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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: Fri, 6 Dec 2019 03:03:18 +0100 (MET)
By Pierre-Henry DESHAYES

Half Moon Island, Antarctica, Dec 6, 2019 (AFP) - The swimsuit-clad tourists leap into the icy water, gasping at the shock, and startling a gaggle of penguins.   They are spectators at the end of the world, luxury visitors experiencing a vulnerable ecosystem close-up.   And their very presence might accelerate its demise.   Antarctica, a vast territory belonging to no one nation, is a continent of extremes: the coldest place on Earth, the windiest, the driest, the most desolate and the most inhospitable.   Now, it's also a choice destination for tourists.

All around Half Moon Island, off the Antarctic Peninsula, blocks of ice of all sizes float by on a calm sea, their varying forms resembling weightless origami shapes.    On this strip of land, that juts out of the Antarctic Polar and towards South America, visitors can see wildlife normally only viewed in zoos or nature documentaries along with spectacular icy landscapes.   The ethereal shades of white that play across the pillowy peaks change with the light, acquiring pastel hues at dawn and dusk.   "Purity, grandeur, a scale that's out of this world," says Helene Brunet, an awestruck 63-year-old French pensioner, enjoying the scene.    "It's unbelievable, totally unbelievable. It's amazing just to be here, like a small speck of dust."

AFP joined the 430 passengers on board the Roald Amundsen, the world's first hybrid electric cruise ship, on its maiden voyage in the Southern Ocean.    "It's not your typical beach, but it's awesome to do it," says a numb Even Carlsen, 58, from Norway, emerging from his polar plunge in the three-degree C (37.4 F) water.   When tourists go ashore, bundled up in neon-coloured windbreakers and slathered in SPF50 sunscreen, they have to follow strict rules: clean your personal effects so you don't introduce invasive species, keep a respectful distance from wildlife to avoid distressing them, don't stray from the marked paths and don't pick up anything.   "We mucked up the rest of the world. We don't want to muck up Antarctica too," says an English tourist, as she vacuums cat hair off her clothes before going ashore.

- 'Heart of the Earth' -
The Antarctic peninsula is one of the regions on Earth that is warming the fastest, by almost three degrees Celsius in the past 50 years, according to the World Meteorological Organization -- three times faster than the global average.    In March 2015, an Argentinian research station registered a balmy 17.5 degrees Celsius, a record.    "Every year you can observe and record the melting of glaciers, the disappearance of sea ice... (and) in areas without ice, the recolonisation of plants and other organisms that were not present in Antarctica before," said Marcelo Leppe, director of the Chilean Antarctic Institute.

Antarctica is "like the heart of the Earth," he added, saying that it expands and contracts like a heart beating, while the mighty current which revolves around the continent is like a circulatory system as it absorbs warm currents from other oceans and redistributes cold water.   The Antarctic Treaty, signed 60 years ago by 12 countries -- it now has 54 signatories -- declared the area a continent dedicated to peace and science, but tourism has gradually increased, with a sharp rise in the past few years.   Tourism is the only commercial activity allowed, apart from fishing -- the subject of international disputes over marine sanctuaries -- and is concentrated mainly around the peninsula, which has a milder climate than the rest of the continent and is easier to access.

Cruise ships have roamed the region for around 50 years, but their numbers only started to increase from 1990, as Soviet ice-breakers found new purposes in the post-Cold War era.   Some 78,500 people are expected to visit the region between November and March, according to the International Association of Antarctica Tour Operators (IAATO).   That's a 40-percent increase from last year, due in part to short visits by a few new cruise ships carrying more than 500 passengers, too many to disembark under IAATO regulations.     "Some might say 'Well, 80,000 people, that doesn't even fill a national stadium'... (and that it) is nothing like Galapagos which welcomes 275,000 a year," says IAATO spokeswoman Amanda Lynnes.    "But Antarctica is a special place and you need to manage it accordingly."

- 'Leave Antarctica to the penguins' -
It is Antarctica's very vulnerability that is attracting more and more visitors.   "We want to see this fantastic nature in Antarctica before it's gone," Guido Hofken, a 52-year-old IT sales director travelling with his wife Martina, says.    They said they had paid a supplement to climate compensate for their flight from Germany.

But some question whether tourists should be going to the region at all.   "The continent probably would be better off being left to penguins and researchers, but the reality is, that is probably never going to happen," said Michael Hall, professor and expert on polar regions at the University of Canterbury in New Zealand.   "Vicarious appreciation never seems to be enough for humans. So with that being the case, it needs to be made as low risk to the Antarctic environment and as low carbon as possible," said Hall.    "However, when the average tourist trip to Antarctica is over five tonnes of CO2 emissions per passenger (including flights), that is a serious ask."

Soot or black carbon in the exhaust gases of the scientific and cruise ships going to the region is also of concern, said Soenke Diesener, transport policy officer at German conservation NGO Nabu.   "These particles will deposit on snow and ice surfaces and accelerate the melting of the ice because the ice gets darker and will absorb the heat from the sun and will melt much faster," he told AFP.   "So the people who go there to observe or preserve the landscape are bringing danger to the area, and leave it less pristine than it was," he added.

- Responsible tourism -
Antarctic tour operators insist they are promoting responsible tourism.   The trend is for more intimate, so-called expedition cruises, in contrast to popular giant cruise liners elsewhere which are criticised for being invasive and polluting.   With greener ships -- heavy fuel, the most commonly used for marine vessels, has been banned in Antarctica since 2011 -- cruise companies have sought to make environmental awareness a selling point, occasionally earning them accusations of greenwashing.

Global warming, pollution and microplastics are the result of human activities on other, faraway continents, say tour operators.   Here, their motto is "Take nothing but photographs, leave nothing but footprints, keep nothing but memories".   But before they've even set foot on the cruise ships departing from South America -- the most common itinerary -- visitors to Antarctica will already have flown across the world, causing emissions that harm the very nature they have come so far to admire.

Most visitors hail from the Northern Hemisphere, and almost half are from the United States and China, IAATO says.   "I'm a tourist who feels a little guilty about taking a flight to come here," admits Francoise Lapeyre, a 58-year-old globetrotter om France.   "But then again, there are priorities. There are some trips I just won't take, because they leave a big footprint and they're not worth it.   "Crisscrossing the planet to go to a beach for example," she says.

- Don't mention climate change -
Like other expedition cruises where accessible science is part of their trademark, the Roald Amundsen, owned by the Hurtigruten company, has no dance floor or casino.  Instead, there are microscopes, science events and lectures about whales and explorers like Charles Darwin.   But they steer clear of climate change, which is only mentioned indirectly.   That's a deliberate decision as the subject has proven "quite controversial", said Verena Meraldi, Hurtigruten's science coordinator.   "We held several lectures dedicated specifically to climate change but it leads to conflicts. There are people who accept it as a fact, others who don't," she said.   Onboard, "passengers" are referred to as "guests" and "explorers" rather than "cruisers".   "Explorers" are typically older, well-heeled, often highly travelled pensioners who are handed walking sticks as they step ashore.   "My 107th country," says a Dane, stepping ashore onto Antarctica.

The Roald Amundsen "guests" choose between three restaurants, from street food to fine dining -- a far cry from the conditions endured by the Norwegian adventurer for whom the ship is named, who had to eat his sled dogs to survive his quest to reach the South Pole in 1911.   They have paid at least 7,000 euros ($7,700) each for an 18-day cruise in a standard cabin, and up to 25,000 euros ($27,500) for a suite with a balcony and private jacuzzi.   Other cruises are banking on ultra-luxury, with James Bond-like ships equipped with helicopters and submarines, suites of more than 200 square metres (2,153 square feet) and butler services.   With a seaplane to boot, the mega-yacht SeaDream Innovation will offer 88-day cruises "from Pole to Pole" starting in 2021. The two most expensive suites, with a price tag of 135,000 euros per person, are already booked.
 
- Worlds collide -
Outside, in the deafening silence, wildlife abounds.   All around are penguins, as awkward on land as they are agile in water. Massive and majestic whales slip through the waves, and sea lions and seals laze in the sun.   On Half Moon Island, chinstrap penguins -- so called because of a black stripe on their chin -- strut about in this spring breeding season, raising their beaks and screeching from their rocky nests.   "This is to tell other males 'This is my space' and also, maybe, 'This is my female'," ornithologist Rebecca Hodgkiss, a member of the Hurtigruten's scientific team, explains, as a group of tourists stroll around ashore.   The colony of 2,500 penguins has been gradually declining over the years, but it's not known if that is man's fault or they have just moved away, according to Karin Strand, Hurtigruten's vice president for expeditions.   Invisible to the naked eye, traces of humankind are however to be found in the pristine landscape.   Not a single piece of rubbish is in sight but microplastics are everywhere, swept in on ocean currents.   "We've detected them in the eggs of penguins for example," Leppe told AFP.

- Venice under water -
The Antarctic, which holds the world's largest reserve of freshwater, is a ticking time bomb, warn experts and studies.   They say that the future of millions of people and species in coastal areas around the world depends on what is happening here.   As a result of global warming, the melting ice sheet -- especially in the western part of the continent -- will increasingly contribute to rising sea levels, radically re-drawing the map of the world, says climate scientist Anders Levermann, of the Potsdam Institute for Climate Impact Research.   This meltwater will contribute 50 centimetres (almost 20 inches) to the global sea level rise by 2100, and much more after that, he said.   "For every degree of warming, we get 2.5 metres of sea level rise. Not in this century, but in the long run," he said.

Even if the international community meets its obligations under the Paris Agreement to limit global warming to under two degrees Celsius, sea levels will still rise by at least five metres.   "Which means that Venice is under water, Hamburg is under water, New York, Shanghai, Calcutta," he said.   It's impossible to predict when, but the scenario appears unavoidable, says Levermann.   In the same way that a cruise ship powering ahead at full speed can't immediately stop, sea levels will continue to rise even if all greenhouse gas emissions were to cease immediately, a study has said.

- Changing the world? -
The tourism industry says it hopes to make "ambassadors" out of Antarctica visitors.   "It's good for the animal life and for the protection of Antarctica that people see how beautiful this area is, because you cherish what you know and understand," said Hurtigruten chief executive Daniel Skjeldam.   Texan tourist Mark Halvorson, 72, says he is convinced.   "Having seen it, I am that much more committed to having a very high priority in my politics, in my own inner core convictions to being as environmentally friendly in my life as I can," he said.   So, do Guido and Martina Hofken see themselves as future "ambassadors of Antarctica"?    "Just a little bit, probably. But I don't think I will change the world," Guido Hofken concedes.    "The best thing would be for nobody to travel to Antarctica."
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."
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Denmark

Denmark, Greenland and the Faeroe Islands US Consular Information Sheet
March 05, 2008
COUNTRY DESCRIPTION:
Denmark is a highly developed stable democracy with a modern economy.
Greenland is a self-governing dependency of Denmark.
>The Faroe Islands are a self-governing overseas administrative division of Denmark.
For additional information, visit the State Department page http://www.state.gov/p/eur/ci/da.

ENTRY REQUIREMENTS:
Passport and visa regulations are similar for Denmark, Greenland, and the Faroes.
A valid passport is required.
U.S. citizen tourist and business travelers do not need visas for visits of up to 90 days.
That period begins when entering any of the following countries which are parties to the Schengen agreement: Austria, Belgium, The Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Iceland, Italy, Latvia, Lithuania, Luxembourg, Malta, the Netherlands, Norway, Poland, Portugal, Slovakia, Slovenia, Spain, and Sweden.
Contact the Royal Danish Embassy at 3200 Whitehaven Street NW, Washington, DC
20008, telephone (202) 234-4300 or visit its web site at http://www.ambwashington.um.dk/en for the most current visa information.

Note:
Although European Union regulations require that non-EU visitors obtain a stamp in their passports upon initial entry to a Schengen country, many borders are not staffed with officers carrying out this function.
If an American citizen wishes to ensure that his or her entry is properly documented, it may be necessary to request a stamp at an official point of entry.
Under local law, travelers without a stamp in their passports may be questioned and asked to document the length of their stay in Schengen countries at the time of departure or at any other point during their visit, and could face possible fines or other repercussions if unable to do so.

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:
Denmark remains largely free of terrorist incidents, however, the country shares, with the rest of Western Europe, an increased threat of Islamic terrorism.
Like other countries in the Schengen area, Denmark’s open borders with its Western European neighbors allow the possibility of terrorist groups entering and exiting the country with anonymity.
Americans are reminded to remain vigilant with regard to their personal security and to exercise caution.

Public demonstrations occasionally occur in Copenhagen and other Danish cities and are generally peaceful events.
Prior police approval is required for public demonstrations, and police oversight is routinely provided to ensure adequate security for participants and passers-by.
Nonetheless, as with any large crowd comprised of diverse groups, situations may develop which could pose a threat to public safety.
U.S. citizens are advised to avoid areas where public demonstrations are taking place.

From time to time Copenhagen may experience protest activities from young people in their attempt to defend their self-proclaimed rights to either property (club activity buildings) or other privileges provided by Danish public means.
American citizens should be aware that participation in illegal demonstrations or street riots may result in immediate imprisonment and long term bans on re-entering Denmark.

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

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

CRIME:
Denmark, Greenland, and the Faroes all have relatively low violent crime rates, however, non-violent crimes of opportunity have increased over the last few years, especially in Copenhagen and other major Danish cities, where tourists can become targets for pickpockets and sophisticated thieves.
Criminals frequent airports, train stations, and cruise ship quays to take advantage of weary, luggage-burdened travelers.
Thieves also operate at popular tourist attractions, shopping streets, and restaurants.
In hotel lobbies and breakfast areas, thieves take advantage of even a brief lapse in attention to snatch jackets, purses, and backpacks.
Women’s purses placed either on the backs of chairs or on the floor are typical targets for thieves.
Due to the increase of crimes of opportunity, Embassy Copenhagen has experienced a high rise in passport thefts during the summer of 2007.
Car and home break-ins are also on the rise.

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

Denmark has a program to provide financial compensation to victims who suffer serious criminal injuries.
According to existing regulations, the victim must report the incident to the police within 24 hours.
Danish police routinely inform victims of serious crime of their rights to seek compensation.
The relevant forms can be obtained from the police or the Danish Victims’ Compensation Board:
Civilstyrelsen, Erstatningsnaevnet, Gyldenløvesgade 11, 1600 Copenhagen V, TEL:
(45) 33-92- 3334; FAX:
(45) 39-20-45-05; www.erstatningsnaevnet.dk; email: erstatningsnaevnet@erstatningsnaevnet.dk.
Claim processing time is a minimum of 3 months.
There is no maximum award limit.

See our information for Victims of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION:
Excellent medical facilities are widely available in Denmark.
In Greenland and the Faroe Islands, medical facilities are limited and evacuation is required for serious illness or injury.
Although emergency medical treatment is free of charge, the patient is charged for follow-up care.

Information on vaccinations and other health precautions, such as safe food and water precautions and insect bite protection, may be obtained from the Centers for Disease Control and Prevention’s (CDC) hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747) or via the CDC'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) web site at http://www.who.int/en.
Further health information for travelers is available at http://www.who.int/ith/en.

MEDICAL INSURANCE:
The Department 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 Denmark is provided for general reference only, and may not be totally accurate in a particular location or circumstance.

A valid U.S. driver's license may be used while visiting Denmark, but the driver must be at least 18 years old.
Driving in Denmark is on the right side of the road.
Road signs use standard international symbols.
Many urban streets have traffic lanes reserved for public transport only.
Unless otherwise noted on traffic signs, the speed limit is 50 km/h in urban areas, 80 km/h on open roads, and 130 km/h on expressways.

Use of seat belts is mandatory for drivers and all passengers.
Children under three years of age must be secured with approved safety equipment appropriate to the child's age, size, and weight.
Children from three to six years of age may use approved child or booster seats instead of seat belts.

Driving under the influence of alcohol or drugs is considered a very serious offense.
The rules are stringently enforced, and violations can result in stiff fines and possible jail sentences.

Copenhagen, the capital and largest city in Denmark, has an extensive and efficient public transportation system.
Trains and buses connect Copenhagen with other major cities in Denmark and to Norway, Sweden, and Germany.
Bicycles are also a common mode of transportation in Denmark.
Passengers exiting public or tourist buses, as well as tourists driving rental cars, should watch for bicycles on their designated paths, which are usually located between the pedestrian sidewalks and the traffic lanes.

Danish expressways, highways, and secondary roads are of high quality and connect all areas of the country.
It is possible to drive from the northern tip of Denmark to the German border in the south in just four hours.
Greenland has no established road system, and domestic travel is performed by foot, boat, or by air.
The majority of the Faroe Islands are connected by bridges or serviced by boat.
Although the largest islands have roads, most domestic travel is done on foot, horseback, boat, or by air.

The emergency telephone number for police/fire/ambulance in Denmark and the Faroe Islands is 112.
In Greenland contact the local police.

Please refer to our Road Safety page for more information.
Visit the web site of the country’s national tourist office and national authority responsible for road safety at http://www.denmark.org.
See also additional information on driving in Denmark at http://www.trafikken.dk/trafikken.asp?page=company&objno=7.

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

SPECIAL CIRCUMSTANCES:
The official unit of currency in Denmark is the Danish krone.
ATM machines are widely available throughout Denmark.
Please see our information on customs regulations.

For information concerning the importation of pets into Denmark, please visit the following website:
http://www.foedevarestyrelsen.dk.

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 protection 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 Denmark’s laws, even unknowingly, may be expelled, arrested, or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in Denmark are severe and convicted offenders can expect long jail sentences and heavy fines.
Engaging in illicit 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 Denmark are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department’s travel registration web site, https://travelregistration.state.gov, and to obtain updated information on travel and security within Denmark.
Americans without Internet access may register directly with the nearest U.S. Embassy or Consulate.
By registering, American citizens make it easier for the Embassy or Consulate to contact them in case of emergency.
The U.S. Embassy is located at Dag Hammarskjolds Alle 24; 2100 Copenhagen, telephone: (45) 33-41-71-00; Embassy fax: (45) 35-43-02-23; Consular Section fax: (45) 35-38-96-16; After-hours emergency telephone: (45) 35-55-92-70.
Information is also available via the U.S. Embassy’s web site at http://denmark.usembassy.gov/.
The United States has no consular presence in Greenland or the Faroe Islands.
* * *
This replaces the Consular Information Sheet dated August 23, 2007 to update the sections on Entry Requirements and Information for Victims of Crime.

Travel News Headlines WORLD NEWS

Date: Thu 24 Oct 2019
Source: Eurosurveillance 2019, 24(43) [edited]

[ref: Agergaard CN, Rosenstierne MW, Boedker R, et al. New tick-borne encephalitis virus hot spot in Northern Zealand, Denmark, October 2019. Euro Surveill. 2019; 24(43): pii=1900639]
---------------------------------------------------------------------
Abstract
--------
Tickborne encephalitis virus (TBEV), a member of the family Flaviviridae, genus _Flavivirus_, causes tickborne encephalitis (TBE). In Denmark, TBE is endemic only on the island of Bornholm, with an incidence of 4 per 100 000 inhabitants per year [1,2]. Here we report 3 clinical cases of TBE in patients hospitalised within a month [June/July 2019] and all residing at the boundary of the same forest, Tisvilde Hegn [Capital Region], in Northern Zealand.

Discussion
----------
The incidence of TBE has been increasing in Denmark, in its neighbouring countries as well and in the rest of Europe in recent years, which mirrors the increased abundance of ticks, the increased geographic spread and potentially climate changes [8-11]. The vector for the European virus subtype, TBEV-Eu, is _Ixodes ricinus_, which is prevalent in most of Europe and the dominant tick species in Denmark (greater than 90%) [12]. In 2009, 2 clinical cases of TBE were reported outside Bornholm and TBEV was detected in Northern Zealand in ticks collected in the forest of Tokkekebb Hegn, which is 40 km [25 mi] south east of Tisvilde Hegn, in 2009, 2010, and 2011 [4,5]. Surprisingly, TBEV was no longer detected in the same area in Tokkekoeb Hegn during 2016 and 2017 [13]. In 2018, another 2 human cases of TBE outside Bornholm were identified on the Island of Funen and in Jutland, respectively, but no new micro foci of TBEV has been localized [14], (data not shown).

All 3 patients presented here live close to Tisvilde Hegn in Northern Zealand, and had typical biphasic disease starting with fever, gastrointestinal or influenza-like symptoms and fatigue, followed by a few days of recovery before clinical meningitis/meningoencephalitis at hospitalisation and neurologic sequelae in terms of primarily fatigue and dizziness.

Subsequent collection of _I. ricinus_ ticks from a part of Tisvilde Hegn surrounding a well-visited forest playground, where Case 3 recalled a tick bite, identified a specific area adjacent to the playground to be an acute, new, high-risk TBEV micro-focus in Northern Zealand. The estimated high prevalence of TBEV is 8% at the centre of the focus which exceeds recent prevalence estimates of 0.6% from endemic Bornholm, as well as Denmark's neighbouring countries and most European countries [4,5,8,10,11,13,15]. The presence of the virus in nymphs, but not adult ticks, and the molecular evolutionary analyses of the homogeneous TBEV sequences suggests a single TBEV introduction in 2019, probably by migrating birds from Norway. Tisvilde Hegn and the forest playground is well-visited by Danish and international tourists, and containment measures such as fencing, grass cutting and signage along the playground's eastern side have been made in order to minimise the risk of further infections and spreading.
====================
[The complete article including figures, tables, and references is available at the source URL above.  There were previous reports of human cases TBE virus infection in Denmark in 2009 and again in 2018. The authors note that TBE virus was not found in ticks in the area in 2016 and 2018, nor were any human cases identified there then. They speculate that the virus was introduced by ticks on migratory birds.

TBE is caused by 3 different subtypes of tick borne encephalitis virus: Western European TBE virus, Far Eastern TBE virus, and Siberian TBE virus. Western European TBE (also known as Central European encephalitis) is endemic in western and central European countries and is expanding its range. - ProMED Mod.TY]

Date: Fri 26 Jul 2019
Source: Food Safety News [edited]
<https://www.foodsafetynews.com/2019/07/wgs-project-helps-denmark-uncover-campylobacter-outbreak/>

Fifty people are ill in Denmark from campylobacteriosis after eating chicken meat but authorities believe the actual number of patients may be much higher. Statens Serum Institut (SSI), Danish Veterinary and Food Administration (Fødevarestyrelsen) and DTU Food -- National Food Institute are investigating the _Campylobacter jejuni_ outbreak. _Campylobacter_ is the main cause of bacterial intestinal infections in Denmark and more than 4500 cases were registered in 2018. The same type of _Campylobacter_, sequence type 122, identified in patients by whole genome sequencing has also been found in chicken meat from one slaughterhouse, named as HKScan in Vinderup, a town in North-western Jutland.

HKScan is a Nordic meat and meals company employing more than 600 people in Denmark at production units in Vinderup and Skovsgaard. The Danish Veterinary and Food Administration is continuing to investigate and officials have been sent to help the company track and eliminate the source of infection. Those sick are 20 women and 30 men aged 14 to 87 with a median age of 49 years. As part of a project this year [2019] involving the Clinical Microbiology Department (KMA) in Aalborg, the Danish Veterinary and Food Administration and SSI; _Campylobacter_ isolates from patients diagnosed in Aalborg since March 2019 have been collected, sent to SSI and whole genome sequenced. _Campylobacter_ isolates are not routinely submitted and sequenced so the outbreak has been detected due to the project and may otherwise have gone unnoticed. In the past it has been difficult to detect and solve such outbreaks.

Some isolates also come from other KMA's as part of the Danish Integrated Antimicrobial Resistance Monitoring and Research Programme (DANMAP) project. Steen Ethelberg, a senior scientist at SSI, said patients have fallen sick over a couple of months and are still being reported. "The most recent estimate for how many more cases are in the population relative to the diagnosed laboratory controlled cases is a factor of 12 so there would be more cases that are actually ill in any outbreak," he told Food Safety News. "The reason we know about this outbreak is because we are running a project in one part of the country where all the patient isolates are being collected and subjected to whole genome sequencing.

Since the outbreak is mainly based on one of the 10 labs only you would expect patients all over the country. It seems likely that there could be more cases and we also have some smaller clusters detected in the project." Ethelberg said the project is trying to see how WGS may be helpful in understanding _Campylobacter_. "It is about collecting patient isolates from one lab and at the same time analysing chicken meat and subjecting the _Campylobacter_ isolates in chicken meat to WGS and then comparing the sequences. In the project we are learning about the aetiology of _Campylobacter_ but we also see outbreaks in real time.

This outbreak is big enough that we thought it should be reported to the public but in a sense it is not so different because we know many people are ill from _Campylobacter_ from poultry products." The Danish Veterinary and Food Administration has been taking samples for _Campylobacter_ of various cuts of chicken from different stores and these have been sequenced. Annette Perge, from the agency, told Food Safety News that it was still too early to conclude the outbreak was over. "The slaughterhouse produces both fresh and frozen products hence we can't rule out that products may still be on the market or bought and stored frozen at private households.

Based on patient interviews it has not been possible to point out specific products, places of purchase, or periods of purchase," she said. "Furthermore there is no legal requirements stating that _Campylobacter_ is prohibited in poultry meat. However even without legal requirements foods used as intended should not result in illness. The slaughterhouse is a large establishment and their products are sold at all the major Danish retail chains." The agency does not yet know if a link was limited to one farm or establishment, according to Perge. "The link between food isolates and routine samples taken at the slaughterhouse, samples of thigh skin from chickens taken routinely for analyses, and the patient isolates was seen when comparing whole genome sequencing results.

However it has not been possible to verify the link through interview with patients. We have no indication that this outbreak is due to a contamination persisting in the slaughterhouse. They have been allowed to continue production. They are assisting us in any way possible to solve the case." Perge said samples from chickens from a specific farm showed a close resemblance to the patients. "The farm has been visited by the audit team from the slaughterhouse and corrections to practices have been made. At the moment no chickens are delivered for slaughter as they are not yet old enough. Meat from chickens slaughtered from that farm will be tested for _Campylobacter_ and eventual isolates will be sequenced and compared to the outbreak strain. If the meat contains larger numbers of _Campylobacter_, the use of the meat will be restricted." [Byline: Joe Whitworth]
========================
[The source of the outbreak may we'll be chicken, a common vehicle for this enteric pathogen. - ProMED Mod.LL]

[HealthMap/ProMED-mail map of Denmark:
<http://healthmap.org/promed/p/111>]
Date: Tue 28 May 2019
Source: Food Safety News [edited]
<https://www.foodsafetynews.com/2019/05/ongoing-yersinia-outbreak-traced-to-fresh-spinach-more-than-50-sick/>

An outbreak of yersiniosis in Denmark and Sweden with more than 50 cases has been linked to fresh spinach. Statens Serum Institut, a public health research institute in Denmark, reports 20 people have been infected in the country. One person needed hospital treatment. The Public Health Agency of Sweden has recorded 37 confirmed cases. In March 2019, 20 cases of _Yersinia enterocolitica_ [infection] were found in Denmark. There were 11 women and 9 men aged 2 to 74 years old, with most cases aged 20 to 30. Patients were distributed throughout Denmark in Hovedstaden, Sjaelland, Syddanmark, Midtjylland, and Nordjylland.

The link to spinach was based on a case control study and the traceback investigation, which indicated spinach from Italy was responsible. In March 2019, most fresh spinach in Denmark comes from Spain or Italy. No specific batch of product was found to be the source of the outbreak and no product testing was conducted. After interviews with patients, Statens Serum Institut did a study in which healthy people of the same gender and age, and who lived in the same municipality as those sick, were asked if they had eaten certain foods that many of the yersiniosis patients ate. The study showed patients had consumed fresh spinach to a far greater extent than the control people.

The investigation found spinach was bought in Netto and a supermarket chain in Sweden. Danish officials said the implicated product is no longer on the market because the country had not seen any cases since March 2019 and given duration of the outbreak it was likely only one batch that was contaminated. The cause of the outbreak was _Yersinia enterocolitica_ serotype O3, biotype 4. Whole genome sequencing found all patients were infected with the same bacterial strain. "Although the outbreak is over, we can use this knowledge to prevent it from happening again. It is also a good reason to remind consumers that leafy greens always must be washed thoroughly before eating," said Luise Müller, an epidemiologist from Statens Serum Institut.

Denmark sees about 400 _Yersinia enterocolitica_ cases a year, with 366 having been reported in 2018. In Sweden, the increase in _Yersinia_ infections started in March [2019] and the 37 cases were from across the country. 7 men and 20 women with an age range from 6 to 62 years fell ill. Swedish officials said they were not able to analyse food samples since no case had spinach left at home and their case-control study did not identify a specific food item. Infection with yersinia is relatively rare in Sweden, with between 200 to 300 cases reported annually. Previous outbreaks have been caused by raw or undercooked meat consumption and contaminated ready-to-eat vegetables.

After an incubation period of 3 to 7 days, symptoms includes fever, diarrhoea, and abdominal pain in the right lower part of the abdomen. [byline: Joe Whitworth]
========================
[It is not specifically stated whether the strains in Denmark and Sweden are genetically related. The 2 species of _Yersinia_ associated with foodborne disease are _pseudotuberculosis_ and _enterocolitica_. The latter species can be associated with abdominal pain as a hallmark symptom. As a mesenteric lymphadenitis, yersiniosis can mimic appendicitis but may also cause infections of other sites, such as wounds, joints, and the urinary tract.

As noted in the FDA "Bad Bug Book" (<https://wayback.archive-it.org/7993/20170406190140/https://www.fda.gov/Food/FoodborneIllnessContaminants/CausesOfIllnessBadBugBook/ucm070040.htm>, "Strains of _Y. enterocolitica_ can be found in meats (pork, beef, lamb, etc.), oysters, fish, and raw milk.

The exact cause of the food contamination is unknown. However, the prevalence of this organism in soil, water, and animals, such as beavers, pigs, and squirrels, offers ample opportunities for it to enter our food supply. Poor sanitation and improper sterilization techniques by food handlers, including improper storage, cannot be overlooked as contributing to contamination." In addition, some strains of these organisms can be associated with blood transfusion-associated illnesses due to an ability to grow at refrigerator temperatures. - ProMED Mod.LL]

[HealthMap/ProMED-mail maps:
Denmark: <http://healthmap.org/promed/p/111>
Sweden: <http://healthmap.org/promed/p/108>]
Date: Wed 2 May 2019
Source: CPH Post [edited]

A bacterial infection found in the intestines of many animals and common in pigs, _Yersinia enterocolitica_, has been found in 18 Danes since 30 Mar 2019. So far, 10 women and 8 men aged 2-74 from all over Denmark have been diagnosed with the rare infection, reported BT.  "Right now, we have an outbreak of the bacterium _Yersinia enterocolitica_. It is a disease like salmonella that typically infects people via food," said Luise Muller from the State Serum Institute (SSI).

The disease is not common in Denmark. Over the last 5 years, there have only been 3 outbreaks. SSI is trying to localise the source of the infection by looking for common threads in the infected people's diet.

Typical symptoms are generally feeling under the weather, violent stomach pains, fever, and diarrhoea. The incubation period is usually 3-7 days. "The best advice we can give people is to cook meat thoroughly and wash fruit and vegetables carefully," said Muller.

Sweden has seen a similar outbreak, and the Danish and Swedish authorities are working together to map the infection.

In the 1980s, the infection used to be just as common as salmonellosis and campylobacteriosis, but it has become rarer nowadays. In 2014 there were 414 registered cases.  [Byline: Stephen Gadd]
==========================
[The 2 species of _Yersinia_ associated with food-borne disease are _pseudotuberculosis_ and _enterocolitica_. The latter species can be associated with abdominal pain as a hallmark symptom. As a mesenteric lymphadenitis, yersiniosis can mimic appendicitis but may also cause infections of other sites, such as wounds, joints, and the urinary tract.

As noted in the FDA "Bad Bug Book" (<https://wayback.archive-it.org/7993/20170406190140/https://www.fda.gov/Food/FoodborneIllnessContaminants/CausesOfIllnessBadBugBook/ucm070040.htm>), "Strains of _Y. enterocolitica_ can be found in meats (pork, beef, lamb, etc.), oysters, fish, and raw milk. The exact cause of the food contamination is unknown. However, the prevalence of this organism in soil, water, and animals, such as beavers, pigs, and squirrels, offers ample opportunities for it to enter our food supply. Poor sanitation and improper sterilization techniques by food handlers, including improper storage, cannot be overlooked as contributing to contamination."

Additionally, some strains of these organisms can be associated with blood transfusion-associated illnesses due to an ability to grow at refrigerator temperatures. - ProMED Mod.LL]

[HealthMap/ProMED-mail map:
Date: Sun, 28 Apr 2019 18:03:54 +0200

Copenhagen, April 28, 2019 (AFP) - A further 110,000 air passengers faced being left grounded after Scandinavian carrier SAS on Sunday cancelled 1,213 flights as pilot strike action spiralled.   Pilots demanding better pay and conditions walked off the job in Sweden, Denmark and Norway on Friday and the disruption is now expected to hit some 280,000 travellers overall.   SAS had initially predicted that 170,000 passengers would be affected by the end of Sunday, but now says a further 667 Monday flights and 546 more due Tuesday will be annulled.

The stoppage by 1,409 pilots is affecting domestic, European and long-haul flights.   The Swedish Air Line Pilots Association, which initiated the strike, has said that months of talks have failed to find a solution to pilots' "deteriorating work conditions, unpredictable work schedules and job insecurity".   "No discussion is currently underway between the two parties," Rawaz Nermany, president of the association, said on Sunday.   "To overcome our differences, SAS must show a real willingness to discuss and meet around the negotiating table," he told the Swedish TT agency.   But the Swedish Confederation of Transport Enterprises insists it cannot accept a demand for a 13-percent wage increase, given their "already high average wage of 93,000 kronor (8,766 euros, $9,769) a month".

The pilots' association say work schedules, not wages, are their main gripe as most SAS pilots have to work at variable times and days and sometimes have to work several weekends in a row.   SAS has implemented repeated savings programmes in recent years to improve its profitability, after almost going bankrupt in 2012.   "If SAS gives in to the demands of the pilots, we can be pretty sure that in a few quarters, SAS will be in deficit and will have to fight to survive," Jacob Pedersen, chief analyst of the Danish bank Sydbank, told the Ritzau agency.

In the first quarter of 2019, the airline widened its losses, impacted by negative exchange effects and high fuel prices.   It posted a net loss of 469 million kronor, compared to 249 million a year earlier.   Although the carrier forecast a full-year profit Sydbank on Friday predicted the strike would cost SAS 60 to 80 million kronor ($6 million to $8 million) per day.
More ...

Mauritania

Mauritania US Consular Information Sheet
September 23, 2008
COUNTRY DESCRIPTION:
Mauritania is a developing country in northwestern Africa.
Arabic is the official language, but French is widely used and several local languages are als
spoken.
Tourist facilities in the capital, Nouakchott, are adequate, but limited or non-existent elsewhere.
Read the Department of State Background Notes on Mauritania for additional information.

ENTRY/EXIT REQUIREMENTS:
A passport and a visa are required, as is evidence of a yellow fever vaccination.
For the most current visa information, contact the Embassy of the Islamic Republic of Mauritania, 2129 Leroy Place NW, Washington, DC
20008, tel. (202) 232-5700, or the Mauritanian Permanent Mission to the UN, 211 East 43rd Street, Suite 2000, New York, NY 10017, telephone (212) 986-7963 or 8189, or e-mail Mauritania@un.int.
Overseas, inquiries should be made at the nearest Mauritanian embassy or consulate.

See our information on dual nationality, the prevention of international child abduction and Customs regulations.

SAFETY AND SECURITY:
There is increasing activity by the terrorist group Al Qaeda in the Islamic Maghreb (AQIM) in Mauritania.
On December 24, 2007, terrorists shot and killed four French tourists and wounded a fifth near the town of Aleg, in southeastern Mauritania.
On December 26, 2007, terrorists killed four soldiers near the town of El Ghallaouiya in northern Mauritania.
These two attacks were followed by an attack on the Israeli Embassy and an adjoining nightclub frequented by westerners early in the morning of February 1, 2008.
The perpetrators of these attacks are believed to be linked to AQIM.
These are the first attacks that have occurred in Mauritania since June 2005, when members of the terrorist group GSPC (now known as AQIM) attacked a military outpost based at Lemgheity, near the Algerian and Malian borders.
In the attack, they killed or wounded about 35 soldiers.
Travelers should avoid all non-essential travel to the Hodh El Charghi region of southeastern Mauritania due to increased AQIM activities in the border area.
Official Americans continue to travel to the town of Atar, although AQIM has also talked about targeting Westerners there.
Travelers should check http://mauritania.usembassy.gov for current Consular Warden messages concerning Mauritania.

Travelers should exercise prudence and caution when traveling in Mauritania.
They should not venture outside of urban areas unless in a convoy and accompanied by an experienced guide, and even then only if equipped with sturdy vehicles and ample provisions.
The U.S. Embassy in Nouakchott has received reports of banditry and smuggling in the more remote parts of Mauritania.
Landmines also remain a danger along the border with the Western Sahara and travelers should cross only at designated border posts.
The U.S. Embassy recommends that travelers avoid travel in regions north and east of Zouerate, Ouadane, and Tichit unless with a government escort.
Travelers planning overland trips from Mauritania to Morocco, Algeria, Senegal or Mali should check with the U.S. Embassy in Nouakchott before setting out.
For more information about travel in Mauritania, please see the section “Traffic Safety and Road Conditions” below.

The Mauritanian military led a bloodless coup on August 6, 2008.
There has been increased political unrest following the coup, but no violence.
There have also been increased political gatherings and street demonstrations.
The police have been using tear gas to break up some anti-coup demonstrations.
An increased police presence and additional vehicle controls may also be expected.
U.S. citizens should avoid large crowds and maintain security awareness at all times.

In Nouakchott and other major cities in Mauritania, there is an increased security presence and additional checkpoints.
Police routinely conduct road blocks at which they may ask for proof of identity and drivers’ licenses.
These checkpoints should be respected.
Americans visiting Mauritania should be prepared for such inquiries and carry their identification cards at all times.
It is best to drive cautiously and be prepared to stop at short notice.

American citizens should be aware of their surroundings at all times and maintain good personal security practices, including always locking their homes and cars.
They should avoid established patterns and take care not to draw attention to themselves.
When going out, they should avoid being part of large, highly visible groups of Westerners and when in restaurants or cafes, avoid sitting in areas that are easily visible from the street.

Although U.S. citizens are generally welcomed in Mauritania, there were reports of anti-American incidents such as threats and stoning of vehicles, following the 1998 U.S.- and British-led intervention in Iraq, and demonstrations outside the Embassy during the 2003 U.S. intervention in Iraq.
Some Muslim extremists have occasionally perceived Christian non-governmental organizations as a threat.
However, local authorities closely monitor political violence and religious extremist groups.

For the latest security information, Americans traveling abroad should regularly monitor the Department of State, Bureau of Consular Affair’s web site at http://travel.state.gov, where the current Travel Warnings and Public Announcements, 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. and Canada or, for other callers, a regular toll line at 1-202-501-4444.
These numbers are available from 8:00 a.m. to 8:00 p.m. eastern time, Monday through Friday (except U.S. federal holidays).

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

CRIME:
Crime in Mauritania is moderate but steadily increasing.
Most incidents occur in the cities and larger towns, and are petty crimes such as pick pocketing and the theft of improperly secured and openly visible valuables left in vehicles.
Most criminal activity occurs at night and walking alone at night is not advisable.
Residential burglaries and robberies, particularly at the beaches in Nouakchott, are not uncommon.
In Nouakchott, travelers should avoid the beach at night.
During the day, beach-goers should travel in large groups or stay in popular areas because of the increase in the number of thefts and robberies, some involving injury to victims, reported there in the past several years.
Violent crimes and crimes involving the use of weapons are rare, but increasing.
Rapes and assaults have occurred and, in some instances, involved the American community.
Foreign tourists, including Americans, might be targeted for kidnapping in Mauritania.

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 in finding appropriate medical care, contact family members or friends, and explain how funds can be transferred.
Although the investigation and prosecution of the crime is solely the responsibility of local authorities, consular officers can help you to understand the local criminal justice process and to find an attorney if needed.

See our information on Victims of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION:
Medical facilities in Mauritania are limited.
There are few modern clinics or hospitals beyond the capital and a few major towns.
At local pharmacies, some medicines are difficult to obtain; travelers are advised to bring their own supplies.

Malaria is a serious and sometimes fatal disease.
Chloroquine-resistant P. falciparum malaria is a severe form of the disease that is found in many parts of western Africa, including Mauritania.
Because travelers to Mauritania are at high risk for contracting malaria, they should take one of the following anti-malarial drugs:
mefloquine (Lariam™), doxycycline, or atovaquone/proguanil (Malarone™).
The Centers for Disease Control and Prevention (CDC) have determined that a traveler who is on an appropriate anti-malarial drug has a greatly reduced chance of contracting the disease.
In addition, other personal protective measures, such as the use of insect repellents, may help to reduce malaria 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 anti-malarial drugs they have been taking.
For additional information on malaria, protection from insect bites, and anti-malarial drugs, please visit the CDC travelers’ health web site at http://www.cdc.gov/malaria/.

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

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

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

Public transportation is not safe and road conditions in Mauritania are generally poor, particularly in the interior.
Overland travel is difficult and roadside assistance is almost nonexistent.
The country’s size and harsh climate make road maintenance and repair especially problematic.
Mauritania has only about 2,070 km (1,286 miles) of surfaced roads, 710 km (441 miles) of unsurfaced roads, and 5,140 km (3,194 miles) of unimproved tracks.
Drivers should not offer rides to hitchhikers, nor should visitors to Mauritania accept rides offered by strangers.


The traditional route to Nouadhibou, prior to the completion of a paved road, was along the beach during low tide.
Some travelers continue to use this route, as do visitors to coastal fishing villages and other points of interest, and smugglers and others who try to avoid the security checkpoints that are often established along the asphalt roads.
Pedestrian visitors to the beach should exercise caution because of the beach’s use as a route for motorized vehicles.

U.S. citizens traveling overland for long distances in Mauritania should travel in convoys and be sure to have suitable four-wheel drive vehicles, a local guide, an adequate supply of water and food, and a second fuel reservoir.
Multiple vehicles are recommended in case of breakdown.
A Global Position Satellite (GPS) receiver and satellite phone are essential when traveling in remote areas.
Visitors are urged not to travel alone into the desert.

Driving in Mauritania is treacherous, and we encourage travelers to hire a trained local driver.
Traffic patterns differ considerably from American-style “rules of the road,” and many Mauritanians drive without regard to traffic signs or rules.
Roadway obstructions and hazards caused by drifting sand, animals, and poor roads often plague motorists; when combined with the number of untrained drivers and poorly maintained vehicles, heightened caution is imperative at all times.
Drivers should be alert to conditions and always wear their seat belts.
Motorcycle and bicycle riders should wear helmets and protective clothing.
Nighttime driving is discouraged.

The telecommunications infrastructure is limited and cellular telephone coverage is not wide spread.
For those traveling outside the major urban areas, it is recommended to have a satellite telephone readily available.

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 Mauritania, the U.S. Federal Aviation Administration (FAA) has not assessed Mauritania’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:
Mauritanian customs authorities may enforce strict regulations concerning the temporary import or export of items such as firearms, narcotics, alcoholic drinks and pork products.
Contact the Embassy of Mauritania in Washington, DC for specific information regarding customs regulations.

The local currency is the ouguiya, and it may not be imported or exported.
Credit cards can be used only at a few hotels in the capital, Nouakchott, and the northwestern city of Nouadhibou.
ATM machines are available only in Nouakchott.
Major foreign currencies are changeable in banks and numerous currency exchanges; however, this service is not always available without advanced notice or prior arrangement.
There is a risk of getting fraudulent bank notes even from banks which often do not have the security means to detect fake bank notes.
Furthermore, credit card fraud is a problem, so it is strongly advisable to pay hotel bills in cash.

Islamic ideals and beliefs in the country encourage conservative dress.
Sleeved garments and below-the-knee skirts are recommended, and people should avoid wearing shorts.
Please see our Customs Information.

CRIMINAL PENALTIES:
While in a foreign country, a U.S. citizen is subject to that country's laws and regulations, which sometimes differ significantly from those in the United States and may not afford the protections available to the individual under U.S. law.
Penalties for breaking the law can be more severe than in the United States for similar offenses.
Persons violating Mauritania’s laws, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession or use of, or trafficking in illegal drugs in Mauritania 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 Mauritania are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department’s travel registration web site so that they can obtain updated information on travel and security within Mauritania. Americans without Internet access may register directly with the nearest U.S. Embassy or Consulate.
By registering, American citizens make it easier for the Embassy or Consulate to contact them in case of emergency.
The U.S. Embassy is located between the Presidency building and the Spanish Embassy on Rue Abdallaye.
The postal address is B.P. 222, Nouakchott, telephone (222) 525-2660/2663, 525-1141/45, or 525-3038 (ext. 5441), and fax (222) 525-1592.
The Consular Section may be contacted by e-mail at ConsularNKC@state.gov
* * *
This replaces the Consular Information Sheet dated April 29, 2008, to update the section on Safety and Security.

Travel News Headlines WORLD NEWS

Date: Mon 30 Apr 2018
Source: Outbreak News Today [edited]
<http://outbreaknewstoday.com/crimean-congo-hemorrhagic-fever-case-reported-mauritania-28755/>

The Mauritania Ministry of Health has reported a confirmed case of Crimean-Congo haemorrhagic fever [CCHF] in Ould Yengé commune, Guidimaka region located in the southern-most part of the country. The case-patient is a 58-year-old male herder from Elghabra locality who became ill on [16 Apr 2018] (reportedly) after tending to a sick cow days earlier. He presented to a private clinic the same day [16 Apr 2018] with high fever, arthralgia and headache. He was admitted, managed for an unspecified medical condition and discharged on [18 Apr 2018].

The following day [19 Apr 2018], he developed bleeding from the gums and nose, and was admitted to the regional hospital where he was transfused and subsequently discharged on [20 Apr 2018], following an apparent clinical improvement. On [21 Apr 2018], the case-patient's health deteriorated and he was taken to Guerou health centre, from where he was immediately referred to Cheikh Zayed hospital in Nouakchott on [22 Apr 2018].

A blood specimen was obtained and shipped to the national public health laboratory. The test result released on [24 Apr 2018] was IgM positive for Crimean-Congo haemorrhagic fever. A total of 32 close contacts, including 10 health workers and 4 family members, have been listed and are being followed up. Efforts to identify other close contacts are ongoing.

The case-patient used public transportation and a taxi at various stages of his movement during the course of illness. Preliminary investigations also established that all the 4 healthcare facilities that managed the case-patient did not apply appropriate infection prevention and control measures, potentially indicating a higher number of contacts.

According to the WHO, Crimean-Congo haemorrhagic fever is a widespread disease caused by a tick-borne virus (_Nairovirus_) of the _Bunyaviridae_ family. The CCHF virus causes severe viral hemorrhagic fever outbreaks, with a case fatality rate of 10-40 percent. CCHF is endemic in Africa, the Balkans, the Middle East and Asian countries south of the 50th parallel north - the geographical limit of the principal tick vector.

The hosts of the CCHF virus include a wide range of wild and domestic animals such as cattle, sheep and goats. Animals become infected by the bite of infected ticks and the virus remains in their bloodstream for about one week after infection, allowing the tick-animal-tick cycle to continue when another tick bites.

Although a number of tick genera are capable of becoming infected with CCHF virus, ticks of the genus _Hyalomma_ are the principal vector. The CCHF virus is transmitted to people either by tick bites or through contact with infected animal blood or tissues during and immediately after slaughter. The majority of cases have occurred in people involved in the livestock industry, such as agricultural workers, slaughterhouse workers and veterinarians. Human-to-human transmission is possible.
=======================
[There is need to emphasize inter-sectoral collaboration involving health, veterinary and entomology/environmental services to map the areas of vector distribution. Furthermore, awareness messages among the high exposure groups should be widespread as CCHF vector propagates from May onwards leading to higher transmission rates in summer. - ProMED Mod.UBA]

[HealthMap/ProMED-mail map:
Guidimaka Region, Mauritania: <http://healthmap.org/promed/p/25044>]
Date: Mon 27 Nov 2017
Source: Outbreak News Today [edited]

Following cases of Crimean-Congo haemorrhagic fever (CCHF) reported this spring and summer [2017], the Mauritania Ministry of Health has reported an addition CCHF case last week [week ending Sun 26 Nov 2017] in a 48-year-old male farmer from Haye Sakin community in Dar Nairn, at the outskirt of the capital city, Nouakchott. He fell sick on the [11 Nov 2017] and was later treated and discharged last week.  The frequency of these events affirms the relative prevalence of the pathogen and the reservoir and vector for CCHF virus (Hyalomma ticks) in the country.

According to the WHO, Crimean-Congo hemorrhagic fever is a widespread disease caused by a tick-borne virus (Nairovirus) of the _Bunyaviridae_ family. The CCHF virus causes severe viral haemorrhagic fever outbreaks, with a case fatality rate of 10-40 percent.  CCHF is endemic in Africa, the Balkans, the Middle East and Asian countries south of the 50th parallel north - the geographical limit of the principal tick vector. The hosts of the CCHF virus include a wide range of wild and domestic animals such as cattle, sheep and goats.

Animals become infected by the bite of infected ticks and the virus remains in their bloodstream for about one week after infection, allowing the tick-animal-tick cycle to continue when another tick bites. Although a number of tick genera are capable of becoming infected with CCHF virus, ticks of the genus _Hyalomma_ are the principal vector.

The CCHF virus is transmitted to people either by tick bites or through contact with infected animal blood or tissues during and immediately after slaughter. The majority of cases have occurred in people involved in the livestock industry, such as agricultural workers, slaughterhouse workers and veterinarians. Human-to-human transmission is possible.
=========================
[Crimean-Congo hemorrhagic fever (CCHF), an acute viral disease in humans, is characterized by extensive ecchymoses, bleeding, and hepatic dysfunction and is associated with a 30 percent case-fatality ratio (World Health Organization Crimean-Congo haemorrhagic fever. Fact sheet no. 208. Geneva: the Organization; 1998). It is caused by CCHF virus (genus _Nairovirus_, family _Bunyaviridae_).

CCHF is a zoonosis transmitted to large and small mammals and birds by ticks. Although the virus has been isolated from several genera and species of ixodid ticks, the main group of vectors involved in CCHF virus transmission appears to be ticks of the genus _Hyalomma_ (Hoogstraal H. The epidemiology of tick-borne Crimean-Congo haemorrhagic fever in Asia, Europe, and Africa. J Med Entomol. 1979;15(4):307-417.). Immature ticks acquire the virus by feeding on infected small vertebrates. Once infected, they remain infected throughout their development and, when they are mature, transmit the infection to large animals, such as livestock. Transovarian transmission has also been demonstrated.

The circulation of CCHF virus and the high prevalence of infected animals and ticks have been well documented in Mauritanian farming areas since 1983 (Gonzalez JP, LeGuenno B, Guillaud M, Wilson ML. A fatal case of Crimean-Congo haemorrhagic fever in Mauritania: virological and serological evidence suggesting epidemic transmission. Trans R Soc Trop Med Hyg. 1990;84(4):573-6).

Mauritania experienced a fairly large CCHF outbreak in 2003, involving 38 cases with a case fatality rate of 28.6 percent. Over 90 percent of the cases (35/38) were resident in Nouakchott. In 2017, the WHO reported confirmation of a 3rd CCHF case in Boutilimit as well as in 2 patients referred from Mauritania to Dakar, Senegal who tested positive between May and June 2017. These cases had also originated from the capital city Nouakchott. This may be indicative of the relative prevalence of the reservoir and vector for the CCHF virus (Hyalomma ticks) in the country.

Even though the country has established adequate diagnostic capacity, which facilitated rapid confirmation of cases; the national authorities and partners need to carry out extensive outbreak investigations, including seroprevalence studies, to determine the potential risk for continued CCHF outbreaks in humans and institute effective prevention and control measures, with a strong animal health component  (<http://apps.who.int/iris/bitstream/10665/258794/1/OEW34-192582017.pdf>).

The case reported in this report is a farmer admitted in early
November [2017], however no exposure history is mentioned. - ProMED Mod.UBA]

[HealthMap/ProMED-mail map Nouakchott, Nouakchott, Mauritania:
Date: 28 Aug 2017
Source: Outbreak News Today [edited]

On 24 Aug 2017, the Mauritania Ministry of Health notified WHO of a confirmed case of Crimean-Congo hemorrhagic fever (CCHF) in a 47-year-old shepherd, from Arafat Village in Mohammedia, Boutilimit Prefecture, located about 150 km southeast of the capital, Nouakchott.

In May 2017, health officials reported 2 imported cases of Crimean-Congo hemorrhagic fever (CCHF) in Senegal imported from Mauritania. A 3rd imported case was reported in June 2017.

He developed headache, muscle and joints pains and diarrhea on 20 Aug 2017 and sought medical attention. He was treated with anti-malarial medicines and analgesics.

After 2 days, he returned for medical care as his condition worsened. He was tested for CCHF because of bleeding manifestations and was IgM positive for Crimean-Congo haemorrhagic fever by enzyme-linked immunosorbent assay (ELISA). The patient is still hospitalized and in stable clinical condition.

Mauritania experienced a fairly large CCHF outbreak in 2003, involving 38 cases with a case fatality rate of 28.6 percent. According to the WHO, Crimean-Congo hemorrhagic fever is a widespread disease caused by a tick-borne virus (Nairovirus) of the Bunyaviridae family. The CCHF virus causes severe viral hemorrhagic fever outbreaks, with a case fatality rate of 10-40 percent.

CCHF is endemic in Africa, the Balkans, the Middle East and Asian countries south of the 50th parallel north, the geographical limit of the principal tick vector. The hosts of the CCHF virus include a wide range of wild and domestic animals such as cattle, sheep and goats.

Animals become infected by the bite of infected ticks, and the virus remains in their bloodstream for about one week after infection, allowing the tick-animal-tick cycle to continue when another tick bites. Although a number of tick genera are capable of becoming infected with CCHF virus, ticks of the genus _Hyalomma_ are the principal vectors.

The CCHF virus is transmitted to people either by tick bites or through contact with infected animal blood or tissues during and immediately after slaughter. The majority of cases have occurred in people involved in the livestock industry, such as agricultural workers, slaughterhouse workers and veterinarians. Human-to-human transmission is possible.  [Byline:  Robert Herriman]
==================
[An outbreak of Crimean-Congo hemorrhagic fever was documented in Nouakchott, the capital of Mauritania in 2003. The index case was detected on 18 Feb 2003. By 21 Mar 2003, the Ministry of Health of Mauritania had reported a total of 35 cases (18 laboratory confirmed) of Crimean-Congo haemorrhagic fever (CCHF), including 6 deaths [Crimean-Congo hemorrhagic fever - Mauritania (04) http://promedmail.org/post/20030324.0732].

In the period from February to August 2003, 38 persons were infected with Crimean-Congo hemorrhagic fever (CCHF) virus; 35 of these persons were residents of Nouakchott. The 1st patient was a young woman who became ill shortly after butchering a goat. She transmitted the infection to 15 persons in the hospital where she was admitted and 4 members of her family. In Nouakchott, 2 disease clusters and 11 isolated cases were identified. Of the patients not infected by the 1st case-patient, almost half were butchers, which suggests that the primary mode of animal-to-human transmission was direct contact with blood of infected animals.

Cattle heavily infested with ticks were more likely to be CCHFV seropositive, and vector control to reduce the tick burden can result in reduced seroprevalence. Cattle are noted as the most sensitive indicator of low-level CCHFV circulation because they tend to be highly infested with _Hyalomma_ spp. ticks, which are the most common vectors of CCHF  [<http://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0004210>].

The circulation of CCHF virus and the high prevalence of infected animals and ticks have been well documented in Mauritanian farming areas since 1983 [Crimean-Congo haemorrhagic fever and Rift Valley fever in south-eastern Mauritania. Saluzzo JF, Digoutte JP, Camicas JL, Chauvancy G Lancet. 1985 Jan 12; 1(8420):116].

Since then, this is the latest case reported from that country, with history of exposure to livestock. - ProMed Mod.UBA]

[A HealthMap/ProMED-mail map can be accessed at:
<http://healthmap.org/promed/p/13859>.]
Date: Sat 3 Jun 2017, 11:08 AM
Source: Alakhbar [in French, trans. Mod.AB, edited]

A suspected case of Rift Valley fever (RVF) was discovered at the Nouakchott Hospital Center according to a source for Alakhbar.

The patient is a 37-year-old Mauritanian. He was isolated upon his arrival at the hospital after the 1st medical tests revealed the existence of fever. Further in-depth analyzes are required for confirmation.

The Mauritanian health authorities have often denied the existence of the virus in its 1st appearances.

RVF is a disease that mainly affects animals but can contaminate humans either by mosquito bites or by contact with blood, physiological fluids, or organs of infected animals. The RVF virus was 1st identified in 1931 during an investigation of an epidemic affecting sheep in a Rift Valley farm in Kenya.
=====================
[If this case were to be definitively confirmed in the laboratory, it would have occurred almost 18 months after the series of cases, including 4 fatal cases, which Mauritania had experienced over various provinces in October 2015. At the same time, at least 4 foci of the disease occurred in sheep and goats in Brakna region (Aleg, Tidjikja, Magta-Lahjar, Kiffa).

The recent episode of RVF in Niger (September 2016 to February 2017) could be the cause of the re-emergence of the disease in Mauritania because, although these 2 countries do not share a common border, there is an incessant movement of livestock between the different areas of the Sahel where nomadism is a widespread lifestyle. It would appear that veterinary surveillance in these areas is sub-optimal, and this would explain why the detection of human cases precedes that of animal cases at the origin of these cases. - ProMED Mod.AB]

[RVF virus likely is endemic in parts of Mauritania, with cases of human and domestic animals occurring sporadically there. ProMED Mod AS provided an excellent comment on RVF previously; "Rift Valley fever (RVF) is a peracute or acute zoonotic disease of domestic ruminants. It is caused by a single serotype of a mosquito-borne virus of the _Bunyaviridae_ family (genus _Phlebovirus_). The disease occurs in climatic conditions favouring the breeding of mosquito vectors and is characterised by abortion, neonatal mortality, and liver damage. The disease is most severe in sheep, goats and cattle. Older, non-pregnant animals, although susceptible to infection, are more resistant to clinical disease. There is considerable variation in the susceptibility to RVF of animals of different species. Camels usually have an inapparent infection with RVF virus (RVFV), but sudden mortality, neonatal mortality, and abortion occur, and abortion rates can be as high as in cattle.

"Humans are susceptible to RVFV and are infected through contact with infected animal material (body fluids or tissues) or through bites from infected mosquitoes. RVFV has also caused serious infections in laboratory workers and must be handled with biosafety and biocontainment measures. It is recommended that laboratory workers be vaccinated if possible.

"RVFV is endemic in many African countries and may involve several countries in the region at the same time or progressively expand geographically over the course of a few years. In addition to Africa, large outbreaks have been observed in the Arabian Peninsula and some Indian Ocean Islands. These generally, but not exclusively, follow the periodic cycles of unusually heavy rainfall, which may occur at intervals of several years, or the flooding of wide areas favouring the proliferation of mosquitoes.

"Rainfall facilitates mosquito eggs to hatch. _Aedes_ mosquitoes acquire the virus from feeding on infected animals and may potentially vertically transmit the virus so that new generations of infected mosquitoes may hatch from their eggs. This provides a potential mechanism for maintaining the virus in nature, as the eggs of these mosquitoes may survive for periods of up to several years in dry conditions. Once livestock is infected, a wide variety of mosquito species may act as the vector for transmission of RVFV and can spread the disease.

"Low level RVF activity may take place during inter-epizootic periods. RVF should be suspected when exceptional flooding and subsequent abundant mosquito populations are followed by the occurrence of abortions, together with fatal disease marked by necrosis and haemorrhages in the liver that particularly affect newborn lambs, kids and calves, potentially concurrent with the occurrence of an influenza-like illness in farm workers and people handling raw meat.

"During an outbreak, preventive measures to protect workers from infection should be employed when there are suspicions that RVFV-infected animals or animal products are to be handled.

"The above and much more information is available at

ProMED would appreciate receiving additional information including laboratory results about this case and any new ones that might appear as they become available, in addition to information on presumed location of infection as the diagnosis was made in the capital city, but no mention of where the individual came from. - ProMED Mod.TY]

[A HealthMap/ProMED-mail map can be accessed at:

A HealthMap/ProMED-mail map can be accessed at:
Date: Tue 22 Mar 2016
Source: Points Chaud [in French, trans. Mod.MPP, edited]

A Mauritanian who came from Angola with yellow fever died on Monday [20 Mar 2016] at the Friendship Hospital. According to the Mauritanian community in Angola, the deceased had contracted the disease in Angola and decided to return to the country 2 days ago on a plane from a Moroccan company. His situation deteriorated after having been transferred to the Friendship Hospital where he died on Monday [20 Mar 2016].

It's not known whether the health authorities of the country had or did not have any concept of the severity of his disease. It's known that Angola presently has an epidemic of yellow fever ongoing that has already killed [more than] 158 people.

Yellow fever is a serious disease transmitted by insects that proliferate in standing water in dirty locations and places with waste.
=====================
[This is yet another case where a yellow fever virus infected individual travelled to a distant country in Africa. YF-infected individuals have travelled from Angola to the DR Congo and to Kenya. The risk of ongoing transmission in Mauritania is unknown, but health authorities there should be vigilant. - ProMED Mod.TY]

[HealthMap/ProMED-mail maps can be accessed at
More ...

French Guiana

French Guiana US Consular Information Sheet
August 14, 2006

COUNTRY DESCRIPTION: French Guiana is an overseas department of France. It is a sparsely populated tropical area located on the northern coast of South America. French is the pred
minant language; English is not widely spoken. Tourist facilities are available, especially in the larger cities such as Cayenne and Kourou, but in some instances are not highly developed.

ENTRY/EXIT REQUIREMENTS: Passports are required of U.S. citizens entering French Guiana. Visitors who arrive by land or on a commercial air carrier with a return ticket may enter for up to 90 days without a visa. See our Foreign Entry Requirements brochure for more information on French Guiana and other countries. Visit the Embassy of France web site at for the most current visa information, or contact the Embassy of France at 4101 Reservoir Road N.W., Washington, DC 20007; telephone (202) 944-6000; or the nearest French Consulate in Atlanta, Boston, Chicago, Houston, Los Angeles, Miami, New York, New Orleans or San Francisco.

Find more information about Entry and Exit Requirements pertaining to dual nationality and the prevention of international child abduction . For further information about customs regulations, please read our Customs Information .

SAFETY AND SECURITY: For the latest security information, Americans traveling abroad should regularly monitor the Department's Internet web site , where the current Worldwide Caution Public Announcement , Travel Warnings and Public Announcements 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: Petty street crime occurs throughout the major cities. Individuals should make sure to keep valuables out of sight, especially if left unattended in an automobile.

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 care within French Guiana is limited, and hospital facilities are available only in major urban areas. Patients' rooms in hospitals are primarily open-air facilities; instead of glass panes, hospital windows are fitted with wooden slats.

Information on vaccinations and other health precautions, such as safe food and water precautions and insect bite protection, may be obtained from the Centers for Disease Control and Prevention's hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747) or via the CDC's Internet site at 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 .

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

Primary roads in French Guiana are well paved and well maintained. Emergency call boxes are available at regular intervals on the main highways. Roads in rural areas are less developed. Roads leading to more remote regions in the interior are often improved dirt roads. French Guiana has a relatively moderate to high volume of traffic and police enforce traffic safety. Night driving can be dangerous, especially in the remote interior regions or on less-developed rural roads. Public transportation in the form of taxis and vans is relatively safe.

Please refer to our Road Safety page for more information. Visit the website of the French National Tourist Organization at http://www.franceguide.com.

AVIATION SAFETY OVERSIGHT: The U.S. Federal Aviation Administration (FAA) has assessed the Government of France as being in compliance with ICAO international aviation safety standards for oversight of France's air carrier operations. For more information, travelers may visit the FAA's Internet web site at .
SPECIAL CIRCUMSTANCES: In addition to being subject to all French laws affecting U.S. citizens, dual nationals may also be subject to other laws that impose special obligations on French citizens. For additional information, please see our Dual Nationality flyer .
French customs authorities may enforce strict regulations concerning temporary importation into or export from French Guiana of items such as firearms, medications, animals, etc. It is advisable to contact the Embassy of France in Washington or one of the many French consulates in the United States for specific information regarding customs requirements.
Customs authorities encourage the use of an ATA (Admission Temporaire/Temporary Admission) Carnet for the temporary admission of professional equipment, commercial samples, and/or goods for exhibitions and fair purposes. ATA Carnet Headquarters , located at the U.S. Council for International Business , 1212 Avenue of the Americas, New York, NY 10036, issues and guarantees the ATA Carnet in the United States. For additional information call (212) 354-4480, e-mail atacarnet@uscib.org, or visit www.uscib.org for details. Please see our Customs Information .

CRIMINAL PENALTIES: While in a foreign country, a U.S. citizen is subject to that country's laws and regulations, which sometimes differ significantly from those in the United States and may not afford the protections available to the individual under U.S. law. Penalties for breaking the law can be more severe than in the United States for similar offenses. Persons violating French laws, even unknowingly, may be expelled, arrested, or imprisoned. Penalties for possession, use, or trafficking in illegal drugs in French Guiana 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 on international adoption of children and international parental child abduction, see the Office of Children's Issues website.

REGISTRATION / EMBASSY LOCATION: Americans living or traveling in Suriname are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department's travel registration website and to obtain updated information on travel and security within Suriname. Americans without Internet access may register directly with the nearest U.S. Embassy or Consulate. By registering, American citizens make it easier for the Embassy or Consulate to contact them in case of emergency. The U.S. Embassy is located at Dr. Sophie Redmondstraat 129, telephone (011)(597) 472-900, web site http://paramaribo.usembassy.gov. The Consular Section hours of operation for routine American citizen services are Mondays and Wednesdays from 1:30 pm - 3:30 pm, or by appointment, except on American and Surinamese holidays. U.S. citizens requiring emergency assistance evenings, weekends, and holidays may contact an Embassy duty officer by cell phone at (011)(597) 088-08302.
* * *
This replaces the Consular Information Sheet dated November 2, 2005 to update all sections.

Travel News Headlines WORLD NEWS

Date: Tue 14 Aug 2018
Source: France Guyane [in French, trans. ProMED Corr.SB, edited]
<http://www.franceguyane.fr/actualite/education-sante-environnement/un-cas-de-fievre-jaune-contracte-en-guyane-412398.php>

A 47-year-old man of Swiss nationality contracted yellow fever in French Guiana. He was diagnosed last weekend by the Institut Pasteur. The fact that he had been present in French Guiana for 4 months without having apparently left it makes it very likely that he contracted the virus in the department, and more precisely in the area of the County Bridge.

In a message addressed to certain health professionals, the Regional Health Agency (ARS) details the situation: "A new case of yellow fever was confirmed last weekend by the Pasteur Institute of Guyana, and after that diagnosed in France. After a visit to CHAR, the patient was transferred urgently to a liver resuscitation unit in Paris.

This is a 47-year-old man of Swiss nationality who had returned by land from Brazil but who had been in French Guiana for 4 months and who had not left the territory (of Guyana) since his arrival. Therefore, we can consider that this is a local infection. The patient was not vaccinated. According to information available at this stage, he was working on the marking of forest roads in the County Bridge area, and it can be assumed that he was infected in these areas, and investigations are underway to detect associated cases and to trace more closely the movements of the patient.

This new case confirms that yellow fever is present in Guyana. While awaiting more precise information, this also seems to indicate that the virus is present in the littoral zone and justifies the vaccination of the whole department's population.
========================
[Sylvatic yellow fever (YF) is endemic in areas of 13 countries and territories of the South American region, including Argentina, Brazil, Paraguay, Bolivia, Peru, Ecuador, Colombia, Venezuela, Panama, Guyana, Suriname, French Guiana and the island of Trinidad.

A 20 Mar 2018 PAHO/WHO Epidemiological Update on Yellow Fever stated that there were confirmed cases this year [2018] in several South American countries including French Guiana (see Yellow fever - Americas (22): South America http://promedmail.org/post/20180321.5699760). Individuals traveling, working or residing in these areas should be vaccinated against YF.

Unfortunately, the Swiss worker was not. The patient's condition was not mentioned, other than that he was transferred urgently to a liver resuscitation unit in Paris, but was still alive. - ProMED Mod.TY]

[HealthMap/ProMED maps available at: Switzerland:
<http://healthmap.org/promed/p/105>

Region d'outre-mer de French Guiana, France:
<http://healthmap.org/promed/p/577>]
Date: Sun, 26 Mar 2017 22:38:35 +0200
By Marion BRISWALTER

Cayenne, March 26, 2017 (AFP) - French Guiana came to a standstill Sunday on the eve of a major strike which has elbowed its way into France's presidential campaign.   Air France cancelled all flights to the South American territory for Sunday and Monday, when 37 labour unions were to launch a general strike demanding a "Marshall Plan" to improve public services and security.   Barricades have been erected on roads since last week, and the US State Department has warned travellers to stay away, citing the risk of violence.   The protests also led to the indefinite postponement of an Arianespace rocket launch at Europe's Guiana Space Centre in Kourou.

The French government has sent a delegation to negotiate with the strikers, asking them to lay out their demands.   But 13 of the territory's 22 mayors have refused to meet the delegation, demanding along with the strikers that French ministers come in person.   "This has gone on long enough! All we have is plundered, it's time to recognise the people of Guiana," a woman at the barricade blocking access to the airport at Cayenne, the capital, told AFP on Sunday.   "I am listening to the Guianans," said Ericka Bareigts, the minister of overseas territories, though she has ruled out travelling to the territory for now.   "We will be able to go to Guiana once the conditions are right and progress has been made," she said.   The road barricades were temporarily lifted Sunday and some stores opened so that people could stock up on food and other supplies before the strike began.

- 'Failed policies' -
The "Collective to Get Guiana Moving" has called for better access to health services and electricity, economic development and job creation programmes, and renewed efforts to keep children from dropping out of school.   The territory, with about 250,000 inhabitants, relies on huge injections of public funds.   "The government must respond rapidly to these requests," Segolene Royal, the French environment minister, said after a recent visit to the territory.   The visiting delegation has already had a scanner installed at the airport to help stop drug trafficking, and pledged to speed up the arrival of EU aide.   But several of the candidates seeking the French presidency have pounced on the crisis just a month before the first round of voting.   For Francois Fillon, the conservative candidate, "This situation is the consequence of the failed policies of Francois Hollande," the outgoing Socialist president.

Marine Le Pen, the far-right National Front candidate, condemned what she called an "cruel minimum service" of recent governments in Paris toward the territory.   In response, Bareigts, the overseas territories minister, and Interior Minister Matthias Fekl said Sunday after a meeting with Prime Minister Bernard Cazeneuve that "We will not tolerate any exploitation of this social crisis, neither to disrupt public order nor for campaign purposes."   A similar revolt gripped French Guiana in 2008 over soaring fuel prices, shutting down schools and the airport.   The strike ended after 11 days, when the government agreed to cut fuel prices.
Date: Mon, 21 Mar 2016 11:58:00 +0100

Paris, March 21, 2016 (AFP) - Up to a third of flights were cancelled at French airports on Monday as air traffic controllers entered a second day of strikes.    Low-cost airline Ryanair deplored what it said was the 41st strike by French air traffic controllers since 2009.   Around 140 passengers spent the night in Paris's Orly airport where half of flights were cancelled on the first day of strikes on Sunday.

Authorities Monday asked airlines to cut a third of flights at Orly and Marseille airports, and 20 percent at Lyon, Nice and Beauvais near Paris.    The striking union, which represents around a fifth of air traffic controllers, is campaigning against job cuts and the lack of investment in new technology.   Air France said journeys out of Paris's other main airport, Charles De Gaulle, were not facing cancellations, but last-minute delays were possible.    EasyJet said it had cancelled 90 flights and that more disruptions were possible.
Date: Wed 2 Sep 2015
Source: OIE WAHID, weekly disease information 2015; 28 (36) [edited]

Rabies, French Guiana
--------------
Information received on [and dated] 2 Sep 2015 from Dr Loic Evain, Directeur General adjoint, CVO, Direction generale de l'alimentation, Ministere de l'Agriculture, de l'Agroalimentaire et de la Foret, Paris, French Guiana.

Summary:
Report type: Immediate notification
Date of start of the event: 20 Aug 2015
Date of confirmation of the event: 31 Aug 2015
Reason for notification: Reoccurrence of a listed disease
Date of previous occurrence: October 2009
Manifestation of disease: Clinical disease
Causal agent: Lyssavirus (RABV vampire bat rabies types)
Serotype: RABV
Nature of diagnosis: Laboratory (advanced)
This event pertains to a defined zone within the country.

New outbreaks (1)
Summary of outbreaks:
Total outbreaks: 1
Outbreak 1: Cayenne, Cayenne
Date of start of the outbreak: 20 Aug 2015
Outbreak status: continuing (or date resolved not provided)
Epidemiological unit: Not applicable
Affected animals:
Species / Susceptible / Cases / Deaths / Destroyed / Slaughtered
Dogs / 1 / 1 / 1 / 0 / 0

Affected population: On Thu 20 Aug 2015, a 6-month-old dog was taken to the veterinarian since he was showing a decreased appetite without neurological signs and again the next day (Fri 21 Aug) following a deterioration of his general condition with convulsions, aggressiveness, visual loss and difficulties with movement. He was hospitalized and died on the night from Friday to Saturday. A rabies investigation was then launched and the Pasteur Institute confirmed the diagnosis on 31 Aug 2015.

Epidemiology:
Source of the outbreak(s) or origin of infection: unknown or inconclusive

Epidemiological comment: The virus isolated in the dog is a Lyssavirus of RABV species and of "vampire bat rabies" type. It is estimated that the virus excretion phase started on 5 Aug 2015. During this period, the dog was in a fully fenced house. No runaway was reported during the period. He just went out for some walks on a lead in the neighbourhood and some visits to the veterinarian. The dog did not bite but could have chewed or lick wounds or the face. The epidemiological investigation has identified to date 12 contact people and no contact animals. However, there are stray cats near the house where the rabid dog was. Although the origin of the contamination of the dog is still uncertain, the most likely hypothesis is the contact with a bat, since the dog has eaten dead animals found in the garden several times. Following confirmation of the diagnosis, a regulated zone was put in place in order to limit the movements of domestic carnivores, to establish increased surveillance and to strengthen the capture of stray animals. Carnivores improperly vaccinated that could have had contact with the case will be euthanized. Carnivores properly vaccinated that could have had contact with the case will be under clinical monitoring for 6 months.

Control measures
Measures applied: movement control inside the country; screening; quarantine; zoning; no vaccination; no treatment of affected animals Measures to be applied: No other measures.

Diagnostic test results:
Laboratory name and type:
Institute Pasteur (Paris) (National laboratory)Species / Test / Test date / Result
Dogs / direct fluorescent antibody (FAT) test / 28 Aug 2015 / Positive
Dogs / pathogen isolation on cell culture / 31 Aug 2015 / Positive

Future Reporting: The event is continuing. Weekly follow-up reports will be submitted.

The location of the outbreak can be seen on the interactive map included in the OIE report at the source URL above.
====================
[This immediate notification officially confirms the information communicated in the ProMED-mail report archive number 20150903.3620512.

"Rabies transmitted by the common vampire bat (_Desmodus rotundus_) is a major public health concern in subtropical and tropical areas of Latin America. Infected vampire bats can transmit rabies to domestic mammals and humans through their haematophagous behavior."  <https://www.aphis.usda.gov/wildlife_damage/nwrc/publications/12pubs/anderson121.pdf>

Pictures of the common vampire bat (_Desmodus rotundus_) can be seen at

[A HealthMap/ProMED-mail map can be accessed at:
Date: Tue 1 Aug 2015
Source: France-Guyane [in French, trans. ProMED CopyEd.LMI, edited]

Yesterday [31 Jul 2015], the Pasteur Institute in Paris confirmed a case of rabies in a 6-month old puppy living in Cayenne. The animal was hospitalized on 21 Aug 2015 at a veterinary hospital for nervous symptoms. He died the following night. 16 people in contact with the dog were sent to the anti-rabies center at the hospital in Cayenne.

The Director for Food, Agriculture and Forestry (Daaf) continues to investigate to discover the origin of the infection. He reminds people of the following guidelines:
- any sudden death of a domestic animal with no identified cause should be reported to a veterinarian;
- any dog, cat, monkey, bat, or other animal bite should be reported to the Daaf;
- early vaccination (starting at 3 months) of domestic animals, with a yearly booster shot is required.

As a precaution, a lot more will be done to catch stray animals in the neighbourhood and the entire area comprising the Zephyr bypass, Montabo, and Baduel roads, and Saint-Antoine path.
=================
[Cayenne is the capital of French Guiana (FG), an overseas region of France on the northeast coast of South America, bordering, on the west, Suriname and on the east and south, Brazil (the Amapa State). See maps at <http://geology.com/world/french-guiana-map.gif> and <http://healthmap.org/promed/p/3486>.

According to French Guiana's reports to the OIE, rabies has been absent there in domestic animals since 2003 and in wildlife since 2009.

According to Ref 1 below, on 28 May 2008, the French National Reference Center for Rabies (Institut Pasteur, Paris) confirmed the rabies diagnosis, based on hemi-nested polymerase chain reaction on skin biopsy and saliva specimens from a Guianan, who had never travelled overseas and died in Cayenne after presenting clinically typical meningoencephalitis.

>From the Author Summary:
"Until 2008, rabies had never been described within the French Guianan human population. Emergence of the 1st case in May 2008 in this French Overseas Department represented a public health event that markedly affected the local population, healthcare workers, and public health authorities. The anti-rabies clinic of French Guiana, located at Institut Pasteur de la Guyane, had to reorganize its functioning to handle the dramatically increased demand for vaccination. A rigorous epidemiological investigation and a veterinary study were conducted to identify the contamination source, probably linked to a bat bite, and the exposed population. Communication was a key factor to controlling this episode and changing the local perception of this formerly neglected disease. Because similar clinical cases had previously been described, without having been diagnosed, medical practices must be adapted and the rabies virus should be sought more systematically in similarly presenting cases. Sharing this experience could be useful for other countries that might someday have to manage such an emergence."

Results of the investigation into the source of infection of the 6-month old domestic dog reported above are anticipated with interest.

The increased incidence of rabies transmission to humans by vampire bats in Latin America, specifically in the Amazon region of Brazil, is discussed in Ref 2 below.

References
----------
1. Meynard J-B, Flamand C, Dupuy C, et al: First human rabies case in French Guiana, 2008: PLoS Negl Trop Dis. 2012;6(2):e1537. doi: 10.1371/journal.pntd.0001537; available at  <http://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0001537>.
2. Schneider MC, Romijn PC, Uieda W, et al: Rabies transmitted by vampire bats to humans: an emerging zoonotic disease in Latin America? Rev Panam Salud Publica. 2009; 25(3): 260-9; available at <http://www.scielosp.org/scielo.php?pid=S1020-49892009000300010&script=sci_arttext>. - ProMED Mod.AS]
More ...

World Travel News Headlines

Date: Fri, 13 Dec 2019 16:41:23 +0100 (MET)
By Mariëtte Le Roux and Joseph Schmid

Paris, Dec 13, 2019 (AFP) - French commuters gritted their teeth for a ninth day of public transport strikes Friday, with unions vowing to keep up their protest against a pension overhaul through the holidays unless the government backs down.   Officials have said they are ready to negotiate, with Education Minister Jean-Michel Blanquer meeting teachers' representatives on Friday to try and stave off another day of class shutdowns.   "It was an intense and frank meeting... but we still need details, and maintain our call to strike on Tuesday," Stephane Crochet of the SE-Unsa union said.

Unions are hoping for a repeat of 1995, when they forced a rightwing government to back down on pension reforms after three weeks of metro and rail strikes just before Christmas.   The prospect of a protracted standoff has businesses fearing big losses during the crucial year-end festivities, and travellers worried that their Christmas plans may be compromised.   "Right now it's a catastrophe here, but we're hoping there will be a solution before Christmas," Frederic Masse, a foie gras producer at the huge Rungis wholesale food market south of Paris, told AFP on Friday.

The capital city was again choked by huge traffic jams as most metro lines remained shut, only a handful of buses and trams were running, and one in four TGV trains were cancelled.   "I'm sick of this, and I won't be able to keep working if it goes on," Zigo Makango, a 57-year-old security agent, told AFP onboard a bus in the Bobigny suburb northeast of Paris.   To get home at night Makango said he has to use taxis, but "my boss doesn't reimburse me for that".

- 'Historic reform' -
President Emmanuel Macron on Friday expressed his "solidarity" with people impacted by the strike, "but I want the government to continue its work" in forging a single pension system, a key campaign promise.   "It's a historic reform for the country," he told journalists at an EU summit in Brussels. 

The overhaul unveiled by Prime Minister Edouard Philippe would do away with 42 separate regimes, some of which offer early retirement and other benefits to public-sector employees such as train drivers, dockers and even Paris Opera employees.   But Philippe angered unions further by proposing a reduced payout for people who retire at the legal age of 62 instead of a new, so-called "pivot age" of 64.

They have called for new mass demonstrations for next Tuesday, the third since the action started on December 5 in the biggest show of strength in years by France's notoriously militant unions.   Philippe insisted on Twitter that "My door is open and my hand outstretched".   But Laurent Brun of the hard-line CGT union, the largest among public-sector workers including those at rail operator SNCF, has already warned "There won't be any Christmas truce" unless the government drops the plan entirely.

- France divided -
A poll released Thursday by the Elabe institute found France evenly divided on Philippe's plan, with 50 percent for and 49 percent against.  But 54 percent rejected the mooted 64-year cutoff for a full pension, and 54 percent supported the protest.

Staff at four of France's eight oil refineries were on strike Friday, affecting output and raising fears of shortages down the line.   And both Paris operas, the Garnier and the Bastille, again cancelled Friday performances and others through the weekend.   Macron's government insists the changes will make for a fairer system and help erase pension system deficits forecast to reach as much as 17 billion euros ($19 billion) by 2025.   The average French person retires at just over 60, years earlier than most in Europe or other rich OECD countries.
Date: Fri, 13 Dec 2019 14:05:22 +0100 (MET)

Milan, Dec 13, 2019 (AFP) - More than 300 flights were cancelled Friday in Italy due to a planned one-day strike by workers from Alitalia and Air Italy.   Alitalia said in a statement that 315 flights were cancelled on Friday, with another 40 cancelled Thursday night and Saturday morning. It was not immediately clear how many flights were cancelled at Air Italy.   The 24-hours strike, which involves pilots, flight attendants and ground personnel, was called by three unions to draw attention to what they called "the ongoing crisis at Alitalia and Air Italy."

The strike was felt most in Sardinia, with about 30 flights cancelled.    Money-losing Alitalia has been under special administration since 2017 when employees rejected a restructuring plan that would have laid off 1,700 workers out of an approximately 11,000.   The government has so far looked for buyers without success.    Unions plan to meet on Tuesday with Economy Minister Stefano Patuanelli.    A potential consortium of buyers for the ailing carrier fell apart last month after Atlantia, which operates Rome's airports, pulled out.
Date: Fri, 13 Dec 2019 05:24:44 +0100 (MET)
By Neil SANDS

Wellington, Dec 13, 2019 (AFP) - Adventure tourism is a key part of New Zealand's international appeal but the White Island volcano eruption is a tragic reminder that such activities carry genuine risk that must be better explained to travellers, experts say.   The South Pacific nation offers a wealth of adrenaline-fuelled pursuits, from heli-skiiing on snow-capped mountains to ballooning and blackwater rafting through caves.

Some, such as bungee-jumping, jet-boating and zorbing -- where you hurl yourself down a hill inside an inflatable ball -- were invented or popularised in a country that prides itself on catering to intrepid visitors.   The tourism industry as a whole is among New Zealand's biggest earners, generating about NZ$16.2 billion ($10.7 billion) and attracting 3.8 million international visitors annually.     "Adventure tourism is a massive sector in New Zealand. We are promoting ourselves as the adventure capital of the world," professor Michael Lueck, a tourism expert at Auckland University of Technology, told AFP.

New Zealand is also renowned for its rugged landscapes, which feature prominently films such as Kiwi director Peter Jackson's "Lord of the Rings".   Day-trips to White Island combined both, taking tourists including cruise ship passengers to a desolately beautiful island off the North Island coast where they could experience the thrill of standing on an active volcano.   Instead, at least 16 people are believed to have died and dozens suffered horrific burns when 47 tourists and guides were caught on the island during Monday's eruption.

The disaster has raised questions about why tourists were allowed on a volcano where experts had recently raised threat levels, as well as broader issues about the regulation of risky activities in the tourism sector.   "There will be bigger questions in relation to this event," Prime Minister Jacinda Ardern told parliament after the eruption.   "These questions must be asked, and they must be answered."

- 'Slapdash' or world's best? -
The disaster on White Island -- also known as Whakaari -- is not the first mass-fatality accident to affect tourists in New Zealand.   In 2015, seven people were killed when a scenic helicopter flight crashed into Fox Glacier. Two years earlier, a hot-air balloon claimed 11 lives and in 2010 nine died when a plane carrying skydivers plunged into a paddock.

Briton Chris Coker's son Brad, 24, died in the skydive plane crash and since then he has campaigned from afar for tighter regulations in New Zealand's adventure tourism sector.   "In my opinion, the New Zealand authorities... are still slapdash about tourist safety," Coker told news website stuff.co.nz after the White Island eruption.   "To run tourists there is insane. I know they signed a waiver and so on, but it's not really taking care of people."

Trade body Tourism Industry Aotearoa disputes such assessments, saying operators are "working within a world's best regulatory framework", but could not eliminate risk completely.   "Operators put safety first, but adventure activity inherently carries some risk and it's critical that 'adventure' remains in adventure tourism," TIA chief executive Chris Roberts told AFP.   "Operators take all practical actions to minimise the risks and the safety culture of individual operators remains the key factor in preventing accidents."

Roberts said the issue was not tourism operators, but the alert system they relied on at volcanic destinations such as White Island, which attracts about 17,000 visitors a year.   The GeoNet monitoring agency raised White Island's threat level in the week before the eruption but also advised current activity "does not pose a direct hazard to visitors".   "The reviews need to look at the science and specifically the guidance provided about volcanic activity, and whether the operating practices followed for the past 30 years need to change," Roberts said.

- 'Understand the risks' -
Travel companies such as White Island Tours brief customers before setting off and require them to sign a waiver declaring they understand the risk, as well as supplying equipment such as hard-hats and gas masks.   However, some relatives of those affected by the eruption have expressed scepticism that their loved ones truly appreciated the potential danger they faced.   Options for legal redress are limited under New Zealand's Accident Compensation Commission scheme, which covers victims' medical bills and provides modest compensation but does not allow civil suits for damages.

Neither Roberts nor Lueck expected the White Island eruption to hit international arrivals in New Zealand, which have continued to climb despite major earthquakes in 2011 and 2016.   The nature of any review arising from White Island remains uncertain, but Lueck said at the very least tourists needed to be better informed about any risks.   "Operators and tourism boards should have tourists understand what these risks are, and not brush over quickly signing a waiver," he said.   "Only then can tourists make an informed decision and decide whether or not they want to take that particular risk."
Date: Thu, 12 Dec 2019 21:25:36 +0100 (MET)

Kinshasa, Dec 12, 2019 (AFP) - Twenty-three cases of Ebola have been recorded in four days in eastern Democratic Republic of Congo, where deadly violence is hampering efforts to end the 16-month-old epidemic, authorities said on Thursday.   Ten cases were recorded on Tuesday alone in Mabalako in North Kivu province, after six on Monday, according to the Multisectoral Committee for Epidemic Response (CMRE).   Three out of the six were practitioners of traditional medicine, it said.

On Wednesday, three cases were recorded in North Kivu, including one in the Biena neighbourhood -- which has had no new Ebola cases for the last 85 days.   More than 2,200 people have died since the epidemic was declared on August 1, 2018.   As of November 22, the rate of new cases had fallen to 10 per week.   CMRE said "security reasons" -- attacks on Ebola health workers and sites by armed groups and angry youths -- had "paralysed" work in the key zones of Beni, Biakato and Mangina.   The attacks led to a pullout of locally-employed Ebola workers in Biakato by the UN's World Health Organization (WHO) and Doctors Without Borders (MSF).
Date: Thu, 12 Dec 2019 15:59:23 +0100 (MET)

Juba, Dec 12, 2019 (AFP) - Devastating flooding in South Sudan following a fierce drought could tip parts of the country into famine in the next few months, the World Food Programme (WFP) warned on Thursday.   According to the UN refugee agency nearly one million people were affected by floodwaters that submerged entire towns, compounding an already dire humanitarian situation after six years of war.

The WFP said that 5.5 million people are expected to be going hungry in early 2020 -- the time at which the population is generally benefiting from their harvest in October and November of the previous year.   An earlier harvest failed due to drought. This time crops have been washed away.    "The number of people in need is likely to increase because of the catastrophic level of destruction caused by floods since October following a drought that hammered parts of the country earlier in the year," the agency said in a statement.

The floods wiped out 73,000 metric tons of potential harvests as well as tens of thousands of cattle and goats, said the WFP.   "We know the problems that we've been having in South Sudan, but the rains and the floods have led to a national disaster and are much worse than anyone could have anticipated," said WFP Executive Director David Beasley.    "In fact, if we don't get funding in the next few weeks and months, we are literally talking about famine. We need support, we need help and we need it now."   The agency estimated its needs at $270 million (242 million euros) for the first half of 2020.   South Sudan declared a "man-made" famine affecting around 100,000 people in 2017. 

The term "famine" is used according to a scientific system agreed upon by global agencies, when at least 20 percent of the population in a specific area has extremely limited access to basic food; acute malnutrition exceeds 30 percent; and the death rate exceeds two per 10,000 people per day for the entire population.   "Famine in South Sudan was defeated after four months in 2017 by a concerted large-scale humanitarian response," said the WFP.   "Experts now say the country's food security outlook has never been so dire."   Political instability is also high as President Salva Kiir and his rival Riek Machar have again delayed their formation of a power-sharing government, this time by 100 days until February 2020.
Date: Wed, 11 Dec 2019 09:33:13 +0100 (MET)
By Holly ROBERTSON

Sydney, Dec 11, 2019 (AFP) - Up to 20,000 protesters rallied in Sydney on Wednesday demanding urgent climate action from Australia's government, as bushfire smoke choking the city caused health problems to spike.   Sydney has endured weeks bathed in toxic smoke as hundreds of blazes have raged across the countryside, with hospitals recording a 25 percent increase in the number of people visiting emergency departments last week.   On Tuesday smoke alarms rang out across Australia's biggest city, with thick haze triggering smoke alarms and forcing buildings to be evacuated, school children to be kept indoors, and ferries to be cancelled.   The devastating fires have focused attention on climate change, with scientists saying the blazes have come earlier and with more intensity than usual due to global warming and a prolonged drought.   Police estimated the crowd size at 15,000, organisers put the figure at 20,000.

Many of the protestors voiced anger at the government's silence in the face of the crisis.   "The country is on fire" said 26-year-old Samuel Wilkie attending his first climate protest. He described politicians' response as "pathetic".    "Our government is not doing anything about it," said 29-year-old landscape gardener Zara Zoe. "No one is listening, no one is doing anything."   Prime Minister Scott Morrison -- a staunch backer of Australia's vast coal industry -- has said little about the smoke since the crisis began, preferring to focus on fire-hit rural communities.   Organiser Chloe Rafferty said that had created anger at the conservative government's inaction.   "I think the wider public can see that we are not expecting the climate crisis in the future but we are facing the climate crisis now," she told AFP.   "People are experiencing it in their day-to-day lives."   As well as a rise in people visiting hospitals with smoke-related health symptoms, the number of emergency calls for ambulances spiked 30 percent last week.    "For most people, smoke causes mild symptoms like sore eyes, nose and throat," top health department official Richard Broome said.   "However, people with conditions like asthma, emphysema and angina are at greater risk because the smoke can trigger their symptoms."

Smoke from bushfires is one of the biggest contributors to air pollution in Australia, releasing fine particles that can lodge deep within people's lungs and cause "severe" health impacts over time, according to scientist Mick Meyer from government-funded scientific research agency CSIRO.   "The impact of smoke on people remote from the fires may, on occasion, substantially exceed the direct injury to people within the fire zone," he wrote in The Conversation.   "But we currently lack the operational tools to understand the extent of these impacts or to manage them."   Six people have been killed and more than 700 houses destroyed in bushfires this fire season.   Though the human toll has been far lower than the deadliest fire season in 2009 -- when almost 200 people died -- the scale of this year's devastation has been widely described as unprecedented.   Three million hectares (7.4 million acres) of land has been burnt -- the size of some small countries -- and vast swathes of koala habitat scorched.   Official data shows 2019 is on track to be one of the hottest and driest years on record in Australia.
Date: Tue 3 Dec 2019
Source: Trinidad Express [abridged, edited]

The number of local deaths from the influenza virus has risen to 24. At the Health Ministry's update last week, 16 fatalities were reported from the flu, with Health Minister Terrence Deyalsingh appealing to citizens -- especially those considered at-risk -- to get vaccinated.
Date: Sat 30 Nov 2019
Source: The New Indian Express, Express News Service [edited]

According to official data, 14 swine flu [influenza A/H1N1] deaths across the state were recorded this year [2019] till [17 Nov 2019]. The figure is slightly less than the previous year's [2018] toll of 17. The total number of H1N1 swine flu-positive cases [has] also come down this year [2019] compared with 2018 from 402 to 325. Health officials are setting up isolation wards in hospitals as a preventive measure.

As the winter season has set in and the minimum temperatures are coming down, health officials are instructing the public to take precautions in order to stay away from being infected by swine flu. The health department has initiated steps to set up district-[wide] swine flu testing facilities and isolation wards in every district hospital, area hospital, and community health centre.

As per the requirement of treatment procedure, the government has to set up special isolation wards in all government hospitals and provide protection kits to the healthcare staff, especially to those who will attend to the patients suffering from the flu. Across the state, Visakhapatnam registered the highest number of positive swine flu cases and deaths. Out of 325 positive cases, 180 alone were reported from Visakhapatnam, of which 8 died. West Godavari district registered 3 deaths, and Anantapur, East Godavari, and Srikakulam registered one death case each.

All the district health officials have been instructed to intensify awareness camps and screening centres. As part of the action plan, isolation wards with 5-10 beds are to be set up in every teaching, district, and area hospital. A sufficient stock of drugs, masks, and PPE [personal protective equipment] kits are to be made available. Currently, there are 18 labs eligible for conducting confirmation test in the state. "We are creating awareness by distributing pamphlets and putting up screening centres at bus stops and railway stations," DMHO [district medical and health officer] Dr. TSR Murthy said.

Symptoms of swine flu are generally similar to that of seasonal flu. These include cough, fever, sore throat, stuffiness, runny nose, body aches, headache, chills, fatigue, diarrhoea, and vomiting. Later on, breathlessness, chest pain, drowsiness, low blood pressure, sputum mixed with blood, and bluish discoloration of nails also develops.
Date: Thu 28 Nov 2019
Source: GDN Online [edited]

Two expatriates living in Oman died after contracting the seasonal influenza (H1N1) or swine flu in the governorate of Dhofar -- the 1st in July and the 2nd in August [2019]. They were among 78 confirmed cases of swine flu registered at the Sultan Qaboos Hospital over the first 9 months of 2019 in the governorate.

The hospital authorities reported a total of 599 registered suspected cases of H1N1 between January and last September [2019]. Doctors working at Sultan Qaboos Hospital dealt overall with 1779 cases of respiratory infections during the same period.

Patients most vulnerable to the respiratory viruses are those over 18 years, particularly pregnant women; those suffering from chronic illnesses, kidney and heart diseases, liver problems, diabetes, asthma, blood disorders, and HIV/AIDS; and even health workers, according to Muscat Daily.
Date: Wed 11 Dec 2019
Source: UNICEF/WHO Situation report 11 Dec 2019 [edited]

Highlights
- 5 new human cases reported in the past week
- In response to 1st human vaccine-derived poliovirus type 1 (VDPV1) case from the island province of Basilan, in the Bangsamoro Autonomous Region in Muslim Mindanao (BARMM), outbreak immunization was conducted
in Maluso, Basilan, with bivalent oral polio vaccine (bOPV) against polio type 1, vaccinating 13 547 children under 10 years old (102% of the target).
- Currently 9 human cases confirmed with circulating VDPV type 2 (cVDPV2), 1 case with VDPV1, 1 case with cVDPV1, and 1 case with immunodeficiency-related VDPV type 2 (iVDPV2).
- A case with VDPV1 from Sultan Kudarat is pending genetic analysis; 1 case of cVDPV1 from Malaysia was confirmed as genetically linked to the Basilan case.
- Synchronized polio vaccination campaign conducted on [25 Nov 2019 - 10 Dec 2019] (including 2 days of extension) vaccinated 4 309 566 children under 5, which is 98% of the target total of 4.4 million children under 5. A total of 1 395 365 children under 5 were vaccinated in National Capital Region (NCR), which is 109% of the target, and 2 914 201 (94%) in Mindanao.
- DOH planning to conduct outbreak immunization with bOPV targeting 710,296 children under 10 in the Sulu Archipelago, Zamboanga City, and Lambayong, Sultan Kudarat, on [6-12 Jan 2020].
- Current polio outbreak resulting from persistently low routine immunization coverage, and poor sanitation and hygiene.
- Philippines is affected by both cVDPV1 and cVDPV2. cVDPV is considered a public health emergency of international concern (PHEIC).

cVDPV1
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- In response to the 1st human case confirmed with VDPV1 from Maluso, Basilan (BARMM), outbreak immunization was conducted in the area with bOPV for children under 10 years old, vaccinating 13,547 children under 10 years of age (102% of the target).
- A cVDPV1 case in Sabah state, Malaysia, was confirmed to be genetically linked to the Basilan case by the Victorian Infectious Diseases Reference Laboratory (VIDRL) in Australia. Since the 2 viruses are genetically linked, they are both classified as circulating.
- A new VDPV1 case from Sultan Kudarat (Region XII) was confirmed on [6 Dec 2019] and is pending further genetic analysis.
- All 13 cVDPV1 environmental samples found in Manila are genetically linked.

cVDPV2
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- All 9 human cases and 17 environmental samples confirmed with cVDPV2 are genetically linked. All human cases were reported from Mindanao (BARMM and Region XII), whereas environmental samples were found in NCR and Davao.
- All samples were tested by the National Polio Laboratory at the Research Institute for Tropical Medicine (RITM), whereas sequencing and genetic analysis is done at the NIID in Japan, and additional genetic characterization is provided by the United States Centers for Disease Control and Prevention (CDC).
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[Given the identification of the cVDPV1 case in Malaysia that is genetically related to the VDPV1 case in Basilan, it is now clear there are at least 2 separate cVDPV outbreaks in the Mindinao region of the Philippines: one of the outbreaks is associated with cVDPV2, and the other with cVDPV1 and one outbreak of cVDPV1 in the Manila Metropolitan area (although only environmental samples have been positive without AFP (acute flaccid paralysis) cases as yet.) What all these areas have in common is pockets of populations with suboptimal vaccination coverages. Clearly, we await further information on the genetic profiling of the newly identified VDPV1 case in Sultan Kudarat, also located in southern Philippines. Note that Basilan Island, Sultan Kudarat, and Sabah state in Malaysia, while all in the same general area, are not contiguous, each being on a different island. In. total, there are 11 cases of AFP in the Philippines that are attributable to infection with a VDPV.

A map showing the provinces in the Philippines can be found at

HealthMap/ProMED-mail map of the Philippines: