at Bafoussam and apprehended.
In Douala, armed bandits robbed a soap company at gun point, surprising the employees.
They attempted to loot the company’s computers, but were intercepted by a SWAT team and ran off.
Also in January, an Embassy employee using public transportation in the Northwest Province was the victim of highway robbers, who robbed the passengers (including a local mayor) and roughed-up those who did not have enough money.
In February 2008, Cameroon experienced a brief period of civil unrest during a taxi strike that involved road blockages, attacks on public and private vehicles, looting, burning of government and other buildings, and roaming crowds of malcontents.
This period was attended by a sharp increase in reported crimes, including the stabbing death of a night watchman at a residence in Yaoundé, an attack at the Brussels Airline travel agency in the Bonapriso district of Douala, an attack by a group of armed bandits on a motorbike rider who suffered a gunshot wound to the head, and numerous reports of rape and armed attacks with firearms and machetes in Douala.

Recently, many American citizens have become victims of Cameroonian advance-fee fraud and other scams offering antiques, exotic and domesticated animals, and even adoption services through the Internet.
Americans should be very cautious about sending money or traveling to Cameroon to meet someone contacted via the Internet.
Commercial scams targeting foreigners, including many U.S. citizens, continue to be a problem.
The scams generally involve phony offers of lucrative sales and repeated requests for additional funds to pay for unforeseen airport and/or customs fees.
No one should provide personal financial or account information to unknown parties.
The ability of U.S. Embassy officers to extricate U.S. citizens from unlawful business deals and the consequences is limited.
For more information on international financial scams, including those involving Internet dating, a promise of an inheritance windfall, a promise of a work contract overseas, overpayment for goods purchased on-line, or money-laundering, see the Department of State's publication International Financial 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:
Medical facilities in Cameroon are extremely limited.
Even in large cities, emergency care and hospitalization for major illnesses and surgery are hampered by the lack of trained specialists, outdated diagnostic equipment, and poor sanitation.
Medical services in outlying areas may be completely nonexistent.
Doctors and hospitals often require immediate payment for health services in cash.
Pharmacies in larger towns are well stocked, but in other areas many medicines are unavailable.
Travelers are advised to carry their own supply of needed prescription and anticipated over-the-counter medicines.

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

In March 2006, avian influenza (H5N1) was confirmed in wild ducks in northern Cameroon.
There have been no reports of avian influenza among humans in Cameroon.
Avian influenza has been reported in both birds and humans in neighboring Nigeria.
For additional information on avian influenza as it affects American citizens residing abroad, please visit the U.S. Department of State’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 website at http://wwwn.cdc.gov/travel/default.aspx.
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/en.

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

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

Cameroon's road networks, both paved and unpaved, are poorly maintained and unsafe at all times of the year.
Vehicles are poorly maintained and there is no mechanism or requirement to inspect for roadworthiness.
During the rainy season, many roads are barely passable with four-wheel-drive vehicles.
Livestock and pedestrians create constant road hazards (especially at night) and road safety rules are frequently ignored.
There are few road and traffic signs; speed limits are neither posted nor enforced.
Buses and logging trucks travel at excessive speed and are a constant threat to other road traffic.

Travelers on roads near the borders with CAR and Chad should ensure that their vehicles are fully fueled, and that they have adequate cooking fuel, food, and water for several days as well as a reliable means of communication, such as a satellite or cell phone, or radio.

Visitors who are not in possession of a valid passport and a visa may experience difficulties at police roadblocks or other security checkpoints.
It is not uncommon for a uniformed member of the security forces to stop motorists on the pretext of a minor or non-existent violation of local motor vehicle regulations in order to extort small bribes.
Visitors are advised not to pay bribes and to request that the officer provide a citation to be paid at the local court.

Local law states that vehicles involved in an accident should not be moved until the police arrive and a police report can be made.
If an accident results in injury, drivers should be aware of the possibility that a "village justice" mentality may develop.
If an angry crowd forms, drive directly to the U.S. Embassy or another location where you can receive assistance.
Contact the local police once you are safely away from danger.
Cameroon has no real equivalent to 911-type service or roadside emergency telephone numbers, but you can dial 112 in major cities to contact ambulance services.
American citizens should contact the U.S. Embassy (237) 2220-1500 if emergency assistance is needed.
Please refer to our Road Safety page for more information.

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

SPECIAL CIRCUMSTANCES:
While visiting game parks and reserves, tourists should bear in mind that they are ultimately responsible for maintaining their own safety.
Tourists should use common sense when approaching wildlife, maintain a safe distance from animals, and heed all instructions given by guides or trackers.
Even in the most serene settings, the animals in Cameroon's game parks are wild and can pose a threat to life and safety.

Cameroonian Customs authorities may enforce strict regulations concerning temporary importation into or export from Cameroon of items such as large quantities of medicine or wood products.
Customs regulations also restrict the importation of ivory.
Please see our information on customs regulations.

Cash in local currency, the Central African franc (CFA), is the only form of payment accepted throughout the country.
Larger hotels in Yaoundé and Douala will change U.S. dollars and cash traveler's checks, though at a disadvantageous rate.
Credit card cash advances are not available, and most banks do not cash personal or traveler's checks for non-clients.
While credit cards are accepted at some larger hotels and shops in Yaoundé and Douala, caution is urged, as identity theft is endemic in the region.
Some larger banks in Yaoundé and Douala have ATM facilities, and several banks in Cameroon have wire transfer services through Western Union.
The U.S. Embassy does not provide currency exchange, check cashing or other financial services.
Tourists and business travelers should also note that there is an increasing circulation of counterfeit U.S. and Cameroonian currency in the country.
In recent years, business travelers have experienced difficulty in obtaining adequate services from Cameroon's banking sector.
Business travelers are also advised that using the services of a local agent is strongly recommended in establishing a presence in the Cameroonian market.

While photography is not officially forbidden, security officials are sensitive about photographs taken of government buildings, military installations, and other public facilities, many of which are unmarked.
Photography of these subjects may result in seizure of photographic equipment by Cameroonian authorities.
Due to the threat of harassment and the lack of signs designating sites prohibited for photography, photography should be limited to private homes and among friends.
U.S. citizens are advised to seek proper permission before taking a photograph of a specific subject or location.

The government of Cameroon has recently started enforcing laws against homosexuality.
Charges of homosexuality and/or of corruption are also made and enforced indiscriminately in the course of business or personal disputes.

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.
Cameroonian law does not afford many of the protections to which Americans are accustomed, and legal proceedings tend to be complex, lengthy, and subject to inappropriate influence.
Penalties for breaking the law can be more severe than in the United States for similar offenses.
Additionally, the condition of detention centers, while improving, is poor.
Persons violating Cameroonian laws, even unknowingly, may be expelled, arrested or imprisoned.
During the February 2008 civil unrest, there were reports that people were arrested arbitrarily by law enforcement officials quelling the civil disorder that ensued.
Although no expatriates were known to have been arrested, the Department of State cautions Americans against venturing out during such periods of unrest.

Penalties for possession, use, or trafficking in illegal drugs in Cameroon 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 Cameroon are encouraged to register with the U.S. Embassy through the State Department’s travel registration website so that they can obtain updated information on travel and security within Cameroon.
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 in Yaoundé is located on Avenue Rosa Parks in the Mbankolo Quartier, adjacent to the Mount Febe Golf Club; mailing address P.O. Box 817; embassy tel. (237) 2220-1500, fax: (237) 2220-1572.
The Embassy Branch Office in Douala is located on the corner of Rue Ivy and Rue French in the Ecobank Building in Bonanjo, tel: (237) 3342-5331, fax: (237) 3342-7790.
Further information, including the U.S. Embassy's business hours, is available at the U.S. Embassy's web site: http://yaounde.usembassy.gov.
*

*

*
This replaces the Country Specific Information for Cameroon dated 7 June 2007, to update sections on Country Description, Entry and Exit Requirements, Safety and Security, Crime, Aviation Safety Oversight, Criminal Penalties, Children’s Issues, and Registration/Embassy Location.

Travel News Headlines WORLD NEWS

Date: Tue 1 Oct 2019
Source: Outbreak News Today [edited]

Health officials have reported a confirmed case of monkeypox in the Ekondo-Titi health district in South-west region of Cameroon last week. Supportive measures for case management have been put in place, and community-based surveillance has been stepped up in the region.

Monkeypox is a rare disease that occurs throughout remote parts of Central and West Africa, often near tropical rain forests. Fever, headache, muscle aches, swollen lymph nodes, and exhaustion are followed by a rash. Patients are usually ill for 2-4 weeks. Monkeypox is fatal in as many as 10% of people who get it.
===================
[Monkeypox (MPX) cases in Cameroon are not new. MPX cases there were reported last year (2018) (see Monkeypox - Africa (10): Cameroon http://promedmail.org/post/20180605.5838919). The previous ProMED-mail posts on monkeypox cases in Cameroon did not provide numbers of cases (see ProMED-mail. Monkeypox - Africa (09): Cameroon http://promedmail.org/post/20180519.5805270). Monkeypox virus is widespread in central and west Africa, and sporadic human cases occur there.

Monkeypox is a rare viral disease predominantly found in central and west Africa. People get the disease through contact with an infected animal, which can occur in a number of ways. People may be bitten or come into contact with the animal's blood or body fluids. Infection can also occur if a person touches the rash on an infected animal's skin, which sometimes happens during food preparation. Infected people can pass the disease on to other people. Symptoms are similar to smallpox, but milder. They start out flu-like: fever, headache, muscle aches, backache, swollen lymph nodes and a general feeling of discomfort and exhaustion. Within a few days, patients show a rash of raised bumps. The illness lasts 2-4 weeks. There is no specific treatment available for the disease. It is fatal in about 10 percent of all cases [for the central African clade, but seldom fatal for the West Africa clade.

There is no indication of how the above case contracted MPX, but it seems likely to have been from an animal source. The main reservoirs of monkeypox virus are suspected to be rodents, including rope squirrels (_Funisciurus_ spp; an arboreal rodent) and terrestrial rodents in the genera _Cricetomys_ and _Graphiurus_. Halting the bushmeat trade and consumption of wild animals in order to halt MPX virus exposure will be culturally and economically difficult, so continued occasional occurrence of cases can be expected. - ProMED Mod.TY]

[HealthMap/ProMED map available at:
Date: Tue, 29 Oct 2019 20:29:08 +0100 (MET)
By Reinnier Kaze

Yaoundé, Oct 29, 2019 (AFP) - More than 30 people were killed after their houses were swept away Tuesday in a landslide caused by torrential rain in the western Cameroon city of Bafoussam, state media reported, showing images of rescuers desperately sifting the rubble for survivors.   "Searches are ongoing. We fear there are further deaths," a senior local official told AFP, on condition of anonymity, as nightfall neared.   the state-run Cameroon Tribune newspaper, on its Facebook page, said "at least 33 bodies" had been found.   Cameroon Radio Television (CRTV) earlier gave a death toll of around 30 after a score of houses collapsed.

A government statement broadcast on CRTV spoke of a "serious" incident causing "much loss of life" without mentioning a toll.   "The houses that collapsed were built on the side of a hill in a risk zone," said the official of the West Region, of which Bafoussam is the capital, some 300 kilometres (185 miles) northwest of the capital Yaoundé.   He said the landslide was caused by the torrential rain that has fallen in the country over the past few days as well as the wider region, with neighbouring Central African Republic and Nigeria also seriously hit.

Pictures of the tragedy at Bafouassam posted to social media showed ramshackle houses having crumbled into the ochre-coloured terrain and men clad in hard hats digging away at piles of mud in the search for survivors.   Landslides are quite exceptional in the area although further south they are less rare in the rainy season, notably in the English-speaking southwest. It was in the southwestern coastal resort town of Limbe that five people died in a landslide following flooding in July last year.

Beyond Cameroon, the Central African Republic, already mired in a brutal civil war, is reeling from ten days of torrential rain which have plunged swathes of the country underwater, creating a new emergency in one of the world's poorest nations.   Tens of thousands of people have been left homeless after the CAR's largest river, the Oubangui, burst its banks at the height of the country's worst floods in decades which have left parts of the capital Bangui submerged, prompting authorities to warn of the risk of cholera.   Several agrarian states in another Cameroon neighbour, Nigeria, have also been hit by flooding. A torrential downpour Monday allowed dozens of inmates to escape from prison in the central state of Kogi.
Date: Tue 9 Jul 2019
Source: Agence Cameroun Presse [in French, trans. Corr.SB, edited]

A highly contagious disease with faecal-oral transmission, cholera is transmitted by dirty hands or by food contamination and water (contaminated water). According to our colleague, [Journal du Cameroun], 48 deaths due to cholera have been recorded in the northern part of Cameroon.

According to figures compiled on Mon 8 Jul 2019 by the Ministry of Public Health (Minsante), the cholera epidemic, which is raging in the northern part of Cameroon, has already killed 48 people. The northern region, which has been particularly affected by this epidemic for almost a year, has a fatality rate of 6.2%.

Outside the North, the neighbouring Far North region is also affected by the disease, which raises fears of a spread of the disease with the onset of rains in this part of the country. Cholera had also been reported in the southern part of the country, particularly in the Central and Littoral regions, where one death had been registered.

According to the Journal du Cameroun, since the reappearance of the disease last February 2019, 775 reported cases have been counted and confirmed, revealing "an alarming epidemiological situation".

It should be noted that cholera 1st appeared in Cameroon in 1971. Since 1990, major epidemics have been recorded, particularly in 1991, 1996, 1998, 2004, 2010 and 2011. The general trend shows an annual increase in the number of cases. Between 2004 and 2016, epidemiological surveillance reported 50 007 cases with 2052 deaths, a high case fatality rate of 4.1%.

The main epidemics were recorded in the north, in the northern regions and the Far North and in the south of the country in the Littoral region, which is home to the economic capital Douala.  [Byline: Danielle Ngono Efondo]
Date: Thu, 30 May 2019 19:24:40 +0200

Yaoundé, May 30, 2019 (AFP) - Cameroon has declared a public emergency after reporting a polio case in its far north, four years after the virus disappeared from the country, the health ministry said on Thursday.   The confirmed case of polio type 2 was found in the Mada area in the remote north bordering Chad and Nigeria, the ministry said in a statement.   It declared a "new polio epidemic following the confirmation of a case of poliovirus type 2 detected in samples."

A source at the ministry said the outbreak may have been caused in part by a refusal of vaccinations and the cross-border movement of people in the area.   Polio is a highly infectious viral disease which mainly affects young children and can result in permanent paralysis. There is no cure and it can only be prevented through immunisation.   International polio vaccination efforts have run into problems in Pakistan and Afghanistan. Militants and religious leaders in rural areas often tell locals immunisation is part of a shadowy conspiracy to weaken their faith.
Date: Wed, 28 Nov 2018 11:40:16 +0100

Yaoundé, Nov 28, 2018 (AFP) - At least 29 people were wounded Wednesday when a women bomber blew herself up in a border town in Cameroon's Far North, a region frequently hit by Boko Haram jihadists, security sources said.    But a second bomber was shot dead by troops deployed in the town before she could detonate her explosives, the source said.    "A suicide bomber blew herself up this morning in Amchide" on the Nigerian border, a regional security source said, speaking on condition of anonymity and giving a toll of 29 wounded.

The attack occurred on market day when the town was filling up with early-morning shoppers, a local civil defence group official said.    "There were many people hurt, I saw about 20," he said. "After the attack, the market emptied."   A once-bustling trade hub, in 2014 Amchide was thrust into the forefront of a major battle between Cameroonian troops and Boko Haram militants who held the nearby Nigerian town of Banki for several months.    The violence forced most residents to flee the town, although some have now begun to return.    After pushing back Boko Haram, the Cameroonian army dug long trenches around Amchide and even inside the town to foil new incursions by the jihadists, with Wednesday's attack the first in many months.
More ...

Ukraine

Ukraine - US Consular Information Sheet
March 28, 2008
COUNTRY DESCRIPTION:
Ukraine is undergoing profound political and economic change as it moves from its Soviet past toward a market economy, multi-party democracy, and integration into
uro-Atlantic and other international institutions.
In recent years, the availability of goods and services has increased along with increased rates of growth in Ukraine's economy, and facilities for travelers have improved somewhat.
Nonetheless, the availability of travel and tourist services remains uneven throughout the country, and Ukraine still lacks the abundance of many of the goods and services taken for granted in other countries.
Read the Department of State Background Notes on Ukraine for additional information.

ENTRY/EXIT REQUIREMENTS: Depending on the length and purpose of travel, U.S. citizens may or may not be required to get a Ukrainian visa prior to coming to Ukraine.
A passport valid for six months beyond the planned date of travel is required.
According to Ukrainian Presidential Decree #1008, dated June 30, 2005, U.S. citizens are exempt from the requirement to have a Ukrainian visa as long as the duration of their stay in Ukraine does not exceed 90 days and the purpose of their travel is tourism, private travel, or business. U.S. citizens whose planned stay in Ukraine exceeds 90 days, and so consequently bears the characteristics of a long-term stay, must have visas authorizing their entry into Ukraine. If the purpose of their visit is other than tourism, private travel, or business, an appropriate visa must be obtained. U.S. citizens may apply for all types of visas through Ukrainian Embassies and Consulates overseas. A list of required documents for the visa application will be determined based on the purpose and length of travel on a case-by-case basis. Contact details for Ukrainian Embassies and Consulates are available on the Ministry of Foreign Affairs of Ukraine web site at http://www.mfa.gov.ua/mfa/en/305.htm.

Visas may be obtained from the Consular Office of the Embassy of Ukraine in Washington, DC, or from Ukrainian Consulates General in New York, Chicago, or San Francisco.
For additional information about Ukrainian visas and related policy, please contact the Ukrainian Embassy or Consulate nearest you.

Embassy of Ukraine
3350 M Street, NW
Washington, D.C. 20007
Tel: (202) 333-0606
Fax: (202) 333-0817
Web site: http://www.mfa.gov.ua/usa/en/
Consulate General of Ukraine in New York
240 East 49th Street
New York, NY 10017
Tel: (212) 371-5690
Fax: (212) 371-5547
Web site: http://www.ukrconsul.org/
Consulate General of Ukraine in San Francisco
530 Bush Street, Suite 402
San Francisco, CA 94108
Tel: (415) 398-0240
Fax: (415) 398-5039
Web site: http://www.ukrainesf.com/
Consulate General of Ukraine in Chicago
10 East Huron St.
Chicago, IL 60611
Tel: (312) 642 4388
Fax: (312) 642 4385
Web site: http://www.ukrchicago.com/
The Government of Ukraine does not issue visas at the point of entry into Ukraine.
Travelers whose purpose of travel puts them in a category that requires a visa must obtain the correct Ukrainian visa prior to arrival; otherwise they will be turned back to the United States or will have to travel to another country to obtain a visa.

Please check your visa carefully upon receipt and pay careful attention to validity dates.
Each traveler is responsible for understanding the type of visa issued and the provisions of the visa.
Frequently, American citizens are refused entry to Ukraine because they thought they possessed a multiple entry visa, but in fact their visa was valid for only a single entry; Americans occasionally try to reenter Ukraine after using their single-entry visa, believing they have unlimited travel for six months.
In some cases, Americans attempt to enter Ukraine before their visa becomes valid.
This is a common mistake, since in Ukraine the date is written day-month-year, not month-day-year.
Thus, a visa issued on 01/05/07 is valid from May 1, 2007 and NOT from January 5, 2007.
Such travelers can be detained at the port of entry, refused admission and sent back to the country from which they traveled.
The U.S. Embassy in Kyiv is unable to assist travelers in these situations.

All foreigners entering or staying in Ukraine must be registered with Ukrainian authorities. American Citizens traveling to or staying in Ukraine are reminded that recent changes to Ukrainian immigration law change the registration procedures for short-term stays. The registration for short-term visits of up to 90 days is completed at the border by the customs offices.
Such registration is valid for 90 days out of each period of 180 days; the calculation of the 90-day period begins from the date of first entry into Ukrainian territory.

The initial registration for both short- and long-term visits to Ukraine, with or without a visa, is accomplished at the border when entering Ukraine.
Future extensions for stays exceeding 90 days are completed through the Ukrainian Ministry of Internal Affairs’ Office of Citizenship, Immigration and Registration (OVIR).
Most cities will have several OVIR offices.
Extensions are not automatic, however, and are valid only for continued presence in the country.
It is not possible to depart Ukraine and return on the extension, nor can an adjustment to visa status be made from within Ukraine. Applications for extension of registration should be submitted at least three days before the current registration expires.

Travelers who intend to visit Russia from Ukraine must also have a Russian visa.
The Consular Section of the Russian Embassy in Ukraine is located at Prospekt Kutuzova 8, tel.: (380-44) 284-6816, fax 284-7936, e-mail: general@rucons.kiev.ua, http://www.embrus.org.ua.

Visitors to Ukraine should also note that Ukrainian law requires them to obtain mandatory health insurance.
For more information see the section on Medical Insurance below.

Visit the Embassy of Ukraine’s web site at http://www.mfa.gov.ua/usa/en/1609.htm for the most current visa information.
Also, see the Ukrainian Ministry of Foreign Affairs’ web site at http://www.mfa.gov.ua/usa/en or http://www.ukraineinfo.org/.

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 Regulations sheet and visit the Ukrainian State Customs Service web site at http://www.customs.gov.ua/dmsu/control/en/index.

SAFETY AND SECURITY:
Ukraine is largely free of significant civil unrest or any organized anti-American domestic political movements.
However, occasionally, mass demonstrations occur in larger cities, such as Kyiv, and are usually sponsored by individual political forces.
In 2008, there has been an upsurge in the number of pro-Russian anti-NATO protests.
These protests are likely to increase in size and frequency as Ukraine pursues closer ties to the alliance.
While the majority of these protests are small and peaceful, they can still result in violence and it is best to avoid such gatherings.

There also have been increasing incidents of racially-motivated violence; groups of “skinheads” and neo-Nazis target people of Asian, African, or other non-European descent, as well as religious minorities, in Kyiv and throughout Ukraine (see the section on Crime below).

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, including the Worldwide Caution, can be found.

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

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

CRIME:
Ukraine is undergoing a significant economic, political, and social transformation, and income disparities have grown sharply.
As a result, foreign visitors may be perceived as wealthy targets for criminals.
Americans often stand out in Ukraine, and are therefore more likely to be targeted than in Western European countries, where incomes are higher and Americans may blend in better.

Most street crime ranges from various scams, simple pocket picking, purse snatching, and theft of personal items from parked cars, to mugging, armed robbery, or the drugging of unsuspecting victims at nightspots and bars (where they are then robbed).
Cases of assaults in apartment building corridors, elevators, and stairwells, as well as armed break-ins and crimes involving small caliber firearms have also been reported.
Please see the Embassy’s web site for additional security information for Americans at http://kyiv.usembassy.gov/amcit_security_eng.html.

A commonly reported scam in Kyiv is”The Wallet Scam”, which involves a person dropping a wallet or a packet of money near a potential victim. After the victim picks up the wallet and attempts to return it to the individual who “dropped” it, the perpetrator then claims that the wallet is missing money which the victim stole.
The perpetrator either threatens to call the police if the victim does not pay, or asks the victim to show his or her wallet to the perpetrator to ensure that the victim did not take any money.
When the victim produces his or her wallet, the perpetrator grabs the money and flees.
Another variant involves a second person who claims to be a police officer – who is of course involved in the crime – who approaches the victim after the wallet has been picked-up.
This second person also asks to see the wallet, grabbing the money and fleeing or, through sleight-of-hand, stealing the victim’s money.

While most travelers do not encounter problems with crime in Ukraine, there has been an increase in the number of hate crimes directed at ethnic and religious minorities over the past few years. Many of these incidents are conducted by “skinheads” or neo-Nazis in Kyiv, but similar crimes have also been reported throughout the country. In Kyiv, these incidents have occurred without provocation in prominent downtown areas commonly frequented by tourists.
While the majority of people targeted have been of Asian, African, or other non-European descent, all travelers should exercise caution.
In addition to incidents of assault, racial minorities may be subject to various types of harassment, such as being stopped on the street by both civilians and law enforcement officials. Individuals belonging to religious minorities have also been harassed and assaulted in Kyiv and throughout Ukraine.

The police and government’s slow response to hate crimes is a continuing concern.
Although senior Government of Ukraine officials (including the President and Prime Minister) have publicly deplored these hate crimes and groups, Ukrainian street level law enforcement activities are unable to effectively deter hate crimes or adequately protect racial minorities.
The Embassy has received numerous reports from victims of violent hate crimes, as well as from bystanders, stating that uniformed police officers observed the assaults and did nothing to prevent the attacks, to assist the victims afterward, or to investigate and apprehend the attackers.
The Government of Ukraine took initial steps to address the problem in the final months of 2007 with the establishment of special law enforcement units to prevent and investigate hate crimes in Ukraine.
It remains to be seen if these units will be effective.

Credit card and ATM fraud is widespread.
Ukraine operates as a cash economy, and money scams are widespread.
Although credit card and ATM use among Ukrainians is increasingly common, it is nevertheless strongly recommended that visitors and permanent residents of Ukraine refrain from using credit cards or ATM cards except at major international establishments.

Burglaries of apartments and vehicles represent a significant threat to long-term residents.
Although few cars are actually stolen, primarily because of increased use of alarm systems and security wheel locks, vehicular break-ins and vehicular vandalism are common.

Ukraine lacks reliable tourist and travel services for foreign victims of crime.
Transferring funds from the United States, replacing stolen traveler’s checks or airline tickets, or canceling credit cards can be difficult and time consuming.
There are few safe low-cost lodgings, such as youth hostels.
Public facilities in Ukraine are generally not equipped to accommodate persons with physical disabilities.

Over the past several years, the Embassy has received a number of reports of harassment and intimidation directed against foreign businesspersons and interests.
While these reports have become much less frequent in recent years, they have not ended entirely.
Reported incidents range from physical threats (possibly motivated by rival commercial interests tied to organized crime), to local government entities engaging in such practices as arbitrary termination or amendment of business licenses, dilution of corporate stock to diminish U.S. investor interest, delays of payment or delivery of goods, and arbitrary “inspections” by tax, safety or other officials that appear designed to harm the business rather than a genuine attempt at good governance. American business entities are encouraged to read the Corruption, Money Laundering and Organized Crime section of the 2007 Crime Report for Ukraine at http://kyiv.usembassy.gov/amcit_crimereport_eng.html.
American businesses and other private sector organizations are also encouraged to read the most recent Overseas Security Advisory Council (OSAC) Annual Crime and Safety Report for Ukraine at https://www.osac.gov/Regions/country.cfm?country=42.

Computer fraud is also becoming more common in Ukraine.
Internet scams appear to be on the rise.
The Embassy suggests refraining from wiring money unless the recipient is well-known and the purpose of business is clear.
American citizens have reported transferring money to Ukraine to pay for goods purchased from residents of Ukraine via online auction sites, but never receiving the goods in return.
The Embassy regularly receives complaints from Americans regarding scams involving marriage and dating services.
Numerous Americans have lost money to agencies and individuals that claimed they could arrange for student or fiancée visas to the U.S.
Additional information is available on our web site in a document titled “Marriage Brokers” at http://kyiv.usembassy.gov/amcit_marriage_eng.html and on the Department of State’s web site under Ukraine: Internet and Other Fraud Schemes.

In many countries around the world, counterfeit and pirated goods are widely available.
Transactions involving such products may be illegal under local law.
In addition, bringing them back to the United States may result in forfeitures and/or fines.
More information on this serious problem is available at http://www.cybercrime.gov/18usc2320.htm.

INFORMATION FOR VICTIMS OF CRIME:
The loss or theft abroad of a U.S. passport should be reported immediately to the local police and the nearest U.S. Embassy or Consulate.
If you are the victim of a crime while overseas, in addition to reporting to local police, please contact the nearest U.S. Embassy or Consulate for assistance.
The Embassy/Consulate staff can, for example, assist you to find appropriate medical care, contact family members or friends and explain how funds 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 provide a list of local attorneys who have informed the Embassy that they are willing to take foreign clients.

See our information on Victims of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION:
In December 2005, Ukraine reported the first cases of H5N1 (“avian influenza,” "avian flu," "bird flu," "chicken flu") among birds in Crimea.
Further outbreaks followed in 2006.
On January 18, 2008, another outbreak of the H5N1 avian influenza virus was detected at a poultry farm in the Krasnogvardiyskyi Rayon in Crimea. There are no registered human cases of H5N1 in Ukraine.
For detailed information on H5N1, please review the Avian Influenza Fact Sheet.

The U.S. Embassy maintains a list of hospitals and clinics with some English-speaking staff.
Many facilities have only limited English speakers.
There are no hospitals in Ukraine that provide a level of medical care equal to that found in American hospitals, or which accept American health insurance plans for payment (see the section on Medical Insurance below).
Some facilities are adequate for basic services.
Basic medical supplies are available; however, travelers requiring prescription medicine should bring their own.
Elderly travelers and those with existing health problems may be at risk due to inadequate medical facilities.
When a patient is hospitalized, the patient, relative, or acquaintance must supply bandages, medication, and food.
The Embassy recommends that ill or infirm persons not travel to Ukraine.
The Embassy also recommends that travelers obtain private medical evacuation insurance prior to traveling to Ukraine.

Medical evacuation remains the best way to secure western medical care.
This option, however, is very expensive and could take at least several hours to arrange.
Travelers may wish to purchase medical evacuation insurance prior to travel, or have access to substantial lines of credit to cover the cost of medical evacuation.
The Consular Section of the U.S. Embassy has information on various air ambulance companies that perform medical evacuations to Europe or to the U.S.
Serious medical problems requiring hospitalization and/or medical evacuation to other European countries can cost from $25,000 to $50,000, and to the U.S. as much as $70,000 or more.
More information can be found on the U.S. Embassy's web site in the document “Medical Services in Kyiv” at http://usembassy.kiev.ua/amcit_medical_serv_eng.html.

Please note that while the Embassy can help American travelers and their families make contact with a medical evacuation service, the U.S. Government cannot pay for medical evacuation.
Travelers should make sure they have medical evacuation insurance, which is available from many private companies, or have funds available for evacuation, should the need arise.

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, http://wwwn.cdc.gov/travel/default.aspx.
Tuberculosis is an increasingly serious health concern in Ukraine.
For further information, please consult the CDC’s Travel Notice on TB at http://wwwn.cdc.gov/travel/yellowBookCh4-TB.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.

RADIATION AND NUCLEAR SAFETY:
In 1986, the Chornobyl incident resulted in the largest short-term, unintentional, accidental release of radioactive materials to the atmosphere ever recorded.
The highest areas of radioactive ground contamination occurred within thirty kilometers of the Chornobyl nuclear power station.
The city of Kyiv was not badly affected because of the wind direction, but it was not completely spared.
The last operating reactor at the Chornobyl Nuclear Power Plant site closed officially on December 15, 2000. All identified stabilization measures on the existing sarcophagus are complete, and preparatory work to start construction of the new shelter is almost nearing completion. The contract for the new Chornobyl shelter was awarded in September 2007 and its construction is projected to be completed in 2012.

The Ukrainian government has an effective program of monitoring fresh foods and meats sold in local markets.
Street purchase of produce should be avoided.
Wild berries, mushrooms, and wild fowl and game should be avoided, as these have been found to retain higher than average levels of radiation.
Background levels of radiation are monitored regularly by the Embassy and, to date, have not exceeded the level found on the Eastern seaboard of the United States. If external radiation levels are high enough to require evacuation, the U.S. Embassy will notify the American community through the Embassy warden e-mail and text messaging system.

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.

The Ukrainian parliament passed a law in 1997 whereby all visitors to Ukraine are required to obtain mandatory health insurance. According to information from the Ukrainian authorities, the cost of this medical insurance depends on the anticipated length of a foreigner's stay in Ukraine.
The cost for the insurance is approximately 25 cents per day (more for short stays).
This required insurance can be purchased after arrival and covers only the costs of basic medical care inside Ukraine; it does not cover medical evacuation.
Failure to purchase mandatory health insurance often results in refusal of treatment at Ukrainian public hospitals and clinics.
Private clinics do not require Ukrainian public health insurance, but can be as expensive as similar clinics in the United States and may require payment in advance
More information can be found online in Ukrainian at http://www.pro100.com.ua, or by calling +38 (044) 206 2885 from abroad or 8-800-500-1080 from within Ukraine.

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 Ukraine is provided for general reference only, and may not be totally accurate in a particular location or circumstance.

Generally, roads in Ukraine outside major urban areas are in poor condition and are poorly lit.
Visitors should drive defensively at all times, since local drivers often disregard traffic rules.
Drivers are often poorly trained or drive without a valid driver's license.
Drivers can also be very aggressive, and they normally do not respect the rights of pedestrians, even at clearly marked pedestrian crossings.
Pedestrians should also be aware of cars driving or attempting to park on sidewalks.
Many cars do not meet the safety standards common in America.

Due to heavy traffic and congested roads, vehicle accidents are a common occurrence in larger Ukrainian cities, especially in Kyiv. In Ukraine, it is mandatory for motorists involved in vehicle accidents not to remove the vehicle from the site of the accident, unless it presents a clear safety concern. Local police must be notified and will report to the scene to conduct an investigation. Persons should be prepared to wait until the police arrive and complete their report. Due to traffic and slow response, it may take up to several hours for police to arrive. When police arrive, they will ascertain responsibility, take the drivers’ personal information, and file a report of the accident.

Cross-country travel at night and in winter can be particularly dangerous.
The Embassy strongly recommends that visitors and permanent residents of Ukraine refrain from driving their private vehicles after dark outside of major cities.
However, major roads are drivable during daylight hours.
Roadside services such as gas stations and repair facilities are becoming more common, particularly on the main national and regional overland highways and in large and mid-size cities.

Nonetheless, such services are far from American standards, and travelers should plan accordingly.
There have been isolated reports of carjackings of western-made or foreign-registered cars.
There has also been an increase in the number of documented reports of criminal acts (primarily theft) occurring on trains and other modes of public transport.

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 Ukraine’s Civil Aviation Authority as not being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for the oversight of Ukraine’s air carrier operations.
For more information, travelers may visit the FAA’s web site at http://www.faa.gov/safety/programs_initiatives/oversight/iasa.

SPECIAL CIRCUMSTANCES:
Ukraine does not recognize dual nationality.
American citizens entering Ukraine with a Ukrainian passport will be treated as Ukrainian citizens by the local authorities.
This may include being required to perform mandatory military service.
Also, Ukrainians who have immigrated to the U.S. without obtaining the proper exit visa from Ukrainian authorities may be subject to civil or criminal penalties, and will be required to obtain an exit visa before returning to the U.S.
For additional information, see the Consular Affairs web site at http://travel.state.gov/index.html for our Dual Nationality flyer.

Ukraine is a cash economy.
Traveler’s checks and credit cards are gaining wider acceptance in larger cities.
Even in Kyiv, however, acceptance of credit cards is not nearly as widespread as in the U.S. or in Western European countries.
Expect credit card use to be limited to major hotels, upscale restaurants, international airlines, and the rapidly growing, but still select number of up-market stores.

Exchanging U.S. dollars into the national Ukrainian currency, hryvnya, is simple and unproblematic, as licensed exchange booths are widespread, and exchange rates are normally clearly advertised.
Currency exchange is only legal at such licensed exchange booths, banks, and currency exchange desks at hotels; anyone caught dealing on the black market can expect to be detained by the local militia.

There are many banks and licensed currency exchange booths located in major cities.
ATMs (a.k.a. bankomats) are becoming more common throughout Ukraine, particularly in Kyiv and in other larger cities.
In smaller cities and towns, ATMs are still virtually non-existent.
Most ATMs disperse cash only in the local currency, hryvnya. The difficulties of a currency shortage can be avoided by coming to Ukraine with a sufficient supply of hard currency to cover necessary obligations during travel.
Funds may be transferred by wire, advances may be drawn on credit cards, and traveler’s checks may be cashed at many locations.
Again, the Embassy emphasizes that the incidence of credit card and ATM bankcard fraud is high, and strongly recommends that visitors and permanent residents of Ukraine refrain from using local ATMs.

Customs regulations prohibit sending cash, traveler’s checks, personal checks, credit cards, passports, or other forms of identification through the international mail system, as well as via courier mail (FedEx, DHL, etc.).
Customs authorities regularly confiscate these items as contraband.
Ukrainian customs authorities may also enforce strict regulations concerning temporary importation into or export from Ukraine of items such as firearms, antiquities, currency, etc.
It is advisable to contact the Embassy of Ukraine in Washington, or one of Ukraine's consulates in the United States for specific information regarding customs requirements.
As in many countries around the world, counterfeit and pirated goods are widely available.
Transactions involving such products are illegal and bringing them back to the United States may result in forfeitures and/or fines.

Ukrainian law requires that travelers declare all cash and jewelry, regardless of value, upon entering Ukraine.
Travelers should fill out a customs declaration and ask customs officials to stamp it.
According to Ukrainian law, foreign citizens may bring up to $15,000 in cash, or up to $30,000 in traveler’s checks, into Ukraine without a special license.
A traveler must declare the imported currency.
If customs officials determine that a traveler entering or exiting the country is carrying undeclared currency, they can and often do confiscate the undeclared funds.
When leaving the country, foreign travelers are only allowed to take out a maximum of $3,000 in cash, or as much cash as they declared upon their entry into Ukraine.
If a traveler wants to take out more than $3,000, the traveler must have a customs declaration proving that he or she in fact brought the corresponding sum of money into the country.

Travelers desiring to bring more than $15,000 into Ukraine must obtain a special license AFTER entering the country.
Details for obtaining this license are available on the Embassy's web site in the document “Ukrainian Customs: Procedures for Transporting Currencies, Monetary Instruments, or Precious Metals” at http://kyiv.usembassy.gov/amcit_travel_ukrcustoms_eng.html.
Ukraine has strict limitations for the export of antiques and other goods and artifacts deemed to be of particularly important historical or cultural value.
This includes any items produced before 1950.

Ukraine is a developing democratic nation undergoing significant political, economic, and governmental reform.
This includes reform of police and emergency services.
Visitors should be aware that although Ukrainian police and emergency services have made much progress, they still generally remain below Western European and U.S. standards in terms of training, responsiveness, and effectiveness.
American citizens have reported waiting sometimes hours for Ukrainian police and ambulance services to respond to calls for emergency assistance.
Although this may generally be atypical, it does nevertheless occur.

It is advisable to contact the Embassy of Ukraine in Washington, or one of Ukraine's consulates in the United States, for specific information regarding customs requirements.
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 Ukraine’s laws, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in Ukraine 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 Ukraine are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department’s travel registration web site and to obtain updated information on travel and security within Ukraine.
Americans without Internet access may register directly with the nearest U.S. Embassy or Consulate.
By registering, American citizens make it easier for the Embassy or Consulate to contact them in case of emergency.

The Consular Section of the U.S. Embassy is located at #6 Mykoly Pymonenka St., 01901 Kyiv, Ukraine. Telephone: (38-044) 490-4422, fax 486-3393. The American Citizen Services unit is located at the same address and can be reached at (38-044) 490-4445
The Embassy is located at #10 Yuriy Kotsyubynsky St. 01901 Kyiv, Ukraine. Tel.: (38-044) 490-4000.
* * *
This replaces the Country Specific Information Sheet dated February 15, 2008 to update the sections on Safety and Security and Crime.

Travel News Headlines WORLD NEWS

Date: Mon 28 Oct 2019, 12:41 PM
Source: 112 International [edited]

"A total of 15 students of the secondary school No. 7 in Chernihiv were hospitalized with suspicion of hepatitis A on [28 Oct 2019]," the press service of Ukraine's State Emergency Service reports. It is noted that at the moment a complex of epidemic prevention measures are being carried out.

Besides, a 2018 hepatitis outbreak was spotted in Mykolaiv -- 47 people were hospitalized with a confirmed diagnosis.
========================
[With this number of cases admitted with the suspicion of acute hepatitis A on the same day, it is likely that a point-source outbreak related to a food or water source occurred. The definitive test for the disease is the finding of IgM anti-HAV in the blood.

Chernihiv, also known as Chernigov, is a historic city in northern Ukraine, which serves as the administrative centre of the Chernihiv Oblast (province), as well as of the surrounding Chernihiv Raion (district) within the oblast. - ProMED Mod.LL]

[HealthMap/ProMED map available at:
Date: Thu 24 Oct 2019 (accessed Mon 28 Oct 2019)
Source: Ministry of Health, Ukraine, press release [in Ukrainian, machine trans., edited]

In Ukraine, the 1st confirmed case of vaccine-associated paralytic polio has occurred in a 2 year old child from Volyn Oblast. The parents deliberately refused the vaccinations provided by medical standards. Recent cases of illness in Ukraine were recorded in 2015 and 2017.

Pathogenesis of the disease
---------------------------
Sources of the disease: a person who is ill or a carrier that carries the virus asymptomatically. Fecal-oral routes (dirty hands, water, contaminated food, excrement) and airborne droplets are considered as transmission routes.

Symptoms: In most cases, the disease first goes unnoticed, which worsens the patient's chances of recovery; then there are signs that are different in nature, depending on the form of the virus. You can learn more about the symptoms on the website of the Public Health Center at <https://old.phc.org.ua/pages/diseases/other_social_diseases/poliomyelitis>  [in Ukrainian]

The incubation period of the disease is 2-35 days, more often 7-14 days. The following types of disease are classified: with and without lesions of the central nervous system (CNS). It should be noted that even atypical poliomyelitis (without lesion of the CNS) is capable of seriously harming the patient. They all pose a significant threat to the unvaccinated person and cause irreversible processes that can lead to death.

Myths and refutations
---------------------
On World Polio Day [24 October], the Ministry of Health of Ukraine dispels myths that provoke refusal of immunization. Common among parents is talk about the dangers of vaccination and the side effects of vaccination. You can read more about refuting these stereotypes at <https://moz.gov.ua/article/health/9-mifiv-pro-vakcinaciju> [in Ukrainian].

Why are vaccines safe?
----------------------
The Global Polio Eradication Initiative is using several vaccines to combat the disease. In Ukraine, there are 2 types -- the inactivated polio vaccine (IPV) and the oral polio vaccine (OPV). Both vaccines are purchased through the United Nations Children's Fund (UNICEF) and have a World Health Organization  ualification that guarantees quality and ongoing monitoring of manufacturers. For more information on vaccine production standards, go to: <https://moz.gov.ua/article/news/nichogo-krim-pravdi-5-faktiv-pro-vakcini>  [in Ukrainian]

The WHO website explains:
- OPV is one of the safest vaccines invented by humanity and used to immunize newborns;
- it is so safe that it can be used even when the baby is sick;
- OPV is used several times to achieve the maximum immunity of the vaccine, but the increase in the number of vaccinations does not increase the risk of side effects.

Where, when, and who should be vaccinated?
------------------------------------------
Polio vaccination is required from the birth of a baby. Vaccination must be carried out in a comprehensive manner, without missing any dose, to increase the body's resistance to the disease.
1st dose - at 2 months of baby's life;
2nd dose - at 4 months;
3rd dose - at 6 months;
4th dose - at 18 months;
5th dose - at 6 years;
6th dose - at 14 years.

Free polio vaccination is available from your family doctor or pediatrician at public health facilities, as well as from private contractors with the National Health Service of Ukraine. More information is available at <https://moz.gov.ua/article/immunization/chomu-v-aptekah-i-privatnih-klinikah-mozhe-ne-buti-vakcin-ta-de-zrobiti-scheplennja-bezoplatno> [in Ukrainian].

The only way to protect yourself and your children from the effects of this disease is vaccination, as there is no specific treatment. The Ministry of Health of Ukraine recommends that you consult the calendar of preventive vaccinations at <https://moz.gov.ua/article/immunization/kalendar-profilaktichnih-scheplen>  [in Ukrainian]
--------------------------------------
communicated by:
Viki Hansen-Landis, RN, MPH
Medical Information and Analysis team, International SOS
======================
[According to information from the Global Polio Eradication Initiative, Ukraine had 2 cases of cVDPV1 confirmed in 2015 (see <http://polioeradication.org/polio-today/polio-now/this-week/circulating-vaccine-derived-poliovirus/> for table of cVDPVs by type and year, and see Poliomyelitis update (05): Ukraine, vaccine-derived, WHO http://promedmail.org/post/20150901.3616558 and Poliomyelitis update (04): Ukraine, 2 cases, RFI http://promedmail.org/post/20150901.3616015 for details on these cases). No additional cases of cVDPV were reported by the Ukraine to WHO in 2017. If there is additional information on case(s) reported in 2017, ProMED-mail would greatly appreciate receiving it, as well as information on the serotype of cVDPV associated with this current case.

The addition of this case will bring the total number of cVDPV associated cases confirmed with date of onset in 2019 to 103, and the number of countries reporting cVDPV associated paralytic cases to 20.

Maps of Ukraine can be seen at
and <http://healthmap.org/promed/p/123>.
Volyn oblast is located in the north west of Ukraine, sharing a border with Poland to the west and Belarus to the north. - ProMED Mod.MPP]
Date: Thu, 22 Aug 2019 19:34:04 +0200 (METDST)

Kiev, Aug 22, 2019 (AFP) - Around 200 anti-vaccine protesters rallied in central Kiev Thursday after authorities threatened to ban unvaccinated children from schools in Ukraine, which has been hit by a deadly measles outbreak.   Ukraine has one of the lowest vaccination rates in Europe and has recorded more than 57,000 measles cases since the start of the year, including 18 deaths.

This is a record number of cases since the country gained independence from the Soviet Union in 1991.    "I came here with my child to protect her right for education without vaccination, without injecting poison into her blood," said 29-year-old Iryna Lazutkina, who was at the protest with her young daughter.   "Vaccination is a ticking time bomb," she said, suggesting that it could lead to allergies, autoimmune diseases and even cancer -- claims which are not backed up by medical research.    Authorities blame distrust of vaccines among a section of the population, as well as an earlier shortage of medical supplies, for the current outbreak.   In mid-August, the government threatened to ban unvaccinated children from schools.    This year the health ministry organised mass vaccinations in schools in areas most affected by the crisis.

Acting health minister Ulyana Suprun last week warned of the likelihood of diphtheria and tetanus outbreaks because of low vaccination rates.   But the protesters, many of them young parents with children, insisted they had the right to refuse vaccinations.    "I am for free choice and against discrimination," said Alla Fedorchuk, a 25-year-old who travelled to the capital from the western city of Lutsk.    Her three-year-old son has not been vaccinated. Fedorchuk said a relative suffered side effects after vaccination.

Some protesters carried banners that read "Forced medical intervention is a crime."    Kateryna Bulavinova, a consultant with the UN children's agency UNICEF, said local doctors' lack of knowledge about vaccines was a reason why many missed out on them.   Bulavinova said that doctors and nurses must explain to patients in detail how the vaccine works and what kind of reactions are normal.    "When there is this understanding, the fear goes away," she said.   According to the UNICEF survey, Ukrainians were most likely to be put off vaccines because of fears of side effects or a distrust of the manufacturers.   There is growing concern over global public resistance to vaccinations.

Measles cases nearly tripled globally during the first seven months of the year compared to the same period in 2018, the World Health Organization (WHO) said this month.    Measles, which is highly contagious, can be entirely prevented through a two-dose vaccine, but the WHO has in recent months sounded the alarm over vaccination rates.    The airborne infection causing fever, coughing and rashes can be deadly in rare cases and had been officially eliminated in many countries with advanced healthcare systems.
Date: Wed 14 Aug 2019
Source: Unian [abridged, edited]

Director of the Department of Health of Kyiv Valentyna Hinzburh has said that an outbreak of measles in Kyiv has become the largest since the independence of Ukraine.

According to her, over 5000 people fell ill with measles in Kyiv in 6 months of 2019, of which almost 3000 were adults. This is 3 times the figure recorded in the same period of 2018. About 50% of patients required hospitalization due to the severe course of the disease. This year [2019], 2 adults died from measles, as they were not vaccinated and reported to the doctor too late.

Ukraine is among the countries that have reported the highest numbers of measles cases in 2019.

"Today, nothing but vaccines will protect Kyiv from outbreaks and epidemics of vaccine-preventable infectious diseases," Hinzburh said. She said the current situation in the capital and Ukraine as a whole was a result of reduced collective immunity. "Here are just a few figures that are staggering. In 2015, 5 people got measles in Kyiv, 3 in 2016, 87 in 2017, 3045 in 2018, and over 5000 for 6 months in 2019!" she said.
Date: Sun 21 Jul 2019
Source: Outbreak News Today [edited]

A foodborne illness outbreak is being investigated by the Rivne OLC of the Ministry of Health of Ukraine. Between 15-18 Jul 2019, 84 acute gastrointestinal disease cases were reported, including 52 cases in Zdolbunivskyi district. 61 people required hospitalization, including children.

Preliminary results in the investigation links the illnesses to the consumption of dishes at the celebration of the wedding and birthdays from 13 and 14 Jul 2019 at the cafe "Gourmet" in the Mizoch village. 92 persons, including 84 patients and 8 employees of the café "Gourmet" have been cultured and tested trying to determine an aetiology. On 18 Jul 2019, in the 1st 4 patients, _Salmonella_ Enteritidis was isolated and identified. A microbiological study was carried out on samples of rinses from environmental objects on BGKP [bacteria of the _Escherichia coli_ group], samples of drinking water and samples of food products.

Cafe Gourmet has been closed since [Mon 18 Jul 2019].

Specialists of Dezhkprodskopyvsnoj region in the Rivne region conducted an inspection of the cafe and found the following inadequacies: the fixed capacity (cafe "Gourmet") was not registered in the State Register of capacity of market operators, there was no branch for washing and processing of raw vegetables, violation of the technology of cooking, no room for cleaning, disinfection, and storage working tools and equipment (2 washing baths were located directly in the cooking compartment), creation of cross flows between prepared dishes and raw materials, equipment and tools were kept in improper condition and conditions (no dishes for drying dishes), there were no thermometers in refrigerators, no labelling of kitchen utensils and inventory, no menus and technological and costing cards, no accompanying documents for foodstuffs and raw materials.
=========================
[The vehicle for transmission is not clear but there would be more than one given the many issues with kitchen hygiene described. This allows a significant risk of cross-contamination. - ProMED Mod.LL]

[HealthMap/ProMED-mail map: <http://healthmap.org/promed/p/65153>]
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Pitcairn Islands

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Travel News Headlines WORLD NEWS

Date: Fri, 13 Apr 2007 22:07:35 +0200 (METDST) WASHINGTON, April 13, 2007 (AFP) - A strong earthquake shook the bed of the southeast Pacific ocean west of Chile on Friday, the United States Geological survey reported. The quake, measuring 6.1 on the open-ended Moment Magnitude scale, struck the southern part of the East Pacific Rise, an expanse of sea floor lying between South America and the islands of the South Pacific, at 1824 GMT. The epicenter was 6.2 miles (10 kilometers) underwater at a point more than 1,960 miles (3,200 km) west of the Chilean coastal town of Osorno and 1,440 miles (2,320 km) east-southeast of the tiny British territory of Pitcairn Island. The Moment Magnitude scale measures the area of the fault that ruptured and the total energy released.
Date: Tue, 11 Jan 2005 05:32:57 +0100 (MET) AUCKLAND, Jan 11 (AFP) - The British government is seeking social workers for the remote Pitcairn islands, a community riven by sex abuse where six men including the mayor were last year convicted of multiple under-age sex crimes. Safe Overseas Services has placed advertisements in New Zealand newspapers to find social workers for Pitcairn, Britain's last territory in the Pacific and one of the world's most isolated communities. The three-month posting, paid for by the British government, will see successful applicants work in a community of less than 50 people, the New Zealand Herald reported Tuesday. While the advert says applicants should have an understanding of the dynamics of sexual abuse for victims and offenders, it does not specifically refer to the traumas the Pitcairn community faced last year during the trials. In addition to the six found guilty of rapes and indecent assaults on the tiny island's young female community over nearly 40 years, six more Pitcairn men now living offshore also face sex abuse charges. Liz Beddoe, the head of applied social sciences at the University of Auckland Faculty of Education, said the positions offered the opportunity of a lifetime. "If you're in a position to do it, it would be worth it," she was quoted as saying. But she said the job would not be easy and would require compatible people who were able to cope with the isolation and perhaps people with complementary skills. "The reality is, in a community like that everybody will have been affected. It's a bit like the rebuilding effort after the tsunami in some of those remote communities ... While it is nowhere near as extreme as that, socially and emotionally it will have had that kind of impact on the community." The adverts make no mention of the arduous high seas voyage to reach Pitcairn, located halfway between New Zealand and South America, but hint at the isolation and living conditions there. "As this position involves living and working with one other colleague in a remote situation, applications from suitably qualified applicants with experience of working together are especially welcome." Enthusiasm, self-motivation and good health are also requirements, the advert in the New Zealand Herald says. Although Pitcairn is a British territory, lawyers for the convicted men expect to argue before the Privy Council in London that England does not have jurisdiction over the island which was settled in 1790 by Fletcher Christian and his mutineers on board HMS Bounty. The mutineers burnt the ship, and the lawyers have argued that meant they severed their ties with Britain. Another legal challenge is due to be heard in New Zealand next month with lawyers to argue that even if Britain does have jurisdiction over the island, it never declared a law against under-age sex there.
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World Travel News Headlines

Date: Fri, 8 Nov 2019 12:35:08 +0100 (MET)

Tehran, Nov 8, 2019 (AFP) - An earthquake rocked northwestern Iran before dawn on Friday, killing at least five people and injuring more than 300 in crumbling and collapsed buildings.   The 5.9-magnitude quake struck at 1:17 am (2247 GMT Thursday) about 120 kilometres (75 miles) southeast of the city of Tabriz, in East Azerbaijan province, the Iranian Seismological Centre said.

Described as "moderate", the quake was eight kilometres (five miles) deep and was followed by five aftershocks.    The provincial governor, Mohammad-Reza Pourmohammadi, told Iranian media that rescue operations were underway in 41 villages, but the damage was largely concentrated in two, Varnakesh and Varzaghan.   According to the emergency services, nearly 340 people were admitted to hospital for treatment, but all but 17 were discharged by Friday noon.   Some 40 homes were levelled by the quake and over 200 head of cattle killed.

Around 100 injured residents were pulled out of the rubble of their damaged or flattened homes.   Around noon, emergency teams distributed survival kits, stoves, blankets and tents in 78 villages.   In Varnakesh, an emergency shelter was set up.   State television broadcast images of people who had fled their homes warming themselves around a fire lit on a public highway.   But the damage appeared to be less widespread than initially feared.   The United States Geological Survey (USGS) had issued an alert warning that "significant casualties are likely and the disaster is potentially widespread".

In many areas people had returned to their homes by daybreak after the initial panic subsided and the aftershocks petered out.   The gas supply was restored to all but one of the affected villages.   The quake was felt in the provincial capital Tabriz and as far away as the city of Rasht, near the Black Sea coast 200 kilometres (125 miles) from the epicentre.   Tabriz, which has a population of more than a million, is a historic city which served as Iran's capital several times between the 13th and 16th centuries. Its bazaar is a UNESCO world heritage site.   Iran sits where two major tectonic plates meet and experiences frequent seismic activity.

The country has suffered a number of major disasters in recent decades, including at the ancient city of Bam, which was decimated by a catastrophic earthquake in 2003 that killed at least 31,000 people.     In 1990, a 7.4-magnitude quake in northern Iran killed 40,000 people, injured 300,000 and left half a million homeless, reducing dozens of towns and nearly 2,000 villages to rubble.   Iran has experienced at least two other significant quakes in recent years -- one in 2005 that killed more than 600 people and another in 2012 that left some 300 dead.
Date: Fri, 8 Nov 2019 11:03:11 +0100 (MET)

London, Nov 8, 2019 (AFP) - Royal Mail on Friday made a High Court bid to block a postal strike by workers due next month ahead of Christmas and around the time of Britain's general election.   Members of the Communication Workers Union recently voted to strike amid a dispute with management over pay and other employment conditions.   In a statement, Royal Mail pointed to "potential irregularities in the ballot".   It added: "The company is making this High Court application because the integrity and legal soundness of any electoral process is vital," Royal Mail said in relation to the strike ballot.   "This is particularly the case in relation to potential industrial action around the general election on 12 December 2019.    "Royal Mail is also making this application because of the damage industrial action would do to the company and its customers in the run-up to Christmas," the group added.   It expects the hearing to take place next week.
Date: Thu, 7 Nov 2019 17:15:09 +0100 (MET)

Paris, Nov 7, 2019 (AFP) - Top European medical bodies demanded Thursday that Chinese traditional medicines be subject to the same regulatory oversight as conventional Western methods, despite recent WHO recognition of their use.   "Just because the World Health Organisation includes a chapter on Traditional Chinese Medicine in its new International Classification of Diseases, it is not automatically safe to use without robust evidence," Professor Dan Marhala, President of the Royal Swedish Academy of Sciences, said in a statement issued by top European medical and scientific bodies.   The European Academies' Science Advisory Council (EA SAC) and the Federation of European Academies of Medicine (EAM) said European lawmakers must protect the health of European citizens.

Accordingly, the existing European regulatory framework should be revised to make sure Traditional Chinese Medicine (TC) is held to the same standards of proof and evidence as conventional medicine.   "There have been examples where some Traditional Chinese Medicine has undergone thorough pre-clinical investigation and proven in rigorous clinical trials to contribute significant health benefit -- artemisinin therapy for malaria, for example," Marhala said.   "There may be more leads to diagnosis and therapeutic benefit yet to be discovered but this can in no way mean that other claims can be accepted uncritically."   It was not necessarily the Who's intention to promote the use of TC, but its stamp of approval could lead supporters to promote wider application, the statement cautioned.   As a result, patients could be confused over which diagnosis was appropriate and which therapy was effective.   More serious still, said former EASAC president Jos van der Meer, is that some TCMs "can have serious side effects and interactions with other treatments."   "Moreover, patients may be at risk that severe diseases are treated ineffectively and conventional medical procedures delayed," he added.

The WHO included TCMs in an official classification of diseases coming into effect in January 2022.   In 2015, China's Tu Youyou won the Nobel Prize for medicine for discovering artemisinin, giving a huge boost to the credibility of TCM which many in the west deride as lacking scientific foundation and verging on quackery.   In China, traditional medicine has a long, distinguished history and its practitioners are treated with great respect.   EASAC comprises the national science academies of EU Member states, plus Norway and Switzerland.   FEAM groups medical academies which provide advice to the European authorities.
Date: Thu, 7 Nov 2019 17:11:10 +0100 (MET)

Riga, Nov 7, 2019 (AFP) - Thousands of doctors and nurses rallied Thursday in front of the Latvian parliament in Riga calling for better pay in what was the Baltic state's largest protest in over a decade.   Police said more than 5,000 people, including patients, turned out for the protest, which featured coffins and signs with slogans such as "United for health", "I only want to work one job" and "Patients supporting doctors and nurses".   The LVSADA medical labour union organised the rally to condemn lawmakers for planning to increase their own salaries next year while reneging on a promise to boost wages in the chronically underfunded medical profession.   "We won't allow the healthcare system to be starved again," LVSADA chief Valdis Keris said at the rally, which state hospital employees attended by taking a day of unpaid leave.

Some doctors also participated in the protest by only performing emergency surgery and tending to emergency patients on Thursday while rescheduling everything else.    "The average monthly wage for a doctor at a Latvian public hospital is only between 1,000-3,000 euros ($1,100-$3,300)," protester and doctor Roberts Furmanis said in a statement sent to media.    "I work my daily shift at one hospital, at night I also work overtime driving around in an ambulance, plus sometimes I lecture at medical schools on my rare days off," he added.   "I get less than 3,000 euros a month for those jobs combined. How am I supposed to support my family?"   Last year, lawmakers voted to raise wages for almost all employees of the government-run healthcare system, but now say that they are unable to find the necessary funds in the 2020 state budget.    "I express deep regret for last year's promise, which we cannot carry out," speaker of parliament Inara Murniece told the rally.

Those protesting, however, point out that the 2020 state budget exceeds 10 billion euros for the first time ever in the country of just 1.9 million people -- or 700 million more euros than this year.    Medical workers are upset that while there is no room for better healthcare wages in the new budget, the country's lawmakers and ministers plan to increase their own salaries next year and have also earmarked taxpayer money for their respective political parties.    Thursday's rally was Latvia's largest since some 10,000 people attended a January 2009 protest against government cuts, which grew violent and resulted in dozens of arrests.
Date: Thu, 7 Nov 2019 15:13:02 +0100 (MET)
By Michelle FITZPATRICK

Frankfurt am Main, Nov 7, 2019 (AFP) - Tens of thousands of Lufthansa passengers faced disruptions Thursday as cabin crew in Germany staged a "massive" 48-hour walkout in the biggest escalation yet of a bitter row over pay and conditions.   The strike called by Germany's UFO flight attendants' union started at 2300 GMT on Wednesday and was to last until 2300 GMT on Friday.

Lufthansa said it had scrapped 700 flights on Thursday and some 600 the following day, warning that "around 180,000 passengers will be affected" across Germany.   The UFO union argued that the stoppage was necessary because negotiations with Lufthansa bosses were deadlocked.   But it accepted a surprise olive branch offered by Lufthansa CEO Carsten Spohr on Thursday, and agreed to preliminary talks over the weekend.    The current strike would carry on as planned "but would not for now be expanded", UFO said on its website.   Lufthansa said it regretted the inconvenience to passengers and stressed that it was working "to minimise the impact of this massive strike on our customers".

The carrier was running an alternative flight schedule where possible, and said passengers could rebook their journeys for free or swap their flights for train tickets.  Knut Kress, a passenger at a quieter than usual Munich airport, voiced support for the flight attendants.   "It's good that there are still unions defending something," he told AFP. But 48 hours "is a long time", he added.   Fellow traveller Birgit Kellner complained about the lack of notice for passengers.   "They should inform passengers a little earlier, not just two days before."   The walkout is UFO's biggest call to action since a week-long strike in 2015 hit Lufthansa with mass cancellations.   It is also seen as a test of strength for the union, weakened by months of infighting that have left Lufthansa questioning its right to speak for cabin crew.

- Internal disputes -
Lufthansa's finance chief Ulrik Svensson declined to put a price tag on the strike but said such stoppages typically cost "between 10 and 20 million" euros per day.   The union already staged a day-long warning strike last month at four Lufthansa subsidiary airlines, causing several dozen flights to be axed at Eurowings, Germanwings, SunExpress and Lufthansa CityLine.

But the flagship Lufthansa brand was spared the upheaval after management offered an unexpected two-percent pay rise to avert the strike.   Since then, however, UFO vice-president Daniel Flohr said no progress had been made in talks.   As well as higher pay for cabin crew across the Lufthansa group, UFO is demanding more benefits and easier routes into long-term contracts for temporary workers.

Lufthansa, however, has long argued that UFO no longer has the right to represent its staff following an internal leadership tussle, and has challenged the union's legal status in court.   But CEO Spohr hinted at a shift in position when he told reporters Thursday Lufthansa wanted to try to resolve the existing legal issues with UFO in the weekend meeting, hoping to then start formal arbitration talks.

UFO's internal disputes have cost it support among the Lufthansa group's 21,000 flight attendants, with some members switching to rival unions.   Separately on Thursday, Lufthansa reported a jump in third-quarter net profits but said it was slashing over 700 jobs at its Austrian Airlines subsidiary as the group seeks to trim costs in the face of fierce competition.
Date: Thu, 7 Nov 2019 09:57:41 +0100 (MET)

Singapore, Nov 7, 2019 (AFP) - Tourists visiting Singapore can now check in at some hotels using facial recognition technology under a pilot programme that could cut waiting times and help tackle a labour crunch.  The tech-savvy country of 5.7 million people is increasingly turning to automation to speed up services and deal with workforce shortages, with robots deployed for tasks ranging from cleaning to making noodles.

Under the pilot launched Wednesday, visitors will not need to wait to be checked in by hotel staff but can instead use a phone app fitted with facial recognition technology or machines which scan their passports.   The data from the scan is sent to immigration authorities for checks after which the visitor is issued a room key, said the Singapore Tourism Board and Hotel Association, which announced the initiative this week.

The technology, reportedly being trialled at three hotels and is similar to that used in some airports including Singapore's Changi, could reduce check-in times by up to 70 percent, they said.   Singapore welcomed a record high 18.5 million visitors last year, up 6.2 percent from the year before. The city has more than 400 hotels with 67,000 rooms.
Date: Wed, 6 Nov 2019 15:31:58 +0100 (MET)

Amman, Nov 6, 2019 (AFP) - Eight people, including four tourists, were wounded in a knife attack on Wednesday at the famed archeological site of Jerash in northern Jordan, a security spokesman told AFP.   Four tourists -- three Mexicans and a Swiss woman -- were wounded, along with a Jordanian tour guide and a security officer who tried to stop the assailant, public security directorate spokesman Amer Sartawi said.   The attack took place around noon (1000 GMT) at the Roman ruins of Jerash, a popular attraction 50 kilometres (30 miles) from the capital Amman.   The health ministry confirmed that eight people had been wounded, with Sartawi saying earlier that they had "been transported to hospital for treatment".    He said the assailant had been arrested but did not specify his nationality, noting that the motive was as yet unknown.

Jordanian tour guide Zouheir Zreiqat was at the scene and told AFP that the attack happened "just before midday when around 100 foreign tourists" were at the site.    "A bearded man in his twenties wearing black and brandishing a knife started to stab tourists," according to Zreiqat.   He said others started to shout for help and he, along with three other tour guides and three tourists managed to stop the assailant.   "We chased him until we could grab him and get him on the ground," Zreiqat said.    "We took the knife from him. He stayed silent, without saying a word until the police arrived and arrested him."

- Violent attacks -
It was not the first time tourist sites have been targeted by attacks in Jordan.    In December 2016, in Karak, home to one of the region's biggest Crusader castles, 10 people were killed in an attack that also left 30 wounded.    Seven police officers, two Jordanian civilians and a Canadian tourist were killed in the attack.

The attack was claimed by the Islamic State group (IS) and sparked concern over its impact on tourism, a mainstay of the Jordanian economy.    Ten people were convicted of carrying out the attack, with two sentenced to death.   Several violent incidents struck the country the same year, including a suicide attack in June claimed by IS that killed seven Jordanian border guards near the frontier with Syria.    Amman has played a significant role in the United States-led coalition fight against IS in Syria and Iraq, both neighbouring Jordan.

- Economic troubles -
Lacking in natural resources, the country of nearly 10 million depends on tourism and the kingdom has been working to pull the key sector out of a crisis caused by regional unrest in recent years.   Jordan's economy as a whole was hit hard by the combined impact of the international financial crisis, the Arab Spring uprisings that convulsed the Middle East in 2011 and the conflict in Syria.

Tourism accounts for 10 to 12 percent of gross domestic product and the government aims to double this by 2022, former tourism minister Lina Annab told AFP in an interview last year.  The country boasts 21,000 archaeological and historical sites that span millennia, according to the tourism board.   They include the Roman ruins of Jerash, the ancient city of Petra, the Dead Sea and Wadi al-Kharrar, or Bethany Beyond the Jordan, where some believe Jesus was baptised.   Jordan welcomed seven million tourists in 2010, but arrivals plunged to around three million in each of the following two years, tourism board head Abed Al Razzaq Arabiyat said in April.    Numbers have rebounded as spillover from the war in neighbouring Syria has abated, officials have said, with the government working to bring annual tourist arrivals back up to 7 million by 2020.
Date: Tue, 5 Nov 2019 00:54:14 +0100 (MET)

Nuku'alofa, Tonga, Nov 4, 2019 (AFP) - A 6.6 magnitude earthquake struck off the coast of the Pacific island nation of Tonga on Tuesday, but there was no threat of a tsunami, officials said.    The United States Geological Survey (USGS) said the shallow undersea quake hit about 134 kilometres (83 miles) west of Neiafu, the country's second-largest town.    It said the temblor was not expected to have caused significant damage. The quake was not felt in Tonga's capital, Nuku'alofa, according to an AFP reporter.    There was also no threat of a tsunami, the Pacific Tsunami Warning Center said.    A second quake of 5.5 magnitude was recorded a few minutes later, the USGS said.
Date: Mon, 4 Nov 2019 23:47:26 +0100 (MET)

Santiago, Nov 4, 2019 (AFP) - A strong 6.0-magnitude earthquake shook Chile on Monday, rattling buildings in the capital while a big anti-government demonstration was under way.   The quake struck at 6:53 pm (2153 GMT) with its epicentre near the northern town of Illapel, the US Geological Survey said.   A strong and prolonged shaking was felt in the capital.   Chile's National Seismological Center measured the quake at magnitude 6.1, revising down an earlier estimate of 6.3.   There were no immediate reports of damage or casualties.   "There have been no reports of damage to people, disruption of basic services or infrastructure," the National Emergency Office said.   The Army Hydrographic and Oceanographic Service said the quake was unlikely to cause a tsunami on Chile's Pacific coast.

When the quake hit, police in Santiago were dispersing protesters at the start of the third week of anti-austerity protests targeting the conservative government.   Chile is one of the world's most earthquake-prone countries.   The 9.5-magnitude 1960 Valdivia earthquake was the strongest ever recorded on the magnitude scale, according to the USGS.   In 2010 an 8.8-magnitude followed by a tsunami killed more than 500 people.   Chile lies on the Ring of Fire -- an arc of fault lines that circles the Pacific Basin and is prone to frequent earthquakes and volcanic eruptions.
Date: Mon, 4 Nov 2019 20:37:19 +0100 (MET)
By Eugenia LOGIURATTO

Recife, Brazil, Nov 4, 2019 (AFP) - Months after thick oil began turning idyllic beaches in Brazil into "black carpets," workers and volunteers wearing rubber gloves race against time to scrape off the remaining fragments ahead of the country's peak tourism season.   Paiva, Itapuama and Enseada dos Corais in the northeastern state of Pernambuco are among hundreds of beaches fouled by an oil spill that began to appear in early September and has affected more than 2,000 kilometers (1,250 miles) of Atlantic coastline.

As ocean currents brought large globs of crude to shore near the capital Recife in recent weeks, locals rushed to the normally picturesque beaches and used their bare hands to remove the toxic material coating sand, rocks and wildlife.    "I was shocked, there were people entering the water without gloves, without safety equipment, in the middle of the oil," coconut seller Glaucia Dias de Lima, 35, told AFP as she picked up chunks of crude from Itapuama beach.

Thousands of military personnel have been dispatched to help clean up the oil that has killed dozens of animals, including turtles, and reached a humpback whale sanctuary off Bahia state that has some of the country's richest biodiversity.   It is the third major environmental disaster to strike Brazil this year. In recent months fires ravaged the Amazon rainforest and in January a mine dam collapsed in the southeast, spewing millions of tons of toxic waste across the countryside.    Wildfires are still raging across the Pantanal tropical wetlands.

While thousands of tons of crude waste have been recovered so far, the space agency INPE said Friday there might still be oil at sea being pushed by currents. It could reach as far south as Rio de Janeiro state, the agency said.   President Jair Bolsonaro warned Sunday that "the worst is yet to come," saying only a fraction of the spilled crude had been collected so far.    The government on Friday named a Greek-flagged tanker as the prime suspect for being the source of the oil slicks.   The ship Bouboulina took on oil in Venezuela and was headed for Singapore, it said. The tanker's operators have denied the vessel was to blame.

- Fishing paralyzed -
As the southern hemisphere's summer approaches, people dependent on the fishing and tourism industries are nervously waiting for test results to show if the water is safe to swim in and eat from.   Northeastern Brazil is a popular tourist destination all year round, but visitor numbers usually explode in the hotter months. 

Eco-tourism guide Giovana Eulina said the disaster would affect the sector and she called for a campaign to "encourage people to come here."   Fishing in the region also has been largely paralyzed by the oil spill, even in areas where crude has not been detected.   "We still don't have a concrete answer from a scientist who says that (the water) is really contaminated," said Sandra Lima, head of a local fishing association.    Edileuza Nascimento, 63, stands in muddy water near Recife and extracts shellfish that she will sanitize at home, freeze and then sell.   It was already a struggle for fishermen to make a living, she said. But the oil slick has been "too much."    "It has come to finish off the fishing families."