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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 ...

Morocco

General
********************************************
Morocco is a North African country and a favourite destination for many Irish tourists. The climate, relative shortness of the flights and the idyllic swimming conditions encourage many to vis
t.
Safety & Security
********************************************
The border regions of the country can be volatile and travellers planning to visit away from the main tourist routes should take extra precautions. The Western Sahara region is still in dispute though there has been an official cease-fire in place since 1991. The possibility of unexploded mines exists though it should be remembered that this area is many miles away from the normal tourist resorts. The level of street crime in Morocco is low but growing. Busy market places, parks and beaches are popular locations for petty criminals. Tourists should take care not to flaunt personal wealth and to avoid travelling away from the main tourist zones late at night. Travelling alone is a particular risk and only authorised guides and taxis should be used. Tourists have been threatened with serious injury at knife point if they have refused to purchase cannabis.
Laws & Customs
********************************************
It is an Islamic country and ladies in particular should take care to dress modestly. Islamic festivals can cause significant changes to occur which affect tourists including the holy month of Ramadan when all street cafés close until 5.30pm each day as strict Muslims do not eat during the daylight hours. The main tourist hotels continue to serve food as normal but many shops will remain closed. During these times tourists will need to carefully check their tickets and any travel arrangements may need to be changed. Banks and larger shops will remain open between 9am and 3pm Monday to Friday. Drug offences are treated very seriously and those visiting the Rif Mountains should realise this is a major cannabis growing area. Visitors with Arabic Bibles or those involved in any perceived outreach activity may find they are subjected to prolonged interrogation.
Health Facilities
********************************************
The level of health care available in many of the main hotels and resorts is perfectly adequate but care should be taken if your illness necessitates admission. Communication in English may be difficult and many medications will be unavailable. Frequently small private hospitals are used where standards vary greatly. Check that your travel insurance provides adequate cover for repatriation if required.
Food & Water Facilities
********************************************
The food and water provided in many of the main tourist resorts is very satisfactory but variations can easily occur and travellers should be careful at all times. Lettuce, undercooked bivalve shellfish (mussels, oysters, clams etc) and untreated water are all frequently implicated in sickness among travellers. Eating previously peeled fruit is also unwise and should be avoided. Bottled water purchased from main shops or hotels should be used for drinking and brushing your teeth.
Insect Bites & Mosquitoes
********************************************
There is only a very small risk of malaria transmission throughout Morocco and prophylaxis is not recommended for the majority of tourists. However, sandflies do abound during the summer months and can transmit a nasty disease known as Leishmaniasis. These small flies tend to hover close to the ground in shaded areas and can easily bite without the individual noticing. It is essential to use good insect repellent when at risk and to report any slow healing bite or sore to a doctor after your return home.
Sun Exposure
********************************************
The level of sun exposure in Morocco during the summer months can be intense. Take care to avoid the midday sun and use high sun blocking creams at all relevant times. Take particular care of children while in such a hot climate. Extra water and salt will be required to replace the amounts lost through perspiration. Salted crisps and nuts will be a useful source of salt.
Water Sports & Activities
********************************************
Many tourist locations in Morocco offer extended water sport facilities for tourists. Always check out what the standard of care is before agreeing to take part. Ask tourists who arrived before you and check with your holiday representative if possible. Confirm that good safety procedures are in place and that your travel insurance covers any accidents as a result of your activities.
Cash Facilities
********************************************
Traveller’s cheques and credit cards are accepted in many of the main tourist resorts. ATM machines are available in Casablanca and Rabat. It may be difficult to reconvert Moroccan money back to sterling and so care should be taken not to change too much initially until you clarify your expenses.
Travel by Train
********************************************
To visit other parts of the country many travellers use the train journey south from Tangier. However, be wary of any invitation from fellow passengers to alight at Asilah rather than continuing the journey south. A number of tourists have been held hostage and forced to make credit card transactions or cash withdrawals before being freed.
Road Transport
********************************************
Many tourists to Morocco hire motorbikes or cars to see more of the country. This is regarded as a high-risk activity and special care will be required at all times. Driving practices throughout Morocco are poor and traffic signals do not always function. Modern freeways link the main cities of Tangier, Rabat, Fez and Casablanca. Flash flooding can occur during the rainy season (November – March).
Rabies
********************************************
Rabies does occur in Morocco and it is essential that you avoid any and all contact with at risk animals. Typically this includes dogs, cats and monkeys but this viral disease can infect any warm-blooded animal. Take particular care to warn children to avoid animals and to report any contact as soon as possible.
Vaccinations
********************************************
There are no essential vaccines for entry into Morocco from Ireland. However most tourists are advised to consider adequate cover against:
*
Poliomyelitis (childhood booster)
*
Tetanus (childhood booster)
*
Typhoid (food and water disease)
*
Hepatitis A (food and water disease)
Those planning a longer or more rural trip will also need to consider cover against diseases like Hepatitis B and Rabies.
Summary
********************************************
The majority of tourists visiting Morocco will remain very healthy and well. However, following simple precautions against food and water disease and sun exposure will be essential.

Travel News Headlines WORLD NEWS

Date: Sat, 2 Feb 2019 14:22:56 +0100

Rabat, Feb 2, 2019 (AFP) - An outbreak of swine flu in Morocco has left nine people dead in the past week, the kingdom's health minister said Saturday.   The spread of the H1N1 virus was "normal" for the time of the year, said Anas Doukkali, quoted by Morocco's official MAP news agency.   The first death in Morocco from the influenza-type virus was reported by local media on Wednesday, since when anxious rumours have spread on social media.   "Vigilant efforts continue to detect possible cases in different hospitals across the kingdom," said government spokesman Mustapha Khalfi.

H1N1 is a respiratory disease contracted through contact between humans and pigs and transmitted between people through inhalation.   A major H1N1 outbreak sparked a World Health Organization pandemic alert in June 2009. It killed around 18,500 people in 214 countries before the alert was lifted in August 2010.
Date: Thu, 20 Dec 2018 13:44:40 +0100

Paris, Dec 20, 2018 (AFP) - Here is a recap of previous attacks targeting foreign tourists holidaying in North Africa, after Moroccan authorities arrested three suspects in the murder this week of two Scandinavian hikers.

- Morocco -
On April 28, 2011, a bomb attack on a popular tourist cafe in the city of Marrakesh kills 17 people, 11 of them European citizens, and wounding dozens of others.   The two men responsible for the attack are sentenced to death and seven others handed jail sentences ranging from two to 10 years.  The bombing is the deadliest in Morocco since attacks in the coastal city of Casablanca in 2003 that killed 33 people and 12 bombers.

- Tunisia -
On March 18, 2015, two men gun down 20 foreign tourists and a policeman at the Bardo National Museum in Tunisia. Among the dead are French, Italian and Japanese nationals.   The two attackers are shot dead by security forces.    The carnage, claimed by the Islamic State (IS) group, is the deadliest assault on foreigners in Tunisia since 2002.   Twenty-five people are being tried for the attack and could face the death sentence.   On June 26, 2015, a Tunisian student goes on a shooting spree at the Riu Imperial Marhaba Hotel in the beach resort of Sousse, killing 38 foreign tourists including 30 from Britain. The attack is claimed by IS.   The trial begins in May 2017 with 26 Tunisian nationals prosecuted including six members of the security forces accused of not assisting people in danger.

- Algeria -
On September 21, 2014 French national Herve Gourdel, 55, is kidnapped while hiking in a national park in the northeastern Kabyle region of Algeria.   Three days later the IS-linked Jund al-Khilifa, or "Soldiers of the Caliphate", claims to have beheaded Gourdel in a video posted online after Paris rejected their demand to halt air strikes in Iraq.  Gourdel's body is found three months later.
Date: Tue, 18 Dec 2018 11:59:06 +0100

Rabat, Dec 18, 2018 (AFP) - Moroccan authorities on Tuesday arrested a suspect following the murder of two Scandinavian women in the High Atlas mountains, a popular trekking destination for tourists.   Other suspects are being sought over the killings of the Danish and Norwegian hikers who were found dead on Monday with cuts to their necks, the interior ministry said.   The bodies were discovered in an isolated mountainous area 10 kilometres (six miles) from the tourist village of Imlil in the High Atlas range.   Imlil is a starting point for trekking and climbing tours of Mount Toubkal, which at 4,167 metres is the highest summit in North Africa.

The suspect was arrested in the former imperial city of Marrakesh, a tourist hub located at the foot of the mountains about 60 kilometres north of Imlil, and held in custody for questioning, the ministry said.   The Moroccan authorities described it as a "criminal act" but did not give further details about the circumstances of the murders.   The Danish victim, Louisa Vesterager Jespersen, 24, "had her throat cut," her mother Helle Petersen was quoted by the Danish newspaper B.T. as saying.   Her family had warned her against going to Morocco "because of the chaotic situation," she added.   According to her Facebook page, Jespersen had studied in Norway to be a guide.

- 'Every precaution' -
Norwegian media named the other victim as 28-year-old Maren Ueland.   "Her priority was safety. The girls took every precaution before going on this trip," her mother Irene Ueland told Norwegian broadcaster NRK.   The two women studied at a university in southern Norway and had planned to travel together for a month, she said, adding that her last contact with her daughter was on December 9.

A Norwegian policeman from the embassy in Rabat is travelling to Marrakesh to act as a liaison between the authorities.   Security was stepped up in the region and hiking suspended following the discovery of the bodies, Moroccan media said.   "It's very bad for the region. There will undoubtedly be cancellations," a local guide, Hossein, told AFP from Imlil.   Tourism is a cornerstone of Morocco's economy and the kingdom's second-largest employer, after agriculture.   The sector accounts for 10 percent of national income and is one of the country's main sources of foreign currency.   After several years of near-stagnation, Morocco welcomed a record 11.35 million visitors in 2017, exceeding the 11-million mark for the first time.
Date: Mon 12 Nov 2018, 9.54 AM EST
Source: The Guardian [edited]

A Briton has died after contracting rabies while visiting Morocco, public health officials have said. The UK resident was infected with the disease after being bitten by a cat, Public Health England (PHE) said on [Mon 12 Nov 2018]. PHE did not release any further details but reassured the public there was no wider risk. It said health workers and close contacts of the deceased were being assessed and offered vaccination where necessary.

Jimmy Whitworth, the professor of international public health at the London School of Hygiene and Tropical Medicine, told the Press Association: "My understanding is that this is somebody who had contact with a cat that was behaving abnormally and sought care, I believe in Morocco and in the UK, but unfortunately didn't receive vaccination until it was too late. I believe that the cat bit this person a few weeks ago."

He said that symptoms typically took 2 to 3 months to appear but could materialise in as little as a week. "That's why seeking prompt care and getting vaccination is so important," he said. "In this tragic case the person didn't get the vaccine in time." Given the lack of information, Whitworth said it was impossible to know whether the delay was in the UK or Morocco but it illustrated the importance of health workers being aware of the possibility of the disease.

There are no documented instances of direct human to human transmission of rabies. The disease does not circulate in either wild or domestic animals in the UK, although some species of bats can carry a rabies-like virus.

[Rabies] is common elsewhere, including in parts of Asia and Africa. PHE said the case was a reminder to travellers to rabies-affected countries to avoid contact with dogs, cats and other animals wherever possible, and seek advice about the need for a rabies vaccine prior to travel.

Dr Mary Ramsay, the head of immunisations at PHE, said: "This is an important reminder of the precautions people should take when travelling to countries where rabies is present. If you are bitten, scratched or licked by an animal you must wash the wound or site of exposure with plenty of soap and water and seek medical advice without delay."

It is only the 6th case of human rabies in the UK since 2000, all but one caused by animal exposure overseas. The last was in 2012, when a woman in her 50s died in London after being bitten by a dog in South Asia. She was reportedly turned away twice by doctors at a hospital in Kent before she was finally diagnosed.  [byline: Haroon Siddique]
======================
[According to another media source, the victim, a 58 year old man from Aylesbury Bucks, was staying 30 miles away from the Moroccan capital Rabat, visiting family, when he was infected with the disease. He did receive treatment but allegedly was not given anti-rabies serum in time;  <https://www.dailymail.co.uk/news/article-6382379/PICTURED-British-father-two-died-rabies-UK.html>.

The following statistics on rabies in animals were submitted by
Morocco for 2016 (last available annual report):
Official vaccinations in dogs: 71 759
Rabies outbreaks: 76

species / cases / deaths / killed
dogs / 41 / 28 / 13
cats / 12 / 11 / 1
bovine / 71/ 62 / 9
equine / 44/ 38/ 6
ovine / 6 / 5 / 1

The numbers of human cases, as reported to the OIE for the years 2010-2015, were 19, 18, 19, 24, 20, and 19, respectively. The number of human cases during 2016 (the most recent available data) was 17.

The tourism industry is well developed in Morocco; in 2017, Morocco was Africa's top tourist destination, with 10.3 million tourist arrivals, most of them from Europe, predominantly France and Spain. In the past, cases of rabies in animals illegally introduced from Morocco with returning visitors were recorded in France

The event is being investigated. - ProMED Mod.AS]

[HealthMap/ProMED maps available at:
England, United Kingdom: <http://healthmap.org/promed/p/279>
Date: Mon, 12 Nov 2018 15:54:12 +0100

London, United Kingdom, Nov 12, 2018 (AFP) - A Briton has died after being bitten by a cat with rabies in Morocco, officials said Monday, only the seventh known case in the United Kingdom since 2000.   England's health service issued a reminder Monday for travellers to avoid coming into contact with animals when travelling to rabies affected countries, particularly those in Asia and Africa.

Rabies has been effectively eradicated in Britain, although they do still spread among some bats.   "There is no risk to the wider public in relation to this case but, as a precautionary measure, health workers and close contacts are being assessed and offered vaccination when necessary," said Mary Ramsay, the health service's chief of immunisation.   The Press Association news agency said the person was bitten a few weeks ago and not given potentially life-saving treatment early enough.

Rabies is a viral disease that causes an inflammation of the brain. It is usually fatal by the time the first symptoms emerge.   England's health service said that no cases of humans acquiring the disease from any animal other than a bat have been recorded within the country since 1902.   One person acquired it from a bat in Scotland in 2002, and five people contacted while travelling between 2002 and 2017, the health service said.
More ...

World Travel News Headlines

Date: Mon, 24 Jun 2019 16:11:10 +0200

Kinshasa, June 24, 2019 (AFP) - More than 1,500 people have died in a nearly 10-month-old outbreak of Ebola in the Democratic Republic of Congo, the health ministry said Monday.   As of Sunday, 1,506 people have died out of 2,239 recorded cases, it said.   Earlier this month, the virus claimed two lives in neighbouring Uganda among a family who had travelled to the DRC.   Nearly 141,000 people have been vaccinated in the affected eastern DRC provinces of Ituri and North Kivu, the epicentre of the outbreak.

Ebola spreads among humans through close contact with the blood, body fluids, secretions or organs of an infected person, or objects contaminated by such fluids.   The current outbreak in the DRC is the worst on record after an epidemic that struck mainly in Liberia, Guinea and Sierra Leone between 2014-2016, killing more than 11,300 people.   Chronic violence and militia activity in Ituri and North Kivu as well as hostility to medical teams among locals have hampered the response.

On Monday, a crowd of people opposed to the burial of two Ebola victims in the Beni area burnt the vehicle of a health team, local police chief Colonel Safari Kazingufu told AFP.   He said a member of the medical team had been injured in the attack and taken to hospital.    The United Nations in May nominated an emergency coordinator to deal with the crisis. However, the World Health Organization (WHO) said this month the outbreak currently did not represent a global threat.
Date: Mon, 24 Jun 2019 20:27:21 +0200

Ouagadougou, June 24, 2019 (AFP) - Hundreds of doctors and nurses demonstrated Monday in the Burkina Faso capital Ouagadougou to protest against declining health facilities and to demand better working conditions.   The main doctors' union also warned it would stage a general strike from June 30 to July 7 to demand "concrete responses" to their grievances.

Health professionals staged a series of strikes at the end of May, seriously disrupting work at health centres in the poor West African country.   "We are... asking health authorities not to underestimate the health crisis," said Alfred Ouedraogo, general secretary of the Union of Burkina Doctors.   "For several months, there have been recurring breakdowns in laboratories," he said. "In most health centres, there are no X-ray films."    The protesters marched to the health ministry and submitted their demands.

Health worker Idrissa Compaore said that ever since the introduction of free medical care for children under five and pregnant women, "basic goods were regularly lacking" at health facilities.   "The situation is the same in health centres," he said.   The doctors also want the implementation of an accord signed with the government in 2017 promising better working conditions which they say remains only on paper.   If their demands are not met, the health workers could launch an open-ended strike which would affect consultations and surgeries, Ouedraogo said.
Date: Wed 19 Jun 2019
Source: InSight crime [edited]

Disease outbreaks show desperate Venezuelans have migrated to illegal gold mining areas for work.

Outbreaks of malaria and diphtheria in a region of Venezuela where these diseases are rare has revealed how armed groups are organizing a vast migration to illegal mines.

The outbreaks show that criminals operating in the state of Miranda found a way to make money amid the country's worsening crisis by moving into the illegal gold mines of Bolivar state, in the south of Venezuela.

In the middle of 2017, doctors witnessed an unusual, sustained, and inexplicable malaria outbreak in Valles del Tuy, a region in the state of Miranda located between the coast and the center of Venezuela where the mosquito-borne disease is seldom seen, Efecto Cocuyo reported.

The startling epidemic offered the 1st clue to the changing criminal dynamics in the region.

"Malaria was not a disease native to states in the center of the country, so this caught our attention. We started to ask patients about it to find out how they contracted it. The surprise came when one of the patients told me that he had caught it in the mining region in the state of Bolivar, where they went to work in gold mining," explained a doctor whose practice is in Charallave, the municipal seat in Cristobal Rojas municipality in Miranda state. The doctor asked to remain anonymous for security reasons.

Pressured by the economic situation and massive inflation, residents of the Valles del Tuy region began working during their vacations in the illegal mines in Bolivar, more than 500 kilometers [about 311 mi] away. The doctor said that they were recruited by 'pranes', or prison gang bosses, who had previously been the leaders of local 'megabandas' in Valles del Tuy.

The megabandas' grip on Valles del Tuy began in 2013, when various sites were converted into so-called peace zones, areas where security forces could not enter.

Later, when kidnappings and extortion stopped being profitable in the poor areas where they operated, members of the same megabandas migrated to the mining region in search of other sources of income, and to escape police and military raids.

InSight crime analysis
----------------------
Criminals are not immune to the effects of Venezuela's current economic, political, and social crisis.

Many criminals, primarily pranes and leaders of megabandas, have been forced to abandon their former strongholds and change the pattern of their criminal activities, according to investigations conducted by InSight Crime.

Criminals are trading robbery, petty theft, and kidnappings for drug trafficking and illegal mining. Additionally, they are migrating to states where these illicit economies are strongest: Sucre, Zulia, Tachira, and Bolivar. In the south of Venezuela, Bolivar has become the principal destination for the pranes of Valles del Tuy.

Ramon Teran Rico, alias "Monchi," for example, was the leader of one of the largest criminal organizations in the state of Miranda. Community representatives told InSight Crime that he fled to Bolivar's mines 2 years ago.

Monchi was the 1st crime boss to try his luck at the Orinoco Mining Arc, a transnational mining project created in 2016. He gradually moved his henchmen there from the Valles del Tuy. Sources in his circle of friends say that he even purchased his own dredge to extract gold.

Leaders of other criminal structures operating in the Valles del Tuy have also had to reinvent themselves in order to survive, and have moved into southern Venezuelan states where they operate comfortably.

Hundreds of residents of the towns in Valles del Tuy have migrated to the mining region. "All of the families here have at least one person that has gone to work in the mines," said a resident of Ocumare del Tuy in Miranda state, who reports seeing his neighbors' children and relatives head for the mines.

In November 2016, a case of diphtheria, an acute infectious disease [that most commonly affects the throat and the tonsils], was detected in the Sucuta sector of Ocumare del Tuy, alerting health authorities to the re-emergence of a disease rarely seen in the center of the country.

Follow-up with the patient found that he had contracted the infection in the Bolivar mines.

Health authorities developed prevention plans targeted at the neighborhoods where criminal groups operate. Investigations conducted by health authorities demonstrated that the men that go to work in the mines, as well sex workers or women who work in the kitchens there, carried these diseases back to the Valles del Tuy.

The public health problem shed light on the fact that an illegal gold mining fever had emerged -- an economic lifeline that is now strengthening organized crime.  [Byline: Venezuela Investigative Unit]
=======================
[Malaria has surged in Venezuela over the past 9 years (see ProMED reports below). Control measures have ceased to exist and drugs for treatment have become difficult to find. The association with illegal haphazard mining was reported from Bolivar state in 2012, and the present report underlines that such activities constitute high risk for malaria and other diseases.

The diphtheria outbreak that began in July 2016 remains ongoing. Through February 2019, Venezuela has seen a total of 2726 suspected cases (1612 confirmed), including 164 in 2019 to date (<http://outbreaknewstoday.com/diphtheria-update-venezuela-60872/>). - ProMED Mod.EP]

[Maps of Venezuela:
Date: 23 Jun 2019
Source: Outbreak News [edited]

The Malaysia Ministry of Health is reporting a methanol poisoning cluster believed linked to counterfeit alcohol.

For the period of 11-21 Jun 2019, 3 methanol poisoning clusters were reported to the National Crisis Preparedness and Response Center (CPRC). The incidents involved 19 cases from the following states:
Penang (8), Johor (6) and Negeri Sembilan (5). The cause of the methanol poisoning was believed to be due to the counterfeit liquor branded by Myanmar Whiskey, Miludeer Beer, Whiskey 99 and Martens Extra Strong.

The cluster of methanol poisoning cases in Penang began on 11 Jun 2019 and involved 8 Myanmar citizens. Two of the cases have died. They had been drinking Myanmar branded whiskey. The drink was purchased from the same seller who sells directly at the premises where these poisoning victims work. On 21 Jun 2019, one methanol poisoning case was still being treated at a Penang hospital in critical condition, while 5 others were discharged.

In the state of Johor, reporting of methanol poisoning cases has been received since 18 Jun 2019. It involves 6 cases, 3 Malaysians and one Pakistani, Nepalese and Indian, respectively. Three of the cases involved were found to have consumed a drink believed to be counterfeit branded Miludeer Beer. Four of the cases of methanol poisoning have died. On 21 Jun 2019, one case was still being treated at the Sultanah Aminah Hospital (HSA) in critical condition, and one more reported case of blurred vision was being treated in a regular ward at Sultan Ismail Hospital, Johor Bahru, Johor.

The Negeri Sembilan Health Department (JKNNS) reported one methanol poisoning cluster on 20 Jun 2019 involving 5 cases from the Port Dickson district including 2 deaths. It involves 3 Malaysians, one Indian citizen and one Myanmar citizen. Investigations found cases involved drinking alcoholic beverages allegedly branded Miludeer Beer (2 cases), Whisky 99 (1 case) and Martens Extra Strong (1 case), while one case had no brand information. On 21 Jun 2019, 3 cases were being treated at Port Dickson Hospital, 2 critical cases, and one case in a regular ward.

Clinical samples were taken from all 19 cases for methanol test analysis. The results showed 5 positive cases of methanol and one negative case of methanol but showed symptoms and clinical signs of methanol poisoning. Laboratory results for the remaining 13 cases are still pending.

The Penang State Health Department, Negeri Sembilan and the State of Johor have collaborated with the Royal Malaysian Police and Royal Malaysian Customs in an investigation to identify the sources of the counterfeit alcoholic drink.

The MOH continues to monitor the situation and take preventative and control measures to address these methanol poisoning incidents. Consumers are advised to ensure each purchased alcohol product has a label containing complete manufacturer, importer, agent and listing information.

Consumers are also advised to avoid consuming home-brewed alcoholic beverages or alcohol being sold at low prices.

If individuals have symptoms of methanol intoxication such as stomach-ache, nausea, vomiting, headache, and vision loss within 5 days of consuming an alcoholic drink, MOH advises them to seek immediate treatment at any clinic or the closest hospital.
===========================
[Methanol toxicity initially lacks severe toxic manifestations. Its pathophysiology represents a classic example of lethal synthesis in which toxic metabolites cause fatality after a characteristic latent period. In other words, these people may not realize they are sick or ill until some time after consumption.

Methanol is sometimes used as an ethanol substitute for alcohol. Foods such as fresh fruits and vegetables, fruit juices, fermented beverages, and diet soft drinks containing aspartame are the primary sources of methanol in the human body, but [they contain] minute quantities.

Wood alcohol is also known as methanol. It is a commonly used toxic organic solvent causing metabolic acidosis, neurologic issues, and death when ingested. It is a part of many commercial industrial solvents and of adulterated alcoholic beverages or is mistaken as being the same as alcohol for ingestion. Methanol toxicity remains a common problem in many parts of the developing world, especially among members of lower socioeconomic classes.

Neurological complications are recognized more frequently due to advanced technologies and because of early recognition of the toxicity and advances in supportive care. Hemodialysis and better management of acid-base disturbances remain the most important therapeutic improvements.

Serum methanol levels of greater than 20 mg/dL correlate with ocular injury. Funduscopic changes are notable within only a few hours after methanol ingestion. The mechanism by which the methanol causes toxicity to the visual system is not well understood. Formic acid, the toxic metabolite of methanol, is regarded as being responsible for ocular toxicity, and blindness can occur in humans.

The prognosis in methanol poisoning correlates with the amount of methanol consumed and the subsequent degree of metabolic acidosis; more severe acidosis confers a poorer prognosis. Methanol has a relatively low toxicity. The adverse effects are thought to be from the accumulation of formic acid, a metabolite of methanol metabolism. The prognosis is further dependent on the amount of formic acid that has accumulated in the blood, with a direct correlation existing between the formic acid concentration and morbidity and mortality. Little long-term improvement can be expected in patients with neurologic complications.

The minimal lethal dose of methanol in adults is believed to be 1 mg/kg of body weight. The exact rates of morbidity and mortality from methanol intoxication are not available.

Rapid, early treatment is necessary for survival, but sequelae such as blindness may be permanent.

Metabolic acidosis in methanol poisoning may necessitate the administration of bicarbonate and assisted ventilation. Bicarbonate potentially may reverse visual deficits. In addition, bicarbonate may help to decrease the amount of active formic acid.

Antidote therapy, often using ethanol or fomepizole, is directed towards delaying methanol metabolism until the methanol is eliminated from the patient's system either naturally or via dialysis. Like methanol, ethanol is metabolized by ADH, but the enzyme's affinity for ethanol is 10-20 times higher than it is for methanol. Fomepizole is also metabolized by ADH; however, its use is limited because of high cost and lack of availability.

Hemodialysis can easily remove methanol and formic acid. Indications for this procedure include (1) greater than 30 mL [1 oz] of methanol ingested, (2) serum methanol level greater than 20 mg/dL, (3) observation of visual complications, and (4) no improvement in acidosis despite repeated sodium bicarbonate infusions.

Intravenous administration of ethanol in a 10 percent dextrose solution may be helpful. As ethanol prolongs the elimination half-life of methanol, the treatment may take several days, and the patient should be hospitalized. Dialysis may be necessary to prevent kidney failure as well. Hemodialysis remains an effective treatment.

Portions of this comment were extracted from:

[HealthMap/ProMED map available at:
Date: Fri 21 Jun 2019
Source: WHO/EMRO (Regional Office for the Eastern Mediterranean) [edited]

Situation reports on Al-Hol camp, Al-Hasakah
--------------------------------------------
- Over the past 2 weeks, a total of 633 people have left the camp. This number includes 107 people who returned to their homes in north-east Syria. There were no new arrivals during the reporting period.
- 9 medical points are reporting regularly to the disease Early Warning And Response System (EWARS). Leishmaniasis, acute diarrhoea, bloody diarrhoea, and severe acute malnutrition (SAM) remain the most commonly reported diseases.
- 38 new cases of leishmaniasis were detected. All patients are being treated by a WHO-supported mobile team in coordination with the Al-Hasakeh Directorate of Health.
- 7 suspected cases of measles were reported. No new cases of tuberculosis were detected during the reporting period.
- 30 children with severe acute malnutrition with medical complications were admitted to Al-Hikmah hospital during the reporting period, of whom 22 were discharged, one died, and the remainder are still under treatment. Mortality rates related to severe acute malnutrition remain below the emergency threshold.
- 2 new static health care points have been established, bringing the total number to 12. There is still an acute shortage of health care points in the Foreign Annex.
- 35 water sources were tested for microbial contamination in Al-Hasakeh water national laboratory during the reporting period. All 35 samples tested negative for contamination. WHO continues to test the quality of water from different sources in the camp.
- Stool samples from patients with diarrhoea were tested for
_Salmonella_, _E. coli_, and cholera, with all samples testing negative. Blood samples from patients with suspected measles were also sent for testing, and all samples tested negative.
- Following intensive negotiations by WHO, the local authorities have given their approval in principle to evacuate a patient requiring advanced mental health treatment
===================
[Leishmaniasis has surged throughout Syria during the civil war on all sides and continues to be a health problem in the refugee population. - ProMED Mod.EP]

[HealthMap/ProMED-mail map of Syria:
Date: Mon, 24 Jun 2019 05:38:33 +0200

Jakarta, June 24, 2019 (AFP) - A powerful magnitude 7.3 quake struck eastern Indonesia on Monday, US seismologists said, but no tsunami warning was issued and there were no immediate reports of major damage or casualties.   The quake hit at a depth of 208 kilometres (129 miles) south of Ambon island in the Banda Sea at 11:53 local time, the US Geological Survey said.

The Pacific Tsunami Warning Center said there was no threat of a tsunami as the quake was too deep.   The strong temblor came hours after a 6.1-magnitude earthquake hit Papua, also in the eastern part of the Southeast Asian archipelago.   That quake hit about 240 kilometres (150 miles) west of the town of Abepura in Papua province, at a relatively shallow depth of 21 kilometres, according to the USGS.

There were also no immediate reports of casualties after the earthquake.   A shallower 6.3-magnitude hit the area last week, but the damage was not extensive.   Indonesia experiences frequent seismic and volcanic activity due to its position on the Pacific "Ring of Fire", where tectonic plates collide.   Last year, a 7.5-magnitude quake and a subsequent tsunami in Palu on Sulawesi island killed more than 2,200 with a thousand more declared missing.   On December 26, 2004, a 9.1-magnitude earthquake struck Aceh province, causing a tsunami and killing more than 170,000.
Date: Sat, 22 Jun 2019 21:45:46 +0200
By Anna SMOLCHENKO with Irakli METREVELI in Tbilisi

Moscow, June 22, 2019 (AFP) - Russia's government on Saturday banned Georgian airlines from flying into its territory, extending restrictions imposed by President Vladimir Putin as part of growing tensions between Moscow and its ex-Soviet neighbour.   Putin had signed a decree late Friday banning Russian airlines from flying to pro-Western Georgia from July 8 in response to anti-Moscow rallies in the Georgian capital Tbilisi.

The protests broke out after a Russian lawmaker addressed parliament from the speaker's seat earlier this week, a hugely sensitive move for two countries whose relations remain tense after a brief war in 2008.   The rallies have morphed into a broader movement against the Georgian authorities while the Kremlin has branded them a "Russophobic provocation".   On Saturday, protesters took to the streets of the Georgian capital for a third day of rallies, with some 3,000 demanding snap elections and electoral reform.   The crowd sang a profanity-laced, anti-Putin chant and some of the demonstrators held up placards insulting the Russian president.   Demonstrators also shot paper airplanes into the sky in response to the Russian bans.

Russia's transportation ministry said that from July 8 two Georgian airlines would be banned from flying to Russia, citing the need to ensure "aviation safety" and debt owned by the Georgian companies.   The Kremlin has said the ban against travel to Georgia was to "ensure Russia's national security and protect Russian nationals from criminal and other unlawful activities."

Authorities recommended travel companies stop selling holiday packages to Georgia and advised Russian tourists to return home.   Russia's travel industry and ordinary Russians hit out at the decision by the Kremlin, saying it was a politically motivated move that has little to do with safety concerns.   "Tourism in Georgia is on the rise, and the decision has shocked the whole industry," Aleksan Mkrtchyan, head of Pink Elephant, a chain of travel agencies, said in a statement.

- 'This is politics' -
The ban during high season is expected to hit the travel industry in both countries hard and become a major nuisance for Russian holidaymakers.   Russia and Georgia fought a brief but bloody war in 2008 and tensions between the two governments remain high.   But Georgia -- known for its picturesque Black Sea resorts, rich national cuisine and generous hospitality -- has emerged as one of the most popular destinations for Russian tourists over the past few years, with more than 1.3 million visiting last year.

Irina Tyurina, a spokeswoman for the Russian Tourism Union, said that most in the industry believed that Georgia was not a dangerous destination.   "Georgians have traditionally treated Russians well," Tyurina told AFP.    It was too early to estimate potential industry losses from the ban, she said.   More than 7,000 people have signed a petition calling on Moscow to resume flights.

Russian tourists in Tbilisi expressed regret at the restrictions.   "We are against the ban," Nina Guseva told AFP in the Georgian capital. "We are not guilty and we do not have to suffer."   Fellow traveller Mikhail Strelkov added: "This is politics and has nothing to do with people on holidays."   In Russia, many struck a similar note.   Elena Chekalova, a prominent chef and culinary blogger, said the latest Kremlin move "shocked" her.   "Why are they deciding for us what we cannot eat, where we cannot fly, who we cannot be friends with?" she wrote on Facebook.

- Simmering discontent -
Moscow has suspended flights to Georgia before -- during a spike in tensions in October 2006 and in August 2008 following the outbreak of the five-day war over the breakaway regions of Abkhazia and South Ossetia.   "Putin decided to punish Georgia because there are street protests there," opposition leader Alexei Navalny said on Twitter.   A senior government official in Tbilisi said the Kremlin ban was politically motivated.   "Putin's decision is of course political and has nothing to do with safety concerns," the official told AFP on condition of anonymity.

Analysts say the latest restrictions may further fuel simmering discontent with Kremlin policies.   Since 2014, Russians have been chafing under numerous rounds of Western sanctions over Moscow's role in Ukraine and other crises, with real incomes falling for the fifth year in a row.    During an annual phone-in with Russians this week, Putin dismissed calls to "reconcile" with the West to alleviate economic hardship, saying Moscow needed to protect its interests and "nothing" would change anyway.
Date: Sat, 22 Jun 2019 04:35:24 +0200
By Alexandre MARCHAND

Chennai, India, June 22, 2019 (AFP) - Angry residents fight in queues at water taps, lakes have been turned into barren moonscapes and restaurants are cutting back on meals as the worst drought in living memory grips India's Chennai.   The hunt for water in south India's main city has become an increasingly desperate obsession for its 10 million residents after months with virtually no rain.   The bustling capital of Tamil Nadu state usually receives 825 million litres of water a day, but authorities are currently only able to supply 60 percent of that.   With temperatures regularly hitting 40 degrees Celsius (104 Fahrenheit), reservoirs have run dry and other water sources are dwindling each day.

A rainstorm on Thursday night, the first for about six months, brought people out onto the streets to celebrate, but provided only temporary relief.   "We don't sleep at night because we worry that this well will run out," said Srinivasan V., a 39-year-old electrician who starts queueing for water before dawn in his home district near Chennai airport.   The 70 families who use the well are allowed three 25-litre pots each day. Most pay high prices to private companies to get the extra water they need to survive.   Local officials organise a lottery to determine who gets to the front of the queue. The lucky first-comers get clear, fresh water. Those at the end get an earth-coloured liquid.

- Long, hot wait -
Srinivasan said he waits about five hours each day in water queues and spends around 2,000 rupees ($28) a month on bottled water or paying for a tanker truck to deliver water.   It is a big chunk of his 15,000-rupee monthly salary. "I have loans, including for the house, and I can't repay them now," he said.

The desperation has spilled over into clashes in Chennai. One woman who was involved in a water dispute with neighbours was stabbed in the neck.   In another suffering Tamil Nadu city, Thanjavur, an activist was beaten to death by a neighbouring family after he accused them of hoarding water.   Many in Chennai do not have the money to pay for extra supplies, and arguments in queues for free water often turn violent.   The hunt for H2O dominates daily life.   Some Chennai restaurants now serve meals in banana leaves so that they do not have to wash plates. Others have stopped serving lunch altogether to save water.

- Isolated showers -
Families have had to reorganise daily life, setting up schedules for showers and devoting up to six hours a day to line up for water -- three in the morning, three in the afternoon.   Most of those queuing are women, including housewife Nagammal Mani, who said looking for water was like "a full time job".   "You need one person at home just to find and fill up the water while the other person goes to work," she said.   Chennai gets most of its water from four lakes around the city. But it had a poor monsoon last year and levels have not recovered since.   The bones of dead fish now lie on the cracked bottoms of the lakes.   While weak rainfall is a key cause of Chennai's crisis, experts say India's poor record at collecting water does not help, particularly as the country of 1.3 billion people becomes increasingly urbanised.   The drought is seen as a symbol of the growing threat faced in many of India's highly vulnerable states, which have been hit by longer periods each year of sweltering heat that has devastated food production.

Hundreds of villages have already emptied in the summer heat this year because their wells have run dry.   Pradeep John, a local weather expert known online as "Tamil Nadu Weatherman", said if families in the area had spent their money on rain-collection equipment instead of truckloads of water they would be "self-sufficient" now.   "We've got almost 1,300-1,400 millimetres of rainfall every year. So that is a very significant amount of rainfall," he told AFP.   "So we have to find out where the problem lies, where the problem of urbanisation lies -- whether we are encroaching into the (rain) catchment areas -- improve these catchment areas, and then find a long-term solution."   John said there is no immediate hope for rains to end the crisis, with the monsoon not expected before October.   "If the water doesn't come, people will be shedding blood instead of tears," said housewife Parvathy Ramesh, 34, as she endured her daily queue in Chennai's stifling heat.
Date: Fri, 21 Jun 2019 22:49:46 +0200
By Laure FILLON

Paris, June 21, 2019 (AFP) - Forecasters say Europeans will feel sizzling heat next week with temperatures soaring as high as 40 degrees Celsius (104 degrees Fahrenheit) in an "unprecedented" June heatwave hitting much of Western Europe.   From Great Britain to Belgium to Greece, a wave of hot air coming from the Maghreb in North Africa and Spain will push up temperatures starting this weekend and hitting a peak around mid-week.    Spain's meteorological agency (Aemet) has issued a "yellow alert" for severely bad weather for Sunday and says it expects the country to see a "hotter than usual" summer, like last year.

In Germany, forecasters are predicting temperatures up to 37 degrees C on Tuesday and 38 C on Wednesday, with similar hot weather also expected in Belgium and Switzerland.   The British MetOffice said it was particularly concerned that the heatwave could trigger "violent storms" and warned Britons to expect "hot, humid and unstable" weather.   Greece will be one of the countries most affected by the heatwave with temperatures hitting 39 degrees C at the weekend.

In France, meteorologist Francois Gourand said the heatwave is "unprecedented for the month of June" and will no doubt beat previous heat records.    Back in the summer of 2003, France suffered an intense heatwave that led to the deaths of nearly 15,000 mostly elderly people.   Starting on Tuesday, France will see temperatures from 35 to 40 degrees C, which will remain high at night offering little respite from the heat, forecasters predicted.   "Since 1947, only the heatwave of 18 to 28 June, 2005, was as intense," said Meteo France, adding the scorching weather would probably last a minimum of six days.   This latest intense heatwave again shows the impact of global warming on the planet, and such weather conditions are likely to become more frequent, meteorologists said.
Date: Thu, 20 Jun 2019 13:08:42 +0200

Berlin, June 20, 2019 (AFP) - German cabin crew union UFO called Thursday for a strike against airline giant Lufthansa in July, threatening travel chaos during the busy summer holiday season over a wage dispute.   Employees of Lufthansa's subsidiaries Eurowings and Germanwings are expected to vote next week on whether to take action.   Depending on the ballot, dates for the walkout are to be announced for July.   In the coming weeks, UFO union members will also decide whether to go on strike at main company Lufthansa.   "Lufthansa has deliberately managed to escalate wage disputes with its employees," said UFO vice-president Daniel Flohr in a statement.

Lufthansa called off talks with UFO last week and Flohr warned that strike action could cause "flight attendants, passengers and shareholders an additional worry this summer".   With most German schools shut for summer holidays in July, the industrial action could seriously disrupt travel plans in the peak season.   However, a Lufthansa spokesman insisted "there can be no strike, as currently there are neither wage agreements still open nor concrete demands".  The German airline reacted angrily with spokesman Boris Ogursky telling AFP it wants a "reliable collective bargaining partner" to be able to "jointly  develop solutions in the interest of employees and the company.  "At present we cannot see when and how UFO can once again fulfil its role  as a predictable, constructive bargaining partner.    "Therefore, no talks are currently taking place."