WORLD NEWS

Getting countries ...
Select countries and read reports below or

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
***************************************
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: Sun 22 Sep 2019
Source: La Voz [in Spanish trans. Mod.TY, edited]

Viruses transmitted by mosquitoes are emerging in the Americas. To historic dengue in recent years have been added Zika and chikungunya [viruses], 2 pathogens that before were restricted only to Africa. Madariaga has now been added to that list [of viruses new in the Americas].

Researchers from the Instituto de Medicina Regional of the Universidad Nacional del Nordeste (IMR-Unne) and from the Instituto de Virologia, and J. M. Vanella of the Universidad Nacional de Cordoba (Inviv, UNC) detected its presence in mosquitoes captured in the Chaco. "Madariaga is a virus that causes disease in equine animals and is of low pathogenicity for humans, but in 2010 caused an outbreak in humans in Panama with 10 cases," said Marta Contigiani, who works in the UNC laboratory. It was also isolated in 2015 and 2016 from human samples in Haiti.

Ornella Stechina, of the IMR-Unne, was the person who detected presence of the virus in the mosquitoes. The work was done with the financial support of this institution with Mariana Stein, a researcher from CONICET [the national science agency] as the person in charge.

Contigiani explained that there have been no subsequent cases in horses since 1988. "In other provinces in the country, serological studies have detected [Madariaga] virus infections. There is a vaccine for equine animals, but its application is not obligatory," she said.

However, she warned that global climate change (including deforestation in the Amazon Basin) influences the geographic distribution and emergence of diseases, with appearance of new environments that are favorable for the development of vectors and that favor the development of the [transmission] cycle.

"To this we must add the genetic changes that are observed in these viruses," she stated.

For some time, experts have been issuing alerts about the emergence and reemergence of arboviruses, pathogens that are transmitted by insects.

"West Nile virus rapidly invaded North America, and now cases are being found in Central and South America. Also, Mayaro and eastern equine encephalitis viruses have increased their activity and have been found in new regions," said Raquel Gleiser, a researcher at the Instituto Multidisciplinario de Biologia Vegetal of the UNC (Imbiv) in an article published in the Journal of Medical Entomology.

Madariaga virus is a strain of eastern equine encephalitis virus, which was early on detected in Argentina. Contigiani did not discard the possibility that a variant that had greater capacity to replicate, the proliferation of competent vectors, and propitious environmental conditions could cause an outbreak in the region.

The evidence for warning about Madariaga virus is not at the same level as for chikungunya [virus], although they are in the same family (Togaviridae). "For now, the epidemiological behavior is different. Chikungunya virus has _Aedes aegypti_ as its vector, whereas the vector of Madariaga virus is within the _Culex_ genus," she said.

This study detected the virus in mosquitoes of the _Culex_ genus in wildland areas in Choco province. Thus, they identified this vector in Argentinian territory for the 1st time.

Although the mosquito species or species that had the virus could not be detected, the genus _Culex_ has more than 1000 species, many of which are of urban habits such as _Culex pipiens_ that we hear buzzing at night.

Madariaga virus can infect various mammals that could serve as hosts, such as rats and bats, as well as birds.

In Argentina, it was found for the 1st time in animals in the decade of the 1930s. The strain found in the Chaco belongs to the same lineage discovered in those years, which indicates that the virus is endemic in the region.

For now, the infections studied in humans has been for the most part mild and asymptomatic.

Adrian Diaz of the Cordoba Institute, Griselda Oria (IMR-Unne), and Carolina Torres of the Universidad de Buenos Aires participated as part of the work that was published a week ago in the American Journal of Tropical Medicine and Hygiene [reference below].

The researchers suggest that more epidemiological studies be done to determine the vectors and potential hosts and do deeper studies about the genetic characteristics of the [virus] strains that circulate in the country in order to know whether this virus is endemic in the region or is reintroduced.

"Ideally, studies will be done [in the field] with sentinel animals to detect virus circulation as well. In other countries, they use sentinel chickens for these types of studies," Contigiani commented, and clarified that in case [virus] circulation was detected, animal health officials must take relevant measures.

"There is no human vaccine, so [human] health officials must indicate measures [needed] for prevention and control," she added.

The vector is the most common, _Culex_. However, there is no virus circulation in Cordoba.

_Culex_ is a genus of hematophagous mosquitoes in the Culiidae family, many species of which act as vectors of important diseases, such as West Nile, filariasis, virus encephalitis (Japanese, Venezuelan, equine, and St. Louis) and avian malaria, as well as Madariaga virus. There are more than 80 varieties [of what?].  [Byline: Lucas Viano]
=================
[The isolation of Madariaga virus from Culex mosquitoes in northern Argentina is interesting, but, as the authors point out, merits additional studies to determine whether it is a human or animal (especially equine) pathogen of importance for human or animal health in Argentina. Studies of the Culex species involved in transmission of the virus and determination of the animal hosts are essential to understand cycles of transmission.

Reference:
Ornela Sofia Stechina, Griselda Ines Oria, Carolina Torres, Luis Adrian Diaz, Marta Contigiani and Marina Stein. First Detection of Madariaga virus in Mosquitoes Collected in a Wild Environment of Northeastern Argentina. 2019. Am. J. Trop. Med. Hyg., 00(0), 2019, pp. 1-3 DOI: <https://doi.org/10.4269/ajtmh.19-0475>.

Chaco province is in the far north of Argentina. - ProMED Mod.TY]

[HealthMap/ProMED map available at:
Chaco Province, Argentina: <http://healthmap.org/promed/p/54342>]
Date: Sun 4 Aug 2019
Source: Diario Uno [in Spanish, trans. ProMED Mod.JG, edited]

A family living in El Borbollon, Las Heras, ate ham and sausages after fixing pork at their home, but after this, 11 persons needed medical attention because of the occurrence of symptoms related to trichinellosis.

It was reported that the Provincial Livestock Direction confiscated homemade ham and sausages after receiving an alert from the Epidemiology Area of Lagomaggiore Hospital, which stated they received and attended (infected) people with symptoms of thichinellosis.

The operation was carried out last Friday in a household located in El Borbollon, which was pointed out as the infection source after 3 persons (2 of them less than legal age) were brought to Lagomaggiore Hospital seeking medical care. As days went by, 8 additional compatible cases -- presenting with similar symptoms -- were reported in Lencinas Hospital.

Once the protocol involving Food Hygiene, Zoonoses, Livestock Farming, and Epidemiology local departments and also the local municipality was activated, 2 pieces of ham, 2 pork shoulders, one piece of pork tenderloin, dry sausages and Bondiola pork were confiscated. Considering the size of these pieces, it is thought a large animal was involved.

Laboratory tests were immediately performed, and because of positive results, the meat products were destroyed and properly disposed of in a local slaughterhouse, aiming to prevent the dissemination of this disease.

Trichinellosis is a parasitic disease caused by ingesting _Trichinella spiralis_ larvae located in muscles (meat). This condition is characterized by high fever, muscle pain and vomiting or diarrhoea. The disease affects humans and many mammals. This condition is acquired by eating infected pork meat.

Common symptoms are diarrhoea, abdominal pain, fatigue, nausea, vomiting, and in severe cases also fever.
=====================
[Trichinellosis caused by _Trichinella spiralis_ is common in Argentina, especially in northern Argentina (see ProMED reports below). The source of meat is pigs from small farms or even "backyard pigs" slaughtered and processed without proper veterinary control. - ProMED Mod.EP]

[HealthMap/ProMED map available at:
Mendoza, Mendoza, Argentina: <http://healthmap.org/promed/p/5900>]
Date: Wed 24 Jul 2019
Source: Jujuy al Momento [in Spanish, trans. ProMED Mod.TY, edited]

The disease [virus], transmitted by rodents, has now taken the life of a man, and there are 18 confirmed cases [of hantavirus infection]. There is concern in the health sector because of the lack of environmental policies to confront the problem of trash dumps, one of the environments where these animals [rodents] proliferate.

- There are now 18 confirmed cases of hantavirus [infections].
- There are 372 suspected cases.
- The increase in the number of trash dumps in the whole province contributes to aggravation of the situation.

The Ministry of Health indicated that there are 372 suspected cases of hantavirus [infections] in Jujuy, with 18 confirmed cases. An adolescent died in the Talar locality, and 17 patients are recuperating favorably.

The majority of the cases are registered in Palma Sola and San Pedro with 4 in each locality.

There was also a case of hantavirus [infection] very close to San Salvador that occurred in the Palpala rural area. This city is one of those with evidence of the greatest increase in trash dumps, to the point that several of them begin to increase in proximity to the plazas and urban neighborhoods.

_Hantavirus_ is a genus that groups various RNA viruses that are transmitted by rodents and, in humans, generally produces 2 types of afflictions: a type of viral hemorrhagic fever, a hemorrhagic fever with renal syndrome; or hantavirus pulmonary syndrome, a very serious affliction.

The disease has a strict relationship to trash deposits since this is where these [reservoir] animals eat and reproduce. Despite this, the Ministry of the Environment, headed by Maria Ines Zigaran, still has not recognized policies to attack the problem.
=====================
[Cases of hantavirus infections have been increasing in Jujuy province since early April 2019. The number of confirmed hantavirus infections in Jujuy province has increased from 11 cases reported on 8 Apr 2019, in the localities of San Pedro, Palma Sola, Libertador General San Martin, and Calilegua, to 15 cases on 10 May 2019, and now to 18 cases reported above. The above report of 372 suspected cases is a surprisingly large number. It will be interesting to learn how many of these cases are ultimately confirmed as hantavirus infections. The confirmed cases are from a variety of locations, indicating that the virus and its reservoir rodent hosts are widespread in the province. The public is well advised to follow the Ministry's recommendations for avoidance of infection.

The hantaviruses responsible for these 18 confirmed cases are not stated in the earlier reports or the one above. An earlier report from Jujuy province this year (2019) apparently presumed that the hantavirus involved in that case was Laguna Negra, although it is not stated that this virus had 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 (in 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 (in western Argentina, in _O. flavescens_); and Laguna Negra (in northern Argentina, in _Calomys laucha_). Seoul virus with its brown rat (_Rattus norvegicus_) host (a frequenter of trash dumps) is another possibility. Without laboratory confirmation, it is not possible to say with certainty which hantavirus was involved. Andes virus seems unlikely in these cases in Jujuy province. - ProMED Mod.TY]

[Map of Argentina:

HealthMap/ProMED-mail map:
Jujuy province, Argentina: <http://healthmap.org/promed/p/53166>]
Date: Sat 29 Jun 2019 10:38 ART
Source: La Voz, Argentina [in Spanish, trans. Rapp. Kathryn Soderholm, abridged, edited]

The Ministry of Health of San Luis issued an epidemiological alert after 3 cases of trichinosis were confirmed by laboratory. The cases are one child, his father, and his mother. Another 12 probable cases are under investigation, all from the distant towns of Concaran and Villa Mercedes, 163 [101 mi] and 100 kilometres [62 mi], respectively, from the provincial capital [San Luis].

The affected patients would have contracted the disease after consuming sausages purchased in La Punilla at the beginning of June [2019], and the symptoms were detected 48 hours ago, the News Agency of the provincial state declared.

The head of Epidemiology, Rodrigo Verdugo, confirmed that the analyses were performed last [Thu 27 Jun 2019] after the suspected cases were referred on [26 Jun 2019].

The other 12 cases are being investigated and will be confirmed by blood sample.

The boy, who is 8 years old, remains hospitalized in the San Luis Hospital; another patient hospitalized in Merlo and another in Villa Mercedes.

Representatives from the department of Epidemiology with the Sanitary and Fiscal Control Program (Cosafi) toured La Punilla and Concaran, where the other cases originated, making visits to the premises that may have samples of these foods, explained Claudia Olarte, head of the Epidemiological Surveillance Service.

Verdugo noted that "this is the 1st outbreak" of this year [2019] and recalled that in 2018, 3 cases were detected, one of which also originated in La Punilla, so the Health department is also investigating in nearby towns such as Papagayos and Villa del Carmen.
=====================
[La Punilla is approximately 200 km [about 125 mi] south of Cordoba, in San Luis province. Trichinellosis has been reported often from Argentina. The source is homemade sausages from backyard pigs, slaughtered and used or sold at local markets without veterinary control. - ProMED Mod.EP]

[HealthMap/ProMED-mail map of Argentina:
Date: Sat 18 May 2019
Source: Food Safety News [edited>

Two cases of foodborne botulism linked to hummus have been confirmed by Argentinian health authorities. The National Administration of Drugs, Foods and Medical Devices (ANMAT) reported that an investigation confirmed the botulism cases and results of an epidemiological survey determined illness was associated with a hummus product. Hummus was sold under the brand Tsuki Macro Vegan, which is based in Palermo, Buenos Aires.

The general directorate of hygiene and food safety and ANMAT inspected the processing establishment where the product was made and imposed a ban on processing and marketing. It was also detected that the product did not have the relevant sanitary authorization. The processing firm was asked to carry out an immediate withdrawal from the national market of all units of the implicated branded hummus.

ANMAT advised the public to refrain from consuming the product and to keep the containers closed and separated from other foods. The agency also told those who sell the products to stop marketing it.

Botulism is a rare but life-threatening condition caused by toxins produced by _Clostridium botulinum_ bacteria. In foodborne botulism, symptoms generally begin 18-36 hours after eating a contaminated food. However, they can start as soon as 6 hours after, or up to 10 days later. Botulism can cause symptoms including general weakness, dizziness, double vision, and trouble with speaking or swallowing. Difficulty in breathing, weakness of other muscles, abdominal distension, and constipation may also occur. People experiencing these problems should seek immediate medical attention.

The latest incident follows a different outbreak in Rancul, a town in the La Pampa province of Argentina, at the start of May 2019 with 4 suspected cases. Health authorities in La Pampa reported that 4 people older than 57 years old were in a serious condition and needed hospital treatment. The poisoning was a result of a meal shared by 7 friends in Rancul. The suspected source is preserves such as peppers that were prepared in a homemade way by one of the people who fell ill.
===================
[Hummus is an unusual source of botulism but has been reported, also from a commercially produced product.

Mad'arova L, Dorner BG, Schaade L, et al.: Reoccurrence of botulinum neurotoxin subtype A3 inducing food-borne botulism, Slovakia, 2015. Euro Surveill. 2017 Aug 10; 22(32): pii: 30591. doi: 10.2807/1560-7917.ES.2017.22.32.30591.

Abstract
--------
A case of foodborne botulism occurred in Slovakia in 2015. _Clostridium botulinum_ type A was isolated from 3 nearly empty commercial hummus tubes. The product, which was sold in Slovakia and the Czech Republic, was withdrawn from the market, and a warning was issued immediately through the European Commission's Rapid Alert System for Food and Feed (RASFF). Further investigation revealed the presence of botulinum neurotoxin (BoNT) subtype BoNT/A3, a very rare subtype implicated in only one previous outbreak (Loch Maree in Scotland, 1922). It is the most divergent subtype of BoNT/A with 15.4% difference at the amino acid level compared with the prototype BoNT/A1. This makes it more prone to evading immunological and PCR-based detection. It is recommended that testing laboratories are advised that this subtype has been associated with foodborne botulism for the 2nd time since the 1st outbreak almost 100 years ago, and to validate their immunological or PCR-based methods against this divergent subtype. - ProMED Mod.LL]

[HealthMap/ProMED-mail map:
More ...

Cape Verde

General
The Cape Verde islands are situated off the west coast of Africa (adjacent to Senegal) and are becoming a more popular destination for European travellers aiming to avoid the major busy tourist destinations of the world. There are nine inhabi
ed islands within the group and also some uninhabited volcanic ones. The capital is Praia (on Santiago) and Portugese is the official language. The major port is Mindelo on the island of Sao Vicente.

Travelling to Cape Verde
There is a recently opened international airport in Praia and a second international airport (Amilcar Cabral) located on Sal Island which is about 150 kms northeast of the capital. Generally the facilities for tourists are still quite limited though improving and most developed on Sal.
Arriving in Cape Verde
The climate is oceanic tropical with temperatures varying from 20oC to 30oC throughout the year. The light rainfall tends to occur in Aug to November. During this time humidity can be higher but this is not usually a significant factor.
Food & Water
In line with many hotter regions of the world the level of food and water hygiene varies greatly from area to area and depending on the establishment. Travellers are advised to eat freshly cooked hot food, to avoid cold meals (salads etc) and particularly to avoid any undercooked bivalve shellfish meals (clams, mussels, oysters etc). Fresh milk may be unpasteurised and should be avoided.
Travelling around the islands
As with many archipelago destinations there is a way of moving from island to island if you wish to explore. This can be by boat or plane in many but not all cases. However if travelling by plane be aware that the limited baggage handling capacity of the small planes may lead to some delay in eventually receiving your luggage. During the dry dusty season (December to April) flights may be cancelled due to poor visibility. The road traffic moves on the right and seatbelts are compulsory for all in the front seat. Motorcyclists must wear helmets and have their lights on at all times.

Accidents
The majority of accidents occur because of unlit narrow winding roads, aggressive driving and alcohol impairing the senses. There are a large number of festivals and around these times alcohol intake increases considerably with the resultant increase in danger for all road users.
Emergency numbers
The emergency numbers are 130 for medical assistance, 131 for fire assistance and 132 for the police. There is no organised roadside assistance and travellers are strongly advised to avoid hiring cars or motorbikes. Taxis and buses provide a reasonable service and are a much safer option.
Sun Exposure & Dehydration
Many travellers from Europe will enjoy the beautiful climate to excess and run the risk of severe sunburn and dehydration. This is particularly true for the first 24 to 48 hours after arrival (when the traveller may fall asleep under the glaring sun) and also for young children. Sensible covering, avoiding the midday sun and replacing lost fluids and salt are essential to maintain your health.
Swimming and Water Sports
Island life in the tropics tends to increase the amount of water exposure for many tourists. It is important to check out the facilities (both the professionalism of their personnel and the equipment) before undertaking any water sports. Talk to others who have already taken part or your holiday representative and listen to their experiences. This will help you make the right choices. Remember the tides and currents around the various islands can be very strong so always follow local advice and never swim alone. Watch children carefully.
Mosquitoes and Malaria
This island chain has only a few species of mosquitoes and the risk of malaria is thought to be negligible. WHO (2006) does not recommend prophylaxis for travellers but comments that there is a mild risk on Santiago mainly between August and November during the rainy season. Good repellents should be used by all travellers - especially at dusk and dawn.
Safety & Security
Unfortunately there is no idyllic destination throughout the world and petty crime occurs in Cape Verde as elsewhere. Take special care at festivals and in market places. Don't flaunt your personal wealth while out and about. Gangs of children have been involved in attacks against tourists so avoid any potential confrontation.
Contacts
U.S. Embassy: Rua Abilio m. Macedo 81, Praia Tel.: 238-61-56-16/17; Fax: 238-61-13-55; Web: usembassy.state.gov/praia
U.K. Embassy: Shell Cabo Verde, Sarl, Av Amilcar Cabral CP4, Sao Vincente
Tel.: 238-32-66-25/26/27; Fax: 238-32-66-29; E-mail: antonio.a.canuto@scv.sims.com
Vaccines
Travelling directly from Europe there are no essential vaccines for entering Cape Verde. It is a Yellow fever risk region but there have been no cases for many years. Other vaccines need to be considered against food and water borne diseases such as Hepatitis A & Typhoid.
Healthcare
This is a beautiful destination and direct flight will increase the numbers travelling. However all travellers to Cape Verde will need to be seen for a detailed medical consultation to ensure that they have appropriate advice and protection for their individual trip. Further information on health issues and all the latest world travel news reports are available at www.tmb.ie

Travel News Headlines WORLD NEWS

Date: Fri, 3 May 2019 12:24:17 +0200
By Anne-Sophie FAIVRE LE CADRE

Cha das Caldeiras, Cape Verde, May 3, 2019 (AFP) - Four years after the volcano erupted -- razing everything in its path in Cape Verde's Cha das Caldeiras valley -- the floor tiles of the small, rebuilt inn are warm to the touch.    "We constructed too quickly on lava that had not yet cooled down," says hotel owner Marisa Lopes, in her early 30s.   "For the first months, the floors in the rooms were so hot that you couldn't walk on them with bare feet."

Lopes is one of dozens of entrepreneurs locked in a perpetual tug of war with the Pico do Fogo volcano towering over Cha das Caldeiras, whose population numbers 500.    The name means Peak of Fire in Portuguese.   The volcano generates the bulk of the crater community's gross domestic product, attracting some 5,000 tourists every year who need hotel beds, food and tour guides -- about 30 make a living as guides in this remote part of West Africa.   But on the downside, the festering giant erupts once a generation -- six times in the last 200 years -- destroying everything in its path; crops, homes, roads.   On November 23, 2014, Lopes watched helplessly as the Pico -- almost 2,900 metres (9,500 feet) high -- erupted after a 19-year slumber.

Lava engulfed her brand new tourist hostel, eponymously named Casa Marisa.   Three months later, she built a new one, again in the flow zone of the crater.   "The volcano took a house from me, but it gave me another. Without it, there would be no tourism," she told AFP, undeterred.   Despite the constant danger and government efforts to dissuade them, the inhabitants of Cha das Caldeiras keep coming back.     After the last eruption, the military evacuated those in the path of the lava and the state provided food aid for six months afterwards.   But it was the people themselves who reconstructed roads and found the materials for rebuilding homes and hotels. Again.

- 'It's home' -
Cicilio Montrond, 42, was also there in 2014, looking on as a river of molten rock spewing from the Pico do Fogo burnt his fruit trees and buried everything he owned in a thick, grey coat.   The eruption killed no one, but left 1,500 people homeless.   After a few weeks in Sao Filipe, a nearby town to where the valley inhabitants were relocated, Montrond returned to Cha das Caldeiras with his wife.   Not a bird stirred in the air still polluted with ash, not a creature moved on the still warm lava ocean that now covered the valley floor.

For weeks, Montrond and his wife lived in a tent on the roof of their destroyed house with no water, no electricity and no food apart from a few canned goods.   "We lived in makeshift shelters, it was precarious, dangerous. But we were home."   For Montrond, it is unimaginable to live anywhere else than the fertile, lava-fed valley that, between outbursts, boasts an abundance of vines, fig trees and cassava.   "It is the volcano that allows us to live," said Montrond, tourist guide-turned-hotelkeeper and restaurateur.   The Pico's eruptions are rarely deadly in terms of human life.   But what about the next time?   "The volcano is my life," Montrond shrugged, as he gazed upon the house he built with his own hands.    "I was born here, I will die here."

- Rocks were falling -
The volcano gives. The volcano takes.   First it destroys the vines, then it provides fruitful soil for the planting of new ones. These produce wines -- some of it for the export market.   Far from fearing or despising the peak's constant threatening presence, the inhabitants appear to embrace it and have made it part of their identity.   They evoke past eruptions with a smile, sometimes even a touch of nostalgia.   Margarita Lopes Dos Santos, 99, has been forced out of her home by the three last eruptions of the Pico do Fogo.

The first was in June 1951, shortly after she gave birth to her first child.   "I remember the first time like it was yesterday," she said, through a beaming, toothless smile.   "It was a lot more violent. Rocks were falling from the sky. There were tornadoes of ash and of smoke," she recounted, while husking beans.   Outside her house, Lopes Dos Santos has planted flowers -- flashes of red begonias that provide the only colour in the grey and black landscape.   "The resilience of the people of Cha is extraordinary," said Jorge Nogueira, president of the municipal council of Sao Filipe, capital of the island of Fogo, Cape Verde.   "As soon as they could, they came back -- to poor living conditions, but no matter: the only thing that counted for them was to be home."
Date: Tue 3 Oct 2017
Source: Outbreak News Today [edited]

In a follow-up on the locally transmitted malaria increases reported on Cabo Verde [Cape Verde] this year [2017], 254 indigenous cases were reported through [24 Sep 2017].

Most cases (75 percent) have not sought treatment until 48-96 hours after illness onset. Despite this, case fatality rates have remained low (0.4 percent), with one death reported in an indigenous case to date. 7 severe malaria cases and 2 cases of malaria in pregnancy have been reported. There are also anecdotal reports of recrudescence.

To date, the disease has been localized to the city of Praia on Santiago Island without any further spread.

A handful of cases have also been detected on neighbouring islands (Sao Vicente, Sal, and Porto Novo); however, their infections were likely all acquired during travel to Praia or overseas, with no evidence of onward local transmission.

The malaria epidemic in Cabo Verde has begun to show early signs of improvement but the situation remains tenuous, with heavy rainfall continuing between August and October, health officials said.
===================
[The last news from ProMED from 4 Sep 2017 (archive no. http://promedmail.org/post/20170904.5293108) reported 116 cases of malaria in Praia. Thus, over the last month 136 new cases have been diagnosed. It is good news that the outbreak has not spread, showing that the control measures are working. Due to the present outbreak, the CDC is now recommending malaria chemoprophylaxis for travellers visiting the city of Praia on Santiago Island (<https://www.cdc.gov/malaria/new_info/2017/Cape_Verde_2017.html>). - ProMED Mod.EP]

[Maps of Cape Verde can be seen at
<http://healthmap.org/promed/p/6553>. - ProMED Sr.Tech.Ed.MJ]

08 Sep 2017


Following an increase in malaria cases, additional malaria prevention advice for some UK travellers to the capital city of Praia in Cape Verde is recommended.

Since June 2017, the Ministry of Heath for Cape Verde has reported an increase in locally acquired malaria cases in the capital city of Praia on the island of Santiago. As of 5 September 2017, a total of 164 locally acquired falciparum malaria cases have been reported in the local population [2][3]. Currently, there are no reports of malaria in tourists who have visited Cape Verde in 2017.  

Those travelling to Praia who are at increased risk of malaria e.g. long term travellers, or those at risk of severe complications from malaria: pregnant women, infants and young children, the elderly and travellers who do not have a functioning spleen, should consider taking anti-malarials and seek advice about which antimalarial is suitable for them from their travel health advisor.

Date: Sun 3 Sep 2017 08:58:00 WEST
Source: The Portugal News (TPN) Online [edited]
<http://theportugalnews.com/news/portugal-health-department-issues-malaria-warning-for-cape-verde-capital/43059

The Portuguese health department has advised pregnant women not to travel to the Cape Verde island of Santiago [where the capital, Praia, is located], and if travellers cannot put their journey off, they should take anti-malaria drugs.

The health department warning comes after the World Health Organisation (WHO) said in August [2017] that there was an outbreak of malaria in Praia, the archipelago's capital. Travellers are also advised that adults and children should use insect repellent throughout the day and reapply it as often as necessary. If travellers also use sun cream, they should apply the insect repellent on top of the sun cream, not under it, the warning said. So far, there have been 116 cases of malaria in Praia, numbers never before seen in the city, where the highest number was 95 cases in the whole of 2001.
============
[The Cape Verde authorities reported 45 cases of malaria up to 30 Jul 2017 (see archive no. http://promedmail.org/post/20170808.5236283).

The outbreak continues and it is important to introduce identification and spraying of breeding sites. Also using a single dose of primaquine after treatment, which kills gametocytes, to ensure that the cases cannot transmit the infection, as recommended by the WHO (http://www.who.int/malaria/publications/atoz/who_pq_policy_recommendation/en/). - ProMED Mod.EP

Maps of Cape Verde can be seen at
<http://www.nationsonline.org/maps/Cape-Verde-Map.jpg>
and <http://healthmap.org/promed/p/15>. - ProMED Sr.Tech.Ed.MJ]
Date: Tue 8 Aug 2017
Source: Outbreak News Today [edited]

During the past 5 years, an average of one locally acquired case annually of malaria has been reported in Cabo Verde, or Cape Verde. In 2017, between [30 Jun and 30 Jul 2017], 45 indigenous cases and one imported case were reported, all in the capital city of Praia, Santiago Island.

More than half the cases are reported in adult males. The causative agent has been confirmed as _Plasmodium falciparum_ using both microscopy and rapid diagnostic tests (RDTs).

Preliminary investigations have attributed the recent increase in local transmission to several factors, including suboptimal vector control strategies, possibly coupled with inappropriate use (incorrect dilution) of a new insecticide introduced into the country in November 2016; the unauthorized installation of a rice paddy field in the affected area; and an increase in mosquito breeding sites within construction zones of a shopping centre and houses. The local authorities are in the process of removing the paddy field as further investigations are ongoing.

Cape Verde is a low malaria transmission country, eligible for elimination of the disease. With limited underlying immunity, all people (irrespective of their age group) are at risk of infection and of developing severe disease.
======================
[In 2015, Cabo Verde reported 7 _P. falciparum_ infected cases <http://www.who.int/malaria/publications/country-profiles/profile_cpv_en.pdf>. Cabo Verde is close to the African continent, and visitors may be asymptomatic gametocyte carriers and can start a local transmission if the vector control is not optimal, as suggested here. - ProMED Mod.EP]

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

Switzerland

Switzerland US Consular Information Sheet
December 01, 2008
COUNTRY DESCRIPTION:
Switzerland is a highly developed democracy.
Liechtenstein is a democratically run constitutional monarchy.
Read the Department of State Background
otes on Switzerland for additional information.

ENTRY/EXIT REQUIREMENTS:
A passport is required for travel to both Switzerland and Liechtenstein.
A visa is not required for stays up to 90 days in either country.
For more information on entry requirements for both countries, travelers may contact the Embassy of Switzerland at 2900 Cathedral Avenue, NW, Washington, DC 20008, telephone (202) 745-7900, or the nearest Swiss Consulate General in Atlanta, Chicago, Los Angeles, New York, or San Francisco.
Visit the Embassy of Switzerland’s web site at http://www.swissemb.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:
Although there have been no recent terrorist attacks in Switzerland, violence by anti-globalization, anti-Semitic, and anti-establishment (anarchist) groups does occur from time to time.
This violence is typically in the form of property damage and clashes between these groups and the police.
The potential for specific threats of violence involving American citizens in Switzerland is remote.
Nevertheless, the Consular Agencies in Zurich and Geneva may close periodically to assess their security situation.
For the latest security information, Americans traveling abroad should regularly monitor the Department of State, Bureau of Consular Affairs’ web site at http://travel.state.gov, where the current Travel Warnings and Travel Alerts, as well as the Worldwide Caution, can be found.
Up-to-date information on safety and security can also be obtained by calling 1-888-407-4747 toll-free in the U.S. and Canada, or for callers outside the U.S. and Canada, a regular toll line at 1-202-501-4444.
These numbers are available from 8:00 a.m. to 8:00 p.m. Eastern Time, Monday through Friday (except U.S. federal holidays).

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

CRIME:
Switzerland has a low rate of violent crime.
However, pick-pocketing and purse snatching do occur in the vicinity of train and bus stations, airports, and some public parks, especially during peak tourist periods (such as summer and Christmas) and when conferences, shows, or exhibits are scheduled in major cities.
Liechtenstein has a low crime rate.
Travelers may wish to exercise caution on trains, especially on overnight trains to neighboring countries.
Thieves, who steal from passengers while they sleep, can enter even locked sleeping compartments.
Thieves have been known to work in pairs to target train passengers; while one member of the pair creates a diversion at a train window or on a platform, the other steals items left briefly 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, 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.

Switzerland, through its 26 cantons (states), has programs to assist victims of crime and their immediate relatives.
Medical, psychological, social, financial, and legal assistance are available throughout the country.
These programs also protect the rights of the victim during criminal proceedings.
The victim may receive compensation for some damages, if requested during the criminal procedure.
Information is available at the Swiss Department of Justice located on Bundesrain 20, 3003 Bern, telephone: 41-31-322-4750, as well as on the Internet at http://www.bj.admin.ch/bj/en/home.html
The local equivalent to the “911” emergency line in Switzerland is fire 118; police 117; medical 144.
For additional assistance, including possible U.S. compensation, see our information for Victims of Crime.

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

The U.S. Department of State is unaware of any HIV/AIDS entry restrictions for visitors to or foreign residents of Switzerland.
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 Switzerland is provided for general reference only, and may not be totally accurate in a particular location or circumstance.
Although many roads are mountainous and winding, road safety standards are high.
In some mountain areas, vehicle snow chains are required in winter.
Road travel can be more dangerous during summer, winter holidays, the Easter break, and Whitsunday weekend (late spring) because of increased traffic.
Travel on expressways (indicated by green signs with a white expressway symbol) requires purchase of a sticker or “vignette,” which must be affixed to the car’s windshield.
Vignettes can be purchased at most border crossings points, gas stations and at Swiss post offices.
Drivers using the highway system without a vignette are subject to hefty fines levied on the spot.
Public transportation in Switzerland and Liechtenstein is excellent.

Please refer to our Road Safety page for more information.
Visit the website of Switzerland’s national tourist office at http://www.myswitzerland.com/en.cfm/home.

AVIATION SAFETY OVERSIGHT:
The U.S. Federal Aviation Administration (FAA) has assessed the Government of Switzerland’s Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for oversight of Switzerland’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:
Travelers who plan to participate in mountain activities (summer and winter) are strongly encouraged to buy mountain search and rescue insurance. Costs of search and rescue operations are the responsibility of the victim. Search and rescue insurance is available inexpensively in Switzerland and may be purchased at many Swiss post offices.
Information can be obtained from the Swiss National Tourist Office, at http://www.myswitzerland.com, at most tourist information offices or with the Swiss Air Rescue Organization at http://www.rega.ch/en/start_en.aspx .
Such insurance has proved useful as uninsured rescues can easily cost $25,000.

Switzerland’s customs authorities encourage the use of an ATA (Admission Temporaire/Admission) Carnet for the temporary admission of professional equipment, commercial samples, and/or goods for exhibitions and fair purposes.
ATA Carnet Headquarters located at the U.S. Council for International Business, 1212 Avenue of the Americas, New York, N.Y. 10036, and issues and guarantees the ATA Carnet in the United States.
For additional information call (212) 354-4480, send an email to atacarnet@uscib.org, or visit http://www.uscib.org for details.
Please see our information on 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 Switzerland’s laws, even unknowingly, may be expelled, arrested, or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in Switzerland are severe, and convicted offenders can expect long jail sentences and heavy fines.
Engaging in sexual conduct with children or using or disseminating child pornography in a foreign country is a crime, prosecutable in the United States.
Please see our information on Criminal Penalties.

CHILDREN'S ISSUES:
For information see our Office of Children’s Issues web pages on intercountry adoption and international parental child abduction.

REGISTRATION / EMBASSY LOCATION:
Americans living or traveling in Switzerland are encouraged to register with the U.S. Embassy in Bern, with the Consular Agencies in Geneva or Zurich, or through the State Department’s travel registration web site, and to obtain updated information on travel and security within Switzerland and Liechtenstein.
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, Consulate, or Consular Agent to contact them in case of emergency.
The U.S. Embassy is located at Sulgeneckstrasse 19, 3007 Bern; Tel. (41)(31) 357-7011 (2 p.m. – 5 p.m.); fax (41)(31) 357-7280.
The Embassy’s email address is bernacs@state.gov.
The U.S. Embassy website at http://bern.usembassy.gov answers many questions of interest to Americans visiting and residing in Switzerland.

The U.S. Consular Agency in Zurich is located at the American Center of Zurich, Dufourstrasse 101, 8008 Zurich; Tel: (41)(43) 499-2960 (10 a.m. – 1 p.m.), fax (41)(43) 499-2961.
The U.S. Consular Agency in Geneva is located at rue Versonnex 7, CH-1207 Geneva, Tel: 022-840-51 60 (10 a.m. – 1 p.m.); fax 022-840-51 62.
There is no U.S. Embassy or Consulate in Liechtenstein.
For assistance and information on travel and security in Liechtenstein, U.S. citizens may contact or register at the U.S. Embassy in Bern at the address above.
*
*
*
This replaces the Consular Information Sheet dated March 3, 2008 with changes to the sections on Crime and Registration/Embassy Location.

Travel News Headlines WORLD NEWS

Date: Mon 22 Jul 2019
Source: Swissinfo [edited]

Cases of tick-borne diseases, including encephalitis and Lyme disease, almost halved in Switzerland in the 1st 6 months of 2019 compared with the same period last year [2018].

Figures for 2019 so far show 127 cases of meningoencephalitis [the graph shows approximately 75 cases - ProMED Mod.TY], compared with 218 for the 1st half of 2018. Those showing symptoms of Lyme disease fell from 10 000 to 3600.

But Daniel Koch, head of communicable diseases at the Federal Office for Public Health (FOPH), told the Keystone-SDA news agency that while the numbers mark a big fall from 2018, they are closer to the average over a longer time period. Indeed, since 2000, numbers of tick-borne encephalitis declared in the 1st 6 months of the year varied between 24 and 120, FOPH figures show. In 2018, the number was 206.

If the cause of last year's [2018's] peak remains unclear, the subsequent drop in 2019 is also difficult to explain, though it has coincided with a concerted campaign by authorities to encourage vaccination among the population. Tick-borne encephalitis, a debilitating and potentially fatal disease that attacks the nervous system, is preventable through a jab.

To reduce the risk of picking up tick-borne diseases, authorities recommend avoiding particularly at-risk areas -- for example, bushes and tall grass -- as well as using an insect repellent and wearing clothing that covers the arms, legs, and feet.  [Byline: Laurent Gillieron]
===================
[The Swiss government has had a proactive tick-borne encephalitis (TBE) vaccination program this year (2019), beginning early in the year. In a press release [<https://www.admin.ch/gov/fr/accueil/documentation/communiques.msg-id-73873.html>], the office repeated the call for anybody who may be exposed to ticks -- for example walkers, especially in forests -- to be vaccinated. Residents of Geneva or Ticino travelling outside their canton for such activities should also get the jab, it said. The optimum time for vaccination is in winter, the office wrote, so that walkers and hikers are protected once the good weather and riskiest period (from April to October) rolls around.

As cited earlier, according to government information, the most widespread TBE vector tick species in Switzerland is the wood tick (_Ixodes ricinus_, commonly known as the castor bean tick or sheep tick). It prefers deciduous woods with abundant undergrowth, the edge of the forest, and forest paths and waits on low-growing plants until a warm-blooded host (a person or animal) brushes against the plant.

In a previous comment in 2017 concerning TBE in Switzerland, Dr Ivo M Foppa indicated that the incidence of TBE in Switzerland has increased markedly, roughly about 50%, since 2000. The reason for the increase of TBE incidence in Central/Western/Northern Europe is unknown.

TBE is a virus infection caused by one of 3 TBE virus subtypes belonging to the Flaviviridae family: Central European, Siberian, and Far Eastern (formerly known as Russian spring-summer encephalitis). It is transmitted to humans through the bite of infected _Ixodes_ ticks. - ProMED Mod.TY]

[Maps of Switzerland:
Date: Sun, 16 Jun 2019 00:19:43 +0200

Geneva, June 15, 2019 (AFP) - A woman has drowned in Lake Geneva when her sightseeing boat sank as a violent storm battered parts of Switzerland on Saturday, police said.   A man who was in the same boat was able to swim to another vessel from where he fired "two flares", Joanna Matta, police spokeswoman for the canton (region) of Geneva, told AFP.   The man told officers that the woman had been "passing through Geneva" and that the storm had taken them "by surprise", Matta said.   Three police boats and emergency services rushed to the scene. Police divers later retrieved the woman's body from the lake.

The victim, whose nationality remains unknown, was then taken to a hospital in Geneva where she was declared dead.   In a separate incident, the storm also damaged some of the 465 boats taking part in the 81st edition of the Bol d'Or, an annual regatta on Lake Geneva, the event's press service said.   Heavy rain and strong winds lashed the participants on Saturday afternoon, causing boats to capsize although nobody was injured.

However, the storm broke the mast of the ultra-fast "Real Team" catamaran, which had been in the lead and was forced to pull out of the race.   The bad weather struck western Switzerland on Saturday afternoon, bringing hail and winds reaching up to 110 kilometres (70 miles) per hour, according to the national forecaster MeteoSwiss.   In the neighbouring French region of Haute-Savoie the storm also caused damage and left a 51-year-old German tourist dead after a tree came down at a campsite.
diDate: Mon 3 Jun 2019
Source: FM1 Today [in German, machine trans., edited]

Several cases of pneumonia have occurred in the Ticino Maggia Valley in recent weeks. Those affected have been infected with Q fever. The situation is, however, under the control of the health authorities.

Q fever is transmitted by a bacterium found in goats. The Ticino health authorities have therefore ordered the vaccination of exposed animals. In addition, the transport of the animals from one farm to another was prohibited.

Infection with goat milk is considered very unlikely. Even from person to person, the disease is not transmitted. Q fever manifests itself with flu-like illnesses, but without a cold or sore throat. In 1-2 percent of cases there are complications.

Q fever is a notifiable disease in Switzerland. Since the beginning of the year [2019] around 50 cases have been reported, 20 of them from Ticino, said Daniel Koch of the Federal Office of Public Health (FOPH).

Therefore, there will be an increase this year [2019] compared to the approximately 40 cases that have occurred on average per year since 2012. In 2012, the disease was again declared as notifiable after 17 cases of illness occurred in the canton of Vaud.

According to Koch, the situation is under control, despite the increased occurrence of illnesses in Ticino. The established monitoring system proved its effectiveness. The last time a major epidemic of Q fever occurred in 1983. At that time, more than 400 people fell ill in Valais.
Date: Sun, 28 Apr 2019 11:34:28 +0200

Geneva, April 28, 2019 (AFP) - Four German hikers have been killed by an avalanche in the Swiss Alps, police in the southern canton of Valais said Sunday.   The accident took place on Friday in the village of Fieschertal, but bad weather prevented rescue services from finding the victim's bodies before Saturday, police said.   All equipped with search beacons, and an investigation into their deaths has been opened, they added.
Date: Mon 1 Apr 2019
Source: Swiss Info [abridged, edited]

The Federal Office of Public Health external link said on Monday [1 Apr 2019] that 55 cases of measles were reported in March [2019], nearly twice the number of cases registered at the beginning of the year [2019].

In all, 97 cases have been recorded in 2019, the office said. This compares to 15 cases during the same 3-month period at the start of last year [2018]. In 2018, there were a total of 48 measles cases, and in 2017, there were 105.

In the World Health Organization external link (WHO)'s European  region, which covers nearly 900 million people, some 82,600 in 47 countries contracted measles last year [2018], the highest number this decade. Of those, 72 cases were fatal. The worst-affected countries were Ukraine (53,000 cases), followed by Serbia (5076), Israel (2919), France (2913), Russia (2256), Italy (2517), Georgia (2203), and Greece (2193). Six of the 53 countries did not report.

The record number in Europe is partly due to a growing number of pockets where parents are refusing vaccination for their children, the WHO said in February [2019]. At the same time, the WHO said, record numbers of children are getting the vaccine, offering hope that the rise in infections may not last.

In 1987, the Swiss Federal Office of Public Health announced a vaccination strategy that it hoped would eradicate measles by the year 2000. To eradicate measles, the WHO advocates a vaccination coverage of 95% of the population. Swiss coverage is currently below this at 87% for 2-year-olds and 93% for 16-year-olds.

In Switzerland, there are large differences between cantons, with more urban cantons reaching a near-100% level, while rural areas score much lower, with the lowest vaccination rate in the tiny canton of Appenzell Inner Rhodes at 82%.
======================
[HealthMap/ProMED map of Switzerland:
More ...

Portugal

Portugal US Consular Information Sheet
November 18, 2008

COUNTRY DESCRIPTION:
Portugal is a developed and stable democracy with a modern economy.
Tourist facilities are widely available.
Read the Department of State Backgrou
d Notes on Portugal for additional information.
ENTRY/EXIT REQUIREMENTS:
Portugal is a party to the Schengen agreement.
As such, U.S. citizens may enter Portugal for up to 90 days for tourist or business purposes without a visa.
The passport should be valid for at least three months beyond the period of stay.
For further details about travel into and within Schengen countries, please see our fact sheet.

Portuguese law requires some non-European Union foreign nationals to register with immigration officials within three working days of entering Portugal.
The law affects those who transit another Schengen area country by air en route to Portugal and stay at noncommercial accommodations.

Travelers may also contact the Embassy of Portugal at 2012 Massachusetts Avenue NW, Washington, DC
20036, tel. (202) 350-5400, or the Portuguese Consulates in Boston, MA; New Bedford, MA; Providence, RI; New York, NY; Newark, NJ; San Francisco, CA; or Los Angeles, CA.
Visit the Government of Portugal’s web site at http://embassyportugal-us.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:
Portugal remains largely free of terrorist incidents.
However, like other countries in the Schengen area, Portugal’s open borders with its Western European neighbors allow the possibility of terrorist groups entering/exiting the country with anonymity. Americans are reminded to remain vigilant with regard to their personal security and to exercise caution.
Brief general strikes and public protests by public sector employees, industrial workers and/or university student groups take place with some frequency, but are usually publicized in advance and are rarely violent.

For the latest security information, Americans living and traveling abroad should regularly monitor the Department of State, Bureau of Consular Affairs’ web site at http://travel.state.gov, where the current Travel Warnings and Travel Alerts, as well as the Worldwide Caution, can be found.
Up-to-date information on safety and security can also be obtained by calling 1-888-407-4747 toll-free in the U.S. and Canada, or for callers outside the U.S. and Canada, a regular toll line at 1-202-501-4444.
These numbers are available from 8:00 a.m. to 8:00 p.m. Eastern Time, Monday through Friday (except U.S. federal holidays).

The Department of State urges American citizens to take responsibility for their own personal security while traveling overseas.
For general information about appropriate measures travelers can take to protect themselves in an overseas environment, see the Department of State’s A Safe Trip Abroad.
CRIME:
Portugal has a relatively low rate of violent crime.
Travelers may become targets of pickpockets and purse snatchers, particularly at popular tourist sites, restaurants, or on public transportation.
Rental cars and vehicles with non-local license plates can be targets for break-ins; travelers should remove visible luggage from vehicles upon parking.
Travelers should also avoid using automatic teller machines in isolated or poorly lit areas. Drivers in Portugal should keep car doors locked when stopped at intersections.
In general, visitors to Portugal should carry limited cash and credit cards on their person, and leave extra cash, credit cards, and personal documents at home or in a hotel safe.
While thieves may operate anywhere, the U.S. Embassy receives most reports of theft from the following areas:
Lisbon:
Pickpocketing and purse snatching in the Lisbon area sometimes occurs in buses, restaurants, the airport, trains, train stations, and trams, especially aboard tram number 28 to the Castle of São Jorge.
Theft of purses, briefcases and wallets also occurs in hotel lobbies, restaurants and elevators.
At restaurants, items hung over the backs of chairs or placed on the floor may be stolen.
There have been incidents of theft of unattended luggage from the Lisbon Airport.
Special care should be taken in the Santa Apolonia and Rossio train stations, the Alfama and Bairro Alto districts, the Castle of São Jorge and the area of Belém. Though violent crime against tourists is uncommon, an American man was attacked by knife-wielding robbers in September 2008 while walking down the street in Cascais (a popular seaside town near Lisbon) in the early morning hours.

Outside Lisbon:
Thefts have been reported in the towns of Sintra, Cascais, Mafra, Fatima and in the Algarve.
Automobile break-ins sometimes occur in parking areas at tourist attractions and near restaurants.
Special care should be taken in parking at the Moorish Castle and Pena Palace in Sintra and at the beachfront areas of Guincho, Cabo da Roca, and Boca do Inferno.

Azores:
Pickpocketing and purse snatching are not common occurrences in the Azores. There are no reports of organized crime or gangs.

Madeira:
Pickpocketing, while infrequent, may occur in the Old Town and Santa Catarina Park areas of Funchal.

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

Portugal has a crime victim’s assistance program, administered through an organization known by its acronym, "APAV."
Click here for more information (translated into English). Office hours are weekdays, 10 a.m. to 1 p.m., and 2 – 5 p.m. Phone: [351] 707 20 00 77.
To learn about possible sources of American compensation, see our information on Victims of Crime.
The local equivalent to the “911” emergency line in Portugal is: 1-1-2.
English-speaking operators are normally available.

MEDICAL FACILITIES AND HEALTH INFORMATION: Good medical care is available, but facilities may be limited outside urban areas.
Public hospitals offer services at a lower cost generally than private hospitals but sometimes do not maintain the same standards as hospitals in the United States.
Travelers are encouraged to obtain insurance that would cover medical services from a private Portuguese hospital or clinic.
Private hospitals will ask for a credit card or other form of payment upon admission.
In a life-threatening emergency, an ambulance can be requested by calling the national emergency response telephone number 1-1-2.
On the other hand, private ambulances should only be used for transport, not life-threatening emergencies, and usually require on-the-spot payment.
Note that the responsiveness of emergency services is often not up to U.S. standards.

PRESCRIPTION MEDICINES: Travelers sometimes request that relatives or friends in the U.S. mail prescription medicines to them in Portugal, but to do so violates Portuguese law and usually results in the shipment of medications being impounded by Portuguese Customs.
When this occurs, the medications may not be released.
Travelers who use prescription medicine should bring a sufficient supply with them to cover their anticipated stay in Portugal, along with a copy of their physician's prescription.
Should an unforeseen need for prescription refills or new medications arise, Portuguese pharmacies generally carry equivalent medications to those found in the United States, however, they may be sold under a different brand, may not be available in the same dosage, and may require a prescription from a local doctor.

The U.S. Department of State is unaware of any HIV/AIDS entry restrictions for visitors to or foreign residents of Portugal.

Information on vaccinations and other health precautions, such as safe food and water precautions and insect bite protection, may be obtained from the Centers for Disease Control and Prevention’s hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747) or via the CDC’s web site at http://wwwn.cdc.gov/travel/default.aspx.
For information about outbreaks of infectious diseases abroad consult the World Health Organization’s (WHO) web site at http://www.who.int/en.
Further health information for travelers is available at http://www.who.int/ith/en.
MEDICAL INSURANCE:
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 Portugal is provided for general reference only, and may not be totally accurate in a particular location or circumstance.
Portugal has one of the highest rates of automobile accidents and related fatalities in Europe.
Drivers should use extreme caution, as local driving habits, high speeds, and poorly marked roads pose special hazards.
In Portugal, fines for traffic violations are substantial and usually must be paid on the spot. Taxis are a reliable means of transportation, though travelers should be alert to possible discrepancies between the meter fare and the amount requested by the driver.
Buses are reliable and inexpensive.

In the Azores, driving can be treacherous due to narrow cobblestone streets, blind curves, unprotected embankments, herds of cows in the countryside roads, and the high speeds of other drivers.
In contrast to the situation on the Portuguese mainland, traffic violations are registered by radar and later forwarded to the offender via the postal service; payments are not made on the spot.
Taxis do not have meters.
The fare consists of a base fee plus a posted rate per kilometer traveled.
Public buses are inexpensive.
Bus services begin at 7:00 a.m. and generally operate until 8:00 p.m. depending on the destination.

U.S. visitors to Portugal may drive with a valid U.S. driver's license for up to six months. For international driving permits, please contact AAA or the National Auto Club.
For specific information concerning Portuguese driver's permits, vehicle inspection and mandatory insurance, please contact the Portuguese National Tourist Office by telephone at 1-800-767-8842 or visit the website for the Portuguese Directorate-General for Traffic at www.dgv.pt.
Please refer to our Road Safety page for more information. Visit the website of Portugal’s national authority responsible for road safety at www.dgv.pt
AVIATION SAFETY OVERSIGHT:
The U.S. Federal Aviation Administration (FAA) has assessed the Government of Portugal's Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for oversight of Portugal’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:
Portuguese customs authorities may enforce strict regulations concerning temporary importation into or export from Portugal of such items as firearms, antiquities, medications, business equipment, sales samples and other items.
It is advisable to contact a Portuguese Embassy or Consulate in the United States for specific information regarding customs requirements.
Portugal's customs authorities encourage the use of an ATA (Admission Temporaire/ Temporary Admission) carnet for the temporary admission of professional equipment, commercial samples, and/or goods for exhibitions and fair purposes.
ATA Carnet Headquarters, located at the U.S Council for International Business, 1212 Avenue of The Americas, New York, NY 10036, issues and guarantees the ATA carnet in the United States.
For additional information, please telephone (212) 354-4480, or send an e-mail to atacarnet@uscib.org, or visit http://www.uscib.org for details.
Please see our Customs Information.

CRIMINAL PENALTIES:
While in a foreign country, a U.S. citizen is subject to that country's laws and regulations, which sometimes differ significantly from those in the United States and may not afford the protections available to the individual under U.S. law.
Penalties for breaking the law can be more severe than in the United States for similar offenses.
Persons violating Portugal’s laws, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in Portugal are severe, and convicted offenders can expect long jail sentences and heavy fines.
Engaging in sexual conduct with children or using or disseminating child pornography in a foreign country is a crime, prosecutable in the United States.
Please see our information on Criminal Penalties.

CHILDREN'S ISSUES:
For information see our Office of Children’s Issues web pages on intercountry adoption and international parental child abduction.

REGISTRATION / EMBASSY LOCATION:
Americans living or traveling in Portugal are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department’s travel registration web site so that they can obtain updated information on travel and security within Portugal. Americans without Internet access may register directly with the nearest U.S. Embassy or Consulate.
By registering, American citizens make it easier for the Embassy or Consulate to contact them in case of emergency.
The U.S. Embassy is located on Avenida das Forças Armadas, in the neighborhood of Sete Rios.
Telephone 351-21-727-3300, fax 351-21-727-2354, home page: portugal.usembassy.gov.

The U.S. Consulate in the Azores is located in the city of Ponta Delgada on the island of San Miguel. The address is Av. Principe do Monaco, 6-2o, telephone 351-296-282-216, fax 351-296-28-72-16.

There is a part-time U.S. Consular Agency in Funchal, on the island of Madeira, on Rua Alfandega, no. 10-2, Room A-B, telephone 351-291-235-636, fax 351-291-229-360.
The Consular Agency is open Monday through Friday, from 10:00 a.m. to 12:00 p.m.
*

*

*
This replaces the Country Specific Information for Portugal dated April 25, 2008, to update sections on entry/exit requirements, safety and security, information for victims of crime, crime, and medical facilities and health information.

Travel News Headlines WORLD NEWS

Date: Sun, 18 Aug 2019 23:01:00 +0200 (METDST)

Lisbon, Aug 18, 2019 (AFP) - Portuguese fuel tanker drivers whose strike has caused fuel shortages at the summer holiday season on Sunday ended their industrial action.   Drivers have been staging a strike since Monday to demand further wage increases in 2021 and 2022, prompting the government to declare an energy crisis.   "Since all the conditions are now in place to negotiate, we decided to end the strike," Pedro Pardal Henriques, spokesman for the National Union of Dangerous Goods Carriers (SNMMP), told reporters.

A meeting is scheduled for Tuesday, the union President Francisco Sao Bento said, adding that the union did not "rule out new strikes being called if Antram (the employers association) adopts an uncompromising attitude".   Police had launched an operation to escort fuel tankers with extra supplies and Portugal also mobilised about 500 members of the security forces to replace the strikers and drive the trucks.   Despite the shortages, Energy Minister Joao Pedro Matos Fernandes said about two-thirds of the country's 3,000 or so petrol stations had not run dry.
Date: Sun, 11 Aug 2019 15:52:22 +0200 (METDST)

Lisbon, Aug 11, 2019 (AFP) - Many Portuguese petrol stations were sold out Sunday after drivers rushed to fill up before a strike by fuel-tanker drivers kicks off at the height of the summer holidays.   "Empty" signs hung on pumps in Lisbon and elsewhere across the country a few hours before the strike was to begin at midnight (2200 GMT).

"There was enormous anticipation" by car owners, Prime Minister Antonio Costa said, noting that sales had almost doubled in recent days.   An internet site that compiles reports from drivers,  https://janaodaparaabastecer.vost.pt, said that almost 15 percent of the country's 3,000-plus stations were partially or fully sold out.   The open-ended strike appeared certain after an ultimate meeting of unions on Saturday failed to satisfy truck driver's demands for a pay raise.   They staged a four-day strike in April, shortly before Easter weekend, that also caused significant fuel shortages.

The truck drivers, led by a union founded in November 2018, suspended that movement after receiving the wage increase they demanded of at least 1,400 euros ($1,580).   But they are now asking employers to give them new increases in 2021 and 2022.   The government has declared an "energy crisis" which allows it to ration fuel -- to 25 litres (6.6 US gallons) for car owners and 100 litres for trucks.   It has also decreed that tanker drivers will have to deliver a minimum of 50 percent of their normal shipments.

Airports are another priority for fuel deliveries, and around 500 soldiers and paramilitary police could be called upon to drive tanker trucks if the minimum level of deliveries is not adhered to.   Costa did not rule out requisitioning drivers if the situation called for it, while warning that even if the minimum level of service was provided "the strike is going to affect consumers deeply."
Date: Tue, 23 Jul 2019 14:20:24 +0200
By Levi FERNANDES

Lisbon, July 23, 2019 (AFP) - Hundreds of Portuguese firefighters aided by overnight rain gained the upper hand Tuesday against massive wildfires raging for four days and said they hoped to bring them completely under control later in the day before winds pick up and temperatures rise again.

Meanwhile Portugal's civil protection agency rejected critism that not enough resources were deployed to battle the blazes which have ripped through the heavily forested Castelo Branco region, 200 kilometres (120 miles) north of Lisbon, scorching large areas and leaving a trail of blackened destruction.   "The work carried out throughout the night has born its fruits," commander Luis Belo Costa of the agency told a news conference.

"It has been a constant effort. Let's see if we can finish the job," he said, adding that firefighters had managed to stop the advance of the flames in hard-to-reach areas.   Light rains overnight raised humidity levels, aiding the battle against the blazes which the authorities suspect were deliberately started.   But Costa warned winds were expected to pick up in the afternoon, which could complicate the task.

Portugal's civil protection agency had said on Monday morning the wildfires were "90 percent controlled", but strong winds fanned the flames into life again in the afternoon.   At least 7,000 hectares (17,300 acres) have so far been scorched, according to the EU's European Forest Fire Information System.   Nearly 1,300 firefighters were still deployed, Portugal's civil protection agency said Tuesday.
Date: Thu, 18 Apr 2019 03:07:58 +0200

Canico, Portugal, April 18, 2019 (AFP) - Twenty-nine German tourists were killed when their bus spun off the road and tumbled down a slope before crashing into a house on the Portuguese island of Madeira.   Drone footage of the aftermath of the accident showed the badly mangled wreckage of the bus resting precariously on its side against a building on a hillside, the vehicle's roof partially crushed and front window smashed.

Rescue workers attended to injured passengers among the undergrowth where the bus came to rest, some of them bearing bloodied head bandages and bloodstained clothes, others appearing to be more seriously hurt.   Local authorities said most of the dead were in their 40s and 50s.   They were among the more than one million tourists who visit the Atlantic islands off the coast of Morocco each year, attracted by its subtropical climate and rugged volcanic terrain.   "Horrible news comes to us from Madeira," a German government spokesman tweeted after the crash.   "Our deep sorrow goes to all those who lost their lives in the bus accident, our thoughts are with the injured," he added.

German holidaymakers were the second largest group after British tourists to visit the islands -- known as the Pearl of the Atlantic and the Floating Garden in the Atlantic -- in 2017, according to Madeira's tourism office.    The islands are home to just 270,000 inhabitants.    Filipe Sousa, mayor of Santa Cruz where the accident happened, said 17 women and 11 men were killed in the crash, with another 21 injured.    A doctor told reporters another woman died of her injuries in hospital.   "I express the sorrow and solidarity of all the Portuguese people in this tragic moment, and especially for the families of the victims who I have been told were all German," President Marcelo Rebelo de Sousa told Portuguese television.   He said he would travel to Madeira overnight.

- 'Profound sadness' -
Portuguese Prime Minister Antonio Costa added on Twitter that he had contacted German Chancellor Angela Merkel to convey his condolences   "It is with profound sadness that I heard of the accident on Madeira," he wrote on the government's Twitter page.   "I took the occasion to convey my sadness to Chancellor Angela Merkel at this difficult time," he added.  The regional protection service in Madeira confirmed 28 deaths in the accident that happened at 6:30 pm (1730 GMT) Wednesday, while hospital authorities said another woman later died of her injuries.

The bus had been carrying around 50 passengers.   Regional government Vice President Pedro Calado said it was "premature" to speculate on the cause of the crash, adding that the vehicle was five years old and that "everything had apparently been going well".   Judicial authorities had opened an investigation into the circumstances of the accident, the Madeira public prosecutor's office told the Lusa news agency.   Medical teams were being sent from Lisbon to help local staff carry out post-mortems on the dead.
Date: Wed, 17 Apr 2019 13:13:10 +0200

Lisbon, April 17, 2019 (AFP) - Lines stretched out at petrol stations in Portugal on Wednesday as supplies were hit by a fuel haulers strike days before a long holiday weekend.   The queue at one filling station was one kilometre long, according to local media, which said nearly 3,000 were already dry across the country.   An estimated 800 filling stations were out of petrol in the region around the capital Lisbon and 400 around the northern city of Porto.   The union which represents a majority of Portuguese truck drivers who haul dangerous materials went on strike on Monday seeking a wage hike and special protections.

The government on Tuesday ordered a certain number of drivers back to work in order to ensure a minimum service to airports, ports, emergency services, public transport and 40 percent of filling stations in the Lisbon and Porto regions as the country begins marking a three-day holiday weekend for Easter on Friday.   "The minimum service will be enlarged if necessary," Prime Minister Antonio Costa told lawmakers in a debate on Wednesday.   Negotiations held on Tuesday made no progress.
More ...

World Travel News Headlines

Date: Tue, 22 Oct 2019 13:43:23 +0200 (METDST)

Capriata d'Orba, Italy, Oct 22, 2019 (AFP) - A taxi driver has drowned in Italy during violent storms in the north which flooded towns and destroyed a bridge, the fire service said Tuesday.   Farmers in the sweltering south meanwhile sounded the alarm over a draught expected to hit crops hard.   Over 100 people were evacuated Monday across the Alessandria province in the Liguria region, while firefighters carried out 900 operations across the north from Milan to Genoa, as rising waters surged across roads and railways.

The taxi was swept away in the town of Capriata d'Orba, where a bridge had also given way as the river burst its banks.   "There's water everywhere", driver Fabrizio Torre, 52, told his bosses before his phone line cut out, media reported.   His passenger managed to escape the vehicle and survived by clinging to a tree, the reports said.   Two men, aged 61 and 84, were found alive by firefighters after going missing in another part of the storm-hit region.   Rescue workers also pulled young children, their grandmother and the family's dog out of a house submerged by a landslide.   The Po river rose by more than 3.5 metres (11 feet) over a 24-hour period, according to Coldiretti, Italy's main agricultural association.   Lake Maggiore was also nearing a historic level.

Italy has seen "over three storms a day since the start of autumn, 18 percent more than the same period last year," it said.   "And while the north is under rain clouds... in the south, record heat and lack of rainfall has triggered a drought alarm."   Italy was seeing "the effects of climate change, with exceptional weather events becoming the norm".   It noted a "clear endency to tropicalisation" in the Mediterranean country, which was experiencing "a crazy autumn that ranks in the top ten of the hottest since 1800, with a temperature of 1.27 degrees above the average".   The high frequency of violent events was expected to continue, with the north pummelled by rains while farmers in the south risk losing crops.
Date: Tue, 22 Oct 2019 09:57:15 +0200 (METDST)
By Tupad POINTU

La Paz, Oct 22, 2019 (AFP) - Bolivia braced for a general strike on Tuesday hours after violence broke out in several cities when the main opposition candidate rejected presidential election results that seemed set to hand a controversial victory to long-time incumbent Evo Morales.   Opposition supporters reacted with fury, torching electoral offices in the southwestern cities of Sucre and Potosi, while rival supporters clashed in the capital La Paz.    Incidents were reported in cities across the South American country.   Carlos Mesa, who came a close second to Morales in Sunday's polls -- forcing a run-off, according to preliminary results -- denounced revised results released by election authorities as a "fraud."   "We are not going to recognize those results that are part of a shameful, consumated fraud, that is putting Bolivian society in a situation of unnecessary tension," said Mesa.

International monitors from the Organization of American States voiced "deep concern" at sudden changes to the election count to show Morales closing in on an outright victory in the first round.   Preliminary results released late Sunday showed neither Morales, 59, nor 66-year-old Mesa with a majority and "clearly indicated a second round," the OAS mission said.   The partial results put Morales in the lead with 45 percent of the votes, with Mesa on 38 percent, meaning Morales would have to contest a run-off for the first time.   But results released late Monday, after a long and unexplained delay, showed Morales edging towards an outright victory with 95 percent of the votes counted.   Mesa, a former president of the country between 2001-2005, accused Morales of colluding with the Supreme Electoral Tribunal (TSE) to tweak delayed results and avoid a run-off.

- Opposition call general strike -
The call for a general strike was issued by Fernando Camacho, head of an influential civil society organization in Bolivia's biggest city, Santa Cruz, where transport and businesses were expected to shut down from noon.   "Tomorrow we start at 12:00 to block this country," Camacho told opposition demonstrators late Monday, before holding talks with leaders from other regions.   Long lines formed at gas stations amid fears of shortages.   Riot-police dispersed a crowd who tried to storm the electoral offices in the Andean city of Oruro, south of La Paz.    Clashes were also reported in Tarija in the south, Cochabamba in the center and Cobija in the north.

- 'Subverting democracy' -
The United States' top diplomat for Latin America said the Electoral Tribunal was attempting "to subvert Bolivia's democracy by delaying the vote count and taking actions that undermine the credibility of Bolivia's elections."   "We call on the TSE to immediately act to restore credibility in the vote counting process," the official, Michael Kozak, said on Twitter.   The OAS observer mission in the country expressed "surprise at the drastic and hard-to-explain change in the trend of the preliminary results revealed after the closing of the polls," it said in a statement.   It urged the election authority to "firmly defend the will of the Bolivian people" and called for calm on the streets.   "It is extremely important that calm is maintained and any form of violence is avoided in this delicate situation."

- Longest serving president -
Morales, Latin America's longest-serving president, is controversially seeking a fourth term.   He obtained Constitutional Court permission in 2017 to run again for president even though the constitution allows only two consecutive terms.   The former coca farmer and leftist union leader has led the poor but resource-rich Latin American country for the past 13 years, though his popularity has waned amid allegations of corruption and authoritarianism.   He has led the country since taking office in 2006, when he became its first indigenous president.

A new mandate would keep him in power until 2025.   As leader of his Movement for Socialism Party (MAS), Morales points to a decade of economic stability and considerable industrialization as his achievements, while insisting he has brought "dignity" to Bolivia's indigenous population, the largest in Latin America.   He has come under severe criticism this year as wildfires in August and September ravaged Bolivia's forests and grasslands, with activists saying his policies encouraged the use of blazes to clear farmland.
Date: Tue, 22 Oct 2019 06:44:29 +0200 (METDST)

Papeete, Oct 22, 2019 (AFP) - A French tourist has been seriously injured in a rare shark attack in the palm-fringed Pacific islands of Polynesia, emergency services said Tuesday.   The 35-year-old woman was swimming during a whale-watching trip on Monday in the French overseas territory when the oceanic whitetip shark tore into her chest and arms.   "Luckily for her, there were two nurses on the scene who could deliver first aid," firefighter Jean-Jacques Riveta told AFP.   The woman lost both hands and a lot of blood in the attack and was airlifted to hospital, he said.
Date: Tue, 22 Oct 2019 05:13:16 +0200 (METDST)

Wellington, Oct 22, 2019 (AFP) - A huge fire at a construction site sent clouds of acrid black smoke billowing over Auckland on Tuesday, forcing large parts of the downtown area to be cordoned off as firefighters battled the blaze.   The fire broke out on the roof of the SkyCity convention centre site shortly after 1:10pm (0010 GMT) and quickly spread, Fire and Emergency NZ said.   Office workers were warned to stay inside and turn off air conditioning as a thick pall of smoke engulfed the centre of New Zealand's largest city, but there were no reports on injuries.   Unconfirmed reports said the fire was started by a construction worker using a blowtorch on the building, which is one of the venues for the 2021 APEC summit being held in Auckland.
Date: Mon, 21 Oct 2019 18:48:23 +0200 (METDST)

Harare, Oct 21, 2019 (AFP) - At least 55 elephants have died in a month in Zimbabwe  due to a lack of food and water, its wildlife agency said Monday, as the country faces one of the worst droughts in its history.   More than five million rural Zimbabweans -- nearly a third of the population -- are at risk of food shortages before the next harvest in 2020, the United Nations has warned.

The shortages have been caused by the combined effects of an economic downturn and a drought blamed on the El Nino weather cycle.   The impact is being felt at Hwange National Park, Zimbabwe's largest game reserve.   "Since September, we have lost at least 55 elephants in Hwange National Park due to starvation and lack of water," Zimbabwe National Parks spokesman Tinashe Farawo told AFP.   Farawo said the park was overpopulated and that food and water was scarce "due to drought".

Africa's elephant numbers have dropped from around 415,000 to 111,000 over the past decade, mainly due to poaching for ivory, according to the International Union for Conservation of Nature (IUCN).   But Zimbabwe, like other countries in the southern African region, is struggling with overpopulation.   "Hwange was meant for 15,000 elephants but at the moment we are talking of more than 50,000," Farawo said.   "The situation is dire. We are desperately waiting for the rains."   An adult elephant drinks 680 litres (180 gallons) of water per day on average and consumes 450 kilogrammes (990 pounds) of food.

Hungry elephants have been breaking out of Zimbabwe's game reserves and raiding human settlements in search for food, posing a threat to surrounding communities.   Farawo said 200 people have died in "human-and-animal conflict" in the past five years, and "at least 7,000 hectares (17,300 acres) of crop have been destroyed by elephants".   The authorities took action earlier this year by selling nearly 100 elephants to China and Dubai for $2.7 million.   Farawo said the money had been allocated to anti-poaching and conservation projects.   Botswana, Namibia, Zambia and Zimbabwe have called for a global ban on elephant ivory trade to be relaxed in order to cull numbers and ease pressure on their territories.
Date: Mon, 21 Oct 2019 13:34:35 +0200 (METDST)

Santiago, Oct 21, 2019 (AFP) - Chile, reeling from its worst social unrest in decades, has since the 1990s been considered a Latin American hub of political stability and economic growth after 17 years of dictatorship.   Here is some background.

- From dictatorship to democracy -
In 1973 General Augusto Pinochet toppled Socialist President Salvador Allende in a military coup. Allende committed suicide in the presidential palace as troops closed in.   Pinochet imposed a right-wing dictatorship that lasted for 17 years, during which at least 3,200 people were killed or disappeared as a result of political repression. Around 38,000 were tortured.   In 1988 he lost a plebiscite on remaining in power and handed over to democratically elected Patricio Aylwin in 1990, remaining head of the armed forces until 1998.    Pinochet died in 2006 without standing trial for atrocities under his regime.   In 2006 Socialist Michelle Bachelet became Chile's first female president. Re-elected in 2013, she was barred constitutionally from standing again immediately and appointed UN right commissioner in 2018.   The 2017 elections were won by conservative billionaire Sebastian Pinera, who had already been president in 2010-2014.

- Model economy -
Pinochet applied neo-liberal free-market methods, privatising healthcare, education and pensions.   Chile turned to exports and in the 1980s became the preferred Latin American host for foreign investors.   With this economic model still largely in place, growth reached a strong 4% in 2018. The country of 18 million people also has the highest per capita income of Latin America at $20,000.   GDP, however, fell to 1.8% in the first half of 2019 -- due to a challenging external context, adverse climatic conditions and a delay in reforms -- and is expected at 2.5 percent for the year.   Despite slashing poverty from 30% in 2000 to 8.6% in 2019, the country has high social inequalities including in healthcare, education and pensions.   It is the world's biggest producer of copper, with lithium, timber, fisheries, gold, silver, avocados and oil also driving exports.

- Paedophile priests scandal -
The staunchly Roman Catholic country has been rocked by allegations of sexual abuse within the church going back decades.   In May 2018 Pope Francis summoned all 34 Chilean bishops to Rome over the crisis and all tendered their resignations, although only a handful have been accepted.   Since 2000 about 80 priests have been reported to authorities in Chile for alleged sexual abuse, including of children and adolescents.   Prosecutors said in August 2018 they were investigating 158 members of the church, both priests and lay people.   Ultra-conservative Chile allowed divorce only from 2004 and legalised abortion in certain cases in 2017.

- World's most seismic -
Bordered by the Pacific Ocean to the west and the Andes mountain range to the east, long and narrow Chile is the world's most seismic country.   In 1960 it was struck by the most powerful earthquake ever registered which measured 9.5 and struck at Valdivia. More than 5,700 people were killed.   In 2010 a 8.8-magnitude quake in the south and centre unleashed a tsunami that swept away entire villages, leaving around 520 people dead.

- Astronomy heaven -
Benefitting from a totally clear sky for most of the year, northern Chile is home to some of the world's most powerful telescopes.   The construction of the planet's biggest telescope was launched in May 2017 in the Atacama desert by ESO, the European Organisation for Astronomical Research in the Southern Hemisphere.
Date: Sun 20 Oct 2019
Source: Pakistan today [edited]

The death toll from a mysterious throat virus has reached 9 children in Seerani and its surrounding localities in Badin district as one more child infected by the virus died, affected people said on [Sun 20 Oct 2019].

A child, R, son of RM, died after contracting the disease. The most affected areas are reported to be Seerani and its surrounding localities. Teams of the health department and other organizations reached Seerani and took blood samples of at least 30 children who were infected by the virus. The blood samples will be sent to Islamabad for the tests.

The people of the area are worried about this new throat viral disease and have demanded authorities to provide immediate health cover to them.
====================
[There is little information to go on other than the throats of children are affected and the case fatality rate is high (10 of at least 30). No other symptoms are provided, nor is the basis for concluding that a virus is involved or what the epidemiological data are (dates, ages, sex of children involved, and local conditions). ProMED-mail would welcome additional information. - ProMED Mod.TY]

[HealthMap/ProMED map available at:
Date: 21 Oct 2019
Source: Outbreak News Today [edited]
<http://outbreaknewstoday.com/polio-cases-reported-in-zambia-chad-and-togo-73820/>

Circulating vaccine-derived polio virus (cVDPV) type cases have been confirmed in 10 African countries through [16 Oct 2019] this year [2019]. Now, the World Health Organization (WHO) is reporting 3 additional countries from the continent that more recently reported circulating vaccine-derived polio virus type 2 (cVDPV2) cases: Zambia, Chad and Togo.

Zambia
The Ministry of Health of Zambia reported last week on a confirmed case of circulating vaccine-derived polio virus type 2 (cVDPV2) in a 2-year-old child in Chienge district, Luapula province on the border with Democratic Republic of the Congo. This is the 1st case of cVDPV2 reported from Zambia in 2019. [Date of onset of paralysis reported to be 16 Jul 2019 according to another media report <https://www.lusakatimes.com/2019/10/21/polio-case-has-been-recorded-in-zambias-luapula-province/>.

In addition to the initial case-patient, 34 stool samples were collected from healthy contacts, and 2 samples tested positive for VDPV2, which were genetically linked to the case-patient. No established links have so far been found with the ongoing outbreak of cVDPV2 in Democratic Republic of the Congo, where 37 cases have been reported in 2019. The last recorded case of indigenous polio in Zambia was in 1995, while between 2001 and 2002, 5 cases of wild polio virus were identified among Angolan refugees in the Western province of the country.

Chad
Last week, WHO was informed about cVDPV2 in Chad. A cVDPV2 was isolated from a 13-month-old case of acute flaccid paralysis (AFP), with onset of paralysis on [9 Sep 2019] in Chari Baguirmi province, bordering Cameroon. The isolated virus has 32 nucleotide changes from Sabin 2, and is genetically linked to a cVDPV2 detected in Borno, Nigeria and is part of the Jigawa emergence. The last indigenous wild poliovirus cases were reported in 2000 in Chad.

Togo
In addition, last week WHO was informed about cVDPV2 in Togo. A cVDPV2 was isolated from a 30-month-old case of AFP with onset of paralysis on [13 Sep 2019] in Plateaux province, bordering Benin and Ghana. The isolated virus has 32 nucleotide changes from Sabin 2 and is genetically linked to a cVDPV2 detected in Irewole state, Nigeria and is part of the Jigawa emergence as well. The last indigenous wild poliovirus case was reported in 1999 in Togo.
======================
[Three more countries are joining the list of cVDPV outbreak countries, all with cVDPV2 isolates. Two of the 3 countries (Togo and Chad) have viruses related to the Jigawa, Nigeria cVDPV2 outbreak. The case in Zambia is suspected to be associated with the ongoing cVDPV2 transmission in the Democratic Republic of the Congo (DR Congo), but genetic testing is presumably still pending or has been negative. See my comments below after the following section, as they are relevant to what is ongoing globally with respect to cVDPVs.

Below are the HealthMap/ProMED map links to countries where cVDPV cases/outbreaks have occurred in the past 12 months, a total of 20 countries.

Angola: <http://healthmap.org/promed/p/165>
Benin: <http://healthmap.org/promed/p/59>
Cameroon: <http://healthmap.org/promed/p/65>
Central African Republic: <http://healthmap.org/promed/p/66>
Chad: <http://healthmap.org/promed/p/57>
China: <http://healthmap.org/promed/p/155>
Democratic Republic of the Congo: <http://healthmap.org/promed/p/194>
Ethiopia: <http://healthmap.org/promed/p/95>
Ghana: <http://healthmap.org/promed/p/53>
Indonesia: <http://healthmap.org/promed/p/184>
Kenya: <http://healthmap.org/promed/p/174>
Mozambique: <http://healthmap.org/promed/p/177>
Myanmar: <http://healthmap.org/promed/p/148>
Niger: <http://healthmap.org/promed/p/58>
Nigeria: <http://healthmap.org/promed/p/62>
Papua New Guinea: <http://healthmap.org/promed/p/188>
Philippines: <http://healthmap.org/promed/p/158>
Somalia: <http://healthmap.org/promed/p/125>
Togo: <http://healthmap.org/promed/p/64>
Zambia: <http://healthmap.org/promed/p/170> - ProMED Mod.MPP]
Date: Fri 18 Oct 2019 07:32 PM EDT
Source: WSPA [edited]

North Carolina health officials say a 4th person has died from an outbreak of legionnaires' disease linked to a hot tub display at the North Carolina Mountain State Fair, which is held at the Western North Carolina Agricultural Center.

We've also learned another person, who did not attend the NC Mountain State Fair, was diagnosed with legionnaires' after attending a quilt show that was held inside the same building as the hot tub exhibit. That building is the Davis Event Center.

7 News spoke with folks who have been impacted by the outbreak. "We were like 'Oh no, I hope nobody gets sick,'" [LP] said. He attended the North Carolina Mountain State Fair-an event tied to at least 140 cases of legionnaires'. He said 2 people he knows, including his uncle, got sick after the fair. "They didn't actually have legionnaires', but they had respiratory problems that did come out of it," he said. [Perhaps Pontiac fever?] Even so, [LP] was back at the WNC Agricultural Center on [Fri 18 Oct 2019] to help host his club's annual Antique Tractor Show.

And while everything appeared to be business as usual, [LP] was concerned as another person was just diagnosed with the disease and didn't attend the fair. Instead, they were at a quilt show held at the WNC Agricultural Center 2 weeks later. "Anytime there's an outbreak of something, it's always going to have a thing in the back of your mind that says, 'I don't know if I want to do this or not,'" he said.

The Davis Event Center has since been closed; but health officials say it's possible the source for the newest case of legionnaires' may not have been at the WNC Agricultural Center. "There are other possible exposures that this person had, so it's hard. At this point, we can't pinpoint," Jennifer Mullendore with Buncombe County Health and Human Services said.

According to a statement by the WNC Agricultural Center, the hot water system in the Davis Event Center, and every other building on the grounds, went through a disinfecting process as a precautionary measure. "They did some cleaning and doing some real hot high-powered water through the water system here, and so we do have a clean bill of health," Phillips said.  It's unclear at this time when the Davis Event Center will re-open.  [Byline: Scottie Kay]
========================
[The latest status, as of 18 Oct 2019, of the legionellosis outbreak associated with the Mountain State Fair that was held in western North Carolina between 6 and 15 Sep 2019 at the Western North Carolina Agricultural Center (WNC Ag Center) in Fletcher, a town in Henderson County, can be found at <https://epi.dph.ncdhhs.gov/cd/legionellosis/outbreak.html>.

The source of the outbreak has still not as yet been confirmed. However, hot tub displays in one of the buildings (Davis Event Center) has been linked to the outbreak. A site map of the WNC Ag Center that shows the location of the Davis Event Center building can be found at <https://www.wncagcenter.org/p/mountainstatefair/competitions/map>.

One more case and an additional death have been reported since the last ProMED-mail post on this outbreak, but no cases linked to the outbreak had a symptom onset date more than 2 weeks after the end of the fair, that is, within the incubation period for legionnaires' disease (<https://www.cdc.gov/legionella/clinicians/clinical-features.html>). The latest case of legionnaires' disease didn't attend the fair, but instead attended a quilt show held 2 weeks later at the Davis Event Center, but the source for this case is thought possibly to have not been at the WNC Agricultural Center. The Davis Event Center has since been closed.

The number of confirmed cases of legionellosis by county are as follows: Buncombe, 49; Burke, 1; Caswell, 1; Cherokee, 1; Gaston, 1; Granville, 1; Haywood, 12; Henderson, 34; Jackson, 3; Madison, 6; McDowell, 5; Mecklenburg, 5; Mitchell, 2; Polk, 1; Rutherford, 3; Transylvania, 3; Union, 1; Watauga, 1; and Yancey, 1. 10 cases occurred out of state (in South Carolina). Total cases: 141. A map showing the location of the North Carolina counties can be found at <https://geology.com/county-map/north-carolina.shtml>.

Male, 82 (59%)*; female, 58 (41%)*. Median age in years (range): 61 (24-91). Hospitalizations: 94 (69%)*; deaths 4. *Some cases reported with unknown gender or hospitalization status.

A total of 133 (94%) have legionnaires' disease, the pneumonic form of the infection, and 8 (6%) have Pontiac fever, the non-pneumonic form of the infection.

The species of _Legionella_ detected in patients is not specified; however, the usual pathogen in the USA is _L. pneumophila_ serogroup 1 and one sample of water collected from the women's restroom in the Davis Event Center was previously reported to be positive for _L. pneumophila_. Genotyping clinical and environmental isolates will help identify clusters of cases with a common source and identify the source responsible for infection in these clusters. - ProMED Mod.ML]
 
[HealthMap/ProMED-mail map of North Carolina, United States:
Date: Sun 20 Oct 2019 12:52 AM IST
Source: Deccan Chronicle [edited]

The respite from cases of dengue, notwithstanding, the city [Hyderabad] is now caught in the grip of viral encephalitis, or brain fever. There is an alarming increase in the number of viral encephalitis cases being reported across city hospitals. This is ironic as October is medically termed as 'fair-weather' season. The rise in the number of cases has been worrisome and those getting inflicted include children and elders.

Many are complaining of fever of the brain with body temperature touching [106-107 deg F/41.1-41.6 deg C].

According to doctors, at least 3 cases are reported each week in the tertiary hospitals of which 7 major ones are in the city.

Dr Shyam Jaiswal, neurologist at Care Hospitals, explains, "Of late, we have been admitting viral encephalitis-affected children in the hospital. Most fall sick because of the body's low immunity. Immediate hospital care is a must as most complain of severe headache, delirium, and in some cases even loss of memory. The treatment takes between 2-3 days."

It is a medical nightmare that some elders are suffering from both chikungunya and viral encephalitis.

Dr Hari Kishan B, general physician with Apollo Hospitals, explains, "The combination of chikungunya and viral encephalitis has been noted earlier too. These are rare cases but do occur from time to time. The viral infections have been very high this year [2019] and those suffering from diabetes, hypertension, and other cardiovascular ailments, will suffer more when infected with these viruses."  [Byline: Kaniza Garari]
=====================
[This report does not provide total case numbers, nor indicate how long 2-3 cases per week have been occurring. The virus suspected or confirmed as the etiology of these cases is not mentioned, but the comment that October is termed "a fair weather season" suggests that Japanese encephalitis virus may be involved with the usual transmission season declining in October. No mention is made of acute encephalitis syndrome, a clinical designation with a variety of suggested Aetiologies in other cases in north-eastern India. - ProMED Mod.TY]

[Maps of India: