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Greece

Background
Greece offers a great variety of attractions for the international traveller. A beautiful climate linked with great beaches, a vibrant nightlife and historical monuments to rival any other location throughout the world. All of this located
within western Europe and a short flight away from many of the cooler northern destinations - like Ireland. Travellers from these regions descent on Greece in very significant numbers each year and for the vast majority of them they will have a splendid and healthy time. However for some this may not be the case and serious illness and accidents are regularly reported. Following some commonsense rules would go a long way to avoiding disaster and ensuring that this trip is truly one to be remembered for all the right reasons.
Climate
Situated in southern Europe the country enjoys mild winters but very hot summers. There may be occasional cool breezes (meltemia) but these can serve only to fool the traveller into thinking that they are unlikely to burn. Rain is very uncommon during the height of summer (July and August) and all travellers should be advised to use very adequate sun-block lotion at all times.
Slip, Slop, Slap
Following the Australian mantra of Slip, Slop and Slap makes perfect sense. Slip on a shirt, slop on sunscreen and slap on a hat when out and about during the day and this should help protect against the intense suns rays. Nevertheless, despite all their best intentions, travellers get burnt. This is particularly a problem in the first few days after their arrival when they do not realise the intensity of the suns rays and how easily they can be exposed. Falling asleep beside the hotel's swimming pool or on the beach is a very common problem and must be avoided against. The tips of the ears, shoulders (especially along the bra-strap line, ankles and behind the knees are commonly exposed and forgotten areas.
After Sun care
To treat significant sunburn it is important to increase fluid intake but also to take extra salt on your food (unless medically contraindicated for some specific condition like high blood pressure etc). Soothing water soluble lotions (especially ones containing a mild anaesthetic and/or steroid cream) are probably best but certainly avoid any of the ones which paste the skin with a thick layer - which is almost impossible to remove without causing serious pain! The more severe sunburn cases may need medical care and even hospitalisation which really ruins a holiday.
Food & Water
As a European destination Greece has a good level of food and water hygiene. Unfortunately this can vary - especially as you move away from the main tourist destinations and also as the summer temperatures rise and food goes 'off' more quickly. Eating hot food, avoiding cold foods (side-salads, lettuce etc) and never eating undercooked bivalve shellfish (mussels, oysters, clams etc) makes perfect sense. Eating food or taking fruit juice drinks from street vendors is a risk just not worth taking.
Insect bites
There may be both mosquitoes and sandflys about so having good repellents (DEET based ones) is worthwhile. The biggest problem will be early in the morning and towards the end of the daylight hours. However sitting in the shade while having lunch may be nice and cool but it is also often a place where these insects tend to hover looking for their next meal. Just don't allow that meal to be the blood in your unguarded ankle!
Seeing the Monuments
As mentioned previously Greece is covered with ancient monuments and these attract many thousands of tourists each year. The ruins are often not the most hospitable places for sun-sensitive tourists so taking care against the suns rays is essential - especially while standing carefully listening to the tour guide explain some complicated piece of history while the back of your legs get roasted! The other issue, for those trekking through the ruins, is the distinct possibility of a nasty twisted ankle.
Laser Night shows
Many of the ancient sites have beautiful night shows which depict something of the past splendour and are definitely worth seeing. However it is wise to wear good shoes as stumbling across loose stones is a particular problem at night and also bring a small torch, if possible, to guide your way. Getting separated from your travelling companions, or not being able to find your return bus, can lead to some understandable panic so listen carefully to any instructions and look out for some land marks before you get too far away into the night time crowd.
Animal bites
Some tourists may forget that rabies is a problem in many countries throughout the world and, even though Greece is regarded as rabies-free', there is always a problem if someone should get bitten. The possibility that this animal could have been recently smuggled into the country cannot be out ruled and so many would advise full post exposure treatment should this contact occur. Children may be at particular risk due to their inquisitive nature.
Swimming
Sunburn and swimming go hand in hand but drowning can also occur all too frequently within this region. Strong currents, swimming after meals (or alcohol) and the ever popular romantic midnight swim are all serious risk factors. Also children running around the deep end of the pool may lose their footing and topple in without warning. Unfortunately a very small child sinks instantly with very little sign of the emergency to those close by. Parents need to keep aware of this risk at all times.
The summer working holiday
Many of our students head towards Greece for 2 to 3 months during the summer to work. The attractions are obvious but commonsense and sensible life-style choices are needed throughout their stay to lessen the risk of illness or them returning home with an infection they had not bargained for. Unfortunately many return home with life-long illnesses which have been contracted from a single unprotected sexual contact.
Vaccinations for Greece
As a general rule the usual travel vaccines are not recommended for most short-term travellers to this region. However for the student planning to spend a more prolonged period it would be sensible to consider cover against both Hepatitis A and Hepatitis B and also to check that their Tetanus cover is up-to-date.
Summary
This is still one of the most popular destinations for northern European travellers and, in the vast majority of cases, they will have a fantastic time with only good memories. Unfortunately some less prepared folks will end up with serious sunburn and other illnesses or diseases which perhaps are frequently associated with their own lack of care and protection rather than anything specific to this beautiful country.

Travel News Headlines WORLD NEWS

6th December, 2019
HSE Health Protection Surveillance Centre

On 27/11/2019, a possible case of diphtheria was reported to the Department of Epidemiological Surveillance and Intervention through the Mandatory Notification System in Greece. It concerned an 8 years old boy of Greek nationality, who was hospitalized in the ICU of General Children's Hospital  where he died.  This child had underlying conditions (severe pulmonary hypertension) and was admitted to ICU  on 22/11/2019 with clinical presentation of laryngitis (without the presence of characteristic pseudo membranes) and pneumonia, immediately intubated, covered with double antibiotic regimen and died due to deterioration of his clinical presentation on 26/11/2019.
 
According to the epidemiological data given , there is no travel history, group living, no connection to another case and the child does not belong to a specific population group. Regarding his immunization status, the child was vaccinated with at least 3 doses against diphtheria-tetanus-pertussis.
 
Laboratory investigation of bronchial exudate isolated Corynebacterium diphtheriae via VITEK. Further laboratory testing was performed by the Public Health England  reference Laboratory for Corynebacteria. On Thursday 5/12/2019, the National Public Health Organization was informed that multiplex PCR testing was positive for C. Diphtheriae and positive for the diphtheria toxin gene. The Elek test was also positive for toxin production. The results of the child's post-mortem exam are pending.

Contact tracing and management is ongoing and has identified most of the close contacts of the patient. The National Public Health Organization provided recommendations on obtaining nasopharyngeal cultures in close contacts to evaluate carriage as well as the necessary preventive measures to protect the child's close contacts as well as the medical staff involved in direct patient care (i.e. awareness for potential compatible with diphtheria symptoms and administration of antibiotic prophylaxis together with booster or complete vaccination series as appropriate) according to the WHO’s Diphtheria Surveillance Standards (September 2018). In addition we have initiated the procedure for the procurement of a limited stockpile of DAT.
Date: Wed, 27 Nov 2019 09:20:47 +0100 (MET)

Athens, Nov 27, 2019 (AFP) - A strong 6.1-magnitude undersea earthquake shook the Greek island of Crete on Wednesday and was felt in other parts of the country, officials said.   "It was a major earthquake, the whole island shook but fortunately so far no damage has been reported," Crete regional governor Stavros Arnaoutakis told state TV ERT.   The Athens observatory said the quake struck at 9:23 am (0723 GMT) and had a depth of over 70 kilometres (44 miles).

The tremor occurred a day after a 6.4-magnitude earthquake in Albania that has left more than 20 dead and hundreds injured.   Shortly after the Albania tremor, a 5.4-magnitude shock hit Bosnia, the European-Mediterranean Seismological Center reported on Tuesday.   Greece lies on major fault lines and is regularly hit by earthquakes but they rarely cause casualties.   In July 2017, a 6.7-magnitude earthquake killed two people on the island of Kos in the Aegean sea, causing significant damage.
Date: Wed, 2 Oct 2019 12:31:30 +0200 (METDST)

Athens, Oct 2, 2019 (AFP) - Greek workers staged a fresh 24-hour strike Wednesday against government plans to deregulate the labour market, paralysing road and rail transport, closing banks and shutting down news outlets.   Buses and trams stayed in their depots, the Athens metro was shut down and ferries serving islands on both sides of Greece stayed in port. The action also hit rail services, including to Athens airport.   Banks were closed Wednesday and Poesy, the journalists' union, said there would be no news bulletins over the 24-hour strike period.

The strike caused long traffic jams in Athens as the GSEE, the largest union representing private-sector workers, organised a rally in the city centre to protest the planned legislation.    It denounced "the suppression of collective conventions" and what it said was an assault on the unions.   This was the second strike in a week against the planned reforms of conservative Prime Minister Kyriakos Mitsotakis, which he argues will open the way to investment and encourage growth of more than two percent.   A strike last week hit transport, hospitals, schools and the courts.   The unions say the proposed reforms will undermine collective agreements and make it harder to organise strikes.

The proposed law would require a more-than 50 percent turn-out of the workforce in any strike vote for it to be valid.   Union leaders have also denounced a law passed in August which they say makes it easier to sack people in the private sector.   Adedy, the federation of public-sector unions, which organised last week's strike, called on its members to join Wednesday's action.   Mitsotakis came to power in July, replacing the left-wing government of Alexis Tsipras.
Date: Thu 12 Sep 2019, 7:54 PM
Source: Ekathimerini [edited]

The death toll from the West Nile virus since June this year has risen to 20, according to this week's report by the National Health Organization (EODY).

Up until [12 Sep 2019], authorities had diagnosed a total of 176 cases of the mosquito-borne virus. Of these, 109 developed illnesses affecting the central nervous system such as encephalitis or meningitis.

EODY is urging the public to spray insect repellent on bare skin and clothing, to install mosquito nets and screens, to remove stagnant water from basins, vases and gutters, to regularly mow lawns and to water plants in the morning.
=============================
[The first report mentions 20 fatal human cases as compared to the latest ECDC update that mentions 19 and the total case number is 176 versus 171 (ECDC report).

West Nile fever is a disease caused by West Nile Virus (WNV), which is a _Flavivirus_ related to the viruses that cause St. Louis encephalitis, Japanese encephalitis, and yellow fever. It causes disease in humans, horses, and several species of birds. Most infected individuals show few signs of illness, but some develop severe neurological illness which can be fatal. West Nile Virus has an extremely broad host range. It replicates in birds, reptiles, amphibians, mammals, mosquitoes and ticks <https://www.oie.int/doc/ged/D14013.PDF>.

The reservoir of the virus is in birds. Mosquitoes become infected when they bite an infected bird ingesting the virus in the blood. The mosquitoes act as carriers (vectors) spreading the virus from an infected bird to other birds and to other animals. Infection of other animals (e.g. horses, and also humans) is incidental to the cycle [as also evident in the ECDC update above] in birds since most mammals do not develop enough virus in the bloodstream to spread the disease.

Key to preventing the spread of West Nile fever is to control mosquito populations. Horses should be protected from exposure to mosquitoes. Likewise, people should avoid exposure to mosquitoes especially at dusk and dawn when they are most active, use insect screens and insect repellents, and limit places for mosquitoes to breed. - ProMED Mod.UBA]

[HealthMap/ProMED maps available at:
Date: Sun, 15 Sep 2019 15:38:29 +0200 (METDST)

Athens, Sept 15, 2019 (AFP) - More than 160 firefighters on Sunday battled to contain a large fire near Athens blazing for a second day amid gale force winds, officials said.   And in another emergency, authorities evacuated dozens of people from two villages and a hotel on the island of Zakynthos after a new fire broke out on Sunday.

The fire department said the blaze near Athens burned in the mountains above Loutraki, a coastal resort some 60 kilometres (35 miles) west of Athens.   "The fire is burning near the top of the mountain," Stefanos Kolokouris, the fire department's deputy chief of operations, told state TV ERT.   "We are trying to create a perimeter but the terrain is very difficult, with ravines," he said.   Four water bombers and six helicopters were participating in operations. Given a lack of roads in the area, two squads of firefighters had to be carried to the mountaintop by Super Puma helicopter, state agency ANA said.   Officials had already evacuated 50 people from a local monastery when the fire broke out on Saturday, but stressed that other inhabited areas were not in danger.

On Zakynthos, officials ordered the evacuation of the villages of Agalas and Keri in the south of the island. Some 120 tourists were also relocated to a safe area.   The Greek fire department on Sunday said it had been called to nearly 80 fires over the past 24 hours.   It has already faced more than 9,600 rural and urban fires this year.
More ...

Indonesia

*****
Information for Bali
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General
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Bali is one of the main tourist destinations for many Irish travellers to Indonesia. The island is well developed for the tourist industry and genera
ly the climate is tropical and humid throughout the year. Many Irish travellers will use the island as a stopover. If this is for only 24 to 28 hours the extent of your jetlag may leave you little time to enjoy the country and its people.
Safety & Security
************************************
Throughout Indonesia there are many regions where it is unsafe to travel. The Parliament in Indonesia may impeach the President in the near future. Civil disturbance with student demonstrations in the capital Jakarta, earthquakes in the island of Sumatra, unrest regarding the independence of Timor and profound warring fractions on the island of Borneo has the potential to spill over into Bali. Nevertheless during the past years Bali has remained stable and there have been few reports of serious disturbances that have affected tourists or business travellers. Lombok is an island close to Bali often visited by tourists. It is regarded as more unstable and recently (Dec 2000) four explosions during fighting between two villages (Bongor & Parampuan). The main tourist region around Senggigi has remained quiet.

Local Customs
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The laws against illegal drugs are severe and travellers should ensure that they carry sufficient well-marked medication that they may require for their time in Indonesia. Travellers are required to show identification at any time and so carrying photocopies of your passport is a wise precaution. Keep all valuable documents in a safe place and do not flaunt personal wealth while travelling around the island.
Night Activities
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The nightlife in Bali is one of the main attractions for many tourists but sensible precautions are required. Travelling alone is unwise. Take care to ensure that your drink could not be spiked at any stage and do not walk at night, use an authorised taxi where possible. The level of HIV infection among the bar workers is high and close personal contact is very unwise.
Medical Facilities
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The level of available health facilities varies greatly through Bali and other parts of Indonesia. In general most of the main hotels will have English speaking doctors but care would be required if your illness requires hospitalisation.
Food and Water
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It is wise to maintain a high level of care with regard to your food and water while in Indonesia. This includes even those in high quality hotels but also particularly for those eating from street vendors. Bivalve shellfish (e.g. oysters, mussels, clams etc) should be avoided at all times due to inadequate cooking. Bottled water should be purchased from your hotel or good quality shops to ensure that it is pure.
Mosquitoes and Insect Bites
************************************
Malaria transmission occurs throughout Indonesia all year but the risk in Bali is so low that prophylaxis is not generally recommended for most tourists. Nevertheless for those visiting Lombok (overnight visits) the risk exists and prophylaxis should be considered. Other mosquito borne diseases also occur throughout Indonesia and care must be taken to avoid insect bites. In Jakarta and other main cities there is a particular problem with a viral disease called Dengue Fever. The mosquito, which transmits this disease, typically bites during the day and in main urban centres.
Sun Exposure
************************************
The strength of the sun in Bali is considerable higher than that experienced in Ireland at any time of the year. Sufficient head covering should be worm when exposed and travellers should ensure that their fluid intake is sufficient. Salt depletion also needs to be replaced in times of significant perspiration.
Swimming
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If swimming in pools, make sure that sufficient chlorination has been used. Take care with small children when close to the deep end of the pool. If sea swimming make sure that there are always others around and that you heed any local advice and warning signs. Never swim soon after alcohol or for an hour after mealtime.
Jet Lag
************************************
The extent of jet lag, which you will experience, depends on the duration of your flight and the amount of rest you were able to get before arrival. Try to rest for the first 24 hours to allow your body to acclimatise and make sure you do not fall asleep beside the swimming pool during this initial period.
Vaccinations for Bali
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There are no essential vaccines or entry to Bali from Western Europe. However for your personal protection travellers are recommended to consider vaccination cover against;
*
Poliomyelitis (childhood booster)
*
Tetanus (childhood booster)
*
Typhoid (food & water disease)
*
Hepatitis A (food & water disease)
Other travellers planning a more rural or extensive trip may need to consider other vaccine cover against diseases like Hepatitis B, Japanese B Encephalitis, Rabies.
Summary
************************************
The majority of those visiting Bali will enjoy the many tourist attractions on the island. However commonsense and care is required to ensure that you do not expose yourself to unnecessary risk. The staff of the Tropical Medical Bureau can be contacted at either of the numbers below if you require further information.

Travel News Headlines WORLD NEWS

Date: Mon 20 Jan 2020
From: Alyssa Pyke <Alyssa.Pyke@health.qld.gov.au> [edited]

Queensland Health has reported an imported case of Japanese encephalitis virus (JEV) infection in an unvaccinated male who travelled from Bali to Australia in late 2019.

JEV is a mosquito-borne flavivirus and a leading cause of encephalitis throughout Asia. The virus is largely endemic in Indonesia, and a JEV vaccination program for children was initiated on the island of Bali in March 2018 (1).

Several reports have previously described encephalitis caused by JEV infections in travellers who contracted their illness in Bali (2, 3), including an unvaccinated, 10-year-old Australian girl, in 1989 (4).

Laboratory diagnostics performed at Forensic and Scientific Services (FSS) detected JEV RNA by real-time TaqMan qRT-PCR in a cerebrospinal fluid (CSF) sample taken from the imported JEV 2019 case. Specific anti-JEV IgM antibodies were detected in the same CSF sample and in an additional serum sample collected 2 days later using a multiplexed flavivirus microsphere immunoassay. Viral culture of the CSF sample yielded a JEV isolate, JEV Bali 2019.

The JEV Bali 2019 isolate was further characterized by massive parallel sequencing using both the NextSeq Illumina and GridION Oxford Nanopore platforms. The complete JEV 2019 genome sequence obtained was most closely related to a JEV Bali 2017 sequence (GenBank accession number LC461961) with which it shared 99.23% nucleotide identity.

Persistence of JEV and associated disease transmission in the popular tourist isle of Bali highlight this pathogen as an ongoing public health threat, and the continued incidence of cases with serious neurological symptoms, as described in this report, emphasize the importance of appropriate health and vaccination advice to prospective travellers to the region. The development of improved surveillance and diagnostics for JEV and other medically important pathogens should also be prioritized. Recently, whole genome sequencing has substantially enhanced these capabilities, affording timely provision of data regarding the types and genetic characteristics of circulating strains.

The diagnosis of the current JEV 2019 case with a history of travel in Bali, and rapid generation of a complete genome sequence from the recovered JEV Bali 2019 isolate, resulted from the combined efforts of the Public Health Virology and Microbiology laboratories at FSS, Queensland Health, which incorporate the Queensland Reference Centre for Microbial and Public Health Genomics; and the Queensland Health Medical staff at the Sunshine Coast University Hospital, Queensland, Australia.

References
1. Im J, Balasubramanian R, Yastini NW, Suwarba IGN, Andayani AR, Bura V, Jeon HJ, Clemens JD, Marks F. 2018. Protecting children against Japanese encephalitis in Bali, Indonesia. Lancet 391:2500-2501.
2. Wittesjo B, Eitrem R, Niklasson B, Vene S, Mangiafico J. 1995. Japanese encephalitis after a 10-day holiday in Bali. Lancet 345:856-857.
3. Buhl MR, Black FT, Andersen PL, Laursen A. 1996. Fatal Japanese encephalitis in a Danish tourist visiting Bali for 12 days. Scand J Infect Dis 28:189.
4. Macdonald WB, Tink AR, Ouvrier RA, Menser MA, de Silva LM, Naim H, Hawkes RA. 1989. Japanese encephalitis after a two-week holiday in Bali. Med J Aust 150:334-336, 339.
------------------------------------
Dr Alyssa Pyke
Public Health Virology
Forensic and Scientific Services
Department of Health, Queensland Government
Australia
=====================
[As Dr. Pyke points out, individuals infected with JE virus and returning to Australia from Bali, Indonesia have appeared before, as recently as 2018 (see Japanese encephalitis - Indonesia: (BA,SW) http://promedmail.org/post/20181108.6132871).

The very thorough and remarkably rapid laboratory testing established the JE virus aetiology in this case. It is interesting that the sequences of their isolate matched 99.23% with the JEV Bali 2017 JE virus sequence. The current condition of the patient is not mentioned but obviously is a clinical case of JE. It will be interesting to learn whether JE vaccination is recommended for visitors to Bali, a popular tourist destination, and whether tourists will heed vaccination advice, given that JE cases are sporadic and less than 1% of JE virus infected individuals develop clinical illness.

The USA CDC notes that among patients who develop encephalitis, 20%-30% die. Although some symptoms improve after the acute illness, 30%-50% of survivors continue to have neurologic, cognitive, or psychiatric symptoms (see <https://www.cdc.gov/japaneseencephalitis/symptoms/index.html>). - ProMED Mod.TY]

[HealthMap/ProMED maps available at:
Date: Thu 16 Jan 2020
Source: Tempo.co [edited]

Anthrax threatens Ponjong and Semanu subdistricts in Gunung Kidul district, Yogyakarta province, after 27 residents were infected from consuming the meat of a dead cow, a local health official said on Wednesday [15 Jan 2020].

On 4 Jan 2020, health workers found that 600 residents of the 2 subdistricts could have been affected by anthrax, and 78 of them were observed to have the clinical features of this disease, Sumitro, head of the Disease Prevention and Control Unit at the Gunung Kidul Health Office, said. The local health authorities sent the blood samples of the victims for tests. The result showed that 27 people had tested positive to the disease, he told journalists in response to the latest anthrax cases in Gunung Kidul district.

The infected residents had been administered antibiotic prophylaxis for 20 days and were required to undergo another blood test at Bogor city's BBVEt facilities in West Java province, Sumitro said.

The residents who were suffering from the general signs and symptoms of this anthrax were just administered an antibiotic, he said, adding that the infected residents were not isolated because the disease was not contagious.

"Anthrax is a major cause of fatal disease in cattle, sheep, goats, camels, horses, and pigs throughout the world," the World Health Organization (WHO) has stated. It had caused the death of the owner of the infected cow because he had consumed the meat and regularly cleaned the cattle [pen], Sumitro further said.

In halting the spread of the disease, the district's health authorities had closely coordinated with those from the Food and Agriculture Office regarding education and public awareness campaign programs. "We have also disseminated information to the people at large urging them to cook any meat properly, and not to consume the meat of ailing animals," he added.

The anthrax poisoning cases have repeatedly occurred in certain parts of Indonesia over these past few years. But according to Widagdo Sri Nugroho, a University of Gadjah Mada (UGM) veterinarian, "Anthrax is actually found in almost all countries." He was quoted by the UGM's official website (2017) as saying that "of 180 states that join veterinary health organizations, anthrax is found in 94% of states. In Indonesia, it has been identified since 1884 in Teluk Betung, Lampung." [In fact, globally, anthrax is becoming less frequent, and an increasing number of countries are freed of it. - ProMED Mod.MHJ]

Some 22 provinces in Indonesia are endemic, Nugroho noted. In handling the disease, farmers need to be aware of their cattle's condition and are urged to contact veterinarians who would examine their cattle for any indications of anthrax, he added.  [Byline: Antara (translator), Petir Garda Bhwana (editor)]
======================
[Yogyakarta in is the middle of the southern coast of Java, Indonesia; see
<https://en.wikipedia.org/wiki/Yogyakarta>.
For a map of the province, see

If there were gastroenteric cases, this report would have listed deaths in an outbreak of this size. The 27 positive cases probably had cutaneous lesions. The lesson to be taken from this incident is how many humans can be put at risk in 2 communities by just butchering one sick and dying cow. - ProMED Mod.MHJ]

[HealthMap/ProMED-mail map:
Yogyakarta, Special Region of Yogyakarta, Indonesia:
Date: Tue, 7 Jan 2020 08:03:39 +0100 (MET)

Banda Aceh, Indonesia, Jan 7, 2020 (AFP) - A strong earthquake jolted Indonesia's northwest on Tuesday, but no tsunami warning was issued and there were no immediate reports of injuries or damage.   The 6.2 magnitude quake struck at a depth of 20 kilometres (12.5 miles) just off the coast of Simeulue island, west of Sumatra, according to the US Geological Survey.   Indonesia's weather and geophysics bureau said there was no tsunami threat.   People panicked and ran outside their homes when the quake hit.    "We are now watching at the beach to monitor the movement of seawater," Simeulue resident Ahmadi told AFP.

No casualties or infrastructure damage have been reported so far.   Indonesia suffers frequent seismic and volcanic activity due to its position on the Pacific "Ring of Fire", where tectonic plates collide.   More than 2,200 people died and another 1,000 were declared missing in 2018 after a 7.5 magnitude quake and subsequent tsunami on Sulawesi island.   A 9.1 magnitude earthquake on Boxing Day in 2004 struck Aceh province, causing a tsunami that claimed the lives of more than 170,000 people in Indonesia alone.
Date: Mon, 6 Jan 2020 09:59:14 +0100 (MET)

Jakarta, Jan 6, 2020 (AFP) - Indonesians were told on Monday to brace for more heavy downpours after record rains triggered flooding and landslides that authorities said had killed at least 66 people in and around Jakarta.   Whole neighbourhoods in the capital -- a megalopolis home to around 30 million people -- were submerged last week by floodwaters that forced tens of thousands into temporary shelters.

Authorities have warned residents to take precautions and safeguard their possessions ahead of more pounding storms over the coming weeks.   "There is still potential for mid to heavy rainfall with lightning, thunder and strong winds" in greater Jakarta, Indonesia's weather bureau said in a statement Monday.   Last week's deluge was the heaviest in the capital since record keeping began in the 19th century, the agency said, leading to the city's deadliest flood disaster in years.   Some 377 millimetres (14.8 inches) of rain pounded sections of the vast city, with floodwaters reaching up to the second floor of some buildings after rivers overflowed.

At least two people in Jakarta's west were hospitalised on Monday after the collapse of a five-storey building, which Indonesia's search and rescue agency said may have been caused by a build-up of rainwater.    Authorities said Monday the death toll had climbed again to 66 with two more reportedly missing in Lebak, west of the capital.

Flash flooding killed more than half a dozen people in Lebak, including a seven-year-old boy who was reportedly swept away by the water.   Thousands remained in cramped Jakarta shelters Monday as authorities pushed to reach isolated communities outside the city affected by the disaster.   A day earlier, health workers and soldiers sprayed ravaged parts of the capital with disinfectant in a bid to prevent disease outbreaks.
Date: Wed, 1 Jan 2020 13:29:14 +0100 (MET)

Jakarta, Jan 1, 2020 (AFP) - Nine people died after Indonesia's capital was hit by its deadliest flooding in years, authorities said Wednesday, as torrential rains on New Year's Eve left vast swathes of the megalopolis submerged.   Thousands were evacuated to temporary shelters as electricity was switched off in scores of waterlogged neighbourhoods across greater Jakarta, home to about 30 million people, with some train lines and one of the city's airports also shut.   Indonesia's National Disaster Mitigation Agency called on residents to leave flood-hit areas.   "The first priority is saving lives," said agency head Doni Monardo.

A 16-year-old was electrocuted by a power line, while three more people died of hypothermia, according to the disaster agency.   "My son's body was covered with newspaper when my two other children passed by," said Fadrid, who identified himself as the dead teen's father.   "People asked them whether they knew the victim. If they hadn't been passing by, we wouldn't have known my son had been killed," he told AFP.

Among the victims was an elderly couple trapped inside their home in a district where floodwaters reached as high as four metres (13 feet) after a river burst its banks.   Another victim drowned while four people were killed after the Tuesday evening downpour triggered landslides in the city's outskirts.    "We have shut down power (in many areas) to avoid more electrical shocks," Ikhsan Asaad, an official at state firm PLN, told AFP.

Asaad said he could not estimate how many residents had been affected by the power shutdown.   "We're currently focusing on taking measures to ensure people's safety," he added.   Angelina Widiyanti was among scores of residents whose houses were flooded with their possessions ruined by the disaster.   "We've had flooding several times before but it was never this high," she said from her home, where the power had been cut.   "We weren't prepared for this."

Authorities said about 19,000 people were evacuated, but that figure did not include residents in Jakarta's satellite cities.   "We're evacuating people right now," Jakarta governor Anies Baswedan told reporters.   "Everyone living near rivers should anticipate (more) flooding," he added.   Images from across the region showed waterlogged homes and cars submerged in muddy floodwaters, while some people took to paddling in small rubber lifeboats or tyre inner-tubes to get around.

The disaster marked Jakarta's worst flooding since 2013 when several dozen people were killed when the city was inundated by monsoon rains.   Jakarta is regularly hit by floods during Indonesia's rainy season, which started in late November.   On Wednesday, service at Halim Perdanakusuma airport, which handles commercial and military planes, was temporarily shut due to severe flooding on its runways, according to the transport ministry.   Many flights were transferred to Jakarta's main Soekarno-Hatta International Airport.
More ...

Jordan

General Information:
***************************************
The Middle East is a favourite destination for many Irish holiday makers. The combination of a beautiful climate linked with such historical richness is hard to beat. Unfortunately the
security situation throughout the region has led to some significant concerns over the years. Nevertheless, in the vast majority of cases those visiting the region will not encounter any particular concerns in this regard. It is a wise precaution to ensure that your passport is valid for at least a further six months beyond the time of your holiday as otherwise you may be refused entry.
Security Situation:
***************************************
Security throughout the Middle East is generally tight. Carry some means of identification at all times in case you are requested to produce it by police or army personnel. In Jerusalem the city has been divided and it is sensible to remember which quarter you are in at all times.
Health Facilities:
***************************************
Generally the health facilities throughout the region are excellent. However, when visiting certain rural regions you may find it difficult to obtain hospital care similar to that at home. In Israel, travellers can find information in English about emergency medical facilities and after-hours pharmacies in the "Jerusalem Post" and English language "Ha'aretz" newspapers.
Food & Water Facilities:
***************************************
Again, this depends on your location and the facilities which are there at the time of the year you visit. Bottled water is easily available and food hygiene is usually excellent throughout all the main tourist destinations. However, it is generally wiser not to drink hotel tap water and only to use it for brushing your teeth if there is a clear smell of chlorine. When on organised trips tourists are sometimes offered local tea or other drinks. Generally this will be safe as the water is boiled but take care that the cup hygiene is acceptable.
Sun Exposure:
***************************************
The climatic conditions in the Middle East vary considerably throughout the year. Many tourists visit in late autumn or early spring. At these times the climate is much cooler and the evenings can be distinctly chilly. However, during the main tourist season (May to September) the temperatures rise high into the 80’s or 90’s and dehydration can easily occur. Increasing fluid and salt intake is important under these circumstances. It is essential that travellers are aware of the climatic conditions which should be present for their trip and that sensible clothing is used at all times.
Rabies:
***************************************
Tourists should avoid all animals as this viral disease is transmitted through the bite, lick or scratch of any infected warm blooded animal. In Israel the most common animals involved are foxes and jackals and in Jordan, dogs tend to be the main culprits.
Exploring the Region:
***************************************
Leaving the main tourist routes is unwise. There are a number of security risks which have to be considered and there are also significant health concerns which may be encountered. In July 2000 an 18 year old American tourist died of sunstroke when she became separated from her group in the Dead Sea region of Israel. Those exploring caves and parts of the desert areas also run the risk of diseases like Borreliosis and Rabies.
Walking & Trekking:
***************************************
For many going to these countries their trip will involve visiting some of the major ruins and archeological sites. This will involve a good deal of walking and trekking. Good supporting foot wear is essential and it would be wise to carry a crepe bandage in case of a sprained ankle. Having a suitable painkiller or anti-inflammatory medication would also be advantageous. Check your health will be up to the journey.
Swimming:
***************************************
Pools are usually very well maintained and the risk of disease is small. Those swimming in the sea should remember that the Mediterranean is home to many jelly fish. Swim with others and never alone and especially after alcohol or a heavy meal.
Anthrax:
***************************************
This bacterial disease is rare in the Middle east though travellers should be aware that it can be transmitted through unprepared leather goods usually bought in the local market places. Typically the disease may then present with a black ulcerated skin lesion.

Malaria:
***************************************
Fortunately this disease does not occur in Israel or Jordan. However other mosquito and sandfly diseases do occur and so protection against their bites should be used when necessary.
Hepatitis:
***************************************
There are many forms of this disease but the most common is Hepatitis A, often known as Infectious Jaundice. This disease can keep an infected individual off work for many weeks and it is wise to consider vaccination cover before exposure. In Israel approx 65% of the population will have been infected before 18 years of age.
Vaccinations:
***************************************
There are no essential vaccines for entry/exit however most Irish tourists are recommended to receive cover against; Poliomyelitis, Typhoid, Tetanus and Hepatitis A. Those living in these countries or planning an extended trip should also consider cover against Hepatitis B and Rabies.
Summary:
***************************************
Due to the unrest within Israel there are concerns regarding the safety of tourists at this time. If you are travelling to this region it is wise to ensure that your insurance policy is sufficient if your circumstances or travel plans change.

Travel News Headlines WORLD NEWS

Date: Wed, 6 Nov 2019 15:31:58 +0100 (MET)

Amman, Nov 6, 2019 (AFP) - Eight people, including four tourists, were wounded in a knife attack on Wednesday at the famed archeological site of Jerash in northern Jordan, a security spokesman told AFP.   Four tourists -- three Mexicans and a Swiss woman -- were wounded, along with a Jordanian tour guide and a security officer who tried to stop the assailant, public security directorate spokesman Amer Sartawi said.   The attack took place around noon (1000 GMT) at the Roman ruins of Jerash, a popular attraction 50 kilometres (30 miles) from the capital Amman.   The health ministry confirmed that eight people had been wounded, with Sartawi saying earlier that they had "been transported to hospital for treatment".    He said the assailant had been arrested but did not specify his nationality, noting that the motive was as yet unknown.

Jordanian tour guide Zouheir Zreiqat was at the scene and told AFP that the attack happened "just before midday when around 100 foreign tourists" were at the site.    "A bearded man in his twenties wearing black and brandishing a knife started to stab tourists," according to Zreiqat.   He said others started to shout for help and he, along with three other tour guides and three tourists managed to stop the assailant.   "We chased him until we could grab him and get him on the ground," Zreiqat said.    "We took the knife from him. He stayed silent, without saying a word until the police arrived and arrested him."

- Violent attacks -
It was not the first time tourist sites have been targeted by attacks in Jordan.    In December 2016, in Karak, home to one of the region's biggest Crusader castles, 10 people were killed in an attack that also left 30 wounded.    Seven police officers, two Jordanian civilians and a Canadian tourist were killed in the attack.

The attack was claimed by the Islamic State group (IS) and sparked concern over its impact on tourism, a mainstay of the Jordanian economy.    Ten people were convicted of carrying out the attack, with two sentenced to death.   Several violent incidents struck the country the same year, including a suicide attack in June claimed by IS that killed seven Jordanian border guards near the frontier with Syria.    Amman has played a significant role in the United States-led coalition fight against IS in Syria and Iraq, both neighbouring Jordan.

- Economic troubles -
Lacking in natural resources, the country of nearly 10 million depends on tourism and the kingdom has been working to pull the key sector out of a crisis caused by regional unrest in recent years.   Jordan's economy as a whole was hit hard by the combined impact of the international financial crisis, the Arab Spring uprisings that convulsed the Middle East in 2011 and the conflict in Syria.

Tourism accounts for 10 to 12 percent of gross domestic product and the government aims to double this by 2022, former tourism minister Lina Annab told AFP in an interview last year.  The country boasts 21,000 archaeological and historical sites that span millennia, according to the tourism board.   They include the Roman ruins of Jerash, the ancient city of Petra, the Dead Sea and Wadi al-Kharrar, or Bethany Beyond the Jordan, where some believe Jesus was baptised.   Jordan welcomed seven million tourists in 2010, but arrivals plunged to around three million in each of the following two years, tourism board head Abed Al Razzaq Arabiyat said in April.    Numbers have rebounded as spillover from the war in neighbouring Syria has abated, officials have said, with the government working to bring annual tourist arrivals back up to 7 million by 2020.
Date: Mon 26 Apr 2019, 3:51 PM
Source: Roya News [edited]

The initial results of the laboratory specimens of the food poisoning cases in Raymon town, west of Jarash revealed that _E. coli_ bacteria was the cause of the poisoning. The reports indicated that the bacterium was found in samples taken from water tanks in a bakery and restaurant during inspections conducted by teams of the Ministry of Health, the Ministry of Environment and the Jordan Food and Drug Administration (JFDA).

The report said that 5 people were referred to hospital on [Sat 24 Aug 2019], where it was suspected that they have food poisoning. The Ministry of Health had then sent an investigation committee to take water samples, after it was thought that the poisoning was caused by water that people used from 2 water stations.

Water samples were also taken from houses of people who suffered poisoning, 2 restaurants and a bakery. However, the bacteria were found in one of the restaurants and the bakery.

So far, 49 cases were referred to the Comprehensive Health Center, while 22 were referred to Jarash Government Hospital, where 7 of which left the hospital.

Preliminary results of the water samples taken from the 2 stations showed that water is clear of any kind of bacteria. The restaurant and bakery were closed down.
=======================
[_E. coli_ contamination does not necessarily mean that the organism was the cause of the illnesses as the observation can just reflect human faecal contamination and other pathogens including viruses, parasites and other bacteria may be involved. - ProMED Mod.LL]

[HealthMap/ProMED map available at:
Date: Sat, 10 Nov 2018 16:22:28 +0100

Amman, Nov 10, 2018 (AFP) - Flash floods killed 12 people in Jordan and forced nearly 4,000 tourists to flee the famed ancient desert city of Petra, emergency services said on Saturday.   Search teams were scouring valleys near the historic hill town of Madaba for a young girl who was still missing after Friday's floods, civil defence spokesman Iyad Amru told state television.

Among those confirmed dead after torrential rains swept the south of the kingdom were six people found in the Madaba area southwest of the capital Amman.   To the east, three people were killed near Dabaa on the Desert Highway, one of Jordan's three main north-south arteries, while one was killed near Maan in the south.    It was not immediately clear where the other two died.   Amru said two girls had gone missing in the Madaba region, later announcing that one of their bodies had been found.

Government spokeswoman Jumana Ghneimat said authorities had found alive four Israeli tourists who had gone missing in the Wadi Rum desert in southern Jordan but were looking for two more.   "Our embassy in Tel Aviv contacted the Israeli foreign ministry for information on the identities of the missing Israelis," Ghneimat said in statements carried by the state news agency Petra.   Israel initially confirmed the report but in a later update a spokesman for the foreign ministry said that "all the Israelis in Jordan have contacted us. All of them were found".

- Tourists evacuated -
The Jordanian army deployed helicopters and all-terrain vehicles to help with search and rescue operations after floodwaters cut off the Desert Highway in both directions.   A rescuer was also among the dead, the civil defence spokesman said.   State television said the waters had reached as high as four metres (13 feet) in parts of the red-rock ravine city of Petra and the adjacent Wadi Musa desert.

It broadcast footage of tourists sheltering on high ground on both sides of the access road to Jordan's biggest attraction.   The government spokeswoman said 3,762 tourists were evacuated.   Designated a UNESCO World Heritage site in 1985, Petra draws hundreds of thousands of tourists a year to its rock-hewn treasury, temples and mausoleums.   Its buildings have been used as sets for several Hollywood blockbusters including "Indiana Jones and the Last Crusade".   Wadi Rum, also a UNESCO World Heritage site, has attracted generations of tourists with its spectacular sandstone and granite rock formations.   Its landscapes served as a backdrop in the filming of the Hollywood classic "Lawrence of Arabia".

The latest deaths come after October 25 flash floods in the Dead Sea region of the kingdom killed 21 people, most of them children on a school trip.   Jordan's education and tourism ministers both resigned last week over failings in the government's response to those floods.   The education ministry ordered schools closed nationwide on Saturday amid warnings of more heavy rains.   Jordan's minister of water and irrigation, Raed Abu al-Saoud, said on Saturday that the country's 14 main dams had filled up by some 26 percent of full capacity in the past 48 hours because of the torrential rains.   Jordan is a water-poor country that is 90 percent desert.
Date: Fri, 26 Oct 2018 11:36:00 +0200

Amman, Oct 26, 2018 (AFP) - At least 20 people, most of them school pupils, have been killed in flash floods in Jordan, the emergency services said Friday in an updated toll.   A further 35 people were injured following heavy rains on Thursday, including members of the security forces involved in rescue operations, said an official from the civil defence -- Jordan's fire service -- who asked not to be named.   He said rescuers were still searching for people missing in the area, a popular tourist attraction around 50 kilometres (30 miles) west of Amman.   "Most of the dead were schoolchildren aged 11 to 14 who were taking part in a school trip to the Dead Sea region" when their bus was swept away by floodwaters.   Also among the dead were passers-by who had been picnicking in the area, he said, adding that a nearby bridge had collapsed.   "Security force personnel who were taking part in the rescue operations were among the injured," he added.

The Dead Sea, the lowest point on earth, is surrounded by steep valleys and gullies that frequently see flash floods and landslides.   Education Minister Azmi Mahafzah promised a "full inquiry" into the schoolchildren's deaths.   He said the bus took a route not agreed upon by the ministry and the organiser of the trip bore full responsibility.   Roads leading to the area were closed on Friday morning "to allow the continuation of search and rescue operations", the Directorate of General Security said.   The Israeli military said on Thursday it was helping with the operation, sending helicopters and forces specialised in search and rescue.   Jordanian television reported that King Abdullah II had cancelled a planned visit to Bahrain to monitor developments.
Date: Tue 26 Sep 2017
Source: Jordan Times [edited]

Following a rise in hepatitis A cases among school students in Mafraq's Akeider area, the president of the Lower House's Health Committee, Ibrahim Bani Hani, has called for more governmental attention to the area, which "has suffered negligence for so long".

The Ministry of Health has recorded 32 cases of Hepatitis A in students from the Akeider area, in Mafraq Governorate, since [22 Aug 2017]. Hepatitis A is a liver disease caused by a virus transmitted through contaminated food or water, inadequate sanitation and poor personal hygiene, the Health Ministry's spokesperson, Hatem Azrui, told The Jordan Times.

Bani Hani visited Akeider 2 months ago, along with other officials and the Lower House's Environmental Committee, to examine the impacts of the landfill in Akeider on the environment and the health of its citizens. "There is no doubt that hepatitis A has spread in the area due to a lack of hygiene in health and public facilities," he stated.

Mafraq health director at the Ministry of Health, Hani Oleimat, said that the disease is not epidemic and that the rate of [past] infection in adults amounts to over 90 percent.

Azrui said that the ministry has conducted experiments on the water sources at schools and homes and noted that no signs of the virus were found. He said that the disease is spread through sharing personal items like towels at public health facilities.

For his part, Bani Hani stressed that the area is lacking a health centre, which the ministry had promised to build, but noted that "no real measures were taken". He also said that the area suffers from other issues such as the emission of phenol gas from Akeider landfill and the increased number of stray dogs, a potential source of rabies.

Oleimat noted that since the discovery of the cases, no schools have stopped working in the area and noted that the ministry urged the school staff to direct any suspected case to the health directorate, in order to provide the infected students with a 7- to 10-day sick leave. The sickness needs no medication other than rest, Oleimat highlighted, noting that the body of the infected person naturally generates immunity  against the virus.  [Byline: Sawsan Tabazah]
==================
[This is a completely preventable disease using the inactivated hepatitis A vaccine. In the developing world, it is seen primarily in children and by adulthood, almost all individuals are immune. Most infections in children are asymptomatic so a cluster of 32 cases, so far here, implies a great deal more total infections. - ProMED Mod.LL]

[A HealthMap/ProMED-mail map can be accessed at:
More ...

World Travel News Headlines

Date: Wed, 22 Jan 2020 17:37:27 +0100 (MET)
By Helen ROXBURGH

Beijing, Jan 22, 2020 (AFP) - A new SARS-like virus has killed 17 people in China, infected hundreds and reached as far as the United States, with fears mounting about its spread as hundreds of millions travel for Lunar New Year celebrations, which start Friday.   Many countries have stepped up screening of passengers from Wuhan, the Chinese city identified as the epicentre, and the World Health Organization has called an emergency meeting.   Here's what we know so far about the virus:

- It's entirely new -
The pathogen appears to be a never-before-seen strain of coronavirus -- a large family of viruses that can cause diseases ranging from the common cold to Severe Acute Respiratory Syndrome (SARS), which killed 349 people in mainland China and another 299 in Hong Kong between 2002 and 2003.   Arnaud Fontanet, head of the department of epidemiology at the Institut Pasteur in Paris, told AFP the current virus strain was 80 percent genetically identical to SARS.   China has already shared the genome sequencing of this novel coronavirus with the international scientific community.   It has been named "2019-nCoV".

- It's being passed between humans -
The WHO said Monday it believed an animal source was the "primary source" of the outbreak, and Wuhan authorities identified a seafood market as the centre of the epidemic.   But China has since confirmed that there was evidence the virus is now passing from person to person, without any contact with the now-closed market.

The virus has infected more than 400 people across the country, with most cases in Wuhan, according to officials. Li Bin of China's National Health Commission on Wednesday said 1,394 people were still under medical observation.   Doctor Nathalie MacDermott of King's College London said it seems likely that the virus is spread through droplets in the air from sneezing or coughing.   Doctors at the University of Hong Kong published an initial paper on Tuesday modelling the spread of the virus which estimated that there have been some 1,343 cases in Wuhan -- similar to a projection of 1,700 last week by scientists at Imperial College, London.   Both are much higher than official figures.

- It is milder than SARS -
Compared with SARS, the symptoms appear to be less aggressive, and experts say the death toll is still relatively low.   "It's difficult to compare this disease with SARS," said Zhong Nanshan, a renowned scientist at China's National Health Commission at a press conference this week. "It's mild. The condition of the lung is not like SARS."   However, the milder nature of the virus can also cause alarm.

The outbreak comes as China prepares for the Lunar New Year Holiday, with hundreds of millions travelling across the country to see family.   Professor Antoine Flahault, director of the Institute of Global Health at the University of Geneva, told AFP that the fact that the virus seems milder in the majority of people is "paradoxically more worrying" as it allows people to travel further before their symptoms are detected.   "Wuhan is a major hub and with travel being a huge part of the fast approaching Chinese New Year, the concern level must remain high," said Jeremy Farrar, Director of the Wellcome Trust.

- International public health emergency? -
The WHO will hold a meeting on Wednesday to determine whether the outbreak constitutes a "public health emergency of international concern" and if so, what should be done to manage it.   Cases have so far been confirmed in Thailand, Japan, Taiwan, South Korea, Macau and the United States.

The WHO has only used the rare label a handful of times, including during the H1N1 -- or swine flu -- pandemic of 2009 and the Ebola epidemic that devastated parts of West Africa from 2014 to 2016.   The Chinese government announced Tuesday it was classifying the outbreak in the same category as the SARS outbreak, meaning compulsory isolation for those diagnosed with the disease and the potential to implement quarantine measures on travel.   But if the WHO decides to take this step, it would put the Wuhan virus in the same category as a handful of very serious epidemics.

- Global precautions -
As the number of confirmed deaths and infections has risen, so has concern worldwide about the disease spreading to other countries.   In Thailand, authorities have introduced mandatory thermal scans of passengers arriving at airports in Bangkok, Chiang Mai, Phuket and Krabi from high-risk areas in China.

In Hong Kong, where hundreds died during the SARS outbreak of 2002-2003, authorities have said they are on high alert, carrying out scans at the city's airport -- one of the world's busiest -- and at other international land and sea crossing points.

The United States also ordered the screening of passengers arriving on direct or connecting flights from Wuhan, including at airports in New York, San Francisco and Los Angeles.   Taiwan has issued travel advisories, and went to its second-highest alert level for those travelling to or from Wuhan. Vietnam has also ordered more border checks on its border with China.
Date: Wed, 22 Jan 2020 16:53:32 +0100 (MET)
By Beiyi SEOW

Beijing, Jan 22, 2020 (AFP) - The death toll from a new SARS-like virus that has infected hundreds in China rose to 17 on Wednesday, as authorities urged people to steer clear of the city at the centre of the outbreak.   The coronavirus has caused alarm because of its similarity to SARS (Severe Acute Respiratory Syndrome), which killed nearly 650 people across mainland China and Hong Kong in 2002-2003.   With hundreds of millions of people travelling across China this week for the Lunar New Year holiday, the National Health Commission announced measures to contain the disease -- including sterilisation and ventilation at airports and bus stations, as well as inside planes and trains.

In Wuhan, the epicentre of the epidemic, large public events were cancelled and international football matches were moved to a new location. Visitors were urged to stay away, while residents were advised to not to leave the central city, which is home to 11 million people.   "If it's not necessary we suggest that people don't come to Wuhan," Wuhan Mayor Zhou Xianwang told state broadcaster CCTV.    The illness is mainly transmitted via the respiratory tract and there "is the possibility of viral mutation and further spread of the disease", health commission vice minister Li Bin told a news conference in Beijing.   More than 500 cases have now been reported, with the majority in Wuhan, capital of Hubei province.

The virus has now infected at least 444 people in Hubei province alone, said provincial officials at a press conference, adding that the death toll had risen from nine to 17.   Major cities, including Beijing, Shanghai, and Chongqing have also reported cases, as well as provinces in northeastern, central, and southern China.   The World Health Organization started an emergency meeting Wednesday to decide whether or not to declare a rare global public health emergency over the disease, which has now been detected in the United States, Taiwan, Thailand, Japan, South Korea and Macau.

The Chinese government has classified the outbreak in the same category as the SARS epidemic, meaning compulsory isolation for those diagnosed with the illness and the potential to implement quarantine measures.   But they still have not been able to confirm the exact source of the virus.   "We will step up research efforts to identify the source and transmission of the disease," Li said, adding that "the cases are mostly linked to Wuhan".   Countries have intensified efforts to stop the spread of the pathogen -- known by its technical name 2019 Novel Coronavirus (2019-nCoV).   Passengers are facing screening measures at five US airports and a host of transport hubs across Asia. Britain and Italy on Wednesday also announced enhanced monitoring of passengers from Wuhan.

- Virus source -
A prominent expert from China's National Health Commission confirmed this week that the virus can be passed between people.   However, animals are suspected to be the primary source of the outbreak.   A Wuhan market is believed to be the epicentre of the outbreak.

A price list circulating online in China for a business there lists a menagerie of animals or animal-based products including live foxes, crocodiles, wolf puppies and rats. It also offered civets, the animal linked to SARS.   "We already know that the disease originated from a market which conducted illegal transaction of wild animals," said Gao Fu, director of the Chinese centre for disease control and prevention.   He said it was clear "this virus is adapting and mutating".   Hong Kong and British scientists have estimated that between 1,300 and 1,700 people in Wuhan may have been infected.

- Containment -
Health authorities are urging people to wash their hands regularly, avoid crowded places, get plenty of fresh air and wear a mask if they have a cough.   Anyone with a cough or fever was urged to go to hospital.   In Wuhan, city authorities made it mandatory to wear a mask in public places on Wednesday, according to state-run People's Daily.

In response to skyrocketing demand for masks -- which were starting to sell out at pharmacies and on some popular websites -- China's industry and information technology ministry said it would "spare no effort in increasing supply", state media reported.   "These days, I wear masks even in places that are not too crowded, although I wouldn't have done so in the past," said Wang Suping, 50, who works at a Beijing arts school.   At the capital's main international airport, the majority of people were wearing masks.

Hong Kong flag carrier Cathay Pacific said it had agreed to allow staff to wear surgical masks on mainland China flights, and that passengers from Wuhan would be offered masks and antiseptic wipes.   In Wuhan, police were conducting vehicle spot checks for live poultry or wild animals leaving and entering the city, state media said.   Officials also screened people on roads, the airport and the train station for fever.   The local government has cancelled major public activities and banned tour groups from heading out of the city.   Women's Olympics football qualifiers scheduled for February 3-9 in Wuhan have been moved to the eastern city of Nanjing.
Date: Wed, 22 Jan 2020 15:49:25 +0100 (MET)

Montreal, Jan 22, 2020 (AFP) - A Canadian guide died and five French tourists were missing after at least one snowmobile plunged through ice in northern Quebec, police said Tuesday.   The group were riding close to where a river exits the Saint-Jean lake, and were outside the approved area for snowmobiles, police spokesman Hugues Beaulieu told AFP.   Nine people, including the guide, were on the trip on Tuesday evening when the ice broke underneath them.   Police said they were alerted by two of the tourists who had rescued a third tourist from the freezing water.

The 42-year-old guide was pulled out by emergency response teams and taken to hospital, but he died overnight, Beaulieu said, adding "five French tourists are still missing."   The police and army were searching the area on Wednesday, assisted by divers.   "This sector was not part of a marked trail, they were off-piste," said the spokesman.
Date: Wed, 22 Jan 2020 04:55:57 +0100 (MET)

Hong Kong, Jan 22, 2020 (AFP) - Macau on Wednesday reported its first confirmed case of the new SARS-like coronavirus as authorities announced all staff in the city's bustling casinos had been ordered to wear face masks.   The former Portuguese colony is a huge draw for mainland tourists as the only place in China that allows gambling.

With the Lunar New Year approaching this weekend, a huge influx of mainland tourists is expected in the city.   Asian countries have ramped up measures to block the spread of the new virus, which emerged in the Chinese city of Wuhan and has so far killed at least nine people.

On Wednesday, Macau announced its first confirmed case -- a 52-year-old businesswoman from Wuhan who arrived in the city by high-speed rail on Sunday, via the neighbouring city of Zhuhai.    "A series of tests found that she was positive for the coronavirus and had symptoms of pneumonia," Lei Chin-lon, the head of Macau's health bureau, told reporters.    The woman had been staying at the New Orient Landmark Hotel with two friends who were being monitored since her admission to hospital on Tuesday.

Ao Ieong Iu, Macau's Secretary for Social Affairs and Culture, said staff in all casinos would be required to wear masks while anyone arriving at entry ports along the city's border with the mainland would need to fill out health declaration forms.    "We have not banned tourism groups from Wuhan but we are not encouraging them," Ao Ieong said.    "We will stay in close contact with tourism agencies and require them to notify us of all groups going to and coming from Wuhan," she added.
Date: Tue, 21 Jan 2020 22:23:22 +0100 (MET)
By Issam Ahmed with Helen Roxburgh

Washington/Beijing, Jan 21, 2020 (AFP) - The United States on Tuesday announced its first case of a new virus that has claimed six lives in China and sickened hundreds, joining countries around the world in ramping up measures to block its spread.   The man, a US resident in his 30s who lives near Seattle, is in good condition, according to federal and state officials, and approached authorities himself after reading about the SARS-like virus in news reports.   He is "currently hospitalized out of an abundance of precaution, and for short term monitoring, not because there was severe illness," said Chris Spitters, a Washington state health official.  "This is an evolving situation and again, we do expect additional patients in the United States and globally," added Nancy Messonier, a senior official at the Centers for Disease Control and Prevention (CDC), but stressed that the overall risk to Americans remained low.

The man entered the country on January 15 after traveling to Wuhan, two days before the US began deploying health officials at major airports to screen passengers arriving from that central Chinese city which is at the heart of the outbreak. The efforts are to be extended now to a total of five US airports.   It came as countries ramped up measures to block the spread of the virus -- known by its technical name 2019 Novel Coronavirus or 2019-nCoV -- as the number of cases surpassed 300, raising concerns in the middle of a major Chinese holiday travel rush.

Fears of a bigger outbreak rose after a prominent expert from China's National Health Commission confirmed late Monday that the virus can be passed between people.   That conclusion is shared by the CDC, which said "person-to-person spread is occurring, although it's unclear how easily the virus spreads between people," even as the World Health Organization (WHO) adopted a more cautious approach, saying it is still investigating.   The UN agency will hold an emergency meeting Wednesday to determine whether to declare a rare global public health emergency over the disease, which has also been detected in Thailand, Japan and South Korea and Taiwan.

- Holiday rush -
Authorities previously said there was no obvious evidence of person-to-person transmission and animals were suspected to be the source, as a seafood market where live animals were sold in Wuhan was identified as the center of the outbreak.   Hundreds of millions of people are criss-crossing China this week in packed buses, trains and planes to celebrate the Lunar New Year with relatives.

More than 80 new cases have been confirmed, bringing the total number of people hit by the virus in China to 315, with the vast majority in Hubei, the province where Wuhan lies, according to officials.   But cases have also been confirmed around the country, including Beijing and Shanghai.   The first case on the self-ruled island of Taiwan was also confirmed Tuesday, with a woman taken to hospital on arrival at the airport from Wuhan.   Wuhan mayor Zhou Xianwang told state broadcaster CCTV Tuesday that the death toll had risen from four to six.   The coronavirus has caused alarm because of its genetic similarities to Severe Acute Respiratory Syndrome (SARS), which killed nearly 650 people across mainland China and Hong Kong in 2002-2003.

- Fever checks -
At four airports in Thailand, authorities introduced mandatory thermal scans of passengers arriving from high-risk areas of China.   In Hong Kong, authorities said they were on "extreme high alert," with passengers from Wuhan required to fill out health declarations and face possible jail time if they do not declare symptoms.   Enhanced screening measures have also been set up at airports in Australia, Bangladesh, Nepal, Singapore and Russia, Malaysia and Vietnam.   A man showing symptoms of the disease who had travelled to Wuhan has been put in isolation in Australia as health officials await test results, authorities said Tuesday.   In China, the government announced it was classifying the outbreak in the same category as SARS, meaning compulsory isolation for those diagnosed ith the disease and the potential to implement quarantine measures on travel.

In Wuhan, authorities banned tour groups and police were conducting spot checks for animals in vehicles leaving and entering the city, state media said.   It added that city health authorities had scheduled 800 beds to be made available in three hospitals and 1,200 more would soon be ready, and passengers were being screened for fever at the airport, railway stations and bus terminals.   Doctors at the University of Hong Kong released a study on Tuesday estimating that there have been 1,343 cases of the new virus in Wuhan.   The WHO has only called a global public health emergency a handful of times, including during the H1N1 -- or swine flu -- pandemic of 2009 and the Ebola epidemic that devastated parts of West Africa from 2014 to 2016.
Date: Tue, 21 Jan 2020 20:58:18 +0100 (MET)

Lima, Jan 21, 2020 (AFP) - Peru is installing security cameras at its world renowned Machu Picchu site after it was damaged earlier this month by foreign tourists, authorities said Tuesday.   "We are going to strengthen security at Machu Picchu by installing high-tech cameras," Jose Bastante, head of the archaeological park, told AFP.   Bastante said 18 cameras will be located at three strategic points of the citadel as well as access points from surrounding mountains.   "This will allow us to better control visitors and avoid any action or infraction to the regulations, also any type of risk," he said, adding that drones were also being used for security.

Five tourists accused of damaging the iconic site were deported to Bolivia last week and barred from returning to the country for 15 years.    A sixth, from Argentina, was fined $360 and must pay $1,500 to the culture ministry for repairs after he admitted to damaging the Temple of the Sun at the ancient Inca sanctuary.

The Argentine, 28-year-old Nahuel Gomez, also received a suspended sentenced of three years and four months, but can leave the country once the fines are paid.   Gomez admitted to causing a stone slab to fall from a temple wall. It was chipped when it fell, causing a crack in the floor.   "The damaged caused is significant. The integrity of Machu Picchu has been broken," Bastante said.   Members of the group were also suspected of defecating inside the 600-year-old temple.

The Machu Picchu complex -- which includes three distinct areas for agriculture, housing and religious ceremonies -- is the most iconic site from the Inca empire, which ruled over a large swath of western South America for 100 years before the Spanish conquest in the 16th century.   Machu Picchu, which means "old mountain" in the Quechua language indigenous to the area, is at the top of a lush mountain and was built during the reign of the Inca emperor Pachacuti (1438-1471).
Date: Tue, 21 Jan 2020 17:28:23 +0100 (MET)

Johannesburg, Jan 21, 2020 (AFP) - Beleaguered national airline South African Airways (SAA) announced on Tuesday it was cancelling 10 domestic and one international flight in an effort to streamline services and save cash.   The cash-strapped airline was last month placed under a state-approved business rescue plan to avoid total collapse following a costly week-long strike by thousands of its workers.   SAA said in was dropping 10 domestic flights between Johannesburg, Cape Town and Durban, while canning its direct route between Johannesburg and Munich.

Passengers on cancelled domestic flights will be accommodated on its budget sister airline, Mango, while international travellers would be re-routed via its flights between Johannesburg and Frankfurt, and London Heathrow.   "These decisions are in line with SAA's usual policy of reviewing flights and consolidating services with low demand," it said in a statement.   "Furthermore, during the current process of business rescue, these cancellations represent a responsible strategy to conserve cash and optimise the airline's position ahead of any further capital investment."

The company said there might be further flight schedule changes over the coming days.   Aviation analyst Phuthego Mojapele said a spate of cancellations by clients were exacerbating problems for SAA.   "At the moment SAA's perception out there ... it's not really looking good because there is negative news that is being perpetuated on the wires every single day," Mojapele told local television station, eNCA.   "However, SAA's records in terms of safety, in terms of the service has always been excellent," he added.

The debt-ridden carrier, which has failed to make a profit since 2011 and survives on government bailouts, has been awaiting a two-billion rand ($138 million) payout from the Treasury to fund a rescue plan announced in December.   Finance Minister Tito Mboweni last week told journalists that the government was still trying to "find a solution to finance the airline".    Local media have reported that SAA is selling nine older aircraft to make way for new planes, part of a separate plan to rid itself of its most costly aircraft.   SAA, Africa's second largest airline after Ethiopian Airlines, employs more than 5,000 workers. It has a fleet of more than 50 aircraft flying to more than more 35 domestic and international destinations.
Date: Tue, 21 Jan 2020 12:26:16 +0100 (MET)

Taipei, Jan 21, 2020 (AFP) - Taiwan on Tuesday reported its first confirmed case of the new SARS-like coronavirus as the government warned the public against travelling to Chinese city where it emerged.    The patient is a Taiwanese woman in her fifties, living in Wuhan, who returned to the island on Monday with symptoms including fever, coughing and a sore throat.   Asian countries have ramped up measures to block the spread of the new virus as the death toll in China rose to six and the number of cases jumped to almost 300 since it first emerged in the central Chinese city of Wuhan.

The Taiwan patient reported her symptoms to quarantine officials on arrival at Taoyuan airport and was immediately taken to a hospital for treatment, said the island's Centers for Disease Control (CDC).    The woman told officials that she had not visited any local markets or had contact with birds or wild animals while in Wuhan.    Authorities are monitoring some 46 passengers and crew from the same flight, the agency said.

The CDC raised its alert on Wuhan to the highest level, urging the public against travelling to the city unless necessary.    "We ask the public not to panic as the individual was taken to hospital directly from the airport and did not step into the community," it said in a statement, adding that it reported the case to the World Health Organization and China authorities.   The coronavirus has spread to Thailand, Japan, South Korea and Taiwan.
Date: Tue, 21 Jan 2020 12:08:14 +0100 (MET)

Kathmandu, Jan 21, 2020 (AFP) - Eight Indian tourists, including four children, have died after they were found unconscious in their room at a hill resort in Nepal on Tuesday, police said.   The eight -- two couples and their children -- had slept in one room at a hotel in Daman, a popular tourist destination in Makwanpur district about 55 kilometres (34 miles) from Kathmandu.   "They were found unconscious this morning and airlifted to Kathmandu but died during treatment," police spokesman Shailesh Thapa Chettri told AFP.

The families, from the south-eastern state of Kerala, used a gas heater in their room to keep warm, a district official told AFP.   "We suspect they died of suffocation, but autopsy reports will confirm the cause," Chettri added.   India is Nepal's biggest source of tourists, making up some 16 percent of visitors to the Himalayan nation.
Date: Sun, 19 Jan 2020 14:17:42 +0100 (MET)

Kathmandu, Jan 19, 2020 (AFP) - Avalanches, heavy snow and poor visibility hampered the search Sunday for four South Koreans and three Nepalis caught in an avalanche in the popular Annapurna region of the Himalayas, officials said   Relatives of the missing Koreans have arrived in Kathmandu alongside several officials sent by Seoul to help with the emergency rescue efforts, Ang Dorjee Sherpa of the Korean Alpine Federation told AFP.

The missing group was near the Annapurna base camp around 3,230 metres (10,600 feet) above sea level when the avalanche struck after heavy snowfall on Friday.   "Our team reached the area but could not proceed with their search because of more avalanches. We are exploring ways to move the operation forward," said Mira Acharya from Nepal's tourism department.

Rescuers were working with Korean officials to deploy drones in the search on Monday, said Dilip Gurung of the tourism management committee in Chhomrong, which lies on the trekking route.   "It is difficult for people to go. We will try to fly drones to help find something," Gurung said.   Helicopters were sent out on Saturday to rescue about 200 people stranded around Annapurna and other nearby mountains after the incident.

Guesthouses and the trekking route were blanketed in a thick layer of snow.   "The snow was very deep and it took us more than double the time to dig through and walk," said Jeevan Dahal, a guide who was rescued by helicopter.   "We saw the avalanche-hit area from the helicopter. Everything was white."   Tek Gurung, a guesthouse owner aiding the search operation, said more than two metres of snow (6.6 feet) had fallen on the trekking trails and it was "extremely difficult" to search the snow-covered area on foot.

Six of the missing were part of the same expedition, while one Nepali porter was escorting a different group.   The four foreigners -- two men and two women -- were part of an 11-member team of South Korean nationals. Others have safely descended.    Education officials in Seoul said they were part of a team of volunteer teachers working with children in Nepal.

Two more South Koreans were due to arrive in Nepal on Sunday to help with the search, the country's foreign ministry said.   Sherpa said it had snowed heavily around Annapurna in recent days, making the trek risky.   "The weather and snow got worse and, feeling it was becoming dangerous and difficult, they decided to turn. As they were heading back the avalanche hit," Sherpa told AFP on Saturday.

Annapurna is an avalanche-prone and technically difficult mountain range with a higher death rate than Everest, the world's highest peak.    Thousands of trekkers visit the route every year for its stunning views of the Himalayas.   A snowstorm killed about 40 people on the circuit in 2014, in one of the biggest trekking tragedies to hit Nepal.