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Argentina

Irish Diplomatic and Consular Information for Argentina
**********************************************************************
Address:
Embassy of Ireland
Suipacha 1380
2nd Floor
1011 Buenos Aires
Telephone:
+54-1
-4325-8588 / 4325-0849
Fax:
+54-11-4325-7572
Email:

Ambassador:
Her Excellency Paula Ní Shlattara
Secretary:

Jonathan Conlon
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Argentina - US Consular Information Sheet
October 02, 2008
COUNTRY DESCRIPTION:
Last year, Argentina's charm, natural beauty and diversity attracted more than 400,000 American citizen visitors, and this year's total is expected to be even higher. Buenos Aires and other large cities have well-developed tourist facilities and services, including many four- and five-star hotels. The quality of tourist facilities in smaller towns outside the capital varies. The country suffered a major financial crisis in 2001-2002. While it has made a dramatic recovery, continued economic hardship has been linked to a rise in street crime. Read the Department of State Background Notes on Argentina for additional information.

ENTRY/EXIT REQUIREMENTS: A valid passport is required for U.S. citizens to enter Argentina. U.S. citizens do not need a visa for visits of up to 90 days for tourism and business. U.S. citizens who arrive in Argentina with expired or damaged passports may be refused entry and returned to the United States at their own expense. The U.S. Embassy cannot provide guarantees on behalf of travelers in such situations, and therefore encourages U.S. citizens to ensure their travel documents are valid and in good condition prior to departure from the United States. Different rules apply to U.S. citizens who also have Argentine nationality, depending on their dates of U.S. naturalization. For more information, check the Argentine Ministry of the Interior web site at www.mininterior.gov.ar/migraciones/. Most dual nationals are permitted 60-day visits. Dual nationals who stay beyond their permitted time are required to depart on an Argentine passport.
The application process for an Argentine passport is lengthy, and the U.S. Embassy is not able to provide assistance in obtaining Argentine passports or other local identity documents. Children under 21 years of age who reside in Argentina, regardless of nationality, are required to present a notarized document that certifies both parents' permission for the child's departure from Argentina when the child is traveling alone, with only one parent, or in someone else's custody (click on the "international child abduction" link below for more information). An airport tax is collected upon departure, payable in dollars or Argentine pesos.

American citizens wishing to enter Brazil are required to obtain a visa in advance from the Brazilian Embassy or consulate nearest to the traveler's place of residence. The U.S. Embassy in Buenos Aires cannot assist travelers to obtain Brazilian visas. For more information, see the Country Specific Information for Brazil.
Visit the Embassy of Argentina’s web site at http://www.embassyofargentina.us/ 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:
Traffic accidents are the primary threat to life and limb in Argentina. Pedestrians and drivers should exercise caution. Drivers frequently ignore traffic laws and vehicles often travel at excessive speeds. The rate and toll of traffic accidents has been a topic of much media attention over the past year. The Institute of Road Safety and Education, a private Buenos Aires organization dedicated to transportation safety issues, reports that Argentina has the highest traffic mortality rate in South America per 100,000 inhabitants.

Care should be exercised when traveling in Brazil and Paraguay, near the Argentine border, where criminal entities are known to operate. These organizations are involved in the trafficking of illicit goods, and some individuals in the area have been designated by the U.S. Treasury Department for financially supporting terrorist organizations.
The U.S. government is supportive of coordinated efforts by Argentina, Brazil, and Paraguay to combat illegal activity in that region. Americans crossing from Argentina into Paraguay or Brazil may wish to consult the most recent Country Specific Information for those countries.

Demonstrations are common in metropolitan Buenos Aires and occur in other major cities as well. Protesters on occasion block streets, highways, and major intersections, causing traffic jams and delaying travel. While demonstrations are usually nonviolent, hooligans in some of the groups sometimes seek confrontation with the police and vandalize private property. Groups occasionally protest in front of the U.S. Embassy and U.S.-affiliated businesses. U.S. citizens should take common-sense precautions and avoid gatherings or any other event where crowds have congregated to protest. Information about the location of possible demonstrations is available from a variety of sources, including the local media. Additional information and advice may be obtained from the U.S. Embassy at the telephone numbers or email address listed at the end of this document.

Domestic flight schedules can be unreliable. Occasional work stoppages, over-scheduling of flights and other technical problems can result in flight delays, cancellations, or missed connections. Consult local media for information about possible strikes or slow-downs before planning travel within Argentina.
Public transportation is generally reliable and safe. The preferred option for travel within Buenos Aires and other major cities is by radio taxi or "remise" (private car with driver). The best way to obtain safe taxis and remises is to call for one or go to an established stand, rather than hailing one on the street. Hotels, restaurants, and other businesses can order remises or radio taxis, or provide phone numbers for such services, upon request. Passengers on buses, trains, and the subway should be alert for pickpockets and should also be aware that these forms of transport are sometimes interrupted by strikes or work stoppages.

Argentina is a geographically diverse country with mountains, forests, expansive deserts, and glaciers, making it a popular destination for outdoor and adventure sports. Despite the best efforts of local authorities, assisting visitors lost or injured in such remote areas can be problematic. American citizens have been killed in recent years while mountain climbing, skiing, trekking, and hunting. Travelers visiting isolated and wilderness areas should learn about local hazards and weather conditions and always inform park or police authorities of their itineraries. Reports of missing or injured persons should be made immediately to the police so that a search can be mounted or assistance rendered.

For the latest security information, Americans traveling abroad should regularly monitor the Department of State, Bureau of Consular Affairs' web site at http://travel.state.gov, where the current Travel Warnings and Travel Alerts, as well as the Worldwide Caution, can be found.
Up-to-date information on safety and security can also be obtained by calling 1-888-407-4747 toll free in the 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 pamphlet A Safe Trip Abroad.

CRIME: Most American citizens visit Argentina without incident. Nevertheless, street crime in the larger cities, especially greater Buenos Aires and Mendoza, is a problem for residents and visitors alike. As in any big city, visitors to Buenos Aires and popular tourist destinations should be alert to muggers, pickpockets, scam artists, and purse-snatchers on the street, in hotel lobbies, at bus and train stations, and in cruise ship ports. Criminals usually work in groups and travelers should assume they are armed. Criminals employ a variety of ruses to distract and victimize unsuspecting visitors.
A common scam is to spray mustard or a similar substance on the tourist from a distance. A pickpocket will then approach the tourist offering to help clean the stain, and while doing so, he or an accomplice robs the victim. Thieves regularly nab unattended purses, backpacks, laptops, and luggage, and criminals will often distract visitors for a few seconds to steal valuables. While most American victims are not physically injured when robbed, criminals typically do not hesitate to use force when they encounter resistance. Visitors are advised to immediately hand over all cash and valuables if confronted. Thieves will target visitors wearing expensive watches or jewelry.

Your passport is a valuable document and should be guarded. Passports and other valuables should be locked in a hotel safe, and a photocopy of your passport should be carried for identification purposes. The U.S. Embassy has observed a notable rise in reports of stolen passports in the past year. Some travelers have received counterfeit currency in Argentina. Unscrupulous vendors and taxi drivers sometimes pretend to help tourists review their pesos, then trade bad bills for good ones. Characteristics of good currency can be reviewed at the Argentine Central Bank web site at www.bcra.gov.ar.
Along with conventional muggings, so-called express kidnappings continue to occur. Victims are grabbed off the street based on their appearance and vulnerability. They are made to withdraw as much money as possible from ATM machines, and then their family or co-workers are contacted and told to deliver all the cash that they have on hand or can gather in a couple of hours. Once the ransom is paid, the victim is usually quickly released unharmed. There have been some foreign victims. Visitors are particularly advised not to let children and adolescents travel alone.
Travelers worldwide are advised to avoid packing valuables in their checked baggage. In Argentina, officials have publicly acknowledged the systematic theft of valuables and money from checked baggage at Buenos Aires airports. Authorities are working to resolve the problem and have made a number of arrests, but travelers should exercise continued care and caution. In many countries around the world, counterfeit and pirated goods are widely available. Transactions involving such products may be illegal under local law. In addition, bringing them back to the United States may result in forfeitures and/or fines. More information on this serious problem is available at http://www.cybercrime.gov/18usc2320.htm
INFORMATION FOR VICTIMS OF CRIME: The loss or theft abroad of a U.S. passport should be reported immediately to the local police and the nearest U.S. Embassy or Consulate. If you are the victim of a crime while overseas, in addition to reporting to local police, please contact the nearest U.S. Embassy or Consulate for assistance. The Embassy/Consulate staff can, for example, assist you to find appropriate medical care, contact family members or friends and explain how funds 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. The Argentine Federal Police have established a special Tourist Police Unit to receive complaints and investigate crimes against tourists. The unit, located at Corrientes 436 in Buenos Aires, responds to calls around the clock at 4346-5748 or toll-free 0800-999-5000 from anywhere in the country. The local equivalent to the "911" emergency line in the city of Buenos Aires or in the surrounding Province of Buenos Aires is 911 for police assistance. In the city of Buenos Aires, dial 100 in case of fire and 107 for an ambulance. In the Province of Buenos Aires, fire and ambulance numbers vary by location. See our information for Victims of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION: The public health system in Argentina provides emergency and non-emergency services free of charge to all, regardless of nationality or immigration status. However, the quality of non-emergency care in public hospitals is generally below U.S. standards. Medical care in private hospitals in Buenos Aires is generally good, but varies in quality outside the capital. Serious medical problems requiring hospitalization in private facilities and/or medical evacuation to the United States can cost thousands of dollars or more. Private physicians, clinics, and hospitals often expect immediate cash payment for health services.
HIV/AIDS restrictions. The U.S. Department of State is unaware of any HIV/AIDS entry restrictions for visitors to or foreign residents of Argentina.
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 Preventions hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747) or via the CDC's Internet site at http://wwwn.cdc.gov/travel/default.aspx. For information about outbreaks of infectious diseases abroad, consult the World Health Organization (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 policies apply overseas and will cover prior conditions and emergency expenses such as a medical evacuation, which could cost tens of thousands of dollars. If not covered, visitors are encouraged to consider purchasing travel insurance. No Medicare benefits are available abroad. 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 Argentina is provided for general reference only, and may not be totally accurate in a particular location or circumstance.
Driving in Argentina is generally more dangerous than driving in the United States. By comparison, drivers in Argentina tend to be very aggressive, especially in the capital city of Buenos Aires, and frequently ignore traffic regulations. U.S. driver's licenses are valid in the capital and the province of Buenos Aires, but Argentine or international licenses are required to drive in the rest of the country. For further information, please contact the Argentine Automobile Club, Av. Libertador 1850, 1112 Capital Federal, telephone (011) (54)(11) 4802-6061, or contact the Embassy of Argentina as listed in the above section on Entry Requirements. Please refer to our Road Safety page for more information. Visit the websites of Argentina's national tourist office and national roadways office at www.turismo.gov.ar and www.vialidad.gov.ar.

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

SPECIAL CIRCUMSTANCES: In addition to being subject to all Argentine laws affecting U.S. citizens, dual nationals may also be subject to other laws that impose special obligations on Argentine citizens. In some instances, dual nationality may hamper U.S. Government efforts to provide protection abroad. Please see our information on Customs Regulations.

CRIMINAL PENALTIES: While in a foreign country, a U.S. citizen is subject to that country's laws and regulations, which sometimes differ significantly from those in the United States and may not afford the protections available to the individual under U.S. law. Penalties for breaking the law can also be more severe than in the United States for similar offenses. Persons violating Argentina's laws, even unknowingly, may be expelled, arrested or imprisoned. Penalties for possession, use, or trafficking in illegal drugs in Argentina are strict, and convicted offenders can expect lengthy jail sentences and fines. Engaging in sexual conduct with children and using or disseminating child pornography in a foreign country are crimes 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 Argentina are encouraged to register with the U.S. Embassy through the State Department’s travel registration web site, so that they can obtain updated information on travel and security within Argentina. Americans without Internet access may register directly with the U.S. Embassy. By registering, American citizens make it much easier for the Embassy or Consulate to contact them in case of emergency. The U.S. Embassy is located at Avenida Colombia 4300 in the Palermo neighborhood of Buenos Aires (near the Plaza Italia stop on the "D" line subway). The main Embassy switchboard telephone is (54) (11) 5777-4533. Recorded consular information, including instructions on whom to contact in case of an American citizen emergency, is available at tel. (54) (11) 4514-1830. The Consular Section fax is (54) (11) 5777-4293. The Consular Section is open to the public from 8:30 a.m. to noon and 2:30 p.m. to 4 p.m. Monday through Friday, except on American and Argentine holidays. Additional information on Embassy services is available on the Internet at http://argentina.usembassy.gov or by e-mail: BuenosAires-ACS@state.gov
* * *
This replaces the Country Specific Information December 28, 2007 to update Sections on Country Description, Safety and Security, Information for Victims of Crime, Medical Facilities, Traffic Safety and Road Conditions, and Registration/Embassy Locations.

Travel News Headlines WORLD NEWS

Date: Mon 28 Jan 2019 19:10 ART
Source: Tiempo Sur [in Spanish trans. ProMED Mod.TY, edited]

There are now a total of 31 confirmed cases of hantavirus [infections] in the Epuyen [Chubut province] outbreak. The positive cases during recent weeks were under observation and isolation. The numbers of cases of people under observation are reduced to 89.

The Chubut [province] Ministry of Health confirmed in its most recent official statement that there are now 31 confirmed cases of hantavirus [infections], while there are others who are currently under observation. The details of the information provided by the provincial health office explained that on [Fri 25 Jan 2019] an adult patient who had been convalescent from this disease was released from the Esquel Zone Hospital. Also, the same statement mentioned that a hantavirus infection positive patient was released from the intensive care unit in the same hospital and is convalescing in a ward in that hospital.

As an additional comment, the Ministry of Health also remarked the same [Fri 25 Jan 2019] that an adult patient, resident of the El Maiten locality [Chubut province] who was maintained under strict, supervised isolation at home, was later sent to the Esquel Zone Hospital and was confirmed positive for this disease, bringing to 31 the number of confirmed cases.

In the same statement, it was explained that during Friday afternoon [25 Jan 2019] there was notification of the admission of a patient under observation in the Sub Zonal Hospital in El Maiten and is currently under strict isolation.

In that respect, it also is worth clarifying that the measure of selective respiratory isolation effectively accomplished at home is continued, a measure pushed by the same Chubut Ministry of Health, that has reached 89 people.

Coordinated tasks
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Within the guidelines set by the Ministry of Health of Chubut, the Under secretariat of Human Rights, under the Ministry of Government, coordinated a working day at the local Epuyen Cultural Center, where the different emerging issues of the health contingency affecting the locality were addressed. The proposal arose from attitudes and behaviours that show negative beliefs, as well as forms of stigma and discriminatory practices in the community that transcend the theme of health and have an impact on the lives of the people.
======================
[The number of confirmed cases of hantavirus infection continues to increase. The last ProMED-mail post on 19 Jan 2019 (Hantavirus - Americas (06): Argentina (4 provinces) http://promedmail.org/post/20190123.6274142), reported that since the beginning of the epidemiological contingency (on 3 Dec 2018) in that province, there were 29 confirmed cases (27 in Esquel, one in Bariloche, and another in Chile), of which 11 died. The total case count given above is now 31. The current total of deaths is not mentioned in the report above. Except for the index case, the transmission that followed is presumed to be interpersonal and is the reason for isolation of potential contacts. As mentioned in the previous ProMED-mail post, interpersonal transmission of the current Andes hantavirus outbreak in Chubut is unusual. However, person to person transmission has happened before. Mod.PMB provided a reference that indicates that in 1996 there was an outbreak of Andes virus Epilink/96 variant in El Bolson, Rio Negro province, and that starting with the index case, a molecular analysis indicated that 15 cases occurred subsequently. Of these 16 patients, 9 died. Of the total cases, 8 probably became infected in a hospital environment, including 5 physicians (3 died) and a receptionist in a private clinic where 4 more cases occurred. The receptionist died. The data in this study suggest the possible existence of 3- and 4-person transmission chains, assuming that only one rodent-to-human transmission event occurred. It is prudent to see that the relevant agencies working in the area are addressing the social dimensions of this outbreak. There is a small population in this locality and it is easy to understand how this outbreak has sparked rumors and false information that can lead to socially adverse opinions, attitudes, and behaviors.

Reference
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Padula PJ, Edelstein A, Miguel SD, et al. Hantavirus pulmonary syndrome outbreak in Argentina: molecular evidence for person-to-person transmission of Andes virus. Virology. 1998; 241(2): 323-30;  <https://www.sciencedirect.com/science/article/pii/S0042682297989765?via%3Dihub>.

An additional study described 4 clusters of cases in Argentina with probable interpersonal transmission: the 1st a father to son, the 2nd in a rural family, the 3rd among 4 friends who shared a rural cabin, and the 4th a person in contact with another person who, in turn contacted a further person.

Reference
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Martinez VP, Bellomo C, San Juan J, et al. Person-to-person transmission of Andes virus. Emerg Infect Dis. 2005; 11(12): 1848-53;

It is clear that interpersonal Andes hantavirus transmission occurs, although infrequently, more often than ProMED-mail has reported. - ProMed Mod.TY

[Maps of Argentina:
Date: Thu 17 Jan 2019
Source: Express [edited]

Argentina is on lockdown after a deadly virus typically found in rodents has spread to humans, killing 12. A dozen deaths have already been confirmed following a horrific outbreak of the so-called hantavirus, a dangerous disease that affects the pulmonary system after patients become infected through the faeces and urine of rats. Horrifying symptoms, which come on in stages and begin with a fever before ending with haemorrhaging organs, spread at a frighteningly fast rate. The 1st death was a 25-year-old man on Wednesday morning [16 Jan 2019], and another 11 had been announced in just 24 hours. The outbreak happened in the northeast Argentine province of Entre Rios, medical sources have confirmed. Health officials are in the process of battling to control the illness.

The Secretary of Health of Argentina, Adolfo Rubinstein, said in a local radio interview: "Fundamentally, up to now, the route of contagion was the sporadic cases by inhalation of mice secretions. The difference is that it is interhuman contagion; this is what is much more worrisome from the epidemiological point of view."

He also said that the government suspects the Hantavirus outbreak is a "mutation" since "interhuman contagion" can occur.  He stressed that the patients go through a "very serious condition" since this outbreak is registering a "very high mortality, of more than 40%."  He also said the chain of symptoms in humans began when a couple shared a table at a restaurant, which triggered the virus after germs were transited between the pair.

The disease is transmitted by contact with urine, saliva, and droppings of rodents infected with the virus. For transmission between people, a close contact must be made with the patients in the initial period of the febrile episode, which goes from the first 48-72 hours.  The route of propagation is inhalation, so kisses and hugs can get people infected, as well as the saliva particles when speaking. Other symptoms include muscular pains, chills, headaches, nausea, or diarrhoea.

The deer mouse, the white-footed mouse, the rice rat, and the cotton rat are the only types of rodents capable of passing the virus onto humans, with the breeds prominent in Argentina and other areas of South America. [This is incorrect. None of these species occur in Argentina. The deer mouse (_Peromyscus maniiculatus_) and the white-footed mouse (_P. leucopus_) are distributed from Canada to Mexico. The rice rats, several species in the genus _Oryzomys_, and cotton rats, several species in the genus _Sigmodon_, occur from the USA to northern South America. Several other species are hosts of various hantaviruses in Argentina that can infect humans (see the list in the comment above). - ProMED Mod.TY].  [Byline: Carly Read]
======================
[There have been a few sporadic cases of hantavirus infection in Entre Rios province in the past. In 2011, there were 4 confirmed cases of hantavirus pulmonary syndrome in the province, 2 of which died (see ProMED-mail Hantavirus update 2011 - Americas (26): Chile, Argentina, USA http://promedmail.org/post/20110523.1562). In 2013, there was a single case there. The specific hantaviruses involved in these cases, including the current ones above, are not specified. This report states that the 12 cases were confirmed, but the specific hantavirus involved is not mentioned, nor if the confirmation was made on clinical grounds or by laboratory test (and if so, which test). The unusual human-to-human transmission raises several questions that are discussed below for this Entre Rios outbreak and for the one in Chubut province. - ProMED Mod.TY]
Date: Tue 15 Jan 2019
Source: Buenos Aires Times [edited]

The death of a man in Salta province on Tuesday [15 Jan 2019] brings the total number of dead in Argentina as a result of the latest outbreak of hantavirus [infections] to 11; 28 people with the virus remain in hospital under observation.

A man died in Tartagal hospital in Salta province on Tuesday [15 Jan 2019] after a week spent in the hospital, Doctor Viviana Heredia confirmed to local media. Another patient, a 19-year-old man, is isolated in the same hospital. He appeared with a high fever and headaches, local newspaper El Tribuno reported.

"We have no evidence that the virus has been transmitted person-to-person like in Chubut (province), but we do know that it is transmitted in rat faeces and urine, which is why people must avoid food contamination and entering places where rats may have been," Dr Heredia said.

Hantavirus is also known as Orthohantavirus. Humans can contract the virus, which infects rodents but does not cause disease in them, as a result of contact with rodent urine, saliva, or faeces.
====================
[There were several cases of hantavirus infections scattered over the province last year (2018). A total of 21 confirmed cases of hantavirus infections, with 7 deaths from the disease, were registered in the entire province since 1 Jan 2018. The confirmed cases corresponded to localities in Oran, Tartagal, Pichanal, Colonia Santa Rosa, Apolinario Saravia, and Irigoyen. The patients ranged from 22-52 years of age. Although the hantavirus involved is not mentioned, since the report indicates that the cases have occurred in Salta province, including Oran, Oran virus seems likely.

Although rodents were mentioned as possible hosts in the report above, the rodent host of the suspected hantavirus endemic in this area was not reported but likely is the long-tailed pygmy rice rat host, _O. longicaudatus_. An image of this rodent can be accessed at <https://alchetron.com/Oligoryzomys>. - ProMED Mod.TY]
Date: Tue 15 Jan 2019
Source: El Tribuno [in Spanish, trans. ProMED Mod.TY, edited]

The Jujuy provincial minister of health yesterday [Mon 14 Jan 2019] confirmed a hantavirus [infection] case in San Pedro. This is one of the 4 suspected cases evaluated in this Ramallo city and was diagnosed in a 56-year-old patient who is being treated and is progressing well.

This was confirmed for El Tribuno in Jujuy by the subsecretariat for Health Promotion, Prevention, and Attention, Veronica Serra, who stated that there were 4 suspected hantavirus [infection] cases in the province: 3 in the public sector that were negative and one in the private sector that was positive. "Recently, yesterday afternoon, the diagnosis was confirmed for a patient hospitalized in the Santa Maria Clinic in San Pedro, who is being treated and is progressing favourably," the official stated.

She also explained that there is blocking work now, but all epidemiological research will start today [Tue 15 Jan 2019] in the morning.

Serra also remarked that this specific case is different from the type of hantavirus that is circulating in Chubut province and is a milder strain. "The one circulating in Jujuy is a completely different strain [species] than the hantavirus in the south. The transmission of the hantavirus that we have in the province occurs via aspiration of urine of the rodent, not person-to-person as is occurring in the south [See the Chubut comments below. - ProMED Mod.TY]. It is a variant of the disease that is milder as for its transmission," she said.

In Jujuy province last year [2018], 7 cases of hantavirus [infection] were registered, the majority on the Ramal and Valles area. "In 2018 there were 4 cases in Libertador General San Martin, one in San Pedro, one in El Carmen, and the other in Cochinoca department, of which none were fatal; all were treated and progressed favorably."

The health office requests adoption of extreme security measures in order to avoid future cases.

The 1st symptoms are similar to those of flu: high fever, chills, muscular pain, headache, nausea or vomiting, abdominal pain, and diarrhoea, but without upper respiratory tract (cold) symptoms. This mild picture may evolve to cases with severe cardiopulmonary effects.

Some of the recommendations in order to prevent the infection [include]
- Avoid living with rodents and contact with their secretions.
- Avoid entry of rodents and nest-making in houses.
- Close openings in doors, walls, and around pipes.
- Perform cleaning with one part of bleach to 9 parts of water (let stand for 30 minutes and later rinse). Wet the floor before sweeping it in order to not raise dust.
- Ventilate for at least 30 minutes before entering places that have been closed (houses or sheds). Cover the nose and mouth with a damp handkerchief or respiratory mask before entering.
- Take special care when starting up fans or air conditioners whose filters or ducts could have been in contact with [virus] contaminated dust, rodents, or their excreta.

Hantavirus infections represent an emerging zoonosis transmitted to humans by rodents infected with the virus. The natural reservoirs of the infection [virus] are certain wild rodents that have a chronic, asymptomatic infection with persistent viremia and shed the virus in urine, saliva, and excrement.
In Argentina, 2 species of hantaviruses circulate (Andes and Laguna Negra). [This is not correct; there are several more. See comments below. - ProMED Mod.TY].

The hantaviruses are fundamentally transmitted by inhalation of aerosols carrying virus particles coming from feces, urine, and saliva of infected rodents. Other possible routes of transmission are contact of conjunctival, nasal, or oral mucosas with the secretions of infected rodents, or by the bite of an infected rodent.  There is evidence for person-to-person transmission (Andes virus, in the south in Epuyen), and because of this, the secretions of human fluids should be considered dangerous.
========================
[This report apparently presumes that the hantavirus involved in this case is Laguna Negra, although it is not stated that this virus has been laboratory confirmed. As noted in ProMED-mail archive no. http://promedmail.org/post/20110430.1348, several hantaviruses have been associated with human infection and hantavirus pulmonary syndrome in Argentina: Andes virus (western Argentina, in the long-tailed pygmy rice rat host, _Oligoryzomys longicaudatus_); related Andes-like viruses Hu39694 (in central Argentina; rodent host unknown); Lechiguana (in central Argentina in the yellow pygmy rice rat, _O. flavescens_); Oran (in northwestern Argentina in _O. longicaudatus_); Bermejo (western Argentina in _O. flavescens_); and Laguna Negra (in northern Argentina in _Calomys laucha_).

Without laboratory confirmation, it is not possible to say with certainty which hantavirus was involved. Andes virus seems unlikely in this case. - ProMED Mod. TY]
Date: Mon 10 Dec 2018
Source: El Dia [in Spanish, trans. ProMED Corr.SB, edited]

The rural hospital in Epuyen in Chubut province [in southern Argentina] has reported 3 new suspected cases of [a] hantavirus [infection], progressing well, according to the establishment doctors.

It should be noted that Epuyen has already registered 5 confirmed cases positive for hantavirus [infections], one of which was fatal, certificated by the Institute of Infectious Diseases "Carlos Malbran."
=====================
[The previous ProMED-mail post (Hantavirus - Americas (65): Argentina (CH) fatal, susp http://promedmail.org/post/20181205.6178716) reported 5 suspected cases of hantavirus infections. The above report indicated that these 5 suspected cases are now confirmed, but the specific hantavirus involved is not mentioned. Now, there are 3 new suspected cases.

Epuyen is located in the Andes mountains, and the virus most likely involved is Andes hantavirus, which is endemic in the southern Andes. This is the beginning of the summer season, when cases of hantavirus infection occur. The patients likely came into contact with areas inhabited by the rodent reservoir of the virus in the region.

Andes virus is rarely transmitted directly person to person and only through close physical contact, usually within the family. The most common source of the infection is the long-tailed pygmy rice rat.

Images of the long-tailed pygmy rice rat (_Oligoryzomys longicaudatus_), the Sigmodontine rodent host of Andes hantavirus, can be seen at

[HealthMap/ProMED-mail maps:
Argentina:
Chubut Province, Argentina: <http://healthmap.org/promed/p/53508>]
More ...

China

General Information
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The People’s Republic of China is the world’s third largest nation in land mass and shares borders with 16 other countries. It is the worlds most populated country. Nowadays many I
ish travellers will be going to China for business or holiday trips. Much of the country is mountainous or semidesert and the country lies almost entirely in the temperate zone. Only portions of the southern-most area - the provinces of Yunnan and Guangdong, and the Zhuang autonomous region of Guangxi - lie within the tropics. The monsoon climate is a major influence in the south, but the north and west have a typical continental climate.
Weather Profile
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During the summer, warm moist maritime air masses bring heavy rains to eastern China, and hot humid summer weather is typical. Winter offers a sharp contrast when Siberian air masses dominate. In late winter and spring strong north winds sweep across north China and hazy days caused by dust storms are common. Beijing’s spring is mostly dry. In July and August the weather turns hot and humid. Autumn is the nicest time of the year with many warm, clear days and little wind usually.
Chest Complaints
****************************************
Because of the prevailing dust, increased transportation and the burning of soft coal during the winter, Beijing and other major cities in China have a high rate of pollution. This may exacerbate bronchial and/or sinus complaints. The dust level in Lhasa is also very high and this may lead to respiratory problems.
Safety & Security
****************************************
The risk of crime against tourists is low but care of personal belonging should be observed at all times. Maintenance of buildings and general safety precautions may not always be in place and so checking for fire exits (and that they are unblocked) is wise. Use the hotel safety boxes and carry photocopies of any important documents rather than the originals where possible.
Local Medications
****************************************
Western brand-name drugs or non-prescription medicines are seldom available locally although some Chinese equivalents are to be found at reasonable prices. Always carry your own medication (well marked) on your person and bring enough for your trip.

Rabies
****************************************
Rabies is a serious problem throughout China. Reports indicate that as many as five million people are bitten each year by rabid dogs and that approximately 5,000 of these patients die. Travellers should stay well clear of any warm blooded animals, especially dogs. Any contact (lick, bite or scratch) should be treated seriously and immediately by washing out the wound, applying an antiseptic and then seeking urgent medical attention.
River Boat Travel
****************************************
Many of the older river boats in China use untreated river water for washing dishes and in the bathrooms. This increases the risk of illnesses such as traveller’s diarrhoea and a parasitic disease called schistosomiasis (Bilharzia). Also be careful that the ferry is not overcrowded and be aware of any sharp corners or rusty edges due to lack of maintenance.
Altitude Sickness in Tibet
****************************************
Virtually all of the Tibetan Autonomous region, much of Quinghai and Xinjiang, parts of Sichuan, Yannan and Gansu are above 13,000 feet in altitude. Some main roads in Tibet, Qinghai and Xinjiand go above 17,000 feet. At these levels the available oxygen is very low and altitude sickness may occur. Travellers may experience severe headaches, nausea, dizziness, shortness of breath or a dry cough. These symptoms usually settle over a few days with rest, but if not travellers should seek medical assistance and, if possible, descend to a lower altitude. Travellers with a history of cardiac problems or respiratory difficulties should avoid such high altitudes where possible.
Insect Bites and Malaria
****************************************
During the summer months, carry a supply of insect repellent ointments for your trip and use sensible, light coloured clothing to cover yourself when there are mosquitoes or sandflies about.
The risk of malaria in most of China is limited but prophylactic tablets may be prescribed depending on your actual itinerary. Other serious mosquito borne diseases do occur so these will need to be considered.
Sunlight
****************************************
The sunlight during the summer months and in Tibet at high elevations can be intense
so travellers should bring sun screen and sun-glasses and a sensible wide-brimmed hat.

Acupuncture
****************************************
Many tourists are tempted to experience this oriental art in its homeland while visiting China. It is essential to ensure that sterile needles are used at all times as otherwise there may be a risk of transmission of a blood borne disease such as the HIV virus or Hepatitis B.
AIDS risk in China
****************************************
Official figures suggest that AIDS is a very limited risk in China. Only 707 cases were reported up to October 2000. These very low figures are very difficult to verify and so all travellers should take care not to place themselves at risk where possible.
Customs Regulations
****************************************
Never carry any medication for another individual unless they are part of your family. The Chinese authorities have strict drug regulations which may be enforced.
Vaccination Requirements:
****************************************
There are no vaccination requirements for entry / exit purposes but travellers on short trips should consider the following ...
*
Poliomyelitis (childhood booster)
*
Typhoid (food & water disease)
*
Tetanus (childhood booster)
*
Hepatitis A (food & water disease)
Those planning to spend a longer time in China should consider additional vaccination against conditions like Rabies, Hepatitis B, Japanese B Encephalitis, Meningococcal Meningitis, Diphtheria and Mantoux Test / BCG vaccination.
Summary
****************************************
China is teeming with people and a culture very different to ours. It is a land of many contrasts. Travellers generally stay healthy if they follow standard commonsense healthcare advice.

Travel News Headlines WORLD NEWS

Date: Mon, 18 Feb 2019 07:39:41 +0100

Shanghai, Feb 18, 2019 (AFP) - A major Chinese food producer said Monday that traces of the African swine fever virus had been found in its frozen dumplings.   China, the world's biggest consumer and producer of pork, has struggled to contain an outbreak of the virus since the first cases were detected last August.

Officials have said hundreds of thousands of pigs were culled in a bid to stop its spread -- an effort that has also seen restrictions placed on moving pigs from affected areas.   Sanquan Food, based in central Henan province, issued a public statement confirming media reports published in recent days that contaminated pork dumplings were detected in two provinces that do not share a border.   The company said suspect batches of dumplings had reached grocery stores, but that it was sealing affected products and cooperating with authorities.   The statement did not mention a broader recall.

Unconfirmed Chinese media reports have said that products manufactured by several other companies also contained traces of the virus.   African swine fever is not harmful to humans but can be fatal to pigs, raising fears for the country's giant pork industry.    But the media reports prompted anger online from Chinese consumers who vented over the latest in a recurring series of product scandals, despite repeated government promises to ensure safety.   Sanquan Food's share price dropped as much as 2.25 percent in Monday morning trading on the Shenzhen Stock Exchange.
Date: Wed, 13 Feb 2019 12:46:21 +0100

Beijing, Feb 13, 2019 (AFP) - Dozens of tourists celebrating the lunar new year at an upmarket ski resort in north-eastern China have been struck down by novovirus, the winter vomiting bug, the tour operator admitted.    French luxury holiday group Club Med expressed its regret, saying it took the outbreak -- which saw guests suffer from vomiting and diarrhoea -- "very seriously".   "We plan to offer all customers who have been affected by the virus compensation equivalent to three times the price they spent," Club Med said in a statement.

The company has said 42 people reported abnormal symptoms, eight of whom were seen by a doctor, although none required hospital treatment.    However, the China Daily newspaper quoted tourists on Wednesday as saying "more than 200" people had been affected, and there were accusations on Chinese social media the company had underestimated the number of people involved.

The hotel at the Yabuli ski resort in Heilongjiang province is being disinfected, according to the company, but the origin of the infection has not yet been identified.    Chinese conglomerate Fosun bought Club Med in 2015 for more than $1 billion.   China is now Club Med's biggest market outside France, with six resorts in operation and four others planned to open by the end 2020.   Fosun Group is one of China's "grey rhino" companies -- along with Wanda, HNA and Anbang -- that have come under scrutiny from mainland authorities wanting to crack down on debt-fuelled foreign acquisitions.
Date: Fri, 11 Jan 2019 16:00:40 +0100

Shanghai, Jan 11, 2019 (AFP) - At least 145 children were administered expired polio vaccines in eastern China, state media reported, despite the government promising to prevent such lapses in the industry following a major scandal last year.   Thirteen county-level health officials in Jiangsu province have been dismissed since the case came to light earlier this week -- the latest to raise public health concerns -- Jinhu county government said late Friday according to state broadcaster CCTV.

Three other county-level health officials are under investigation and a case has been established against a local official, the broadcaster said.   A parent discovered earlier this week that a batch of orally administered polio vaccines were being given to children at a county-run health facility nearly one month after their December 11 expiration date, CCTV reported on Thursday.   The local government has since found 145 children received the vaccines between December 11 and January 7, CCTV said, quoting a government source.

Local health officials have said the expired vaccines would have decreased efficacy but should not cause adverse health effects.   The World Health Organization's website says that people given such vaccines that have expired are "unlikely to get sick as a reaction to receiving the vaccine" but warns that they might not be adequately immunised.

CCTV said some parents reported adverse reactions among children, including vomiting and drowsiness, but it was unclear if this was just a normal allergic reaction to the medicine.   Beijing announced a nationwide clean-up of the country's vaccine industry last year after it emerged that a major Chinese manufacturer of rabies vaccines had fabricated records. 

Authorities maintain that affected rabies vaccines did not enter the market, but the case triggered public outrage over frequent safety scares involving sub-par or toxic food, drugs and other products despite repeated government crackdowns.   The vaccines have been ordered sealed and the county has launched inspections of all health-related departments.   The polio vaccine is provided free by the government for children between two months and four years old.   AFP calls to the Jinhu government went unanswered.
Date: Fri, 23 Nov 2018 06:12:17 +0100

Beijing, Nov 23, 2018 (AFP) - China's agriculture ministry on Friday confirmed the first cases of African swine fever in Beijing, a disease that has spread across the country despite efforts to contain it.   The disease was found on two farms in the Fangshan District in southwest Beijing where 86 out of more than 1,700 pigs died, the ministry said in a statement.    A special task force has since sealed off the farms for culling and disinfection while live pigs and pork products are barred from leaving the area.

Separately, senior ministry officials said during a briefing that 600,000 pigs have been culled since African swine fever was first detected in August in the world's biggest consumer and producer of pork.   It surfaced in northeastern Liaoning province but has now spread to 20 provinces with 73 cases reported.    "As you can see right now, the situation... is still very severe," said deputy director of the bureau of husbandry and veterinary medicine Feng Zhongwu.    "China has frequent trade with affected countries with a huge amount of goods exchanged. Coupled with the long incubation period of the disease and the difficulty of detection, there is a high risk of the disease getting reintroduced."    The ministry has also blamed the spread on backward farming methods, a lack of hygiene and the need to transport pigs long distances for sale.

In early September, government-controlled media said African swine fever had been discovered in just five provinces, with the agriculture ministry saying that the situation was "generally under control".    But it has steadily moved south into pork-producing districts despite efforts to contain it, including culling over half a million livestock and banning the transport of live pigs in affected areas.   Swine fever has already caused a spike in pork prices in China and fuelled growing fears of a major impact on the world's largest pig producer.   The UN Food and Agriculture Organization (FAO) warned in August that the disease could spread to other parts of Asia.   African swine fever is not harmful to humans but causes deadly haemorrhagic fever in domesticated pigs and wild boar.   With no antidote or vaccine, the only known control method is to cull animals.
Date: Fri 23 Nov 2018
Source: Outbreak News Today[edited]

The Chinese National Health Commission reported on an additional human case of avian influenza A(H5N6) in Jiangsu. This brings the total cases to 23 in China since 2014.

The case involved a 10-year-old girl from Suzhou in Jiangsu. She developed symptoms on [29 Oct 2018] and was hospitalized on [3 Nov 2018]. She is now in a serious condition. Avian influenza is caused by those influenza viruses that mainly affect birds and poultry, such as chickens or ducks.

Clinical presentation of avian influenza in humans includes eye infection (conjunctivitis), flu-like symptoms (such as fever, cough, sore throat, muscle aches) or severe respiratory illness (such as chest infection). The incubation period ranges from 7 to 10 days.

The more virulent forms can result in respiratory failure, multi-organ failure, and even death. People mainly become infected with avian influenza virus through contact with infected birds and poultry (live or dead) or their droppings, or contact with contaminated environments (such as wet markets and live poultry markets). Human-to-human transmission is inefficient.

People in close contact with poultry are more susceptible to contracting avian influenza. The elderly, children, and people with chronic illness have a higher risk of developing complications such as bronchitis and chest infection.
=====================
[H5N6 avian influenza viruses (AIV) have posed a potential threat to public health since emergence in China in 2013. The H5N6 reassortant viruses had been detected in poultry/avian populations in most provinces of southern China and neighbouring countries. Considering the mammalian adaption mutations and antigenic variation detected, t e
spread of these viruses should be monitored carefully due to their pandemic potential. - ProMED Mod.UBA]

More ...

World Travel News Headlines

Date: Fri, 15 Mar 2019 19:08:37 +0100
By Joaquim Nhamirre

Maputo, March 15, 2019 (AFP) - Tropical cyclone Idai battered Mozambican coastal city Beira Friday, leaving half a million people virtually cut off after power lines crashed, airport shut and roads were swamped by flooding that killed 66 people nationwide.   "There is no communication with Beira. Houses and trees were destroyed and pylons downed," an official at the National Institute of Disaster Management (NIDM) told AFP.   Authorities had to close Beira international airport after the air traffic control tower, the navigation systems and the runways were damaged by the storm.   "Unfortunately there is extreme havoc," said the official.   "Some runway lights were damaged, the navigation system is damaged, the control tower antennas and the control tower itself are all damaged.    "The runway is full of obstacles and parked aircrafts are damaged."

Late on Wednesday, the national carrier LAM cancelled all flights to Beira and Quelimane, which is also on the coast, as well as to Chomoio, which is inland.    Power utility Electricidade de Mocambique said in a statement that the provinces of Manica, Sofala and parts of Inhambane have been without power since Thursday.   Officials did not report any confirmed deaths, but local Beira station STV reported a child had died in Manica province west of the city, apparently the victim of a falling roof.   "There was no tsunami-type storm but Beira and Chinde (400 kilometres, 250 miles northeast of Beira on the coast) were badly hit," added the NIDM official.

Another official, Pedro Armando Alberto Virgula, in Chinde, said a hospital, police station and seven schools there lost their roofs and four houses were destroyed.   Virgula added that efforts were under way to assess the damage caused after Idai made landfall late on Thursday.   Local officials said that this week's heavy rains claimed 66 lives, injured 111 people and displaced 17,000 people.   The World Food Programme (WFP) said it would move 20 tonnes of emergency food aid to the affected areas.   The UN Office for the Coordination of Humanitarian Affairs (OCHA) had warned that the storm could pack winds of up to 190 kilometres per hour (118 miles per hour).

- 'Devastation' -
At least 126 people were killed by the downpour that has struck parts of Mozambique, Malawi and South Africa over the past week, officials said.   Heavy rains in neighbouring Malawi have affected almost a million people and claimed 56 lives, according to the latest government toll.   Authorities there have opened emergency relief camps where malaria and shortages of supplies have led to dire conditions, according to AFP correspondents.

Malawian President Peter Mutharika this week declared a natural disaster.   Mozambique's weather service has warned that heavy rain will continue to batter Beira and surrounding areas until Sunday.   The UN warned of damage to crops, "including about 168,000 hectares (415,000 acres) of crops already impacted by flooding in early March, which will undermine food security and nutrition".   Mozambique and Malawi, two of the poorest countries in the world, are prone to deadly flooding during the rainy season and chronic drought during the dry season.   In neighbouring Zimbabwe, weather services have warned that violent thunderstorms, lightning and strong winds will be experienced in the eastern regions of the country.
Date: Fri, 15 Mar 2019 19:00:39 +0100

Niamey, March 15, 2019 (AFP) - Health authorities in Niger said Friday they had found a fake version of a meningitis vaccine after the country had launched a campaign to innoculate millions of children against the disease.   In a statement, the health ministry asked doctors to be vigilant over a "counterfeit" version of a vaccine called Mencevax ACWY.   The fake drug is marked as having been manufactured in December 2016, with an end-date for use by November 2021, it said.   Niger launched a week-long campaign on March 5 to vaccinate six million children against meningitis, which killed nearly 200 people two years ago.   The country lies in the so-called "meningitis belt" stretching from Senegal in the west to Ethiopia in the east, where outbreaks of the disease are a regular occurrence. 

The vaccination programme is against meningitis A, one of the six groups of meningitis bacteria that can cause epidemics.   The ministry's spokesman told AFP the bogus drug had been discovered during a "routine inspection" of a privately-owned pharmacy in the capital Niamey.   An investigation is underway to try to ascertain how many of the fake vaccines have been used, the spokesman said.   Health workers administering meningitis jabs are being asked to take special care about their supply source, and the public are being urged to scrutinise vaccines clearly, even if they buy them in "licensed" pharmacies.   Fake drugs -- medications that are outright counterfeits or whose active ingredients have been diluted -- are a major problem in West Africa.

In the 2017 outbreak, and in an epidemic in 2015 in which nearly 500 people died, Niger sounded the alarm over purported vials of vaccine that just contained water.   Meningitis is transmitted between people through coughs and sneezes, close contact and cramped living conditions.   The illness causes acute inflammation of the outer layers of the brain and spinal cord, with the most common symptoms being fever, headache and neck stiffness.
Date: Fri, 15 Mar 2019 02:55:29 +0100
By Khaliun Bayartsogt

Bornuur, Mongolia, March 15, 2019 (AFP) - In the world's coldest capital, many burn coal and plastic just to survive temperatures as low as minus 40 degrees -- but warmth comes at a price: deadly pollution makes Ulaanbataar's air too toxic for children to breathe, leaving parents little choice but to evacuate them to the countryside.   This exodus is a stark warning of the future for urban areas in much of Asia, where scenes of citizens in anti-pollution masks against a backdrop of brown skies are becoming routine, rather than apocalyptic.   Ulaanbaatar is one of the most polluted cities on the planet, alongside New Delhi, Dhaka, Kabul, and Beijing. It regularly exceeds World Health Organisation recommendations for air quality even as experts warn of disastrous consequences, particularly for children, including stunted development, chronic illness, and in some cases death.

Erdene-Bat Naranchimeg watched helplessly as her daughter Amina battled illness virtually from birth, her immune system handicapped by the smog-choked air in Mongolia's capital.   "We would constantly be in and out of the hospital," Naranchimeg told AFP, adding that Amina contracted pneumonia twice at the age of two, requiring several rounds of antibiotics.   This is not a unique case in a city where winter temperatures plunge towards uninhabitable, particularly in the districts that rural workers moved to in search of a better life.   Here row upon row of the traditional tents -- known as gers -- are warmed by coal, or any other flammable material available. The resulting thick black smoke shoots out in plumes, blanketing surrounding areas in a film of smog that makes visibility so poor it can be hard to see even a few metres ahead.   Hospitals are packed and young children are vulnerable, common colds can quickly escalate into life-threatening illness.

- Birth defects -
The situation was so bad that doctors told Naranchimeg the only solution was to send her little girl to the clean air of the countryside.   Now aged five, Amina is thriving. She lives with her grandparents in Bornuur Sum, a village 135 kilometres away from the capital.   "She hasn't been sick since she started living here," said Naranchimeg, who makes the three-hour round trip to see Amina every week.   "It was very difficult in the first few months," she said. "We used to cry when we talked on the phone."   But like many parents in Ulaanbaatar, she felt the move was the only way to protect her child.

The levels of PM2.5 -- tiny and harmful particles -- in Ulaanbaatar reached 3,320 in January, 133 times what the World Health Organisation (WHO) considers safe.   The effects are terrible for adults but children are even more at risk, in part because they breathe faster, taking in more air and pollutants.   As they are smaller, children are also closer to the ground, where some pollutants concentrate, and their still-developing lungs, brains, and other key organs are more vulnerable to damage.   Effects to prolonged exposure range from persistent infections and asthma to slowed lung and brain development.   The risks apply in utero, too, because gases and fine particles can enter a mother's bloodstream and placenta, causing miscarriage, birth defects and low birth weights, which can also affect a child for the rest of their lives.   Researchers are now investigating whether pollution, like exposure to tobacco smoke, has health effects that could even be passed down to the next generation.

- 'Terribly afraid' -
Buyan-Ulzii Badamkhand and her husband need to stay in capital for work, but they have decided to send their two-year-old son Temuulen more than 1,000 kilometres away.   The 35-year-old mother-of-three struggled with the decision, even moving from one ger district to another in the hope her son's health would improve.   But successive bouts of illness, including bronchitis that lasted a whole year, finally convinced her to send Temuulen to his grandparents.   Hours after he arrived, she called her mother-in-law to discuss her son's medicines.   "But my mother-in-law asked me 'does he still need medicine? He isn't coughing anymore," she said.   "I tell myself that it doesn't matter that I miss him and who raises him, as long as he is healthy, I am content."   Respiratory problems are the most obvious effect of air pollution, but research suggests dirty air can also put children at greater risk for diabetes and cardiovascular disease later in life.   And the WHO links it to leukaemia and behavioural disorders.   When air pollution peaks in winter, Ulaanbaatar's playgrounds empty and those who are able to are increasingly travelling abroad to wait out the smog.

In desperation, Luvsangombo Chinchuluun, a civil society activist, borrowed money to take her granddaughter to Thailand for all of January.   "We can't let her play outside (in Ulaanbaatar) because of the air pollution, so we decided to leave," she said.   The persistent smog has caused tensions in the city, with those living in wealthier areas blaming the ger residents for the pollution and even calling for the tent districts to be cleared.   But the ger residents say coal is all they can afford.   "People come to the capital because they need sustainable income," said Dorjdagva Adiyasuren, a 54-year-old mother of six.   "It's not their fault," she added.    In a bid to tackle the problem, the local government banned domestic migration in 2017, and a ban on burning coal comes into force from May.   But it is unclear whether the moves will be enough to make a difference.   For Naranchimeg, the problems are serious enough to make her consider whether she wants more children.    She explained: "Now, I am terribly afraid of to give birth again. It is risky to carry a child and what will happen to the child after it is born in this amount of pollution?"
Date: Thu, 14 Mar 2019 18:17:56 +0100

Reykjavik, March 14, 2019 (AFP) - Iceland has blocked the millions of tourists who descend upon the volcanic island each year from visiting a canyon that has been overrun since it was featured in a Justin Bieber music video.   An influx of tourists and a humid winter have disrupted the Fjadrargljufur canyon's fragile ecosystem, so the Environment Agency of Iceland has closed the site to the public until June 1.   "During periods of thaw, the path is completely muddy and is practically unusable for hikers," agency advisor Daniel Freyr Jonsson told AFP on Thursday.   "Because the mud is so thick, visitors step over the fences and walk parallel to the path, which rapidly damages the plant life," he added.

Fjadrargljufur is a gorge about 100 meters (yards) deep and two kilometres (1.25 miles) long, with steep green walls and a winding riverbed. The canyon was created by progressive erosion from water melting from glaciers 9,000 years ago.   The canyon was little known to foreigners until the end of 2015, when Canadian singer Justin Bieber featured the site in his song "I'll Show You".   "Visits to the site have risen by 50 to 80 percent per year since 2016," said Daniel Freyr Jonsson, estimating that around 300,000 people visited the canyon in 2018.   A growing number of tourist sites in Iceland have been closed in a bid to
preserve them.

The popular Reykjadalur valley and its hot springs were temporarily closed in April 2018 and a hiking trail overlooking the Skogafoss waterfall is currently shut.   "The infrastructure is not set up to accomodate so many visitors," said Daniel Freyr Jonsson.    "Tourism in winter and spring, the most sensitive periods for wildlife in Iceland, (was previously) almost unheard of in Iceland."   Since 2010 and the eruption of the Eyjafjallajokull volcano -- which generated a lot of publicity for the island -- the number of visitors has grown by 25 percent per year on average.   Last year, a record 2.3 million people visited Iceland.
Date: Thu, 14 Mar 2019 16:50:58 +0100

Geneva, March 14, 2019 (AFP) - The deadly Ebola outbreak raging in eastern Democratic Republic of Congo should be over within six months, the head of the World Health Organization said Thursday.   Seven months since the outbreak erupted in DRC's violence-torn North Kivu province, WHO Director-General Tedros Adhanom Ghebreyesus told reporters there were clear signs the spread of the virus was "contracting".   "Our target is now to finish it in the next six months," he told reporters in Geneva, warning though that increased unrest in the affected area could reverse the progress being made.   "It's always good to plan beyond the horizon to prepare for any eventualities," he said, while voicing optimism that massive efforts to rein in the outbreak are working.

The ongoing Ebola outbreak, the 10th in DRC's history, emerged in North Kivu in August 2018 and then spread to neighbouring Ituri province.    It has claimed 584 lives out of nearly 1,000 believed to have been infected, WHO said.   Security in eastern DRC, a region rampant with rebel fighters, has dramatically complicated the response, with numerous attacks on Ebola treatment centres.   The Doctors Without Borders (MSF) medical charity has also sounded the alarm over increasingly "toxic" relations with local communities, whose resistance to Ebola response efforts have also fuelled the spread.   MSF pointed out that 40 percent of deaths from the extremely contagious virus are occurring in communities rather than in Ebola treatment centres.

- 'Contracting' -
"The Ebola response is failing to bring the epidemic under control," MSF chief Joanne Lieu told reporters in Geneva last week.   But Tedros denied Thursday that this was the case.   "That's not true," he said. "You cannot say it's failing when the outbreak is contracting. It's contracting."   He stressed that over the past seven months, the virus had been contained to North Kivu and Ituri.

"It hasn't spread to other parts of the country and it hasn't spread to neighbouring countries," he said, adding that transmission had been halted in a number of places, including in Beni and Mangina.   "So the cases are now shrinking in certain geographic areas," he said.   Tedros also stressed that the number of new cases had been cut in half since January, with an average of 25 new cases reported each week now compared to 50 at the beginning of the year.   He acknowledged though that violence, unrest and community resistance remained a challenge in Butembo especially, which along with Katwa is where the spread of the virus is now concentrated.   "I don't want to undermine the risk, because it may again (resurge) if the security situation continues to deteriorate," he said, acknowledging that there is still a chance Ebola could spread to other parts of DRC and neighbouring countries.
Date: Thu, 14 Mar 2019 03:42:36 +0100

Kuala Lumpur, March 14, 2019 (AFP) - Over 100 schools in Malaysia have been closed after the dumping of toxic waste into a river caused hundreds of people to fall ill, including many children, authorities said.   A lorry is believed to have dumped the waste in southern Johor state last week, sending hazardous fumes across a wide area and causing those affected to display symptoms of poisoning such as nausea and vomiting.

Over 500 people, many of them school pupils, have received medical treatment after inhaling the fumes, with over 160 admitted to hospital, according to official news agency Bernama.    It was unclear what type of poisonous gas had been emitted near the industrial town of Pasir Gudang.   Education Minister Maszlee Malik initially ordered the closure of 43 schools in the area Wednesday, but later announced that figure had more than doubled.

"The ministry of education has decided to close all 111 schools in the Pasir Gudang area immediately," he said in a statement.    "The education ministry is requesting that all parties take precautions."   Three men were arrested earlier this week over the toxic waste dumping. One is expected to be charged in court soon and could face up to five years in jail if found guilty of breaking environmental protection laws.
Date: Tue 12 Mar 2019
Source: Carmelo Portal [in Spanish, trans. Mod. TY, edited]

The departmental health director, Dr Jorge Mota, confirmed for Carmelo Portal the death in our city of a young 17 year old girl from [a] hantavirus [infection]. "In Colonia department, there are on average 3 cases per year. The evolution of the disease is in thirds. One-third of the [infected] people do not have notable symptoms; another third have serious symptoms, especially respiratory symptoms and ones in all the systems, but with adequate treatment, [the infected people] survive, sometimes with sequelae. There is another third that die. It is those few with the virus that die with an evolution so drastic, such as is the case of this girl, sadly," Dr Mota stated.

The department health director said that hantaviruses are not contagious person-to-person. "It is transmitted from an intermediate animal, the field mouse. Only 3% of these mice have [a] hantavirus. To become infected, one must be in contact with an [infected] mouse's secretions that have dried, are mixed with dust, and are in a closed space, away from sunlight and ventilation. A spa, a shed, or a wood pile [are examples of such a space]. The person had to have been moving around there and inhaled the dust," he explained.

Dr Mota spoke about the epidemiological surveillance that is carried out. "We tracked places where the person was, even those that could be identified 2 months before contracting the virus; sometimes we found the place, but sometimes not." As a preventive measure, Mota stated that in these cases, ventilate these closed spaces for at least half an hour. Wet down floors and shelves with water [with 10% bleach]. Use masks [and gloves].
==========================
[The report above does not mention the circumstances under which the infection might have been acquired nor which hantavirus was responsible for this or earlier cases in Uruguay. Hantaviruses that cause hantavirus pulmonary syndrome (with rodent hosts found in Uruguay) include Laguna Negra virus (_Calomys laucha_), Maciel virus (_Necromys benefactus_), Central Plata virus, Lechiguanas virus (_Oligoryzomys flavescens_, complex of rodents), and Anajatuba virus and Juquitiba virus (_Ologoryzomys fornesi_).

The rodent reservoir hosts shed the virus in its saliva, urine, and faeces, contaminating the environment in which they live and breed.

A HealthMap/ProMED-mail map showing the location of Uruguay in South America can be accessed at
<http://healthmap.org/promed/p/28995>.

A map of Colonia department in southern Uruguay is available at
<https://en.wikipedia.org/wiki/Colonia_del_Sacramento>
and <http://healthmap.org/promed/p/27367>. - ProMED Mod.TY]
Date: Wed 13 Mar 2019
Source: Outbreak News Today [abridged, edited]

The number of measles deaths has topped 1100 in Madagascar. In an update on the measles epidemic in Madagascar, UN health officials report 6607 cases of measles, including 41 deaths, in the week ending 24 Feb [2019]. Cases are reported in children aged 1 to 14 years. Of 114 districts in all 22 regions, 104 are in the epidemic phase, officials report.
=======================
[The number of cases and deaths from measles in Madagascar is horrifying, even more so since the disease is vaccine-preventable. There is no information on how the health sector in the country is responding, but clearly the clinics are overburdened during this devastating outbreak. - ProMED Mod.LK]

[HealthMap/ProMED-mail map of Madagascar:
Date: Mon 11 Mar 2019
Source: Focus Taiwan [abridged, edited]

A Taipei resident in her 20s has been confirmed to be infected with measles and is suspected of having had contact with 247 people during the incubation period, according to the Centers for Disease Control (CDC). The woman, who works at a restaurant in the ATT 4 Fun shopping centre in Taipei's Xinyi District might have been infected through coming into contact with foreign tourists in her workplace, said CDC deputy director-general Lo Yi-chun in a statement issued on Mon [11 Mar 2019].

To date, 247 people considered to have had contact with the patient, including her family, colleagues and health care personnel, have been traced. The contact tracing will continue until 27 Mar [2019]. The CDC alerted people who used the same bus and had been to the same places the patient visited to beware of possible exposure to the measles virus. It asked those who might have had contact with the woman to conduct self-health management for 18 days.

The reported new case has brought the total number of confirmed measles cases in Taiwan to 29 since the beginning of this year [2019], 16 contracted at home and 13 from abroad. Among the 16 indigenous cases, 8 have been linked to imported cases, the CDC said.

Lo reminded the public that measles is highly contagious and now is the peak transmission season. Outbreaks in some Asian countries have been growing, including the Philippines, Vietnam, Thailand, China, India and Indonesia, he said. As of 24 Feb [2019], the number of measles cases in Japan has risen to 258, the highest in the same period since 2009, Lo added.  [byline: Chang Ming-hsuan and Evelyn Kao]
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Date: Thu 14 March 2019
Source: South China Morning Post [abridged, edited]

Health authorities seek passengers on Cathay Pacific Hong Kong-Tokyo flight [1 Mar 2019] after a man [said to be a Cathay Pacific flight attendant] contracted measles, a contagious disease. The man tested positive for the immunoglobulin M antibody that confirms a measles infection. He was admitted to St Paul's Hospital in Causeway Bay after he returned to Hong Kong. He was later declared to be in a stable condition and discharged.

This is the 11th case of measles confirmed in city this year [2019] with at least 7 infections imported. Authorities seek passengers on the Cathay Pacific flight who might have had contact with the 23 year old man.  [byline: Danny Mok]
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