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Aruba

Aruba US Consular Information Sheet
April 02, 2008
COUNTRY DESCRIPTION:
Aruba is an autonomous part of the Kingdom of the Netherlands. Tourist facilities are widely available. Read the Department of State Background Notes on Aruba for addi
ional information.

ENTRY/EXIT REQUIREMENTS: All Americans traveling by air outside the United States are required to present a passport or other valid travel document to enter or re-enter the United States.
This requirement will be extended to sea travel (except closed loop cruises), including ferry service, by the summer of 2009.
Until then, U.S. citizens traveling by sea must have government-issued photo identification and a document showing their U.S. citizenship (for example, a birth certificate or certificate of nationalization), or other WHTI compliant document such as a passport card for entry or re-entry to the U.S.
Sea travelers should also check with their cruise line and countries of destination for any foreign entry requirements.

Applications for the new U.S. Passport Card are now being accepted.
We expect cards will be available and mailed to applicants in spring 2008.
The card may not be used to travel by air and is available only to U.S. citizens. Further information on the Passport Card is available at http://travel.state.gov/passport/ppt_card/ppt_card_3926.html and upcoming changes to U.S. passport policy can be found on the Bureau of Consular Affairs web site at http://travel.state.gov/travel/cbpmc/cbpmc_2223.html.
We strongly encourage all American citizen travelers to apply for a U.S. passport well in advance of anticipated travel.
American citizens can visit travel.state.gov or call 1-877-4USA-PPT (1-877-487-2778) for information on how to apply for their passports.

In addition visitors to Aruba may be asked to show onward/return tickets, proof of sufficient funds and proof of lodging accommodations for their stay. Length of stay for U.S. citizens is granted for thirty days and may be extended to 180 days by the office of immigration.
For further information, travelers may contact the Royal Netherlands Embassy, 4200 Linnean Avenue NW, Washington, DC
20008, telephone (202) 244-5300, or the Dutch Consulate in Los Angeles, Chicago, New York, Houston or Miami.
Visit the web site for the Embassy of the Netherlands at http://www.netherlands-embassy.org and the Aruban Department of Immigration at http://www.aruba.com/about/entryrequirements.php for the most current visa information.

Information about dual nationality or the prevention of international child abduction can be found on our web site.
For further information about customs regulations, please read our Customs Information sheet.

SAFETY AND SECURITY: There are no known extremist groups, areas of instability or organized crime on Aruba, although drug trafficking rings do operate on the island.
For the latest security information, Americans traveling abroad should regularly monitor the Department of State, Bureau of Consular Affairs’ web site at http://travel.state.gov, where the current Worldwide Caution, Travel Warnings, and Travel Alerts 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., 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: The crime threat in Aruba is generally considered low although travelers should always take normal precautions when in unfamiliar surroundings.
There have been incidents of theft from hotel rooms and armed robberies have been known to occur. Valuables left unattended on beaches, in cars and in hotel lobbies are easy targets for theft.
Car theft, especially that of rental vehicles for joy riding and stripping, can occur. Vehicle leases or rentals may not be fully covered by local insurance when a vehicle is stolen or damaged.
Be sure you are sufficiently insured when renting vehicles and jet skis.

Parents of young travelers should be aware that the legal drinking age of 18 is not always rigorously enforced in Aruba, so extra parental supervision may be appropriate. Young female travelers in particular are urged to take the same precautions they would when going out in the United States, e.g. to travel in pairs or in groups if they choose frequenting Aruba’s nightclubs and bars, and if they opt to consume alcohol, to do so responsibly.

Anyone who is a victim of a crime should make a report to Aruban police as well as report it immediately to the nearest U.S. consular office.
Do not rely on hotel/restaurant/tour company management to make the report for you.

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, to contact family members or friends and explain how funds could be transferred.
Although the investigation and prosecution of the crime are 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.

Please see our information for American Victims of Crime Overseas.

MEDICAL FACILITIES AND HEALTH INFORMATION: Medical care is good in Aruba. There is one hospital, Dr. H.E. Oduber Hospital, whose medical standards can be compared with an average small hospital in the U.S. The hospital has three classes of services and patients are accommodated according to the level of their insurance (i.e. first class: one patient to a room, TV, better food; second class: two to three patients to a room, shared bathroom, etc; third class: 15 to 20 people in one hall). There is a small medical center in San Nicolas. The many drug stores, or “boticas” provide prescription and over the counter medicine. Emergency services are usually quick to respond.
There are no country-specific health concerns.

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

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 Aruba is provided for general reference only and may not be totally accurate for a particular location or circumstance.

Driving in Aruba is on the right-hand side of the road. Local laws require drivers and passengers to wear seat belts and motorcyclists to wear helmets. Children under 5 years of age should be in a child safety seat; older children should ride in the back seat. Right turns on red are prohibited in Aruba.

Aruba's main thoroughfare, L.G. Smith Boulevard, is well lit and most hotels and tourist attractions can be easily located.
There is a speed limit in Aruba and driving while intoxicated may result in the loss of a driver’s license and/or a fine.
However, these are not consistently enforced.
Drivers should be alert at all times for speeding cars, which have caused fatal accidents.
In the interior areas of the island, drivers should be alert for herds of goats or donkeys that may cross the roads unexpectedly.
Buses provide convenient and inexpensive service to and from many hotels and downtown shopping areas.
Taxis, while expensive, are safe and well regulated.
As there are no meters, passengers should verify the price before entering the taxi.
The emergency service telephone number is 911. Police and ambulance tend to respond quickly to emergency situations.

Please refer to our Road Safety page for more information. Also, travelers may wish to visit the web site of the country’s national tourist office and national authority responsible for road safety in Aruba for information: http://www.aruba.com/pages/traffictips.htm.

AVIATION SAFETY OVERSIGHT: The U.S. Federal Aviation Administration (FAA) has assessed the Government of Aruba’s Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for oversight of Aruba’s air carrier operations. For more information, travelers may visit the FAA web site at http://www.faa.gov/safety/programs_initiatives/oversight/iasa.
SPECIAL CIRCUMSTANCES: The time-share industry and other real estate investments are two of the fastest-growing tourist industries in Aruba. Time-share buyers are cautioned about contracts that do not have a "non-disturbance or perpetuity protective clause" incorporated in the purchase agreement.
Such a clause gives the time-share owner perpetuity of ownership should the facility be sold.
Americans have also sometimes complained that the time-share units are not adequately maintained, despite generally high annual maintenance fees.

Potential investors should be aware that failed land development schemes involving time-share investments could result in financial losses. Interested investors may wish to seek professional advice regarding investments involving land development projects. Real estate investment problems that reach local courts are rarely settled in favor of foreign investors.

An unusually competitive fee to rent jet skis or other water sports equipment could indicate that the dealer is unlicensed or uninsured. Visitors planning to rent jet skis or other water sports equipment should carefully review all liability and insurance forms presented to them before signing any contracts or agreements. The renter is often fully responsible for replacement costs and fees associated with any damages that occur during the rental period. Visitors may be required to pay these fees in full before being allowed to leave Aruba, and may be subject to civil or criminal penalties if they cannot or will not make payment.

Dutch law in principle does not permit dual nationality. However, there are several exceptions to the rule. For example, American citizens who are married to Dutch citizens are exempt from the requirement to abandon their American nationality when they apply to become a Dutch citizen by naturalization. For detailed information, contact the Embassy of the Netherlands in Washington, DC, or one of the Dutch consulates in the U.S.
Please see our information on customs regulations.

CRIMINAL PENALTIES: While in a foreign country, a U.S. citizen is subject to that country's laws and regulations, which sometimes differ significantly from those in the United States and may not afford the protections available to the individual under U.S. law.
Penalties for breaking the law can be more severe than in the United States for similar offenses.
Persons violating Aruba’s laws, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in Aruba 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 on international adoption of children and international parental child abduction, see the Office of Children’s Issues web pages.
REGISTRATION / EMBASSY LOCATION: Americans living or traveling in Aruba 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 Aruba. 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. Consulate General is located at J.B. Gorsiraweg 1, Willemstad, Curaçao, telephone number (599-9) 461-3066; fax (599-9) 461-6489; e-mail address: acscuracao@state.gov
* * *
This replaces the Consular Information Sheet dated January 3, 2008, to update Entry/Exit Requirements and Crime sections.

Travel News Headlines WORLD NEWS

Date: Sat, 20 Jun 2009 10:52:09 +0200 (METDST)

MADRID, June 20, 2009 (AFP) - A Spanish cruise ship was turned away from three Caribbean islands after swine flu cases emerged among the crew and the 800-odd passengers finally got off in Aruba, the tour operator said Saturday.   The "Ocean Dream" docked in Aruba late Friday after being denied entry in Grenada, Saint Lucia and Barbados, Pullmantur said. Three swine flu cases were reported among the crew but the passengers were unaffected.

On Thursday, 376 Venezuelan passengers were allowed to disembark on the island of Margarita, which belongs to Venezuela.   The ship's nine-day cruise through the Caribbean was hampered by the flu outbreak and the ship could not dock at three destinations on the itinerary.   The A(H1N1) virus has infected more than 44,000 people around the world, resulting in 180 deaths since late March, WHO figures show.
Date: Wed 14 Jan 2009
Source: Amigoe.com [Dutch, machine trans., edited]

Department of Health has called an urgent press conference on Tuesday [13 Jan 2009] to issue a dengue update. The department has done this following the hundreds of calls that have come into Health, after media reports of a 53-year-old woman who died of dengue [virus infection].

According to Trevor Gellecum, Director of Health, it is still not clear that this woman indeed died of dengue. "First, certain tests can be carried out, and it will be 3 weeks before the results could be known," says Van Gellecum. "These tests should be carried out in a laboratory abroad."

According to Wilmer Salazar, microbiologist at Health, the woman had a fever at the weekend, but on Monday [12 Jan 2009] she felt better and she went to work. "Later that day, she was admitted to the hospital in shock. At night she died, "said Salazar. "Until now, there is no confirmed diagnosis of the cause of death, but dengue is suspected. Today [14 Jan 2009], an autopsy was performed so that the tests to be done abroad can take place."

Maribel Tromp, manager at the department of epidemiology and research of the Infectious Disease Service, has indicated that so far 612 suspected cases of dengue have been registered. "Of these, 218 cases [have been] confirmed as positive by the laboratory, and 394 are still under investigation, reports Tromp. "This does not mean that they are negative" [The dates over which these cases occurred are not specified. - ProMed Mod.TY].

 From the moment the news of a potentially fatal dengue victim arose lately, Charline Koolma, director of the Yellow Fever Fight Unit (GKMB), indicated that they have been overwhelmed with calls from people reporting family members possibly with dengue-like symptoms or who want information about the disease. "It is good that we now receive phone calls, although it also had previously been possible. These kinds of extreme cases can be avoided," according Koolman.

"From November last year [2008], the GKMB made several visits to monitor presence of [the dengue virus vector mosquito _Aedes_] breeding sites and adult mosquitoes. Often, the residents are not home, and then a letter was left with an invitation to make contact with the GKMB for the transmission of important information. But there is never a return call until something bad happens, and then it is often too late."

The more information and reports the GKMB gets, the better the service and their work, said Tromp. Finally, all speakers [at the press conference] called on the population and general practitioners to join forces against breeding of the _Aedes_ dengue vector mosquito. Health officials indicated that is the only way to avoid [virus] infection and prevent dengue.
------------------------
[A map showing the location of Aruba in the Caribbean can be accessed at <http://www.aruba-travelguide.com/map/index.html>. - ProMed Mod.TY]
Date: Sun, 2 Sep 2007 19:04:55 +0200 (METDST) MIAMI, Sept 2, 2007 (AFP) - Hurricane Felix barreled through the Caribban Sunday, with forecasters predicting a brush with Aruba and warning of its potential to strengthen into a devastating storm. Forecasters issued a tropical storm warning and hurricane watch for the islands of Aruba, Bonaire and Curacao -- popular tourist destinations in the Netherlands Antilles. A tropical storm watch also has been issued for Jamaica, which was gearing up for violence-marred elections Monday, after Felix was upgraded overnight to Category Two strength on the Saffir-Sampson scale, which peaks at five. At around 1500 GMT Felix's maximum sustained winds were 105 miles (165 kilometers) per hour, and its trek across the open waters of the Caribbean could allow it to attain "major hurricane" status, US forecasters said. "I see no reason why Felix will not become a major hurricane within 12 hours or so," said Richard Pasch, a hurricane specialist with the National Oceanographic and Atmospheric Administration. On Saturday, a weaker Felix passed close to Grenada, reportedly ripping roofs, downing power lines and knocking radio and TV stations off the air. No injuries were reported. The center of the hurricane around 1600 GMT Sunday was about 50 miles (75 kilometers) north of Aruba and about 550 miles (900 kilometers) southeast of Kingston, Jamaica. Felix was moving in a west-northwesterly direction at around 18 miles (30 kilometers) per hour, and was expected to follow the same course throughout Sunday. The storm was not expected to hit Jamaica directly, but its strong outer squalls could rock the island ahead of the elections on Monday. Jamaican officials had already postponed the general election from August 27, after the island was struck last month by Hurricane Dean. Last week, Dean swept through the southern Caribbean with severe winds and rains, leaving a wide swathe of damage and a death toll of 30 from Martinique to Mexico. Felix's track was expected to take it toward Belize or the Yucatan in Mexico, possibly making landfall as a major Category Three hurricane Wednesday. The storm could dump two to four inches (five to 10 centimeters) of rain over islands off the Venezuela coast and the Netherlands Antilles, US forecasters said. On its current path Felix is expected to graze the coastlines of Nicaragua and Honduras late Tuesday and make landfall in Belize on Wednesday. Felix is the second hurricane of the three-month-old Atlantic season, and the first in September, historically the busiest month for hurricanes.
Date: Thu, 9 Sep 2004 10:12:08 +0200 (METDST) CARACAS, Sept 9 (AFP) - Hurricane Ivan has killed at least 11 people in Tobago, Grenada and Venezuela as the it churned off Venezuela's coast Thursday, strengthening to the top Category 5 storm, officials and local media said. Ivan was 135 kilometers (85 miles) northeast of Aruba and 915 kilometers (570 miles) from Jamaica, the Miami-based National Hurricane Center said at 0600 GMT. Its category was raised to a Category 5 hurricane -the top level on the Saffir Simpson hurricane scale, with maximum sustained winds near 255 kilometers (160 miles) per hour. "Some fluctuations in strength are likely," the center said. The "extremely dangerous" hurricane was moving west-northwest at 28 kilometers (17 miles) per hour with urricane force winds extend outward from Ivan's eye up to 95 kilometers (60 miles). Storm surges of 1.0-1.5 meters (three to five feet) as well as rains of 13-18 centimeters (seven five to seven inches) are to be expected. The center issued hurricane warnings for Aruba, Bonaire and Curacao. A television station in Trinidad and Tobago said nine people had died in Grenada, a tiny island nation of 90,000 inhabitants, which Prime Minister Keith Mitchell said was 85 percent destroyed. Power lines were down and hundreds of persons have taken refuge in shelters. Mitchell, whose own house was destroyed, told a Trinidad radio station that the island is without electricity. Another woman was killed by a falling tree in Tobago, according to local media. Prime Minister Patrick Manning headed to Tobago to view the destruction. His government has promised 1.6 million dollars to St. Vincent to help with the construction. Hundreds were evacuated to shelters. Cuba has also begun preparing for the storm in 11 of its 14 provinces, although the island has not fully recovered from Hurricane Charley, which struck August 13. Children in the Netherlands Antilles were sent home from school, as were many workers. Several Venezuelan airports, including the oil-exporting country's main international airport, Maiquetia, which serves Caracas, suspended operations until conditions improve, Air Force colonel Francisco Paz Freitas told Union Radio. In Venezuela, a man was crushed to death when hurricane-force winds toppled a wall in a coastal town near Caracas, emergency service officials said, adding that another person was hurt and 150 people were affected by flooding. Along the low-lying Caribbean coast, authorities reported mudslides and road closings just as early rain bands from the storm unleashed the first downpours. The storm was expected to be off the central coast later in the day, triggering heavy rains and rough surf. The capital, Caracas, lies just a bit inland from there, protected somewhat by the El Avila mountain range. Though the storm is not expected to make landfall in Venezuela, Interior and Justice Minister Jesse Chacon was urging calm and said heavy winds and rain associated with the storm could last for 72 hours. Ivan was expected to pass just north of Aruba, Bonaire and Curacao on Friday as the Caribbean islands were under a hurricane warning, which means hurricane winds could hit them within 24 hours or less, the US hurricane center said. A hurricane watch and a tropical storm warning remain in effect for the Guajira peninsula of Colombia and for the entire northern coast of Venezuela, it noted. Haiti also issued a hurricane watch, meaning it could experience hurricane conditions within 36 hours.
Date: Wed, 8 Sep 2004 05:03:07 +0200 (METDST) PORT-OF-SPAIN, Trinidad Sept 7 (AFP) - Ivan, an "extremely dangerous" hurricane Tuesday knocked out power in Barbados and threatened eastern Caribbean islands, forecasters and emergency officials said. The eye of the powerful storm moved over Barbados Tuesday afternoon, and headed for the eastern Caribbean, where officials issued a hurricane warning for St Vincent, the Grenadines, Grenada and the Netherlands Antilles islands of Aruba, Bonaire and Curacao. Ivan packed sustained winds of 215 kilometers (135 miles) per hour, which made it "an extremely dangerous category four hurricane," the Miami-based National Hurricane Center (NHC) said. In Barbados, "there is an island-wide power outage, expect for the major health care facility, the Queen Elizabeth Hospital," the Caribbean Disaster Emergency Response Agency (CDERA) said. "There are also reports of roof loss, downed utility poles and trees," the agency said, adding that there were also reports of coastal damage from storm surge. Late Tuesday night, the center of the powerful hurricane, the second in just days, was located 175 kilometers (110 miles) west of Grenada. The Netherlands Antilles Tuesday morning put the islands of Aruba, Bonaire and Curacao under a hurricane watch, which means the storm could hit them within 36 hours. In central and eastern Venezuela, officials suspended all air and maritime traffic. Long-term forecasts, which have a wide margin of error, have the hurricane slamming into Jamaica on Friday and then into Cuba on Sunday. This would bring the storm dangerously close to Florida, which has just been pounded by Frances, the second hurricane to hit the southeastern US state in three weeks. The Bahamas islands also were severely impacted by the passage of Frances last week.
More ...

Peru

General Information:
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The number of Irish holiday makers heading to Peru to complete the Inca Train is increasing. This is partly due to easier travel arrangements but the beauty of this region is also attracti
g many. Overall the majority will remain healthy but some will become sick by exposure to a variety of situations which should be protected against. The Inca Trail is situated in southern Peru and the most commonly visited regions include Lima (the capital), Cusco, Machu Picchu and Lake Titicaca. This includes some high mountainous regions of the country and many of the trekking paths are poorly maintained.
Personal Health:
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Generally those planning a holiday along the Inca Trail will be trekking for a part of their time abroad. It is essential that these individuals realise that they may reach significant altitude and that this is not a ‘restful’ holiday. Good general health is required and those with heart problems or respiratory conditions may find that they will be unable to complete the journey. Having a general medical check before booking your ticket may be worth considering for any patient with a chronic illness.
Travelling Alone:
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If you are travelling alone or in a small group it will be essential to take care at all times. In Lima, the level of crime is high and resistance to violent crime often provokes greater violence, while those who do not resist usually do not suffer serious physical harm. Street crime is also prevalent in tourist cities in Peru's interior, including Cusco, Arequipa, Puno and Juliaca, and pickpockets frequent the market areas.
In Cusco, "choke and grab" muggings are common, particularly on streets leading off the main square and in the area around the train station.
Travellers should use only registered taxis in Cusco and should not accept offers of transportation or guide services from individuals seeking clients on the streets.
The number for the tourist police in Lima is (51-1) 225-8698 or 225-8699, or fax 476-7708.
There are also tourist police offices in 15 other cities, including all major tourist destinations such as Cusco, Arequipa, and Puno.
Altitude problems:
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Along the Inca Trail the elevation above sea level can be significant. For instance Cusco is at 10,000 feet and Lake Titicaca is at 13,000 feet. Those visiting these regions should be aware that it is essential to take time to adjust to the altitude, which can adversely affect blood pressure, digestion and energy level.
In 1999, several U.S. citizens died in Peru from medical conditions exacerbated by the high altitude. (See separate TMB leaflet on Altitude Sickness). Adventure travellers should be aware that rescue capabilities in the region are limited.
In recent years, several hikers have died and others have had to be rescued after serious accidents in the Huaraz region of the Cordillera Blanca mountains, where Peru's highest peaks are located.
Coca Tea:
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On arriving in many of these regions you will find street vendors and restaurants selling Coca tea to relieve altitude sickness. Generally this is safe providing the water is boiling but take care of the hygiene for the cup which is used to drink from. Advice would usually be to avoid chewing the leaves of the Coca plant.
Avoiding Insect Bites:
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One of the biggest problems facing travellers to this region is the risk of insect bites. Along the Inca Trail you will often find that many travellers have been bitten significantly by both mosquitoes and sandflys. There are a number of diseases transmitted by these insects in this region and so it is essential to protect yourself. Wearing long sleeved pale coloured clothing and applying good insect repellent (with DEET 30-50% at least) will help. This will be particularly important on the day that you visit Machu Picchu.
Leishmaniasis:
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This is a parasitic disease transmitted by sandflys. The skin ulcers associated with this condition can take months to heal.
Malaria:
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Fortunately this dangerous disease does not occur in southern Peru along the Inca Trail. Those visiting the jungle areas east of the Andes will need protection.
Food and Water:
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It is essential to take care to ensure that all food is fresh and well prepared. Eating from street vendors is a high risk activity and bivalve shellfish should be avoided at all times.
Rabies:
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The risk of this viral disease occurs throughout the country. Avoid all warm blooded animals and seek adequate medical treatment after any bite, lick or scratch. Dogs, cats and monkeys commonly transmit the disease but it can be from any warm blooded animal.
Vaccines:
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For entry/exit purposes it is recommended that all travellers receive cover against Yellow Fever. Having cover also against Typhoid, Tetanus and Hepatitis A is well worthwhile for personal protection. Those planning a longer trip or more extensive trekking will need to consider cover against conditions like Hepatitis B and Rabies.
Summary:
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Make sure you are fit enough for this trip. Trek within your limits and have good shoes and clothing. Bring plenty of insect repellent!
Further Information:
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Contact the Tropical Medical Bureau at the numbers below. This leaflet must not be used in place of a detailed medical consultation.

Wanderlust April/May 2001
Web. www.wanderlust.co.uk
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Visiting Machu Picchu is almost a rite of passage for Latinophiles and for the adventurous there is only one way - along the Inca Trail. While romantics and old-timers lament the loss of independent trekking this remains one of the world’s classic walks. If you want to see Machu Picchu and you like trekking, the euphoric jubilation of passing through the Gate of the Sun is close to unbeatable.
The dry season in the highlands runs from May to October and makes for clearer skies and generally better views. Off-season the weather can be risky, but there are far fewer people.
To be fair this is not the only trek in Peru. Scribes from Pizarro to Parris have waxed lyrical about the breathtaking beauty of the Cordilleras Blanca and Huayhuash. Sheer walls of ice and granite hang precariously above scrubby grassland basking in the warm equatorial sun. As one of the most popular trekking areas in South America, the central cordilleras are ideal for hiking, with most activities starting from the mountain-fringed setting of Huaraz at almost 3,lOOm.
Whitewater rafting is also popular and most is based out of Cuzco; a quick and complete drenching in the River Apurimac takes in awesome scenery and exhilarating Class IV rapids. Trips also head to the source of the Amazon and down to the dramatic Colca Canyon which is twice as deep as the Grand Canyon.
Mountain biking is popular in the central cordilleras along with some challenging opportunities through dramatic Andean scenery in the Cuzco area.
Manu National Park in the Amazon lowlands north of Cuzco is one of the continent’s great untouched wildernesses. Set aside for research and ecotourism, Manu is one of the best places to visit the rainforest and sightings of big cats, although not common, are regular. The nearby town of Puerto Maldonado, close to the famous macaw salt lick in the Tambopata-Candamo Reserve, is a popular spot for jungle tours mixing short hikes with river trips; they generally last a few days.
Adventurous independent travellers may want to join the locals and travel down the Amazon in a hammock on a cargo boat from Pucallpa. Short jungle treks and canoe trips from the northern Amazon town of Iquitos explore small tributaries and indigenous villages to help you encounter the natural wonders of the Amazon rainforest face to face.
Peter Hutchison is editor of Footprint’s
Mexico & Central America Handbook 2001
*******************************************************

Travel News Headlines WORLD NEWS

Date: Fri, 1 Mar 2019 14:48:09 +0100

Lima, March 1, 2019 (AFP) - An earthquake with a magnitude of 7.0 struck south-eastern Peru on Friday but there were no immediate reports of injuries or damage.   It hit in the Andes region in a sparsely populated area.

The US Geological Survey said the epicentre was at a depth of 257 kilometres (160 miles). The agency said most big quakes in South America occur at a maximum depth of 70 kilometres.   The quake hit at 0850 GMT about 27 kilometres northeast of the town of Azangaro, near the border with Bolivia.   "At the moment, some rocks have been reported falling onto roads, but without any damage to persons or material damage," the National Emergency Operations Center said several hours after the quake.

Last week a quake measuring 7.5 with its epicentre in neighbouring Ecuador rattled the coast and Amazon region of northern Peru.   It left nine people injured and caused damage in Ecuador, but Peru was unscathed.   Peru is located in a seismically active region, and on January 14 last year a quake measuring 7.3 killed two people and toppled buildings near the southern city of Arequipa.
Date: Mon, 28 Jan 2019 02:38:38 +0100

Lima, Jan 28, 2019 (AFP) - A landslide crashed into a hotel during a wedding celebration in southeastern Peru, killing at least 15 people, authorities said Sunday.   "The mudslide broke through the walls of the hotel, crashing through," the mayor of the city of Abancay, where the hotel is located, told RPP radio.   The mayor, Evaristo Ramos, said about 100 guests had been invited to the wedding party Saturday and "there are 15 dead and 34 injured."

Firefighters, police and residents worked through the night to rescue people still trapped under rubble, mud and rocks.   Civil defense chief General Jorge Chavez said that the dead were 11 women and four men.   They did not include the bride and groom, Benedicta Palomino and Bladimir Marquez, who were in stable condition, local officials said.    Authorities said the Alhambra hotel was built very close to a hillside. A retaining wall collapsed, and the mudslide brought the hotel roof down on the partygoers below, they said.   People searching for missing relatives were urged to visit surrounding health centers to find and identify their loved ones.
Date: Fri 19 Oct 2018
Source: RPP [edited]

There are 4 children under age 5 who are new measles victims after the outbreak in Cusco.

Pablo Grajeda, head of the Bureau of Health Intelligence Directorate Cusco Regional Health (Diresa) said that the child has high fever and rashes on various parts of his body, so we proceeded to perform scrub with vaccination in the area.

So far this year [2018] at least 76 suspected measles cases were recorded throughout the Cusco region. Analyzes are sent to Lima for confirmation or to rule out a case; the results usually come up in 3 weeks, said the doctor.

Four weeks ago, DIRESA Cusco asked the Ministry of Health (MoH), to declare a health emergency for an outbreak of measles; however, the request has not been answered. At this time, there are only vaccines for children under 5 years.
Date: Thu 27 Sep 2018
Source: Express.co.uk [edited]

Vampire bats carry an infectious bacteria that is potentially deadly to humans, warns a new study. Researchers found that many carry bartonella bacteria that cause endocarditis, a potentially life-threatening illness in humans and domestic animals. The findings, published in the journal PLoS Neglected Tropical Diseases [see reference below], show that common vampire bats in Latin America are frequently infected by bartonella. And their subsistence on blood creates a risk for bacterial transmission from bats to humans and livestock.

The researchers found that bartonella infections in vampire bats are highly prevalent in Peru and Belize, and that bartonella genotypes are distributed widely, rather than clustered geographically. Previous studies have suggested that vampire bats may be a source of bartonella infections among humans. But little was known about the bats' individual risk of infection, the genetic diversity of bartonella bacteria in bat populations, and how the bacteria may be transmitted among bats or to other species.

Over 2 years, the researchers collected blood, saliva, and faecal samples from vampire bats across Belize and Peru. Samples were then tested to ascertain how many bats were infected. Individual risk factors for infection were identified by analysing the relationship between bat age, sex, forearm size, and reproductive status. Samples testing positive for bartonella were then subjected to genomic sequencing and phylogenetic analysis to shed light on possible bacteria transmission routes.

Two out of every 3 tested bats (67 per cent) were found to be bartonella carriers, with the highest risk of infection in large males. Bacterial genotypes were widely distributed across Central and South America.

The researchers also investigated how bartonella might spread between individuals. While _Bartonella_ spp are often transmitted by biting arthropods, vampire bat saliva, and fecal samples were also found to be positive for bartonella, suggesting the possibility that transmission could occur through bites or environmental contamination.

While the preliminary results provide insights into the infection rate among vampire bats and the genetic diversity of bat-endemic bartonella, study lead author Dr Daniel Becker, of Montana State University in the US, said further study is necessary. Dr Becker added: "Given the high rates of vampire bat bites and proximity to humans, and domestic animals, such efforts to verify the possibility and frequency of oral and environmental exposures would elucidate bartonella transmission dynamics in this common host species and the risks of cross-species transmission.
==========================
[Reference
---------
Becker DJ, Bergner LM, Bentz AB, et al. Genetic diversity, infection prevalence, and possible transmission routes of _Bartonella_ spp in vampire bats. PLoS Negl Trop Dis. 2018; 12(9): e0006786. doi: 10.1371/journal.pntd.0006786;  <https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0006786>.

_Bartonella_ spp are usually transmitted by hematophagous arthropods. For example, _B. henselae_ utilizes fleas for cat-to-cat transmission, _B. quintana_ is vectored by lice, and _B. bacilliformis_ by sand flies. This finding suggests vampire bats may act as non-arthropod vectors of these pathogens.

There are 3 species of hematophagous bat in the neotropical region, one of which -- _Desmodus rotundus_ -- is a well known reservoir of rabies. This species feeds on a wide range of hosts, including humans, although will preferentially feed on large livestock such as cattle and horses. For a picture of _D. rotundus_ go to  <https://upload.wikimedia.org/wikipedia/commons/3/3f/Desmodus.jpg>.

This research shows that there is high risk of bartonella infection following a vampire bat bite, and therefore more preventive actions should accompany the vaccination against rabies. - ProMED Mod.PMB]

[HealthMap/ProMED map available at:
Date: Fri, 24 Aug 2018 14:41:29 +0200

Lima, Aug 24, 2018 (AFP) - A powerful 7.1 magnitude earthquake struck Peru's border with Brazil on Friday, the US Geological Survey said, but national authorities said there were no initial reports of casualties or damage in the sparsely populated region.   "So far no damage or victims have been reported and monitoring continues," said Peru's National Institute of Civil Defense (INDECI).   The US agency said the quake hit at a depth of 609 kilometers (380 miles) on Peru's eastern frontier with Brazil.   Jorge Chavez, the civil defense chief, said the depth of the quake had caused its force to dissipate, blunting its impact on the surface.   "The depth has made it so there is no surface damage," he said on RPP radio.   The earthquake hit shortly after 0900 GMT, about 140 kilometers west of the Peruvian town of Iberia, the USGS said.
More ...

World Travel News Headlines

Date: Mon, 25 Mar 2019 11:52:43 +0100

Sanaa, March 25, 2019 (AFP) - Nearly 110,000 suspected cases of cholera have been reported in war-hit Yemen since the beginning of January, including 190 related deaths, the UN said on Monday.   The UN office for humanitarian affairs (OCHA) said children under the age of five make up nearly a third of 108,889 cases which were reported between January 1 and March 17.

OCHA said the spike, which comes two years after Yemen suffered its worst cholera outbreak, was concentrated in six governorates including in the Red Sea port of Hodeida and the Sanaa province home to the capital.   Early rains could be blamed for the recent increase in suspected cholera cases, it said.   "The situation is exacerbated by poor maintenance of sewage disposal systems in many of the affected districts, the use of contaminated water for irrigation, and population movements," OCHA added.   The waterborne disease is endemic to Yemen, which witnessed the worst cholera outbreak in its modern history in 2017.

More than one million suspected cases were reported within an eight-month period that year. More than 2,500 people died of the infection between April and December 2017.    Yemen's brutal conflict, which pits Iran-linked rebels against a regional pro-government alliance led by Saudi Arabia, has left some 10,000 people dead since 2015 and pushed millions to the brink of famine.    The war has created the perfect environment for cholera to thrive, as civilians across the country lack access to clean water and health care.
Date: Wed 20 Mar 2019
Source: Outbreak News Today [edited]

Swedish public health authorities, Folkhalsomyndigheten, is reporting an outbreak of psittacosis, or parrot disease, since November 2018. According to officials, some 60 cases have been reported from the regions of Vastra Gotaland, Kalmar, Jonkoping, and Skane. This is the highest number of cases reported in one winter in 2 decades.

Those who have now fallen ill have mainly come into contact with bird droppings from wild birds, for example through the handling of bird tables and other outdoor activities. A smaller number are believed to have been infected by domestic birds (parrots) in cages. The most common way someone gets infected with the bacteria that cause psittacosis (_Chlamydia psittaci_) is by breathing in dust containing dried secretions (e.g., droppings, respiratory) from infected birds. It is rare for psittacosis to spread from person to person.

In general, psittacosis causes mild illness in people. The most common symptoms include fever and chills, headache, muscle aches, and dry cough. Psittacosis can also cause pneumonia (a lung infection) that may require treatment or care in a hospital. Rarely, psittacosis can result in death. Most people begin developing signs and symptoms of psittacosis within 5-14 days after exposure to the bacteria (_C. psittaci_). Occasionally, people report the start of symptoms after more than 14 days.
=================
[The news report above attributes the increase in number of human cases of psittacosis in Sweden since Nov 2018 mainly to contact with wild bird droppings, for example through the handling of bird tables and other outdoor activities. Outbreaks of avian chlamydiosis, due to _Chlamydia psittaci_ or the other Chlamydia species, have been reported occasionally in wild birds including shorebirds, waterfowl, and migratory birds, especially in birds under stress (<http://www.cfsph.iastate.edu/Factsheets/pdfs/psittacosis.pdf>).

An outbreak in Australia was probably caused by organisms carried in wild birds and spread when organisms in bird droppings became aerosolized during activities such as lawn mowing (<https://www.ncbi.nlm.nih.gov/pubmed/15757553>). An increase in psittacosis cases in Sweden in the winter of 2013 was also linked to wild birds, apparently through exposure to wild bird droppings; most cases were associated with tending bird feeders (<https://www.ncbi.nlm.nih.gov/pubmed/23725809>; also see ProMED-mail post Psittacosis - Sweden (02): wild bird http://promedmail.org/post/20130509.1701695).

Vastra Gotaland, Kalmar, Jonkoping, and Skane are counties located in southern Sweden. A map of Swedish counties can be found at <https://fotw.info/flags/se(.html>. - ProMED Mod.ML]

[HealthMap/ProMED-mail map:
Date: Wed 20 Mar 2019
Source: PNA [edited]

A public elementary school in Tubungan town, Iloilo has recorded a total of 36 chickenpox cases from 15 Jan to 3 Mar [2019], the Provincial Health Office (PHO) said. In an interview on Wednesday [20 Mar 2019], Dr. Patricia Grace Trabado, PHO head, said the cases were observed as patients who sought treatment at the rural health units (RHU) and private clinics in Tubungan.

All the cases were recorded in Cadabdab Elementary School, with 21 male and 15 female students affected. Trabado said affected pupils might still be attending school even though they were infected, which resulted in its transmission.

She emphasized that the spread of the infection might have been prevented if the children were advised not to attend school with the onset of infection. "If a child is showing chickenpox symptoms, especially when he or she was previously exposed to an affected person, then the pupil will be advised to stay at home," she said.

Trabado said the source of the infection came from the 1st patient working in Iloilo City but lives in Tubungan town. "The patient might have a family member that attends school in Cadabdab. From there, we see where the infection originated," she said. Trabado, however, did not give figures of the disease other than that from the school.

The RHUs and private clinics were able to monitor and manage the cases, Trabado said. All the student patients were discharged, given medication, and let the viral infection take its course. "And eventually, the patients recovered," she said. However, Trabado warns that a child with chickenpox can get secondary infection when he or she scratches the blisters, creating skin lesions.

She added that cases of chickenpox and mumps are mostly observed during the summer season. Trabado said patients with chickenpox experience fever and headache in the first 1 or 2 days before the itchy blister rash appears.  [Byline: Gail Momblan]
======================
[HealthMap/ProMED-mail map:
Date: Wed 20 Mar 2019
Source: USDA Animal and Plant Health Inspection Services [edited]
<https://content.govdelivery.com/accounts/USDAAPHIS/bulletins/23806a5>

The US Department of Agriculture's (USDA) under secretary for marketing and regulatory programs, Greg Ibach, is alerting international travellers of a deadly swine disease they could unknowingly bring back into the United States on their clothes, shoes, or hands.

African swine fever (ASF) is a highly contagious and deadly disease affecting both domestic and feral (wild) pigs. It does not affect human health and cannot be transmitted from pigs to humans. Recent spread of the disease to new countries in Asia and Europe has triggered a series of actions by USDA, state agriculture departments, and the pork industry to bolster protections against ASF in the United States and keep ASF out of North America.

"ASF has never been detected in the United States," said Ibach, "but an outbreak here would not only affect the pork industry, but also have major impacts on trade and raise food prices for consumers. We are asking international travellers to help prevent the spread of ASF to the United States by understanding what products can be brought back into the United States and declaring any agricultural items in their baggage."

The USDA's Animal Plant and Health Inspection Service's (APHIS) new traveller website provides updated information about potentially harmful pests and diseases that can hitchhike on food or other agricultural products. When returning to the United States, travellers are reminded to declare food items and animal products in their luggage. Failure to declare items may result in serious penalties.

"USDA and US Customs and Border Protection (CBP) recognize the crucial work of detector dog teams at US ports of entry." said Ibach. "While travellers' declarations of any food products brought with them to the United States is a critical step to protecting US agriculture, the dogs and secondary agricultural inspections provide another line of defence to keep ASF out of the country."

Travellers will also see some changes at airports as USDA works with CBP to increase screenings of passenger baggage. This includes training and adding 60 additional beagle teams for a total of 179 teams working at key US commercial, sea, and air ports and ensuring travellers who pose an ASF risk receive secondary agricultural inspection. USDA is also coordinating with CBP to expand arrival screenings, including checking cargo for illegal pork and pork products.

Anyone who visits a farm in an ASF-affected country should take specific precautions before returning to the United States. Follow the farm's biosecurity protocols and wear site specific footwear and coveralls or clothing. Thoroughly clean and disinfect or dispose of clothes and footwear worn on the farm before returning, and declare the farm visit to CBP when re-entering the United States. Travelers should not visit farms or any other locations with pigs -- including livestock markets, zoos, circuses, and pet stores with pot-bellied pigs -- for at least 5 days after returning.

More information on ASF, partner resources, and additional resources for travellers are available on the APHIS ASF webpage
and in this infographic
======================
[This disease would be extremely serious for the US, and likely for all of North America. The warning is appropriate for travellers to be more alert to situations that could ultimately have horrible outcomes. - ProMED Mod.TG]

[HealthMap/ProMED-mail map:
Date: Wed 20 Mar 2019
Source: ReliefWeb [edited]

The Federal Ministry of Health, in collaboration with the World Health Organization (WHO), Gavi, the Vaccine Alliance, and UNICEF, has launched a large-scale mass vaccination campaign in Sudan to vaccinate more than 8.3 million people 9 months to 60 years of age against yellow fever in the states of Blue Nile, Gezira and Sennar during 10-29 Mar 2019.

The campaign represents a crucial step in protecting a large portion of the population and reducing the risk of severe and deadly yellow fever outbreaks in the country. It is the 3rd and final drive thatSudan is undertaking to protect populations at risk and prevent yellow fever epidemics, pending the implementation of infant immunization as routine practice.

The campaign forms a critical part of Sudan's ongoing work to protect all populations against yellow fever epidemics, in alignment with the global Eliminate Yellow fever Epidemics (EYE) Strategy. The country plans to complement these yellow fever mass campaigns and ensure long-term protection through the introduction of yellow fever vaccination into routine immunization in the coming months.

"We acknowledge the commitment of the health authorities in Sudan to avail cash and fuel during this economic crisis to ensure that their people, especially children, are protected with a quality vaccine which will contribute to health security and making the world safer," said Dr. Naeema Al-Gasseer, WHO Representative in Sudan.

"Yellow fever vaccination is the most important tool we have to prevent yellow fever outbreaks. The vaccine will be freely available to any eligible person and will provide life-long protection against the disease. While protecting yourself against mosquito bites is important to reduce the risk of many diseases, only vaccination can eliminate the risk of yellow fever outbreaks," she added.

Yellow fever is a viral disease that is transmitted by certain types of mosquito. Infection can cause fatal illness, including jaundice, and death, and can spread rapidly, locally and internationally, especially in urban areas. However, the disease can be prevented by a single dose of a highly effective and safe vaccine. This campaign aims to boost protection in the general population and will target all eligible people.

Sudan is at high risk for the spread of yellow fever due to a combination of climate and ecological factors, and because there are still areas of low population immunity. Recent years have seen global changes in the epidemiology of yellow fever, with outbreaks occurring in areas that were not previously assessed as being at high risk.

"We are observing a changing nature in yellow fever disease dynamics. It is very important that every eligible person in this campaign receives the vaccine to protect themselves, their families and their communities," said Professor Dr. Babkir Kabaloo, Undersecretary of the Federal Ministry of Health.

"The current campaign represents one of the final phases in the Ministry's efforts to protect the entire nation against yellow fever outbreaks. This campaign will cover Blue Nile, Gezira, and Sennar states. In the coming months, the remaining states of Khartoum, Northern and River Nile will also be covered, completing the protection of the entire Sudanese population," he added.

Sudan's health authorities and partners are working to introduce yellow fever vaccine in the national immunization schedule in the near future. This will help ensure the protection of the whole population and generations to come against this fatal but preventable disease.
=====================
[It is good to see this ambitious yellow fever (YF) vaccination campaign drawing to a close. Incorporating YF vaccine into routine childhood vaccination schedules is prudent and if successful will eliminate the need for intensive, country-wide campaigns to deal with outbreaks. YF is no stranger to Sudan. Between 3 Oct and 24 Nov 2013, a total of 44 confirmed cases of YF were reported, including 14 deaths. A total of 12 localities in West and South Kordofan were affected by that outbreak. There was a large YF outbreak in the Darfur state in 2012-2013. In 2012, the World Health Organisation (WHO) said that more than 840 people were infected with YF in Darfur and that the epidemic affected 35 of 64 localities in the region since September 2012. The total recorded cases of YF in Greater Darfur hit 849 with a 20% death toll during an epidemic in 2012 (see WHO Disease Outbreak News <http://who.int/csr/don/2012_12_03/en> as reported by ProMED post http://promedmail.org/post/20130125.1513849, as noted at the time by Mod.JW). Mounting campaigns in the face of these types of outbreaks is inefficient, logistically difficult, and costly -- financially and in terms of human lives. - ProMED Mod.TY]

[HealthMap/ProMED-mail map:
Date: Thu 21 Mar 2019
Source: SBS News, Australian Associated Press (AAP) report [edited]

An egg recall has been announced following the discovery of a _Salmonella_ outbreak at a Victorian egg farm. The scare has prompted a recall of some brands of eggs from outlets in 4 states.

To date, 5 cases of _Salmonella [enterica_ serotype] Enteritidis have been linked to eggs produced by Victoria's Bridgewater Poultry, the state's health department said on [Thu 21 Mar 2019]. The company's free-range and barn-laid eggs are packaged as Woolworths brand, Victorian Fresh, and Loddon Valley, with best-before dates ranging from [20 Mar to 29 Apr 2019]. They are on shelves in Victoria, New South Wales, Tasmania, and South Australia. All other eggs are safe to eat, Chief Health Officer Brett Sutton said.

"It is important to know that not all eggs are affected, but any eggs carrying the listed brands should return them to the point of sale for a full refund. Alternatively, they can be discarded by throwing them into the garbage, not the garden or compost. "These eggs should not be given to pets or livestock."

Vulnerable people, including the elderly, are urged to avoid eating raw egg products.

Eggs of concern:
- Woolworths 12 Cage Free Eggs 700 g
- Victorian Fresh Barn Laid Eggs 600 g
- Victorian Fresh Barn Laid Eggs 700 g
- Victorian Fresh Barn Laid Eggs 800 g
- Loddon Valley Barn Laid 600 g (Victoria and South Australia only)
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[Salmonellosis is often thought to be associated with cracked eggs or eggs dirty with faecal matter, a problem controlled by cleaning procedures implemented in the egg industry. It is clearly the case, however, that most of the salmonellosis outbreaks linked to eggs were associated with uncracked, disinfected grade A eggs, or foods containing such eggs. The undamaged eggs become contaminated during ovulation, and thus were contaminated with the bacteria before the egg shell was formed. To avoid this, uncooked eggs should only be used as an ingredient, if pasteurized. - ProMED Mod.LL]

[Maps of Australia:
Date: Wed 20 Mar 2019 3:50 PM EDT
Source: The Day [edited]

Groton [New London county] public health officials are reminding residents to refrain from feeding or approaching wild or stray animals after a dog found in the area of Midway Oval tested positive for rabies [Wed 20 Mar 2019].

Rabies is a deadly disease caused by a virus that can infect all warm-blooded animals, including people, the Ledge Light Health District said in an alert sent to media outlets.

The disease mostly is spread by wild animals, but stray cats and dogs may also become infected and spread the virus, the district's alert said. The rabies virus lives in the saliva and brain tissue of infected animals, and the disease can be spread by scratches from infected animals or when infected saliva comes into contact with open wounds, breaks in the skin or mucous membranes, including the eyes, nose and mouth.

For more information, contact Ledge Light Health District at (860) 448-4882, extension 1311, or the animal control officer at (860) 441-6709.
======================
[HealthMap/ProMED-mail map of Connecticut, United States:
Connecticut county map:

Please keep your animals up-to-date on their rabies vaccine. It is for their protection and for your protection.

Regarding the 1st article, it sounds like South Carolina could consider using some oral rabies vaccine bait for some of their wild animals.

Unfortunately, wild animals may attack even when you are unaware of their presence.

Animals may be either unusually friendly and timid (dumb rabies) or aggressive and vicious (furious rabies). These are 2 presentations of the same disease but we should be aware of both forms and teach both forms to our children. - ProMED Mod.TG]
Date: Wed 20 Mar 2019
Source: Aiken Standard [edited]

[One person] in Aiken county may have been exposed to rabies following an unfriendly encounter with a wild raccoon, according to the South Carolina Department of Health and Environmental Control [DHEC].

According to a DHEC press release, the victim was on the North Augusta Greeneway Walking Trail on 16 Mar 2019 when they were bitten by a raccoon. The raccoon was later submitted to DHEC and tested positive for rabies. [Apparently the DHEC knows there is a victim so their earlier statement of "may have been exposed" seems a bit odd. - ProMED Mod.TG]

The victim who was bitten has since been referred to their health care provider. The raccoon on the Greeneway trail was the 3rd animal diagnosed with rabies in Aiken county this year [2019]. Statewide, there have been 32 confirmed cases of rabies in 2019. Coyotes, foxes, and skunks are also common carriers of the virus. Although it is extremely rare in people, rabies can be spread to humans and can also claim the lives of pets. The virus causes hallucinations, hydrophobia (fear of water), aggression, and death in its final stages.

Rabies is normally spread through bites but can also be spread when open wounds or areas like the eyes, nose, or mouth come into contact with saliva or blood of an infected animal. Infected areas should be washed with soap and water and medical attention should be sought immediately.  If a wild animal is foaming at the mouth and shows a lack of motor control (stumbling, staggering, or bumping into things) it may have rabies. Rabid animals are often very aggressive and do not fear people or other animals. [This behaviour may describe raccoons with distemper, but although they are not usually aggressive with distemper, they can be. The point is, when an animal is not acting normally it is time to move on and leave it alone and report it to the authorities in your area. - ProMED Mod.TG]

"To reduce the risk of getting rabies, always give wild and stray animals their space," said David Vaughan, Director of DHEC's Onsite Wastewater, Rabies Prevention, and Enforcement Division. "If you see an animal in need, avoid touching it and contact someone trained in handling animals, such as your local animal control officer or wildlife rehabilitator."

DHEC also stresses the importance of keeping pets up to date on their rabies shots to prevent the spread of the disease. For more information, call DHEC's Environmental Affairs Aiken office at 803-642-1637 during normal business hours on weekdays.  [Byline: Kristina Rackley]
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[HealthMap/ProMED-mail map of South Carolina, United States:
South Carolina county map:
Date: Thu, 21 Mar 2019 16:10:28 +0100

Kinshasa, March 21, 2019 (AFP) - A six-month-old baby in the eastern DR Congo city of Bunia has died of Ebola, becoming the first fatality of the disease in a provincial capital, the heath ministry said Thursday.   Bunia, which has a population of 300,000, is the capital of Ituri province, which along with neighbouring North Kivu province has been battling an epidemic of Ebola since last August.

The baby is among 610 fatalities out of 980 recorded cases, the ministry said in a statement.   "The parents are apparently in good health," it said.   "Extensive investigations are underway and will include, among other things, analysis of the maternal milk to identify the source of contamination."   The ministry added that it had also registered 97 new cases in the previous three weeks.   This increase "was expected" given the impact of an attack on two Ebola treatment centres by armed groups in the troubled region, it said.
Date: Thu, 21 Mar 2019 22:32:17 +0100

Blantyre, Malawi, March 21, 2019 (AFP) - Heavy rains could cause a dam in southern Malawi to give way if there is no let-up, authorities said Thursday, urging local residents to take shelter.   The warning came after cyclone Idai battered neighbouring Mozambique last Friday killing 242 people    Hurricane-force winds and rains have also ravaged hit eastern Zimbabwe where over 100 have died.

In Malawi, the storm has affected nearly a million people with over 80,000 displaced, according to the WHO.   The Chagwa dam "has had one of its major embankments eroded due to heavy rains," the interior security ministry said in a statement. "(It) is likely to burst in the event of heavy and incessant rains."   The statement advised local residents in the southern African country to evacuate "in case of an emergency".