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Antartica

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

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

Travel News Headlines WORLD NEWS

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

France and Monaco US Consular Information Sheet
December 22, 2008
COUNTRY DESCRIPTION:
France is a developed and stable democracy with a modern economy.
Monaco is a developed constitutional monarchy.
Tourist facilities are widely
available.
Read the Department of State Background Notes on France and Monaco for additional information.
ENTRY/EXIT REQUIREMENTS:
France is party to the Schengen agreement.
As such, U.S. citizens may enter France for up to 90 days for tourist or business purposes without a visa.
A passport is required and should be valid for at least three months beyond the period of stay.
Anyone intending to stay more than 90 days must obtain the appropriate visa issued by one of the French Consulates in the U.S., prior to departure for France.
This also applies to anyone considering marriage in France.
For further information about travel into and within Schengen countries, please see our fact sheet.
A passport is required to enter Monaco. A visa is not required for tourist/business stays up to 90 days in Monaco.
For further information concerning entry requirements for France, travelers may contact the Embassy of France at 4101 Reservoir Road NW, Washington, DC
20007, tel. (202) 944-6000, email: info@ambafrance-us.org, or the French Consulates General in Atlanta, Boston, Chicago, Houston, Los Angeles, Miami, New Orleans, New York, or San Francisco.

For further information on entry requirements to Monaco, travelers may contact the Embassy of the Principality of Monaco. 2314 Wyoming Avenue, NW Washington, DC
20008, Tel: 202-234-1530, email: embassy@monaco-usa.org, or the Consulate General of Monaco, 565 Fifth Avenue – 23rd floor, New York, NY 10017, tel.: 212-286-0500, email: info@monaco-consulate.com.
For more information, visit the Embassy of France web site at www.consulfrance-washington.org or the Embassy of the Principality of Monaco web site at http://www.monaco-usa.org for the most current visa information.

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

SAFETY AND SECURITY:
The Government of France maintains a threat rating system, known locally as “Vigipirate,” similar to the U.S. Department of Homeland Security Advisory System.
Under this plan, in times of heightened security concerns, the government augments police with armed forces and increases visibility at airports, train and metro stations, and other high-profile locations such as schools, major tourist attractions, and government installations.
Over the last few years, there have been numerous arrests of suspected Islamic militants involved in various terrorist plots.
As with other countries in the Schengen area, France maintains open borders with its European neighbors, allowing the possibility of terrorist operatives entering/exiting the country with anonymity.

Political assassinations and bombings have occurred in France.
The National Front for the Liberation of Corsica (FLNC), as part of its decades-long bombing campaign on the island of Corsica, continues to conduct limited operations in the south of France and on Corsica.
In the 1990s there was a wave of bombings and attacks in Paris carried out by Algerian terrorists.
Today, numerous radical Islamic groups claim sympathizers within France’s large immigrant community, as evidenced by arrests over the last few years.

Although Americans have not been specifically targeted in terrorist attacks in France within the past few years, travelers should maintain vigilance.
Immediately report unattended packages observed in public places or any other suspicious activities. French law enforcement authorities are proactive and will respond immediately.
If there is a security incident or suspicious package, do not linger in the area to observe.

Although violent civil disorder is rare in France, in the past, student demonstrations, labor protests, and other types of demonstrations have developed into violent confrontations between demonstrators and police.
This was the case in March/April 2006, when a series of large demonstrations took place in central Paris. Several weeks of unrest occurred in the suburbs of Paris, as well as in other French cities and towns, in November 2005.
Neither of these periods of disorder exhibited any anti-U.S. sentiment, but it is important to remember that even a passer-by can be harmed should demonstrations devolve into violence.
Americans are advised to avoid street demonstrations, particularly if riot police are on the scene.

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

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

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

CRIME:
While both France and Monaco have relatively low rates of violent crime, a limited number of neighborhoods in the larger French cities merit extra caution.
Additionally, although the overall crime rate has fallen slightly in recent years, the violent crime rate has increased.
Thieves commonly target vehicles with non-local license plates, and work in or near tourist attractions such as museums, monuments, restaurants, hotels, beaches, trains, train stations, airports, and subways.
Americans in France and Monaco should be particularly alert to pickpockets in train stations and subways.
Travelers should keep photocopies of travel documents and credit cards separate from the originals, along with key telephone numbers to contact banks for credit card replacement.

Although thieves may operate anywhere, the U.S. Embassy in Paris receives frequent reports of theft from several areas in particular:
Paris: The Paris Police Prefecture published a pamphlet entitled “Paris in Complete Safety,” which provides practical advice and useful telephone numbers for visitors and can be accessed at http://www.prefecture-police-paris.interieur.gouv.fr/prevention/article/paris_securite_anglais.htm. Thieves operate on the rail link (RER) from Charles de Gaulle Airport to downtown Paris, where they prey on jet-lagged, luggage-burdened tourists.
In one common ruse, a thief distracts a tourist with a question about directions while an accomplice steals a momentarily unguarded backpack, briefcase, or purse.
Thieves also time their thefts to coincide with train stops so they may quickly exit the car just before the automatic doors close.
Travelers should consider taking an airport shuttle bus or taxi from the airport into the city.
Reports of stolen purses, briefcases, and carry-on bags at Charles de Gaulle Airport are not uncommon.
Travelers should monitor their bags at all times and never leave them unattended.
As thieves commonly target laptop bags, travelers should avoid carrying passports and other valuables in computer bags.
Another common method involves picking up a traveler’s shoulder bag that has been placed on the floor while the traveler is busy at the ticket counter. Also be aware that unattended bags are subject to destruction by airport security.

There are reports of robberies in which thieves on motorcycles reach into a moving car by opening the car door or accessing an open window or even breaking the window to steal purses and other bags visible inside.
The same technique is used against pedestrians walking with purses/bags/cameras slung over their street-side shoulder.
Those traveling by car should remember to keep the windows up and the doors locked and items that may be attractive to thieves out of sight.
Pedestrians are encouraged to remain aware of their surroundings at all times, and to keep bags slung across the body, with the bag hanging away from the street.

Many thefts occur on the Number One Subway Line, which runs through the center of Paris by many major tourist attractions (including the Grand Arch at La Défense, the Arc de Triomphe, the Champs Elysées, Place de la Concorde, the Louvre, and the Bastille).
Pickpockets are especially active on this metro line during the summer months and use a number of techniques.
The most common, and unfortunately the most successful, is the simple “bump and snatch,” where an individual bumps into the tourist while at the same time reaching into the pockets/purse/bag.
Visitors should be particularly careful when metro doors are closing, as this is a favored moment for the less-sophisticated pickpockets to simply grab valuables and jump through the closing doors, leaving the victim helplessly watching as the thief flees.
Visitors are encouraged NOT to confront thieves aggressively; they often operate in groups and may become violent if cornered.
Simply drawing attention to an attempted theft will most likely stop the operation, and result in a tactical withdrawal by the thief.

Gare du Nord train station, where the express trains from the airport arrive in Paris, is also a high-risk area for pocket-picking and theft.
Travelers should also beware of thefts that occur on both overnight and day trains, especially on trains originating in Spain, Italy, and Belgium.
These involve the theft of valuables while passengers are sleeping, or when the bags are left unattended.

In hotels, thieves target lobbies and breakfast rooms, and take advantage of a minute of inattention to snatch jackets, purses, and backpacks.
While many hotels do have safety latches that allow guests to secure their rooms from inside, this feature is not as universal as it is in the United States.
If no chain or latch is present, a chair placed up against the door and wedged under the handle is usually an effective obstacle to surreptitious entry during the night.
There are, however, reports of thieves breaking into hotel rooms on lower floors through open windows while the occupants are sleeping.
To guard against this, hotel room windows should be kept locked at all times. Whenever possible, valuables should be kept in the hotel safe.

Many Americans report thefts occurring in restaurants and nightclubs/bars, where purses are stolen from the back of a chair or from under the table.
Again, keep valuables on your person and do not leave them unattended or out of sight.
Thefts also occur at the major department stores such as Galeries Lafayette and Printemps where tourists often place wallets, passports, and credit cards on cashier counters during transactions.

Automated Teller Machines (ATMs) are very common in France and provide ready access to cash, allowing travelers to carry as much money as they need for each day.
The rates are competitive with local exchange bureaus, and an ATM transaction is easier than cashing a traveler’s check.
However, crime involving ATMs is increasing.
Travelers should not use ATMs in isolated, unlit areas or where loiterers are present.
Travelers should be especially aware of persons standing close enough to see the Personal Identification Number (PIN) being entered into the machine.
Thieves often conduct successful scams by simply observing the PIN as it is entered and then stealing the card from the user in some other location.
If the card becomes stuck, travelers should immediately report it to the bank where the machine is located.

Large criminal operations in Paris involving the use of ATMs that “eat” the user’s ATM card have been reported.
This most often happens during a weekend or at night when the bank is closed.
The frustrated traveler often walks away after unsuccessfully trying to retrieve the card, with plans to return the first day the bank is open.
In such cases, a criminal gang has modified the machine using an add-on device equipped with a microchip that records the user’s PIN when it is typed in, and also prevents the card from being ejected.
The criminal retrieves the card from the device once the visitor departs, downloads the recorded PIN and then goes to other ATMs and withdraws as much cash as possible.
ATM users are strongly encouraged to carry a 24-hour emergency number for their ATM card and bank account that will enable the immediate prevention of withdrawals from the account if difficulties occur.

Pigalle is the “adult entertainment district” of Paris.
Many entertainment establishments in this area engage in aggressive marketing and charge well beyond the normal rate for drinks.
Reports of threats of violence to coerce patrons into paying exorbitant beverage tabs are not uncommon.
There have also been several violent confrontations between rival gangs in the district, including one in August 2007 one block from the famous Moulin Rouge cabaret.
Visitors are encouraged to avoid this area unless touring with a well-organized and reputable tour company.

Normandy:
There has been an increase in break-ins and thefts from vehicles in the parking lots at the Normandy beaches and American cemeteries common.
Valuables should not be left unattended in a car, and locking valuables in the trunk should not be considered a safeguard.
Thieves often pry open car trunks to steal bags inside.

Southern France: Thefts from cars with unlocked doors or open windows stopped at red lights or caught in slow traffic are very common, particularly along the Riviera of the Nice-Antibes-Cannes area, and in Marseille.
Car doors should be kept locked and windows raised at all times to prevent incidents of "snatch-and-grab" thefts.
In this type of scenario, the thief is usually a passenger on a motorcycle. Break-ins of parked cars are also fairly common.
Valuables should not be left in the car, not even in the trunk, when the vehicle is unattended.

INFORMATION FOR VICTIMS OF CRIME:
The loss or theft abroad of a U.S. passport should be reported immediately to the local police and the nearest U.S. Embassy or Consulate.
If you are the victim of a crime while overseas, in addition to reporting to local police, please contact the nearest U.S. Embassy or Consulate for assistance. The Embassy/Consulate staff can, for example, assist you to find appropriate medical care, 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.
Under French law, compensation is available to victims of crime committed on French soil under certain circumstances. To learn about resources in the U.S., including possible compensation, see our information on Victims of Crime
The local equivalents to the “911” emergency line in France are as follows: 17 (police emergency), 18 (fire department) and 15 (emergency medical/paramedic team/ambulance).
In Monaco, the numbers are 17 (police emergency), 18 (fire department) and 9375-2525 (medical/paramedic team/ambulance).

MEDICAL FACILITIES AND HEALTH INFORMATION:
Medical care comparable to that found in the United States is widely available. In France, the phone number for emergency medical services is 15.
In Monaco, the phone number for emergency medical services is 9375-2525.

The U.S. State Department is unaware of any HIV/AIDS related entry restrictions for visitors to or foreign residents of France.
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 web site at http://wwwn.cdc.gov/travel/default.aspx.
For information about outbreaks of infectious diseases abroad consult the World Health Organization’s (WHO) web site at http://www.who.int/en.
Further health information for travelers is available at http://www.who.int/ith/en
MEDICAL INSURANCE:
The Department of State strongly urges Americans to consult with their medical insurance company prior to traveling abroad to confirm whether their policy applies overseas and whether it will cover emergency expenses such as a medical evacuation.
Please see our information on medical insurance overseas.

TRAFFIC SAFETY AND ROAD CONDITIONS:
While in a foreign country, U.S. citizens may encounter road conditions that differ significantly from those in the United States.
The information below concerning France and Monaco is provided for general reference only, and it may not be totally accurate in a particular location or circumstance.
Roads in France are generally comparable to those in the United States, but traffic engineering and driving habits pose special dangers.
Usually, lane markings and sign placements are not as clear as in the United States.
Drivers should be prepared to make last-minute maneuvers, as most French drivers do.
The French typically drive more aggressively and faster than Americans, and tend to exceed posted speed limits.
Right-of-way rules in France may differ from those in the United States.
Drivers entering intersections from the right have priority over those on the left (unless specifically indicated otherwise), even when entering relatively large boulevards from small side streets.
Many intersections in France are being replaced by traffic circles, where the right-of-way belongs to drivers in the circle.

On major highways, service stations are situated at least every 25 miles.
Service stations are not as plentiful on secondary roads in France as they are in the United States.
Paris, the capital and largest city in France, has an extensive and efficient public transportation system.
The interconnecting system of buses, subways, and commuter rails serves more than 4 million people a day with a safety record comparable to or better than the systems of major American cities.
Similar transportation systems are found in all major French cities. Between cities, France is served by an equally extensive rail service, which is reliable.
High-speed rail links connect the major cities in France. Many cities are also served by frequent air service.

Please refer to our Road Safety page for more information.
Visit the web site of the French and Monegasque National Tourist Office at http://us.franceguide.com/.
The website contains specific information concerning French and Monegasque driver's permits, vehicle inspection, road tax, and mandatory insurance.
AVIATION SAFETY OVERSIGHT:
The U.S. Federal Aviation Administration (FAA) has assessed the Government of France's Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for oversight of France's air carrier operations.
For more information, travelers may visit the FAA’s web site at http://www.faa.gov/safety/programs_initiatives/oversight/iasa
SPECIAL CIRCUMSTANCES:
French and Monegasque customs authorities enforce strict regulations concerning temporary importation into or export from France of items such as firearms, antiquities, medications, business equipment, sales samples, and other items.
It is advisable to contact the Embassy of France in Washington, DC, one of France's consulates in the United States, or the Consulate General of Monaco in New York for specific information regarding customs requirements.
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 or Monegasque laws, even unknowingly, may be expelled, arrested, or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in France or Monaco 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 AND CONSULATE LOCATIONS:
Americans living or traveling in France or Monaco are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department’s travel registration web site, so they can obtain updated information on travel and security within France and Monaco.
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 cases of emergency.

The U.S. Embassy/Consular Section in Paris is located at 4 avenue Gabriel, 75008 Paris (Place de La Concorde, métro stop Concorde), telephone: in country 01-43-12-22-22; from the U.S. 011-33-1-43-12-22-22 (24 hours); fax for Passport Services in country 01-42-96-28-39; from the U.S. 011-33-1-42-96-28-39; for Special Consular Services (emergencies) fax: in country 01-42-61-61-40; from the U.S. 011-33-1-42-61-61-40. Further information can be obtained at the U.S. Embassy's web site at http://france.usembassy.gov/
The Consulate General in Marseille is located at Place Varian Fry, 13006 Marseille, telephone: in country 04-91-54-92-00; from the U.S. 011-33-4-91-54-92-00 (24 hours); Consular Section fax: in country 04-91-55-56-95 and main fax 04-91-55-09-47; Consular Section fax from the U.S. 011-33-4-91-55-56-95, and main fax from the U.S. 011-33-4-91-55-09-47.
Web site: http://france.usembassy.gov/marseille.html.

The Consulate General in Strasbourg is located at 15 Avenue d'Alsace, 67082 Strasbourg, telephone: in country 03-88-35-31-04; from the U.S. 011-33-3-88-35-31-04; fax: in country 03-88-24-06-95; from the U.S. 011-33-3-88-24-06-95.
Web site: http://france.usembassy.gov/strasbourg.html.

The Consulate General in Strasbourg does not produce passports on the premises.
American citizens in this area whose passports are lost or stolen and have urgent travel needs should contact the U.S. Embassy in Paris.

The U.S. Government also has consular representation in Bordeaux, Lyon, Rennes, Nice and Toulouse that provide limited services to Americans, by appointment only.

The American Presence Posts in Bordeaux, Lyon and Rennes do not produce passports on the premises.
American citizens in this area whose passports are lost or stolen and have urgent travel needs should contact the Consular Section of the U.S. Embassy in Paris.

The American Presence Post in Toulouse and the Consular Agency in Nice do not produce passports on the premises.
American citizens in this area whose passports are lost or stolen and have urgent travel needs should contact the U.S. Consulate General in Marseille.

The American Presence Post in Bordeaux is located at 10 place de la Bourse, 33076 Bordeaux (entry on 1 rue Fernand Philippart); telephone: in country 05-56-48-63-80; from the U.S. 011-33-5-56-48-63-80; fax: in country 05-56-51-61-97; from the U.S. 011-33-5-56-51-61-97.
Web site: http://france.usembassy.gov/bordeaux.html
The American Presence Post in Lyon is located at 1, quai Jules Courmont, 69002 Lyon; telephone: in country 04-78-38-33-03; from the U.S. 011-33-4-78-38-33-03; fax: in country 04-72-41-71-81; from the U.S. 011-33-4-72-41-71-81.
Web site: http://france.usembassy.gov/lyon.html
The American Presence Post in Rennes is located at 30, quai Duguay Trouin, 35000 Rennes; telephone: in country 02-23-44-09-60; from the U.S. 011-33-2-23-44-09-60; fax: in country 02-99-35-00-92; from the U.S. 011-33-2-99-35-00-92.
Web site: http://france.usembassy.gov/rennes.html
The American Presence Post in Toulouse is located at 25, Allée Jean Jaures, 31000 Toulouse; telephone: in country 05-34-41-36-50; from the U.S. 011-33-5-34-41-36-50; fax: in country 05-34-41-16-19; from the U.S. 011-33-5-34-41-16-19. Web site: http://france.usembassy.gov/toulouse.html
The Consular Agency in Nice is located at 7, Avenue Gustave V, 3rd floor, 06000 Nice, telephone: in country 04-93-88-89-55; from the U.S.
011-33-4-93-88-89-55; fax: in country 04-93-87-07-38; from the U.S. 011-33-4-93-87-07-38. Web site: http://france.usembassy.gov/nice.html
*
*
*
*
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This replaces the Country Specific Information for France and Monaco dated May 5, 2008, to update the sections on Entry/Exit Requirements, Safety & Security, Crime, Medical Facilities and Health Information, Children’s Issues and Registration/Embassy Location.

Travel News Headlines WORLD NEWS

Date: Fri 24 Sep 2010
Source: Maville.com [in French, trans. ProMed Corr.SB. summ., edited]
<http://www.monaco.maprincipaute.com/actu/actudet_--Monaco-Premier-cas-de-dengue-importee-_loc-1522542_actu.Htm>

A young resident, aged 18, returned from the Caribbean with the disease. Since early September 2010, the government has been strengthening mosquito control.  "Monaco does not have any indigenous dengue cases," said Stephane Valeri, Government Counsellor for Social Affairs and Health. "However, we have identified a case of imported dengue fever in early September [2010]. There is nothing to worry about for this young 18 year old resident of Monaco, who returned from the Caribbean with the disease. He is now in perfect health," said Stephane Valeri.

However, with the announcement of the 1st indigenous dengue fever cases in Nice, mosquito control, already assiduous in gardens and public spaces, has been strengthened. The 1st objective is to kill the tiger mosquito larvae. "The tiger mosquito [_Aedes albopictus_. - ProMed JW] has been located in our area for 3 years now, says Philip Porcu, Territory Chief Technician, Directorate of Planning and Urban Development.
====================
[All it takes to initiate a dengue outbreak is the presence of a viremic individual in an area where there is a significant population of _Aedes_mosquito vectors, as has been the case in nearby Nice, France this month (September 2010). The concern and vigorous preventive actions by Monaco health authorities are justified. Although ProMED does not normally report imported dengue cases with no subsequent local transmission, the risk of transmission elicited this report.

A HealthMap/ProMED-mail interactive map of Monaco can be accessed at
<http://healthmap.org/promed/en?v=43.7,7.4,5>. - ProMed Mod.TY]
Date: Sun, 30 May 2004 11:17:10 +0200 (METDST) MONACO, May 30 (AFP) - A strong blast damaged Monaco's Louis II stadium and a nearby building overnight, the principality's press office said Sunday. Nobody was injured by the explosion, the cause of which was not immediately known. "A major fire" broke out following the 2:00 am (midnight GMT) blast, which hit one of the stadium entrances adjoining administrative offices, the press office said. The industrial building facing that entrance also suffered damage. An enquiry has been opened into the blast, headed by the prosecutor general and "no possibility, accidental or criminal, is being ruled out," the office said. The stadium is the home playing field of the Monaco football team, which lost in the Champions League final on Wednesday to Portugal's FC Porto. The match was played in Germany. Access to the building and the damaged building facing it were blocked off Sunday. An inquiry led by Monaco's official security service was under way.
6 Dec 1999 MONTE CARLO, Monaco (AP) - Fortunes are won and lost through the night in the smoke-filled, exclusive backrooms of Monaco's casino, built by the architect of the Paris Opera House. Jewelry stores and Belle Epoque hotels with Italian-style frescoes and pink marble columns overlook the Mediterranean, where huge private yachts are moored year-round. But for all its wealth, this tiny, sun-kissed tax haven, smaller than New York's Central Park and for decades a magnet for the international jet set, seems to lack soul. "It's like a film set," Marco Peruzzi, a day-tripper from nearby Italy, said as he gazed at the sand-colored royal palace where the Grimaldi dynasty has ruled for seven centuries. "You may get a glimpse of celebrities. But you're left with an empty feeling." See http://www.infobeat.com/stories/cgi/story.cgi?id=2562433955-79a
More ...

World Travel News Headlines

Date: Fri, 23 Aug 2019 18:13:17 +0200 (METDST)

London, Aug 23, 2019 (AFP) - British Airways pilots on Friday said they will strike for three days in September in a dispute over pay, in a move that could affect tens of thousands of travellers.   The strikes on September 9, 10 and 27 were announced by the British Airline Pilots Association (Balpa), which said there had been a 93-percent vote in favour of industrial action.   "It is completely unacceptable that Balpa is destroying the travel plans of tens of thousands of our customers with this unjustifiable strike action," said the airline.   "We are extremely sorry that after many months of negotiations, based on a very fair offer, Balpa has decided on this reckless course of action," it said.

British Airways said it would change schedules to try and ensure as many people as possible can take their flights but warned that "many" customers will not be able to travel.   "We will be offering refunds and re-bookings for passengers booked on cancelled flights," it said.   Balpa said the strikes were "a last resort" but added that pilots had made "sacrifice after sacrifice" in recent years.   Balpa estimated each day of strike action would cost the company around £40 million (44 million euros, $49 million).
Date: Fri, 23 Aug 2019 15:08:04 +0200 (METDST)
By Obert SIMWANZA

Lusaka, Aug 23, 2019 (AFP) - Children living in a central Zambian mining town are still exposed to high levels of toxic lead 25 years after the mine closed, Human Rights Watch said Friday, as lawyers announced plans to take legal action.   Decades of lead mining have left Kabwe, around 150 kilometres (95 miles) north of Lusaka, severely polluted, with serious health implications for residents.   The mine, which operated from the early 1900s until its closure in 1994, was at one time the world's largest lead mine. It was run by the Zambian government from the early 1970s when the mining industry was nationalised.     In a report published Friday, HRW said the town in the Copperbelt area still has extreme levels of contamination and children continue to be exposed to high levels of toxic lead in soil and dust around their homes, schools and play areas.

HRW's children's rights fellow and report author Joanna Naples-Mitchell described the situation in Kabwe as "a public health emergency" and said the government was "not responding with the sense of urgency that is warranted".    "The Zambian government is aware that Kabwe has been severely contaminated... since the 1990s and efforts to clean up have been inadequate," she told AFP.   A class action suit is being prepared to demand compensation for poisoning from Anglo American South Africa, a former investor in the mine, London-based law firm Leigh Day announced Friday. The law firm deals in human rights issues.   The case will be brought in courts in South Africa, where the mining firm is based, said the lawyers, who are acting on behalf of some 200 children who have been treated for lead poisoning.   Anglo American on Friday said in a statement it did not believe it was "in any way responsible for the current situation" in Kabwe.    "We were concerned to learn of the situation at Kabwe as reported by the press," it said, adding "the nationalisation more than 40 years ago effectively placed these issues under the control of the Zambian Government".

- 'Severely contaminated' -
The HRW report said that although lead and zinc mining have stopped in the town, various medical studies conducted over the past seven years show children there still had elevated levels of lead in their blood.   Between 2003 and 2011, the World Bank funded a government project to decontaminate Kabwe's affected townships, and to test and treat children. But some 76,000 people, or a third of the town's population, still live in contaminated areas.   One recent study published last year and cited by HRW estimated that more than 95 percent of children in the townships surrounding the lead mine have elevated blood lead levels and that about half of them require medical intervention.   "This is the worst environmental disaster I have seen in 30 years of practice," said lawyer Richard Meeran of Leigh Day.    Johannesburg-based collaborating lawyer Zanele Mbuyisa said they will argue that "the environmental damage created has potentially contaminated almost three generations of men, women and children".

- Insufficient resources -
Three years ago, the government launched another five-year World Bank-funded project to get rid of the lead and carry out new rounds of testing and treatment.   The project targets around 10,000 people including children, pregnant women and mothers.   "We think this a very important opportunity for the Zambian government to find a lasting solution to this problem," said Naples-Mitchell.   She urged Zambia to find new and effective methods to clean up the lead, adding that their 2018 study indicated that pollution levels were "as high they had been in the 1970s".    In a letter last month, the government indicated to HRW that it does not have enough resources to address the full scale of the contamination.   The government did not immediately comment on the report.   Children are more vulnerable to lead poisoning since they absorb four to five times as much as an adult and this can retard their growth and IQ, while in worst cases it can result in brain damage or even death.
Date: Fri, 23 Aug 2019 14:02:01 +0200 (METDST)

Khartoum, Aug 23, 2019 (AFP) - Rain and flash floods have killed 54 people in Sudan since the start of July and affected nearly 200,000, the United Nations said Friday.   The worst affected area is While Nile state in the south but Khartoum and other regions have also been affected.   "More than 37,000 homes have been destroyed or damaged," the UN said, quoting figures from the government body it partners with in the crisis response.   "Humanitarians are concerned by the high likelihood of more flash floods," it said, adding that most of the 54 recorded deaths were due to collapsed roofs and electrocution.

The floods are having a lasting humanitarian impact on communities, with cut roads, damaged water points, lost livestock and the spread of water-borne diseases by insects.   The UN Office for the Coordination of Humanitarian Affairs said an extra $150 million were needed from donors to respond to the floods, in addition to the $1.1 billion required for the overall humanitarian situation in Sudan.
Date: Thu, 22 Aug 2019 21:40:50 +0200 (METDST)

Warsaw, Aug 22, 2019 (AFP) - At least five people, including two children, were killed and more than 100 others were injured Thursday during a sudden thunderstorm in Poland and Slovakia's Tatra mountains, according to rescuers and officials.   Most of the victims were on the Polish side, where lightning struck a large metal cross on top of Mount Giewont and a metal chain near the summit, rescuers said. One person died in Slovakia.   "There were a lot of incidents involving lightning strikes today in the Tatras," Polish mountain rescue service chief Jan Krzysztof told Poland's PAP news agency.    "More than 100 people are injured," Poland's Prime Minister Mateusz Morawiecki said after arriving in the nearby mountain resort town of Zakopane.

Rescuers believe many hikers were nearby when lightning struck the cross on Giewont's summit.   They had set out to climb Poland's highest mountains when the skies were clear earlier in the day.    "We heard that after (the) lightning struck, people fell... the current then continued along the chains securing the ascent, striking everyone along the way. It looked bad," Krzysztof said.    Lightning also struck on the nearby Czerwone Wierchy mountain massif, injuring a Portuguese citizen.
Date: Wed 21 Aug 2019
Source: Forbes [edited]

A Missouri county has imposed mandatory hepatitis A vaccinations for food handlers. Franklin County, Missouri, joins a handful of jurisdictions across the country with mandatory hepatitis A vaccine programs aimed at preventing further cases. This development is part of a larger trend aimed at expanding vaccinations for hepatitis A and addressing future outbreaks of the disease.

Hepatitis A is a contagious liver disease that can cause symptoms ranging from fever to jaundice and, in extreme cases, liver failure and death. According to the Centers for Disease Control and Prevention, the virus is most commonly spread in the USA via the fecal-oral route, meaning that a person unknowingly ingests something contaminated with the faeces of an infected person.

Hepatitis A is a particularly insidious virus, as an infected person is most contagious 2 weeks before symptoms develop, and those symptoms can take as long as 50 days after exposure to develop. Fortunately, hepatitis A is preventable by vaccine.

CDC is investigating outbreaks of hepatitis A across 29 states. According to CDC, 233 individuals have died from hepatitis A between 2016 and 2019 out of over 24 000 reported cases. Several states, including Kentucky, Florida, Ohio, and West Virginia, have seen thousands of cases.

In an effort to curb the increase in reported cases of hepatitis A, many local jurisdictions are considering mandatory hepatitis A vaccines for food service workers. For example, Missouri has reported 387 cases of hepatitis A in the past 2 years. Over 50 of these cases are from Franklin County, which has a population of about 100,000 residents. Franklin County officials have imposed mandatory vaccinations for individuals who handle food. Food establishments, including restaurants, have 90 days to ensure their employees are vaccinated. Nearby St Louis County, Missouri enacted a mandatory vaccine requirement nearly 20 years ago. Similar ordinances requiring vaccines for food service workers were enacted in Kentucky's Ashland and Boyd Counties in 2018.  [byline: Tommy Tobin]
=====================
[A campaign to protect the patrons of restaurants from acquiring hepatitis A from the food as being done now in this county in Missouri is more than reasonable, as has been stated here previously. In addition to the recent outbreak of 23 cases of HAV linked to a New Jersey golf club (see alsos below), the following is an only partial list of recent reports of restaurant employees acquiring HAV:

Washington 16 Aug 2019
Hepatitis A forces Lynnwood restaurant to temporarily close

New York 16 August 2019
Confirmed case of hepatitis A in Platinum Pizza employee, vaccines to be made available to patrons

Florida 6 Aug 2019
Ocala restaurant employee infected with hepatitis A, officials say

Tennessee, Ohio 1 Aug 2019
National epidemic of hepatitis A outbreaks puts restaurant customers at risk

Mississippi 24 Jul 2019
Health officials investigating possible hepatitis A exposure at Mississippi restaurant

HealthMap/ProMED map available at:
Missouri, United States: <http://healthmap.org/promed/p/227>]
Date: Sun 18 Aug 2019
Source: Associated Press [edited]

Health officials in Las Vegas are using the word "outbreak" to describe a sharp spike in hepatitis A cases reported mostly among homeless people and drug users. The Southern Nevada Health District reported on Wednesday [14 Aug 2019] that from November [2018] to June [2019] it tallied 83 cases of the virus that causes liver damage and can lead to death.

That's far more than the 58 cases reported in 2016, 2017, and 2018, combined. The district says more than 80% of reported patients were people without a permanent place to live, and 92% use drugs, whether intravenous or not.

Clinical services chief Dr Fermin Leguen told the Las Vegas Review-Journal recently that the numbers are alarming. He noted that cases are being reported nationwide. Public health emergencies have been declared in cities including Miami and Philadelphia, and the Centers for Disease Control and Prevention is tracking outbreaks in 27 states. An outbreak of hepatitis A among homeless people in San Diego killed 20 in 2017.

Clark County officials announced in July 2019 that during a 2-day count in January 2019, almost 5300 people were tallied living on sidewalks, vacant lots, parks, and drainage tunnels in and around Las Vegas. That was down from about 6100 in 2017. The Southern Nevada Health District said the trend in hepatitis A cases has been upward: 6 reported cases in 2016; 13 cases in 2017; and 39 in 2018.

The Review-Journal accompanied a crisis intervention team visiting hepatitis A "hot spots" in Las Vegas to offer vaccine shots. The vaccine for the hepatitis A virus is effective soon after inoculation, although a 2nd dose is required after 6 months for full coverage.

Fuilala Riley, president of Help of Southern Nevada, told the newspaper that access to running water for people to wash their hands is important in preventing spread of the virus. Hepatitis A is most often transmitted through consumption of water or food contaminated with faeces.
=======================
[Nevada has yet to be listed in the CDC site following this unnecessary outbreak.  As the number of cases continues to rise in a number of states, and news of smaller (so far) outbreaks occur in others, the question at the end of ProMED-mail post http://promedmail.org/post/20190104.6241686 by a Kentucky official -- "This is a disease of developing countries. One has to ask: Why are we seeing it in the USA?" -- is more and more relevant. We are seeing these outbreaks because of the inability to deal with marginalized populations in our midst. The dramatic cutbacks in public health infrastructure in some of these states clearly feed the fire of these outbreaks. They must be addressed by bolstering public health resources and education and directly addressing the needs of these marginalized populations. - ProMED Mod.LL]

[HealthMap/ProMED-mail map of Las Vegas, Nevada, United States:
Date: Wed 21 Aug 2019
Source: Bring Me the News [edited]

There have now been 69 people to have fallen sick from the _Escherichia coli_ outbreak at Lake Nokomis. Health officials put out an alert earlier this month [August 2019] after 3 children became sick with the bug after swimming at the lake, prompting the closure of both its beaches.

The Minnesota Department of Health said on Friday [16 Aug 2019] it had received 49 confirmed cases of _E. coli_-related illness since the outbreak, and on Tuesday [20 Aug 2019] revealed that this number had grown to 69. Those affected went swimming at the south Minneapolis lake between 16 Jul and 11 Aug 2019, with the Shiga-toxin producing _E. coli_ taking up to 16 days to show symptoms. [We generally consider 10 days to be the long end of the incubation period. - ProMED Mod.LL]

Both beaches at the lake have been closed and will remain that way for the rest of the season, as part of MDH's response to contain the outbreak. Of the total cases, 20% affected children aged 10 and younger. Fortunately, nobody has required hospitalization.

The Star Tribune reports that with other beach closures at Bde Maka Ska and Lake Hiawatha, among others, this summer, it is the most beach closures seen in the city since it started testing for bacteria in 2003. The MDH advises anyone showing symptoms of a Shiga-toxin _E. coli_ infection -- diarrhea (often bloody), stomach cramps, no or low-grade fever -- should see a healthcare provider.  [byline: Adam Uren]
========================
[This has become a substantial outbreak.  It is important to understand that there are many different kinds of _E. coli_. The organism is an important component of the human intestinal tract and can perform important functions helpful to its host. These strains can cause human infections if they "escape" from the usual location into the urinary tract, gall bladder, or abdominal cavity. They are also what are mentioned when a beach is closed for _E. coli_ contamination. In this circumstance, officials are measuring the organism or "coliforms" in the water to reflect human sewage contamination.

In addition, some strains of _E. coli_ can produce toxins that can induce diarrhea, and much of so-called travelers' diarrhea is caused by these strains. All of these strains are human bacteria, not zoonotic organisms, that is, not spread from animal hosts. One _E. coli_ group called Shiga toxin producing or enterohemorrhagic _E. coli_ (EHEC), the organism likely to be involved here, is zoonotic. Spread in a number of ways, including via undercooked ground beef, contaminated vegetables, and direct or direct contact with farm animals including contaminated water, EHEC can cause significant disease and even death.

In the spring of 2000, in Walkerton, a town of 5000 in southern Ontario, an outbreak of _E. coli_ O157:H7 infection claimed 7 lives -- 6 adults and a child -- and over 200 were seen at local area hospitals.

Swimming-associated transmission is illustrated in the following references:

1. Keene WE, McAnulty JM, Hoesly FC, et al. A swimming-associated outbreak of hemorrhagic colitis caused by _Escherichia coli_ O157:H7 and _Shigella sonnei_. N Engl J Med. 1994; 331(9): 579-84; available
2. CDC. Lake-associated outbreak of _E. coli_ O157:H7 - Illinois. MMWR 1996; 45(21): 437-9; available at
3. Ackman D, Marks S, Mack P, et al. Swimming-associated hemorrhagic colitis due to _Escherichia coli_ O157:H7 infection: evidence of prolonged contamination of a fresh water lake. Epidemiol Infect. 1997; 119:1-8; available at

[HealthMap/ProMED-mail map of Lake Nokomis, Minnesota, United States:
28 Jul 2019

As many as 13 have died while 6677 have been infected across Tanzania. In Dar es Salaam region alone, 6631 cases and 11 deaths have occurred.

HealthMap/ProMED-mail map of Tanzania:
8 Aug 2019

Dengue-type1 outbreak was declared on the 27 Feb 2019 following a laboratory (NZLabPlus) confirmation of 7 dengue type 1 cases. From 28 Jan-4 Aug 2019, a cumulative number of 78 dengue cases have been reported (22 confirmed, and 56 probable-NS1Ag positives). Rarotonga and Aitutaki are the only islands affected and most of the cases have been from the main island of Rarotonga. Aitutaki has managed to contain its number of cases to 3. The last case was reported on 18 Apr 2019. A total of 42 cases have been hospitalised and given free mosquito nets to take and use at home. Apart from some severe cases, the hospitalisation was also an effort to contain and minimise the spread of the infection into the community. Unfortunately, some cases refused to be admitted but were given some health advice and mosquito precautionary measures. No deaths reported.

- Cook Islands. 17 Aug 2019. 78 dengue cases have been reported in Cook Islands since the outbreak began early in the year [2019]. The Cook Islands News reports the Ministry of Health saying 22 were confirmed cases while 56 have been deemed probable positives.

HealthMap/ProMED-mail map of Cook Islands:
19 Aug 2019

358 indigenous cases and 2 imported cases of dengue 2 have been confirmed since the beginning of 2019, according to the latest Health Watch bulletin. Tahiti is still in an epidemic phase: all communes are affected except Mahaena, Pueu, and Teahupoo. In the islands, Bora-Bora is in epidemic phase (at least 3 cases without epidemiological link): Vaitape and Faanui are affected. Moorea is in an epidemic phase: The communes of Afareaitu, Haapiti, and Paopao are affected. Six islands are in the alert phase: Nuku-Hiva (Taiohae), Fakarava, Raiatea, Rangiroa, Huahine, and Hiva Oa (Atuona). Since dengue type 2 has not circulated in the country since the year 2000, the population is poorly immunized, and the epidemic may be large. People under 20 or arriving in French Polynesia after 2000 are most at risk of becoming infected.

HealthMap/ProMED-mail map of French Polynesia: