WORLD NEWS

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

American Samoa

Samoa US Consular Information Sheet
January 23, 2008
COUNTRY DESCRIPTION:
Samoa consists of the two large islands of Upolu and Savai’i and seven small islets. The country has a stable parliamentary democracy with a developing economy. To
rist facilities are accessible by bus, taxi and car and are within walking distance of access roads. Infrastructure is adequate in Apia, the capital, but it is limited in other areas. Nearly all Internet connections use a relatively slow dial-up method. Samoa has two digital telephone service providers, and visitors can easily purchase prepaid phones that cover virtually the entire country. The Samoa Tourism Authority, at http://www.visitsamoa.ws/, provides a wide range of information of interest to travelers. Read the Department of State Background Notes on Samoa for additional information.

ENTRY/EXIT REQUIREMENTS:
U.S. nationals who are not U.S. citizens, and who are resident in American Samoa, must obtain a visitor permit prior to all travel to Samoa. U.S. nationals have not been permitted to travel to Samoa on certificates of identity since May 2005 except on a case by case basis. (U.S. law distinguishes between individuals who are citizens and those who are nationals. The U.S. passport bio-page shows one’s status as either a citizen or a non-citizen national.) As of March 22, 2006, visitor permits to travel to Samoa can be applied for at the new Samoa Consulate General office in Pago Pago, American Samoa. A valid passport and an onward/return ticket are required for all Americans (both citizens and nationals) to travel to Samoa. Visitor permits are not required for U.S. citizens (only for U.S. nationals) seeking to stay in Samoa for up to 60 days. All visitors are required to pay a departure tax of 40 Tala (approximately 17.50 USD) upon leaving the country. Further information about entry requirements and the departure tax may be obtained from the Samoa Mission to the United Nations at 800-2nd Avenue, Suite 400J, New York, NY 10017, telephone (212) 599-6196, fax (212) 599-0797. Visit the Embassy ofSamoa web site at http://www2.un.int/public/Samoa/ 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:
In Apia and many villages, stray dogs wander the streets. Visitors should not approach or feed them; they can become aggressive in the presence of food or if they feel threatened.

Although there have been no major accidents involving the ferry service linking Upolu and Savai’i, vessels are sometimes overloaded. One of the ferries, a multi-deck automobile ferry, sometimes transports passengers on its automobile deck. Americans who choose to use this ferry are encouraged not to remain in the automobile deck during the crossing and to ride only in the passenger compartment in order to avoid injury from shifting vehicles.

Samoa has numerous “blowholes” (lava tubes open to the sea where wave action produces, often spectacular, geysers). These blowholes are popular tourist attractions. The footing around the mouths of most blowholes is very slippery. To avoid being swept in, visitors should not approach too closely and should never stand between the opening of the blowhole and the sea.

Snorkeling and diving in ocean lagoons is a popular activity for many visitors to Samoa. Tide changes can produce powerful currents in these lagoons. Visitors are encouraged to consult local residents and tour operators about hazards and conditions at a particular location before venturing into the water.

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:
Overall, Samoa is considered a low threat environment. Nevertheless, visitors should remain aware of their surroundings, lock their doors at night, and not leave their belongings unattended. Incidents of petty theft/robberies of personal effects are common. Some such incidents have involved residential break-ins. While rare, violent assaults, including sexual assaults have occurred in Samoa. No specific groups have been targeted, nor have there been any racially motivated or hate crimes against Americans. Police responsiveness in Apia is generally good. Because of the very limited police presence elsewhere in Samoa (where order is maintained primarily by local village authorities), police responsiveness elsewhere is problematic.

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.

See our information on Victims of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION:
Health care facilities in Samoa are adequate for routine medical treatment, but are limited in range and availability; complex illnesses and life-threatening emergencies generally need to be treated elsewhere. Dental facilities do not meet U.S. standards, but good dental treatment and some emergency care can be obtained nearby at the LBJ Tropical Medical Center in Pago Pago, American Samoa. The national hospital and a small private hospital are located in Apia, and there are several small district hospitals on Savai'i and in outlying areas of Upolu. There are no hyperbaric chambers on any of the islands for the treatment of scuba diving related injuries. Serious cases of decompression sickness are evacuated to the nearest treatment center in Suva, Fiji, or Auckland, New Zealand. Serious medical conditions and treatments that require hospitalization and/or medical evacuation to the United States can cost thousands of dollars. Travelers should carry emergency evacuation insurance. Doctors and hospitals often expect immediate cash payment for health services. There is no reported incidence of malaria or rabies in Samoa. Occasional outbreaks of typhoid and non-hemorrhagic dengue do occur.

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

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

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

Safety of public transportation and rural road conditions in Samoa, are considered fair, while urban road conditions/maintenance is considered good. Taxis in particular are widely available and used by Samoans and visitors alike; buses are slow, generally crowded and uncomfortable, and rarely utilized by visitors. Rental cars can also be obtained. No roadside assistance is available. Most major roads are tar-sealed, but secondary roads are predominantly dirt and gravel and may be overgrown with vegetation. A four-wheel drive vehicle is recommended for travel on these roads. Travelers should be aware that vehicle safety regulations are rarely enforced and traffic violations occur routinely. Roads outside Apia are often narrow, winding, relatively steep, with narrow or no shoulders, and poorly lighted. Pedestrians as well as vehicles and livestock regularly travel these roads. Due to poor and deteriorating road conditions, night driving on unlit rural roads can be dangerous and should be avoided if possible. Roads in Samoa often traverse small streams. Drivers are urged to exercise extreme caution when fording these streams, which can become swollen and dangerous with little warning. Vehicles should never enter a stream if the roadbed is not visible or if the water’s depth exceeds the vehicle’s clearance.

Speed limits in Samoa are 25 miles per hour in the Apia area and 35 miles per hour outside Apia, with certain exceptions. At unmarked intersections, traffic on the left has the right of way. As in the United States, vehicular traffic moves on the right side of the road; although right-hand-drive vehicles (mainly from New Zealand) do exist in Samoa. Importing right hand drive vehicles to Samoa is currently legally forbidden.

Please refer to our Road Safety page for more information. Visit the web site of the country’s national tourist office at Samoa Tourism Authority at http://www.visitsamoa.ws/.

AVIATION SAFETY OVERSIGHT:
The U.S. Federal Aviation Administration (FAA) has assessed the Government ofSamoa’s Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for oversight of Samoa’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:
Some overseas treatment centers, known as Behavior Modification Facilities, operate in Samoa. Though these facilities may be operated and staffed by U.S. citizens, the Samoan government is solely responsible for compliance with local safety, health, sanitation and educational laws and regulations, including all licensing requirements of the staff in country. These standards, if any, may not be strictly enforced or meet the standards of similar facilities in the U.S. Parents should be aware that U.S. citizens and non-citizen nationals 14 years of age and older have a right to apply for a passport and to request repatriation assistance from the U.S. government, both without parental consent. Any U.S. citizen or non-citizen enrollee has the right to contact a representative from the U.S. Embassy. For further information, consult the Department of State's Fact Sheet on Behavior Modification Facilities, available via the Bureau of Consular Affairs home page. Parents may also contact the U.S. Embassy in Apia or the country officer in the Office of American Citizens Services, Bureau of Consular Affairs at 202-647-5226.

Financial Transactions:
Although some businesses (especially those in Apia or those frequented by tourists) do accept credit cards, many (including gas stations) do not. Major credit cards (Visa, Master Card, and American Express) are accepted at major hotels and some restaurants and stores. Samoan currency can be obtained from ATMs, which are located in Faleolo Airport and in many locations in Apia. For more information on ATM locations and banking services see ANZ web site at http://www.anz.com/samoa/overview.asp and WESTPAC web site at http://www.westpac.com.ws/pacific/publish.nsf/Content/PFSA+HomePage.

Disaster Preparedness: Samoa is located in an area of high seismic activity. Although the probability that a major earthquake would occur during an individual trip is remote, earthquakes can and will continue to happen. Major cyclones have occurred in the past and are always a concern. Strong winds and very heavy rains are common, especially during the rainy season from November to April. During this period, Samoa receives most of its annual average of over 130 inches of rain. General information about natural disaster preparedness is available via the Internet from the U.S. Federal Emergency Management Agency’s (FEMA) web site at http://www.fema.gov/.

Customs: Samoa customs authorities may enforce strict regulations concerning temporary importation into or export from Samoa of items such as firearms, fruits, pets and other animals, and drugs. It is advisable to contact the Samoan Mission to the United Nations at 800 2nd Avenue, Suite 400J, New York, NY 10017, telephone (212) 599-6196 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 Samoa’s laws, even unknowingly, may be expelled, arrested or imprisoned. Penalties for possession, use, or trafficking in illegal drugs in Samoa are severe, and convicted offenders can expect long jail sentences and heavy fines. Engaging in sexual conduct with children or using or disseminating child pornography in a foreign country is a crime, prosecutable in the United States. Please see our information on Criminal Penalties.

CHILDREN'S ISSUES:
Samoa is not a member of the Hague Convention on the Civil Aspects of International Child Abduction. 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 Samoa are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department’s travel registration web site so that they can obtain updated information on travel and security withinSamoa. Americans without Internet access may register directly with the nearest U.S. Embassy or Consulate. By registering, American citizens make it easier for the Embassy or Consulate to contact them in case of emergency. The U.S. Embassy is located in the Accident Compensation Board (ACB) Building, Fifth Floor, Apia. The Embassy is open to the public from 8:15 a.m. to 5:00 p.m. Monday - Friday. The Embassy's mailing address is U.S. Embassy, P.O. Box 3430, Apia, Samoa 0815. The telephone numbers are (685) 21436/21631/22696 and 21452. The fax number is (685) 22030. An Embassy officer can be reached after hours in an emergency involving the welfare of a U.S. citizen or non-citizen national at (685) 21514 or (685) 777-1776. Visit the U.S. Embassy’s web site at http://samoa.usembassy.gov/.
* * *
This replaces the Consular Information Sheet (now known as Country Specific Information) dated May 21, 2007, to update sections on Country Description and Crime.

Travel News Headlines WORLD NEWS

American Samoa. 8 Mar 2017.
(susp) as of mid-February 30 cases of Dengue.

A HealthMap/ProMED-mail map showing the location of American Samoa in the Pacific can be accessed at <http://healthmap.org/promed/p/380>
and a map of the island at <http://www.nationsonline.org/maps/tutuila-island-map.jpg>. - ProMED Mod.TY
Date: Sat 20 Sep 2014
Source: Radio New Zealand [edited]

Latest figures from Samoa's Ministry of Health show an increase of suspected and confirmed cases of chikungunya [virus infections] from 400 to 626 since the outbreak of the acute fever, rash and joint pain disease was reported in July [2014].

However, the ministry says so far presentation of the main signs and symptoms of those affected have largely been mild.

The highest number of people affected is recorded in the districts of Vaimauga west in the urban area with 151 cases; Faleata east, 139 cases; and 113 in Faleata west.  The majority of patients is young.

In American Samoa, the chikungunya outbreak is on the wane. Health officials say there are now 823 probable cases of the mosquito-borne illness, with 15 people requiring hospital care.
===========
[The chikungunya outbreak continues to grow in Samoa, from 269 cases reported on 25 Aug 2014 to 433 reported on 8 Sep 2014 and now to 626 cases. One hopes that a prompt and aggressive clean up of breeding sites will reduce the vector mosquito population enough to halt, or at least reduce, transmission.

On 26 Jul 2014, it was reported that American Samoa had about 100 cases, with 3 laboratory confirmed as chikungunya virus infections (see ProMED-mail archive no. 20140727.2638925). This is a sharp outbreak, with over 700 cases in a little over one month, apparently peaking at 823 probable cases reported above. Once introduced into American Samoa, spread of the virus is not surprising, because it has had dengue virus transmission in the past, and the same mosquitoes that transmit dengue viruses can transmit chikungunya virus as well.

A map showing the location of Samoa in the Pacific Ocean can be accessed at <http://www.worldatlas.com/webimage/countrys/oceania/wsnewz.gif>. A HealthMap/ProMED-mail map showing the location of both Samoa and American Samoa in the Pacific Ocean can be accessed at <http://healthmap.org/promed/p/380>. - ProMed Mod.TY]
Date: Mon 9 Sep 2014
Source: Radio New Zealand [edited]
<http://www.radionz.co.nz/international/pacific-news/253977/chikungunya-related-cases-reach-over-700-in-american-samoa

The latest reports from American Samoa reveal that chikungunya-related [febrile] cases have now reached over 700, and there is now one probable case in Ofu, Manua. The virus was discovered in the territory in July 2014, but there have been no reported cases in Manua until now.

Health officials are urging residents not to travel to Manua if they have chikungunya, and testing is being done to determine whether the case in Ofu is due to the virus. Since July 2014, there have been 11 hospitalisations with the virus but no deaths.

Health officials continue to urge those with symptoms to drink plenty of fluids, get a lot of rest, and visit the emergency department if symptoms become serious.
=======================
[On 26 Jul 2014, it was reported that American Samoa had about 100 cases, with 3 laboratory confirmed as chikungunya virus infections (see ProMED-mail archive no. 20140727.2638925). This is a sharp outbreak, with over 700 cases in a little over one month. Once introduced into American Samoa, spread of the virus is not surprising, because it has had dengue virus transmission in the past, and the same mosquitoes that transmit dengue viruses can transmit chikungunya virus as well.

A HealthMap/ProMED-mail map showing the location of American Samoa in the Pacific Ocean can be accessed at
Date: Tue 5 Aug 2014
Source: Radio New Zealand International [edited]

The American Samoan Department of Health says there are now more than 300 confirmed cases of chikungunya or 'chik' virus in the territory.

The Health Director Motusa Tuileama Nua says his department and LBJ hospital have confirmed the outbreak of fever, rashes, and joint pains among people on the main island of Tutuila is due to chikungunya.

He says there have been 343 recorded cases, with 6 patients hospitalised and no deaths, since the beginning of July [2014].

He recommends those who are ill with fever and body aches do not travel off island.
--------------------------
Communicated by:
Roland Hubner
Superior Health Council
Brussels
Belgium
===============
[CHIKV has been circulating in Pacific islands this year (2014).

Maps showing the location of American Samoa in the Pacific Ocean can be accessed at
<http://healthmap.org/promed/p/380>. - ProMed Mod.TY]
****************************
American Samoa: confirmed
Date: Fri 8 Aug 2014
Source: Samoa News [edited]

The American Samoa Department of Health and the LBJ hospital have created a 24 hour a day hotline for the CHIK virus. The CHIK hotline number is 731-7511.

The Health Alert issued yesterday [7 Aug 2014] confirms chikungunya (CHIK) virus as the cause of fever, rash, and joint pains outbreak on Tutuila and there have been more than 390 recorded cases, with 7 patients hospitalized and no deaths since 1 Jul 2014.

According to the health alert, there is no cure for CHIK virus [infection, and] it can usually be treated at home by drinking lots of fluids, taking pain medicine like Tylenol, ibuprofen, or Aleve as needed but only as much and with cautions as recommended on the package.

The health alert urges not to work while your joints are painful, let them rest and apply ice or cold packs on the joints and this may protect against prolonged joint pain.

DOH notes you should go to the Emergency Room to see a doctor if symptoms persist more than 10 days, or if you have bleeding from any part of the body or bruised skin. Call the hotline "or come to the ER or clinic if you are worried about your condition getting worse."

The alert once again urges that people stay indoors in air-con, behind screens, or under bed nets while you are ill, because if you are bitten by mosquitoes while you are ill, you can spread the disease to your family and neighbors.

For travelers, the DOH urges those who are ill not to travel off island, including to Manu'a. "If you travel and become ill when you arrive, tell the doctor who sees you that you may have been exposed to the CHIK virus."  [Byline: B. Chen]
----------------------------------
Communicated by:
Roland Hubner
Superior Health Council
Brussels
Belgium
-----------------------------------
[Interestingly, the 5 Aug 2014 report above indicated that there were 343 reported cases, and in the subsequent report of 8 Aug 2014 above, that number has increased to 390 cases, indicating that transmission of CHIK virus is continuing. - ProMed Mod.TY]
******
Samoa: suspected cases
Date: Fri 8 Aug 2014
Source: Island Business [edited]

Samoa's Ministry of Health has reported 2 deaths from acute fever and rash, saying it is now an outbreak. A press statement from the Director General, Leausa Toleafoa Dr Take Naseri, says there have been 21 recorded cases as of earlier this week with 4 people hospitalised.

The cases are suspected to be chikungunya virus, similar to dengue fever, but results are yet to be confirmed and 3 children and one man have been admitted to the intensive care unit.

The ministry says collaboration with other government agencies, and media campaigns, aim to raise awareness of the outbreak and help its containment.

Samoa has also sought assistance from the Ministry of Health's development partners including the Secretariat of the Pacific Community and the World Health Organisation.

In neighbouring American Samoa, there have been more than 300 confirmed cases of chikungunya.
======================
[This is the 1st ever ProMED-mail report of a chikungunya outbreak in Samoa. Concerning the current outbreak, it would be unusual to have 2 deaths from chikungunya virus infections of a total of 21 recorded cases. One explanation for the high proportion of fatal cases could be significant underreporting of non-fatal cases. No mention is made indicating that there were contributory underlying medical conditions in these 2 fatal cases. ProMED-mail will be interested in receiving results of the laboratory tests when they become available.

Maps showing the location of Samoa in the Pacific Ocean can be accessed at
at <http://healthmap.org/promed/p/2>. - ProMed Mod.TY]
Date: Wed 14 May 2014
Source: Radio New Zealand International [edited]

Health officials in American Samoa are warning the public about an amoebic dysentery outbreak which has so far affected 26 people, half of which have been admitted to the LBJ hospital. A Pacific Island Health Officers' Association Epidemiologist, Mark Duran, says the department of health is leading an investigation into the source of the parasite.

Dr Duran says amoebic dysentery is spread through contamination of human waste. "It especially attacks the intestines and invades its way into the wall of the intestines; it causes abdominal pain, it causes bloody diarrhoea, fever." Dr Duran says in serious cases the parasite can travel through the body and cause abscesses especially in the liver.
===================
[Maps of American Samoa can be seen at
<http://healthmap.org/promed/p/380>. - ProMed Sr.Tech.Ed.MJ]
More ...

Jordan

General Information:
***************************************
The Middle East is a favourite destination for many Irish holiday makers. The combination of a beautiful climate linked with such historical richness is hard to beat. Unfortunately the
security situation throughout the region has led to some significant concerns over the years. Nevertheless, in the vast majority of cases those visiting the region will not encounter any particular concerns in this regard. It is a wise precaution to ensure that your passport is valid for at least a further six months beyond the time of your holiday as otherwise you may be refused entry.
Security Situation:
***************************************
Security throughout the Middle East is generally tight. Carry some means of identification at all times in case you are requested to produce it by police or army personnel. In Jerusalem the city has been divided and it is sensible to remember which quarter you are in at all times.
Health Facilities:
***************************************
Generally the health facilities throughout the region are excellent. However, when visiting certain rural regions you may find it difficult to obtain hospital care similar to that at home. In Israel, travellers can find information in English about emergency medical facilities and after-hours pharmacies in the "Jerusalem Post" and English language "Ha'aretz" newspapers.
Food & Water Facilities:
***************************************
Again, this depends on your location and the facilities which are there at the time of the year you visit. Bottled water is easily available and food hygiene is usually excellent throughout all the main tourist destinations. However, it is generally wiser not to drink hotel tap water and only to use it for brushing your teeth if there is a clear smell of chlorine. When on organised trips tourists are sometimes offered local tea or other drinks. Generally this will be safe as the water is boiled but take care that the cup hygiene is acceptable.
Sun Exposure:
***************************************
The climatic conditions in the Middle East vary considerably throughout the year. Many tourists visit in late autumn or early spring. At these times the climate is much cooler and the evenings can be distinctly chilly. However, during the main tourist season (May to September) the temperatures rise high into the 80’s or 90’s and dehydration can easily occur. Increasing fluid and salt intake is important under these circumstances. It is essential that travellers are aware of the climatic conditions which should be present for their trip and that sensible clothing is used at all times.
Rabies:
***************************************
Tourists should avoid all animals as this viral disease is transmitted through the bite, lick or scratch of any infected warm blooded animal. In Israel the most common animals involved are foxes and jackals and in Jordan, dogs tend to be the main culprits.
Exploring the Region:
***************************************
Leaving the main tourist routes is unwise. There are a number of security risks which have to be considered and there are also significant health concerns which may be encountered. In July 2000 an 18 year old American tourist died of sunstroke when she became separated from her group in the Dead Sea region of Israel. Those exploring caves and parts of the desert areas also run the risk of diseases like Borreliosis and Rabies.
Walking & Trekking:
***************************************
For many going to these countries their trip will involve visiting some of the major ruins and archeological sites. This will involve a good deal of walking and trekking. Good supporting foot wear is essential and it would be wise to carry a crepe bandage in case of a sprained ankle. Having a suitable painkiller or anti-inflammatory medication would also be advantageous. Check your health will be up to the journey.
Swimming:
***************************************
Pools are usually very well maintained and the risk of disease is small. Those swimming in the sea should remember that the Mediterranean is home to many jelly fish. Swim with others and never alone and especially after alcohol or a heavy meal.
Anthrax:
***************************************
This bacterial disease is rare in the Middle east though travellers should be aware that it can be transmitted through unprepared leather goods usually bought in the local market places. Typically the disease may then present with a black ulcerated skin lesion.

Malaria:
***************************************
Fortunately this disease does not occur in Israel or Jordan. However other mosquito and sandfly diseases do occur and so protection against their bites should be used when necessary.
Hepatitis:
***************************************
There are many forms of this disease but the most common is Hepatitis A, often known as Infectious Jaundice. This disease can keep an infected individual off work for many weeks and it is wise to consider vaccination cover before exposure. In Israel approx 65% of the population will have been infected before 18 years of age.
Vaccinations:
***************************************
There are no essential vaccines for entry/exit however most Irish tourists are recommended to receive cover against; Poliomyelitis, Typhoid, Tetanus and Hepatitis A. Those living in these countries or planning an extended trip should also consider cover against Hepatitis B and Rabies.
Summary:
***************************************
Due to the unrest within Israel there are concerns regarding the safety of tourists at this time. If you are travelling to this region it is wise to ensure that your insurance policy is sufficient if your circumstances or travel plans change.

Travel News Headlines WORLD NEWS

Date: Sat, 10 Nov 2018 16:22:28 +0100

Amman, Nov 10, 2018 (AFP) - Flash floods killed 12 people in Jordan and forced nearly 4,000 tourists to flee the famed ancient desert city of Petra, emergency services said on Saturday.   Search teams were scouring valleys near the historic hill town of Madaba for a young girl who was still missing after Friday's floods, civil defence spokesman Iyad Amru told state television.

Among those confirmed dead after torrential rains swept the south of the kingdom were six people found in the Madaba area southwest of the capital Amman.   To the east, three people were killed near Dabaa on the Desert Highway, one of Jordan's three main north-south arteries, while one was killed near Maan in the south.    It was not immediately clear where the other two died.   Amru said two girls had gone missing in the Madaba region, later announcing that one of their bodies had been found.

Government spokeswoman Jumana Ghneimat said authorities had found alive four Israeli tourists who had gone missing in the Wadi Rum desert in southern Jordan but were looking for two more.   "Our embassy in Tel Aviv contacted the Israeli foreign ministry for information on the identities of the missing Israelis," Ghneimat said in statements carried by the state news agency Petra.   Israel initially confirmed the report but in a later update a spokesman for the foreign ministry said that "all the Israelis in Jordan have contacted us. All of them were found".

- Tourists evacuated -
The Jordanian army deployed helicopters and all-terrain vehicles to help with search and rescue operations after floodwaters cut off the Desert Highway in both directions.   A rescuer was also among the dead, the civil defence spokesman said.   State television said the waters had reached as high as four metres (13 feet) in parts of the red-rock ravine city of Petra and the adjacent Wadi Musa desert.

It broadcast footage of tourists sheltering on high ground on both sides of the access road to Jordan's biggest attraction.   The government spokeswoman said 3,762 tourists were evacuated.   Designated a UNESCO World Heritage site in 1985, Petra draws hundreds of thousands of tourists a year to its rock-hewn treasury, temples and mausoleums.   Its buildings have been used as sets for several Hollywood blockbusters including "Indiana Jones and the Last Crusade".   Wadi Rum, also a UNESCO World Heritage site, has attracted generations of tourists with its spectacular sandstone and granite rock formations.   Its landscapes served as a backdrop in the filming of the Hollywood classic "Lawrence of Arabia".

The latest deaths come after October 25 flash floods in the Dead Sea region of the kingdom killed 21 people, most of them children on a school trip.   Jordan's education and tourism ministers both resigned last week over failings in the government's response to those floods.   The education ministry ordered schools closed nationwide on Saturday amid warnings of more heavy rains.   Jordan's minister of water and irrigation, Raed Abu al-Saoud, said on Saturday that the country's 14 main dams had filled up by some 26 percent of full capacity in the past 48 hours because of the torrential rains.   Jordan is a water-poor country that is 90 percent desert.
Date: Fri, 26 Oct 2018 11:36:00 +0200

Amman, Oct 26, 2018 (AFP) - At least 20 people, most of them school pupils, have been killed in flash floods in Jordan, the emergency services said Friday in an updated toll.   A further 35 people were injured following heavy rains on Thursday, including members of the security forces involved in rescue operations, said an official from the civil defence -- Jordan's fire service -- who asked not to be named.   He said rescuers were still searching for people missing in the area, a popular tourist attraction around 50 kilometres (30 miles) west of Amman.   "Most of the dead were schoolchildren aged 11 to 14 who were taking part in a school trip to the Dead Sea region" when their bus was swept away by floodwaters.   Also among the dead were passers-by who had been picnicking in the area, he said, adding that a nearby bridge had collapsed.   "Security force personnel who were taking part in the rescue operations were among the injured," he added.

The Dead Sea, the lowest point on earth, is surrounded by steep valleys and gullies that frequently see flash floods and landslides.   Education Minister Azmi Mahafzah promised a "full inquiry" into the schoolchildren's deaths.   He said the bus took a route not agreed upon by the ministry and the organiser of the trip bore full responsibility.   Roads leading to the area were closed on Friday morning "to allow the continuation of search and rescue operations", the Directorate of General Security said.   The Israeli military said on Thursday it was helping with the operation, sending helicopters and forces specialised in search and rescue.   Jordanian television reported that King Abdullah II had cancelled a planned visit to Bahrain to monitor developments.
Date: Tue 26 Sep 2017
Source: Jordan Times [edited]

Following a rise in hepatitis A cases among school students in Mafraq's Akeider area, the president of the Lower House's Health Committee, Ibrahim Bani Hani, has called for more governmental attention to the area, which "has suffered negligence for so long".

The Ministry of Health has recorded 32 cases of Hepatitis A in students from the Akeider area, in Mafraq Governorate, since [22 Aug 2017]. Hepatitis A is a liver disease caused by a virus transmitted through contaminated food or water, inadequate sanitation and poor personal hygiene, the Health Ministry's spokesperson, Hatem Azrui, told The Jordan Times.

Bani Hani visited Akeider 2 months ago, along with other officials and the Lower House's Environmental Committee, to examine the impacts of the landfill in Akeider on the environment and the health of its citizens. "There is no doubt that hepatitis A has spread in the area due to a lack of hygiene in health and public facilities," he stated.

Mafraq health director at the Ministry of Health, Hani Oleimat, said that the disease is not epidemic and that the rate of [past] infection in adults amounts to over 90 percent.

Azrui said that the ministry has conducted experiments on the water sources at schools and homes and noted that no signs of the virus were found. He said that the disease is spread through sharing personal items like towels at public health facilities.

For his part, Bani Hani stressed that the area is lacking a health centre, which the ministry had promised to build, but noted that "no real measures were taken". He also said that the area suffers from other issues such as the emission of phenol gas from Akeider landfill and the increased number of stray dogs, a potential source of rabies.

Oleimat noted that since the discovery of the cases, no schools have stopped working in the area and noted that the ministry urged the school staff to direct any suspected case to the health directorate, in order to provide the infected students with a 7- to 10-day sick leave. The sickness needs no medication other than rest, Oleimat highlighted, noting that the body of the infected person naturally generates immunity  against the virus.  [Byline: Sawsan Tabazah]
==================
[This is a completely preventable disease using the inactivated hepatitis A vaccine. In the developing world, it is seen primarily in children and by adulthood, almost all individuals are immune. Most infections in children are asymptomatic so a cluster of 32 cases, so far here, implies a great deal more total infections. - ProMED Mod.LL]

[A HealthMap/ProMED-mail map can be accessed at:
Date: Tue 26 Sep 2017
Source: GIDEON (Global Infectious Disease Epidemiology Network) [edited]

re: ProMED-mail Hepatitis A - Jordan: (MA)
-----------------------------------------------------------
The potential benefit for hepatitis A vaccination in Jordan is illustrated by the chart at

In 1999, Israel became the world's 1st country to institute routine hepatitis A immunization (blue arrow), and has since largely eradicated the disease [1].

Reference
---------
1. Chart generated by a Gideon multi-graph tool, see
--------------------------------------------
Communicated by:
Stephen Berger
Geographic Medicine
Tel Aviv Medical Center
Tel Aviv, Israel
=========================
[ProMED thanks Dr Berger for his continued contributions. - ProMED Mod.LL]

[A HealthMap/ProMED-mail map can be accessed at:
Date: Sun 24 Sep 2017
Source: Arab Jordan [in Arabic, trans. ProMED Mod.NS, edited]

A total of 27 children suffered from hepatitis A in Al-Akaider area, 30 km (18 mi) northeast of Al-Mafraq city within Hosha district [Mafraq province]. This prompted the Ministry of Health to send a specialized epidemiological team to determine the causes of the outbreak. According to information received from the people, the disease has reached an epidemic level as the infection has spread among children, especially schoolchildren. This required closing the 2 schools located in the area to maintain the health and safety of children and stop the transmission of the disease.

The Director of Health of Al-Mafraq, Hani Alimat, stated that the disease is endemic in the region, reducing the negative effect on children because the recovery from the infection gives immunity throughout life.

Alimat said that the ministry had sent a specialized epidemiological team to take samples and examine them in laboratories. He indicated that the tests proved that the children are infected with hepatitis A, which is often caused by the use of unclean toilet facilities. He confirmed that the laboratory tests of the water lines in the houses showed that the water is clean.

Alimat stressed that during visiting the 2 schools that have 280 students, they found that the health environment is poor due to having poor toilet facilities and drinking water, in addition to the absence of walls to protect these facilities and the presence of dead animals around the area. He explained that the increased number of cases made the Directorate of Health allocating a doctor to the health center throughout the day hours to receive patients. There are also field visits to the schools in addition to providing a health educator to give lectures on awareness of how to deal with the infection. Alimat also pointed out that the field visits of the health monitors in the area closed a shop for not complying with health requirements.
======================
[The age-specific seroprevalence rates for hepatitis A antibody as reflected in the citation below supports, in the absence of widespread hepatitis A vaccine use, almost universal hepatitis A infection in Jordan occurring in childhood or adolescence.

Hayajneh WA, Balbeesi A, Faouri S: Hepatitis A virus age-specific sero-prevalence and risk factors among Jordanian children. J Med Virol. 2015; 87: 569-74;

Abstract
--------
Hepatitis A virus (HAV) has been a significant cause of infections among the children and adolescents of Jordan. Availability of safe vaccines made it necessary to identify the ill-defined temporal immunity trends for HAV and possible age-specific prevalence transitions. This community-based cross sectional study was conducted during the period July-August 2008 on 3066 recruited subjects from the 12 governorates of Jordan, with predefined criteria. Several households were chosen at random within each selected block to enrol the subjects. They were interviewed and data were collected. Their sera were tested for total antibodies against HAV. A multivariate model was then performed to identify the possible risk factors.

The HAV seroprevalence rates among the age categories-second year, 2-4 years, 5-9 years, 10-14 years, 15-19 years, and those above 20 years were 26 percent, 32 percent, 44 percent, 63 percent, 78 percent, and 94 percent, respectively. The model revealed the association of several risk factors for higher HAV seroprevalence rates: (i) older age groups; (ii) lower maternal education levels; (iii) residing in certain governorates; (iv) using public net drinking water; and (v) avoiding use of public net sewage system.

This study provided strong evidence for continuous transition of HAV epidemiology towards intermediate endemicity in Jordan, with more susceptible adolescents and adults. Following the World Health Organization (WHO) recommendations for countries with intermediate endemicity, large-scale hepatitis A vaccination is recommended for children in Jordan. This is strengthened by the availability of effective and safe HAV vaccines, improving the socio-economic status of the Jordanians, and increasing life expectancy among Jordanians. - ProMED Mod.LL]

[Maps of Jordan can be seen at
and <http://healthmap.org/promed/p/63190>. - ProMED Sr.Tech.Ed.MJ]
More ...

World Travel News Headlines

Date: Tue, 19 Mar 2019 12:35:15 +0100
Watamu, Kenya, March 19, 2019 (AFP) - If you live in a country with venomous snakes, or are travelling to one, here are a few tips to avoid being bitten.

- Do not provoke -

Snakes usually will not attack unless they feel threatened. In the bush, wear sturdy leather shoes and stomp heavily when walking, striking with a stick on the ground in front of you to warn any reptiles you are coming -- they will most likely just slither away.
Most strikes occur when snakes feel cornered or under threat, or when people accidentally step on them.

- Be alert and prepared -

Outside, have a good look around you for snakes that may hang from tree branches or swim in water, and be careful when turning over rocks or other objects. And remember: snakes are evolved to be well-camouflaged in their environment, whether it be the desert, forest or bush.
Thick, protective gloves are recommended for gardening and farming.
Carry a lamp at night.
Birds can help too: Many species possess an alarm cry to alert others of hidden danger.
Inside, check your bed and dark corners -- snakes can enter homes in pursuit of prey, heat or water.
The neater your home, the more likely you will spot an out-of-place snake. A mosquito net around your bed can be an effective snake repellent.

- Once bitten -
If you or someone else is bitten, try and remember the colour and shape of the snake, and seek immediately medical care at a clinic or hospital.
Remove any bracelets, rings or watches that may hamper blood flow in case of swelling.
Do NOT try and catch the snake, apply a tourniquet, cut the wound, suck out the venom, or drink alcohol or coffee.
Also do not seek to inject your own antivenom, which can induce a violent allergic reaction and needs to be administered in a professional environment with adrenaline and oxygen on hand.

Sources: Doctors Without Borders, Centers for Disease Control and Prevention, Health Action International, Bio-Ken research centre.

Date: Tue, 19 Mar 2019 08:06:51 +0100

Sentani, Indonesia, March 19, 2019 (AFP) - At least 89 people are known to have died after flash floods and landslides tore through Indonesia's Papua region, with the toll expected to rise further as rescuers hunt for dozens still missing, the national disaster agency said Tuesday.   Scores have also been injured in the disaster, triggered by torrential rain on Saturday, with some 6,800 people evacuated to temporary shelters.   The military has taken up the grim task of putting mud-caked corpses into body bags, with the search hampered by mountains of debris including rocks and fallen trees.

Seventy-four people remain unaccounted for, while around 150 suffered broken bones, cuts and other injuries.   "Many people are choosing to stay at shelters because they're still traumatised and scared of more flash floods, so some evacuation centres are packed," said national disaster agency spokesman Sutopo Purwo Nugroho.

The government has issued a 14-day state of emergency in Papua, which shares a border with independent Papua New Guinea on an island just north of Australia.   Flooding is common in Indonesia, especially during the rainy season which runs from October to April.   In January, floods and landslides killed at least 70 people on Sulawesi island, while earlier this month hundreds in West Java province were forced to evacuate when torrential rains triggered severe flooding.

Meanwhile, three people were killed -- including two Malaysian tourists -- and some 182 were injured after an earthquake Sunday triggered a landslide on the Indonesian tourist island of Lombok, next to Bali.   Lombok was rocked by several earthquakes last summer, killing more than 500 people and leaving over 150,000 homeless.

Last September, the country was hit by an earthquake and tsunami in Palu on Sulawesi island which killed around 2,200 people.    The Southeast Asian archipelago of some 17,000 islands is one of the most disaster-prone nations on Earth, straddling the Pacific Ring of Fire, where tectonic plates collide. Earthquakes and volcanic eruptions are common.
Date: Mon, 18 Mar 2019 23:35:47 +0100
By Nova SAFO

Chicago, March 18, 2019 (AFP) - The US Midwest struggled Monday with historic flooding that claimed at least three lives, displaced residents and damaged hundreds of homes and businesses.    Swollen waters hit much of Nebraska, as well as parts of Iowa, Wisconsin, and South Dakota, after a major storm last week dumped snow and rain, even as melting snow was already raising the levels of area waterways.   Neighboring states could also be affected as floodwaters drain, officials said.    President Donald Trump on Monday described the floods as "devastating" and said the White House would remain in close contact with state officials.    "Our prayers are with the great people of South Dakota," he said in one tweet.    In another aimed at Iowa residents, he said: "We support you and thank all of the first responders working long hours to help the great people of Iowa!"

- 'Historic' flooding -
The National Weather Service (NWS) described the flooding as "major" and "historic," forecasting that it would continue across large sections of the middle of the country.    "Flood Warnings and Advisories are scattered throughout the Plains, Mississippi Valley, and western parts of the Ohio Valley region, with a focus in Nebraska and western Iowa," the NWS said in an advisory.    "Farther west and north, areal flooding is also possible in the Northwest and Northern Plains as snowmelt continues over frozen ground."   The early damage assessment total for the state of Nebraska was more than $260 million, according to emergency management officials.

Record flooding was reported in 17 locations in the state and 10 American Red Cross shelters were operating for displaced residents.    At its highest point, the Missouri River was expected to crest at 47.5 feet (14.5 meters), beating its 2011 record by more than one foot.    "Comparisons to 2011 were inevitable," the NWS office in Iowa tweeted, "but these floods have resulted in many more rescues and widespread damage in eastern Nebraska and western Iowa."   Failing levees were blamed for flooding in numerous communities -- damaging homes and businesses.    The US Army Corps of Engineers, which maintains federal levee systems, said a majority were compromised along an approximately 100-mile portion of the Missouri River in southeast Nebraska.

- Military base under water -
Hundreds of people were rescued in Nebraska, where 54 cities issued emergency declarations, as did four Native American tribal areas.    Fremont, a city of more than 25,000, was surrounded by floodwaters over the weekend and cut off from aid.    It finally received food and other emergency supplies Sunday after crews managed to clear debris and mud from a road, officials said.    Three dozen Iowa counties were under states of emergency.    Roads were closed throughout Wisconsin and more than 200 people were evacuated, according to officials.

A third of Offutt Air Force Base in Nebraska was overcome with floodwater, and was not expected to be dry again until Thursday.   "It's important to understand that this is going to take weeks and months to recover so this will be a prolonged effort," one of the base's leaders, Kevin Humphrey, said in a statement.    Three people were reported killed.   A Nebraska farmer died Thursday, during the height of the storm, trying to rescue a motorist stranded by floodwaters, the Omaha World-Herald reported.    On the same day, 80-year-old Betty Hamernik died after being trapped by floodwaters in her home in rural Columbus, Nebraska, according to the newspaper.    Aleido Rojas Galan, 55, was killed Friday in Iowa when his vehicle was swept away by floodwaters, TV station KETV said.
Date: Mon, 18 Mar 2019 16:57:59 +0100

Kiev, March 18, 2019 (AFP) - Eleven people have died and more than 30,000 have been infected this year in a major measles outbreak in Ukraine, the European country worst hit by the disease, Kiev said Monday.  The latest victim was a nine-year-old girl who died from complications Saturday after contracting the highly infectious disease, the health ministry said.

Some 30,500 people, including 17,000 children, have been infected so this year.   Authorities said shortages of vaccine in previous years and anti-vaccination sentiment, often driven by online campaigns spreading false information about the alleged risks, were the main reasons behind the outbreak.

The World Health Organization (WHO) recommends a 95-percent vaccination rate to prevent mass hospitalisations and fatalities.   But in Ukraine, just 42 percent of one-year-olds had been vaccinated as of end-2016, according to the United Nations children's agency UNICEF.   Measles cases more than tripled across Europe in 2018, with Ukraine accounting for most of the gain.

Europe as a whole saw nearly 83,000 cases last year, according to WHO figures.  The Ukrainian government reported 54,000 cases in 2018. There were 16 deaths nationwide.  In 2019, the authorities launched a special campaign including sending mobile vaccination teams to rural schools in two western regions particularly hard hit in the outbreak.   Measles is characterised by high fever and a reddish rash. It usually triggers only mild symptoms but remains one of the leading causes of death among young children globally.
Date: Sun, 17 Mar 2019 16:19:02 +0100

Paris, March 17, 2019 (AFP) - Eurostar trains from Paris to London were hit by cancellations and "severe delays" on Sunday as French customs officers staged work-to-rule industrial action.     The customs officers are demanding higher pay and better working conditions while seeking to demonstrate what might happen if full border controls are put in place once Britain leaves the European Union.

Paris-to-London trains were experiencing "severe delays and lengthy queues for our services," Eurostar said on its website. "We strongly recommend that you do not travel today."   Four trains had been cancelled by lunchtime on Sunday, with another three on Monday and one on Tuesday.   Sunday's work-to-rule was just the latest in a string of strike actions by the French customs officers.

Work-to-rule strikes began in early March, in the Channel ports of Dunkirk and Calais, northern France, leading to long delays for trucks waiting to cross to Britain.   The customs workers want better pay but also more staff to cope with British travellers who will no longer have European passports once the UK leaves the European Union.

Brexit is due to happen on March 29 but looks increasingly likely to be delayed as the British parliament is yet to agree on a divorce plan.   On Wednesday French unions representing the around 17,000 customs workers rejected a government offer of a 14 million euro ($15.8 million) payroll boost, saying it was insufficient.
Date: Sun, 17 Mar 2019 16:15:35 +0100

Mataram, Indonesia, March 17, 2019 (AFP) - At least two people were killed and dozens injured Sunday after an earthquake on the Indonesian tourist island of Lombok triggered a landslide, officials said.    The 5.5-magnitude quake is thought to have caused the landslide at the Tiu Kelep waterfall in the north of the island.   "Two people died in the landslide in the Tiu Kelep waterfall after the earthquake, one of them is a Malaysian," a disaster agency spokesman told AFP.   At least 44 people were injured in the earthquake, according to the agency, including eight Malaysians, while more than 30 houses were destroyed and about 500 others slightly damaged.

Indonesia is one of the most disaster-prone nations on Earth due to its position straddling the so-called Pacific Ring of Fire, where tectonic plates collide.   Lombok was rocked by several earthquakes last summer, killing more than 500 people and leaving over 150,000 homeless.   Last September, the country was hit by an earthquake and tsunami in Palu on Sulawesi island which killed around 2,200 people.
Date: Fri 15 Mar 2019
Source: Prothom Alo [edited]

The 3 members of a family from Baliadangi upazila's [2nd-lowest tier of regional administration] Ujarmoni village in Thakurgaon [district] are suspected to have been infected with the deadly Nipah virus, reports United News of Bangladesh [apparently later confirmed as Nipah virus; see below. - ProMED Mod.TY].

The victims include a 28 year old mother; her son, aged 8; and her daughter, aged 4. They were taken to Rangpur Medical College Hospital on Thursday [14 Mar 2019], said ABM Maniruzzaman, the resident medical officer of Baliadangi Upazila Health Complex. He said the victims had been suffering from fever for the last 3 days. They also reported headache and vomiting. The trio was 1st taken to Thakurgaon Modern Sadar Hospital and later shifted to RMCH.

Nipah virus is transmitted from animals to humans and can also be transmitted through contaminated food or directly between people, according to the World Health Organisation. There is no vaccine for the virus, which is spread through body fluids and can cause inflammation of the brain.

The mother's husband said his wife and children fell sick after eating jujube [fruit of the _Ziziphus jujuba_ bush] on Wednesday night [13 Mar 2019].

Thakurgaon civil surgeon Abu Mohammad Khairul Kabir said their blood samples had been collected for testing. A medical team from the Institute of Epidemiology, Disease Control and Research is scheduled to visit RMCH.

In February [2019], 5 members of a family died mysteriously in Baliadanga upazila. It is unclear what caused their deaths [Nipah virus is suspected]. In 2001, Nipah virus was identified as the causative agent in an outbreak of human disease occurring in Bangladesh. Genetic sequencing confirmed this virus as Nipah virus, according to the Centre for Disease Control and Prevention.
======================
[This is the 2nd family in Bangladesh to have been infected by Nipah virus this year [2019]. Nipah virus infections occur sporadically in Bangladesh. As noted in the previous comment (ProMED-mail archive no. http://promedmail.org/post/20150204.3143251), "Giant fruit bats or flying foxes (_Pteropus_ of several species) are reservoirs of Nipah virus, and . . . they contaminate date palm sap or the fruit. [The above report suggests that the family may have eaten contaminated jujube fruit]. This is the season for cases of Nipah virus infection to occur. The transmission season is usually January to April."

"It is unfortunate that the public awareness efforts have not prevented these cases from occurring. Perhaps because cases are sporadic and geographically scattered there is little public perception of risk of infection and serious disease. Until effective public education to prevent infection by avoiding eating contaminated fruit or date palm sap is implemented, sporadic cases will continue to occur."

An image of a _Pteropus_ fruit bat can be found at

[HealthMap/ProMED-mail maps:
Rangpur Division, Bangladesh: <http://healthmap.org/promed/p/16030>]
Date: Fri 15 Mar 2019
Source: Le Journal de Mayotte [in French, trans. ProMED B, edited]

The circulation of Rift Valley fever (RVF) continues in Mayotte. An animal disease of viral origin, Rift Valley fever mainly affects domestic ruminants (cattle, sheep, goats), causing abortions and high mortality in young animals. It can be transmitted from the infected animal to humans.

In total, since the beginning of the epidemic (end of November [2018]),
- samples taken by veterinarians from sick animals or during abortions led to the identification of 8 new outbreaks this week [week of Mon 11 Mar 2019], for a total of 60 cases in animals (including 49 cattle). Animal foci are located mainly in the centre and north west of the island;
- a total of 101 human cases of RVF have been reported to the platform/cell watch and health emergencies of the ARS OI (CVAGS) of Mayotte by the CHM laboratory. Of those who could be interviewed, almost 80% report having been in contact with animals;
- since the beginning of the health alert, human cases have been located mainly in the centre and north west of the island, with nearly 60% of cases in Chiconi and Tsingoni.

Since 25 Feb 2019, the weekly number of new human cases has been on the decrease.  [byline: Anne Perzo]
========================
[This Rift Valley fever (RVF) outbreak has been going on since November 2018. The number of human cases of RVF has increased from 82 to 101 in about 2 weeks. However, it is good to learn that the number of new human cases is decreasing. The above report implies that the human infections are the result of contact with infected animals or their products, with fewer from virus transmission by mosquito vectors. The cattle cases certainly are the result of mosquito transmission.

Because RVF virus can be transovarially transmitted in populations of aedes mosquito vectors, and those resulting eggs can persist for a long period of time in nature, cases can occur periodically when the virus-containing eggs hatch, and infected adult females emerge from them. There is a risk that RVF will reappear on the island after the current outbreak has ended.

Recent studies have shown that RVF virus may severely injure human foetuses if contracted by mothers during pregnancy. There is no indication of whether any of the 101 RVF virus-infected people were pregnant. Abortions in infected livestock are common. There is no vaccine available for human use, but there is for livestock. There is no mention of whether the livestock populations in the area have been vaccinated.

The clinical findings related to the above human cases are not mentioned. In an earlier comment, ProMED noted that: "The most common complication associated with RVF is inflammation of the retina. As a result, approximately 1-10% of affected patients may have some permanent vision loss. Approximately 1% of humans that become infected with RVF virus die of the disease." - ProMED

[ealthMap/ProMED-mail map of Region d'outre-mer de Mayotte, France:
Date: Thu 14 Mar 2019
Source: Outbreak News Today [edited]

Tasmania health officials are advising people who live on the east coast, or plan on travelling there, to ensure they protect themselves against mosquitoes following a number of cases of Barmah Forest virus. To date, 5 confirmed cases of the mosquito borne disease have been reported, with 2 additional cases being investigated. Officials note that these cases represent the 1st time the officials have been able to confirm the virus was contracted in Tasmania.

Public Health Services has partnered with University of Tasmania to conduct mosquito trapping in an attempt to learn more about this outbreak. PHS and UTAS staff will volunteer their time this weekend [16-17 Mar 2019] to set a number of traps on the East Coast. The trapping will attempt to confirm the presence of mosquito species known to carry the virus, and also to hopefully trap a mosquito carrying the virus for further research.

Barmah Forest virus is spread by the bite of an infected mosquito. It is related to Ross River virus. Barmah Forest virus is relatively common in mainland states but has not been thought to be present in Tasmania until recently.

Many people may be asymptomatic. If symptoms are present, they can manifest as fever, headache, aches and pains in muscles and joints, tiredness, rash, and swollen or stiff joints. Symptoms usually develop 3-21 days after being bitten by an infected mosquito. Most people recover completely in a few weeks.

Preventing insect bites will also protect against other mosquito borne diseases, such as Ross River virus, and tickborne diseases, such as Flinders Island spotted fever.

To protect against mosquitoes and ticks,
- avoid mosquito-infested areas when possible;
- cover up with a loose-fitting, long-sleeved shirt and long pants when outside;
- apply mosquito repellent to exposed skin;
- take special care during peak mosquito-biting hours, especially around dawn and dusk, and when outdoors or camping; and
- remove potential mosquito-breeding sites from around the home and screen windows and doors.
=======================
[Clearly, Barmah Forest virus (BFV) is currently being transmitted in Tasmania, reportedly for the 1st time. Interestingly, Dr Steve Berger's comment (Barmah Forest virus - Australia (02): (TS) comment http://promedmail.org/post/20190310.6360212) indicated that 19 cases of BFV infections have been reported in Tasmania from 1999-2018, suggesting that these infections were acquired in other Australian states. The previously ProMED-mail-posted cases of BFV infections have been in Queensland state. It will be interesting to learn which mosquito species are transmitting the virus in Tasmania. The Tasmania Public Health Services' advice to prevent mosquito bites should be taken seriously. - ProMED Mod.TY]

[HealthMap/ProMED-mail map of Tasmania, Australia:
Date: Fri, 15 Mar 2019 19:08:37 +0100
By Joaquim Nhamirre

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

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

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

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

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