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Argentina

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

Ambassador:
Her Excellency Paula Ní Shlattara
Secretary:

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

CHILDREN'S ISSUES: For information see our Office of Children's Issues web pages on intercountry adoption and international parental child abduction.
REGISTRATION / EMBASSY LOCATION: Americans living or traveling in Argentina are encouraged to register with the U.S. Embassy through the State Department’s travel registration web site, so that they can obtain updated information on travel and security within Argentina. Americans without Internet access may register directly with the U.S. Embassy. By registering, American citizens make it much easier for the Embassy or Consulate to contact them in case of emergency. The U.S. Embassy is located at Avenida Colombia 4300 in the Palermo neighborhood of Buenos Aires (near the Plaza Italia stop on the "D" line subway). The main Embassy switchboard telephone is (54) (11) 5777-4533. Recorded consular information, including instructions on whom to contact in case of an American citizen emergency, is available at tel. (54) (11) 4514-1830. The Consular Section fax is (54) (11) 5777-4293. The Consular Section is open to the public from 8:30 a.m. to noon and 2:30 p.m. to 4 p.m. Monday through Friday, except on American and Argentine holidays. Additional information on Embassy services is available on the Internet at http://argentina.usembassy.gov or by e-mail: BuenosAires-ACS@state.gov
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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: Tue 9 Apr 2019
Source: El Tribuno [in Spanish trans. ProMED Mod. TY, edited]

Authorities of the Jujuy Ministry of Health yesterday [8 Apr 2019] confirmed that 11 cases of hantavirus [infections] are confirmed in the province, distributed in the localities of San Pedro, Palma Sola, Libertador General San Martin, and Calilegua.  "The majority of the affected people have a history of having gone fishing or hunting in the forest," and so "probably did not take the necessary precautions", stated the Jujuy Subsecretary of Prevention for Health, Veronica Serra.

The official stated that 11 hantavirus [infection] cases have been confirmed so far this year [2019], "all of them in the Jujuy Ramal [area]' she said.

Concerning the medical treatment of the infected people, she indicated that some have "greater cardiopulmonary complications than others, but progress favourably," she stated.

Jujuy has registered cases of hantavirus [infections] since 1996, with a yearly average of 17, which generally appear in the summer season. In 2018 there were 7 cases with no fatalities.

Taking these data into account, so far in 2019 there are now 57% more cases compared to last year [2018].

"The majority of the cases are registered until the month of April and we hope that they are maintained within [numbers] expected for this year [2019]," she said, and recalling that more than 20 years ago the cases, "were much higher."

The confirmed [patients] this season were [infected] in the cities of San Pedro, Libertador General San Martin, Calilegua, and in the localities of Aguas Calientes, Palma Sola, and El Remate. Hantaviruses cause an acute virus disease. Wild mice (mainly the long-tailed] mouse) transmit [the virus] to people, and shed the virus in saliva, faeces, and urine.

The most frequent route of infection is by inhalation and occurs when breathing in open or closed places (sheds, gardens, pastures), where faeces or urine of infected rodents shed the virus, contaminating the environment. Other ways to contract the disease are by direct contact, that is to say, touching live or dead infected rodents or the urine or faeces of these rodents and person to person when there is close contact with an infected person during the 1st symptomatic days, through aerosols.

The symptoms of hantavirus [infections] are flu-like: fever, muscle pain, chills, headache, nausea, vomiting, abdominal pain, and diarrhoea. After a few days, respiratory difficulty may appear and get worse.
======================
[The hantaviruses responsible for these 11 cases are not stated in the report above. An earlier report from Jujuy province this year (2019) apparently presumed that the hantavirus involved in that case was Laguna Negra, although it is not stated that this virus had been laboratory confirmed. As noted in ProMED-mail archive no. http://promedmail.org/post/20110430.1348, several hantaviruses have been associated with human infection and hantavirus pulmonary syndrome in Argentina: Andes virus (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]

[Maps of Argentina:
22 Mar 2019
Argentina (Santa Fe province and national).

(Conf.) 180 cases. Municipality most affected: Santa Fe 105 cases. Nationally, the localities with dengue cases are: Ingeniero Juarez (Formosa province), Puerto Iguazu (Misiones), Los Blancos, Oran, and Tartagal (in Salta); Santa Fe, Rosario and Buenos Aires cities; the partido La Matanza and the department of Ledesma in Jujuy. DEN-1 virus circulating with 2 patients with DENV-4. 36 cases with history of travel to Brazil, Bolivia, Colombia and Dominican Republic.
Date: Mon 28 Jan 2019 19:10 ART
Source: Tiempo Sur [in Spanish trans. ProMED Mod.TY, edited]

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

General:
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The Republic of Maldives is a series of over 1190 islands which are situated southwest of Sri Lanka. Frequently Irish tourists will combine these two destinations in a single holiday and enjoy the
pleasures of both destinations. The islands of the Maldives are spread over one million square kilometers and there are 26 atoll formations. The facilities for tourism is well developed throughout the resort islands and
straying away from these more built up regions will require advance approval. The climate is tropical with fairly consistent rainfall and temperatures throughout the year. The more northern islands are most commonly affected by cyclones and the rainfall in the southern regions tends to be between November to March. Temperatures are usually fairly consistently above 20C.

MALDIVES TOURIST BOARD WEB PAGE
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The web site http://www.visitmaldives.com/intro.html gives a potential visitor an excellent insight into the Islands and the range of facilities which they have to offer.
Safety and Security:
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Crime rate on the Maldives is low although tourists should be aware that they should take care of personal belongings at all times. It is wise to use the hotel safe deposit boxes on the island resorts.
Health Facilities:
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The medical facilities within the Maldives is limited to the main resorts. There are two hospitals on the main island (Male) and the cost of treatment can be high. Having personal health insurance is a wise precaution.
Transport within the Islands:
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The main means of transport between the islands tends to be by boat or seaplane. Only very few of the islands have cars but this is not generally a problem for tourists. In the main capital of Male the traffic moves on the left side of the road and there are taxis if required. Water taxis called ‘Dhonis’ are available between the airport and the capital and also to some of the outlying islands. The Air Taxi service stops one hour before sunset.
Food & Water Facilities:
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The tourist resorts have a high level of hygiene and the risk of significant illness among those who follow sensible food and water hygiene is small. Avoiding all bivalve shellfish is usually a wise precaution and this includes oysters, mussels and clams. The water in the main resorts will be chlorinated but check this on arrival. If unsure it will always be wiser to use sealed bottled water for drinking and brushing your teeth.
Malaria & Rabies Risk:
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There is no malaria or rabies transmission on the Maldives though avoidance of both mosquitoes and animals is always a wise precaution.
Water Sport Facilities:
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Those undertaking water sport activities and scuba diving should be aware that rescue facilities are not always easily available in all regions. There are decompression facilities available but these may be located at some distance from where the incident occurs. Make sure that you always choose to use one of the better maintained providers. If you are unhappy about their apparent level of expertise and care for their clients, change to a different provider but don’t take risks.
Sun Exposure:
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The level of direct sunlight throughout the islands is high and visitors should take special care with regard to the possibility of sun exposure and dehydration. Sea swimming should be in the company of others and take care to listen to local advice.
Local Laws & Customs:
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Throughout the Maldives their practice Islam and the overt public observance of any other religion is not permitted. In the past few years a number of non-Maldivian families have been expelled for religious activities. Tourists are permitted to carry personal religious texts (Bible etc) without difficulty. There are no cash dispensing machines and travellers cheques are used infrequently. The island resorts tend to be expensive and visitors should carry sufficient funds. Dress is usually informal but topless bathing is prohibited.
Vaccinations for the Maldives:
***************************************
Unless you are flying from tropical Africa there are no essential vaccines for entry or exit. However for your own personal health it is recommended that travellers are covered against the following diseases;
*
Poliomyelitis (childhood booster)
*
Tetanus (childhood booster)
*
Typhoid (food & water borne disease)
*
Hepatitis A (food & water borne disease)
For those considering a longer or more rural trip over vaccines may be considered including Hepatitis B.
Summary:
***************************************
Most Irish travellers to the Maldives will enjoy a splendid relaxing holiday in this beautiful series of islands. Nevertheless, commonsense and care are essential with some predeparture planning to ensure that all your travel plans run smoothly.

Travel News Headlines WORLD NEWS

Maldives - National. 2 Apr 2019

1303 cases of dengue and chikungunya reported, and viruses definitely on the rise now.
17th February 2019

- National. 12 Feb 2019. 107 cases of dengue reported so far in February [2019]: 16 cases in capital Male' and 91 in the outlying atolls. 237 cases of dengue were reported in the Male' region alone in December [2018], and the total number of cases in atolls has reached 321.
Date: Thu 7 Feb 2019
From: Taiichiro Kobayashi <tkobayashi@cick.jp> [edited]

[re: Dengue/DHF update (03): Asia (Japan ex United Arab Emirates) http://promedmail.org/post/20190201.6290139, Dr. Kobayashi shared the following information for correction to his earlier contribution on Promed-mail.]

"After publication of this information on ProMED-mail, the patients described to us a true story. They travelled not only UAE but also Maldives from [31 Dec 2018 to 4 Jan 2019]. The reason why they didn't share the information about their Maldives stay was a private issue. But we don't want to confuse the society. Finally, we diagnosed that these patients were infected with dengue fever in Maldives, not in UAE.

"We deeply apologize for our misinformation. We learned that clinicians could make a mistake about the origin of imported infectious diseases because clinicians have to get information on itinerary only by patients' testimony."
----------------------------------------
Communicated by:
Taiichiro Kobayashi MD, DTM&H, MCTM, PhD
Department of Infectious Diseases
Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome
Hospital
3-18-22 Honkomagome, Bunkyo-ku,
Tokyo 113-8677, Japan
=======================
[ProMED appreciates Dr. Kobayashi's update on the previously submitted report.   This highlights the fact that a lot of information related to travel is based on patient's or their family accounts, which may be incomplete or even misleading. That being said, key epidemiological information on the location of early cases of a novel disease or an impending outbreak is often closely linked to travel history and the endemic diseases in the visited areas. - ProMED Mod.UBA]

[HealthMap/ProMED maps available at:
Date: Tue, 22 Jan 2019 13:10:25 +0100

Colombo, Jan 22, 2019 (AFP) - Five tourists including a honeymooning couple have drowned in a single week in the Maldives, officials said, prompting a nationwide safety warning to holiday resorts in the pristine islands.   Tourism officials said all resort operators in the paradise archipelago were urged Monday to keep a close eye on their clients after the spate of deaths.

Strong currents caused by a north-east monsoon were blamed for the slew of drownings in the idyllic atoll nation, where such accidents are usually few and far between.   Around 1.4 million tourists visit the Maldives every year but the latest government data shows just 31 people drowned in 2017.

On January 13, two Filipino newlyweds were swept to their deaths by a powerful undertow.   The man got into trouble and his wife went to his aid, but both perished. Their bodies were recovered and repatriated to the Philippines, officials said.    An 84-year-old Czech tourist and a 66-year-old South Korean woman died within two days of each other at a resort near the capital Male while snorkelling.   A Russian woman on a dive trip was the latest casualty on Sunday.

A Pakistani holidaymaker came close to death but was plucked to safety and taken to hospital.   The tourism ministry was in the process of identifying safe zones for ocean swimming and diving after the spike in drownings, officials said.   The Maldives relies on tourism and visitors come for the turquoise waters and white sand beaches of the islands scattered some 800 kilometres (500 miles) across the equator.
Date: Mon, 24 Sep 2018 12:52:15 +0200

Colombo, Sept 24, 2018 (AFP) - The Indian Ocean island nation of the Maldives is famed as an upmarket tourist destination of white beaches and turquoise waters but is threatened by rising sea levels and endured stifling political control.   After the surprise election win of opposition leader Ibrahim Mohamed Solih in weekend elections, here is some background about the Muslim nation.

- Indian Ocean paradise -
The country is a collection of 1,192 tiny islands scattered 800 kilometres (550 miles) across the equator.   Only 200 islands are inhabited with the country's population put at 340,000 in the last census in 2014.   Tourism is the principal income earner, providing 41 percent of gross domestic product (GDP) in 2016 and nearly 20 percent of jobs, the World Travel and Tourism Council says.    The archipelago's beauty drew nearly 1.4 million foreign visitors in 2017, with the destination especially prized among honeymooners.

- Politically tense -
Maumoon Abdul Gayoom ruled with an iron fist for 30 years until 2008 when he lost the first-ever multi-party poll to human rights activist Mohamed Nasheed.   Nasheed was forced to resign in 2012 after a police mutiny and demonstrations that he said were part of a coup plot.

In disputed elections the following year, he was defeated by Gayoom's half brother, Abdulla Yameen, a strongman president who was defeated in elections Sunday.    Yameen, whose regime has been bankrolled by China in a departure from the country's traditional alliance with India, imprisoned or forced into exile all his main rivals while curtailing press freedom and social networks.    Nasheed, who became an opposition leader, was jailed in 2015 on a terrorism charge widely criticised as politically motivated.

The following year he was granted prison leave for medical treatment in London, where he secured political asylum with the help of high-profile human rights lawyer Amal Clooney.   In February this year judges ordered the release of jailed opponents of Yameen, who hit back with a 45-day state of emergency, suspending the constitution and arresting the Chief Justice and another judge of the Supreme Court.   His aged half-brother Gayoom was also jailed for allegedly conspiring with the Supreme Court to topple him.

- Threatened by rising seas -
Eighty percent of the Maldives is less than a metre above sea level, making it one of the countries most threatened by rising sea levels linked to climate warming.   In 2009 Nasheed held a cabinet meeting underwater to raise awareness of the risk, also warning his people could become climate refugees.

- Buddhist turned Muslim -
Situated along Indian Ocean trading routes and about 650 kilometres southwest of Sri Lanka, the Maldives has been colonised several times.    Once a Buddhist kingdom, it converted to Islam around the 12th century.    Portuguese explorers occupied the main island of Mahe in the 16th century. The territory then became protectorates of the Dutch and the British before complete independence in 1965.    Sunni Islam today remains the state religion, all other religions being
banned.

The Maldives follows a moderate version of Islam while banning alcohol, except in tourist hotels, and homosexuality.    It also flogs women found guilty of "fornication", says Amnesty International, which is critical of a human rights situation that it says includes restrictions on peaceful protests and expression.   The Maldives left the Commonwealth in 2016 in a row over criticism of its rights record.   There are fears of radicalisation with the arrival of Middle East preachers and via radical websites.
More ...

South Korea

General Information
****************************************
The land mass of Korea is currently divided into North and South since World War 11. The South is a democratic Republic and there are extensive tourist facilities available throughout
he main urban areas. The national tourism organisation (KNTO) operates an English language web site (http://www.knto.or.kr) which provides useful information for intending tourists.
Weather Profile
****************************************
South Korea has four distinct seasons throughout the year. The winters can be very cold while the summers hot and very humid. The rainfall is mainly concentrated during the summer season.
Overcoming Jet Lag
****************************************
ry to arrange your flights so that you arrive in plenty of time before the first match. Allow 48 hours if at all possible to get over the inevitable jet lag. Walk about on the flight, drink plenty of water and stay off the alcohol. Flight crews are understandably very sensitive nowadays about any disturbance and the last thing you will want is to be dumped off the flight to make your own way home. Sleep on the plane if possible though remember this may increase the risk of blood clots so move your legs about when awake. Talk to your doctor about taking aspirin if you are at higher than normal risk (older age group, over weight, on the contraceptive pill, varicose veins etc).
Arriving into Seoul
****************************************
The new Incheon international airport is an hour or two away from Seoul and there are no subways or rail systems connecting the airport to the city. However, buses and taxis are easily available. Customs facilities are good but careful so remember not to carry any parcels for another unless you are certain of the contents. A departure tax may be payable on leaving South Korea.
Personal Safety
****************************************
In Seoul, like any other major city, there is an increased risk of petty crime (pickpocketing, purse snatching etc) so take extra care of your belongings - especially in crowded places like markets, local buses and football matches! The Itaewon and other large markets are known risk areas for this type of activity. Use the hotel safe for your main valuables and carry little of importance while out and about.
Emergency Numbers
****************************************
In South Korea the emergency number for the main services is 112. The operators will usually speak good English. There is also a 24/7 service available through the Korean National Police where travellers can report crime etc. The number in Seoul is 313-0842 and in other regions 02-313-0842.
Medical Services
****************************************
Generally the level of health facilities throughout most of the main urban centres is excellent. However, treatment can be expensive and the medical providers will expect payment before treatment is started. Make sure your travel health insurance is adequate for your journey.
Road Safety
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The road infrastructure throughout most of South Korea is excellent. However, accidents do occur and if hiring a car ‘defensive’ driving is essential at all times while abroad. Safety belts are compulsory at all times for both front and rear seats. Any accident tends to lead to long delays as the paperwork is sorted out. The Koreans may at times drive their motorbikes and scooters on foot pavements so care should be taken at all times.
Customs Regulations
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The level of security at South Korean immigration is high so beware of the delays which may be incurred.
Food & Water Care
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While travelling it is essential that care is taken to protect your stomach against unnecessary risk. Generally tourists will be keen to try out the local cuisine but this can lead to days of illness. In most circumstances it is wise to stick to hot, freshly cooked food fruit you peel yourself. Bivalve shell fish (mussels, clams, oysters etc) are seldom cooked sufficiently to sterilise them completely and are best avoided. Undercooked fish (Sushi) or any meats should also be avoided.
Heat & Humidity
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The summer months in South Korea are hot and sticky. It will be important to have the right clothing (light weight loosely fitted cotton) and to drink plenty of water to replace what is lost through dehydration. Salt will also need to be replaced and providing there is no medical contraindication eating crisps, salted nuts etc is an excellent way to replenish your levels.
Avoiding Prickly Heat
****************************************
The term prickly heat is used in a variety of ways but the cause is generally the same. In a hot climate the body perspires to maintain the internal temperature at a correct level. In the perspiration there will be fluid and your personal salts. The fluid evaporates but the salt dries against the skin. It is your individual reaction to this salt that leads to the ‘prickly heat rash’. The reaction to these salts can be minimised by removing the salts from the skin surface as soon as possible. Change your clothes regularly, use plenty of talcum powder to absorb the perspiration and dry off well after showering.
Breathing the air
****************************************
Any of the airborne diseases are most commonly spread when folks crowd together. International football matches, market places, local transport and the cinema are times when exposure and infection are most likely. Carrying some simple cold remedies might be a wise precaution and avoid the crowds where possible!
Vaccines for your trip
****************************************
In most cases the only particular problem for those visiting either Japan or South Korea will be the risk of Hepatitis A (food and water spread). Of course Tetanus and various other food and water problems can occur but generally the risk is small providing a sensible approach is taken to act sensibly.

Travel News Headlines WORLD NEWS

Date: Wed, 21 Nov 2018 09:39:44 +0100

Seoul, Nov 21, 2018 (AFP) - Tens of thousands of workers launched a half-day strike across South Korea Wednesday, accusing the government of rolling back pro-labour policies in the face of deepening economic woes.   Some 40,000 of those who put down tools -- including some in the auto industry -- rallied in Seoul and 13 other cities, the Korean Confederation of Trade Unions (KCTU), a major labour umbrella group, said.   An AFP journalist in the capital said a crowd of around 10,000 workers gathered outside the country's parliament wearing red headbands, chanting slogans and waving banners, as hundreds of riot police took positions nearby.   The KCTU estimated 160,000 affiliated workers would join the walkout nationwide.

A government move to introduce greater flexibility to the country's maximum 52-hour work week -- to adjust to fluctuations in demand -- has particularly angered workers.    They are also calling for liberal president Moon Jae-in's government to deliver on election promises to raise the minimum wage from 7,530 won (US$6.66) to 10,000 won (US$8.85) by 2020.    Earlier this month, Moon sacked his top two economic officials, as the world's 11th-largest economy struggles with slowing growth, rising unemployment and persistent income gaps.   These difficulties have hit the president's approval ratings, now at 52 percent -- a drop of 13 percentage points over five weeks, according to Gallup Korea.
Date: Sat, 6 Oct 2018 13:31:00 +0200

Seoul, Oct 6, 2018 (AFP) - Two people died and one person is missing in South Korea as powerful typhoon Kong-Rey hit the country on Saturday, the government said.    A 66-year-old man died while crossing a bridge in the city of Gwangju, south of Seoul, the national disaster management agency said without elaborating on the cause of the death.

Another man, aged 83, was found dead after being washed away by a river in a southern county of Yeongdeok, while a 76-year-old went missing after falling into a river in the southern port of Pohang.    The powerful typhoon dumped heavy rain across the country from Friday before moving away from the peninsula Saturday afternoon. 
Date: Sat, 8 Sep 2018 13:02:52 +0200

Seoul, Sept 8, 2018 (AFP) - South Korea reported its first case of Middle East Respiratory Syndrome (MERS) in three years, health officials said on Saturday.   A 61-year-old businessman was diagnosed with the highly contagious viral respiratory illness, according to officials at the Korea Centers for Disease Control and Prevention (KCDC).   He returned to South Korea Friday from a business trip in Kuwait where he stayed for three weeks, the KCDC said a statement.

"Authorities have traced and separated 20 people who have come in close contact with the infected person," KCDC head Chung Eun-gyeong told journalists.   They include medical staff, flight attendants and passengers of the plane the man flew back to South Korea on, she said.    He was hospitalised with fever and phlegm and has been quarantined at a university hospital, she added.   It is the first case of MERS diagnosed in South Korea since 2015, when an outbreak killed 38 people and triggered widespread panic.
Date: Sat 8 Sep 2018
Source: Yonhap News (4th LD - update) [edited]

A patient in Seoul was diagnosed on Saturday [8 Sep 2018] with the 1st case of Middle East Respiratory Syndrome (MERS) in South Korea since 2015. The 61-year-old man, whose personal information was withheld for privacy reasons, was diagnosed with the disease at about 4 p.m. Saturday [8 Sep 2018], the Korea Centers for Disease Control and Prevention (KCDC) said. It is the 1st case of MERS diagnosed in South Korea since 2015, when an outbreak killed 38 people and triggered widespread panic.

According to the KCDC, the man took a business trip to Kuwait from [Thu 16 Aug 2018 to Thu 6 Sep 2018] and returned home via the United Arab Emirates on Friday [7 Sep 2018]. He visited a local hospital during his stay in Kuwait for diarrhea but showed the same symptom again on his way back home. He was rushed to the emergency room of Samsung Medical Center in southern Seoul upon his arrival at Incheon International Airport.

The Samsung hospital checked the patient in an isolated section of the emergency room and reported him to the health authorities as a suspected case of MERS for showing symptoms of fever, phlegm, and pneumonia. He was then moved to Seoul National University (SNU) Hospital in central Seoul and tested positive for the disease.

"The man currently is not in critical condition and does not have such symptoms as shortness of breath and a decrease in blood pressure, but we have to watch him closely, because his conditions may deteriorate in the next 1-2 weeks judging from our experiences from the previous outbreak," Kim Nam-jung, a doctor treating the patient at the SNU Hospital, said.

MERS is a viral respiratory disease with a fatality rate of 20-46 percent. It is caused by a novel coronavirus carried by camels and can be spread when someone is in close contact with a patient for a sustained period.

A total of 20 people, including flight attendants and medical staff, are under isolation at home for coming in close contact with the patient, but the number could rise in the future, the KCDC said.

The authorities believe there is a high chance that the patient was infected with the disease in Kuwait, because he stayed in Dubai for only a short time for a transfer. The government said it will try to find out if any Koreans were infected with the disease after being in close contact with him in Kuwait.

"We don't see that the patient was exposed much to regional society since he was isolated upon his arrival at the Samsung hospital," Jeong Eun-kyeong, director of the KCDC, said during a press briefing at the Central Government Complex in Seoul. "We'll do our best to investigate and manage people who contacted him in order to prevent any secondary infections."

As part of efforts to effectively control the new outbreak, the government raised the status of the KCDC to that of a vice-ministerial level organization. Prime Minister Lee Nak-yon instructed the Ministry of Health and Welfare to do all it can do to prevent the possible spread of the viral respiratory disease.

"We should prevent the possible spread of MERS by quickly and thoroughly conducting an epidemiological investigation," Lee told the health minister after being briefed on the new outbreak. Lee will preside over an emergency meeting of relevant ministers to discuss measures to prevent the disease's spread on Sunday [9 Sep 2018] afternoon, according to his office.
======================
[As a reminder, during the period of late May through early July 2015, there was a major outbreak of MERS-CoV in South Korea, with a total of 185 cases reported from South Korea and one additional case who travelled from South Korea to China, where he was diagnosed and treated. The index case was a business man who had travelled to the Middle East (multiple countries including Bahrain and Saudi Arabia). The index case did not give a history of travel to the Middle East when evaluated in the medical facilities he sought assistance. Unfortunately, he was a "superspreader," and a number of individuals he infected were also superspreaders. The situation of healthcare management and health facility-seeking behavior on the part of the population led to multiple hospitals involved in this outbreak and a total of 186 cases associated with this event. (I suggest a journey through the "see also" list below to see that outbreak as it unfolded.) Many lessons were learned from that outbreak that are reflected in the management of this current case as reported by the news media reports included above. A travel history of this current case was identified at the 1st encounter of this patient by the health sector, and the patient was evaluated in a secluded area of the emergency room (which was not the realities during the 2015 outbreak, as many patients roamed freely in emergency rooms when 1st seen by the health sector).

This current case gives a history of travel and work in Kuwait, with a short stopover in Dubai en route home. He also gives a history of being seen at a health facility in Kuwait with a diarrheal illness (diarrhea can be part of the presenting symptoms with a MERS-CoV infection), so it is possible he was already infected with the MERS-CoV leading to his medical visit in Kuwait. It is also possible that the diarrheal incident was not due to a MERS-CoV infection, and he may have been seen in a health facility where there was another patient with active MERS-CoV infection that had not been diagnosed. I suspect that over the next few days more information on this will become available and will be reflected in either direct Ministry of Health (MOH) press releases and/or a report from the MOH submitted to the WHO Emergencies, Preparedness and Response Disease Outbreak News.

According to the ECDC Risk Assessment of Fri 24 Aug 2018, Kuwait has reported 4 cases of MERS-CoV infection, and Dubai has not reported any cases since MERS-CoV was identified in September 2012 (see <https://ecdc.europa.eu/sites/portal/files/documents/RRA-Severe-respiratory-disease-associated-MERS-CoV-22nd%20update-29-aug-2018.pdf>). Of additional note is that Thailand reported a case of MERS-CoV infection ex Kuwait in 2016, suggesting that there is MERS-CoV transmission in Kuwait, albeit rarely reported through the years. Hence, it is highly likely transmission occurred during this patient's travel to and within Kuwait. - ProMED Mod.MPP]

[HealthMap/ProMED-mail maps:
Date: Thu, 12 Apr 2018 06:40:28 +0200

Seoul, South Korea, April 12, 2018 (AFP) - One person died and a dozen tourists were injured in a hot air balloon crash on South Korea's popular resort island of Jeju Thursday morning, police said.   The balloon was carrying 12 passengers and a pilot -- who suffered a head injury and was later pronounced dead -- police said, adding they were investigating the cause of the crash.

Photos showed the deflated balloon draped over forest trees, with the basket lying on the ground.   "It appears that the hot air balloon somehow fell rapidly and crashed into the trees," South Korea's Yonhap news agency quoted an unnamed rescue worker as saying.

All 12 passengers suffered minor injuries and were being treated in hospital, police said, without giving their nationalities.   The island off the southern coast of the peninsula is a well-known holiday destination for South Koreans as well as a growing number of Chinese tourists.    More than 15 million people visited the island last year.
More ...

World Travel News Headlines

Date: Fri, 19 Apr 2019 04:57:44 +0200
By Fran BLANDY

Udier, South Sudan, April 19, 2019 (AFP) - By the time he was brought into the remote clinic in northeastern South Sudan, two-year-old Nyachoat was already convulsing from the malaria attacking his brain.   After being given medication he lies fast asleep, naked and feverish, attached to a drip, his anxious mother sitting on the bed next to him.   Nyachoat could be saved, but others are not so lucky.   In South Sudan mind-bending horrors abound of war, ethnic violence, rape, hunger and displacement.

But for civilians living in the shadow of conflict, the greatest danger is often being cut off from health services, whether due to violence or lack of development in the vast, remote areas that make up much of the country.   According to the International Committee of the Red Cross (ICRC), which supports the tiny clinic where Nyachoat is recovering in Udier village, 70 percent of all illness deaths are due to easily treatable malaria, acute watery diarrhoea and respiratory infections.   In case of more serious illness there is "no place" to go, said Nyachoat's 22-year-old mother Buk Gader.

A study by the London School of Hygiene and Tropical Medicine (LSHTM) last year showed almost 400,000 people had died as a result of South Sudan's nearly six-year war.   Half of these were due to violent deaths, and half because of the increased risk of disease and reduced access to healthcare as a result of the conflict.   ICRC health field officer Irene Oyenya said the Upper Nile region was particularly affected.   "There were (aid) organisations which were supplying primary healthcare, but then during the war, most of the organisations got evacuated" and pulled out of the country, she said.

- Blocked by swamps -
Udier is a village with a dirt airstrip whose sun-baked sand, which when not used by twice weekly ICRC flights bringing medicine and supplies, serves as a football pitch for youths. It is also a pedestrian highway for those who come from far flung huts and cattle camps to market.   In the tiny market, there is little fresh food available. Villagers can buy red onions or sit for a strong Sudanese coffee, infused with ginger, while in the dry season nomadic Falata herdswomen in flowing dresses sell milk from their cattle.   A brick building next to the airstrip, its roof long blown off in a storm, is the village school, but for several days in a row no teacher shows up.   In the surrounding villages, women are hard at work mudding their huts and re-thatching the roof in anticipation of the rains to come within weeks.

When they do come, swelling the swampy marshlands and rivers for miles around, roads will become impassable.    It becomes "difficult for young children to swim or women or men to carry patients to reach here," said Oyenya.   Marginalised for decades prior to independence from Sudan in 2011, and engulfed in war since 2013, South Sudan has seen little development. The healthcare sector is one of many propped up by international aid organisations.   However, the country is also the most dangerous for humanitarian workers with around 100 killed over the past five years, according to United Nations figures. Dozens of organisations have been forced to pull out of areas they served due to the conflict.

The Upper Nile region, where Udier is situated near the borders of Sudan and Ethiopia, was wracked by conflict in 2017 as government forces waged a major offensive to seize the opposition-held town of Pagak.   The ICRC was forced to evacuate patients and staff from its hospital and health centre in the village of Maiwut which was looted, leaving "not even a needle on the ground", according ICRC's Oyenya.   Many relocated to Udier, which was spared from fighting.   A year later in 2018, angry protesters looted around 10 humanitarian agency compounds in the town of Maban, 72 kilometres (44 miles) north of Udier.   ICRC's head of delegation in South Sudan, James Reynolds, said a peace deal signed in September 2018 "has improved security, mobility, and access for humanitarian workers".   But fresh fighting in the southern Equatorias region "has made access to certain areas very difficult."

- Women bear the burden -
In opposition-held Udier, the clinic supported by the ICRC provides crucial healthcare support to the region, where like throughout South Sudan, maternal and child mortality is sky-high.   Every day a small group of patients sits outside under a fragrant Neem tree, waiting to be helped, some from nearby while others have walked for a day or two.   Oyenya says a major challenge is that women, who do all the heavy work and take care of up to 10 children, may delay bringing them to the centre in time. That can be deadly.

Sometimes the children come alone: a nine-year-old girl in a purple polka dot dress confidently tells Oyenya she is suffering from bloody diarrhoea and, she thinks, malaria. Her parents are nowhere in sight.   For anything more serious, such as pregnancy complications, blood transfusions and operations, the nearest hospital is in government-held Maban, a five-hour drive away or a three-day walk.   The other option is a three-day walk to Gambella in Ethiopia.   "They may reach there alive, or they may not reach there alive," said Oyenya.
Date: Fri, 19 Apr 2019 03:13:16 +0200
By Andrea PALASCIANO

Naftalan, Azerbaijan, April 19, 2019 (AFP) - Immersed up to her neck in a dark viscous liquid, Sulfiya smiles in delight, confident that the fetid substance will cure her painful condition.   Sulfiya, a Russian woman in her 60s, has travelled to Azerbaijan's north-western city of Naftalan in the hope that crude oil baths at a local sanatorium will end her years of suffering from polyarthritis, a disease affecting the joints.   "This is so pleasant," she enthuses, despite the reek of engine oil.

Her naked dip in oil heated to just above body temperature lasts 10 minutes, after which an attendant scrapes the brown oil off her skin and sends her into a shower.   The native of Russia's Tatarstan region said she and her friends "have long dreamed of coming" for treatment in Naftalan.   The petroleum spa resort in the oil-rich Caucasus country is a draw for visitors despite its proximity to Nagorny Karabakh, a region disputed between Azerbaijan and Armenia in a long-running armed conflict.

After 10 days of bathing in crude oil Sulfiya says she now feels "much better" and has even reduced her medication for the polyarthritis that she has had for 12 years.   "It is a gift from God," agrees 48-year-old Rufat, an Azerbaijani journalist and opposition party member who is undergoing treatment in the sanatorium called Sehirli, or "magic" in Azerbaijani.   Azerbaijan's vast oil deposits were discovered in the mid-19th century, making what was at the time part of the Russian Empire one of the first places in the world to start commercial oil production.

Oil exports to markets all over the world are the largest sector of Azerbaijan's economy, but the crude that comes from subsoil reservoirs in Naftalan is not suitable for commercial use.   Instead the local oil is used to treat muscular, skin and bone conditions as well as gynaecological and neurological problems.   According to a legend, which spa staff readily tell clients, the healing properties of Naftalan's "miraculous oil" were discovered by accident when a camel left to die near a pool of oil was cured.

The small town of Naftalan some 300 kilometres (185 miles) from the capital Baku became a popular health resort for Soviet citizens in the 1920s.   "In the past, when there weren't any hotels or sanatoriums, people would come to Naftalan and stay with locals," said one of the doctors at the Sehirli sanatorium, Fabil Azizov, sitting in her office under a portrait of strongman President Ilham Aliyev.   "But as time passed, sanatoriums were built and treatment methods developed."

- Controversial benefits -
Some specialists warn the method has dangerous side effects.   "Despite the stories of past cures, the use of crude oil for medicinal purposes has been condemned by Western doctors as potentially carcinogenic," former journalist Maryam Omidi wrote in a 2017 book published in Britain about Soviet-era sanatoriums.

In fact, the oil at Naftalan is almost 50 percent naphthalene, a carcinogenic substance found in cigarette smoke and mothballs that in large amounts can damage or destroy red blood cells.   But doctors and patients at Naftalan brush aside any misgivings and the sanatorium even has a small museum displaying crutches that once belonged to patients who have recovered from their illnesses.

- 'We heard gunshots' -
During its heyday in the 1980s, Naftalan would host more than 70,000 visitors a year.    But in 1988, a bloody war began with neighbouring Armenia for the control of Azerbaijan's separatist Nagorny Karabakh region, which unilaterally proclaimed independence from Baku in 1991.

The conflict claimed the lives of some 30,000 people from both sides and forced hundreds of thousands to flee their homes.   A 1994 ceasefire agreement ended hostilities, but the arch foes have yet to reach a definitive peace deal and there are frequent skirmishes along the volatile frontline.   During the war, the sanatoriums in Naftalan -- a few kilometres from the frontline -- were converted into hospitals for wounded soldiers and temporary accommodation for refugees.

Over the last two decades, the Azerbaijani authorities have worked hard to re-establish Naftalan's reputation as a health resort.    They resettled refugees in other regions, demolished decrepit Soviet-era sanatoriums and built brand-new tourist facilities.   Modern Naftalan is a blend of kitsch-looking high-end spas where a week's treatment costs some 1,000 euros, and modest sanatoriums where a week's treatment costs around 100 euros.   The simmering Karabakh conflict may be out of sight, but guests can still feel uncomfortably close to the military action.   During one of the deadliest recent bouts of fighting in April 2016, "we heard gunshots," said a member of staff at Naftalan's luxurious Garabag spa, adding quickly that "everyone stayed on."
Date: Fri, 19 Apr 2019 02:59:34 +0200

Montreal, April 19, 2019 (AFP) - Three world-renowned professional mountaineers -- two Austrians and an American -- were missing and presumed dead after an avalanche on a western Canadian summit, the country's national parks agency said Thursday.   American Jess Roskelley, 36, and Austrians Hansjorg Auer, 35, and David Lama, 28, went missing Tuesday evening in Banff National Park, according to media reports. Authorities launched an aerial search the next day.

The three men were attempting to climb the east face of Howse Pass, an isolated and highly difficult route, according to Parks Canada.   They were part of a team of experienced athletes sponsored by American outdoor equipment firm The North Face, the company confirmed to AFP.   Rescuers found signs of several avalanches and debris consistent with climbing equipment, Parks Canada said, leading them to presume that the climbers were dead.

Poor weather conditions have increased avalanche risks in the mountainous area on the border between Alberta and British Columbia, with the search halted for safety reasons.   It is unlikely the three men survived, John Roskelley, father of missing Jess Roskelley, told local media in the US state of Washington.   "This route they were trying to do was first done in 2000. It's just one of those routes where you have to have the right conditions or it turns into a nightmare. This is one of those trips where it turned into a nightmare," he told the Spokesman-Review.   Himself considered one of the best American mountaineers of his generation, John Roskelley climbed Mount Everest with his son in 2003, making then 20-year-old Jess Rosskelley the youngest person to have conquered the summit.
Date: Thu, 18 Apr 2019 17:35:41 +0200

London, April 18, 2019 (AFP) - Climate change activists on Thursday brought parts of the British capital to a standstill in a fourth consecutive day of demonstrations that have so far led to more than 400 arrests.   Hundreds of protesters continued to rally at several spots in central London, where they have blocked a bridge and major road junctions this week as part of a Europe-wide civil disobedience campaign over the issue.   The Metropolitan Police said, as of 0830 GMT on Thursday, that 428 people had been arrested since the protests began on Monday, with reports of further detentions during the day.   Meanwhile, a judge denied bail to three people who appeared in court charged with obstructing the transport system at financial hub Canary Wharf on Wednesday.

District judge Julia Newton ordered the trio, who allegedly glued themselves to a train, be held in custody until their next court appearance on May 16.   Under pressure in the media to crackdown on the distruptive demonstrations, interior minister Sajid Javid warned "unlawful behaviour will not be tolerated" after meeting Met Commissioner Cressida Dick.   "No one should be allowed to break the law without consequence," he said in a statement, adding he expected police "to take a firm stance".   Protesters have been snaring traffic and setting up impromptu encampments at Waterloo Bridge, Parliament Square and at Oxford Circus in London's busy West End entertainment and shopping district.   They laid trees in pots along the bridge's length and also set up camps in Hyde Park in preparation for further demonstrations.

More than 1,000 officers were being deployed to the streets of the capital each day this week, according to the interior ministry.   The police have ordered the protesters to confine themselves to a zone within Marble Arch, a space at the junction of the park, Oxford Street and luxury hotel-lined Park Lane.   The protests are being spearheaded by the "Extinction Rebellion" activist group, which was established last year in Britain by academics and has become one of the world's fastest-growing environmental movements.   It has vowed to maintain the protests for weeks in a bid to force state action over climate change, with Heathrow Airport -- Europe's busiest flight hub -- the latest site to be targeted on Friday.

The group wants the British government to declare a climate and ecological emergency, reduce greenhouse gas emissions to zero by 2025, halt biodiversity loss and be led by new "citizens' assemblies on climate and ecological justice".   Its protesters say they are practising non-violent civil disobedience and aim to get arrested to raise awareness of their cause.    The majority arrested this week were detained for breaching public order laws and obstructing a highway.   However, police seized three men and two women outside the UK offices of energy giant Royal Dutch Shell on suspicion of criminal damage after they allegedly daubed graffiti and smashed a window there.
Date: Thu, 18 Apr 2019 07:40:27 +0200

Taipei, April 18, 2019 (AFP) - A 6.0-magnitude earthquake jolted Taiwan on Thursday, the US Geological Survey said, shaking buildings and disrupting traffic.   In the capital Taipei, highrises swayed violently while some panicked school children fled their classrooms in eastern Yilan county, according to reports.      Local media said the quake had been felt all over the island and a highway connecting Yilan and Hualien was shut down due to falling rocks.    The quake struck at 13:01 pm (0501 GMT) at a depth of 19 kilometres (11.8 miles) in eastern Hualien county. There were no immediate reports of casualties.

The island's central weather bureau put its magnitude at 6.1.   The Japan Meteorological Agency warned people living near the coast could notice some effects on sea levels, but said there would be no tsunami.   "Due to this earthquake, Japan's coastal areas may observe slight changes on the oceanic surface, but there is no concern about damage," the agency said.   Hualien was hit by a 6.4 magnitude earthquake last year that killed 17 people.    Taiwan lies near the junction of two tectonic plates and is regularly hit by earthquakes.    The island's worst tremor in recent decades was a 7.6 magnitude quake in September 1999 that killed around 2,400 people.
Date: Thu, 18 Apr 2019 03:07:58 +0200

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

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

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

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

The bus had been carrying around 50 passengers.   Regional government Vice President Pedro Calado said it was "premature" to speculate on the cause of the crash, adding that the vehicle was five years old and that "everything had apparently been going well".   Judicial authorities had opened an investigation into the circumstances of the accident, the Madeira public prosecutor's office told the Lusa news agency.   Medical teams were being sent from Lisbon to help local staff carry out post-mortems on the dead.
Tanzania - National. 11 Apr 2019

Tanzania on Thursday [11 Apr 2019] confirmed an outbreak of dengue fever, saying the business capital, Dar es Salaam, has reported 252 cases and Tanga has 55 diagnosed cases.
- La Reunion. 10 Apr 2019

From 800 confirmed cases the previous week, the dengue epidemic increased to 904 cases in the week.
<https://la1ere.francetvinfo.fr/reunion/dengue-barre-900-cas-confirmes-semaine-est-depassee-698934.html> [in French, trans. ProMED Corr.SB]

- La Reunion. 12 Apr 2019. Dengue La Reunion (French overseas territory): dengue cases near 5000 in Q1 2019. New transmission zones have been identified in Saint-Andre, Saint-Denis, Sainte-Marie, and Sainte-Suzanne. In addition, the number of hospitalizations is increasing with 25-30 recorded weekly.

- La Reunion. 27 Mar 2019. The circulation of the dengue virus continues at a sustained level, say the prefecture and the ARS. From 11-17 Mar 2019, 682 cases of dengue fever were confirmed. Since the beginning of the year [2019], 153 emergency room visits have been recorded and 80 patients have been hospitalized. In addition, 5 deaths have been reported since the beginning of 2019, of which 2 have been considered, after investigation, as directly related to dengue fever. The most active households are located at: the Saint-Louis River, Saint Louis, Saint Pierre, the Etang-Sale Cabris Ravine.
- Cook Islands. 12 Apr 2019

As of Wednesday [10 Apr 2019], the Ministry for Health has 18 confirmed and 12 probable dengue fever cases. This is a total of 30 cases compared to 24 previously identified.
- Taihiti (French Polynesia). 13 Apr 2019

DEN-2 confirmation of several autochthonous cases