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Austria

Austria - US Consular Information Sheet
July 29, 2008
COUNTRY DESCRIPTION:
Austria is a highly developed, stable democracy with a modern economy.
Tourism is an important pillar of the Austrian economy and facilities are widely availab
e.
Read the Department of State Background Notes on Austria for additional information, or see the information at the Austrian National Tourist Office web site, http://www.austria.info.
ENTRY/EXIT REQUIREMENTS:
A valid passport is required. U.S. citizens can stay without a visa for tourist/business for up to 90 days in each six-month period. That 90-day period begins when you enter any of the Schengen countries: Austria, Belgium, the Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Iceland, Italy, Latvia, Lithuania, Luxembourg, the Netherlands, Norway, Poland, Portugal, Slovakia, Slovenia, Spain, and Sweden.
Note:
Although European Union regulations require that non-EU visitors obtain a stamp in their passports upon initial entry to a Schengen country, many borders are not staffed with officers carrying out this function.
If an American citizen wishes to ensure that his or her entry is properly documented, it may be necessary to request a stamp at an official point of entry.
Under local law, travelers without a stamp in their passports may be questioned and asked to document the length of their stay in Schengen countries at the time of departure or at any other point during their visit, and could face possible fines or other repercussions if unable to do so.
There are no vaccination requirements for international travelers.
Visit the Embassy of Austria web site at http://www.austria.org/ for the most current visa information. There are four Austrian Consulates General in the United States. As each one serves clients from a particular region, please contact the appropriate office for assistance. If you reside outside the U.S. please contact the responsible Austrian Embassy or Consulate in your country of residence.
A list of Austrian Embassies/Consulates is available at http://www.bmeia.gv.at/aussenministerium/buergerservice/oesterreichische-vertretungen.html.
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:
Austria remains largely free of terrorist incidents. However, like other countries in the Schengen area, Austria’s open borders with its Western European neighbors allow the possibility of terrorist groups entering/exiting the country with anonymity. Americans are reminded to remain vigilant with regard to their personal security and to exercise caution.

Austrian intelligence experts have registered increased radicalization of immigrant Muslim individuals and of small conspiratorial groups, as well as intensified use of the Internet as a propaganda and communications platform. Despite some terrorism-related incidents in 2007 directed against individual Austrian nationals or the Government of Austria, authorities overall believe the likelihood of terrorist attacks in Austria remains relatively low; the State Department rates Austria as a “Medium” threat for transnational terrorism.

Every year, a number of avalanche deaths occur in Austria's alpine regions. Many occur when skiers/snowboarders stray from the designated ski slopes. Leaving the designated slopes to ski off-piste may pose serious risks and may delay rescue attempts in case of emergency. Skiers/snowboarders should monitor weather and terrain conditions, and use the available avalanche rescue equipment. Avalanche beepers (transceivers) are the most common rescue devices and, when properly used, provide the fastest way of locating an avalanche victim, usually enabling authorities to begin rescue operations within minutes.

For the latest security information, Americans traveling abroad should regularly monitor the Department of State’s, 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:
Austria has one of the lowest crime rates in Europe, and violent crime is rare. However, crimes involving theft of personal property have increased in recent years.
As such, most crimes involving Americans are crimes of opportunity involving theft of personal belongings. Travelers are also targets of pickpockets who operate where tourists tend to gather. Some of the spots where such crimes are most frequently reported include Vienna’s two largest train stations, the plaza around St. Stephan’s Cathedral and the nearby pedestrian shopping areas (in Vienna’s First District).

There has been an increase in thefts and pick-pocketing on public transportation lines, especially on those lines coming into and out from the city center. U.S. citizens are advised to secure personal belongings and always take precautions while on public transportation and in public places such as cafes and tourist areas. Many citizens have had to disrupt travel plans while awaiting replacements for lost and stolen passports since emergency passports are generally only authorized in rare circumstances such as critical medical emergencies.
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.
Information on the Austrian crime victim compensation program can be found on the U.S. Embassy web site at http://vienna.usembassy.gov/en/embassy/cons/compens.htm.
The local equivalent to the 911 emergency line in Austria is 133.See our information on Victims of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION:
There are an adequate number of hospitals available in Austria. Local hospitals will not settle their accounts directly with American insurance companies. The patient is obliged to pay the bill to the local hospital and later claim a refund from his/her insurance carrier in the United States. MEDICARE payments are not available outside the United States.

The Austrian Medicine Import Act generally prohibits the import of prescription drugs into Austria, with two exceptions:
A) Travelers residing outside the European Union are allowed to carry with them (as part of their personal luggage) drugs and medicines, but only the quantity that an individual having a health problem might normally carry; and,
B) Travelers while staying in Austria may receive drugs and medicines for their personal use by mail. The quantity is limited to the length of their stay in Austria and must never exceed three packages.
Generally, it is recommended that travelers have either a prescription or written statement from their personal physician that the medicines are being used under a doctor's direction and are necessary for their physical wellbeing while traveling.
Public health conditions in Austria are excellent. The level of community sanitation in Vienna meets or exceeds that of most large American cities. Disease incidence and type are similar to that seen in the major cities of Western Europe and the United States. At the present time, air pollution is not a major health problem in Vienna.

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

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 (CDC) 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.

Any person, regardless of citizenship, who wants to take up residence in Austria, must be covered by some health insurance plan that covers full medical treatment in Austria. American citizens interested in joining the health insurance plan under the Austrian system should apply to the Health Insurance Agency (Gebietskrankenkasse) in the province (Bundesland) where they reside.
Further information may be obtained from the appropriate “Gebietskrankenkasse” http://www.sozialversicherung.at/portal/index.html?ctrl:cmd=render&ctrl:window=esvportal.channel_content.cmsWindow&p_menuid=955&p_tabid=6&p_pubid=687.
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 Austria is provided for general reference only, and may not be totally accurate in a particular location or circumstance.
Road conditions in Austria are generally excellent. During the winter, however, roads in alpine areas may become dangerous due to snowfall, ice, or avalanches. Some mountain roads may be closed for extended periods and tire chains are often required. Drivers should exercise caution during the heavily traveled vacation periods (December-February, Easter, July-August). Extra caution is recommended when driving through autobahn construction zones, particularly on the A-1 East/West Autobahn. Reduced lanes and two-way traffic in these zones have resulted in several deadly accidents in recent years. Traffic information and road conditions are broadcast on the English language channel fm4, located between 91 and 105 FM depending on the locale.

A U.S. driver’s license alone is not sufficient to drive in Austria. The U.S. driver’s license must be accompanied by an international driver’s permit (obtainable in the U.S. from American Automobile Association and the American Automobile Touring Alliance) or by an official translation of the U.S. driver’s license, which can be obtained at one of the Austrian automobile clubs (OEAMTC or ARBOE). This arrangement is only acceptable for the first six months of driving in Austria, after which all drivers must obtain an Austrian license.

Austria requires all vehicles using the autobahn to display an “Autobahn Vignette” highway tax sticker on the inside of the vehicle’s windshield. The sticker may be purchased at border crossings, gas stations in Austria, and small “Tabak” shops located in Austrian towns. Fines for failing to display a valid autobahn vignette on the windshield of your car are usually around $120.

Austrian autobahns have a maximum speed limit of 130 km/hr, although drivers often drive much faster and pass aggressively. The use of hand-held cell phones while driving is prohibited. Turning right on red is also prohibited throughout Austria. The legal limit for blood alcohol content in Austria is .05 percent and penalties for driving under the influence tend to be stricter than in many U.S. states.

Tourists driving rented vehicles should pay close attention to the provisions of their rental contract. Many contracts prohibit drivers from taking rented vehicles into eastern European countries. Drivers attempting to enter countries listed as “prohibited” on the car rental contract may be arrested, fined, and/or charged with attempted auto theft. Austrian police are authorized to hold the rented vehicle for the car rental company.
Emergency roadside help and information may be reached by dialing 123 or 120 for vehicle assistance and towing services (Austrian automobile clubs), 122 for the fire department, 133 for police, and 144 for ambulance.
The European emergency line is 112.
Austrian Federal Railroads (Österreichische Bundesbahnen) offer excellent railroad service to all major towns of the country and also direct connections with all major cities in Europe. Trains are well maintained and fares are reasonable. There is also an extensive network of bus lines operated by the Austrian Postal Service (Österreichische Post). All major cities also offer excellent public transportation services.
Please refer to our Road Safety page for more information. Visit the web-site of Austria’s national tourist office (Österreich Werbung) at http://www.austria.info and the national authority responsible for road safety (Kuratorium für Verkehrssicherheit) at http://www.kfv.at/.

AVIATION SAFETY OVERSIGHT The U.S. Federal Aviation Administration (FAA) has assessed the Government of Austria’s Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for oversight of Austria’s air carrier operations.
For more information, travelers may visit the FAA’s web site at: http://www.faa.gov/safety/programs_initiatives/oversight/iasa.
SPECIAL CIRCUMSTANCES:
Travelers using U.S. issued debit cards in Austrian Automatic Teller Machines (ATMs) may encounter problems. If the request for cash is rejected, travelers should check their accounts immediately to see whether the money was in fact debited from their account. If this is the case, they should notify their banking institution immediately. Prompt action may result in a refund of the debited amount. Receipts should always be requested and kept for verification with your home bank.
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 Austrian laws, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in Austria are severe, and convicted offenders can expect long jail sentences and heavy fines.
Engaging in sexual conduct with children or using or disseminating child pornography in a foreign country is a crime, prosecutable in the United States.
Please see our information on Criminal Penalties.

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

REGISTRATION / EMBASSY LOCATION:
Americans living or traveling in Austria are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department’s travel registration web site so that they can obtain updated information on travel and security within Austria.
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 Consular Section of the U.S. Embassy is located at Parkring 12a, tel. +43- 1-31339-7535, fax: +43-1-5125835, web site: http://vienna.usembassy.gov/en/index.html
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This replaces the Country Specific Information sheet for Austria dated January 23, 2008, without substantive changes.

Travel News Headlines WORLD NEWS

Date: Sun, 3 Mar 2019 04:10:56 +0100
By Sophie MAKRIS

Vienna, March 3, 2019 (AFP) - It looks like a scene from the halcyon days of the railways: travellers finding their sleeper berth, turning on the reading light and stowing their cases under the bed.    But it's still a common nightly ritual at Vienna's main station, where overnight train routes have endured in the age of low-cost flights -- and are even expanding.   From early evening onwards, the departures board at Vienna's "Hauptbahnhof" station becomes a roll call of destinations to whet the appetite of any globetrotter: Venice, Rome, Zurich, Berlin, Warsaw...   It's an unusual sight in a continent where budget airlines and faster trains have become the norm and led to the closure of many slower overnight routes.

But Austria's state railway company OeBB is looking to expand its network.   It already runs 26 such routes, either on its own or in partnerships with other operators.   In late 2016, OeBB bought the night train operation of its German counterpart Deutsche Bahn, which was looking to offload a department it judged insufficiently lucrative.   Around 60 percent of DB's overnight routes were preserved, including a revamped Vienna-Berlin service which started a few months ago.   Pointing to the "moderate growth" in passenger numbers -- more than 1.4 million used the services in 2018 -- OeBB has ordered 13 new trains equipped with state-of-the-art sleeper carriages.

- Eco-friendly -
It's no surprise then that Austria has become the poster child for rail enthusiasts, who say it provides an example of how overnight train travel can provide an alternative to air travel and even help in the fight against climate change.    "With regard to the target of becoming carbon-neutral by 2050, night trains which run on renewable energy are an attractive alternative," according to Thomas Sauter-Servaes, transport expert at the Zurich University of Applied Sciences.

But as with all those who have researched the sector, he admits that cross-border overnight rail travel can represent a logistical and financial challenge.   The profits per passenger take a hit from the extra space that sleeper compartments require, on top of the higher labour costs for those who have to work on the trains overnight and money spent on laundry.   And that's before you take into account the hefty fees sometimes charged by other network owners for use of the rails, the technical difficulty of decoupling and then re-attaching carriages, and navigating the myriad of different rules a train has to adhere to over a long journey.

Sauter-Servaes points out that international air transport has a big commercial advantage in being exempt from VAT and fuel taxes.   Among those preparing to board at Vienna station to spend a night on the rails on a recent evening, some told AFP they had chosen a night train with the environment in mind.   "It's a small gesture, and it won't stop me taking the plane for my holiday in Madagascar this autumn, but it's better than nothing," said Austrian traveller Yvonne Kemper.   David, a 42-year-old from Germany, said he was using the Hamburg service because he needed to get to Goettingen in Germany for a business trip -- a medium-sized town which, typically, is served by night trains but has no airport.

- An Austrian tradition -
OeBB spokesman Bernhard Rieder explained that Austria's attachment to night trains is down to "a tradition stemming from Austria's mountainous terrain, which limited the development of high-speed lines".   He added that "the night train sector is distinct in that it can't function without strong cross-border cooperation."   "Night trains are and will continue to be a niche market, but that doesn't mean a niche market can't be profitable."   But Poul Kattler, from the pan-European "Back on Track" group which campaigns for more cross-border night trains, says the sector should be more ambitious.   "If national railway companies were more aggressive in the market and the EU built a truly common rail policy, we could offer a real transport alternative and a very popular European project," he says.
Date: Tue, 15 Jan 2019 15:26:31 +0100

Vienna, Jan 15, 2019 (AFP) - Around 60 guests were evacuated from an Austrian hotel and holiday apartment house early Tuesday after the buildings were engulfed by an avalanche, rescue services said.   "It was lucky the avalanche didn't occur four hours earlier when all of the guests were in the dining room," said Heribert Eisl, of the mountain rescue team in Ramsau am Dachstein, a village in the central Styria region where the accident happened at 1:00 am (0000 GMT).

The dining room was filled with snow up to one metre (three feet) below the ceiling, he told a news conference.   The avalanche shattered the hotel's windows and overturned vehicles in the car park, but no-one was injured, Eisl said.   "We hadn't expected the avalanche to wreak such damage," he continued.

A number of areas in the Austrian Alps have been on high avalanche alert for the past 10 days as a result of heavy snowfall across the west and centre of the country since early January.    In some regions, more than three metres of snow has fallen.   The army has been called in to help clear roads and roofs and evacuate residents in the wake of the bad weather, which has also affected southern Germany and parts of Switzerland.
Date: Mon, 7 Jan 2019 20:17:54 +0100

Vienne, Jan 7, 2019 (AFP) - Three skiers and two snowshoe hikers have died as heavy snow and avalanches hit Austria, isolating several areas of the mountainous country, authorities said Monday.

Two German skiers lost their lives in avalanches in the western region of Vorarlberg on Sunday, and a Slovenian died in the region of Salzburg, rescue services said.   The bodies of two missing snowshoe hikers were discovered Monday as snow caused chaos in parts of the country, blocking roads and shuttering schools.   Two other hikers are still missing in the country's northeast.   Up to 1.5 metres (five feet) of snow has fallen in central and north Austria since the middle of last week, with up to three metres accumulating in the mountains around Salzburg, Austria's meteorological service said.

Some 2,000 people, including tourists, were left stranded in villages in the Soelktal valley in the southeast.    Army helicopters used in avalanche control were grounded due to the bad weather.    In the Hochkar mountain range in Lower Austria, ski resorts were closed until further notice, with inhabitants and tourists requested to vacate the area.    More snow is expected this week, with up to 80 centimetres forecast from Tuesday.
Date: Tue 16 Oct 2018
Source: Food Safety News [edited]

Austria has become part of a multi-country hepatitis A outbreak with 31 confirmed cases linked to frozen strawberries imported from Poland.  The outbreak of hepatitis A virus (HAV) is connected to the one recently declared over in Sweden which affected 20 people in 6 counties. Of these cases, 17 were confirmed and 3 were probable. Dates of symptom onset ranged from 30 May 2018 to 10 Jul 2018. Ages ranged from 9 to 92 years and 13 out of 20 were women.

In July and August 2018, Austria recorded 9 hepatitis A cases with the source unknown. Researchers reported in the Eurosurveillance journal that by sharing the sequence information identified in Sweden internationally, 14 cases in Austria were found linked to strawberries from the same producer.

Genotyping of the hepatitis A outbreak strain in Sweden showed of 17 of the 20 cases confirmed an identical genotype IB strain. Environmental investigations and interviews with kitchen personnel found strawberries had not been heated adequately before serving. Following the outbreak, the juice bar chain where at least 10 cases had fallen ill stopped using frozen strawberries in smoothies and changed to pasteurized frozen pellets of the fruit.

The incriminated batch of frozen strawberries was withdrawn in June 2018 but it had best before date 6 Apr 2020. In total, 1664 packages with 5 kg [11 lbs] strawberries each were removed from the Swedish market.

Almost 2 months after the initial outbreak alert in Sweden, Austria reported a case of HAV infection with a strain indistinguishable from the Swedish outbreak strain. It can take up to 6 weeks after exposure for symptoms to develop. In late August 2018, the Austrian reference laboratory for viral hepatitis reported 5 cases sharing the Swedish outbreak genotype IB strain to the Ministry of Health (MOH). The Austrian Agency for Health and Food Safety (AGES) was told to investigate the outbreak.

As of early October 2018, 36 cases of laboratory-confirmed acute hepatitis A had been reported to public health authorities in Austria since June 2018. Of those, 14 met the definition of a confirmed case and 4 were classified as non-outbreak infections based on sequence-typing data. For confirmed cases, disease onset ranged from 8 Jun to 20 Sep 2018, age range was between 5 and 70 years, with 8 males and 6 females affected. 12 patients ate strawberry ice cream during the incubation period and 9 remembered the restaurants where they ate it. For the remaining 18 cases, sequence-typing data was not yet available and patient interviews regarding food exposure during their incubation periods is ongoing, according to the researchers.

Since mid-May 2018, only one wholesaler in Austria purchased frozen strawberries from the producer in Poland, but further distribution included two wholesalers in Slovakia and one ice cream producer in Italy.

The Austrian importer of frozen strawberries from the Polish producer is expecting a supply of 22 tons at the end of 2018 and has requested evidence for a HAV-negative test result of samples. It has also asked for a guarantee from purchasers that frozen strawberries are heated before consumption.

There are several challenges with HAV outbreaks related to berries, according to the researchers. "First, the trace back can be difficult as berries are typically harvested by one producer, then packed by another food business operator whereby batches may then be mixed or split. Another point to consider during HAV outbreak investigations is the long incubation period of hepatitis A up to 6 weeks. After such a long time, it can be difficult to recall food consumption and collect food leftovers. Furthermore, the time from the onset of symptoms to a primary diagnosis and the sequence information can take several weeks," they said.

"In the current outbreak, leftovers from the suspected frozen strawberries in Sweden were sent to Livsmedelsverket and the presence of HAV could be confirmed by real-time PCR and Sanger sequencing, providing evidence for the source of infection. While being invaluable in tracing the source of infections, the molecular detection of viruses in food is challenging." Researchers also said boiling recommendations could be considered for frozen strawberries in Sweden. Such advice is already in place for frozen, imported raspberries because of the risk of norovirus.  [Byline: Joe Whitworth]
==========================
[Frozen berries have been implicated in hepatitis A transmission in the past. The exact mechanism of contamination of the berries is generally not clearly established, but hepatitis A is essentially only a human pathogen transmitted by the fecal-oral route. Transmission can be through food or water contamination or, as has been occurring in a number of large and some still ongoing outbreaks in the USA, through poor sanitation involving marginalized populations such as the homeless, with spill over into other groups. - ProMED Mod.LL]

[HealthMap/ProMED-mail maps
Date: Tue, 10 Jul 2018 16:14:43 +0200

Vienna, July 10, 2018 (AFP) - An American tourist brought an unexploded World War Two shell to Vienna airport in her luggage, Austrian police said on Tuesday.   The 24-year-old had found the bomb on Sunday while walking in the Dachstein mountains, according to police in Lower Austria state.

She kept the shell in her belongings as a souvenir and declared it to customs officers when she came to the airport on Monday, who immediately rang the police.   A bomb disposal unit was called and in order to safely remove the device, the baggage hall and parts of the arrivals area were closed for around 15 minutes.   There was no danger to passengers and no delays as a result, according to police.

The tourist was charged with public endangerment through negligence and given a four-figure fine.   More than 70 years after World War II and a century after World War I, unexploded bombs still regularly turn up across Austria and Germany, often during construction work.
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Eritrea

Eritrea US Consular Information Sheet
November 26, 2008
COUNTRY DESCRIPTION:
Eritrea is a poor but developing East African country, the capital of which is Asmara. Formerly a province of Ethiopia, Eritrea became an independent country on M
y 24, 1993, following a 30-year struggle that culminated in an overwhelming referendum vote for independence. Tourism facilities are very limited. Read the Department of State Background Notes on Eritrea for additional information.

ENTRY/EXIT REQUIREMENTS:
All travelers should have a passport and valid visa prior to arrival; visas are not available at the airport unless specifically pre-authorized by the Eritrean government.
Travelers visiting Eritrea using a foreign passport do not need an exit visa, provided they leave before their entrance visa expiration date.
Persons staying beyond their entrance visa expiration date may be subject to fines or imprisonment, or be required to remain in Eritrea for an extended period while their case is reviewed in court.
All long-term residents, regardless of citizenship, must obtain an exit visa 30 days prior to departure, unless they hold a difficult-to-obtain multiple entry visa.
Upon entry and exit, visitors must declare all foreign currency, and may be asked to declare electronic equipment such as cameras, computers and video equipment.
Visitors must save all receipts for foreign exchange and present these upon departure to account for all foreign currency spent in Eritrea.
Failure to report foreign currency or meet customs requirements usually results in both a fine and imprisonment.
There is also a $20 airport departure tax.
Information about the airport tax and entry/exit requirements is available from the Embassy of Eritrea, 1708 New Hampshire Avenue NW, Washington, DC 20009; telephone (202) 319-1991; fax (202) 319-1304.
Overseas, inquiries may be made at the nearest Eritrean embassy or consulate.

U.S. citizens born in Eritrea, to Eritrean parents, or who in any other way appear to have Eritrean origins, are required to register with the Immigration and Nationality office in Asmara within seven business days of their entry into the country.
The Eritrean government sometimes subjects U.S. citizens of Eritrean heritage to the same entry/exit requirements as Eritrean citizens.
See the “Special Circumstances” section below for more information about dual nationality.

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:
Eritrea and Ethiopia fought a border war from 1998-2000.
United Nations peacekeepers patrolled the border until March 2008, when Government of Eritrea diesel fuel restrictions resulted in the peacekeepers’ withdrawal.
Both Eritrea and Ethiopia maintain large military presences along the border and currently all border crossings into Ethiopia from Eritrea remain closed.
U.S. citizens are strongly advised to avoid travel near the Eritrean-Ethiopian border and to register their presence in Eritrea with the U.S. Embassy in Asmara.

Since April 2008, large numbers of Eritrean troops have been deployed along the northeastern border of Djibouti.
U.S. citizens are strongly advised to avoid non-essential travel to the Southern Red Sea region of Eritrea, including the port of Assab.

Landmines and unexploded ordnance remain a serious problem throughout the country.
There are reports of accidents and numerous incidents where vehicles and people occasionally detonate mines.
Many detonations occurred on relatively well-traveled roads in and near the Gash Barka region of western Eritrea; subsequent investigations indicated that several mines had been recently laid.
Vast areas of the country still have not been certified free of mines and unexploded ordnance left over from both the 30-year war for independence and the subsequent 1998-2000 conflict with Ethiopia.
Americans should avoid walking alone and hiking in riverbeds or areas that local government officials have not certified as safe.

Although Eritrea and Sudan have diplomatic relations, the procedures for crossing their common border are not clear and subject to change.
Overland travel between the two countries is dangerous and ill advised.
Travelers crossing from Eritrea to Sudan north and west of the Keren-Barentu road risk becoming victims of banditry or Islamic extremist insurgent activity.
Several incidents were reported in 2007, apparently involving insurgents or criminals in this area.
The U.S. Embassy also received reports of sporadic bombings of vehicles and government facilities in the Gash Barka region near Sudan in 2007 and 2008.
If travel near the Eritrean-Sudanese border is essential, travelers should consult both the Eritrean authorities and the U.S. Embassy in advance.
Foreign travelers who wish to visit any area outside of Asmara must apply at least ten days in advance for a travel permit from the Eritrean government.

For the latest security information, Americans traveling abroad should regularly monitor the Department of State, Bureau of Consular Affairs’ website 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 pamphletA Safe Trip Abroad.
CRIME:
Although still a safe city by many measures, Asmara reported significant increases of street crime, such as theft, robbery, and assault in 2008.
Travelers should exercise vigilance in their personal security and safety precautions regarding what valuables they carry and which areas they visit.

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:
Medical facilities in Eritrea are extremely limited.
Travelers must carry their own supplies of prescription drugs and preventative medicines because pharmaceuticals are in short supply.
Food and water-borne illnesses are very common among travelers, so drink only bottled or purified water and eat foods that are cooked or peeled.
Malaria is a serious risk to travelers in the lowlands of Eritrea, but Asmara is generally considered free of the disease.

There is no HIV testing requirement for temporary or permanent entry into Eritrea.
Please verify this information with the Embassy of Eritrea before you travel.

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 website at http://wwwn.cdc.gov/travel/default.aspx.
For information about outbreaks of infectious diseases abroad consult the World Health Organization’s (WHO) website 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 Eritrea is provided for general reference only, and may not be totally accurate in a particular location or circumstance.

The roads between major cities (Asmara, Massawa, Mendefera, Dekemhare, Barentu, and Keren) are paved and in relatively good condition.
However, secondary roads and those in remote areas are usually unpaved and in poor condition.
U.S. citizens should avoid traveling on these roads, especially at night.
Bad weather can also make the condition of poor roads worse.
If you must take unpaved roads, check first with local government and village officials as new minefields continue to be discovered.

Landmines and unexploded ordnance litter the countryside in many areas, occasionally causing injuries and deaths.
Although the UN conducted de-mining efforts until late 2007, evidence of new mines has been reported, particularly in areas near the Ethiopian border.
All areas that are not well traveled are potentially dangerous due to live mines, especially north and west of Keren.
There are also minefields near Massawa, Ghinda, Agordat, Barentu, south of Tessenae, Nakfa, Adi Keih, Arezza, Dekemhare, and in a roughly 40-kilometer wide region just west of the Eritrean-Ethiopian border between the Setit and Mereb Rivers.

Many Eritreans use inexpensive public transportation, especially bus service.
Travelers should avoid taking buses due to extreme over-crowding.
Taxis are plentiful and inexpensive in Asmara, but usually carry multiple passengers along pre-defined routes.
If an empty taxi is available, a customer may request a "contract" taxi, which accepts no additional passengers, for a significantly higher fixed price.
Drivers should be aware of heavy and erratic pedestrian and bicycle traffic obstructing vehicle flow.
Occasionally horse-drawn carts, cattle, or goats add to the obstacles.
Other hazards are children and the elderly, who sometimes wander into the path of moving traffic, as well as small, slow, motorized carts.
Elderly or disabled people usually drive these carts and do not always yield to faster moving traffic.
When parallel parking on city streets, watch for pedestrians as you back into the space.
Please refer to our Road Safetypage for more information.

AVIATION SAFETY OVERSIGHT:
As there is no direct commercial air service to the United States by carriers registered in Eritrea, the U.S. Federal Aviation Administration (FAA) has not assessed Eritrea’s Civil Aviation Authority for compliance with International Civil Aviation Organization (ICAO) aviation safety standards.
For more information, travelers may visit the FAA’s internet website at http://www.faa.gov/safety/programs_initiatives/oversight/iasa.

SPECIAL CIRCUMSTANCES:
Due to Eritrean government restrictions impacting Embassy operations, the consular section of the U.S. Embassy in Asmara does not provide routine services to American citizens in Eritrea, including reports of birth, passports, and notaries.
Americans traveling or residing in Eritrea who require such services must travel to a U.S. Embassy or Consulate outside Eritrea, and should plan accordingly.

American citizens should also be aware that U.S. diplomatic personnel are subject to travel restrictions.
The Government of Eritrea requires resident diplomats to apply 10 days in advance for travel outside of Asmara city limits; often travel permission is not given.
This restriction can delay or prevent U.S. Embassy emergency assistance to American citizens outside of Asmara.

The consular section of the U.S. Embassy in Asmara has been closed for visa services since January 2007.
Eritrea has complicated citizenship laws and does not recognize renunciation of Eritrean citizenship.
Dual nationals who enter the country on Eritrean documents are treated as Eritrean citizens, regardless of their other citizenship.
U.S. citizens born in Eritrea, or who otherwise are considered to have acquired Eritrean citizenship, may be subject to certain obligations, including being drafted into national service, regardless of the documents they present at entry.
(National service is approximately six months of military training, followed by an often unspecified number of years in military or other government service.)

U.S.-Eritrean dual nationals who enter the country on an Eritrean passport or national ID card must obtain an exit visa prior to departure.
Exit visa applications can significantly delay travel plans or be denied, even for persons who entered Eritrea legally.
Eritrean dual nationals are also required to pay a 2% income tax on overseas earnings to the Eritrean Government prior to being granted an exit visa.
Additionally, Eritrean authorities sometimes to not allow Eritreans who left the country after 1993 to depart Eritrea after visiting the country, even if they have a U.S. passport and a valid Eritrean visa.

The government of Eritrea does not inform the U.S. Embassy of the detention of American citizens, and does not allow Embassy officials to visit incarcerated Americans.

Visitors are advised to exercise caution when taking photographs in Eritrea.
Foreigners in Asmara have been harassed and detained by local police and plain clothes security officials for taking photographs of street scenes in the city.
No law has been cited, but the arresting officials' justifications have been that (unmarked) government buildings are in the background and/or that the pictures are being taken (illegally) for commercial reasons.

All foreign nationals in Eritrea are required to apply for permits to travel outside of Asmara.
Travel permits must be presented at all checkpoints.
Checkpoints are found on major roads through Eritrea, but locations may change without notice.
Applications for travel permits are available at the Ministry of Tourism located on Harnet Avenue.
There is a high risk of earthquakes in Eritrea.
General information about natural disaster preparedness is available on the Internet from the U.S. Federal Emergency Management Agency (FEMA) at http://www.fema.gov.
Please see our information on Customs Regulations.

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 Eritrean laws, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in Eritrea are severe, and convicted offenders can expect long jail sentences and heavy fines.
Engaging in sexual conduct with children or using or disseminating child pornography in a foreign country is a crime, prosecutable in the United States.
Please see our information on Criminal Penalties.
CHILDREN'S ISSUES:
For information see our Office of Children’s Issues web pages on intercountry adoption
and international parental child abduction.

REGISTRATION / EMBASSY LOCATION:
Americans living or traveling in Eritrea are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department's travel registration web site, and to obtain updated information on travel and security within Eritrea.
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 at 179 Alaa Street, PO Box 211, Asmara; telephone (291-1) 12-00-04; fax (291-1) 124-255 and (291-1) 127-584; the Embassy’s web site is located at http://eritrea.usembassy.gov/
*

*

*
This replaces the Country Specific Information for Eritrea dated April 28, 2008, to update sections on Entry/Exit Requirements, Safety and Security, Crime,
Medical Facilities and Health Information, and Special Circumstances.

Travel News Headlines WORLD NEWS

Date: Sat 10 Sep 2016
Source: Asmarino Independent [edited]

Activists have reported a serious cholera outbreak in the Upper Gash-Barka Region of Eritrea, which is proving difficult to control. The outbreak was 1st observed at Barentu Referral Hospital 2 weeks ago when people who had travelled from the upper Gash region were reported to be suffering from an illness that was not diagnosed easily. However, as a result of the extended time taken for accurate diagnosis of cholera due to a severe shortage of expertise and infrastructure, the outbreak spread widely, affecting areas of the Gash-Barka Region.

It has now been a week since the Ministry of Health acknowledged the outbreak as being a potential national epidemic and has briefed health professionals in the region to that effect.

So far, the effort to curb the spread is proving futile, and the impact of the outbreak is being felt across the region. Markets were deserted as a result of the spread, and even cattle markets in small villages outside Barentu have been cordoned off to prevent the spread. An expert at the Ministry of Health's public health section for preventing such epidemics stated: "There is currently no national emergency response team to prevent and control such outbreaks; we are, therefore, prone to such epidemics, as it always takes time to pull such a team together to both control the outbreak and treat victims."

Already, the current epidemic is said to have spread from the Upper Gash Region to the Southern Region and particularly to the area of Mai Dima, where an epidemic control team has been dispatched.

According to health experts in the region, when such an outbreak occurs, even able-bodied adults find it impossible to cope with the acute loss of bodily fluids. Without appropriate medical assistance, it is impossible for patients to recover, and the situation is considerably worse for pregnant women and children.

Given the lack of public health awareness, Arbi Harnet calls on the people to take preventive actions by strictly adhering to personal and public hygiene practices.
======================
[A HealthMap/ProMED-mail map showing Eritrea is available at
Date: Sat, 23 Jan 2016 12:14:06 +0100

Nairobi, Jan 23, 2016 (AFP) - Eritrean President Isaias Afwerki on Saturday dismissed fears the Horn of African nation faces a food crisis, despite sweeping drought across the wider region leaving millions in need of aid.   Floods and failed rains caused by the El Nino weather phenomenon have sparked a dramatic rise in the number of people going hungry in east Africa.

But authoritarian and isolated Eritrea has long rejected UN food aid in favour of a policy of self reliance, and Isaias said he was not worried.    "In view of the harvest shortfall that has affected the whole Horn of Africa region, President Isaias stated that the country will not face any crisis in spite of reduced agricultural output," the information ministry said, after he was interviewed by state-run media.   Isaias praised the government's "judicious policy and approaches of bolstering its strategic food reserves."

In November, the UN warned that Eritrea was among the countries at risk, like all the other nations in the wider region. "The current El Nino pattern, being the strongest ever recorded, has caused severe drought in the Horn of Africa nation, resulting in crop reduction by 50 to 90 percent; even failure in some regions," the United Nations said earlier this month.   In Ethiopia, over 10 million people need food aid, it added.    In Eritrea, few if any major foreign aid agencies are allowed operate, while the UN has limited access across the country, and most assessments are dependent on government reports.

Thousands of Eritreans flee the county each month, saying they are escaping conscription and rampant rights abuses.   Refugees from the repressive Red Sea state make up the third-largest number of people risking the dangerous journey to Europe after Syrians and Afghans, running a gauntlet of ruthless people smugglers to make the treacherous Mediterranean crossing.
Date: Thu 30 Jul 2015
Source: Eurosurveillance edition 2015; 20(30) [edited]

Louse-borne relapsing fever (_Borrelia recurrentis_) in asylum seekers from Eritrea, the Netherlands, July 2015
----------------------------------------------------------------------
[Authors: Wilting KR, Stienstra Y, Sinha B, Braks M, Cornish D, Grundmann H]

Two patients from Eritrea, recently arrived in the Netherlands, presented with fever and were investigated for malaria. Bloodfilms showed spirochetes but no blood parasites. Louse-borne relapsing fever caused by _Borrelia recurrentis_ was diagnosed. Treatment was complicated by severe Jarisch-Herxheimer reactions [inflammatory reaction observed after antimicrobial treatment of several infectious diseases] in both patients. Physicians should be aware of the possibility of _B. recurrentis_ infection in migrant populations who travel under crowded conditions, especially after passing through endemic areas such as Ethiopia and neighbouring countries.

_Borrelia recurrentis_ has for many centuries caused infections of often epidemic proportions known as relapsing fever. Since the infection is exclusively transmitted by body lice and humans are their only host, large scale outbreaks are only expected under circumstances conducive to louse infestation. We here report the 1st introduction of louse-borne relapsing fever into the Netherlands after World War II.

Case descriptions
-----------------
Patient 1
On 4 Jul 2015, a young adult from Eritrea was referred from the National Reception Centre for Asylum Seekers (Asielzoekercentrum, AZC) to a regional hospital in the northern Netherlands with a 5-day history of headache, dizziness, right upper quadrant pain, myalgia, and fever (39.3 deg C [102.7 deg F]). Malaria was suspected. The patient had been in the Netherlands for only 2 days after arriving in Europe 14 days earlier. En route to Europe, they travelled through Ethiopia, Sudan, and Libya. Previously, they had noticed chills while sheltering in an unofficial street camp in Rome where they stayed with a small group of fellow Eritreans before travelling to the Netherlands.

Thick and thin bloodfilms did not show malaria parasites and commercial malaria antigen tests were negative. However, filamentous unidentified structures were reported in the thick film by the laboratory of the peripheral hospital. The patient received empirical treatment with a single dose of ceftriaxone (2000 mg intravenously) for suspected bacterial septicaemia. After administration, their condition deteriorated and the patient was transferred within the next 2 hours to the University Medical Center Groningen (UMCG) where they arrived at the emergency department with headache, peripheral hypothermia (35.3 deg C [95.5 deg F]), hypotension (systolic/diastolic blood pressure 78/52 mmHg, heart rate of 106 beats per minute), abdominal pain but no hepatosplenomegaly, and shortness of breath (respiratory rate 23 breaths/min). Laboratory analysis showed leucocytopenia (leucocytes: 1.6 x 10(9)/L, norm: 4.5-10 x 10(9)/L), anaemia (haemoglobin: 6.5mmol/L, norm: 8.6-11.2 mmol/L) and thrombocytopenia (thrombocytes: 16x10(9)/L, norm: 150-450x10(9)/L). C-reactive protein (CRP) was 254 mg/L (norm: less than 1 mg/L). Kidney function was normal. The patient's liver function tests showed mildly elevated transaminases (alanine transaminase: 58 U/L, norm: 7-56 U/L; aspartate transaminase: 108 U/L, norm: 10-40 U/L; alkaline phosphatase: 124 U/L, norm 20-140 U/L; gamma-glutamyl transferase: 93 U/L, norm 0-51 U/L) and total bilirubin levels of 38 micromole/L (norm: less than 26 micromol/L) and direct bilirubin 35 micromol/L (norm: less than 7 micromol/L). Oxygen saturation was 91 percent (norm: 95-100 percent). Giemsa-stained thick and thin films revealed spirochetes in large numbers (Figure 1 [available at the source URL]) and no malaria parasites.

Given the patient's travel history, louse-borne relapsing fever was suspected. The clinical deterioration was provoked by the ceftriaxone administration leading to a severe Jarisch-Herxheimer reaction [1]. Treatment was switched to doxycyline 200 mg per day intravenously intravenously to reduce the risk of relapse [2]. The patient was transferred to the intensive care unit (ICU) for fluid resuscitation, cardiac support with noradrenalin, and supportive oxygen delivery via high flow nose mask.

_B. recurrentis_ was confirmed by 16S rDNA PCR and sequencing directly from blood 2 days later. The patient stayed at the ICU for 2 days, made a full recovery and was discharged after 6 days. The body louse _Pediculus humanus humanus_ was recovered from [the patient's clothing (Figure 2 [available at the source URL]).

Patient 2
In 9 Jul 2015, a 2nd young adult from Eritrea was directly referred by the responsible physician at the AZC to the UMCG. On arrival, the patient presented with general malaise, headache, fever (38.5 deg C [101.3 deg F]) and cough. Blood tests showed elevated inflammatory parameters (leucocytes: leucocytes: 12.7 x 10(9)/L, CRP: 320 mg/L), normal kidney function and slightly elevated transaminases, but the blood sample was haemolytic. Thick and thin films showed spirochetes and treatment was started with doxycyline 200 mg orally. 2 hours later the patient developed a severe Jarisch-Herxheimer reaction [that] required admission to intensive care where they received fluid resuscitation, inotropic treatment with noradrenalin, and oxygen via a face-mask. _B. recurrentis_ was confirmed by 16S rDNA sequencing.

The patient reported symptoms of chills and fever 2 weeks before presentation at our hospital. Their journey through North Africa followed the same route as that of Patient 1, but Patient 2 had arrived in Europe a week earlier. Patient 2 had camped out in the streets for 5 days in Rome (as had Patient 1). Patient 2 arrived in the Netherlands 2 weeks before presenting at our hospitals after travelling through Austria and Germany. The patient made a full recovery and was discharged after 5 days. Lice could not be recovered from the clothing.

Discussion
----------
_B. recurrentis_ should be suspected in patients presenting with fever and a recent history of migration from or through endemic countries (Ethiopia, Sudan, Eritrea, and Somalia). The infection is transmitted through body lice (_P. humanus humanus_, formally known as _P. humanus corporis_), which typically lives and breeds in the seams of clothes but can occasionally also be found in bed linens. Immigrants may share their clothing and that can pose an additional risk of transmission. The incubation period for relapsing fever is usually 4 to 8 days with a range of 2 to 15 days [3]. It should be noted that head lice (_P. humanus capitis_), which are not uncommon in Northern Europe, are incompetent vectors and cannot transmit _B. recurrentis_. The spirochetes are easily visible under a microscope in a Giemsa-stained thick or thin blood film as used for the diagnosis of _Plasmodium_ spp [4]. In our patients, the diagnosis was confirmed in both cases by 16S rDNA PCR and sequencing from blood.

Published evidence supports a single dose of tetracycline 500 mg intravenously as the conventional treatment, but considering the limited availability of this drug, doxycycline 200 mg can be used as an effective alternative [2,5]. In young children, pregnant women, or patients with a tetracycline allergy, erythromycin 500 mg can be used instead [6].

Both patients had travelled independently along a similar route before arriving in the Netherlands. Given the incubation period, it cannot be ruled out that the infection was acquired within Europe. Crucial information about risk factors such as exact travel history, recollection of louse infestation or bites and onset of symptoms was, however, impossible to obtain from our patients. Apart from being very sick and the fact that communication required an interpreter versed in Tigre our patients appeared to be traumatised and intimidated and not eager to volunteer information for fear of legal consequences.

Both patients developed a severe Jarisch-Herxheimer reaction after starting antibiotic treatment. _B. recurrentis_ evades host immune defences, resulting in very high bacterial loads (10(6)-10(8)/microl), and effective antibiotic therapy is followed by severe reactions characterised by sudden rigors, fever, and hypotension in virtually all treated patients [3]. Clinical symptoms are associated with increased plasma concentrations of tumour necrosis factor alpha (TNF-alpha), interleukin-6 and interleukin-8 [7]. Treating physicians should be aware of this complication and the chances that ICU admission may be warranted. It is advised that patients receive 2 well-placed intravenous lines for rapid fluid resuscitation. Treatment of Jarisch-Herxheimer reaction consists mainly of supportive care. Corticosteroids seem to have limited beneficial effect but studies suggests that TNF-alpha blockers may be useful [8].

An ad hoc survey at the AZC on [16 Jul 2015] found body lice on 2 newly arrived Eritreans. Since then, all asylum seekers arriving from endemic countries to the AZC have been segregated into a different compound, where they turn over all of their personal clothes in exchange for disposable overalls. Personal clothes are then washed and returned on the next day. Used overalls and bed linen are subsequently destroyed. In addition to delousing, all arrivals receive a single dose of ivermectin as pre-emptive treatment against scabies and Eritreans who arrive with clinically manifest scabies (about 80 percent of all new arrivals) receive a 2nd dose a week later. No new cases of _B. recurrentis_ infection have been identified since mandatory delousing was implemented.

Conclusion
----------
Because infections with _B. recurrentis_ pose a significant health risk to other migrants, aid workers, healthcare personnel, and arguably to the general population, screening and delousing should be considered for arriving migrants already at ports of entry into the European Union. Our patients may have acquired body lice before arriving in Europe but transmission of infected lice between migrants after arrival in Europe cannot be ruled out and could pose an additional public health challenge.

[Figures and references are available at the source URL above.]
======================
[Relapsing fever is a bacterial infection caused certain species of the spirochete _Borrelia_. These organisms are able to periodically change their surface protein molecules to evade the host's immune response, thus causing a relapsing illness. Following an incubation period of about 7 days, the illness is characterized by recurring episodes of high fever, headache, muscle and joint pain, nausea and vomiting, each episode lasting several days, followed by a several-day asymptomatic interval. There may be up to 3-4 recurrences. Complications may include involvement of the lungs (ARDS; acute respiratory distress syndrome), central nervous system, spinal cord, eyes, heart, and liver. The bacteremia is intense (more than 10,000 organisms per ml of blood) during febrile episodes, which allows detection of organisms on a Wright-Giemsa stained blood smear. Thick blood smears are more sensitive than thin smears.

There are 2 types of relapsing fever: Tick-borne relapsing fever (TBRF) and louse-borne relapsing fever (LBRF). LBRF is more severe than TBRF, with case-fatality rates without antimicrobial treatment of 30 to 70 percent in outbreaks. TBRF occurs in the Western hemisphere, Africa, Asia, the Mediterranean region and the Middle East. In the western United States, TBRF is usually associated with sleeping in rustic, rodent-infested cabins in mountainous areas. In the United States, 3 species, _Borrelia hermsii_, _B. parkerii_, and _B. turicatae_, transmitted by the bite of soft-bodied ticks (genus _Ornithodoros_) cause TBRF. A recently discovered _Borrelia_ species, _Borrelia miyamotoi_, has been found in hard-bodied ticks (_Ixodes_) in regions where Lyme disease is endemic.

LBRF is caused by a single species, _Borrelia recurrentis_, transmitted through abraded skin when the body louse is crushed during scratching. LBRF is endemic in Ethiopia, Sudan, Eritrea, and Somalia. Outbreaks are found in developing regions affected by war and in refugee camps characterized by overcrowding and poor personal hygiene. While mammals and reptiles may serve as a reservoir for tick-borne _Borrelia_ species, humans are the only host of _B. recurrentis_.

Treatment of relapsing fever consists of either a tetracycline (such as, doxycycline), a macrolide (such as, erythromycin), penicillin, or other beta-lactam antibiotics (such as, ceftriaxone). LBRF can be treated effectively with a single dose of the antibiotic (<http://jid.oxfordjournals.org/content/137/5/573.abstract>), whereas treatment of TBRF requires 7-10 days to prevent relapse. When initiating antibiotic therapy, all patients should be observed for a Jarisch-Herxheimer reaction. The reaction, caused by massive release of tumor necrosis factor alpha (TNF-alpha), interleukin-6, interleukin-8, and other cytokines, is manifest by a worsening of symptoms with rigors, tachycardia, sweating, hypotension, and high ever, occurs in over 50 percent of cases. The Jarisch-Herxheimer reaction can be fatal. Pretreatment with anti TNF-alpha antibody has been found to suppress Jarisch-Herxheimer reactions (<http://www.nejm.org/doi/full/10.1056/NEJM199608013350503>).

Corticosteroids and antipyretic agents have little or no effect (<http://jid.oxfordjournals.org/content/137/5/573.abstract> and <http://www.ncbi.nlm.nih.gov/pubmed/6132178?dopt=Abstract>), whereas meptazinol, an opioid agonist-antagonist, has been reported to reduce the severity of the reaction (<http://www.ncbi.nlm.nih.gov/pubmed/6132178?dopt=Abstract>). Treatment with intravenous fluids and vasopressors to maintain adequate blood pressure may be required. - ProMed Mod.ML]

[A HealthMap/ProMED-mail map can be accessed at:
Date: Fri, 20 Jan 2012 13:40:00 +0100 (MET)

ADDIS ABABA, Jan 20, 2012 (AFP) - Addis Ababa said Friday that two Germans kidnapped during a deadly attack by unidentified gunmen on a group of tourists in northern Ethiopia had been taken to neighbouring Ethiopia. Germany said it was still investigating the pair's whereabouts. "There is news that they are in Eritrea by now," foreign ministry spokesman Dina Mufti told AFP.

The Germans are believed to have been abducted when gunmen attacked a group of tourists in Ethiopia's remote Afar region earlier this week. Five people were killed in the attack: two Germans, two Hungarians and one Austrian. The German foreign ministry said three members of Germany's Federal Crime Agency were dispatched to Ethiopia to assist search efforts.  "The Federal Crime Agency (has) sent staff to Ethiopia in order to support the Embassy," a spokeswoman for Germany's foreign ministry told AFP from Berlin.  "They are trying to investigate where the two missing Germans could be." Six other Germans were among twelve survivors, some of them wounded, who were flown back to Addis Ababa on Wednesday. A Belgian citizen with gunshot wounds remains in hospital in Mekele in northern Ethiopia. The five bodies have been flown to the capital.

The attack took place near the famed Erte Ale volcano in Ethiopia's sparsely populated Danakil desert, close to the tense Ethiopia-Eritrea border.  The area, which boasts spectacular moon-like landscapes and is famed to be the hottest place on earth, is popular among travellers.  No group has claimed responsibility for the killings, but Ethiopia blamed arch-foe Eritrea for carrying out the attack. Eritrea vehemently denied being behind the incident, calling Ethiopia's claim "ludicrous" and a "smear campaign." The two Horn of Africa countries fought a bloody border war from 1998 to 2000 which killed 70,000 people. The border remains contested, with Ethiopian troops occupying land that international courts say belongs to Eritrea.
Date: Tue, 30 Aug 2011 12:41:08 +0200 (METDST)
by Jenny Vaughan

Shire, Ethiopia, Aug 30, 2011 (AFP) - In Ethiopias Endabaguna refugee camp, rows of gaunt Eritreans clad in rubber sandals give vent to their exasperation after days of trekking and dodging soldiers in an attempt to escape failed crops, hunger and an autocratic government. Over 12 million people across the Horn of Africa are struggling from the region's worst drought in decades, but secretive Eritrea is the only country to deny it has been affected by the crisis. "This year I farmed, but there was lack of rain. I dont know whats going to happen, only God knows," said Mehreteab, a refugee. He escaped from the army, risking death or jail if caught crossing the heavily militarized border, leaving his wife and three children behind. "There is no food and no grain in the home," he said. "I dont have any idea whats going to happen to them." Camps in northern Ethiopia receive about 900 refugees every month from Eritrea, one of the regions most isolated countries. A former colony of Italy and then part of Ethiopia, Eritrea fought a 30-year war with Ethiopia and only gained independence in 1991. A subsequent border conflict with Ethiopia from 1998-2000 still simmers.  Former rebel leader Issaias Afewoki, who has been in power since 1991 without elections, has cracked down on all dissidents and severely restricted press and religious freedom.

The majority of those arriving in the Ethiopian camps are young men escaping conscription, which forces men above 16 to serve in the military for decades on minimal pay. The UN recently called for tighter economic sanctions after releasing a report linking Eritrea to a failed bomb plot at the African Union. According to satellite imagery from the weather monitoring group FEWSNET, rainfall in parts of Eritrea this year has been "below average" - less than 10 percent of normal levels in some areas. Aid workers admit it is nearly impossible to know just how gravely the Eritrea is affected because access to information is so limited in the country where the only media is state-run. "Its been a black hole for us, we dont know whats going on there," said Matthew Conway, spokesman for the UN humanitarian coordination office in Nairobi. "But thats not to say its not happening."

The US ambassador to the United Nations has said she is "deeply concerned" that Eritrea is facing extreme hunger, and urged the government to allow humanitarian access. "The people of Eritrea who most likely are suffering the very same food shortages that were seeing throughout the region are being left to starve," Susan Rice told reporters in New York. And much like other countries in the region, such as Ethiopia and Kenya, Eritrea is vulnerable to increased food prices, exacerbating the crisis. According to the UN agriculture agency, global food prices jumped 33 percent in the last year. "High international prices affected every country in the world, so from that you can assume Eritrea is affected," said Shukri Ahmed, an economist at the Food and Agriculture Organization. Fiercely self-reliant Eritrea stopped sending market information to FAO about three years ago, Ahmed said, so it is impossible to know how much food prices have risen in the country. "Unfortunately, we dont have any information on the ground," he told AFP by phone from Rome.

Over half of Eritrea's food is imported, the FAO estimate, leaving it vulnerable to market fluctuations for staples such as sorghum and maize. Eritrean refugee Berhane, 35, said the cost of food has surged in recent years, though wages have remained the same. Intermittent work as a labourer earned him about $5 per day. But the cost of grain is about $3 per kilo and a sheep is about $170, more than he could make in a month, he told AFP. "How is someone with no money or daily work supposed to buy this?" he asked. "It is too expensive." Facing steep food costs, he relied on a small plot of land to feed his family. But the rains were two months late this year and his harvest failed. "The government doesnt do anything. Nothing. There are no rations," he told AFP.

The Eritrean authorities deny the country is facing food scarcity. "This nonsense about a hidden famine in Eritrea is utterly false," the Eritrea's information ministry said in an online statement last week. Instead, Asmara claims last year's harvest was the best in a decade, while state run media heap praise on government-run food security programs. But refugee Gebrielxavier, 25, said this is not true. He left Eritrea last November because his crop failed, he could not find work and his family went hungry. "We couldnt live. We were famished," he said. "And the government? It did nothing." He is now running a café in the refugee camp, where he earns less than $2 a  day and relies on UN food rations, but says he is still better off. "I got my freedom," he said.
More ...

World Travel News Headlines

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

- Do not provoke -

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

- Be alert and prepared -

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

An image of a _Pteropus_ fruit bat can be found at

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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