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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.
More ...

India

General Information
*******************************************
India is bounded by the Himalayas in the north and extends 2000 miles southwards into the Indian Ocean, between the Bay of Bengal on the East and the Arabian Sea on the West. The cou

try has three main geographic regions: the Himalaya Mountains on the Nepal-Tibet border; the Gangetic Plain lying below the Himalayas; the Deccan Plateau south of the Gangetic Plain. The climate throughout India is determined, to a large extent, by the massive Himalayan mountainous barrier in the northeastern part of the country. Many Irish travellers to India spend a significant period of time within the country but even those on short holidays or business trips need to take care to maintain their general health.

Climate
*******************************************
Most of the country is tropical or sub-tropical and subject to seasonal monsoon winds. This is especially true in the southwestern regions. * New Delhi There are three distinct seasons in New Delhi. Between mid-April to mid-July there is the hot dry season with dust storms. From mid-July to September there is a rainy season and a cooler season from October to March. * Bombay Bombay has a tropical climate and has an annual average temperature of about 270C. The hot humid season occurs in April and May. A monsoon occurs from June to September with about 70" of rainfall. A cool season extends from November to February when the temperatures can drop somewhat. * Calcutta Humidity remains high throughout most of the year. This is especially true between May to October when humidity levels of 90% are common. Most of the rainfall occurs during the monsoon season between June to October. * Madras The climate remains tropical throughout the year. December and January are relatively cool months and the heat increases rapidly from March to June. Premonsoon rains bring relief in July and the temperatures decrease slowly until the cooler season returns in November.

Safety & Security:
*******************************************
For most Irish travellers this will not be a major concern. However, the experience of travelling through any of the major cities is something many tourists will not forget. Taking care on Indian roads is a constantly essential activity. Parts of the country are unstable and recent earthquakes have led to disruptions to the transport infrastructure. As in many other countries travelling alone or late at night is unwise. In Kashmir tourists have been targeted and it is sensible to check you itinerary carefully before you travel throughout the country. In the northeastern part of the country (Assam, Manipur, Nagaland, Tripura, and Meghalaya) there have been sporadic incidents of violence by ethnic insurgent groups, including the bombing of buses and trains reported.

General Health Issues
*******************************************
It is essential that travellers recognise that there is a higher risk to their health while travelling in India. These risks are mainly associated with malaria and food and water borne diseases but conditions like accidents, rabies, tuberculosis and cholera are also present in many regions.

Food Borne Disease
*******************************************
A vegetarian diet is common throughout the country. Frequently the care taken with food preparation will be below standards usually seen in Western Europe. Work surfaces may be contaminated and food handlers may themselves infect the food before it is served. Cold foods should be avoided, where possible, and travellers should only consume hot food which has been freshly prepared. Stir fries may not reach sufficient cooking temperatures and need to be treated with great care. Shell fish and lettuce should always be avoided as they are one of the main ways food borne diseases are transmitted.

Water Borne Disease
*******************************************
Tap water should NOT be used for drinking or brushing teeth unless the smell of chlorine is obvious. Don’t use water from a jug in the hotel bedroom for anything except general washing. Sealed mineral water bought from your hotel should be used for all consumption and for brushing teeth.

Malaria
*******************************************
Malaria is usually transmitted through the bite of an infected mosquito. This may occur throughout India, including all the major cities. The highest risk time is during the monsoon season (May to October approximately) but there is risk throughout the year. Travellers should take care against mosquito bites and maintain their prophylactic tablets during their time in India and also for a further four weeks after leaving the country.

Rabies
*******************************************
This viral disease is transmitted by any infected warm-blooded animal. Dogs, cats, monkeys etc are frequently involved. Travellers should avoid all contact with animals and any bite (lick or scratch) should be treated by immediately washing out the area, applying an antiseptic and then seeking urgent medical attention. India reports many thousand deaths each year from this dreadful disease.

Vaccinations
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Most short term travellers should consider vaccination cover against Poliomyelitis, Typhoid, Tetanus and Hepatitis A. Malaria tablets will also be required. For longer trips please contact the Tropical Bureau at the numbers below.

Other Health Information
*******************************************
A full range of information on healthy travelling overseas can be obtained from the educational department of the Tropical Medical Bureau.

Travel News Headlines WORLD NEWS

Date: Tue 4 Mar 2019
Source: Deccan Herald [edited]

A 35 year old man died of Kyasanur Forest disease (KFD), also known as monkey fever, at KMC hospital in Manipal on Monday [4 Mar 2019].

The deceased was a resident of Bannumane village in Aralagodu Gram Panchayat jurisdiction in Sagar taluk. With this, the death toll due to KFD has risen to 11 in the last 4 months.  [byline: Nrupathunga S K]
========================
[The above report provides no epidemiological information or exposure history of the new fatal case. The current KFD outbreak continues with 11 confirmed deaths, and concurrent animal deaths are also being reported. The efforts to improve public education on preventive measures should help check the virus transmission and control the current outbreak. - ProMED Mod.UBA]

[HealthMap/ProMED-mail map of Karnataka state, India:
Date: Wed 13 Mar 2019
Source: The Times of India, Times News Network (TNN) [edited]

A confirmed case of West Nile fever, a relatively unknown viral infection in the region, [has been] reported in the district. A 7 year old boy from AR [Abdu Rahiman] Nagar was admitted to the Kozhikode Medical College hospital on [Mon 11 Mar 2019].

The health authorities in Malappuram have informed that the infection was confirmed. The patient had been under treatment for a fever, and he was shifted to the medical college after showing symptoms of the West Nile viral infection. Following the report of the disease, the district health administration has issued a special alert across the district against the disease, which is typically spread by culex mosquitoes.

According to the World Health Organization (WHO), West Nile virus [WNV] is mainly transmitted to people through the bites of infected mosquitoes, and it can cause a fatal neurological disease and death in people. Birds are the natural hosts of WNV. Human infection is most often the result of bites from infected mosquitoes, which become infected when they feed on infected birds, which circulate the virus in their blood for a few days, says the WHO website. No human-to-human transmission of WNV through casual contact has been documented, according to WHO. Symptoms of infection include fever, headache, fatigue, body aches, nausea, and vomiting.

The prevalence of the virus was raised in Alappuzha and parts of Kottayam in 2006 during the outbreak of chikungunya. A suspected case of disease was also reported in a 24 year old woman in Kozhikode last year [2018].

District medical officer (DMO) K Sakeena said that health authorities have initiated efforts to prevent the spread of disease, including vector control activities. "We have issued a warning to private hospitals, veterinary doctors, and public health authorities. As no vaccines are available for humans, the only way to reduce infection in people is by raising awareness of the risk factors and educating people about the measures they can take to reduce exposure to the virus," she said, adding that the cleaning of drainages and waterlogged areas, the main breeding grounds of mosquitoes, is on. She said that community programmes also would be conducted to destroy mosquito breeding sites in residential areas.

Health authorities have already identified the presence of culex mosquitoes in the premises of the house of the boy who was infected, and local sanitation works also were carried out in the region.  [byline: T P Nijeesh]
=======================
[West Nile virus (WNV) has been reported from many states in India. Evidence of WNV cases through serology was reported from Vellore and Kolar districts in 1977-1978 and 1981. WNV-neutralizing antibodies have been detected in human sera collected from Tamil Nadu, Karnataka, Andhra Pradesh, Maharashtra, Gujarat, Madhya Pradesh, Orissa, Rajasthan, and Maharashtra. During an outbreak of AES [acute encephalitis syndrome] in Kerala in May 2011, WNV was confirmed in clinical specimens. Since then, WNV encephalitis cases have regularly been reported in Kerala [<https://www.nhp.gov.in/disease/communicable-disease/west-nile-fever>].

WNV is a zoonotic flavivirus that is mainly transmitted to people through the bites of infected mosquitoes. WNV is maintained in nature through the mosquito-bird transmission cycle, as birds are the natural hosts of the virus and act as both carriers and amplifying host. Humans, horses, and other mammals can be infected. Ornithophilic (feeds on birds) mosquitoes belonging mainly to _Culex_ species act as vectors for transmission of infection from infected birds to vertebrate hosts. - ProMED Mod.UBA]

[HealthMap/ProMED-mail map of India:
Date: Sun 3 Mar 2019 23:53 IST
Source: The Hindu [edited]

Sagar taluk [Shimoga district] is reeling under a fresh outbreak of Kyasanur Forest disease (KFD), also known as monkey fever, as 3 persons hailing from here have died because of this tick-borne viral infection in just 3 days. On [Sun 3 Mar 2019], [SP], 58, a resident of Nandodi from Aralagod gram panchayat [GP] in Sagar taluk, died at a private hospital in Manipal. With this, the KFD death toll in the district since December [2018] has touched 12. According to sources in the Department of Health and Family Welfare, 6 persons suffering from symptoms of KFD in Aralagod GP limits have been admitted in various private hospitals since [Sat 2 Mar 2019]. 2 of them are said to be in serious condition.

Of the recent 3 victims, [P], who died on [Sat 2 Mar 2019], and [S] had been administered primary as well as a booster dose of vaccine against KFD. An officer serving with the department told The Hindu on the condition of anonymity that the deaths of vaccinated persons has created apprehension about the potency of the vaccine. The issue will be brought to the notice of the authorities at the Institute of Animal Health and Veterinary Biologicals, Bengaluru, where the vaccine is produced, the officer said. So far, more than 90 000 persons from affected areas spread over Sagar, Tirthahalli, Hosanagar, Sorab, Shikaripur, and Bhadravati taluks have been administered primary and booster dose of the vaccine. The booster dose will offer around 65 percent immunity against the disease. The immunity level in the vaccinated person will be enhance to 83 percent after a third round of vaccination, usually administered nine months after the booster dose.

Following the fresh outbreak, vigilance has been stepped up in Aralagod and surrounding areas. Staff from the Forest and Health and Family Welfare departments are combing forests to find dead monkeys. Dimethyl phthalate (DMP), a tick-repellent oil, is also being provided for the residents in Aralagod through Accredited Social Health Activists.
Date: Sun, 24 Feb 2019 15:39:48 +0100

Guwahati, India, Feb 24, 2019 (AFP) - At least 58 more workers have died in north-eastern India after drinking toxic liquor, police said Sunday, taking the death toll from the latest mass alcohol poisoning beyond 150.   The deaths in Assam state came less than two weeks after tainted liquor killed around 100 people in the northern states of Uttar Pradesh and Uttarakhand.   At least 200 others were still receiving treatment in hospitals across Assam.   "A total of 85 people have died in Golaghat district due to consumption (of toxic alcohol)," Dhiren Hazarika, deputy commissioner of the worst affected region, told AFP.   "Another 100 are undergoing treatment... The rush of new patients has (only) slowed down today afternoon," he added.

Samir Sinha, Assam's principal health secretary, told AFP 71 deaths had been confirmed in neighbouring Jorhat district by Sunday afternoon.    "131 people, including 13 critical patients, are undergoing treatment at hospitals in Jorhat," he said.   "What is happening is also a kind of fear psychosis. Many locals, even if they took (illegal alcohol) four or five days back, are worried and reporting (for check-ups) at the local medical facilities," he added.    Sinha said that additional teams of medical personnel and supplies had been rushed to the affected districts.    Police said people started falling sick after consuming a batch of illegally produced liquor late Thursday.

The victims, who include many women, worked at local tea estates in the region.    Doctors said those rushed to hospital in critical condition were suffering from severe vomiting, extreme chest pain and breathlessness.    "A total of ten people have been arrested. We have sent the samples of the liquor... to a forensic laboratory. The report is awaited," Mukesh Agarwala, additional director general of state police, told AFP on Sunday.   Assam Chief Minister Sarbananda Sonowal has ordered an inquiry into the deaths.   Apart from the arrests, two excise department officials were suspended for failing to take adequate precautions over the sale of the alcohol.   Assam health minister Himanta Biswa Sarma vowed those responsible for the tainted liquor would be brought to justice.

- Methanol -
Hundreds of mainly poor people die each year in India from tainted liquor, which normally costs just a few US cents a bottle.   Cheap, locally made booze is common in rural parts and bootleggers often add methanol -- a highly toxic form of alcohol sometimes used as an antifreeze -- to their product to increase its strength.    If ingested in large quantities, methanol can cause blindness, liver damage and death.   Many drinkers in Uttar Pradesh and Uttarakhand were taken to hospital earlier this month in writhing pain after drinking illicit alcohol.   About 100 people died after consuming the tainted moonshine.   In 2015, more than 100 people died in a Mumbai slum after drinking illegal liquor.

Of the estimated five billion litres of alcohol drunk every year in India, around 40 percent is illegally produced, according to the International Spirits and Wine Association of India.   Many Indian states have implemented or pushed for prohibition, which, according to critics, further increases the unsupervised manufacture and sale of alcohol.    Bihar, one of India's poorest states, banned alcohol in 2016. But just months after prohibition took effect, 16 people died after consuming toxic liquor.   The entire staff of a local police station in the eastern state were suspended for "dereliction of duty" and failure to stop bootlegging.
Date: Sun 24 Feb 2019
Source: Reuters [edited]

At least 150 people have died from drinking toxic bootleg liquor in a north-eastern state of India, the 2nd such tragedy in the country this month [February 2019], with many more hospitalized as authorities try to pinpoint the source and round up perpetrators.

The figure is based on reports from 3 hospitals in the eastern part of the state, Assam. Authorities had estimated the number of dead at 84.  "We have still more than 170 people admitted in hospitals with new patients being brought in from nearby areas. Some developed complications 2 days after consuming the liquor," Assam's health minister Himanta Biswa Sarma said.

"We have sent samples for forensic examinations to ascertain the ingredients used in the particular lot of spurious liquor leading to the deaths of so many people," he added.  The Assam liquor tragedy comes almost 2 weeks after more than 100 people died from drinking tainted alcohol in 2 northern Indian states, Uttarakhand and Uttar Pradesh, in the worst such case in the country since 2011.

Deaths from illegally-produced alcohol, known locally as "hooch" or "country liquor," are a regular occurrence in India, where many cannot afford branded spirits. In Assam, bootleg liquor production and consumption is usually found in and around the state's tea plantations where it is consumed by poorly-paid laborers.

There were about 10 different distilleries producing the spurious liquor going to various tea plantations and other areas, said Mrinal Saikia, a local lawmaker from the Bharatiya Janata Party, which rules Assam and the country. But the main ingredient used in the country liquor was supplied by one person from a nearby area, he said.  "Close to about 1500 people must have consumed that lot of spurious liquor on Thursday [21 Feb 2019] leading to the deaths of 150," Saikia said.  "We are interrogating them and will soon find out the source and people involved in supplying that toxic lot of spirit," said Mukesh Agarwal, Assam's additional police chief.  [Byline: Zarir Hussain]
=======================
[While illegal alcohol or some mixture thereof occurs from time to time, it seems to be primarily because methanol is used instead of ethanol.  "Methanol toxicity initially lacks severe toxic manifestations. Its pathophysiology represents a classic example of lethal synthesis in which toxic metabolites cause fatality after a characteristic latent period. In other words, these people may not realize they are sick or ill until some time after consumption.

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

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

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

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

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

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

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

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

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

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

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

Portions of this comment were extracted from

[HealthMap/ProMED map available at:
Assam State, India: <http://healthmap.org/promed/p/299>]
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.