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Argentina

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

Ambassador:
Her Excellency Paula Ní Shlattara
Secretary:

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

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

American citizens wishing to enter Brazil are required to obtain a visa in advance from the Brazilian Embassy or consulate nearest to the traveler's place of residence. The U.S. Embassy in Buenos Aires cannot assist travelers to obtain Brazilian visas. For more information, see the Country Specific Information for Brazil.
Visit the Embassy of Argentina’s web site at http://www.embassyofargentina.us/ for the most current visa information. Information about dual nationality or the prevention of international child abduction can be found on our web site. For further information about customs regulations, please read our Customs Information sheet.

SAFETY AND SECURITY:
Traffic accidents are the primary threat to life and limb in Argentina. Pedestrians and drivers should exercise caution. Drivers frequently ignore traffic laws and vehicles often travel at excessive speeds. The rate and toll of traffic accidents has been a topic of much media attention over the past year. The Institute of Road Safety and Education, a private Buenos Aires organization dedicated to transportation safety issues, reports that Argentina has the highest traffic mortality rate in South America per 100,000 inhabitants.

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

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

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

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

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

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

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

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

MEDICAL FACILITIES AND HEALTH INFORMATION: The public health system in Argentina provides emergency and non-emergency services free of charge to all, regardless of nationality or immigration status. However, the quality of non-emergency care in public hospitals is generally below U.S. standards. Medical care in private hospitals in Buenos Aires is generally good, but varies in quality outside the capital. Serious medical problems requiring hospitalization in private facilities and/or medical evacuation to the United States can cost thousands of dollars or more. Private physicians, clinics, and hospitals often expect immediate cash payment for health services.
HIV/AIDS restrictions. The U.S. Department of State is unaware of any HIV/AIDS entry restrictions for visitors to or foreign residents of Argentina.
Information on vaccinations and other health precautions, such as safe food and water precautions and insect bite protection, may be obtained from the Centers for Disease Control and Preventions hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747) or via the CDC's Internet site at http://wwwn.cdc.gov/travel/default.aspx. For information about outbreaks of infectious diseases abroad, consult the World Health Organization (WHO) web site at http://www.who.int/en. Further health information for travelers is available at http://www.who.int/ith
MEDICAL INSURANCE: The Department of State strongly urges Americans to consult with their medical insurance company prior to traveling abroad to confirm whether their policies apply overseas and will cover prior conditions and emergency expenses such as a medical evacuation, which could cost tens of thousands of dollars. If not covered, visitors are encouraged to consider purchasing travel insurance. No Medicare benefits are available abroad. Please see our information on medical insurance overseas.

TRAFFIC SAFETY AND ROAD CONDITIONS: While in a foreign country, U.S. citizens may encounter road conditions that differ significantly from those in the United States. The information below concerning Argentina is provided for general reference only, and may not be totally accurate in a particular location or circumstance.
Driving in Argentina is generally more dangerous than driving in the United States. By comparison, drivers in Argentina tend to be very aggressive, especially in the capital city of Buenos Aires, and frequently ignore traffic regulations. U.S. driver's licenses are valid in the capital and the province of Buenos Aires, but Argentine or international licenses are required to drive in the rest of the country. For further information, please contact the Argentine Automobile Club, Av. Libertador 1850, 1112 Capital Federal, telephone (011) (54)(11) 4802-6061, or contact the Embassy of Argentina as listed in the above section on Entry Requirements. Please refer to our Road Safety page for more information. Visit the websites of Argentina's national tourist office and national roadways office at www.turismo.gov.ar and www.vialidad.gov.ar.

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

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

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

CHILDREN'S ISSUES: For information see our Office of Children's Issues web pages on intercountry adoption and international parental child abduction.
REGISTRATION / EMBASSY LOCATION: Americans living or traveling in Argentina are encouraged to register with the U.S. Embassy through the State Department’s travel registration web site, so that they can obtain updated information on travel and security within Argentina. Americans without Internet access may register directly with the U.S. Embassy. By registering, American citizens make it much easier for the Embassy or Consulate to contact them in case of emergency. The U.S. Embassy is located at Avenida Colombia 4300 in the Palermo neighborhood of Buenos Aires (near the Plaza Italia stop on the "D" line subway). The main Embassy switchboard telephone is (54) (11) 5777-4533. Recorded consular information, including instructions on whom to contact in case of an American citizen emergency, is available at tel. (54) (11) 4514-1830. The Consular Section fax is (54) (11) 5777-4293. The Consular Section is open to the public from 8:30 a.m. to noon and 2:30 p.m. to 4 p.m. Monday through Friday, except on American and Argentine holidays. Additional information on Embassy services is available on the Internet at http://argentina.usembassy.gov or by e-mail: BuenosAires-ACS@state.gov
* * *
This replaces the Country Specific Information December 28, 2007 to update Sections on Country Description, Safety and Security, Information for Victims of Crime, Medical Facilities, Traffic Safety and Road Conditions, and Registration/Embassy Locations.

Travel News Headlines WORLD NEWS

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Ecuador US Consular Information Sheet
November 05, 2008
COUNTRY DESCRIPTION:
Ecuador is a Spanish-speaking country about the size of Colorado.
It has a developing economy and a democratically elected government.
Ecuador is geogra
hically and ethnically diverse.
In general, tourist facilities are adequate but vary in quality.
Ecuador adopted the U.S. dollar in 2000.
Both U.S. coins and Ecuadorian coins, which are equivalent to the value of the U.S. coins, are used.
Read the Department of State Background Notes on Ecuador for additional information.

ENTRY/EXIT REQUIREMENTS:
A U.S. passport with remaining validity of at least six months is required to enter Ecuador. A valid U.S. passport is required to depart Ecuador.
Tourists must also provide evidence of return or onward travel.
U.S. citizens traveling on regular passports for tourism or business do not need a visa for a stay of 90 days or less.
Those planning a longer visit must obtain a visa in advance of arrival.
Travelers who stay in Ecuador beyond the allowed entry time are charged a substantial fee and are barred from re-entering Ecuador for six months from the date of departure.
An airport exit tax is required when departing Ecuador.

U.S. citizens whose passports are lost or stolen in Ecuador must obtain a new passport at the U.S. Embassy in Quito or the U.S. Consulate General in Guayaquil and present it, together with a police report of the loss or theft, to the main immigration offices in those cities prior to arriving at the airport in order to obtain permission to depart.

Ecuador’s exit procedures mandate that minors (under the age of 18) who are citizens or residents of Ecuador and who are traveling alone, with one parent, or with a third party, must present a copy of their birth certificate and written authorization from the absent parent(s) or legal guardian.
When a parent is deceased, a notarized copy of the death certificate is required in lieu of the written authorization.
If documents are prepared in the United States, the authorization and the birth certificate must be translated into Spanish, notarized and authenticated by the Ecuadorian Embassy or an Ecuadorian consulate within the United States.
It is not uncommon for some local authorities to insist these documents be apostilled (authenticated).
Documents must be apostilled by the same State that issued the document.
For a list of State Authentication Authorities go to http://travel.state.gov/about/info/customer/customer_312.html; if documents are prepared in Ecuador, only notarization by an Ecuadorian notary is required.
This paragraph does not apply to children who enter Ecuador with U.S. passports as tourists, unless they hold dual U.S./Ecuadorian citizenship.

For further information regarding entry, exit, and customs requirements, travelers should contact the Ecuadorian Embassy at 2535 15th Street NW, Washington, DC 20009; telephone (202) 234-7166; web page http://www.ecuador.org/; or the Ecuadorian Consulate in Chicago (312) 338-1002/03; fax (312) 338-1004, Houston (713) 572-8731, Jersey City (201) 985-1700, Los Angeles (323) 658-5146; (323) 658-1068; fax (323) 658-1198, Miami (305) 539-8214, New Orleans (504) 523-3229, New York (212) 808-0211, or San Francisco (415) 982-1819.
Visit the Embassy of Ecuador’s web site at http://www.ecuador.org
for the most current visa information.

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

SAFETY AND SECURITY: The U.S. Embassy in Quito advises caution when traveling to the northern border region of Ecuador, to include areas in the provinces of Sucumbios, Orellana and Carchi, northern Esmeraldas, and southern Esmeraldas, south of Atacames.
U.S. government personnel are under limitations with respect to traveling alone and over-nighting in these areas due to the spread of organized crime, drug trafficking, small arms trafficking, and incursions by various Colombian terrorist organizations.
Since 1998, at least ten U.S. citizens have been kidnapped near Ecuador's border with Colombia.
One U.S. citizen was murdered in January 2001 by kidnappers holding him for ransom. Violent crime has significantly increased in 2007 and 2008 with American citizens being victims of crimes, to include but not limited to, homicides, armed assaults, robberies, sexual assaults, and home invasions.
American citizens have also been the victims of violent crime on beaches regardless of whether the beach is a popular tourist destination or remote.

Political demonstrations occur frequently throughout Ecuador for various reasons. Protesters often block city streets and rural highways, including major arteries such as the Pan American Highway. Public transportation is often disrupted during these events. Protesters may burn tires, throw rocks and Molotov cocktails, engage in destruction of property and detonate small improvised explosive devices during demonstrations. Police response may include water cannons and tear gas. U.S. citizens and U.S. affiliated interests are not usually targeted, but U.S. citizens are advised to avoid areas where demonstrations are in progress and to be prepared with backup transportation plans. Although political demonstrations have not been directed at foreigners in the past, visitors are reminded that peaceful demonstrations can turn violent with little or no warning.
Additionally, foreigners are prohibited from protesting in Ecuador and may be subject to arrest for participating in demonstrations of any kind.
Please see the following links for the local information in Quito and Guayaquil's Consular Districts, respectively at http://ecuador.usembassy.gov/security-and-safety/warden-messages.html and http://guayaquil.usconsulate.gov/warden_messages.html . U.S. citizens may also keep informed of daily happenings by following the local news and police reports.

Ecuadorian authorities may declare states of emergency in provinces and regions affected by civil unrest, natural disaster, or other disruptions. During states of emergency, authorities have expanded powers to restore order, including suspension of some constitutional rights, expanded detention powers, and imposition of curfews.

Radicals in various locations in Ecuador, including Quito, Guayaquil, and Cuenca, have occasionally placed small explosive devices that release political literature, known locally as pamphlet bombs. Targets have included local and international businesses and various Government of Ecuador buildings. Although no foreign tourists have been injured in these explosions, American citizens visiting or residing in Ecuador are urged to take common-sense precautions and avoid suspicious looking packages.

U.S. citizens should carry identification at all times, including proof of U.S. citizenship.
Travelers to Ecuador’s beach areas should be aware that strong currents, undertow, and underwater hazards may exist and are not always posted.
Most beaches lack staffed lifeguard stations.

For information on the Galapagos Islands, please see the “Special Circumstances” section of this Country Specific Information.
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:
Crime is a serious problem in Ecuador, and visitors should be alert and cautious.
Non-violent crime is common: hundreds of Americans are robbed every year in Ecuador.
Violent crime has increased in recent years.
Thieves and small gangs armed with guns or knives are now sometimes active even in smaller cities such as Otavalo, Manta, and Cuenca.
Tourists have been robbed at gunpoint on beaches and along hiking trails, including on the well-populated trail to the summit of Pichincha Volcano in Quito.
Incidents of rape have increased, even in well-traveled tourists areas and when the victims traveled in groups for safety. Shootings, kidnappings, and carjackings are still relatively rare, but American citizens have been victimized by those crimes.
The Ecuadorian government has increased police patrols in tourist areas, but travelers should remain alert to their surroundings and maintain constant control of personal belongings.

Travelers should avoid wearing expensive-looking jewelry and watches.
Avoid deserted beaches, hiking trails, and infrequently traveled roads, as well as the interior regions of large city parks, particularly at night. Robberies on public buses are a continuing problem.
The Embassy recommends that visitors use legitimate taxicabs (yellow, with meters) to travel around the larger cities.
Public buses can be dangerous – from both a traffic safety and a personal security point of view.

Pickpockets and other petty thieves are particularly active in public markets, airports, bus terminals, restaurants, and crowded streets.
Backpackers are frequently targeted for robbery and “snatch and grabs”; business travelers carrying laptop computer bags are similarly targeted.
Many travelers who travel by bus store their luggage below the bus, where it is sometimes stolen.
Therefore, we recommend that you do not store your passport in your luggage. Always be aware of your surroundings, and try to not travel alone.
Thefts from vehicles are common.
Do not leave anything of value in plain view in a car, including sunglasses or sports equipment.
Carjackings have occurred in both rural and urban areas.
Visitors are advised to drive with doors locked and windows rolled up.

In Quito, travelers should be particularly alert on the crowded streets of south Quito, at the Panecillo, in Old Quito, and in the areas of El Tejar, Parroquia San Sebastian, Avenida Cristobal Colon, and Gonzalez Suarez.
The U.S. Embassy strongly discourages hiking to the summit of Pichincha as violent crime is sharply rising.
Groups as large as eight have been robbed at gunpoint by masked men; female hikers have been sexually assaulted.
The Mariscal Sucre District is a popular tourist area in Quito with numerous restaurants, bars, hotels, and shopping sites.
Since 1999, U.S. government employees and private U.S. citizens have been victimized there, prompting the U.S. Embassy to put certain bars off-limits and to declare a nighttime curfew in the area for its employees.
Increased police presence and better lighting in prime tourist squares of Old Quito have improved safety, but similar measures in the Mariscal district have not been as effective.

In Guayaquil, take extra caution in the downtown area at night, in the street market area of La Bahia, at the Christ Statue (Sagrado Corazon de Jesus) on Cerro del Carmen, in the airport area, and in the southern part of the city.
The riverfront park area called the Malecon 2000 and the passage up to the lighthouse in the Las Penas area are generally safe and well patrolled although at night caution should be observed.
There have been repeated instances of travelers followed from the airport and intercepted by robbers using two vehicles to cut off the traveler.
There is some evidence that those most at risk are people who appear to be returning from family visits laden with gifts and large amounts of cash.
There have been armed robberies of restaurants and their patrons, including in the fashionable areas of Guayaquil.
Guayaquil has also experienced an increase in kidnappings for ransom, often in connection with hijackings, although tourists have not been targeted.

Criminals sometimes use incapacitating drugs such as scopolamine on unsuspecting tourists in order to rob them.
These so-called date rape drugs are put into drinks in order to drug the unsuspecting victim.
This drug can render the victim disoriented and can cause prolonged unconsciousness and serious medical problems.
Never allow a stranger to “buy” you a drink and never leave your drink unattended.
Several American citizens have reported thefts of property following ingestion of such substances.

Every year, 15 to 20 American citizens are arrested for attempting to traffic drugs between Ecuador and the United States, or between mainland Ecuador and the Galapagos.
Suitcases with false bottoms and other packages are common methods of transporting illegal substances. Many of these citizens claim to have been unaware that they were transporting drugs.
As in any other country, do not accept gifts, packages, or suitcases from other persons; even trusted travel companions have been known to take advantage of their friends and family to traffic drugs through Ecuador’s airports. See the Criminal Penalties section below for more details about Ecuador strict laws and sentences regarding illegal drug trafficking.

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

INFORMATION FOR VICTIMS OF CRIME:
The loss or theft abroad of a U.S. passport should be reported immediately to the local police and the nearest U.S. Embassy or Consulate.
If you are the victim of a crime while overseas, in addition to reporting to local police, please contact the nearest U.S. Embassy or Consulate for assistance.
The Embassy/Consulate staff can, for example, assist you to find appropriate medical care, contact family members or friends and explain how funds could be transferred.
Although the investigation and prosecution of the crime is solely the responsibility of local authorities, consular officers can help you to understand the local criminal justice process and to find an attorney if needed.
Female victims of crime may receive assistance from the Comisaria de la Mujer at Ave. 24 de Mayo y Calle Loja, telephone 593 2 228 4016 or the Oficina de Derechos de la Mujer, Guayanas E-331 y Inglaterra, Quito 593 2 252 9909.
The local equivalent to the emergency line in Ecuador is the same as the U.S., dial “911”. The operators typically speak Spanish only. Victims should also call the Embassy or Consulate to report the crime and for assistance.

See our information on Victims of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION:
Adequate medical and dental care can be readily obtained in the major cities of Ecuador.
In smaller communities and in the Galapagos Islands services are limited, and the quality is variable and generally below U.S. standards.
Ambulances, with or without trained emergency staff, are in critically short supply.
Acute surgical and cardiac services are not available on the Galapagos Islands.
Serious cases must be evacuated to the Ecuadorian mainland or the United States for treatment.
Pharmacies are readily available in any city.
However, the availability of some medications is sporadic, and formulations and brand names will differ from products available in the U.S.
Narcotics and tranquilizers are extremely limited in availability.
“Pharmacists” sometimes prescribe and dispense medications.
These individuals often have little training and prescribe broad-spectrum antibiotics and other inappropriate medications.
Travelers should not seek their advice.
Folk healers and traditional markets offer herbal and folk remedies which should be avoided as formulations are questionable and some components may interact with other prescription medications.

Travelers to Quito (close to 10,000 feet) and other highland areas may require some time to adjust to the altitude, which can adversely affect blood pressure, digestion, and energy level.
Travelers are encouraged to consult with their personal health care providers before undertaking high-altitude travel.
In particular, travelers with heart or lung problems and persons with sickle cell trait may develop serious health complications at high altitudes.

Scuba divers in the Galapagos Islands should be aware of limited facilities for decompression.
A privately owned decompression chamber is available on Santa Cruz Island in the Galapagos Islands.
The Ecuadorian Navy operates a second decompression chamber at the San Eduardo Naval Base in Guayaquil.
Due to the high costs for these services and associated emergency transportation, divers are advised to obtain adequate medical evacuation and divers insurance.

Travelers should be aware of the presence of malaria, dengue fever, and yellow fever in areas of Ecuador below 4,500’ elevation.
Historically there has not been dengue or malaria in the Galapagos archipelago, and yellow fever has only occurred in the Amazon Basin.
Travelers who are on an appropriate anti-malarial drug have a greatly reduced chance of contracting malaria, while vaccine can provide protection against yellow fever.
Avoiding mosquito bites is the only effective prevention for dengue and personal protective measures, such as the use of insect repellents, help to reduce the risk of contracting all of these illnesses.
Travelers who become ill with a fever or flu-like illness while traveling in a high-risk area, and for up to one year thereafter, should seek prompt medical attention.
For additional information on malaria or dengue, protection from insect bites, and anti-malarials, consult the Center for Disease Control and World Health Organization web sites listed below.

The U.S. Department of State is unaware of any HIV/AIDS entry restrictions for visitors to or foreign residents of Ecuador.
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 web site at http://www.who.int/en.
Further health information for travelers is available at http://www.who.int/ith .

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

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

Road travel throughout Ecuador can be dangerous, especially at night.
Many roads are poorly maintained or unmarked.
Heavy rains and mudslides often close or wash out roads.
Heavy fog is common in mountainous areas.
Driving practices differ from U.S. standards.
Inter-urban and inter-provincial bus passengers are often targets of crime, including robbery and sexual assault.

Highways are often unmarked and do not have signs indicating destinations.
Road safety features such as crash barriers and guardrails along steep mountainsides are rare.
In the countryside livestock are often herded along roads or graze on roadsides.
Many roads are used for pedestrian and animal traffic as well as vehicular traffic.
Driving habits vary from region to region.
In general, drivers in Quito and the mountain areas and the Oriente (eastern jungle) drive more slowly, observe traffic signals, and slow down for speed bumps.
Vehicles are reasonably well maintained.
On the coast, drivers have a more liberal approach to vehicle maintenance and traffic regulations.
In all areas buses, both intra-city and intercity, will stop at any point on their route to pick up or drop off passengers.
Speed bumps abound, even on major highways such as the Pan American Highway, to slow traffic.
Drivers turn right and left from any lane and do not yield for pedestrians and cyclists.

Intoxicated drivers can be encountered at any time, but they are especially prevalent on weekends and holidays.
Ecuador’s frontier regions are largely rural, poor, and lack police presence.
Because drug traffickers, criminal organizations, and smugglers of all types use clandestine border crossings to move their goods, the U.S. Embassy advises against driving on all but the most traveled highways.

If you are the driver of a vehicle involved in an automobile accident, you will likely be taken into police custody, especially if injuries are involved.
You are almost certain to spend some time in jail until all parties are satisfied that responsibility has been assigned and adequate financial satisfaction received.
Drivers may face criminal charges if injuries or damages are serious.
When driving your own vehicle or a rented vehicle, be sure to have proper vehicle registration papers with you.
Please refer to our Road Safety page for more information.
Visit the web site of the country’s national tourist office at http://www.turismo.gov.ec/ and the Ministerio de Transporte y Obras Publicas, the national authority responsible for road safety, at http://www.mtop.gov.ec/ .

AVIATION SAFETY OVERSIGHT:
The U.S. Federal Aviation Administration (FAA) has assessed the Government of Ecuador's Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for oversight of Ecuador'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
GALAPAGOS ISLANDS: A significant number of Ecuadorian tour vessels operating in the Galapagos Islands are neither inspected nor operated in accordance with U.S. regulations, and do not meet U.S. safety standards.
The Government of Ecuador requires that vessels carrying more than sixteen passengers comply with the International Safety Management (ISM) code established by the International Maritime Organization.
However, the quality of inspections, oversight, crewmember proficiency evaluation, and other requisites for safe vessel operation may vary substantially.
Tour boat accidents are more frequent among small vessels (those carrying fewer than sixteen passengers), but travelers should inquire about safety features of any vessel, regardless of size. When boarding vessels be sure to look for the life boats, floatation devices and if possible take a moment to inspect the life vest you would be using if there were an accident.

There have been at least three cases in 2004-2006 in which small quantities of drugs have been placed by unknown persons in unsecured pockets of tourists' checked bags, including backpacks, en route to the Galapagos.
Upon arrival, these drugs have been detected by police canine units, and the owners of the bags have been arrested and detained for months while the cases are resolved.
Travelers are advised to secure all parts of their bags thoroughly before checking them on flights to the Galapagos.

Strikes and disturbances by local fisherman in the Galapagos Islands have become violent on occasion.
While tourists have not been targeted, the incidents affected their movement and access to some sites.
Such disturbances have been minimal since April 2004, but the issue remains unsettled and could resurface at any time.

The islands are over 600 miles from the mainland and help may be slow in arriving in case of emergency.
The Government of Ecuador has very limited search and rescue capabilities.
Travelers to the Galapagos are encouraged to contact tour operators and visit the Bureau of Consular Affairs' web site for the most recent information when planning their trips to the Galapagos.

OTHER LEGAL ISSUES: Under Ecuadorian law, business disputes that normally would be handled by civil litigation in the United States may be converted into criminal proceedings.
This provision of the law has been used to impose travel prohibitions against resident U.S. citizens, and it also has led to the arrest and incarceration of U.S. business people while they were awaiting a hearing on the civil matter.

When considering purchasing property in Ecuador, Americans should be aware that competing claims to property might only surface after an apparently legal sale has been made.
Deficiencies in the Ecuadorian system for surveying and registering property and weaknesses in the judicial system mean that these disputes can last years.
The Mission is aware of several cases of American citizen land owners in Ecuador being threatened with physical harm and/or confiscation of their property by individuals claiming rights to the land, and, in at least one case, buildings have been razed.
American citizens considering buying property in Ecuador should engage a competent attorney and carefully research land title issues before making a purchase.

DISASTER PREPAREDNESS: Ecuador has 19 potentially active volcanoes, including nine that have shown recent activity.
Earthquakes occur frequently.
Three active volcanoes within 50 kilometers of Quito pose a significant threat to the city: Guagua Pichincha, Cotopaxi, and Reventador.
The primary threat is from failures of transportation, water, communications, and power systems due to heavy ash fall and damage to infrastructure outside the city.
Air transportation is especially vulnerable.
Potentially serious respiratory problems are caused by inhalation of ash.

The town of Banos, a popular tourist destination approximately 120 kilometers south of Quito, is at the base of the Tungurahua Volcano.
Tungurahua has erupted explosively several times since 1999, most recently in February of 2008, causing deaths and forcing thousands to evacuate their homes.
Explosive eruptions can occur with little warning.
The resulting flows of mud and lava could pose a significant and immediate threat to Banos and other population centers in the vicinity.
Travelers should to be aware of these conditions when choosing to stay overnight in Banos, especially on the western side of the town, and should be ready to evacuate on short notice.

Other volcanoes active in Ecuador include Reventador, 100 kilometers east of Quito, and Cotopaxi, 50 kilometers south of Quito.
In 2002, lava and mudflows caused by Reventador volcano closed a major Quito/northern-border highway and volcanic ash blanketed Quito, shutting down the Quito airport for several days.

The Quito City Government and the Ecuadorian Geophysical Institute monitor these volcanoes and issue regular reports on their activity.
In the event of eruptions, travelers should pay close attention to the news media for updates on the situation.
Other volcanoes in Ecuador may also exhibit increased activity at any time.
Further information is available via the Internet from the Ecuadorian Geophysical Institute at http://www.igepn.edu.ec/ and the National Oceanic and Atmospheric Administration at http://www.ssd.noaa.gov/VAAC/guag.html .

CUSTOMS REGULATIONS:
Ecuadorian customs authorities may enforce strict regulations concerning temporary importation into or export from Ecuador of items such as firearms, religious materials, antiquities, medications, electronic equipment, and currency.
Contact the Embassy of Ecuador in Washington, D.C., or one of Ecuador’s consulates in the United States for specific information regarding customs requirements. Please see our customs information.

CRIMINAL PENALTIES:
While in a foreign country, a U.S. citizen is subject to that country's laws and regulations, which sometimes differ significantly from those in the United States and may not afford the protections available to the individual under U.S. law.
Penalties for breaking the law can be more severe than in the United States for similar offenses.
Persons violating Ecuadorian laws, even unknowingly, may be expelled, arrested, or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in Ecuador 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.

The Ecuadorian government is required by international law to notify the U.S. Embassy or the nearest U.S. Consulate promptly when an American citizen is arrested and requests such notification.
Delays in notification can limit the assistance the U.S. Government can provide an arrested American citizen.
Therefore, Americans should promptly identify themselves as such to arresting officers and request that the U.S. Embassy in Quito or the U.S. Consulate in Guayaquil be notified immediately.

Prison conditions in Ecuador are extremely poor.
In many facilities food is insufficient in both quantity and quality, and prisoners must pay for adequate nutrition from their own funds.
Most Ecuadorian prisons provide poor medical care, and urgent medical conditions may receive only minimal attention.
The Guayaquil penitentiary medical clinic does not have medicine but is staffed with medical personnel. Prisoners must personally pay to have someone outside of the prison obtain medicine and prescriptions. Those accused of crimes in Ecuador can expect lengthy delays before trial and sentencing.
The accused are usually incarcerated while awaiting trial and sentencing, and in the case of serious crimes, bail is generally not an option.

CHILDREN'S ISSUES:
For information on 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 Ecuador are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department’s travel registration web site and to obtain updated information on travel and security within Ecuador.
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 in Quito is located at Avigiras E12-170 y Eloy Alfaro.
The telephone during business hours (8:00a.m. to 5:00 p.m.) is (011) 593 2 398 5000.
For after-hours emergencies use (011) 593 2 398 5000. Within the same city use the last seven digits.
Add the city code for intercity telephone calls.
The Embassy's web site is http://ecuador.usembassy.gov/
The U.S. Consulate General in Guayaquil is located at the corner of 9 de Octubre and Garcia Moreno (near the Hotel Oro Verde); telephone (011-593-4) 232-3570 during business hours (8:00 a.m. to 5:00 p.m.) or 232-1152 for after-hours emergencies; fax (011-593-4) 232-0904.
The Consulate General's web site is http://guayaquil.usconsulate.gov/.

Consular services for U.S. citizens in the Galapagos Islands are provided by the Consulate General in Guayaquil with assistance from a U.S. Consular Agent in Puerto Ayora, Galapagos, at (05) 2526-330 or (05) 2526-296.

The Consular Section in Quito is open for American Citizen Services, including registration, from 1:30 to 4:00 p.m., Monday through Thursday, excluding U.S. and Ecuadorian holidays.
In order to provide better customer service and reduce waiting times, the American Citizen Services section in Guayaquil uses an online appointment system. Appointments are available from 12:00 noon to 4:00 p.m., Monday through Thursday. Notary appointments are Friday, 8:00 a.m. to 12:00 p.m., excluding U.S. and Ecuadorian holidays. Walk-in service remains available, but customers with appointments take precedence.
To make an appointment, go to http://guayaquil.usconsulate.gov/online_appointments.html
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This replaces the Country Specific Information for Ecuador dated March 28, 2008, to update the sections on Entry/Exit Requirements, Information for Victims of Crime, and Traffic Safety and Road Conditions.

Travel News Headlines WORLD NEWS

Date: Fri, 7 Sep 2018 12:17:58 +0200

Quito, Sept 7, 2018 (AFP) - A deep 6.2 magnitude earthquake struck Ecuador on Thursday night, causing damage to buildings and injuring two people.   The quake hit at 9:12 pm local time (0212 GMT on Friday) at a depth of 93.5 kilometres, near the center of the South American country.   It was felt across several provinces, according to Twitter users. Two people were injured in the town of Cumanda.

The walls of homes cracked and ceilings caved in, mayor Marco Marquiasca said.   Local authorities recorded its magnitude as 6.5.   Ecuador suffered a 7.8 magnitude earthquake on April 16, 2016, which devastated villages in the coastal provinces of Manabi and Esmeraldas and killed 673 people.   The losses amounted to more than $3 billion, according to authorities.    Located on the boundary of the Nazca and South America tectonic plates, Ecuador is very prone to seismic activity.
Date: Thu, 16 Aug 2018 03:58:11 +0200

Quito, Aug 16, 2018 (AFP) - Colombia's government said Wednesday that 19 of the victims of a deadly bus crush in Ecuador were its citizens, as Quito lowered the overall death toll from the accident.   Ecuador's foreign ministry said in a statement that 23 people were killed in the Tuesday crash, instead of 24 as previously announced.   Twelve Colombians, four Venezuelans and two Ecuadorans who died in the accident have been identified, the statement said.

The bus, which had foreign license plates, overturned and crashed into three houses after a collision with an all-terrain vehicle near Quito.   Ecuador transport colonel Julio Barba said the driver "probably overused the brakes... which produced an overheating of the brake system leading to a loss of control of the vehicle."   Colombia's Transport Ministry had said on Tuesday that the bus was not authorized to carry tourists.  One of the two drivers, who was injured in the crash, has been arrested.

Traffic accidents are among the leading causes of death in Ecuador. According to the watchdog group Justicia Vial, on average seven people are killed and some 80 people injured each day in traffic accidents.   And 96 percent of those accidents are due to human error, according to the group's figures.   On Sunday, 12 people were killed and 30 injured when a bus carrying fans of Barcelona SC, Ecuador's most popular football club based in Guayaquil, ran off the highway and flipped.
Date: Mon, 11 Jun 2018 22:10:52 +0200

Quito, June 11, 2018 (AFP) - A Lebanese man has been stuck in immigration purgatory at an airport in Ecuador for 42 days after losing his passport and being returned there from Spain.   Nizam Hussein Shalak, 56, who does not speak Spanish, has been residing in the international terminal of the Jose Joaquin de Olmedo airport in Guayaquil, El Universo newspaper reported.   "It is a case of inadmissibility because he has no documents," a foreign ministry source said.   "The only legal body to issue a travel document is the Lebanese consulate in Bogota," which has not responded to requests that it do so, the source said.   "We are closely following the case and are working with the interior (ministry) to get Lebanon to issue him a travel document so he can return to his country."   The situation resembles that of an Iranian refugee who lived in a Paris airport from 1988 to 2006 and was portrayed in the film "The Terminal" starring Tom Hanks.

Shalak visited Guayaquil two months ago and stopped on the way back to Lebanon in Lima, Peru, and Barcelona, Spain, where he was detained after losing his passport as well as his credit cards, El Universo newspaper reported.   He stayed in Barcelona for 10 days and Lima for another 11 before being returned to Guayaquil, where he had to make a makeshift a bed on the seats of the terminal.   "He eats with the coupons that the airline... gives him from time to time" and showers "every three or four days, when they take him to a bathroom in another part of the terminal," the newspaper said.   The foreign ministry source said that while Shalak left with a passport, he did not have one upon his return and could not pass immigration.   Therefore, "he is not legally in the country."
Date: Fri, 6 Apr 2018 03:41:33 +0200

Quito, April 6, 2018 (AFP) - An Ecuadoran soldier died Thursday from wounds sustained in a roadside bomb blast two weeks ago on the border with Colombia, Ecuadoran President Lenin Moreno said, calling the explosion a "terrorist act."   He said on Twitter that the corporal was being treated in a military hospital when he succumbed to his grievous injuries, which had resulted in both his legs being amputated.   "A hug of solidarity to his family," Moreno tweeted.   The death took to four the number of soldiers killed in the March 20 blast, which occurred near the border town of Mataje. A dozen others were wounded.

Ecuador has since January been confronted with an unusual wave of attacks directed at its security forces.    The government blames dissident rebels with Colombia's former FARC guerrilla group which has disbanded and become a political party following a landmark 2016 peace deal.   An Ecuadoran media team comprising a reporter, a photographer and a driver were abducted last week in Mataje.   Quito has stepped up the military presence in the region, and has reinforced cooperation with Colombia to try to quell the border violence. But the task is a difficult one, with dense jungle providing cover to insurgents.
Date: Thu, 8 Feb 2018 12:14:44 +0100
By Jordi MIRO

Puerto Ayora, Ecuador, Feb 8, 2018 (AFP) - With its iconic giant tortoises, crested black iguanas, huge ocean manta rays and a veritable menagerie of other cool creatures, the Galapagos Islands are one of the most beautiful places you will probably never visit.  Why not?

Who wouldn't want to go to a white sand beach and soak up some sun alongside a lounging iguana, or surf in waters with those lumbering tortoises swimming beside you and a rainbow of tropical fish below?   But in order to protect the flora, fauna and ecosystems of this Pacific archipelago that inspired Charles Darwin's theory of evolution, Ecuador is in the odd position of having to turn away perhaps millions of would-be tourists each year.

Keeping a tight lid on tourism is the way the South American country has preserved this volcanic string of 19 large islands, dozens of islets and rocky outcroppings.   Authorities wage this fight as world tourism grows and grows -- it was up seven percent last year -- and they must resist the temptation to let in hordes of visitors, their pockets bulging with dollars.   "The Galapagos are the crown jewel, and as such, we have to protect them," Tourism Minister Enrique Ponce de Leon told AFP. "We must be drastic in caring for the environment."

- Welcome, sort of -
With a network of small hotels and ferries running between the islands, the Galapagos -- about 1,000 kilometers (600 miles) off the coast -- is an eco-tourism destination that is among the most select spots in all of the Pacific.   Flights from Quito or Guayaquil cost about $400 round-trip, and a one-week stay ranges from $2,000-7,000 per person.   The flow of tourists has risen to 245,000 per year and authorities say that's pretty much the limit: the maximum the islands can withstand without harming their various ecosystems.   "The environmental, social and biological features of this place -- which is like no other -- forces us to set a limit, to manage tourism in terms of supply, rather than demand," said Walter Bustos, director of the Galapagos National Park.

- Restrictions galore -
Preyed on in the past by pirates and whaling ships, the Galapagos these days confront illegal fishing, the effects of climate change and the arrival of intrusive species such as dogs, cats and rats brought over from the mainland.   The national park was created in 1959 to protect 97 percent of the islands' land surface, and in 1978 UNESCO classified the archipelago as a World Heritage Site.   A marine reserve spanning 138,000 square kilometers (53,280 square miles) was also established.

And a 38,000-square-kilometer marine sanctuary in which all fishing is banned was set up between two of the islands, one called Darwin and the other Wolf. Those waters are home to the highest concentration of sharks on Earth.   The islands depend on imports from the mainland and have limited sources of water, so authorities make sure the human population does not grow. These days, only 26,000 people live on the four islands that are in fact inhabited.   By law, Ecuadorans from the mainland are treated as foreigners on the Galapagos. And to obtain permanent residency, such people have to have been married to a local for at least a decade.

For years, the authorities have been limiting construction and promoting the use of renewable energy sources and electric cars. Plastic bags are banned.   On the island of Baltra, which is the main port of entry, the airport runs exclusively on solar and wind power.   "The challenge is to manage tourism in a sustainable way, one that preserves the ecosystems and generates profits. We must not view tourists as the devil," said Juan Carlos Garcia, conservation director of the World Wildlife Fund in Ecuador.

- Open skies -
But of course, limiting tourism here is of no help to the broader Ecuadoran economy, which operates with dollars as the official currency.   And these have been lean years for hard currency in oil-producing Ecuador because of low global crude prices and accumulation of lots of debt. Tourism and mining have emerged as lifesavers.   Last year, visitors to this fabulously diverse country boasting volcanos and thick Amazon jungle shot up 14 percent compared to 2016, totalling 1.6 million. But that is small compared to other countries in Latin America.

President Lenin Moreno's idea is for tourism is to prop up the economy, even more than oil.   For that reason, he decreed an open-skies policy a few months ago to free up air traffic and bring more tourists to Quito and Guayaquil.   And many of these travelers will want to go to the Galapagos. The state-owned airline TAM has announced more flights to the islands.    Will the island authorities be able to withstand this pressure?   "We need to stress quality, and have those who come now stay longer -- have them tour the rest of the country, offering them package deals," says the tourism minister.
More ...

World Travel News Headlines

Date: Mon, 25 Mar 2019 11:52:43 +0100

Sanaa, March 25, 2019 (AFP) - Nearly 110,000 suspected cases of cholera have been reported in war-hit Yemen since the beginning of January, including 190 related deaths, the UN said on Monday.   The UN office for humanitarian affairs (OCHA) said children under the age of five make up nearly a third of 108,889 cases which were reported between January 1 and March 17.

OCHA said the spike, which comes two years after Yemen suffered its worst cholera outbreak, was concentrated in six governorates including in the Red Sea port of Hodeida and the Sanaa province home to the capital.   Early rains could be blamed for the recent increase in suspected cholera cases, it said.   "The situation is exacerbated by poor maintenance of sewage disposal systems in many of the affected districts, the use of contaminated water for irrigation, and population movements," OCHA added.   The waterborne disease is endemic to Yemen, which witnessed the worst cholera outbreak in its modern history in 2017.

More than one million suspected cases were reported within an eight-month period that year. More than 2,500 people died of the infection between April and December 2017.    Yemen's brutal conflict, which pits Iran-linked rebels against a regional pro-government alliance led by Saudi Arabia, has left some 10,000 people dead since 2015 and pushed millions to the brink of famine.    The war has created the perfect environment for cholera to thrive, as civilians across the country lack access to clean water and health care.
Date: Wed 20 Mar 2019
Source: Outbreak News Today [edited]

Swedish public health authorities, Folkhalsomyndigheten, is reporting an outbreak of psittacosis, or parrot disease, since November 2018. According to officials, some 60 cases have been reported from the regions of Vastra Gotaland, Kalmar, Jonkoping, and Skane. This is the highest number of cases reported in one winter in 2 decades.

Those who have now fallen ill have mainly come into contact with bird droppings from wild birds, for example through the handling of bird tables and other outdoor activities. A smaller number are believed to have been infected by domestic birds (parrots) in cages. The most common way someone gets infected with the bacteria that cause psittacosis (_Chlamydia psittaci_) is by breathing in dust containing dried secretions (e.g., droppings, respiratory) from infected birds. It is rare for psittacosis to spread from person to person.

In general, psittacosis causes mild illness in people. The most common symptoms include fever and chills, headache, muscle aches, and dry cough. Psittacosis can also cause pneumonia (a lung infection) that may require treatment or care in a hospital. Rarely, psittacosis can result in death. Most people begin developing signs and symptoms of psittacosis within 5-14 days after exposure to the bacteria (_C. psittaci_). Occasionally, people report the start of symptoms after more than 14 days.
=================
[The news report above attributes the increase in number of human cases of psittacosis in Sweden since Nov 2018 mainly to contact with wild bird droppings, for example through the handling of bird tables and other outdoor activities. Outbreaks of avian chlamydiosis, due to _Chlamydia psittaci_ or the other Chlamydia species, have been reported occasionally in wild birds including shorebirds, waterfowl, and migratory birds, especially in birds under stress (<http://www.cfsph.iastate.edu/Factsheets/pdfs/psittacosis.pdf>).

An outbreak in Australia was probably caused by organisms carried in wild birds and spread when organisms in bird droppings became aerosolized during activities such as lawn mowing (<https://www.ncbi.nlm.nih.gov/pubmed/15757553>). An increase in psittacosis cases in Sweden in the winter of 2013 was also linked to wild birds, apparently through exposure to wild bird droppings; most cases were associated with tending bird feeders (<https://www.ncbi.nlm.nih.gov/pubmed/23725809>; also see ProMED-mail post Psittacosis - Sweden (02): wild bird http://promedmail.org/post/20130509.1701695).

Vastra Gotaland, Kalmar, Jonkoping, and Skane are counties located in southern Sweden. A map of Swedish counties can be found at <https://fotw.info/flags/se(.html>. - ProMED Mod.ML]

[HealthMap/ProMED-mail map:
Date: Wed 20 Mar 2019
Source: PNA [edited]

A public elementary school in Tubungan town, Iloilo has recorded a total of 36 chickenpox cases from 15 Jan to 3 Mar [2019], the Provincial Health Office (PHO) said. In an interview on Wednesday [20 Mar 2019], Dr. Patricia Grace Trabado, PHO head, said the cases were observed as patients who sought treatment at the rural health units (RHU) and private clinics in Tubungan.

All the cases were recorded in Cadabdab Elementary School, with 21 male and 15 female students affected. Trabado said affected pupils might still be attending school even though they were infected, which resulted in its transmission.

She emphasized that the spread of the infection might have been prevented if the children were advised not to attend school with the onset of infection. "If a child is showing chickenpox symptoms, especially when he or she was previously exposed to an affected person, then the pupil will be advised to stay at home," she said.

Trabado said the source of the infection came from the 1st patient working in Iloilo City but lives in Tubungan town. "The patient might have a family member that attends school in Cadabdab. From there, we see where the infection originated," she said. Trabado, however, did not give figures of the disease other than that from the school.

The RHUs and private clinics were able to monitor and manage the cases, Trabado said. All the student patients were discharged, given medication, and let the viral infection take its course. "And eventually, the patients recovered," she said. However, Trabado warns that a child with chickenpox can get secondary infection when he or she scratches the blisters, creating skin lesions.

She added that cases of chickenpox and mumps are mostly observed during the summer season. Trabado said patients with chickenpox experience fever and headache in the first 1 or 2 days before the itchy blister rash appears.  [Byline: Gail Momblan]
======================
[HealthMap/ProMED-mail map:
Date: Wed 20 Mar 2019
Source: USDA Animal and Plant Health Inspection Services [edited]
<https://content.govdelivery.com/accounts/USDAAPHIS/bulletins/23806a5>

The US Department of Agriculture's (USDA) under secretary for marketing and regulatory programs, Greg Ibach, is alerting international travellers of a deadly swine disease they could unknowingly bring back into the United States on their clothes, shoes, or hands.

African swine fever (ASF) is a highly contagious and deadly disease affecting both domestic and feral (wild) pigs. It does not affect human health and cannot be transmitted from pigs to humans. Recent spread of the disease to new countries in Asia and Europe has triggered a series of actions by USDA, state agriculture departments, and the pork industry to bolster protections against ASF in the United States and keep ASF out of North America.

"ASF has never been detected in the United States," said Ibach, "but an outbreak here would not only affect the pork industry, but also have major impacts on trade and raise food prices for consumers. We are asking international travellers to help prevent the spread of ASF to the United States by understanding what products can be brought back into the United States and declaring any agricultural items in their baggage."

The USDA's Animal Plant and Health Inspection Service's (APHIS) new traveller website provides updated information about potentially harmful pests and diseases that can hitchhike on food or other agricultural products. When returning to the United States, travellers are reminded to declare food items and animal products in their luggage. Failure to declare items may result in serious penalties.

"USDA and US Customs and Border Protection (CBP) recognize the crucial work of detector dog teams at US ports of entry." said Ibach. "While travellers' declarations of any food products brought with them to the United States is a critical step to protecting US agriculture, the dogs and secondary agricultural inspections provide another line of defence to keep ASF out of the country."

Travellers will also see some changes at airports as USDA works with CBP to increase screenings of passenger baggage. This includes training and adding 60 additional beagle teams for a total of 179 teams working at key US commercial, sea, and air ports and ensuring travellers who pose an ASF risk receive secondary agricultural inspection. USDA is also coordinating with CBP to expand arrival screenings, including checking cargo for illegal pork and pork products.

Anyone who visits a farm in an ASF-affected country should take specific precautions before returning to the United States. Follow the farm's biosecurity protocols and wear site specific footwear and coveralls or clothing. Thoroughly clean and disinfect or dispose of clothes and footwear worn on the farm before returning, and declare the farm visit to CBP when re-entering the United States. Travelers should not visit farms or any other locations with pigs -- including livestock markets, zoos, circuses, and pet stores with pot-bellied pigs -- for at least 5 days after returning.

More information on ASF, partner resources, and additional resources for travellers are available on the APHIS ASF webpage
and in this infographic
======================
[This disease would be extremely serious for the US, and likely for all of North America. The warning is appropriate for travellers to be more alert to situations that could ultimately have horrible outcomes. - ProMED Mod.TG]

[HealthMap/ProMED-mail map:
Date: Wed 20 Mar 2019
Source: ReliefWeb [edited]

The Federal Ministry of Health, in collaboration with the World Health Organization (WHO), Gavi, the Vaccine Alliance, and UNICEF, has launched a large-scale mass vaccination campaign in Sudan to vaccinate more than 8.3 million people 9 months to 60 years of age against yellow fever in the states of Blue Nile, Gezira and Sennar during 10-29 Mar 2019.

The campaign represents a crucial step in protecting a large portion of the population and reducing the risk of severe and deadly yellow fever outbreaks in the country. It is the 3rd and final drive thatSudan is undertaking to protect populations at risk and prevent yellow fever epidemics, pending the implementation of infant immunization as routine practice.

The campaign forms a critical part of Sudan's ongoing work to protect all populations against yellow fever epidemics, in alignment with the global Eliminate Yellow fever Epidemics (EYE) Strategy. The country plans to complement these yellow fever mass campaigns and ensure long-term protection through the introduction of yellow fever vaccination into routine immunization in the coming months.

"We acknowledge the commitment of the health authorities in Sudan to avail cash and fuel during this economic crisis to ensure that their people, especially children, are protected with a quality vaccine which will contribute to health security and making the world safer," said Dr. Naeema Al-Gasseer, WHO Representative in Sudan.

"Yellow fever vaccination is the most important tool we have to prevent yellow fever outbreaks. The vaccine will be freely available to any eligible person and will provide life-long protection against the disease. While protecting yourself against mosquito bites is important to reduce the risk of many diseases, only vaccination can eliminate the risk of yellow fever outbreaks," she added.

Yellow fever is a viral disease that is transmitted by certain types of mosquito. Infection can cause fatal illness, including jaundice, and death, and can spread rapidly, locally and internationally, especially in urban areas. However, the disease can be prevented by a single dose of a highly effective and safe vaccine. This campaign aims to boost protection in the general population and will target all eligible people.

Sudan is at high risk for the spread of yellow fever due to a combination of climate and ecological factors, and because there are still areas of low population immunity. Recent years have seen global changes in the epidemiology of yellow fever, with outbreaks occurring in areas that were not previously assessed as being at high risk.

"We are observing a changing nature in yellow fever disease dynamics. It is very important that every eligible person in this campaign receives the vaccine to protect themselves, their families and their communities," said Professor Dr. Babkir Kabaloo, Undersecretary of the Federal Ministry of Health.

"The current campaign represents one of the final phases in the Ministry's efforts to protect the entire nation against yellow fever outbreaks. This campaign will cover Blue Nile, Gezira, and Sennar states. In the coming months, the remaining states of Khartoum, Northern and River Nile will also be covered, completing the protection of the entire Sudanese population," he added.

Sudan's health authorities and partners are working to introduce yellow fever vaccine in the national immunization schedule in the near future. This will help ensure the protection of the whole population and generations to come against this fatal but preventable disease.
=====================
[It is good to see this ambitious yellow fever (YF) vaccination campaign drawing to a close. Incorporating YF vaccine into routine childhood vaccination schedules is prudent and if successful will eliminate the need for intensive, country-wide campaigns to deal with outbreaks. YF is no stranger to Sudan. Between 3 Oct and 24 Nov 2013, a total of 44 confirmed cases of YF were reported, including 14 deaths. A total of 12 localities in West and South Kordofan were affected by that outbreak. There was a large YF outbreak in the Darfur state in 2012-2013. In 2012, the World Health Organisation (WHO) said that more than 840 people were infected with YF in Darfur and that the epidemic affected 35 of 64 localities in the region since September 2012. The total recorded cases of YF in Greater Darfur hit 849 with a 20% death toll during an epidemic in 2012 (see WHO Disease Outbreak News <http://who.int/csr/don/2012_12_03/en> as reported by ProMED post http://promedmail.org/post/20130125.1513849, as noted at the time by Mod.JW). Mounting campaigns in the face of these types of outbreaks is inefficient, logistically difficult, and costly -- financially and in terms of human lives. - ProMED Mod.TY]

[HealthMap/ProMED-mail map:
Date: Thu 21 Mar 2019
Source: SBS News, Australian Associated Press (AAP) report [edited]

An egg recall has been announced following the discovery of a _Salmonella_ outbreak at a Victorian egg farm. The scare has prompted a recall of some brands of eggs from outlets in 4 states.

To date, 5 cases of _Salmonella [enterica_ serotype] Enteritidis have been linked to eggs produced by Victoria's Bridgewater Poultry, the state's health department said on [Thu 21 Mar 2019]. The company's free-range and barn-laid eggs are packaged as Woolworths brand, Victorian Fresh, and Loddon Valley, with best-before dates ranging from [20 Mar to 29 Apr 2019]. They are on shelves in Victoria, New South Wales, Tasmania, and South Australia. All other eggs are safe to eat, Chief Health Officer Brett Sutton said.

"It is important to know that not all eggs are affected, but any eggs carrying the listed brands should return them to the point of sale for a full refund. Alternatively, they can be discarded by throwing them into the garbage, not the garden or compost. "These eggs should not be given to pets or livestock."

Vulnerable people, including the elderly, are urged to avoid eating raw egg products.

Eggs of concern:
- Woolworths 12 Cage Free Eggs 700 g
- Victorian Fresh Barn Laid Eggs 600 g
- Victorian Fresh Barn Laid Eggs 700 g
- Victorian Fresh Barn Laid Eggs 800 g
- Loddon Valley Barn Laid 600 g (Victoria and South Australia only)
========================
[Salmonellosis is often thought to be associated with cracked eggs or eggs dirty with faecal matter, a problem controlled by cleaning procedures implemented in the egg industry. It is clearly the case, however, that most of the salmonellosis outbreaks linked to eggs were associated with uncracked, disinfected grade A eggs, or foods containing such eggs. The undamaged eggs become contaminated during ovulation, and thus were contaminated with the bacteria before the egg shell was formed. To avoid this, uncooked eggs should only be used as an ingredient, if pasteurized. - ProMED Mod.LL]

[Maps of Australia:
Date: Wed 20 Mar 2019 3:50 PM EDT
Source: The Day [edited]

Groton [New London county] public health officials are reminding residents to refrain from feeding or approaching wild or stray animals after a dog found in the area of Midway Oval tested positive for rabies [Wed 20 Mar 2019].

Rabies is a deadly disease caused by a virus that can infect all warm-blooded animals, including people, the Ledge Light Health District said in an alert sent to media outlets.

The disease mostly is spread by wild animals, but stray cats and dogs may also become infected and spread the virus, the district's alert said. The rabies virus lives in the saliva and brain tissue of infected animals, and the disease can be spread by scratches from infected animals or when infected saliva comes into contact with open wounds, breaks in the skin or mucous membranes, including the eyes, nose and mouth.

For more information, contact Ledge Light Health District at (860) 448-4882, extension 1311, or the animal control officer at (860) 441-6709.
======================
[HealthMap/ProMED-mail map of Connecticut, United States:
Connecticut county map:

Please keep your animals up-to-date on their rabies vaccine. It is for their protection and for your protection.

Regarding the 1st article, it sounds like South Carolina could consider using some oral rabies vaccine bait for some of their wild animals.

Unfortunately, wild animals may attack even when you are unaware of their presence.

Animals may be either unusually friendly and timid (dumb rabies) or aggressive and vicious (furious rabies). These are 2 presentations of the same disease but we should be aware of both forms and teach both forms to our children. - ProMED Mod.TG]
Date: Wed 20 Mar 2019
Source: Aiken Standard [edited]

[One person] in Aiken county may have been exposed to rabies following an unfriendly encounter with a wild raccoon, according to the South Carolina Department of Health and Environmental Control [DHEC].

According to a DHEC press release, the victim was on the North Augusta Greeneway Walking Trail on 16 Mar 2019 when they were bitten by a raccoon. The raccoon was later submitted to DHEC and tested positive for rabies. [Apparently the DHEC knows there is a victim so their earlier statement of "may have been exposed" seems a bit odd. - ProMED Mod.TG]

The victim who was bitten has since been referred to their health care provider. The raccoon on the Greeneway trail was the 3rd animal diagnosed with rabies in Aiken county this year [2019]. Statewide, there have been 32 confirmed cases of rabies in 2019. Coyotes, foxes, and skunks are also common carriers of the virus. Although it is extremely rare in people, rabies can be spread to humans and can also claim the lives of pets. The virus causes hallucinations, hydrophobia (fear of water), aggression, and death in its final stages.

Rabies is normally spread through bites but can also be spread when open wounds or areas like the eyes, nose, or mouth come into contact with saliva or blood of an infected animal. Infected areas should be washed with soap and water and medical attention should be sought immediately.  If a wild animal is foaming at the mouth and shows a lack of motor control (stumbling, staggering, or bumping into things) it may have rabies. Rabid animals are often very aggressive and do not fear people or other animals. [This behaviour may describe raccoons with distemper, but although they are not usually aggressive with distemper, they can be. The point is, when an animal is not acting normally it is time to move on and leave it alone and report it to the authorities in your area. - ProMED Mod.TG]

"To reduce the risk of getting rabies, always give wild and stray animals their space," said David Vaughan, Director of DHEC's Onsite Wastewater, Rabies Prevention, and Enforcement Division. "If you see an animal in need, avoid touching it and contact someone trained in handling animals, such as your local animal control officer or wildlife rehabilitator."

DHEC also stresses the importance of keeping pets up to date on their rabies shots to prevent the spread of the disease. For more information, call DHEC's Environmental Affairs Aiken office at 803-642-1637 during normal business hours on weekdays.  [Byline: Kristina Rackley]
========================
[HealthMap/ProMED-mail map of South Carolina, United States:
South Carolina county map:
Date: Thu, 21 Mar 2019 16:10:28 +0100

Kinshasa, March 21, 2019 (AFP) - A six-month-old baby in the eastern DR Congo city of Bunia has died of Ebola, becoming the first fatality of the disease in a provincial capital, the heath ministry said Thursday.   Bunia, which has a population of 300,000, is the capital of Ituri province, which along with neighbouring North Kivu province has been battling an epidemic of Ebola since last August.

The baby is among 610 fatalities out of 980 recorded cases, the ministry said in a statement.   "The parents are apparently in good health," it said.   "Extensive investigations are underway and will include, among other things, analysis of the maternal milk to identify the source of contamination."   The ministry added that it had also registered 97 new cases in the previous three weeks.   This increase "was expected" given the impact of an attack on two Ebola treatment centres by armed groups in the troubled region, it said.
Date: Thu, 21 Mar 2019 22:32:17 +0100

Blantyre, Malawi, March 21, 2019 (AFP) - Heavy rains could cause a dam in southern Malawi to give way if there is no let-up, authorities said Thursday, urging local residents to take shelter.   The warning came after cyclone Idai battered neighbouring Mozambique last Friday killing 242 people    Hurricane-force winds and rains have also ravaged hit eastern Zimbabwe where over 100 have died.

In Malawi, the storm has affected nearly a million people with over 80,000 displaced, according to the WHO.   The Chagwa dam "has had one of its major embankments eroded due to heavy rains," the interior security ministry said in a statement. "(It) is likely to burst in the event of heavy and incessant rains."   The statement advised local residents in the southern African country to evacuate "in case of an emergency".