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Burundi

Burundi US Consular Information Sheet
April 21, 2008
COUNTRY DESCRIPTION:
One of the poorest countries in the world, Burundi is a small, densely populated central African nation bordering Lake Tanganyika, Rwanda, Tanzania and the Democrati
Republic of Congo. After more than 12 years of civil and ethnic strife, an electoral process deemed free and fair resulted in the installation of a democratic government in 2005. Years of fighting have devastated a historically fragile economy that depends largely on subsistence agriculture. Poor public health and education, weather disasters such as drought and floods, crop diseases and lack of infrastructure exacerbate the effects of conflict and delay recovery. Facilities for tourism, particularly outside the capital, are limited. Read the Department of State Background Notes on Burundi for additional information.

ENTRY/EXIT REQUIREMENTS: A passport, visa and evidence of immunization against yellow fever are required for entry. Travelers with an expired visa are not permitted to leave the country without acquiring an exit visa prior to departure. The latest information about visas may be obtained from the Embassy of the Republic of Burundi, Suite 212, 2233 Wisconsin Avenue NW, Washington, DC 20007, telephone (202) 342-2574, or from the Permanent Mission of Burundi to the United Nations in New York at telephone (212) 499-0001 thru 0006.
For information about dual nationality or the prevention of international child abduction, please refer to related web pages at http://travel.state.gov. For further information about customs regulations, please read our Customs Information sheet.

SAFETY AND SECURITY:
See the Department of State’s Travel Warning for Burundi.
For the latest security information, Americans traveling abroad should regularly monitor the Department of State Bureau of Consular Affairs’ web site at http://travel.state.gov, where the current Travel Warnings and Travel Alerts, as well as the Worldwide Caution, can be found.

Up-to-date information on safety and security can also be obtained by calling 1-888-407-4747 toll free in the U.S. and Canada, or, for callers outside the U.S. and Canada, a regular toll-line at 1-202-501-4444. These numbers are available from 8:00 a.m. to 8:00 p.m. Eastern Time, Monday through Friday (except U.S. federal holidays).

The Department of State urges American citizens to take responsibility for their 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: Crime, often committed by groups of armed bandits, poses a high risk for foreign visitors to Bujumbura and Burundi in general. Common crimes include mugging, purse-snatching, pick pocketing, burglary, automobile break-ins and carjacking. Many criminal incidents involve armed attackers. Armed criminals often ambush vehicles, particularly on the roads leading out of Bujumbura. Criminals in Bujumbura often operate in pairs or in small groups involving six or more individuals. Due to insufficient resources, local authorities in any part of Burundi are often unable to provide timely assistance in case of need.
U.S. Government personnel are prohibited from walking on the streets during the hours of darkness and using local, public transportation. Foreigners, whether in vehicles or at home, are always potential crime targets. Americans should exercise common sense judgment and take the same precautions as one would in any major city.

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 the local police, please contact the nearest U.S. Embassy or Consulate for assistance. The Embassy/Consulate staff can, for example, help you to find appropriate medical care, contact family members or friends and explain how funds could be transferred. Although the investigation and prosecution of the crime is solely the responsibility of local authorities, consular officers can help you to understand the local criminal justice process and to find an attorney if needed. See our information on Victims of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION: Medical facilities in Burundi generally do not meet Western standards of care. Travelers should carry an ample supply of properly-labeled prescription drugs and other medications with them, as certain medications and prescription drugs are unavailable or in short supply. Sterility of equipment is questionable, and treatment is unreliable. Ambulance assistance is non-existent. Hospital care in Burundi should be considered in only the most serious cases and when no reasonable alternatives are available.
Malaria prophylaxis is recommended for travel to all parts of Burundi.

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

MEDICAL INSURANCE: The Department of State strongly urges Americans to consult with their medical insurance companies prior to traveling abroad to confirm whether their policies apply overseas and/or cover emergency expenses such as a medical evacuation. Please see our information on medical insurance overseas.

TRAFFIC SAFETY AND ROAD CONDITIONS: When in a foreign country, U.S. citizens may encounter road conditions that differ significantly from those in the United States. The information below concerning Burundi is provided for general reference only, and may not be totally accurate in a particular location or circumstance.
While travel on most roads is generally safe during the day, travelers must maintain constant vigilance. There have been regular reports of violent attacks on vehicles traveling the roads throughout the country outside of Bujumbura. U.S. Government personnel are required to travel upcountry via two-vehicle convoys and have their trips pre-approved by the Regional Security Officer. The Embassy recommends that Americans not travel on the national highways from dusk to dawn. Drivers without valid permits, and the ease with which a driver's license can be acquired without training, make Burundian drivers less careful, predictable, or mindful of driving rules than Western drivers may expect.
There are no traffic signals in Bujumbura, and virtually nothing of the kind elsewhere in the country. Roadways are not marked, and the lack of streetlights or shoulders makes driving in the countryside at night especially dangerous. Additionally, drivers may encounter cyclists, pedestrians, and livestock in the roadway, including in and around the capital. Mini-vans used as buses for 18 persons should be given a wide berth as they start and stop abruptly, often without pulling to the side of the road.
Large holes or damaged portions of roadway may be encountered anywhere in the country, including in Bujumbura; when driving in the countryside, it is recommended that travelers carry multiple spare tires. During the rainy season, many side roads are passable only with four-wheel drive vehicles. Burundi’s supply of gasoline and diesel fuel are imported predominantly from Kenya and Tanzania, and are relatively expensive due to high transportation costs. Service stations are rare outside of the major cities.

Third-party insurance is required, and it will cover any damages (property, injury, or death). If you are found to have caused an accident, you automatically will be fined 10,000 Burundian francs (approximately $10 U.S.) and your driver's license will be confiscated until the police investigation is completed. Although the law provides for the arrest of drunk drivers, in practice, the police do not act on this law. In the city of Bujumbura, the number for police assistance is 22-22-37-77; there is no comparable number outside the capital. If you are involved in an accident causing death, it is advised that you leave the scene of the accident and proceed to the nearest police station.

Please refer to our Road Safety page for more information.

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

SPECIAL CIRCUMSTANCES:
There are no ATMs located in the country and most Burundian hotels and businesses do not accept credit cards. Many hotels in Bujumbura accept payment in U.S. dollars or Euros from non-Burundians. Travelers should be aware that Burundian banking practices prohibit acceptance of U. S. currency printed before the year 2003.
The Embassy recommends that visitors do not photograph airports, military installations, or other government buildings, and obtain permission from individuals before taking their photographs. 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 Burundian laws, even unknowingly, may be expelled from the country, arrested or imprisoned. Penalties for possession, use, or trafficking in illegal drugs in Burundi 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 intercountry adoption and international parental child abduction see our Office of Children’s Issues web pages

REGISTRATION / EMBASSY LOCATION:
Americans living or traveling in Burundi are encouraged to register with the U.S. Embassy through the State Department’s travel registration website so that they can obtain updated information on travel within Burundi and the Embassy’s current security policies, including areas that are off-limits to U.S. Government personnel for security reasons. Americans without Internet access may register directly with the U.S. Embassy. By registering, American citizens make it easier for the Embassy to contact them in case of emergency. The U.S. Embassy is located on Avenue des Etats-Unis, telephone (257) 22-22-34-54, fax (257) 22-22-29-26. The Embassy's web site is http://burundi.usembassy.gov/.
* * *
This replaces the Country Specific Information for Burundi dated July 18, 2007, to update sections on Country Description, Entry/Exit Requirements, Medical Facilities and Health Information, and Traffic Safety and Road Conditions.

Travel News Headlines WORLD NEWS

Date: Wed, 14 Aug 2019 17:49:51 +0200 (METDST)

Nairobi, Aug 14, 2019 (AFP) - The World Health Organization (WHO) said Wednesday that Burundi had begun vaccinating frontline workers against Ebola at its border with the Democratic Republic of Congo, where an outbreak of the virus has killed close to 1,900 people.   The campaign to vaccinate at-risk staff against the deadly hemorrhagic fever started Tuesday at Gatumba, the main crossing point from Burundi to its much-larger neighbour, WHO said.

Burundi has received doses of the rVSV-ZEBOV vaccine, an unlicensed product that has been shown to be effective against the Zairian strain of the virus raging in DR Congo.   It would be administered to those at greatest risk such as health workers along the border, laboratory staff and burial teams, WHO said.   "The vaccination of health and frontline staff is a significant step forward in preparing for the response to this disease," said Dr Kazadi Mulombo, WHO representative in Burundi. 

The vaccine, developed by US pharmaceutical group Merck, proved "highly effective" in a trial conducted in Guinea in 2015 during the Ebola epidemic in West Africa, he added.    The vaccination campaign will be overseen by WHO and Burundi's health ministry.   The Ebola outbreak in eastern DR Congo is the second-worst in history. A total of 1,892 deaths have been recorded since the outbreak began on August 1 2018.   No cases of Ebola have been recorded so far in Burundi, a tiny nation of 11 million.    But its border with DR Congo is 236 kilometres (147 miles) long and considered highly porous, and the whole region is on high alert.

In June, three people from one family died in Uganda from Ebola after returning from DR Congo via an unofficial crossing point.   Burundi also shares a border with Rwanda and Tanzania.   The Congo outbreak is the first where vaccines have been rolled out on a large-scale.   The rVSV-ZEBOV vaccine has already been administered to some 170,000 people, especially frontline workers, in DR Congo.   This week, US researchers announced that two prototype drugs being tested among Ebola patients in eastern DR Congo boost chances of surviving the disease.
Date: Thu 8 Aug 2019 05.00 BST
Source: The Guardian [edited]

A serious outbreak of malaria in Burundi has reached epidemic proportions, killing almost as many people as the Ebola crisis in the nearby Democratic Republic of the Congo.  The outbreak in the tiny Great Lakes country has infected almost half the total population, killing about 1800 people since the beginning of the year [2019].  According to figures gathered by the World Health Organisation, almost 6 million cases have been recorded since the 1st week of January to the end of July [2019], with infections reaching crisis levels in May. The figures look on course to outstrip the epidemic of 2017, when more 6 million cases were recorded for the whole year. The situation has continued to worsen as the government of Burundi has refused to declare an emergency.

The scale of the outbreak was described in the latest report for the UN's office for the Coordination of Humanitarian Affairs, which warned that the outbreak had reached "epidemic" proportions.  "The national malaria outbreak response plan, which is currently being validated, has highlighted a lack of human, logistical, and financial resources for effective response," reported the organisation.  The organisation and other experts have blamed a number of issues for the crisis, including low use of preventative measures and a vulnerable population with low levels of resistance. Experts have also noted an increase in drug resistant strains of the disease in common with other parts of the world.

The climate crisis has been cited as a contributing factor. Mosquitoes, which spread the disease, are reaching higher altitudes in the mountainous country, and have displayed behavioural changes including more aggressive feeding habits.  The country's agricultural policies have also encouraged an increase in rice production that has seen farmers encroach on mosquito-infested areas.  While Burundi has long struggled with malaria, the figures for the current outbreak suggest a 50% increase compared to the equivalent period last year [2018]. The UN organisation noted bleakly that the number of health districts that have passed the epidemic threshold had continued to increase.

Although Burundi declared a national health emergency in 2017 after 1.8 million cases and 700 deaths were recorded, it has declined to declare one for the current outbreak, apparently concerned of the potential impact ahead of elections slated for next year [2010]…  [Byline: Peter Beaumont]
========================
[The WHO profile of malaria in Burundi can be found at

In 2017, the entire population of an estimated 10.9 million people lived in _Plasmodium falciparum_ high-endemic areas. In 2017 the annual incidence of _P. falciparum_ was estimated at 800 cases per 1000 population (WHO 2017 as above).

In 2017 there was an estimated 2.1M [range: 1.3M, 3.4M] cases with an estimated number of deaths of 5300 [range: 4300, 6200] (WHO). The 1st line treatment is artesunate-amodiaquine (AS-AQ) introduced in 2003. Malaria control relies on insecticide treated nets (ITN) but only around 30% of the population used a net the previous night one survey found (WHO 2017 as above) and it was also found that 80% of the mosquitoes were resistant to pyrethroids, the usual class of insecticides used for impregnating nets.

In 2005 the annual incidence was estimated at less than 50 cases per 1000 population (WHO 2017 as above) illustrating that since then the national malaria control programme has failed to improve the situation.

It is particularly worrying that the report above mentions treatment failure and possible drug resistance. With artemisinin resistance spreading in southeast Asia (see ProMED post http://promedmail.org/post/20190723.6583616) any signs of a slow parasite clearance need to be followed up by molecular analysis looking for mutations in key genes. No studies have looked at mutations in key genes predicting reduced susceptibility to the artemisinins or the 4-aminoquinolones (amodiaquine).

Since Burundi's independence in 1962, 2 genocides have taken place in the country: the 1972 mass killings of Hutus by the Tutsi-dominated army (<http://www.preventgenocide.org/edu/pastgenocides/burundi/resources/>), and the mass killings of Tutsis in 1993 by the Hutu majority. Both were described as genocides in the final report of the International Commission of Inquiry for Burundi presented in 2002 to the United Nations Security Council (<https://en.wikipedia.org/wiki/Burundi>). - ProMED Mod.EP]

[HealthMap/ProMED-mail map of Burundi:
Date: Tue, 6 Aug 2019 10:38:45 +0200 (METDST)

Nairobi, Aug 6, 2019 (AFP) - Malaria has killed more than 1,800 people in Burundi this year, the UN's humanitarian agency says, a death toll rivalling a deadly Ebola outbreak in neighbouring Democratic Republic of Congo.   In its latest situation report, the United Nations Office for the Coordination of Humanitarian Affairs (OCHA) said 5.7 million cases of malaria had been recorded in Burundi in 2019 -- a figure roughly equal to half its entire population.   Of those cases, a total of 1,801 died from the mosquito-born disease in Burundi between January 1 and July 21, OCHA said.

The tiny country of 11 million people in the African Great Lakes region has still not declared a national emergency, despite OCHA saying the outbreak crossed "epidemic proportions" in May.   "The national malaria outbreak response plan, which is currently being validated, has highlighted a lack of human, logistical and financial resources for effective response," OCHA said in its latest weekly bulletin on humanitarian emergencies.   "All stakeholders, including the national authorities and partners are called upon to provide the requisite resources to mount a robust response to this event before it escalates."   A lack of preventative measures like mosquito nets, climatic changes and increased movements of people from mountain areas with low immunity to malaria were driving the crisis, OCHA said.

- 'Many crises' -
An OCHA official told AFP that "the decision to declare an epidemic is the sovereignty of the Burundian state".   The country declared a malaria epidemic in March 2017, when the country had recorded 1.8 million cases and 700 deaths, but was resisting doing the same now.   A senior government official, who declined to be named, said the government did not want to admit weakness with elections set for 2020.   "We are less than a year away from the presidential election. (President Pierre) Nkurunziza, who is facing many crises, does not want to recognise what could be considered a failure of his health policy," the official told AFP.   Burundi has been in crisis since 2015, when Nkurunziza ran for a third term and was re-elected in elections boycotted by most of the opposition.

At least 1,200 people were killed and more than 400,000 displaced in violence the UN says was mostly carried out by state security forces.   Nkurunziza announced in 2018 that he would not stand again, confounding critics who accused him of working to extend his grip on power.   UN investigators said in July that "drastic" steps were needed to boost democratic freedoms in Burundi if the government wanted the elections to be considered credible.

Burundi, one of the poorest countries in the region, abuts DR Congo, where the second-worst Ebola outbreak in history has killed more than 1,800 people amid fears the infectious fever could spread beyond its borders.   But malaria is a much bigger killer on the continent.   The World Health Organization recorded nearly 220 million cases of the parasitic illness in 2017, with an estimated 435,000 deaths. More than 90 percent of malaria cases and deaths were in Africa.
Date: Fri, 16 Mar 2018 14:39:07 +0100

Nairobi, March 16, 2018 (AFP) - Nine workers at a construction site outside Burundi's capital Bujumbura were killed in a landslide on Friday, police said.   Heavy seasonal rains caused the hillside next to the Gasenyi river, east of the city, to collapse burying the workers who were building a channel to redirect the river's floodwaters.   Police said in a statement that nine bodies had so far been found, while rescue efforts continue.
Date: Sat 7 Oct 2017 11:52:12 CAT
Source: Global Times, Xinhua News Agency report [edited]

At least 5 cases of cholera were reported this week [week of 2 Oct 2017] in Rugombo town in Cibitoke province, 72 km [about 45 mi] northwest of the Burundian capital Bujumbura, the Burundi News Agency reported Fri 6 Oct 2017. All those 5 cholera cases were reported at Rusiga, adding that lack of clean water is the origin of the propagation of cholera in that area, the state-run agency reported.

The Burundi Red Cross has deployed its agents to distribute drugs in infected households at Rusiga to avoid the propagation of the epidemic, it reported. Cibitoke Governor Joseph Iteriteka on [Fri 6 Oct 2017] held a meeting with health and administration officials based in Cibitoke province to look at ways of curbing the propagation of cholera in Rugombo and Cibitoke town, according to the report. During the meeting, they urged the country's Water and Electricity Company (REGIDESO) to supply water to the 2 towns -- Rugombo and Cibitoke -- as they are the worst threatened, reported the agency.

The Burundian Imbo western lowlands extending from the north in Cibitoke province to the south in Makamba Province near Lake Tanganyika are vulnerable to cholera every year in the dry season, especially between August and October. By the end of August 2017, the east African country's health ministry confirmed 24 cholera cases in Nyanza-Lac in the south-western province of Makamba, which originated from a fisherman who had come from the Democratic Republic of the Congo with symptoms of cholera.
===================
[Cibitoke province is one of the 18 provinces of Republic of Burundi. It is located in extreme northwest Burundi and can be seen on a map at <http://www.un.org/Depts/Cartographic/map/profile/burundi.pdf>. - ProMED Mod.LL]

[A HealthMap/ProMED-mail map can be accessed at
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Nigeria

Nigeria US Consular Information Sheet
June 02, 2008
COUNTRY DESCRIPTION:
Nigeria is a developing country in western Africa that has experienced periods of political instability. It has the largest population on the continent, estimated at
44 million people, and its infrastructure is not fully functional or well maintained. Read the Department of State’s Background Notes on Nigeria for additional information.

ENTRY/EXIT REQUIREMENTS: A passport and visa are required. The visa must be obtained in advance from a Nigerian Embassy or Consulate. Visas cannot be obtained on arrival at the airport. Promises of entry into Nigeria without a visa are credible indicators of fraudulent commercial schemes in which the perpetrators seek to exploit the foreign traveler's illegal presence in Nigeria through threats of extortion or bodily harm. U.S. citizens cannot legally depart Nigeria unless they can prove, by presenting their entry visas, that they entered Nigeria legally. Entry information may be obtained at the Embassy of the Federal Republic of Nigeria, 3519 International Court NW, Washington, DC 20008, telephone (202) 822-1500, or at the Nigerian Consulate General in New York, telephone (212) 808-0301. Overseas, inquiries may be made at the nearest Nigerian embassy or consulate.

Visit the Embassy of Nigeria web site at http://www.nigeriaembassyusa.org/ 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:
The Department of State continues to caution U.S. citizens about the possible dangers of travel to some parts of Nigeria. [Please also see the Crime Section below.] In light of the risk of kidnapping, crime, militant activity, or armed attacks, the U.S. Mission restricts the travel of U.S. government personnel to the following states to official travel only: Delta, Bayelsa, Rivers and Akwa Ibom in the Niger Delta, and Edo and Imo in the south. Only essential travel by non-official Americans is recommended to these areas. In addition, the military's Joint Task Force patrols the creeks in the Niger Delta because of ongoing militant and piracy incidents, especially against oil-related facilities or infrastructure, so individuals may be questioned, detained or arrested when traveling in these sensitive areas without evidence of permission from the Nigerian government or for carrying electronic equipment such as cameras, recorders, etc. Periodically, travel by U.S. mission personnel is restricted in certain parts of Nigeria based on changing security conditions, often due to crime, general strikes, or student/political demonstrations or disturbances. See the Department of State’s Travel Warning for Nigeria for more information.

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 current Travel Warnings, Travel Alerts, and 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: Violent crime committed by individual criminals and gangs, as well as by some persons wearing police and military uniforms, is a problem, especially in Lagos, Abuja and other large cities, although it can occur anywhere. Some visitors and resident Americans have experienced armed muggings, assaults, burglary, carjacking, kidnappings and extortion, often involving violence. Home invasions are on the rise in Lagos, with armed robbers accessing even guarded compounds by following, or tailgating, residents or visitors arriving by car into the compound, subduing guards and gaining entry into homes or apartments. Armed robbers in Lagos also access waterfront compounds by boat. U.S. citizens, as well as Nigerians and other expatriates, have been victims of armed robbery on roads to airports during both daylight and evening hours. Law enforcement authorities usually respond to crimes slowly or not at all, and provide little or no investigative support to victims. U.S. citizens and other expatriates have experienced harassment and shakedowns at checkpoints and during encounters with Nigerian officials.

Nigerian-operated fraud scams, known as 419s, are noted for their cleverness and ingenuity. These scams target foreigners worldwide, posing risks of both financial loss and personal danger to their victims. Scams are often initiated through internet postings or from internet cafes, by unsolicited emails, faxes, and letters, or can involve credit card use. As anywhere else, no one should provide personal or financial information to unknown parties or via Nigerian telephone lines. The expansion of bilateral law enforcement cooperation, which has resulted in numerous raids on commercial fraud premises, has reduced the overall level of overt fraud activity, but new types of sophisticated scams are introduced daily.

American citizens are very frequently the victims of Nigerian confidence artists offering companionship through internet dating websites. These confidence artists almost always pose as American citizens visiting or living in Nigeria who unexpectedly experience a medical, legal, financial or other type of “emergency” that requires the immediate financial assistance of the American citizen in the United States. In these cases, we strongly urge the American citizen in the United States to be very cautious about sending money to any unknown person purportedly acting on their behalf, or traveling to Nigeria to meet someone with whom their sole communications have been via the internet. Other common scams involve a promise of an inheritance windfall, work contracts in Nigeria, or an overpayment for goods purchased on-line. For additional information on these types of scams, see the Department of State's publication, International Financial Scams.

Commercial scams or stings that targets foreigners, including many U.S. citizens, continue to be a problem. One needs to be alert to scams that may involve U.S. citizens in illegal activity, resulting in arrest, extortion or bodily harm. These scams generally involve phony offers of either outright money transfers or lucrative sales or contracts with promises of large commissions or up-front payments, or improperly invoke the authority of one or more ministries or offices of the Nigerian government and may cite, by name, the involvement of a Nigerian government official. In some scams, government stationery and seals are also improperly used to advance the scam. The ability of U.S. consular officers to extricate U.S. citizens from unlawful business deals or scams and their subsequent consequences is extremely limited. U.S. citizens have been arrested by police officials and held for varying periods on charges of involvement in illegal business activity or scams. Nigerian police or other law enforcement officials do not always inform the U.S. Embassy or Consulate immediately of the arrest or detention of a U.S. citizen. The U.S. Department of Commerce has advisories to the U.S. business community on a variety of issues that should be seriously reviewed with respect to doing business in Nigeria. To check on a business’s legitimacy while in the United States, contact the Nigeria Desk Officer at the International Trade Administration, Room 3317, Dept. of Commerce, Washington, D.C. 20230, telephone 1-800-USA-TRADE or (202) 482-5149, fax (202) 482-5198. If you are abroad, contact the nearest U.S. Embassy or Consulate.

The Department of State encourages all travelers abroad to register their travel. The most convenient way to do so would be through the online travel registration page. Travelers may also register in person at the U.S. Embassy in Abuja or the U.S. Consulate General in Lagos. See the section on Registration / Embassy Location below.

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, for example, can provide you with a list for appropriate medical care, or contact family members or friends and explain how funds could be transferred to you to cover unexpected costs. Although the investigation and prosecution of the crime is solely the responsibility of local authorities, consular officers can help you to understand the local criminal justice process and to find an attorney if needed.

See the Department of State’s information on Victims of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION: While Nigeria has many well-trained doctors, medical facilities in Nigeria are in poor condition, with inadequately trained nursing staff. Diagnostic and treatment equipment is most often poorly maintained, and many medicines are unavailable. Caution should be taken as counterfeit pharmaceuticals are a common problem and may be difficult to distinguish from genuine medications. This is particularly true of generics purchased at local pharmacies or street markets. Hospitals often expect immediate cash payment for health services.

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 health insurance policy applies overseas and whether it will cover emergency expenses such as a medical evacuation from a foreign country to the United States or another location. Please see the our brochure 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 Nigeria is provided for general reference only and may not be totally accurate in a particular location or circumstance.

Roads in many areas are generally in poor condition, causing damage to vehicles and contributing to hazardous traffic conditions. There are few working traffic lights or stop signs. The rainy season from May to October is especially dangerous because of flooded roads and water-concealed potholes.

Excessive speed, unpredictable driving habits, and the lack of basic maintenance and safety equipment on many vehicles are additional hazards. Motorists seldom yield the right-of-way and give little consideration to pedestrians and cyclists. Gridlock is common in urban areas. Chronic fuel shortages have led to long lines at service stations, which disrupt or block traffic for extended periods.

Public transportation vehicles are unsafe due to poor maintenance, high speeds and overcrowding. Motorbikes, known in Nigeria as "okadas," are a common form of public transportation in many cities and pose particular danger to motorists, their own passengers and pedestrians. Motorbike drivers frequently weave in and out of traffic at high speeds and observe no traffic rules. Motorbikes are banned within Abuja's city limits. Passengers in local taxis have been driven to secluded locations where they were attacked and robbed. Several of the victims required hospitalization. The U.S. Mission advises that public transportation throughout Nigeria be avoided.

It is recommended that short-term visitors not drive in Nigeria. A Nigerian driver's license can take months to obtain, and to date an international driving permit is not recognized. Major hotels offer reliable car-hire services complete with drivers. Reliable car-hire services can also be obtained at the customer service centers at the airports in Lagos, Abuja, and Kano. Inter-city travelers must also consider that roadside assistance is extremely scarce, and as noted above medical facilities and emergency care are poor, meaning that being involved in a traffic incident might result in a lack of available medical facilities to treat either minor or life-threatening injuries.

All drivers and passengers are reminded to wear seat belts, lock doors, and raise windows. It is important to secure appropriate automobile insurance. It is also important to be aware that drivers and passengers of vehicles involved in accidents resulting in injury or death have experienced extra-judicial actions, i.e., mob attacks, official consequences such as fines and incarceration or involvement with the victim's family. Night driving should be done with extreme caution, but it is recommended to avoid driving between 6:00 p.m. and 6:00 a.m. as bandits and police roadblocks are more numerous at night. Streets are very poorly lit, and many vehicles are missing one or both headlights, tail lights, and reflectors.

The Government of Nigeria charges the Federal Road Safety Commission with providing maps and public information on specific road conditions. The Federal Road Safety Commission may be contacted by mail at: Ojodu-Isherri Road, PMB 21510, Ikeja, Lagos; telephone [243] (1) 802-850-5961 or [234] (1) 805-684-6911.
Please refer to our Road Safety page for more information.

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

The Port Harcourt International Airport, which was closed in mid-2006 for rehabilitation, resumed operations in December 2007 for domestic daylight flights. Installations and improvements needed for international flights and night operations are expected to be completed in 2008.

For additional information on aviation safety concerns, see the Department of State’s Travel Warning for Nigeria.
SPECIAL CIRCUMSTANCES:
Permission is required to take photographs or videotape any government buildings, airports, bridges, and in areas where the military is operating throughout the country. These sites include, but are not limited to, Federal buildings in the Three Arms Zone (Presidential palace area, National Assembly, Supreme Court/Judiciary) of the capital of Abuja, other government buildings around the country and foreign Embassies and Consulates. Many restricted sites are not clearly marked, and application of these restrictions is subject to interpretation by the Nigerian security services and can result in detention. Permission may be obtained from Nigeria's State Security Services, but even permission may not prevent the imposition of penalties or detention. Penalties for unauthorized photography or videography may include confiscation of the still or video camera, exposure of the film or deletion of film footage, a demand for payment of a fine or bribe, and/or detention, arrest, or physical assault. For these reasons, visitors to Nigeria should avoid taking still photos or videotaping in and around areas that are potentially restricted sites, including any government sites.

The Nigerian currency, the naira, is non-convertible. U.S. dollars are widely accepted. Nigeria is a cash economy, and it is usually necessary to carry sufficient currency to cover the expenses of a planned visit, which makes travelers an attractive target for criminals. Credit cards are rarely accepted beyond a few upscale hotels. Due to credit card fraud in Nigeria and by cohorts in the United States, credit card use should be considered carefully. While Citibank cashes some traveler’s checks, most other banks do not. American Express does not have offices in Nigeria; however, Thomas Cook does. Inter-bank transfers are often difficult to accomplish, though money transfer services such as Western Union are available. For further information, visitors may contact the U.S. Embassy or Consulate.

Please see the Department of State’s information on 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 Nigerian laws, even unknowingly, may be expelled, detained, arrested or imprisoned. Penalties for possession, use, or trafficking in illegal drugs in Nigeria 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 the Department of State’s information on Criminal Penalties.

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

REGISTRATION / EMBASSY LOCATION:
Americans living or traveling in Nigeria are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department’s travel registration website so that they can obtain updated information on travel and security within Nigeria and other general information.Americans withoutInternet access may register directly with the nearest U.S. Embassy or Consulate. By registering, American citizens make it easier for the Embassy or Consulate to contact them in case of emergency.

The U.S. Embassy is located at 1075 Diplomatic Drive, Central Area, Abuja. American citizens can call [234] (9) 461-4176 during office hours (Monday through Thursday, 7:30 a.m. to 4:30 p.m.; Friday, 7:30 a.m. to 1:30 p.m.). For after-hours emergencies, call [234] (9) 461-4000. The email address for the Consular Section in Abuja is ConsularAbuja@state.gov.

The U.S. Consulate General is located at 2 Walter Carrington Crescent, Victoria Island, Lagos. American citizens can call [234] (1) 261-1215 during office hours (7:30 a.m. to 4:00 p.m.). For after-hours emergencies, call [234] (1) 261-1414, 261-0050, 261-0078, 261-0139, or 261-6477. The e-mail address for the Consular Section in Lagos is Lagoscons2@state.gov.

The Embassy and Consulate website is http://nigeria.usembassy.gov/.
* * *
This replaces the Consular Information Sheet dated April 16, 2007, to update sections on Country Description, Safety and Security, Crime, Traffic Safety and Road Conditions, Aviation Safety Oversight, Special Circumstances and Registration / Embassy Location.

Travel News Headlines WORLD NEWS

Date: Wed, 20 Nov 2019 17:17:39 +0100 (MET)

Lagos, Nov 20, 2019 (AFP) - Nigerian President Muhammadu Buhari on Wednesday announced a campaign to end defecation in public, in a country where tens of millions of people going to the toilet outside poses a major health risk.    "Nigeria has committed to end open defecation throughout the country by 2025," a statement by the presidency said a day after the United Nations marked World Toilet Day.     The decree set up a new body called the Clean Nigeria Campaign Secretariat to ensure "that all public places including schools, hotels, fuel stations, places of worship, market places, hospitals and offices have accessible toilets and latrines within their premises". 

According to the United Nations children agency, UNICEF, Nigeria has amongst the highest number of people practising open defecation in the world, estimated at over 46 million people -- almost a quarter of the population.   Around Nigeria each year 87,000 children die from diarrhoea, with more than 90 per cent of deaths caused by a lack of water, sanitation and hygiene, according to the World Bank.   The new agency will be disbanded when the goal of ending open defecation has been met, the presidency said.
Date: Sun 3 Nov 2019
Source: Nigeria Centre for Disease Control (NCDC) [edited]

Highlights
- In the reporting week 44 (28 Oct - 3 Nov 2019), 11 new confirmed** cases were reported from Ondo (6) and Edo (5) states with one new death from Edo state.
- From 1 Jan - 3 Nov 2019, a total of 4396 suspected* cases have been reported from 23 states. Of these, 754 were confirmed positive, 19 were probable, and 3623 were negative (not a case).
- Since the onset of the 2019 outbreak, there have been 158 deaths in confirmed cases. Case-fatality ratio in confirmed cases is 21%.
- A total of 23 states (Edo, Ondo, Bauchi, Nasarawa, Ebonyi, Plateau, Taraba, Adamawa, Gombe, Kaduna, Kwara, Benue, Rivers, Kogi, Enugu, Imo, Delta, Oyo, Kebbi, Cross River, Zamfara, Lagos, and Abia) have recorded at least one confirmed case across 86 local government areas [LGAs] - Figure 1.
- 93% of all confirmed cases are from Edo (38%), Ondo (31%), Ebonyi (7%), Bauchi (7%), Taraba (5%), and Plateau (5%) states - Figure 1.
- Predominant age group affected is 21-40 years (range: greater than one month to 98 years; median age: 34 years) - Figure 6.
- The male-to-female ratio for confirmed cases is 1:1 - Figure 6.
- In the reporting week 44, no new healthcare worker was affected. A total of 19 healthcare workers have been infected since the onset of the outbreak in 10 states: Edo (6), Ondo (4), Ebonyi (2), Enugu (1), Rivers (1), Bauchi (1), Benue (1), Delta (1), Plateau (1) and Kebbi (1) with 2 deaths in Enugu and Edo states.
- Nine patients are currently being managed at various treatment centres across the country: Irrua Specialist Teaching Hospital (ISTH) treatment Centre (7) and Federal Medical Centre, Owo (2).
- A total of 8400 contacts have been identified from 21 states. Of these, 356 (4.2%) are currently being followed up, 7967 (94.8%) have completed 21 days follow-up, while 12 (0.1%) were lost to follow-up. A total of 132 symptomatic contacts have been identified, of which 65 (49.2%) have tested positive.
- National Lassa fever multi-partner, multi-sectoral Technical Working Group (TWG) continues to coordinate response activities at all levels.

Figures [available at the source URL above]
-------------------------------------------
Figure 1 [map]. Randomised distribution of confirmed Lassa fever cases in Nigeria as at 3 Nov 2019.
Figure 2 [map]. LGAs with confirmed Lassa fever cases in Nigeria as at 3 Nov 2019.
Figure 3 [graph]. Epicurve of Lassa fever confirmed cases (754) in Nigeria - week 01-44, 2019.
Figure 4 [graph]. November 2019. Weekly trends of Lassa fever confirmed cases in Nigeria, 2016/week 01-2019/week 44.
Figure 5 [graph]. Confirmed Lassa fever cases in Nigeria with state-specific case-fatality rates (CFR) as at 3 Nov 2019.
Figure 6 [graph]. Age-sex distribution of confirmed Lassa fever cases in Nigeria as at 3 Nov 2019.

*Suspected case describes any individual presenting with one or more of the following: malaise, fever, headache, sore throat, cough, nausea, vomiting, diarrhoea, myalgia, chest pain, hearing loss, and either (a) history of contact with excreta or urine of rodents or (b) history of contact with a probably or confirmed Lassa fever case within a period of 21 days of onset of symptoms, or any person with inexplicable bleeding/hemorrhagia.
**Any suspected case with laboratory confirmation (positive IgM antibody, PCR, or virus isolation)
==================
[The 11 new confirmed and 4396 suspected cases indicate that Lassa fever (LF) virus transmission is continuing. Nigeria should be in the period of the year when fewer cases usually occur, as illustrated in the graph in Figure 3 (at the source URL above), but more cases are still occurring. There has been a peak in case numbers between weeks 1 and 11 (January-March) over the past 3 years and probably will be the case again next year (2020).

The number of confirmed deaths has increased by 2 to 158. Fortunately, there are no new healthcare workers infected during this reporting period, and the total number of infected healthcare workers remains at 19, a likely indication that effective barrier nursing and the use of personal protective equipment are being employed. This outbreak remains widespread so far in 2019, with confirmed cases occurring in 23 states, and the number of affected LGAs remains at 86. ProMED-mail readers may wish to see the maps and graphs (Figures 1-6) that are available at the source URL above.

Transmission of LF virus occurs when individuals are in contact with rodent reservoir host excreta or are within healthcare facilities. It would be interesting to know whether the prevalence of Lassa fever virus has been increasing in populations of rodent hosts in areas where human cases are occurring.

Images of the rodent reservoirs of Lassa fever virus:
_Mastomys natalensis_:
_Mastomys erythroleucus_ and _Hylomyscus pamfi_:

There is no mention in the plans above of public education for avoidance of contact with these rodents and their excreta. - ProMED Mod.TY]

[Maps of Nigeria:
Date: Fri 8 Nov 2019
Source: The Nigerian Voice [edited]

Between 1 Aug and 5 Nov 2019, Nigeria experienced an upsurge in cases of yellow fever, with 511 suspected cases in 3 states: 309 from Katsina, 162 from Bauchi, and 40 from Benue. Of the samples tested from these cases, 83 were confirmed positive (43 in Katsina, 34 in Bauchi, and 6 in Benue).

Since the beginning of the year [2019], the Nigeria Centre for Disease Control (NCDC) and the National Primary Health Care Development Agency (NPHCDA) have been working with development partners to support the states to prevent and reduce the number of cases and deaths.

This year [2019], Katsina state has recorded 599 suspected cases, 43 confirmed cases, and 77 deaths among suspected cases. A mass vaccination campaign was carried out in the state in September 2019. Bauchi state has been reporting suspected cases of yellow fever mostly in Alkaleri LGA [local government area]. This year [2019], the state has recorded 183 suspected cases, 34 confirmed cases, and 24 deaths among suspected cases. Following the outbreak in Alkaleri LGA, a reactive vaccination campaign was carried out. Benue state has recorded 150 suspected cases, 6 confirmed cases, and no deaths in 2019. Vaccination campaigns have been carried out in 3 LGAs of the state this year [2019]: Vandekiya LGA in January 2019 and Oju and Ado LGAs in September 2019.

In response to the increase in cases, a multi-agency yellow fever emergency operations centre (EOC) was activated on 5 Nov 2019. Three rapid response teams (RRTs) have been deployed to Katsina, Bauchi, and Benue this week [week of Mon 4 Nov 2019] to support the outbreak response.

Working together, NPHCDA, NCDC, and development partners recently implemented yellow fever mass vaccination campaigns in Alkaleri LGA of Bauchi, 2 LGAs of Benue (Oju and Ado), and all the LGAs in Katsina. All the campaigns were implemented between September and October 2019. In total, yellow fever vaccination campaigns have been implemented in 13 of the 36 states in Nigeria and in the FCT.

Since the re-emergence of yellow fever in Nigeria in 2017, NCDC, NPHCDA, and the National Arbovirus and Vector Research Centre (NAVRC) have been working together to support states to investigate each case and respond to outbreaks.

Yellow fever virus is spread through the bite of an infected mosquito. There is no human-to-human transmission of the virus. Yellow fever is a completely vaccine-preventable disease, and a single shot of the yellow fever vaccine protects for a lifetime. In Nigeria, vaccination against yellow fever is primarily through the routine childhood immunisation. Where necessary, catch-up campaigns are carried out to increase population immunity. The yellow fever vaccine is available for free in all primary healthcare centres in Nigeria as part of the routine childhood immunisation schedule. We encourage every family to ensure that children receive all their childhood vaccines.

In addition to the vaccine, the public is advised to keep their environment clean and free of stagnant water to discourage the breeding of mosquitoes and ensure the consistent use of insecticide-treated mosquito nets, screens on windows, and doors to prevent access for mosquitoes. Hikers, park visitors, and people engaged with activities in the wild especially are encouraged to be vaccinated against yellow fever. It is important to avoid self-medication; visit a health facility immediately if you feel ill.

Healthcare workers and members of the public are reminded that the symptoms of yellow fever include yellowness of the eyes, sudden fever, headache, and body pain. If you have these symptoms or notice someone in your community displaying them, please contact your nearest primary healthcare centre.  [Byline: Jeremiah Agenyi]
========================
[Yellow fever cases have been occurring in various states across Nigeria this year (2019), most recently in the 3 above states. There is no indication in the above report what proportions of the population have been vaccinated in these 3 states, but clearly it is less than the ideal of 80-90%, given these cases. One hopes that the ongoing vaccinations will bring these outbreaks to a halt. - ProMED Mod.TY]

[Maps of Nigeria:
Date: Thu 7 Nov 2019
Source: PM News [edited]

In Bauchi state, 29 people have died so far following the outbreak of yellow fever, an acute viral haemorrhagic disease transmitted by infected mosquitoes. Dr Rilwanu Mohammed, chairman, Bauchi State Primary Healthcare Development Agency (BSPHDA), gave the death toll on Thursday [7 Nov 2019].  "We discovered 224 suspected cases, and 29 were confirmed dead, with 24 in Alkaleri local government, 2 in Bauchi local government, one in Darazo council area, and 2 in Ningi local government," he said.

Mohammed explained that the virus was 1st detected in Alkaleri council area in September [2019], adding that efforts had since been stepped up to avoid further spread. He said that government was doing everything possible to ensure that the disease did not spread to the state capital.  "That is why the government has made efforts through the vaccination of people living in the prone areas. Already, 500,000 doses of vaccines had been administered in Alkaleri, and we are expecting 600 000 doses of vaccines to be administered in the Ningi community," he said.

According to the BSPHDA chairman, yellow fever is not a communicable disease; it can only be transmitted through mosquitoes. He urged communities to give early information to the authorities, especially when they notice unusual happenings around them. Mohammed also urged the residents of the state not to reject vaccines, saying that this was the only way they could be free from the dreaded disease.

The "yellow" in the name refers to the jaundice that affects some patients. Symptoms of yellow fever include fever, headache, jaundice, muscle pain, nausea, vomiting, and fatigue.
======================
[The yellow fever (YF) outbreak is continuing in Bauchi state. On 14 Oct 2019, the Bauchi State Primary Health Care Development Agency confirmed 6 new recorded deaths in the yellow fever outbreak in the state, bringing the total number of deaths to 22 for the year (2019) (see Yellow fever - Africa (19): Nigeria (BA) http://promedmail.org/post/20191016.6729323). A subsequent 3 Nov 2019 report indicated that there are at least 6 additional YF deaths, for a total of 28. Now 29 fatal YF cases are reported with 224 suspected cases. Continuation of the active vaccination campaign is prudent and the only way to bring this outbreak to an end. - ProMED Mod.TY]

[HealthMap/ProMED-mail map:
Bauchi state, Nigeria: <http://healthmap.org/promed/p/3741>]
Date: Sun 3 Nov 2019
Source: Daily Post [edited]

A disease outbreak suspected to be yellow fever [YF] has again killed at least 6 people in different communities in Kyata ward of Ningi Local Government Area after killing over 18 people in Yankari Local Government, all in Bauchi State. The affected communities included Tipchi, Deru, Tudun Wada, Barawo and Sabon Gari, all of which are under Burra District.  A resident of Tipchi, Ilya Muhammed, who confirmed this in a telephone interview with Daily Post, listed the symptoms of the disease to include severe abdominal pain, persistent vomiting (most at times with blood) and high fever.

Corroborating Ilya Muhammed's claim, a health worker in Tipchi Primary Health Care Centre, who did not want his name mentioned, listed dizziness and yellowish eyes as additional symptoms the victims present to them.  "Most of those who came to us here said they had the fever for about 3 days before coming. Seeing their condition and the rampant cases being recorded, we immediately referred them to a higher facility, and in 1-2 days, you hear that so and so person is returned dead," recounts the health worker.

The duo confirmed to Daily Post that the outbreak started almost a month ago and that several complaints have been made to the local government primary health care department, but no action has been taken yet.  "We did report the outbreak to the immediate past director of primary health care in the local government. Maybe their recent suspension might have delayed government intervention", says Ilya Muhammed, who is a community leader in Tipchi.

The health worker who spoke to Daily Post is currently down with fever, while one of his female colleagues also had fever in the last one week, but is said to be recovering.  "As I am speaking to you now, I am currently at home with fever. I couldn't even go to work" claimed the health worker.  They appealed to the authorities concerned to send a team of experts to ascertain the nature of the disease for appropriate and prompt intervention.  [Byline: Hafsat Abdulhamid]
===================
[There have been recent cases of yellow fever (YF) in Bauchi state. On 14 Oct 2019, the Bauchi State Primary Health Care Development Agency confirmed 6 new recorded deaths in the yellow fever outbreak in the state, bringing the total number of deaths to 22 for this year (2019, see Yellow fever - Africa (19): Nigeria (BA) http://promedmail.org/post/20191016.6729323). The 6 cases mentioned above appear to be new ones since they are in the Yankari Local Government area and the previous ones were in Alkaleri and Tafawa Balewa Local Government Areas. The symptoms described above are compatible with YF, but prompt laboratory confirmation is needed, and, if positive for YF, a vaccination response should be implemented promptly.

A 3 Nov 2019 report indicates that there are 10 recent suspected yellow fever deaths
The reason for this discrepancy in case numbers is not clear. - ProMED Mod.TY]

[HealthMap/ProMED map available at:
Bauchi State, Nigeria: <http://healthmap.org/promed/p/3741>]
More ...

Bosnia and Herzegovina

Bosnia & Herzegovina US Consular Information Sheet
December 01, 2008
COUNTRY DESCRIPTION:
Since the December 1995 signing of the Dayton Peace Accords, there has been significant progress in restoring peace and stability in Bosnia and Herze
ovina.
Significant progress has been made in reconstructing the physical infrastructure that was devastated by the war. Nonetheless, political tensions among the ethnic groups persist. Hotels and travel amenities are available in the capital, Sarajevo, and other major towns, but they are relatively expensive. In the more remote areas of the country, public facilities vary in quality.
For more details, read the Department of State Background Notes on Bosnia and Herzegovina.

ENTRY/EXIT REQUIREMENTS:
A passport is required for travel to Bosnia and Herzegovina. American citizens do not require a visa for tourist stays up to three months.
Travelers who are not staying at a hotel (i.e. a private residence) must register with the local police within 24 hours of arrival. U.S. citizens planning to remain in Bosnia and Herzegovina for more than three months must obtain a visa prior to travel, or apply for a temporary residence permit from the local police station having jurisdiction over their place of residence. Applications for temporary residence permits should be submitted 15 days prior to the expiration of the initial three month tourist visa. A police certificate indicating that the applicant has no criminal record is required for this permit and should be obtained from the applicant’s state of residence in the U.S.
For additional information please contact the Embassy of Bosnia and Herzegovina, at 2109 E. Street, NW, Washington, DC 20037, telephone 202-337-6473.
Visit the Embassy of Bosnia and Herzegovina web site at http://www.bhembassy.org for the most current visa information.

Beginning in May 2008, the immigration authorities of Bosnia and Herzegovina began to strictly enforce a provision of a Bosnian law that requires any unaccompanied minor (under 18) to have written permission from both parents in order to enter and leave the country.
If traveling with one parent only, the minor is required to have written permission for the trip from the non-traveling parent. 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:
Landmines remain a problem in Bosnia and Herzegovina. As of 2008, there are still an estimated 13,000 minefields and an estimated 222,000 active land mines.
The area of suspected landmine contamination is estimated at over 2000 square kilometers more than 4% of the country’s territory.
These devices have killed more than 400 people since 1996.
While most urban areas have been largely cleared, special care should be taken when near the former lines of conflict, including the suburbs of Sarajevo.
The de-mining community recommends staying on hard surfaced areas and out of abandoned buildings.
Families traveling with children in Bosnia and Herzegovina should be especially aware of the danger posed by mines and unexploded ordnances.
For more information about landmines please visit http://www.bhmac.org/en/stream.daenet?kat=19
Localized political difficulties continue and random violence may occur with little or no warning.

Bosnian criminals use firearms and explosives to settle personal, business, and political disputes.
In October 2008, an explosive device detonated in a public shopping mall in Vitez, killing a store security guard.
The foreign community is rarely the target of such violence, but there is always the danger of being in the wrong place at the wrong time.
While most Bosnian citizens appreciate the assistance of the international community, occasional anti-foreign sentiment is sometimes encountered.
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 A Safe Trip Abroad.
CRIME:
The overall crime rate throughout the country remains relatively low­the most common being confrontational crimes and residential break-ins.
Pick-pocketing and vehicle break-ins are also a problem. Most pickpockets operate in pairs and employ distraction methods to execute their craft.
There are also documented cases of pick-pocketing and other scams to get money from foreign passengers aboard public transportation.
Travelers should take normal precautions to protect their property from theft and exercise common sense personal security measures, traveling in groups, and staying in well-lighted areas after dark.
Confrontations with local citizens resulting from traffic incidents or public disagreements should be avoided.

INFORMATION FOR VICTIMS OF CRIME:
The loss or theft abroad of a U.S. passport should be reported immediately to the local police and the nearest U.S. Embassy or Consulate.
If you are the victim of a crime while overseas, in addition to reporting to local police, please contact the nearest U.S. Embassy or Consulate for assistance.
The Embassy/Consulate staff can, for example, assist you to find appropriate medical care, contact family members or friends and explain how funds could be transferred.
Although the investigation and prosecution of the crime is solely the responsibility of local authorities, consular officers can help you to understand the local criminal justice process and to find an attorney if needed.
See our Victims of Crime, including possible sources of U.S. assistance..
The local equivalent to the “911” emergency line in Bosnia and Herzegovina is: Police­122; Ambulance--124 and Fire­123.
MEDICAL FACILITIES AND HEALTH INFORMATION:
The lack of adequate medical facilities, especially outside Sarajevo, may cause problems for visitors.
Because many medicines are not obtainable, travelers should bring their own supply of prescription drugs and preventive medicines.
Private practitioners and dentists are becoming more common; however, quality of care varies and rarely meets U.S. or western European standards.
All major surgery is performed in public hospitals.
The U.S. Department of State is unaware of any HIV/AIDS entry restrictions for visitors to or foreign residents of Bosnia and Herzegovina

Information on vaccinations and other health precautions, such as safe food and water precautions and insect bite protection, may be obtained from the Centers for Disease Control and Prevention’s hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747) or via the CDC’s web site at http://wwwn.cdc.gov/travel/default.aspx.
For information about outbreaks of infectious diseases abroad consult the World Health Organization’s (WHO) web site at http://www.who.int/en.
Further health information for travelers is available at http://www.who.int/ith/en
MEDICAL INSURANCE:
The Department of State strongly urges Americans to consult with their medical insurance company prior to traveling abroad to confirm whether their policy applies overseas and whether it will cover emergency expenses such as a medical evacuation.
Please see our information on medical insurance overseas.

TRAFFIC SAFETY AND ROAD CONDITIONS:
While in a foreign country, U.S. citizens may encounter road conditions that differ significantly from those in the United States.
The information below concerning Bosnia and Herzegovina is provided for general reference only, and may not be totally accurate in a particular location or circumstance.
Road travel is possible throughout most of the country.
However, some roads are still damaged from the war, and poorly maintained.
Roads are sometimes blocked due to landslides, de-mining activity, and traffic accidents.
Bosnia and Herzegovina is among the rare countries in Europe that has fewer than ten kilometers of four-lane highway.
The existing, two-lane roads between major cities are quite narrow at places, lack guardrails, and are full of curves.
Travel by road can be risky due to poorly maintained roads, and morning and evening fog in the mountains.
Driving in winter is hazardous due to fog, snow, and ice.
Local driving habits are poor, and many vehicles are in bad condition.
Many accidents occur when drivers exceed safe speeds along winding mountain roads.
Accidents involving drunk driving are an increasing problem.
Driving after dark is especially dangerous, and street lighting is not common outside the major towns.
Road construction may be poorly marked, and automobiles share the road with heavy vehicles and agricultural equipment.
Travelers are encouraged to convoy with other vehicles, if possible, and to plan their trip to ensure they travel only during daylight hours.

Although the number of service stations outside major cities has increased in recent years, many do not offer mechanical or other services.
The emergency number for vehicle assistance and towing service is 1282; Speed limit traffic signs are not always obvious or clear.
The speed limit on the majority of roads is 60 km/h, and on straight stretches of road it is generally 80 km/h.
The use of seat belts is mandatory.
Talking on a cell phone while driving is prohibited.
The tolerated percentage of alcohol in the blood is .03%.

In order to drive legally in Bosnia and Herzegovina, you must have an international driving permit in addition to your U.S. license.

Please refer to our Road Safety page for more information.
Visit the web site of the Bosnia and Herzegovina’s national tourist office and national authority responsible for road safety at http://www.bihamk.ba
AVIATION SAFETY OVERSIGHT:
As there is no direct commercial air service to the United States by carriers registered in Bosnia and Herzegovina, the U.S. Federal Aviation Administration (FAA) has not assessed Bosnia and Herzegovina’s Civil Aviation Authority for compliance with International Civil Aviation Organization (ICAO) aviation safety standards.
For more information, travelers may visit the FAA’s web site at http://faa.gov/safety/programs_initiatives/oversight/iasa .
During the winter months, flights into and out of Sarajevo are frequently delayed or canceled due to heavy fog.
Travelers should be prepared for last-minute schedule changes, lengthy delays, alternate routings, or time-consuming overland transportation.

SPECIAL CIRCUMSTANCES:
Bosnia and Herzegovina is still predominantly a cash economy.
Although the use of credit cards has become more widespread in recent years, travelers still should not expect to use them to cover all expenses. Automated Teller Machines (ATMs) are available in sufficient numbers at international banks in Sarajevo and other major cities and towns.
Traveler's checks can be cashed in banks in major cities, but often with delays of a few weeks or strict monthly limits.
Cash transfers from abroad may also involve delays.
The convertible mark, the national currency, is pegged to the euro under a currency-board regime, which guarantees its stability.
All official payments must be made in convertible marks, though many private stores and service providers also accept euros.
Any bank in Bosnia and Herzegovina should be able to exchange U.S. dollars into convertible marks with the usual bank commission (between 1% and 2%).

Photographing military installations, including airports, equipment, bridges, government checkpoints, troops and the U.S. Embassy, is forbidden.
If in doubt, please ask permission before taking photographs. 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 Bosnia and Herzegovina laws, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in Bosnia and Herzegovina 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 Bosnia and Herzegovina 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 Bosnia and Herzegovina.
Americans without Internet access may register directly with the nearest U.S. Embassy or Consulate.
By registering, American citizens make it easier for the Embassy or Consulate to contact them in case of emergency.
The U.S. Embassy is located at Alipasina 43, telephone (387) (33) 445-700, fax: (387) (33) 221-837; http://sarajevo.usembassy.gov/.
On weekends, holidays, and after hours, an Embassy duty officer can be reached at telephone (387) (33) 445-700.
If after dialing you receive a recorded message, press “0”, and then ask for the duty officer.
* * *
This replaces the Consular Information Sheet dated March 11, 2008, to update sections on Country Description, Entry and Exit Requirements, Safety and Security; and Crime.

Travel News Headlines WORLD NEWS

Date: Tue, 14 May 2019 17:36:11 +0200

Sarajevo, May 14, 2019 (AFP) - Torrential downpour has flooded hundreds of homes and swamped roads in northern Bosnia, officials said Tuesday, as rescuers searched for a six-year-old boy swept away by a swollen stream.   The child went missing in the northern Zepce region, national television BHRT reported on Tuesday. 

The heavy rain, which started Sunday, has sparked fears of a repeat of the 2014 floods that devastated the Balkan region, killing 77 people.   Weather services have predicted the rain will taper off.   Several Bosnian towns in the hardest-hit north have declared a state of emergency and begun protective evacuations.

More than 200 people have been evacuated in villages around north-eastern Doboj, where two rivers have overflowed.   "About 100 houses were flooded, as well as the offices of five companies and 50 hectares of land," said civil defence official Senad Begic.    Floods have also hit around 200 households in northwest Prijedor and 100 east in the town of Celinac.    "The danger has not passed and I invite inhabitants to follow the instructions of the authorities, without panic," urged Radovan Viskovic, Prime Minister of Republika Srpska, Bosnian's Serb-run region.

Dozens of homes were also flooded in neighbouring Croatia, where eight tourists, including two children, were rescued by firemen at a campsite on the banks of the Korana river, national TV reported.   After rising rapidly overnight, water levels in major rivers are falling slightly or stagnating, according to weather services.   In the spring of 2014, the Balkans region was hit by its worst floods in more than a century, which affected 1.6 million people and caused an estimated two billion euros in damage, mostly to houses and farmland.
Date: Thu, 24 Dec 2015 20:40:42 +0100

Sarajevo, Dec 24, 2015 (AFP) - Air pollution forced Bosnian authorities to shut schools in the capital Sarajevo on Thursday, while smog levels also spiked in other parts of the Balkan country due to a lack of rainfall, local officials said.   The air quality index, whose "normal" levels range from 0 to 50, reached 94 in Sarajevo on Thursday, official data showed.   Registered levels had been even higher in recent days, with the index soaring above the dangerous 300 mark and the city literally shrouded in a smog.

Regional authorities in Sarajevo decided to close primary and secondary schools Thursday, they said in a statement, while the city council demanded an early start to the winter holiday, so that children would be spared from being exposed to the smog.   Winter holidays traditionally start later in Bosnia than in western Europe, just ahead of the New Year.

Health authorities urged citizens meanwhile, particularly those with health problems, pregnant women and children, to refrain from going out at all.   Red Cross and non-governmental activists distributed protective masks to people across the city, which is surrounded by mountains that lock in the air especially during dry spells.   Pollution levels were also exacerbated by fumes from heating tens of thousands of homes.

Weather forecasts indicate that smog levels are not expected to improve before January.   Several other Bosnian towns were also hit by smog, especially those with large industrial areas such as Lukavac and Tuzla, where the air pollution index reached 293 and 193 respectively on Thursday.
Date: Tue, 24 Nov 2015 11:23:17 +0100

Sarajevo, Nov 24, 2015 (AFP) - Bosnian prosecutors were investigating an explosion at a police station Tuesday which authorities said could be an act of "terrorism", days after two members of the country's military were shot dead.   Unknown perpetrators threw an explosive device on the roof of the station in the central town of Zavidovici in the early hours, causing minor damage but no injuries, police spokeswoman Aldina Ahmic said.   "There are indications that this case has elements of the criminal act of terrorism," said Ahmic.

The national prosecutor's office has taken over the case and formed a special team tasked with investigating.   The incident comes less than a week after two military men were killed on November 18 by a man who attacked them with automatic weapons near a barracks in Sarajevo before blowing himself up.   Authorities have said that the perpetrator had links to Islamist circles and that the attack was almost certainly a "terrorist act".

Muslims make up about 40 percent of Bosnia's 3.8 million people while the rest of the Balkan country is mostly Serb Orthodox or Catholic.   The vast majority of Bosnian Muslims are moderates but a tiny minority openly support radical Wahhabism.   After the deadly Islamic State attacks in Paris earlier this month, Bosnia's Islamic spiritual leader Husein Kavazovic urged Europe's Muslims to keep the peace, saying the killings were a "sin towards God".
Date: Mon 27 Apr 2015
Source: WBNS-TV, Associated Press (AP) report [edited]

Authorities in Bosnia's capital have declared a foodborne outbreak after nearly 200 preschool children became sick at public day care centers in Sarajevo. Local health minister Emira Tanovic-Mikulec declared the outbreak on Mon 27 Apr 2015. Lab tests show that the food the children ate last week [week of 20 Apr 2015] was infected with salmonella enteridis [see comment below]. Out of the 193 children with fever, diarrhea, and abdominal cramping, 51 had to be hospitalized but none are in a life-threatening condition, hospital officials say.

About 2900 kids eat food prepared in a central kitchen that supplies the 29 centers in Sarajevo. The symptoms started last Wed 22 Apr 2015, when macaroni with cheese and eggs was on the menu.
================
[Both cheese (especially if unpasteurized) and eggs (if undercooked or recontaminated from poor kitchen hygiene) are common reservoirs for salmonellosis. The serotype is not specially stated as, in the original post, the statement is "was infected with salmonella enteridis" which could mean salmonella enteritis (as the name of the condition) or _Salmonella_ Enteritidis (as the name of the organism). - ProMED Mod.LL]

[A HealthMap/ProMED-mail map can be accessed at:
Date: Thu 2 Apr 2015
Source: Outbreak News Today [edited]
-------------------------------------------------------------------------
The US Centers for Disease Control and Prevention (CDC) issued 3 travel notices Wednesday due to on-going measles outbreaks in Angola, Bosnia-Herzegovina and Ethiopia. In Angola, the US federal health agency says the country is experiencing an on-going measles outbreak. The number of confirmed measles cases increased from 6558 in 2013 to 12 036 in 2014; and cases continue to occur in 2015.

In Europe, as of February 2015, the Federal Institute of Public Health in the Federation of Bosnia and Herzegovina has reported more than 3800 cases since January 2014. Most of the cases have been in 3 Central Bosnia Canton municipalities: Bugojno, Fojnica, and Travnik.

Finally, on the Horn of Africa, Ethiopia is experiencing an on-going measles outbreak. The number of confirmed measles cases increased from 6100 in 2013 to more than 14,000 confirmed cases in 2014; cases continue to occur in 2015.

The CDC recommends that travellers to all 3 destinations protect themselves by making sure they are vaccinated against measles, particularly infants 6-11 months of age (1 dose of measles vaccine) and children 12 months of age or older (2 doses of measles vaccine). Clinicians should keep measles in mind when treating patients with fever and rash, especially if the patient has recently travelled internationally.  [Byline: Robert Herriman]
More ...

Congo, Democratic Republic

Democratic Republic of the Congo US Consular Information Sheet
23rd September 2008
COUNTRY DESCRIPTION: The Democratic Republic of the Congo (Congo-Kinshasa) located in central Africa, is the third largest country on the continent. The capital
s Kinshasa. French is the official language. Years of civil war and corruption have badly damaged the country's infrastructure. Read the Department of State Background Notes on the Democratic Republic of the Congo (DRC) for additional information.
ENTRY/EXIT REQUIREMENTS:
A passport, visa and evidence of yellow fever vaccination are required for entry. Some travelers arriving in the DRC without proper proof of yellow fever vaccination have been temporarily detained, had their passports confiscated, or been required to pay a fine. Information about yellow fever vaccination clinics in the U.S. may be found at http://www2.ncid.cdc.gov/travel/yellowfever/.
Visas must be obtained from an embassy of the DRC prior to arrival.
Travelers to the DRC frequently experience difficulties at the airport and other ports of entry, such as temporary detention, passport confiscation and demands by immigration and security personnel for unofficial “special fees.”
All resident foreigners, including Americans, are required to register at the office of the Direction General de Migration (DGM) in the commune of their place of residence.
Visitors who wish to travel in any mining areas must first obtain government approval from various government agencies or ministries, an often cumbersome and time consuming process.
Dual nationals arriving in the DRC should carefully consider which passport they use to enter the DRC. For departure from the DRC, airlines will require a valid visa for all destination countries before they will issue a ticket or allow a passenger to board. Airlines also require that the passenger have the correct entry stamp in the passport they wish to use to exit the country. Passengers who are unable to leave the country on the passport they used to enter the DRC may not be able to continue on their travel itinerary.
Additional information about visas may be obtained from the Embassy of the Democratic Republic of the Congo, 1726 M Street NW, Washington, DC 20036, tel. (202) 234-7690, or the DRC's Permanent Mission to the UN, 866 United Nations Plaza, Room 511, New York, NY 10017, tel. 212-319-8061, fax: 212-319-8232, web site http://www.un.int/drcongo. Overseas, inquiries should be made at the nearest Congolese embassy or consulate. 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:
See the Department of State’s Travel Warning for the Democratic Republic of the Congo.

Though the DRC is now significantly more stable than it has been over the past decade, security remains problematic. The first democratic elections in more than forty years were held in 2006, and a new government is now in place. Post-election disturbances occurred as recently as March 2007 in Kinshasa, resulting in deaths of civilians and military personnel. During civil disturbances in 2007 there were incidents of hostility towards U.S. citizens and other expatriates.

Both inside and outside Kinshasa, there can be roadblocks, especially after dark. Vehicles are often searched for weapons and valuables, and travelers are checked for identity papers. Security forces regularly seek bribes. If confronted with such a situation, it is suggested that U.S. citizens remain courteous and calm. If detained, report the incident to the U.S. Embassy in Kinshasa as soon as possible.

The United Nations has its largest peacekeeping operation in the world in the DRC. Known by its French acronym of MONUC, it has close to 17,000 peacekeepers deployed in the country – primarily in the east. Violence nevertheless persists in the eastern DRC due to the presence of several militias and foreign armed groups, with sporadic outbreaks occurring in North Kivu, South Kivu, and northern Katanga provinces, as well as in the Ituri District of Orientale province. Members of the Lord’s Resistance Army entered into northeastern DRC from Sudan in 2005, and have camps in an isolated region of the DRC, Garamba National Park, where they killed eight MONUC peacekeepers in January 2006.

For the latest security information, Americans traveling abroad should regularly monitor the Department of State, Bureau of Consular Affairs’ web site at http://travel.state.gov, where the current Travel Warnings and Travel Alerts, as well as the Worldwide Caution, can be found.
Up-to-date information on safety and security can also be obtained by calling 1-888-407-4747 toll-free in the U.S. and Canada, or for overseas callers, 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:
In the DRC, poor economic conditions continue to foster crime, especially in urban areas. Travel in many sections of Kinshasa, Kisangani, Lubumbashi and most other major cities, is generally safe during daylight hours, but travelers are urged to be vigilant against criminal activity which targets non-Congolese, particularly in highly congested traffic and areas surrounding hotels and stores. Outlying, remote areas are less secure due to high levels of criminal activity and the lack of adequate training, supervision, and salary payments to the security forces present.

Vehicle thefts, burglaries, and armed robbery occur throughout the country; there have been recent reports of after-dark carjackings, resulting in deaths in the North Kivu area. It is recommended to drive with doors locked and windows closed at all times. If confronted by members of the military or security forces, visitors should not permit soldiers or police officers to enter their vehicles nor get into the vehicle of anyone purporting to be a security official. It is recommended that in such instances U.S. citizens remain courteous and calm and, if threatened, not resist. All incidents should be reported to the U.S. Embassy in Kinshasa.

Consistency in administering laws and regulations is notably absent. Travelers should note that in cases of theft and robbery, legal recourse is limited. Therefore, valuable items may be safer if kept at home or another secure location.

Security officials and/or individuals purporting to be security officials have detained and later robbed American citizens and other foreigners in the city of Kinshasa. This type of crime has increased in recent months, but generally occurs more frequently during the Christmas and New Year's holidays.

Travelers using public transportation or visiting high pedestrian traffic areas of any type are advised to be vigilant against robbery and pick-pocketing which is a persistent problem in all major cities in the DRC. The presence of “street children”, who can be persistent and sometimes aggressive, remains a problem particularly in Kinshasa.
INFORMATION FOR VICTIMS OF CRIME:
The loss or theft abroad of a U.S. passport should be reported immediately to the local police and the nearest U.S. Embassy or Consulate.
If you are the victim of a crime while overseas, in addition to reporting to local police, please contact the nearest U.S. Embassy or Consulate for assistance.
The Embassy/Consulate staff can, for example, assist you to find appropriate medical care, contact family members or friends and explain how funds could be transferred.
Although the investigation and prosecution of the crime is solely the responsibility of local authorities, consular officers can help you to understand the local criminal justice process and to find an attorney if needed.
See our information on Victims of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION:
In the DRC, medical facilities are severely limited, and medical materials are in short supply. Travelers should carry properly labeled prescription drugs and other medications with them and should not expect to find an adequate supply of prescription or over-the-counter drugs in local stores or pharmacies. Payment for any medical services required is expected in cash, in advance of treatment.

Malaria is common throughout the DRC and outbreaks of cholera, typhoid, yellow fever, the Ebola virus, and hemorrhagic fever occur.
Travelers should take appropriate precautions to prevent the spread of HIV/AIDS.
Tuberculosis is an increasingly serious health concern in the DRC.
For further information, please consult the CDC's Travel Notice on TB at: http://wwwn.cdc.gov/travel/yellowBookCh4-TB.aspx.
The U.S. Department of State is unaware of any HIV/AIDS entry restrictions for visitors to or foreign residents of the DRC.

Information on vaccinations and other health precautions, such as safe food and water precautions and insect bite protection, may be obtained from the Centers for Disease Control and Prevention’s hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747) or via the CDC’s web site at http://wwwn.cdc.gov/travel/default.aspx.
For information about outbreaks of infectious diseases abroad consult the World Health Organization’s (WHO) web site at http://www.who.int/en.
Further health information for travelers is available at http://www.who.int/ith/en
MEDICAL INSURANCE:
For planning purposes, the minimum estimated cost of medical air evacuation to the nearest suitable health care facility (in South Africa) is $35,000.

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 the DRC is provided for general reference only, and may vary according to location or circumstance.

Inter-city roads are scarce, and throughout the DRC roads are generally in poor condition, and often impassable in the rainy season. When driving in cities, keep windows up and doors locked. At roadblocks or checkpoints, documents should be shown through closed windows. In the event of a traffic incident involving bodily injury to a third party or pedestrian, do not stop to offer assistance under any circumstances. Proceed directly to the nearest police station or gendarmerie to report the incident and request official government intervention. Attempting to provide assistance may further aggravate the incident, resulting in a hostile mob reaction such as stoning or beating.

Presidential and other official motorcades pose serious risks to drivers and pedestrians in Kinshasa. When hearing sirens or seeing security forces announcing the motorcade's approach, drivers should pull off the road as far as possible, stop their vehicles, and extinguish headlights. Vehicles should not attempt to move until the entire motorcade has passed by; the security forces will physically indicate when this has occurred. Failure to comply may result in arrest, and/or vehicle damage with possible personal injury.

Public transportation of all forms is unregulated and is generally unsafe and unreliable. Taxis, mini-buses, and trains are in poor mechanical condition and are invariably filled beyond capacity.

Visitors who wish to travel in any mining areas must first obtain government approval from various government agencies or ministries, an often cumbersome and time consuming process.

Drivers should stop their cars and pedestrians should stand still when passing a government installation during the raising and lowering of the Congolese flag. This ceremony occurs at roughly 7:30 a.m. and 6:00 p.m.
Please refer to our Road Safety page for more information.

AVIATION SAFETY OVERSIGHT:
The U.S. Federal Aviation Administration (FAA) has assessed the Government of the DRC’s Civil Aviation Authority as not being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for the oversight of the DRC’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.
Civil aviation in the DRC continues to experience air incidents and accidents; more than a dozen crashes and in-flight accidents resulted in more than 300 fatalities between 2000 and August 2008. Incidents included hard landings, engine failures, collapsed landing gear, and planes veering off the runway.
In-country air travel schedules are unreliable and planes are frequently overloaded with passengers and/or cargo.
The U.S. Embassy in the DRC has prohibited official travel by U.S. government employees and contractors on all DRC-owned and -operated commercial air transportation services due to concerns regarding safety and maintenance.
International flights on foreign-owned and -operated carriers are not affected by this notice.
SPECIAL CIRCUMSTANCES:
Photography: Travelers should note that photography in public places in Kinshasa and around any public or government building or monument in the DRC is strictly forbidden. Persons caught photographing such sites will likely have their photographic equipment confiscated and risk detention and possible arrest.

Travel to and from Congo-Brazzaville (Republic of Congo): Ferry service to and from Kinshasa and Brazzaville stops running in the late afternoon, does not operate on Sundays, and may close completely with minimal notice. If ferry service is functioning, a special exit permit from the DRC's Immigration Service and a visa from the Republic of the Congo (Congo-Brazzaville) are required for U.S. citizens to cross the Congo River from Kinshasa to Brazzaville.

Ferry and riverboat service to the Central African Republic is suspended due to rebel control of the Ubangui River.
Phone Service: In the DRC, cellular phones are the norm, as other telephone service is unreliable. Depending on the type of phone, it may be possible to locally purchase a SIM card to use an American-compatible cell phone in the DRC.

Currency: U.S. currency is widely accepted in the urban areas, but most vendors and banking institutions will accept only Series 1996 bills or newer, with the large, off-center portraits, that provide stronger protection against counterfeiting. In addition, bills must be in near perfect condition; even those with minor stains or small tears will be rejected. One dollar bills are rarely accepted, even if in mint condition. U.S. bills should be examined before they are accepted to ensure that they are legitimate, as counterfeit currency is widely circulated. It is recommended that currency exchange be conducted at reputable banks and not on the street where several schemes exist to either short-change the unwitting customer or to pass counterfeit bills.

CRIMINAL PENALTIES:
While in any 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. 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.

Penalties for breaking the law can be more severe in the DRC than in the United States for similar offenses.
Persons violating Congolese laws, even unknowingly, may be expelled, arrested or imprisoned. Penalties for possession, use, or trafficking in illegal drugs in the DRC are severe, and convicted offenders can expect long jail sentences and heavy fines. Accusations of engaging in crimes against the security of the State, which are loosely defined, often result in detention for prolonged periods without being formally arrested. The DRC’s justice system remains plagued by corruption and uneven application of the law. Attorney fees can be expensive and are expected to be paid in advance of services rendered.

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 the DRC are encouraged to register with the U.S. Embassy through the State Department’s travel registration web site, so that they can obtain updated information on travel and security within the Congo. Americans without Internet access may register directly with the U.S. Embassy.
By registering, American citizens make it easier for the Embassy to contact them in case of emergency. The U.S. Embassy is located at 310 Avenue des Aviateurs; tel. 243-081-225-5872 (do not dial the zero when calling from abroad). Entrance to the Consular Section of the Embassy is on Avenue Dumi, opposite the Ste. Anne residence. The Consular Section of the Embassy may be reached at tel. 243-081-884-6859 or 243-081-884-4609; fax 243-081-301-0560 (do not dial the first zero when calling from abroad).
*

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This replaces the Country Specific Information for the Democratic Republic of the Congo, dated April 29, 2008, to update sections on Entry/Exit Requirements and Medical Facilities and Health Information.

Travel News Headlines WORLD NEWS

5th December 2019
World Health Organisation

Measles vaccination drive launched, North Kivu targets 2.2 million children 
 
https://www.afro.who.int/news/measles-vaccination-drive-launched-north-kivu-targets-22-million-children

Kinshasa, 5 December 2019 – Around 2.2 million children are to be vaccinated against measles in North Kivu, the Democratic Republic of the Congo (DRC), where efforts are underway to curb the world’s second-worst Ebola outbreak amid persistent insecurity.

The DRC is also currently experiencing the world’s largest and most severe measles epidemic, affecting all its 26 provinces. Since the start of 2019, more than 250 000 suspected cases and over 5000 deaths mostly among children under 5 years, have been recorded.

This drive closes the second phase of a preventive vaccination campaign and will be followed by a third and final phase planned in 10 remaining provinces: Bas Uélé, Equateur, Haut Katanga, Haut Lomami, Haut Uélé, Kasai Oriental, Lualaba, Maniema, Mongala and Tshuapa.

This mass follow-up campaign will ultimately reach 18.9 million children across the country by the end of the year, particularly targeting those who may have been missed by routine immunization.

“While the Ebola outbreak in the DRC has won the world’s attention and progress is being made in saving lives, we must not forget the other urgent health needs the country faces,” said Dr Matshidiso Moeti, WHO Regional Director for Africa. “This new vaccination campaign aims to protect children in North Kivu, as well as other parts of the country from a disease that is easily preventable with a vaccine.”

Low immunization rates and high levels of malnutrition have contributed to the measles epidemic and associated high rates of mortality.

In North Kivu, the measles vaccination is being carried out under a challenging context, with high insecurity particularly around Beni town and Masisi territory.

“In the context of North Kivu, where the population is highly mobile, it is imperative that we reach out to travellers and ensure that their children are also covered. Every child should receive his or her vaccine so that they are well protected and can grow up healthy,” said Dr Deo Nshimirimana, WHO acting Representative in the DRC.

The five-day campaign is being implemented by the Ministry of Health with the support of WHO and partners and is fully funded by Gavi, the Vaccine Alliance. WHO staff are assisting the health ministry’s national and field coordination efforts, case management, epidemiological surveillance and deployment of a post campaign survey.

“Sadly, measles has claimed more Congolese lives this year than Ebola. We must do better at protecting the most vulnerable, who are often also the hardest to reach. This campaign is an important step in that direction,” said Thabani Maphosa, Managing Director of Country Programmes for Gavi. “For maximum impact, campaigns must be combined with the strengthening of routine immunization and health systems.” 

Strengthening routine immunization, measles case-based surveillance and case management will contribute to ending the current outbreak and eliminating measles as a public health threat in the DRC.  

Lack of funding has hampered efforts for reactive campaigns. To date, US$ 27.5 million have been mobilized; however, another estimated US$ 4.8 million are needed to complete the vaccination campaign and response and to strengthen other elements of response such as disease surveillance, case management and communication.
Date: Wed, 4 Dec 2019 22:05:06 +0100 (MET)

Goma, DR Congo, Dec 4, 2019 (AFP) - Doctors Without Borders (MSF) said Wednesday it was pulling its non-local staff from an eastern region of Democratic Republic of Congo after it said an armed group tried to enter its compound.    The NGO becomes the latest aid agency to withdraw its staff from the Biakato region after an unclaimed attack last week saw three Ebola workers killed at an accommodation camp in Biakato Mines in Ituri province, causing the World Health Organization to withdraw its staff from the area.     MSF and an Ebola Treatment Centre (ETC), which is treating two people with confirmed cases of Ebola and nine suspected cases, decided to stay in the Biakato region despite last week's incident.

The NGO said that on Tuesday night a group wielding machetes and sticks broke into the Biakato Health Centre, which houses the ETC, but did not cause any casualties and did not enter the Ebola facility.   A separate group with the same weapons then tried but failed to enter the MSF facility in Biakato Mines. The NGO said they threw stones but did not do any damage.   "Due to a deterioration in the security situation, MSF made the difficult decision to withdraw all non-local staff from the Biakato region," MSF said in a statement.    According to local authorities, the attackers from last week's incident are likely to be members of the Mayi-Mayi militia group.

The Democratic Republic of Congo is undergoing its 10th Ebola epidemic, which is the second deadliest on record.    An outbreak of the much-feared haemorrhagic virus has killed 2,206 people mainly in North Kivu and neighbouring Ituri, according to the latest official figures.   Insecurity has complicated the epidemic from the outset, compounding resistance within communities to preventive measures, care facilities and safe burials.   On November 4, the authorities said more than 300 attacks on Ebola health workers had been recorded since the start of the year, leaving six dead and 70 wounded, some of them patients.
Date: Fri, 29 Nov 2019 20:07:23 +0100 (MET)

Bukavu, DR Congo, Nov 29, 2019 (AFP) - At least four people, including two children, have died in flooding in the Democratic Republic of Congo, days after 41 died when the capital Kinshasa was battered by torrential rains and landslides.   The victims died in the eastern South Kivu province amid the country's worst flooding in 25 years.   "There have been four deaths and one person missing, 10 injured and more than 70 homes damaged," local administrator Aime Kawaya told AFP.   The latest deaths happened after the heavy rains caused a river to overflow its banks in the Fizi area of south Kivu on Wednesday.   Seven deaths were reported in neighbouring North Kivu earlier this week.
Date: Thu, 28 Nov 2019 19:12:51 +0100 (MET)

Goma, DR Congo, Nov 28, 2019 (AFP) - Four Ebola workers in eastern DR Congo were killed and six injured, adding to the toll of people who have died fighting the nearly 16-month-old epidemic, the UN said Thursday.   A member of the vaccination team and two drivers were killed at an Ebola workers' accommodation camp in Biakato Mines in Ituri province, the World Health Organization (WHO) said.   The attack occurred two kilometres (one mile) from a temporary base used by UN peacekeepers, one of whom was injured in an operation to repel the assailants, the UN said.   A second attack claimed the life of a police guard at an Ebola coordination office in Mangina, a few dozen kilometres (miles) away in North Kivu province.   "We are heartbroken that people have died in the line of duty as they worked to save others," said WHO chief Tedros Adhanom Ghebreyesus.   "The world has lost brave professionals," he said, quoted in a WHO statement issued in Geneva.

Michael Ryan, WHO director of emergency operations, said that after the attack all staff were moved from Biakato Mines to Goma, one of the main cities in the region.   There was no immediate claim for the attacks, which DR Congo's national coordinator for Ebola, Dr. Jean-Jacques Muyembe, said occurred "almost simultaneously, around midnight."   Ryan said that he knew of "no specific intelligence regarding an imminent attack" at Biakato Mines.   None of the dead were WHO staff but a worker with the UN agency was injured, Ryan said.   An outbreak of the much-feared haemorrhagic virus has killed 2,199 in North and South Kivu and Ituri provinces since August 1, 2018, according to the latest official figures.   It is the Democratic Republic of Congo's 10th Ebola epidemic and the second deadliest on record after an outbreak that struck West Africa in 2014-16, claiming more than 11,300 lives.   Mangina is the historic starting point of the epidemic. UN Secretary General Antonio Guterres visited the town on September 1.

- Security fears -
Insecurity has complicated the epidemic from the outset, compounding resistance within communities to preventive measures, care facilities and safe burials.   On November 4, the authorities said more than 300 attacks on Ebola health workers had been recorded since the start of the year, leaving six dead and 70 wounded, some of them patients.    The WHO said that last week, seven cases of Ebola had been recorded, compared with the peak of more than 120 per week in April 2019.    "Ebola was retreating. These attacks will give it force again, and more people will die as a consequence," Tedros warned.    "It will be tragic to see more unnecessary suffering in communities that have already suffered so much. We call on everyone who has a role to play to end this cycle of violence."   Vast tracts of eastern DRC are in the grip of armed groups, especially a shadowy militia called the Allied Democratic Forces (ADF).   The armed forces launched an offensive in the region on October 30, prompting a wave of massacres of civilians by suspected ADF men.   Ninety-nine people have been killed by armed groups in the Beni area alone since November 5, according to the not-for-profit Congo Research Group (CRG).   The bloodshed has sparked a wave of anger at the authorities and the UN mission in the DRC, MONUSCO. Seven people have died in protests since Saturday.

- Low profile -
The latest deaths sparked an immediate reaction Thursday in Beni, where many responders kept a low profile and vaccination teams were not at work, AFP journalists saw.   "A suspected case of Ebola has been reported from the health centre. The investigator has gone there quietly on foot to avoid drawing attention," said Michel Kalongo, a local doctor involved in the anti-Ebola fight.   Normally, an ambulance would have been despatched to conduct tests.   But responders on Thursday did not wear their uniforms, nor did they openly display their medical kits.   "We are blending in with ordinary motorcyclists to avoid public anger," said Timothee Pothsola, a motorbike driver who transports Ebola teams.   Pierre Vernier of the medical charity MSF (Doctors Without Borders) said, "Because of the lack of security, lab work is problematic. It's hard to gather samples."   But, he said, "the real problem is that Ebola monitoring teams cannot carry out work on the ground" to follow up cases where people may have been exposed to the virus.   "Part of the personnel have been evacuated... only veterans who are used to tense situations like this have stayed behind."
Date: Wed, 27 Nov 2019 18:26:08 +0100 (MET)

Geneva, Nov 27, 2019 (AFP) - Measles has killed more than 5,000 people in the Democratic Republic of Congo since January -- more than double the toll in the country's Ebola epidemic -- the World Health Organization said Wednesday.   "The DRC (measles) outbreak is the largest outbreak worldwide. It is one of the largest that we have seen," Kate O'Brien, director of the WHO's immunisation department, told reporters in Geneva.   As of November 17, the country had registered 250,270 measles cases, including 5,110 deaths, the WHO said.

DRC declared its latest measles epidemic in June, and in September the country launched an emergency vaccination campaign to counter the outbreak.   WHO said that campaign was still ongoing, but was expected to be completed by the end of the year.   O'Brien said the epidemic was still "all over the country", pointing out that most of those affected were "children and babies".   Measles is a highly-contagious disease caused by a virus that attacks mainly children. The most serious complications include blindness, brain swelling, diarrhoea, and severe respiratory infections.

The rapid spread of measles in DRC has garnered far less attention than the Ebola epidemic that has also been raging in the east of the country since August 2018. That outbreak has killed some 2,200 people.   Ian Norton, at WHO's Emergency Medical Team Unit, said the UN agency had begun training some of the Ebola teams in DRC to also manage measles cases, "because there is such a large burden".   Efforts to rein in the spread of both Ebola and measles are meanwhile being hampered by violence and unrest across the country, and especially in the east.   On Tuesday, WHO said it had moved 49 Ebola-response staff out of the eastern town of Beni as insecurity in the area surged.

Ninety-four civilians in the Beni area have been killed by armed groups since November 5, following the launch of an offensive by the country's army, according to the Congo Research Group (CRG), a not-for-profit organisation.   "The Ebola response is being hampered by the insecurity," Norton told reporters.   "The same can be said... for the measles response, not just in Beni but across the entire country," he said.   Attacks, even when not directed at medical staff or facilities, can block health workers from getting to work, and can prompt people feeling ill to stay home instead of seeking help.   Norton said the WHO was "extremely worried" by the growing insecurity, warning it had a dire "impact on the management of disease".
More ...

World Travel News Headlines

Date: Fri, 6 Dec 2019 10:30:54 +0100 (MET)

Moscow, Dec 6, 2019 (AFP) - More than 50 polar bears have gathered on the edge of a village in Russia's far north, environmentalists and residents said, as weak Arctic ice leaves them unable to roam.   The Russian branch of the World Wildlife Fund said climate change was to blame, as unusually warm temperatures prevented coastal ice from forming.   The WWF said 56 polar bears had gathered in a one-square-kilometre (0.4-square-mile) area near the village of Ryrkaipy in Chukotka on the north-eastern tip of Russia.

There were concerns they could enter the village, home to fewer than 1,000 people, and patrols had been set up to monitor their movements.   "The number of human and predator encounters in the Arctic is increasing," the WWF said in statement.    "The main reason is the decline of sea ice area due to the changing climate. In the absence of ice cover, animals are forced to go ashore in search of food."

Residents had gathered walrus carcasses in the area to try to keep the bears from wandering into the village.   "We have created a feeding point with walrus carcasses that we gathered along the coast," Tatyana Minenko of the local "Bear Patrol" told news agency RIA Novosti.   "As long as there is no big freeze, the sea ice will not form and the bears will stay on the coast," she said.

Russia's weather service said temperatures in the region should fall from Saturday and that coastal ice should freeze by December 11.    Polar bears regularly visit areas inhabited by humans in Arctic Russia to search for food, often in rubbish tips.   But the number of visits has been growing as the melting of Arctic ice from climate change forces the bears to spend more time on land where they compete for food.
Date: Fri, 6 Dec 2019 10:28:26 +0100 (MET)
By Joseph Schmid

Paris, Dec 6, 2019 (AFP) - Travellers across France endured a second day of chaos on Friday as unions vowed to keep up their strike until President Emmanuel Macron backs down on controversial pension overhauls.   Rail operator SNCF said 90 percent of high-speed TGV trains were again cancelled, and several airlines dropped flights including Air France, EasyJet and Ryanair.

Nine of the capital's 16 metro lines were shut and most others severely disrupted, sparking some 350 kilometres (220 miles) of traffic jams in the Paris region, well above the usual 200 km, the traffic website Sytadin reported.   Many employees were unable to get to work and several schools again provided only daycare, though fewer teachers were on strike compared with Thursday when some 800,000 people demonstrated across the country according to the interior ministry.   Bike paths were crowded with bikes and electric scooters, with metro operator RATP sponsoring special deals for commuters with a range of ride-hailing companies and other transportation alternatives.

The walkout is the latest test for Macron after months of protests from teachers, hospital workers, police and firefighters as well as the "yellow vest" movement demanding improved living standards.   Unions say his "universal" pension system, which would eliminate dozens of separate plans for public workers, forces millions of people in both public and private sectors to work well beyond the legal retirement age of 62.   Health Minister Agnes Buzyn said Friday that the government had "heard" the protesters' anger and would meet with union leaders to discuss the reform on Monday.   The government has yet to lay out the details of its plan, and Buzyn told Europe 1 radio that "there is indeed a discussion going on about who will be affected, what age it kicks in, which generations will be concerned -- all that is still on the table".

- Macron 'determined' -
Yves Veyrier, head of the hardline FO union, warned Thursday the strike could last at least until Monday if the government did not take the right action.   But it remains to be seen if the protests will match the magnitude of the 1995 strikes against pension overhauls, when France was paralysed for three weeks from November to December in an action that forced the government to back down.

Macron, a former investment banker, has largely succeeded in pushing through a series of controversial reforms, including loosening labour laws and tightening access to unemployment benefits.   But this is the first time the various disgruntled groups have come together in protest.   So far Macron has not spoken publicly on the stoppages though a presidential official, who asked not to be named, said Thursday that the president was "calm" and "determined to carry out this reform" in a mood of "listening and consultation".

While most of Thursday's rallies were peaceful, police fired tear gas to disperse dozens of black-clad protesters smashing windows and throwing stones during the Paris march, with one construction trailer set on fire. Sporadic clashes were also reported in some other cities.   Many people were bracing for further disruptions over the weekend, including the prospect of fuel shortages as unions blocked most of the country's eight oil refineries.

The minimum pension age in France is 62, one of the lowest among developed countries, but there are 42 "special regimes" for railway workers, lawyers, opera employees and others offering earlier retirements and other benefits.   The government says a single system will be fairer for everyone while ensuring its financial viability while acknowledging that people will gradually have to work longer.
Date: Fri, 6 Dec 2019 04:23:51 +0100 (MET)

Sydney, Dec 6, 2019 (AFP) - Three hundred animals have been evacuated from a wildlife park north of Sydney as massive bushfires encircled Australia's largest city and foreign firefighters arrived to relieve beleaguered local forces.   Walkabout Wildlife Park said it had shipped out lizards, dingoes, peacocks and marsupials, as firefighters battled more than 100 fires up and down the eastern seaboard.   "This fire has been doing some crazy things, so we have to be prepared," general manager Tassin Barnard told AFP.

Prolonged drought has left much of eastern Australia tinder dry and spot fires have raged every day for the past three months, leaving firefighters struggling to cope.   New South Wales rural fire chief Shane Fitzsimmons said Friday that some US and Canadian firefighters had arrived to help out, easing the strain on the exhausted largely volunteer Australian force.

The incident-management and aviation specialists will help ease "fatigue and crew rotations" he said.   "We are not only appreciative of their presence here today, but of their sacrifice," said Fitzsimmons -- who has become a fixture on Australian television screens for weeks, updating the public on blazes in towns, national parks and backwaters.    "They are volunteering to sacrifice time from loved ones, from families, to give up that special time of the year around Christmas and New Year to come down here and lend us a hand," he said.

More than 600 homes have been destroyed and six people have died since the crisis began in September. That is many fewer than Australia's deadliest recent fire season in 2009 when almost 200 people died, but 2019's toll belies the scale of devastation.    Millions of hectares have burned -- the size of some small countries -- across a region spanning hundreds of kilometres (miles).   Bushfires are common in Australia but scientists say this year's season has come earlier and with more intensity due to a prolonged drought and climatic conditions fuelled by global warming.

The fires have taken a toll in Sydney and other major cities, which have been blanketed in toxic smoke for weeks and occasionally sprinkled with snow-like embers.   Fitzsimmons said he could not "overstate the effect that this profound drought is having" as he warned of a long, painful summer ahead.   "There is an absolute lack of moisture in the soil, a lack of moisture in the vegetation... you are seeing fires started very easily and they are spreading extremely quickly, and they are burning ridiculously intensely."
Date: Fri, 6 Dec 2019 03:03:18 +0100 (MET)
By Pierre-Henry DESHAYES

Half Moon Island, Antarctica, Dec 6, 2019 (AFP) - The swimsuit-clad tourists leap into the icy water, gasping at the shock, and startling a gaggle of penguins.   They are spectators at the end of the world, luxury visitors experiencing a vulnerable ecosystem close-up.   And their very presence might accelerate its demise.   Antarctica, a vast territory belonging to no one nation, is a continent of extremes: the coldest place on Earth, the windiest, the driest, the most desolate and the most inhospitable.   Now, it's also a choice destination for tourists.

All around Half Moon Island, off the Antarctic Peninsula, blocks of ice of all sizes float by on a calm sea, their varying forms resembling weightless origami shapes.    On this strip of land, that juts out of the Antarctic Polar and towards South America, visitors can see wildlife normally only viewed in zoos or nature documentaries along with spectacular icy landscapes.   The ethereal shades of white that play across the pillowy peaks change with the light, acquiring pastel hues at dawn and dusk.   "Purity, grandeur, a scale that's out of this world," says Helene Brunet, an awestruck 63-year-old French pensioner, enjoying the scene.    "It's unbelievable, totally unbelievable. It's amazing just to be here, like a small speck of dust."

AFP joined the 430 passengers on board the Roald Amundsen, the world's first hybrid electric cruise ship, on its maiden voyage in the Southern Ocean.    "It's not your typical beach, but it's awesome to do it," says a numb Even Carlsen, 58, from Norway, emerging from his polar plunge in the three-degree C (37.4 F) water.   When tourists go ashore, bundled up in neon-coloured windbreakers and slathered in SPF50 sunscreen, they have to follow strict rules: clean your personal effects so you don't introduce invasive species, keep a respectful distance from wildlife to avoid distressing them, don't stray from the marked paths and don't pick up anything.   "We mucked up the rest of the world. We don't want to muck up Antarctica too," says an English tourist, as she vacuums cat hair off her clothes before going ashore.

- 'Heart of the Earth' -
The Antarctic peninsula is one of the regions on Earth that is warming the fastest, by almost three degrees Celsius in the past 50 years, according to the World Meteorological Organization -- three times faster than the global average.    In March 2015, an Argentinian research station registered a balmy 17.5 degrees Celsius, a record.    "Every year you can observe and record the melting of glaciers, the disappearance of sea ice... (and) in areas without ice, the recolonisation of plants and other organisms that were not present in Antarctica before," said Marcelo Leppe, director of the Chilean Antarctic Institute.

Antarctica is "like the heart of the Earth," he added, saying that it expands and contracts like a heart beating, while the mighty current which revolves around the continent is like a circulatory system as it absorbs warm currents from other oceans and redistributes cold water.   The Antarctic Treaty, signed 60 years ago by 12 countries -- it now has 54 signatories -- declared the area a continent dedicated to peace and science, but tourism has gradually increased, with a sharp rise in the past few years.   Tourism is the only commercial activity allowed, apart from fishing -- the subject of international disputes over marine sanctuaries -- and is concentrated mainly around the peninsula, which has a milder climate than the rest of the continent and is easier to access.

Cruise ships have roamed the region for around 50 years, but their numbers only started to increase from 1990, as Soviet ice-breakers found new purposes in the post-Cold War era.   Some 78,500 people are expected to visit the region between November and March, according to the International Association of Antarctica Tour Operators (IAATO).   That's a 40-percent increase from last year, due in part to short visits by a few new cruise ships carrying more than 500 passengers, too many to disembark under IAATO regulations.     "Some might say 'Well, 80,000 people, that doesn't even fill a national stadium'... (and that it) is nothing like Galapagos which welcomes 275,000 a year," says IAATO spokeswoman Amanda Lynnes.    "But Antarctica is a special place and you need to manage it accordingly."

- 'Leave Antarctica to the penguins' -
It is Antarctica's very vulnerability that is attracting more and more visitors.   "We want to see this fantastic nature in Antarctica before it's gone," Guido Hofken, a 52-year-old IT sales director travelling with his wife Martina, says.    They said they had paid a supplement to climate compensate for their flight from Germany.

But some question whether tourists should be going to the region at all.   "The continent probably would be better off being left to penguins and researchers, but the reality is, that is probably never going to happen," said Michael Hall, professor and expert on polar regions at the University of Canterbury in New Zealand.   "Vicarious appreciation never seems to be enough for humans. So with that being the case, it needs to be made as low risk to the Antarctic environment and as low carbon as possible," said Hall.    "However, when the average tourist trip to Antarctica is over five tonnes of CO2 emissions per passenger (including flights), that is a serious ask."

Soot or black carbon in the exhaust gases of the scientific and cruise ships going to the region is also of concern, said Soenke Diesener, transport policy officer at German conservation NGO Nabu.   "These particles will deposit on snow and ice surfaces and accelerate the melting of the ice because the ice gets darker and will absorb the heat from the sun and will melt much faster," he told AFP.   "So the people who go there to observe or preserve the landscape are bringing danger to the area, and leave it less pristine than it was," he added.

- Responsible tourism -
Antarctic tour operators insist they are promoting responsible tourism.   The trend is for more intimate, so-called expedition cruises, in contrast to popular giant cruise liners elsewhere which are criticised for being invasive and polluting.   With greener ships -- heavy fuel, the most commonly used for marine vessels, has been banned in Antarctica since 2011 -- cruise companies have sought to make environmental awareness a selling point, occasionally earning them accusations of greenwashing.

Global warming, pollution and microplastics are the result of human activities on other, faraway continents, say tour operators.   Here, their motto is "Take nothing but photographs, leave nothing but footprints, keep nothing but memories".   But before they've even set foot on the cruise ships departing from South America -- the most common itinerary -- visitors to Antarctica will already have flown across the world, causing emissions that harm the very nature they have come so far to admire.

Most visitors hail from the Northern Hemisphere, and almost half are from the United States and China, IAATO says.   "I'm a tourist who feels a little guilty about taking a flight to come here," admits Francoise Lapeyre, a 58-year-old globetrotter om France.   "But then again, there are priorities. There are some trips I just won't take, because they leave a big footprint and they're not worth it.   "Crisscrossing the planet to go to a beach for example," she says.

- Don't mention climate change -
Like other expedition cruises where accessible science is part of their trademark, the Roald Amundsen, owned by the Hurtigruten company, has no dance floor or casino.  Instead, there are microscopes, science events and lectures about whales and explorers like Charles Darwin.   But they steer clear of climate change, which is only mentioned indirectly.   That's a deliberate decision as the subject has proven "quite controversial", said Verena Meraldi, Hurtigruten's science coordinator.   "We held several lectures dedicated specifically to climate change but it leads to conflicts. There are people who accept it as a fact, others who don't," she said.   Onboard, "passengers" are referred to as "guests" and "explorers" rather than "cruisers".   "Explorers" are typically older, well-heeled, often highly travelled pensioners who are handed walking sticks as they step ashore.   "My 107th country," says a Dane, stepping ashore onto Antarctica.

The Roald Amundsen "guests" choose between three restaurants, from street food to fine dining -- a far cry from the conditions endured by the Norwegian adventurer for whom the ship is named, who had to eat his sled dogs to survive his quest to reach the South Pole in 1911.   They have paid at least 7,000 euros ($7,700) each for an 18-day cruise in a standard cabin, and up to 25,000 euros ($27,500) for a suite with a balcony and private jacuzzi.   Other cruises are banking on ultra-luxury, with James Bond-like ships equipped with helicopters and submarines, suites of more than 200 square metres (2,153 square feet) and butler services.   With a seaplane to boot, the mega-yacht SeaDream Innovation will offer 88-day cruises "from Pole to Pole" starting in 2021. The two most expensive suites, with a price tag of 135,000 euros per person, are already booked.
 
- Worlds collide -
Outside, in the deafening silence, wildlife abounds.   All around are penguins, as awkward on land as they are agile in water. Massive and majestic whales slip through the waves, and sea lions and seals laze in the sun.   On Half Moon Island, chinstrap penguins -- so called because of a black stripe on their chin -- strut about in this spring breeding season, raising their beaks and screeching from their rocky nests.   "This is to tell other males 'This is my space' and also, maybe, 'This is my female'," ornithologist Rebecca Hodgkiss, a member of the Hurtigruten's scientific team, explains, as a group of tourists stroll around ashore.   The colony of 2,500 penguins has been gradually declining over the years, but it's not known if that is man's fault or they have just moved away, according to Karin Strand, Hurtigruten's vice president for expeditions.   Invisible to the naked eye, traces of humankind are however to be found in the pristine landscape.   Not a single piece of rubbish is in sight but microplastics are everywhere, swept in on ocean currents.   "We've detected them in the eggs of penguins for example," Leppe told AFP.

- Venice under water -
The Antarctic, which holds the world's largest reserve of freshwater, is a ticking time bomb, warn experts and studies.   They say that the future of millions of people and species in coastal areas around the world depends on what is happening here.   As a result of global warming, the melting ice sheet -- especially in the western part of the continent -- will increasingly contribute to rising sea levels, radically re-drawing the map of the world, says climate scientist Anders Levermann, of the Potsdam Institute for Climate Impact Research.   This meltwater will contribute 50 centimetres (almost 20 inches) to the global sea level rise by 2100, and much more after that, he said.   "For every degree of warming, we get 2.5 metres of sea level rise. Not in this century, but in the long run," he said.

Even if the international community meets its obligations under the Paris Agreement to limit global warming to under two degrees Celsius, sea levels will still rise by at least five metres.   "Which means that Venice is under water, Hamburg is under water, New York, Shanghai, Calcutta," he said.   It's impossible to predict when, but the scenario appears unavoidable, says Levermann.   In the same way that a cruise ship powering ahead at full speed can't immediately stop, sea levels will continue to rise even if all greenhouse gas emissions were to cease immediately, a study has said.

- Changing the world? -
The tourism industry says it hopes to make "ambassadors" out of Antarctica visitors.   "It's good for the animal life and for the protection of Antarctica that people see how beautiful this area is, because you cherish what you know and understand," said Hurtigruten chief executive Daniel Skjeldam.   Texan tourist Mark Halvorson, 72, says he is convinced.   "Having seen it, I am that much more committed to having a very high priority in my politics, in my own inner core convictions to being as environmentally friendly in my life as I can," he said.   So, do Guido and Martina Hofken see themselves as future "ambassadors of Antarctica"?    "Just a little bit, probably. But I don't think I will change the world," Guido Hofken concedes.    "The best thing would be for nobody to travel to Antarctica."
Date: Thu, 5 Dec 2019 16:37:37 +0100 (MET)

Paris, Dec 5, 2019 (AFP) - French rail operator SNCF said Thursday that it had cancelled 90 percent of all high-speed TGV trains and 70 percent of regional trains for Friday due to a strike over the government's pension reforms.   SNCF said that services would "still be very disrupted" on the second day of the biggest transport strike in the country in years, with the Eurostar service to Britain and the Thalys service to northern Europe set to be "very heavily disrupted".   In Paris, where only two of 16 metro lines were operating normally Thursday, public transport workers voted to remain on strike until Monday.

France's civil aviation authority meanwhile told airlines to cut 20 percent of their flights in and out of airports in Paris, Beauvais, Lyon, Marseille, Toulouse and Bordeaux on Friday, the same proportion as on Thursday.   Striking transport workers, air traffic controllers, teachers, fire fighters, lawyers and other groups all fear they will have to work longer or receive reduced pensions under the government's proposal to scrap 42 special pension schemes and replace them with a single plan.   Anticipating the worst travel chaos in years, many employees opted to work from home on Thursday. Those who did venture out travelled mainly by car, bicycle, electric scooter or on foot.
Date: Thu, 5 Dec 2019 12:19:45 +0100 (MET)
By Sofia CHRISTENSEN

Johannesburg, Dec 5, 2019 (AFP) - South African Airways was placed under a state-approved rescue plan on Thursday to avoid the embattled airline's collapse following a costly week-long strike last month.   Thousands of South African Airways (SAA) staff walked out on November 15 after the flag carrier failed to meet a string of demands, including higher wages and job in-sourcing.   The strike was called off the following week after SAA management and unions eventually clinched a deal.

But the walkout dealt a severe blow to the debt-ridden airline, which has failed to make a profit since 2011 and survives on government bailouts.   "The Board of SAA has adopted a resolution to place the company into business rescue," said a statement by South Africa's Public Enterprises Minister Pravin Gordhan, adding that the decision was also supported by the government.   "It must be clear that this is not a bailout," said Gordhan. "This is the provision of financial assistance in order to facilitate a radical restructure of the airline."   The business rescue process will be directed by an independent practitioner. It is meant to prevent a "disorderly collapse of the airline", he added.   Gordhan said the government would provide 2 billion rand ($136 million) to SAA in "a fiscally neutral manner".   Existing lenders will also provide a 2 billion rand loan guaranteed by the government.

- 'Financial challenges' -
South Africa is struggling to get state-owned companies back on track after nine years of corruption and mismanagement under former president Jacob Zuma.   Its national airline -- which employs more than 5,000 workers and is Africa's second largest airline after Ethiopian Airlines -- had been losing 52 million rand ($3.5 million) a day during the strike.   SAA's board said the business rescue, scheduled to start immediately, was decided after consultations with shareholders and the public enterprises department "to find a solution to our company's well-documented financial challenges".

"The considered and unanimous conclusion has been to place the company into business rescue in order to create a better return for the company's creditors and shareholders," said the SAA board of directors in a statement.   The rescue plan will include a "new provisional timetable" and ensure "selected activities... continue operating successfully".   With a fleet of more than 50 aircraft, SAA flies to over 35 domestic and international destinations.   "SAA understand that this decision presents many challenges and uncertainties for its staff," said the board.   "The company will engage in targeted communication and support for all its employee groups at this difficult time.

- 'Lesser evil' -
Unions told AFP they would comment later on Thursday.   They have agreed to a 5.9-percent wage increase backdated to April, but which would only start to be paid out next March depending on funding.   SAA had initially refused any pay rise.    The cash-strapped airline needs two billion rand ($136 million) to fund operations through the end of March. But it was unable to cover all of its staff salaries last month.    "Business rescue allows for the airline to continue to operate while it is being restructured, as opposed to liquidation," analyst Daniel Silke told AFP.   He said the rescue was a "lesser evil for SAA" and would save more jobs than a "shutdown".

But Silke still expected jobs to be cut as SAA attempted to reduce costs.   "Various divisions that make of SAA could be privatised," he said. "There will be a review of SAA aircraft and routes covered by SAA."   Unions had already demanded a three-year guarantee of job security following an announcement last month that almost 1,000 SAA employees could lose their jobs as part of another restructuring plan.   SAA pledged to defer that process to the end of January as part of the deal that ended the strike.
Date: Wed 4 Dec 2019
Source: Stock Daily Dish [edited]

Out of the 7 patients who were admitted to the hospital suspecting Nipah virus infection, one has been tested positive while the other 6 have been tested negative.

Kerala health minister K K Shailaja said at a press briefing in Kochi on Thursday [28 Nov 2019] that of "7 patients admitted to the hospital, one patient's result is positive for Nipah virus, while 6 patients' results are negative. No one has been discharged from the isolation ward. The source of the virus is not confirmed yet."

On the other hand, 2 persons suffering from high fever were put under observation at Trivandrum Medical College on Thursday [28 Nov 2019]. Their samples have been sent for examination.

On 4 Jun [2019], a 23-year-old-man had tested positive for Nipah virus infection, which killed 17 people in Kerala last year [2018].

As of now, a total of 15 people are under observation in the state.

Union minister for health and family welfare Dr Harsh Vardhan had said on 4 Jun [2019] that the centre had rushed a team of doctors to Kerala for investigation in the wake of the scare of Nipah virus. Vardhan had asserted that he was "very vigorously" following the situation.

Nipah virus is transmitted from animals [bats] to humans and then spreads through people to people, causing respiratory illness. Its symptoms include fever, muscle pain, headache, fever, dizziness, and nausea.

The Health Department in Karnataka issued a circular asking administration in Chamarajanagar, Mysuru, Kodagu, Dakshina Kannada, Uttara Kannada, Udupi, Shivamogga, and Chikkamagaluru districts to immediately convene interdepartmental coordination committee meetings, including the veterinary department, the Indian Medical Association, and the Indian Academy of Pediatrics.

Authorities in these 8 districts have been directed to identify 2 isolation beds to quarantine suspected human cases. They have been asked to keep all the logistics available at all levels, read the circular. The department has also asked district authorities to direct government and private hospitals to keep an eye on suspected cases.

Once a patient shows symptoms of Nipah, the hospitals have to monitor for acute encephalitis syndrome, check all vital parameters, and take a travel history of the patients.

The district hospitals should have an ICU with ventilator facilities and capacity to receive emergency cases, the circular read.

The department asked the districts to furnish a daily outbreak report regarding Nipah virus. It also directed authorities to sensitise health assistants and ASHA workers.
==================
[This is the 3rd case of Nipah virus infection [NVI] in Kerala state this year (2019). It is prudent that surveillance and patient-care capacity have been increased. Last year (2018), as of 17 Jul 2018, a total of 19 Nipah virus (NiV) cases, including 17 deaths, were reported from Kerala state: 18 of the cases were laboratory confirmed, and the deceased index case was suspected to have NVI but could not be tested. The 2018 outbreak was localized to 2 districts in Kerala state: Kozhikode and Malappuram.

The exact circumstances under which this or the previous confirmed Nipah virus cases this year (2019) acquired their infections are not stated in the above or in previous reports, nor is it stated whether these individuals had contact with flying fox fruit bats (_Pteropus giganteus_), the reservoir hosts of Nipah virus, or fruit that the bats may have contaminated. It is interesting to note that 12 of 36 fruit bats tested at the National Institute of Virology were positive for Nipah virus. Although Kerala health minister KK Shailaja officially had declared Ernakulam district Nipah-free, it may have been free of human cases but is unlikely to have been free of the virus in _Pteropus giganteus_ fruit bats. - ProMED Mod.TY]

[Maps of India:
Date: Wed 4 Dec 2019
Source: Stock Daily Dish [edited]

Bihar Health Minister Mangal Pandey on [Sat 30 Nov 2019] said the state government is doing its best to save children, as the death toll due to acute encephalitis syndrome [AES] in Muzaffarpur mounted to 73.

Pandey said doctors and nurses are being called in from Patna for additional help. "We are trying everything and anything that can save children's lives. Everything is being made available from medicines to doctors. We have even called doctors and nurses from AIIMS in Patna," he said. "There is a protocol regarding what kind of medicines and facilities should be given and we are doing the same. We are monitoring things regularly and trying to save our children."

Recalling the situation that prevailed 5 years ago, Pandey said a team that was formed to ascertain the cause of this disease concluded that sleeping empty stomach at night, dehydration due to humidity and eating lychee on empty stomach were some of the causes of encephalitis.

"Our government has tried to spread awareness which will be beneficial as well. Advertisement in newspapers, radio jingles, pamphlets and mic [microphone] announcements are going to spread awareness regarding the disease. Health ministry is also working on it," he said.

On being asked about spread of ASE in Gorakhpur last year [2018], he said, "From Gorakhpur to Muzaffarpur region, this disease had spread last year and the Union government had worked on this and we will continue to fight it now."

"This incident in Muzaffarpur is very saddening and we also feel bad when children of our nation die like this. Not the whole district is affected but a large part is suffering from it," he added.

From [1 Jan 2019], until now [5 Dec 2019], 220 children were admitted in Sri Krishna Medical College and Hospital in Muzaffarpur due to AES, out of which 62 lost their lives.

As per the data of SKMCH hospital, 235 children were admitted, of which 89 died; in 2013 - 90 children were admitted, of which 35 died; in 2014 - 334 children were admitted, of which 117 died; in 2015 - 37 children were admitted, of which 15 died; in 2016 - 31 children were admitted, of which 6 died; in 2017 - 44 children were admitted, of which 18 died; and in 2018 - 43 children were admitted, of which 12 died.

Meanwhile, Minister of State for Union ministry for home affairs, Nityanand Rai, visited Sri Krishna Medical College and Hospital to review the situation after the outbreak of AES.

Encephalitis is a viral disease, which causes mild flu-like symptoms such as high fever, convulsions and headaches and has been claiming lives in the district for the past few weeks.
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[The dates within which these AES cases have occurred is not stated. The urgency that has prompted Behar health officials to request the aid of physicians and nurses from adjoining Patna suggests that the AES outbreak is going on currently. The uncertainty about the etiology of AES continues. It is curious that the above report makes no mention of negative or positive tests for Japanese encephalitis among the AES patients, although that virus is endemic in northeastern India, including Bihar state. Neighboring Uttar Pradesh state has had JE cases as well this summer (2019) but has intensified its JE vaccination program.

The issue of the aetiology of AES has been under discussion for a long time. Lychee fruit contain toxins. Encephalopathy and hypoglycaemia have been associated with consumption of lychee fruit contains phytotoxins, specifically alpha-(methylenecyclopropyl)glycine (see ProMED-mail archive no. http://promedmail.org/post/20150201.3132842). However, the current cases cannot be due to lychee consumption, since the season for that fruit has passed.

AES has continued to be attributed to a variety of aetiologies, including Reye syndrome-like disease, possible enterovirus infection from polluted water, heatstroke, lychee fruit consumption, and scrub typhus (_Orientia tsutsugamushi_). A recent publication (reference below) states that dengue virus is one of the 3 most common agents identified in AES, but existing surveillance for AES does not include routine testing for dengue. Until the etiology (or etiologies) of these AES cases is determined, effective and efficient prevention of these cases will not be possible.

Reference:
Ravi V, Hameed SKS, Desai A, et al. Dengue virus is an under-recognised causative agent of acute encephalitis syndrome (AES): results from a 4-year AES surveillance study of Japanese encephalitis in selected states of India. Int J Infect Dis 2019;84 Suppl:19-24. <https://doi.org/10.1016/j.ijid.2019.01.008>.

Available at:

[Maps of India:
HealthMap/ProMED maps available
at:<http://healthmap.org/promed/p/364>, and Bihar, India:
Date: Thu 5 Dec 2019 6:11 PM EET
Source: Enab Baladi [edited]

[Leishmaniasis] is spreading widely among residents of Deir ez-Zor, and especially children. Some of the areas affected are controlled by the Kurdish self-administration while others are under the control of the Syrian regime. Medical sources counted hundreds of infected civilians and confirmed the disease's rapid spread.

According to Atef al-Tawil, a manager of the Leishmania & Environmental Health Programme at the Syrian regime's Ministry of Health, most infections in eastern Deir ez-Zor are spread among school children.

In a Facebook comment on a post by Twasol agency, al-Tawil claimed that cases of leishmaniasis were detected, at the end of November [2019], in primary schools in eastern Deir ez-Zor and its surrounding villages (al-Jalaa, al-Salihiyah, al-Tawtha, al-Abbas, al-Mujawdeh, al-Hasarat, al-Saial, al-Ghabrah).

According to al-Tawil, 455 infections of children were detected. A treatment team of 10 members was formed in the affected locations, to help control the disease to aid in early detection.

The Syrian Ministry of Health acted after several appeals by civilians residing in the area as they noticed the disease spreading among their children. Al-Tawil said that this rapid spread was due to the fact that all the infected people have lately returned to their original areas which lack medical centers.

Autonomous administration areas
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According to Euphrates Post network, leishmaniasis is also widely spread in areas controlled by the Syrian Democratic Forces (SDF). In its post on [Sun 1 Dec 2019], the network claimed that the spread of leishmaniasis is mostly concentrated in the eastern countryside of Deir ez-Zor.

According to the network, unofficial statistics by the SDF-affiliated local council shows more than 7000 leishmaniasis infections among children in al-Baghouz, Hajin, Diban, al-Sha'afa, al-Kishkiye, Abu Hamam, and Gharanij. The local councils' attempts of controlling the disease are still substandard, according to the Euphrates Post.

The network also quoted doctors and nurses calling for international organizations to interfere and provide hospitals and clinics with the required vaccine [there is no vaccine for leishmaniasis; ed.], and to train specialized medical staff in each clinic to deal with the disease.

The autonomous-administration-affiliated media center in Deir ez-Zor also confirmed the spread of leishmaniasis and pointed out that the authorities took actions, by the end of November [2019], to provide treatments.

According to the media center, special medical teams and cadres were distributed among the clinics to provide 12,000 ampoules of the required [medicine] to treat leishmaniasis with the support of the World Health Organization.

Leishmaniasis is a parasitic disease transmitted by the bite of infected female phlebotomine sandflies -- a very small yellow fly that is active at night and makes no sound when it bites -- and the main cause for its spread is dirt and lack of hygiene.  [Byline: Enab Baladi]
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[Deir ez-Zor is east and south of the locations in the previous ProMED reports (see below), indicating further increase in cases of cutaneous leishmaniasis beyond its historical concentration in western Syria (<https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4861536/>) and beyond the area of the MENTOR initiative in northern Syria (<https://wwwnc.cdc.gov/eid/article/24/11/17-2146_article>).

Cutaneous leishmaniasis is endemic in Syria with its reservoir in rodents. It has been a problem throughout the Syrian civil war and in ISIS controlled areas during the war due to a breakdown in rodent and vector control. - ProMED Mod.EP]

[Maps of Syria:
Date: Tue 3 Dec 2019
Source: Twitter feed in Arabic [machine trans., edited]

Taiz health official: 24 laboratory-confirmed cases of West Nile virus and more than 300 suspected cases. #Republic_Yemen
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[Any information on the actual number of WNV cases, their lab confirmation, and public health response activities in this regard will be highly appreciated. - ProMED Mod.UBA]

[HealthMap/ProMED-mail map of Yemen: