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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

Date: Sun, 22 Mar 2020 18:02:51 +0100 (MET)

Athens, March 22, 2020 (AFP) - Greece will impose a nationwide lockdown to stem the spread of the coronavirus, limiting people to their homes except for essential outings, Prime Minister Kyriakos Mitsotakis said Sunday.    "I have given orders that all appropriate action be taken to enforce the ban on all unnecessary movement across the country," Mitsotakis said in a televised address to the nation.   The restrictions will come into force from 6:00 am local time (0400 GMT) on Monday, and will require citizens to carry proof of identity to leave their homes. 

Outings are only permitted for people "going to work, the doctor, or to visit someone who needs help, or those who are buying food or medication", the prime minister said.    Citizens are also permitted to leave the house to walk their pets or exercise outdoors alone or with one other person.

There are 15 recorded deaths and 624 infections from the coronavirus in Greece, which has a population of 11 million.    Since reporting its first death from the virus on March 12, the country has gradually rolled out measures to limit gatherings and non-essential travel along with closing schools, shops and entertainment venues.
Date: Sat, 21 Mar 2020 10:59:18 +0100 (MET)

Athens, March 21, 2020 (AFP) - A strong 5.6 magnitude earthquake struck early Saturday in northwest Greece, damaging property in the city of Parga, authorities said.   The quake struck at 0049 GMT (0249 local time), with the epicentre 11 kilometres (around six miles) from Parga in Kanalaki district, and 316 kilometres northwest of Athens, the Athens geodynamic observatory said.   "No casualties have been reported at the moment," Parga mayor Nikolas Zacharias told AFP by telephone.

"Some old abandoned houses in Kanalaki collapsed and some houses suffered significant damage in this district of 2,500 inhabitants," Zaharias said, adding the temblor was strong throughout the area.   Landslides partially damaged the region's roads, he added.   Greece lies on major fault lines and is regularly hit by earthquakes, but they rarely cause casualties.   In 2017, a 6.7-magnitude earthquake killed two people on the island of Kos in the Aegean sea, causing significant damage.   In 1999, a 5.9-magnitude quake left 143 people dead in Athens and the region northwest of the capital.
Date: Wed, 26 Feb 2020 09:33:48 +0100 (MET)

Athens, Feb 26, 2020 (AFP) - Greece has announced a broad shutdown of public areas and travel restrictions, to be activated in case of a coronavirus outbreak.   The measures, formalised in a decree late on Tuesday, include temporary travel bans to and from countries with a large number of infections.

The decree also permits the requisitioning of beds in hotels and private clinics.   It also foresees the temporary closure of "indoor public gathering areas" such as schools, places of worship, cinemas, theatres, sports halls and businesses.   "We are ready to do whatever is necessary to protect public health," government spokesman Stelios Petsas told reporters.   The country has so far registered no confirmed cases of the virus.   Greece's health ministry has earmarked 13 hospitals nationwide equipped to handle virus cases.

A health ministry spokesman earlier this week noted that owing to the virus' long gestation period, health checks at ports and airports had minor chances of success.   On Monday, the Greek Olympic Committee said it had discussed alternative plans for the Olympic Flame lighting ceremony for the Tokyo 2020 Games in case of a virus outbreak.

The flame for the Tokyo 2020 Olympics is scheduled to be lit on March 12 in ancient Olympia and, following a torch relay on Greek soil, will be handed to the Tokyo organisers at a ceremony on March 19 at the Panathenaic Stadium in Athens.
Date: Tue, 18 Feb 2020 09:07:42 +0100 (MET)

Athens, Feb 18, 2020 (AFP) - Greece was hit with a 24-hour strike Tuesday over a pension reform encouraging people to stay longer in the workforce.   The labour action paralysed public transport in Athens, intercity trains and ferry ship services.   Civil servants are also walking off the job and journalists will stage a three-hour work stoppage against the pension reform.   "This bill is practically the continuation of (austerity) laws introduced in 2010-2019," civil servants' union ADEDY said.

Unions will hold street protests in Athens, Thessaloniki and other major cities later in the day.   The new conservative government says the reform, to be voted by Friday, will make the troubled Greek pension system viable to 2070.   The labour ministry says the overhaul -- the third major revamp in a decade -- will contain pension increases and reduce penalties for pensioners still working.

Successive governments have attempted to reform the pension system, whose previously generous handouts are seen as one of the causes of the decade-long Greek debt crisis.   Chronic overspending and the inaccurate reporting of the budget deficit spooked creditors in 2010, and required three successive bailouts by the European Union and the International Monetary Fund to avert a Greek bankruptcy.   In return for billions of euros in rescue funds, Greece had to adopt unpopular austerity reforms and pension cuts.
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.
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Indonesia

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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
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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
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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
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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
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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;
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Poliomyelitis (childhood booster)
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Tetanus (childhood booster)
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Typhoid (food & water disease)
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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
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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: Fri, 27 Mar 2020 11:53:09 +0100 (MET)

Jakarta, March 27, 2020 (AFP) - Indonesia's coronavirus crisis is far worse than being officially reported and the government's response is "in tatters", the country's doctors association warned Friday as the death toll climbed to 87.   The world's fourth-most populous country only reported its first confirmed infection this month but by Thursday, that had ballooned to over 1,000.

Indonesia's 87 confirmed coronavirus deaths are the highest toll in Southeast Asia, with public health and diplomatic officials warning that its weak health system is being rapidly overwhelmed.   "The government's plans are in tatters and they appear to be avoiding a lockdown," said Indonesian Doctors' Association spokesman Halik Malik.   "Our health system is not as strong as other countries."

A London School of Hygiene & Tropical Medicine study warned this week that cases in Indonesia -- with a population of more than 260 million people -- could be vastly underreported.   The government's virus task force has estimated as many as 700,000 people were at risk of infection nationwide.   But the rate of testing has been low compared with many other countries -- only 2,300 tests were conducted before the government stopped announcing nationwide figures.

Authorities have come under heavy criticism for not imposing lockdowns in major cities, including the capital Jakarta, a vast city home to about 30 million where most of the deaths have been reported.   "The COVID-19 situation in Indonesia is very serious and getting worse quickly," the Canadian embassy in Jakarta said Thursday, saying it was urgently advising citizens to leave.    "The health care system in Indonesia will soon be overwhelmed. The ultimate number of fatalities will be very high."   Indonesia had fewer than four doctors for every 10,000 people, according to World Health Organization data from 2017.

In comparison, neighbouring Malaysia had about 15 doctors and Australia had 35 per 10,000 people.   Images shared on social media have shown Indonesian doctors threatening to go on strike if resources aren't beefed up, with concerns about a lack of ventilators, protective gear and other equipment needed to handle coronavirus cases.   At least seven doctors have died of the virus, according to the official figures.

In a tweet that went viral, the brother-in-law of one of those doctors slammed the Indonesian government's handling of the crisis.   "You were infected as you actively served people. Many health workers have been infected and left. The limited amount of protective equipment is hard to forgive," wrote Pandu Riono, a University of Indonesia public health expert.   The government has pledged to boost testing to upwards of one million checks as extra equipment and test kits are flown in from China.   It has also turned an athletes village built for the 2018 Asian Games into an emergency treatment centre to help ease the pressure on hospitals.
Date: Fri, 27 Mar 2020 09:24:46 +0100 (MET)

Jakarta, March 27, 2020 (AFP) - Indonesia's most active volcano Mount Merapi erupted Friday, shooting a column of ash some 5,000 metres (16,000 feet) into the air in its second major eruption this month.   Ash and sand covered areas several kilometres (miles) away from the peak of the rumbling crater near Indonesia's cultural capital Yogyakarta.   But authorities did not raise Merapi's alert level.   "There has been no reports of damage from the  eruption. We urge people to stay calm and not panic," national disaster mitigation agency spokesman Agus Wibowo said.   Merapi erupted earlier this month, shooting a massive ash cloud some 6,000 metres in the air.    That eruption coated Yogyakarta and neighbouring city Solo with grey dust and forced an airport closure.

Mount Merapi's last major eruption in 2010 killed more than 300 people and forced the evacuation of 280,000 residents.  That was Merapi's most powerful eruption since 1930, which killed around 1,300 people, while another explosion in 1994 took about 60 lives.    The Southeast Asian nation -- an archipelago of more than 17,000 islands and islets -- has nearly 130 active volcanoes.    It sits on the Pacific "Ring of Fire", a vast zone of geological instability where the collision of tectonic plates causes frequent quakes and major volcanic activity
Date: Tue, 3 Mar 2020 05:53:04 +0100 (MET)

Solo, Indonesia, March 3, 2020 (AFP) - Indonesia's most active volcano Mount Merapi erupted Tuesday, shooting a massive ash cloud some 6,000 metres (20,000 feet) in the air which coated nearby communities with grey dust and forced an airport closure.   Ash mixed with sand rained down on towns as far as 10 kilometres (six miles) from the belching crater near Indonesia's cultural capital Yogyakarta.   "There was a thundering noise for at least five minutes and I could see the ash clouds from my house," Jarmaji, a resident of Boyolali regency, told AFP.

Authorities did not raise the rumbling volcano's alert status, but they temporarily shuttered the international airport in Solo city -- also known as Surakarta -- some 40 kilometres away after the early morning eruption.   Indonesia's volcano agency warned residents to stay out of a three-kilometre no-go zone around Mount Merapi, citing possible danger from flowing lava and pyroclastic flows -- a fast-moving mixture of hot gas and volcanic material.

Mount Merapi's last major eruption in 2010 killed more than 300 people and forced the evacuation of some 280,000 residents.   That was Merapi's most powerful eruption since 1930, which killed around 1,300 people, while another explosion in 1994 took about 60 lives.   The Southeast Asian nation -- an archipelago of more than 17,000 islands and islets -- has nearly 130 active volcanoes.   It sits on the Pacific "Ring of Fire", a vast zone of geological instability where the collision of tectonic plates causes frequent quakes and major volcanic activity.
Date: Mon, 2 Mar 2020 08:33:07 +0100 (MET)
By Peter BRIEGER, Agnes ANYA

Denpasar, Indonesia, March 2, 2020 (AFP) - Bali's Galungan festival celebrates the triumph of good over evil, but a new enemy was threatening that cosmic balance this year -- coronavirus.   Temples across the Island of the Gods were filled with faithful who hoped incense-and-flower offerings would get Hindu-majority Bali back on its feet after a drastic slump in Chinese visitors hammered the key tourism sector.  "We're praying for good things in this universe and that the virus is gone soon so Bali's tourism can bounce back," priest Made Langgeng Buwana told AFP during the recent February Galungan celebration in the capital Denpasar.

Concerns over the rapidly-spreading outbreak prompted Indonesia to shut down all flights to and from China last month, dealing a body blow to scores of Bali businesses including restaurants, hotels, travel agents, wedding planners and Mandarin-speaking interpreters. Around a million Chinese tourists visit the holiday island each year -- the second-largest group of foreign arrivals after Australians -- and inject hundreds of millions of dollars into the local economy.    Thousands travelled there from the mainland for last month's Lunar New Year holiday just as the virus outbreak was beginning to snowball, prompting the lockdown of China's Hubei province where the infection was first detected.

- Ghost town? -
In Bali, some China-focused businesses have closed and others say they're on the brink of bankruptcy.   Management at one upscale hotel was so desperate to cut costs they told employees to wear street clothes on the job to reduce uniform cleaning expenses, according to staff.

Bali's tourism industry has suffered -- and recovered -- before, including when volcano Mount Agung erupted in 2018.   "There was a drop then but not something like this," said Robin, 29, an Indonesian interpreter who used to guide wealthy Chinese around the island.   Jakarta has announced more than $700 million in stimulus to bolster
Southeast Asia's biggest economy as its tourism sector takes a hit, while Bali officials hope social media influencers can help draw more visitors.

The island's tourism agency head Putu Astawa -- barely two months into his new job -- acknowledged that losing 100,000 Chinese visitors a month has stung.   But the number of visitors from Australia, Japan, North America and Europe is stable, despite unfounded reports that Bali is a ghost town, he insisted.   "I don't worry about the virus," Astawa said in an interview.   "I worry about social media hoaxes hurting the image of our tourism sector. I'm tired of fighting it."

- 'Fatally impacted' -
The ghost-town image isn't fake news at Dream Island Bali Beach Club, however.   Chinese tourists used to roll in for wedding photos, massages in thatched huts, beachside camel rides and a $17 'Dream Dinner' package with a fire-dance show.   The now-empty operation also ferried mainly Chinese visitors on boats to company-run restaurants nearby.

Those eateries are now closed, the ferries are beached and Dream Island is headed for bankruptcy with half the staff on leave, said manager Wayan Tirta.   "Now we're trying to get local students to come here because there aren't any tourists," he said, plunging his hand downward to show the drop in business.   "We've been fatally impacted by the outbreak and are just trying to stay afloat."   At Dream Island's deserted Mermaid Bay restaurant, Arik and two other staff played with their smartphones as a pair of unemployed camels lay in the sand nearby.   "We don't have anything to do. Hopefully we'll get some more guests," she said.

In Denpasar, OYO 1992 China Town Hotel -- draped in bilingual signage and a huge lobby painting of a woman with a Chinese-style fan --  is also feeling the pinch.   The hotel once employed scores of massage therapists who relied on mainland tourists, but that crucial moneymaker has dried up.   "Before coronavirus we were planning to add more massage beds," said manager Vincent Fonda in the hotel's empty Chinese food restaurant.   "At the end of the day, we're probably going to close down."
Date: Wed, 26 Feb 2020 09:03:45 +0100 (MET)

Jakarta, Feb 26, 2020 (AFP) - A strong 5.9 magnitude earthquake hit a remote part of eastern Indonesia Wednesday, the United States Geological Survey said, but there was no tsunami warning.   The undersea quake struck at a depth of some 61 kilometres (38 miles), about 280 kilometres southwest of the city of Tual in the archipelago's Maluku province.   The Southeast Asian country is one of the most disaster-prone nations on Earth.   In 2018, a 7.5-magnitude quake and a subsequent tsunami in Palu on Sulawesi island left more than 4,300 people dead or missing.
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Niue

No Profile is available at present

Travel News Headlines WORLD NEWS

20th July 2012

- Niue Island. 20 Jul 2012. Two tourists visiting Niue have been taken to hospital with dengue fever. More than 100 people, or about 8 percent of the population, are believed to be suffering from the fever, and visitors are being warned to use insect repellent during early morning and evening. Dengue, which does not often occur on Niue, has been afflicting  the island since February [2012]. It was originally confined to a small area of Niue's main village but has now spread throughout the island. One local man recently died from a serious form of the virus.
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[A HealthMap/ProMED-mail interactive map showing the location of Niue Island in the Pacific Ocean can be accessed at <http://healthmap.org/r/1ZWb>. - ProMed Mod.TY]
Monday 30th April 2012
A ProMED-mail post
<http://www.promedmail.org>

- Niue Island. 24 Apr 2012. The Niue Health Department says it believes the dengue outbreak has peaked. The department says there have been 47 recorded cases of dengue fever, but only one case has been picked up in the last 7 days. The Acting Director of Health, Manila Nosa, says it's a relief to see the wane in cases, but it's too early to say that dengue is completely gone. He said that there has been a lot of rain lately, and it's hoped this won't contribute to a further spread.
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[A HealthMap/ProMED-mail interactive map of Niue Island can be accessed at <http://healthmap.org/r/1ZWb>. - ProMed Mod.TY]
Monday 16th April 2012
A ProMED-mail post
<http://www.promedmail.org>

- Niue Island. 12 Apr 2012. Health authorities on Niue are confident that they are on top of the latest dengue outbreak that has infected 20 people to date. The chief medical officer, Dr Eddie Akau'ola, says this outbreak began about 3 weeks ago but they believe they have been able to contain it. He says it is peaking now and they expect a decline in a week or 2. Dr Akau'ola says none of the cases have been too serious.
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[A HealthMap/ProMED-mail interactive map showing the location of Niue Island in the Pacific can be accessed at <http://healthmap.org/r/2bMz>. - ProMed Mod.TY]
Tuesday 13th March 2012
A ProMED-mail post
<http://www.promedmail.org/>

- Niue Island. 6 Mar 2012. Niue health authorities are hopeful they've contained a rare outbreak of dengue fever on the island where 3 people were reported with dengue last week, with 2 admitted to hospital.
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[A HealthMap/ProMED-mail interactive map showing the location of Niue Island in the Pacific can be accessed at <http://healthmap.org/r/1ZWb>. - ProMed Mod.TY]
Date: Sun, 24 Jul 2011 10:42:49 +0200 (METDST)
by Neil Sands

ALOFI, Niue, July 23, 2011 (AFP) - In a once-thriving village on the Pacific island of Niue, homes lie abandoned, their stucco-clad walls mildewed and crumbling as the jungle slowly reclaims them. "These villages used to be bustling with people -- now you go there in the afternoon and there's no one," says the Niue Tourism Authority chairman Hima Douglas. The number of people living on the lush coral atoll, about 2,500 kilometres (1,550 miles) northeast of New Zealand, has been declining for decades as inhabitants seek a better life overseas.

The population, which peaked at more than 5,000 in the mid-1960s, has dwindled to just 1,200, according to a New Zealand parliamentary report, raising doubts about the island nation's economic viability.  Douglas said a major cyclone in 2004, which destroyed much of Niue's infrastructure, accelerated the exodus, and the threat of future natural disasters was discouraging people from returning. "Of course it's concerning but it's not something we can do too much about until we can build an economy that will give them the confidence to come back," Niue's Premier Toke Talagi told reporters this month. "There aren't simple and easy answers to people leaving. We've got to build a strong economy and hope to attract them back." Known locally as "The Rock", Niue was settled by Polynesian seafarers more than 1,000 years ago and the palm-dotted island's name in the local language means "behold, the coconut".

The British explorer captain James Cook tried to land there three times in 1774 but was deterred by fearsome warriors, eventually giving up to set sail for more welcoming shores and naming Niue "savage island" on his charts. But modern day Niueans are desperate for visitors, with Talagi unveiling plans this month to turn it into a boutique tourism destination in a bid to put his nation on a sound economic footing. Using aid from New Zealand, with which Niue has a compact of free association giving its people dual citizenship, Talagi has overseen construction of a new tourism centre and expansion of the island's Matavai Resort.

Paths have also been cut through the jungle to give visitors access to swimming spots on the rugged limestone coastline, and cruise liners are being encouraged to include Niue on their itineraries. "We can become self-sustaining in the long term (and) reduce New Zealand assistance to Niue," Talagi said, estimating that visitor numbers could quadruple to 20,000 a year in the next decade. Addressing a visiting delegation of New Zealand business executives this month, Talagi acknowledged doubts about the nation's ability to meet the challenge. "I know some of you are a bit sceptical about our ability to become self sustaining... (but) tourism is not going to fail and I don't expect it to fail given the numbers that are being generated," he said.

The New Zealand parliamentary report, released last December, estimates that about 50,000 Niueans and their children now live in Australia and New Zealand, creating a shortage of skilled labour in one of the world's smallest states. "Niue is caught in a vicious cycle, with its economic difficulties both exacerbated by, and reflected in, the long-term decline of its population," it said, adding that 40 years of New Zealand aid "has yielded almost no return". The report's authors suggested Niue should concentrate on promoting itself as a retirement destination for elderly New Zealanders, who could help revitalise the economy. "The climate is excellent, existing buildings could be brought into service, and health facilities are satisfactory," it said. "Retirees would bring steady cash flow and contribute to stable employment options."

Asked about the suggestion, Talangi said "we'll look at everything", although one long-time resident, who asked not to be named, was unenthusiastic at the prospect. "How depressing to think that we might be turned into a major geriatric ward," she said. "Not that I have anything against old people, mind." Another resident said that whatever steps Niue took to improve its economy must result in major changes, pointing out people could earn more by moving to New Zealand and claiming unemployment benefits than working on the island. "It's pretty hard when your cuzzies (cousins) call you and say 'we're getting more on the dole in Auckland than you're getting paid'," he said.
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Oman

Oman US Consular Information Sheet
February 11, 2009
COUNTRY DESCRIPTION: The Sultanate of Oman, a land of great natural beauty on the southeast corner of the Arabian Peninsula, has a long and proud heritage.
Oman has seen rapid economic a
d social development in the past three decades.
The Government of Oman estimated its population at 2,340,815 in its 2003 census, but the current number is likely to be significantly higher due to an influx of expatriate workers in numerous sectors of the economy.
The CIA World Factbook estimates Oman’s population to be 3,311,640 in its latest on-line update as of December 18, 2008.
A monarchy governed by Sultan Qaboos bin Said, the country does not have political parties or a legislature, although a bicameral representative body (the lower house of which is directly elected) provides the government with advice and reviews draft legislation.
While Oman is traditionally Islamic and Islam is the state religion, Omanis have for centuries lived with people of other faiths.
Non-Muslims are free to worship at churches and temples built on land donated by the Sultan.
The economy is largely dependent on the production and export of oil and natural gas, but is becoming increasingly diversified.
Excellent tourist facilities are available in the major cities of Muscat, Salalah, Sohar, and Nizwa and can increasingly be found elsewhere in the country.
Travelers may wish to visit the Sultanate’s tourism web site at http://www.omantourism.gov.om/ for more information.
Travelers may also wish to read the Department of State Background Notes on Oman for additional information.
ENTRY/EXIT REQUIREMENTS:
A valid passport and visa are required for entry into Oman.
Omani embassies and consulates issue multiple-entry tourist and/or business visas valid for up to two years.
Omani immigration officials at the port of entry determine the length of stay in Oman, which varies according to the purpose of travel.
Alternatively, U.S. citizens may obtain a 30-day visa by presenting their U.S. passports on arrival at all Oman land, sea, and air entry points.
Note: The validity period of the applicant's passport should not be less than six months.
Adequate funds and proof of an onward/return ticket, though not required, are strongly recommended.
The fee is Rials Omani 6.00 (approximately USD 16.00).
This visa can be extended for an extra 30 days only; a completed extension application form and the fee of Rials Omani 6.00 (USD 16.00) should be submitted to the Directorate General of Passports and Residence or to its branches at regional Royal Omani Police offices.
Other categories of short-term visit/business/work contract visas are available, but these must be arranged in advance through an Omani sponsor.
To obtain a visa or for details on entry and travel requirements, please contact the Embassy of the Sultanate of Oman, 2535 Belmont Road NW, Washington, DC
20008, telephone (202) 387-1980/2.
Evidence of yellow fever immunization is required if the traveler enters from an infected area.
Visit the Embassy of Oman web site 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.
Forbidden items:
The Sultanate prohibits pornographic materials and firearms from entering Oman.
Local law limits each traveler to two bottles of alcohol.
Items subject to confiscation at the airport due to content considered culturally inappropriate include, but are not limited to, compact discs, digital video discs, and video and audiocassettes.
Please refer to our Customs Information to learn more about customs regulations.
SAFETY AND SECURITY:
There have been no instances in which U.S. citizens or facilities in Oman have been subject to terrorist attacks.
However, the Department of State remains concerned about the possibility of terrorist attacks against United States citizens and interests throughout the region.
American citizens in Oman are urged to maintain a high level of security awareness.
The State Department suggests that all Americans in Oman maintain an unpredictable schedule and vary travel routes and times whenever possible.
Americans are also urged to treat mail or packages from unfamiliar sources with suspicion.
Unusual mail or packages should be left unopened and reported to local authorities.
U.S. citizens with security concerns are encouraged to contact local authorities and the Consular Section of the U.S. Embassy in Muscat.
For the latest security information, Americans traveling abroad should regularly monitor the Department’s web site, where the current Worldwide Caution, Travel Warnings and Travel Alerts can be found.
Up-to-date information on safety and security can also be obtained by calling 1-888-407-4747 toll-free in the U.S.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 information on A Safe Trip Abroad.
CRIME:
The incidence of street crime is low in Oman; violent crime is rare by U.S. standards, but can occur.
Crimes of opportunity remain the most likely to affect visitors.
Visitors to Oman should, therefore, take normal precautions, such as avoiding travel in deserted or unfamiliar areas and after dark.
Visitors should also protect personal property from theft.
In particular, valuables and currency should not be left unsecured in hotel rooms.
Common sense and caution are always the best methods for crime prevention.

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.

The local equivalent to the “911” emergency line in Oman is:
9999
See our information on Victims of Crime.
SPECIAL CIRCUMSTANCES: By Omani custom and law, expressing frustration either verbally or through otherwise innocuous hand gestures is considered insulting and abusive.
Any individual, regardless of citizenship and residency status, may file a personal defamation charge, and accusation of wrongdoing is sufficient to initiate a legal process.
While not commonplace, the incidence of American citizens charged with personal defamation has been on the rise in recent months.
These cases are normally resolved by a formal apology and a payment of damage to the aggrieved party, but one American citizen’s case went to trial in 2008.
Omani law typically does not permit a foreigner accused of a crime, including defamation, to depart the country while legal proceedings are ongoing.
Confrontations leading to defamation charges occur mostly on Oman’s roads, and visitors should exercise caution when dealing with difficult drivers.
Omani employers often ask that expatriate employees deposit their passports with the company as a condition of employment.
While to an extent still customary, this practice is contrary to Omani law.
The U.S. Embassy in Muscat advises Americans to exercise caution on the issue of permitting an employer to hold their passports, since this can operate as a restraint on travel and could give undue leverage to the employer in a dispute.
U.S. passports are the property of the U.S. government.
Islamic ideals provide the conservative foundation of Oman's customs, laws, and practices.
Foreign visitors are expected to be sensitive to Islamic culture and not dress in a revealing or provocative style, including the wearing of sleeveless shirts and blouses, halter-tops and shorts.
Athletic clothing is worn in public only when the wearer is obviously engaged in athletic activity.
Western bathing attire, however, is the norm at hotel pools and beaches.

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 Omani laws, even unknowingly, may be expelled, arrested, or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in Oman 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.

MEDICAL FACILITIES AND HEALTH INFORMATION:
There are a number of modern medical facilities in Oman.
Local medical treatment varies from quite good to inadequate, depending in large part on location.
Many Western pharmaceuticals can be found in Oman.
Hospital emergency treatment is available.
Doctors and hospitals often expect 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 the CDC’s web site.
For information about outbreaks of infectious diseases abroad consult the World Health Organization (WHO).
Further health information for travelers is available from the WHO.

Some HIV/AIDS entry restrictions exist for visitors to and foreign residents of Oman.
Oman requires persons seeking work or residence visas to take an HIV/AIDS test after arriving in the country; U.S. HIV/AIDS tests are not accepted.
Please verify this information with the Embassy of Oman at (202) 387-1980/2 before you travel.

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 Oman is provided for general reference only, and may not be totally accurate in a particular location or circumstance.
Road Conditions and Hazards: Road conditions, lighting, and traffic safety in cities and on major highways are good.
The condition of rural roads varies from good to poor.
Travel between cities, especially at night, may be dangerous due to poor or no lighting, wandering livestock, and speeding drivers.
The safety of public transportation is generally good.
Taxis, minivans, and small buses may swerve to the side of the road to pick up passengers with little notice or regard for other vehicles.

Local Laws and Practices:
Traffic laws in Oman are strictly enforced and the consequences for violating them may be severe by U.S. standards.
For example, running a red light results in a mandatory, non-bailable detention period of 48 hours, followed by confiscation of one’s driver’s license, vehicle registration, and car registration plate until the Omani judicial process is concluded, which may take as long as several months.
Other common traffic violations that carry strict penalties, up to and including jail sentences, fines, and/or deportation, include: driving without a license, driving under the influence of alcohol, failure to wear a seat belt, talking on cellular telephones while driving (other than using hands-free technology), speeding excessively, overtaking another vehicle, screeching a car’s tires or failing to keep one’s car clean.
In the event of a traffic violation and fine, drivers should cooperate with police officers and should not attempt to pay or negotiate payment at the time of the traffic stop.

Effective June 1, 2007, the Royal Oman Police (ROP) introduced new procedures for minor Road Traffic Accidents (RTA) to reduce traffic jams.
According to the ROP, the new procedure is currently in force in the Governorate of Muscat area and will eventually be implemented in the other governorates and regions of the Sultanate.
American citizens considering driving in Oman are advised to familiarize themselves with the new procedures available on the ROP web site under “Minor Road Traffic Accidents.”
Note:
Minor RTA are accidents that cause minor damage to one or more vehicles but do not result in injuries, deaths, or material damage to public/private properties.
Parties involved in such accidents should immediately move their vehicles to the side of the road.

American citizens involved in accidents outside of the Muscat area are advised not to move their vehicles from the accident location until the ROP gives them permission; moving a vehicle may be interpreted as an admission of guilt.

The use of European-style traffic circles is prevalent in Oman.
However, unlike European traffic practice, the driver on the inside lane always has priority.
A driver flashing his/her high beams is generally asking for a chance to pass.
Turning right on a red traffic signal is prohibited.
Visitors should not drive without a valid license.
Short-term visitors in possession of a valid U.S. driver's license may drive rental vehicles, but residents must have an Omani driver's license.
To obtain an Omani license, a U.S. citizen must have a U.S. license that has been valid for at least one year or must take a driving test.
Visitors hiring rental cars should insure the vehicles adequately against death, injury and loss or damage.
Residents may insure their vehicles outside the Sultanate; however, third party liability insurance must be purchased locally.

Emergency Services:
A modern ambulance service using American equipment and staff trained in the U.S. was instituted in 2004 and has been assessed as very good.
The service currently serves only certain urban locations in Oman, including the capital area, but is eventually expected to provide coverage for motor vehicle accident victims throughout the entire Sultanate.
For all traffic-related emergencies, the Royal Omani Police can be contacted by dialing "9999."
Please refer to our Road Safety page for more information.
Visit the web site of Oman’s national tourist office for further information.
AVIATION SAFETY OVERSIGHT:
The U.S. Federal Aviation Administration (FAA) has assessed the Government of Oman’s Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for oversight of Oman’s air carrier operations.
For more information, travelers may visit the FAA’s web.

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 Oman are encouraged to register with the U.S. Embassy in Muscat through the State Department’s travel registration web site and to obtain updated information on travel and security within Oman.
Americans without Internet access may register directly with the U.S. Embassy in Muscat.
By registering, American citizens make it easier for the Embassy to contact them in case of emergency.

The U.S. Embassy is located on Jamiat A’Duwal Al Arabiya Street, Al Khuwair Area (Shatti Al-Qurum), in the capital city of Muscat.
The mailing address is: PO Box 202, Medinat Al Sultan Qaboos 115, Sultanate of Oman, telephone: (968) 24-643-400, fax: (968) 24-643-535.
The Embassy’s Consular e-mail address is ConsularMuscat@state.gov.
American Citizens Services are available on a walk-in basis from 10:30 a.m. to 12:30 p.m. every Saturday, Monday, Tuesday and Wednesday.
The U.S. Embassy is closed on Omani and American holidays.
In the event of an emergency outside of normal office hours, American citizens may call the number above for assistance.
* * *
This replaces the Country Specific Information for Oman dated December 3, 2007 to update the sections on Country Description, Entry/Exit Requirements, Safety and Security, Information for Victims of Crime, Special Circumstances, Medical Facilities and Health Information, Traffic Safety and Road Conditions, and Registration/Embassy Location.

Travel News Headlines WORLD NEWS

Date: Mon, 24 Feb 2020 16:22:59 +0100 (MET)

Dubai, Feb 24, 2020 (AFP) - The new coronavirus hit four more Middle Eastern states on Monday, with Bahrain, Iraq, Kuwait and Oman reporting new cases and the UAE calling on its citizens not to travel to Iran and Thailand.   Oman also halted flights to and from Iran  -- which is battling the deadliest outbreak outside China --with immediate effect.   The move came shortly after two Omani women who had returned from Iran were diagnosed with the disease.

The three cases in Kuwait and the one in Bahrain were also in individuals who had returned from Iran, where the virus has claimed the lives of 12 people.   Bahrain also shut three schools after a man who had transported children to the institutions tested positive after returning from Iran on February 21 via Dubai airport, the health ministry said.

In Kuwait, a 53-year-old Kuwaiti, a 61-year-old Saudi national and a 21-year-old stateless Arab who tested positive had all returned from Iran's holy city of Mashhad, the Kuwaiti health ministry said.   In Iraq, the virus was confirmed in an Iranian national studying in the southern shrine city of Najaf, health officials said.   All seven bourses in the oil-rich Gulf states were down on Monday as fears of a pandemic hit crude prices. The Saudi stock exchange led the slide, shedding 2.95 percent.

- Travel bans -
Iran's confirmed death toll rose to 12 on Monday, with the government vowing to be transparent and dismissing a lawmaker's claim the toll could be as high as 50.   The outbreak has prompted travel bans from nearby countries.

Last week, Kuwait banned entry of all ships from the Islamic republic and suspended flights to and from the country.   Kuwait also banned non-citizens coming from Iran from entering the Gulf state and operated chartered flights to bring back hundreds of Kuwaiti Shiite pilgrims from the Islamic republic.

Around a third of Kuwait's 1.4 million citizens are Shiite Muslims, who travel regularly to Iran to visit religious shrines. Kuwait also hosts roughly 50,000 Iranian workers.   Over half of Bahrain's population of under one million are Shiites, who also travel frequently to Iran.   The United Arab Emirates has already announced 13 cases of the novel coronavirus, all of them foreigners. The latest were a 70-year-old Iranian man, whose condition is unstable, and his 64-year-old wife.

On Monday, Abu Dhabi authorities called on all UAE citizens "to not travel to Iran and Thailand at present and up until further notice" as part of its efforts to monitor and contain the spread of the disease.   UAE airlines have suspended most flights to China -- where the virus first emerged in December -- except to the capital Beijing, but have not yet taken any measures to restrict travel to and from Iran. Around half a million Iranians live and work in the UAE.

Two Gulf states -- Saudi Arabia and Qatar -- remain free of the virus, but all have suspended flights to China.   Qatar Airways said on Monday that people arriving from Iran and South Korea would be asked to stay in home isolation or a quarantine facility for 14 days.   China's death toll from COVID-19 rose to nearly 2,600 on Monday, while the virus has now spread to more than 30 countries.
Date: Thu 28 Nov 2019
Source: GDN Online [edited]

Two expatriates living in Oman died after contracting the seasonal influenza (H1N1) or swine flu in the governorate of Dhofar -- the 1st in July and the 2nd in August [2019]. They were among 78 confirmed cases of swine flu registered at the Sultan Qaboos Hospital over the first 9 months of 2019 in the governorate.

The hospital authorities reported a total of 599 registered suspected cases of H1N1 between January and last September [2019]. Doctors working at Sultan Qaboos Hospital dealt overall with 1779 cases of respiratory infections during the same period.

Patients most vulnerable to the respiratory viruses are those over 18 years, particularly pregnant women; those suffering from chronic illnesses, kidney and heart diseases, liver problems, diabetes, asthma, blood disorders, and HIV/AIDS; and even health workers, according to Muscat Daily.
Date: Thu 14 Feb 2019
Source: Muscat Daily [edited]

The Ministry of Agriculture and Fisheries (MoAF) has announced that it has imposed veterinary quarantine on a farm in the wilayat [district] of Shinas in North Batinah [governorate] after it registered a case of Crimean-Congo haemorrhagic fever (CCHF) in a citizen. MoAF has also confirmed that the citizen infected is undergoing treatment at Sohar Hospital and his condition is stable.

Experts took samples of tick insects, a carrier of the disease from the animals at the citizen's farm and other animals in the area and sent them to the laboratory for examination. MoAF elaborated that experts are guiding the citizen's family on how to handle animals. CCHF is caused by a virus carried by ticks.

Animals like sheep, goats, and cows become carriers after they are bitten by the infected ticks. Humans get infected either by tick-bites or through direct contact with the infected animal's blood and tissues during or after slaughtering. Human-to-human transmission can occur resulting from close contact with blood, secretions, organs, or other bodily fluids from infected persons, the ministry said.
=====================
[CCHF virus has the greatest geographic range of any tick-borne virus and there are reports of viral isolation and/or disease from more than 30 countries in Africa, Asia, Eastern and Southern Europe, and the Middle East. Numerous domestic and wild animals, such as cattle, goats, sheep, and small mammals, such as hares and rodents, serve as asymptomatic hosts for amplification of the virus, which is transmitted through _Ixodid_ ticks, especially _Hyalomma_ spp that act as both reservoirs and vectors  (<https://www.biorxiv.org/content/biorxiv/early/2018/12/20/502641.full.pdf>).

Oman is situated in the south-eastern corner of the Arabian Peninsula, bordering the Kingdom of Saudi Arabia, United Arab Emirates, and Yemen. Cases of CCHF were first detected in Oman in 1995 with 3 unrelated sporadic cases, and another in 1996. A 1996 survey in Oman revealed asymptomatic seropositivity for CCHFV in 1/41 (2.4 percent) of Omanis compared to 73 (30.3 percent) of 241 non-Omani citizens with occupational animal contact. No further human cases of CCHF were reported in Oman until 2011 and there has been a steady increase in cases since then. Asia lineage 1 (clade IV) of CCHF virus has been identified in one of 1996 confirmed cases from Oman. Al-Abri et al have published a detailed report on CCHF cases from Oman from 2011-17 and describe a higher mortality rate of over 36 percent in their study (<http://dx.doi.org/10.1101/502641>).

The Oman MoH has undertaken a number of activities and initiatives to educate and inform the public about the risks of CCHF infection associated with slaughtering. A joint strategic initiative was developed in collaboration with the Ministry of Agriculture and Fisheries and the Ministry of Regional Municipalities and Water Resources. Education and information on prevention of CCHF in different languages has been targeted at those involved in slaughtering and handling animals. In addition, guidelines have been produced for culturally acceptable safe burials. - ProMED Mod.UBA]

[HealthMap/ProMED-mail map of Oman:
Date: 28 Jan 2019
Source: Times of Oman [edited]

Four new cases of Middle East respiratory syndrome (MERS) coronavirus have been detected in Oman, according to the Ministry of Health. "This brings the total number of recorded cases from various governorates in the Sultanate to 18 since 2013," the ministry said in a statement. The new cases are receiving necessary medical care at one of the hospitals.

"The ministry affirms its continued effort to monitor and control the disease through the effective Epidemiological Surveillance System," the ministry added. "All hospitals are capable of dealing with such cases," the ministry said, "We urge all citizens and residents to comply with preventative measures to control infection and to maintain hygiene when sneezing and coughing."

MERS is a viral respiratory disease caused by a novel coronavirus (Middle East respiratory syndrome coronavirus, or MERS-CoV) that was 1st identified in Saudi Arabia in 2012. Coronaviruses are a large family of viruses that can cause diseases ranging from the common cold to severe acute respiratory syndrome (SARS).

Symptoms: "Typical MERS symptoms include a fever, cough and shortness of breath. Pneumonia is common, but not always present. Gastrointestinal symptoms, including diarrhoea, have also been reported. Some laboratory-confirmed cases of the MERS-CoV infection are reported as asymptomatic, meaning that they do not have any clinical symptoms, yet they are positive for a MERS-CoV infection following a laboratory test. Most of these asymptomatic cases have been detected following aggressive contact tracing of a laboratory-confirmed case," the World Health Organization (WHO) said. Approximately 35 per cent of patients reported to be infected with MERS-CoV have died.

"Although most human cases of MERS-CoV infections have been attributed to human-to-human contact in health care settings, current scientific evidence suggests that dromedary camels are a major reservoir host for MERS-CoV and an animal source of MERS infection in humans. However, the exact role of dromedaries in the transmission of the virus and the exact route(s) of transmission are unknown. "The virus does not seem to pass easily from person to person unless there is close contact, such as when providing unprotected care to a patient. Health care associated outbreaks have occurred in several countries, with the largest outbreaks seen in Saudi Arabia, the United Arab Emirates, and the Republic of Korea," the WHO added.
=======================
[According to the above media report (and the MOH press release available at: <https://www.moh.gov.om/en/-/---951>, this now brings the total number of MERS-CoV infected individuals occurring in Oman to 18. According to prior reports, as of the date of the last reported case of MERS-CoV infection by Oman in March 2018, there had been a total of 11 cases reported by Oman (see MERS-CoV (10): Oman, Saudi Arabia, WHO http://promedmail.org/post/20180315.5690014). The addition of these 4 newly confirmed/reported cases would bring the total to 15, unless there were 3 previously reported cases that we have missed. Another explanation might be the addition of 3 Omanis who were diagnosed to have MERS-CoV infection after travelling to other countries. There were 2 reported Omani travelers to Thailand confirmed to have MERS-CoV infections in 2015 and 2016 (MERS-CoV (70) - Thailand ex Oman, 1st report, RFI http://promedmail.org/post/20150618.3447631, and MERS-COV (08): Thailand ex Oman, Saudi Arabia corr http://promedmail.org/post/20160124.3962172) and an Omani confirmed to have a MERS-CoV infection in the United Arab Emirates in 2013 (MERS-CoV - Eastern Mediterranean (81): Saudi Arabia, UAE ex Oman, RFI http://promedmail.org/post/20131108.2044846). Clarification of this would be greatly appreciated. In addition, more information on the newly confirmed cases including age, gender, governorate of presumed exposure, dates of onset of illness, and history of possible high-risk exposures (direct or indirect camel contact, consumption of raw camel products, contact with other confirmed cases of MERS-CoV infection) would be greatly appreciated. Are the 4 newly reported cases a defined cluster with common contacts?

The HealthMap/ProMED map of Oman: <http://healthmap.org/promed/p/124>  - ProMED Mod.MPP]
Date: 15 Mar 2018
Source: WHO Emergencies preparedness, response, Disease Outbreak News (DONs) [edited]

Middle East respiratory syndrome coronavirus (MERS-CoV) - Oman 15 Mar 2018
--------------------------------------------------------------------------
On [4 Mar 2018], the National IRH focal point of Oman reported 1 additional case of Middle East respiratory syndrome coronavirus (MERS-CoV).

The patient was a 74-year-old male Omani national, living in Batinah, who had symptom onset on [23 Feb 2018]. The patient had neither recently travelled nor had any contact with any person with respiratory symptoms or with a known MERS-CoV case. The patient took care of camels that were reportedly ill. The investigation of the patient's exposure in the 14 days prior to the onset of symptoms is still ongoing.

Prior to this patient, the last laboratory-confirmed case of MERS-CoV from Oman was reported in November 2017.

Globally, 2144 laboratory-confirmed cases of MERS-CoV, including at least 750 related deaths, have been reported to WHO.
==================
[This is the 1st laboratory confirmed case of MERS-CoV infection reported by Oman in 2018, bringing the total number of laboratory confirmed cases reported by Oman to 11. During 2017, there were 2 cases reported by Oman. One on 5 Nov 2018 (see MERS-CoV (69): Oman, Saudi Arabia (RI, QS) RFI http://promedmail.org/post/20171105.5425993) and one reported to WHO on 30 Aug 2017, and reported by WHO on 12 Oct 2017 (see MERS-CoV (59): Oman, Saudi Arabia, WHO http://promedmail.org/post/20170913.5313874). In addition, there have been 2 cases reported in Omani citizens travelling to Thailand and confirmed by Thailand. A common observation in the cases reported by Oman is a history of contact with camels in the 14 days preceding onset of illness.

In total, there have been 2144 laboratory-confirmed cases of MERS-CoV reported to WHO since September 2012, including at least 750 related deaths (reported case fatality rate 35.0 percent). (This total includes cases reported by Saudi Arabia up through 11 Jan 2018).

The HealthMap/ProMED map of Oman can be found at:
More ...

Netherlands Antilles

Netherland Antilles US Consular Information Sheet
May 12, 2008
COUNTRY DESCRIPTION:
The five islands of Bonaire, Curaçao, Saba, St. Eustatius (or “Statia”) and St. Maarten (Dutch side) comprise the Netherlands Antilles, an autonomous
art of the Kingdom of the Netherlands. Tourist facilities are widely available. Read the Department of State Background Notes on the Netherlands Antilles for additional information.
ENTRY/EXIT REQUIREMENTS: All Americans traveling by air outside the United States are required to present a passport or other valid travel document to enter or re-enter the United States. This requirement will be extended to sea travel (except closed loop cruises), including ferry service, by the summer of 2009. Until then, U.S. citizens traveling by sea must have government-issued photo identification and a document showing their U.S. citizenship (for example, a birth certificate or certificate of nationalization), or other document compliant with the Western Hemisphere Travel Initiative, such as a passport card for entry or re-entry to the U.S. Sea travelers should also check with their cruise line and countries of destination for any foreign entry requirements.

Applications for the new U.S. Passport Card are now being accepted. Based on current projections, we expect to begin production of the passport card in June 2008 and be in full production in July 2008. The card may not be used to travel by air and is available only to U.S. citizens. Further information on the Passport Card is available at http://travel.state.gov/passport/ppt_card/ppt_card_3926.html and upcoming changes to U.S. passport policy can be found on the Bureau of Consular Affairs web site at http://travel.state.gov/travel/cbpmc/cbpmc_2223.html. We strongly encourage all American citizen travelers to apply for a U.S. passport well in advance of anticipated travel. American citizens can visit travel.state.gov or call 1-877-4USA-PPT (1-877-487-2778) for information on how to apply for their passports.
The U.S. Consulate recommends traveling in the Netherlands Antilles with a valid U.S. passport to avoid delays or misunderstandings. A lost or stolen passport is also easier to replace when outside the United States than other evidence of citizenship. Visitors to the Netherlands Antilles may be asked to show onward/return tickets or proof of sufficient funds for their stay. Length of stay is granted for two weeks and may be extended for 90 days by the head office of immigration. For further information, travelers may contact the Royal Netherlands Embassy, 4200 Linnean Avenue, N.W., Washington, D.C. 20008, telephone (202) 244-5300, or the Dutch Consulate in Los Angeles, Chicago, New York, Houston or Miami. Visit the web site for the Embassy of the Netherlands at http://www.netherlands-embassy.org/homepage.asp for the most current visa information.

We have more information pertaining to dual nationality and international child abduction. Please refer to our customs information to learn more about customs regulations.

SAFETY AND SECURITY:
Drug-related organized crime exists within the Netherlands Antilles but has not directly affected tourists in the past.
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, including 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., 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: In recent years, street crime has increased, especially in St. Maarten. Valuables, including passports, left unattended on beaches, in cars and hotel lobbies are easy targets for theft, and visitors should leave valuables and personal papers secured in their hotel. Burglary and break-ins are increasingly common at resorts, beach houses and hotels. Armed robbery occasionally occurs. The American boating community has reported a handful of incidents in the past, and visitors are urged to exercise reasonable caution in securing boats and belongings. Car theft, especially of rental vehicles for joy riding and stripping, can occur. Incidents of break-ins to rental cars to steal personal items have been reported by American tourists. Vehicle leases or rentals may not be fully covered by local insurance when a vehicle is stolen. Be sure you are sufficiently insured when renting vehicles and jet skis.
INFORMATION FOR VICTIMS OF CRIME: The loss or theft abroad of a U.S. passport should be reported immediately to the local police and the nearest U.S. Embassy or Consulate. If you are the victim of a crime while overseas, in addition to reporting to local police, please contact the nearest U.S. Embassy or Consulate for assistance. The Embassy/Consulate staff can, for example, assist you to find appropriate medical care, to contact family members or friends and explain how funds could be transferred. Although the investigation and prosecution of the crime 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.
Please see our information for American Victims of Crime Overseas.
MEDICAL FACILITIES AND HEALTH INFORMATION: Medical care is generally good in Curaçao and St. Maarten, but may be limited on the other three islands. Hospitals have three classes of services i.e.: First Class: one patient to a room, air conditioning etc.; Second Class: two to six patients to a room, no air conditioning; Third Class: 15 to 30 people in one hall. Patients are accommodated according to their level of insurance.
Bonaire: The San Francisco hospital is a medical center (35 beds) with decompression facilities. The hospital has an air ambulance service to Curaçao and Aruba.
Curaçao: St. Elizabeth hospital is a public hospital that may be compared to midrange facilities in the United States. St. Elizabeth's hospital has a decompression chamber and qualified staff to assist scuba divers suffering from decompression sickness. Several private clinics provide good to excellent medical service.
St. Maarten: St. Maarten Medical Center (79 beds) is a relatively small hospital where general surgery is performed. Complex cases are sent to Curaçao.
Statia: Queen Beatrix Medical Center (20 beds) is a medical facility well equipped for first aid. Surgery cases are sent to St. Maarten.
Saba: Saba Clinic (14 beds) is a well-equipped first aid facility. Surgery cases are sent to St. Maarten. The Saba Marine Park has a decompression chamber and qualified staff to assist scuba divers suffering from decompression sickness.
Information on vaccinations and other health precautions, such as safe food and water precautions and insect bite protection, may be obtained from the Centers for Disease Control and Prevention’s hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747) or via the CDC’s web site at http://wwwn.cdc.gov/travel/default.aspx. For information about outbreaks of infectious diseases abroad consult the World Health Organization’s (WHO) web site at http://www.who.int/en. Further health information for travelers is available at http://www.who.int/ith.
MEDICAL INSURANCE: The Department of State strongly urges Americans to consult with their medical insurance company prior to traveling abroad to confirm whether their policy applies overseas and whether it will cover emergency expenses such as a medical evacuation. Please see our information on medical insurance overseas.
TRAFFIC SAFETY AND ROAD CONDITIONS: While in a foreign country, U.S. citizens may encounter road conditions that differ significantly from those in the United States. The information below concerning the Netherlands Antilles is provided for general reference only, and may not be totally accurate in a particular location or circumstance.
Driving in the Netherlands Antilles is on the right hand side. Right turns on red are prohibited, and traffic conditions require somewhat defensive driving. Local laws require drivers and passengers to wear seat belts and motorcyclists to wear helmets. Children under 4 years of age should be in child safety seats; children under 12 should ride in the back seat.
Nonexistent or hidden and poorly maintained street signs are the major road hazard in the Netherlands Antilles. Therefore, drivers should proceed through intersections with caution. Roads in the Netherlands Antilles are extremely slippery during rainfall. Night driving is reasonably safe in the Netherlands Antilles as long as drivers are familiar with the route and road conditions. Most streets are poorly lit or not lit at all. In Curacao, drivers should be aware of herds of goats that may cross the street unexpectedly. In Bonaire, wild donkeys may also cross the road.
Taxis are the easiest, yet most expensive form of transportation on the islands. As there are no meters, passengers should verify the price before entering the taxi. Fares quoted in U.S. dollars may be significantly higher than those quoted in the local currency. Vans are inexpensive and run non-stop during daytime with no fixed schedule. Each van has a specific route displayed in the front of the windshield. Buses, which run on the hour, have limited routes. The road conditions on the main thoroughfares are good to fair.
See road safety information at the following sites; http://www.curacao.com, http://www.statiatourism.com, http://www.sabatourism.com, http://www.infobonaire.com, http://www.st-maarten.com/.
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 Netherlands Antilles’ Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for oversight of the Netherlands Antilles’ air carrier operations. For more information, travelers may visit the FAA’s web site at http://www.faa.gov/safety/programs_initiatives/oversight/iasa.
SPECIAL CIRCUMSTANCES:
Dutch law in principle does not permit dual nationality. However, there are several exceptions. For example, American citizens who are married to Dutch citizens are exempt from the requirement to abandon their American nationality when they apply to become a Dutch citizen by naturalization. For detailed and specific information on this subject, contact the Embassy of the Netherlands in Washington or one of the Dutch consulates in the U.S. In addition to being subject to all Dutch laws affecting U.S. citizens, dual nationals may also be subject to other laws that impose special obligations on Dutch citizens.
Time-share buyers are cautioned about contracts that do not have a "non-disturbance or perpetuity protective clause" incorporated into the purchase agreement. Such a clause gives the time-share owner perpetuity of ownership should the facility be sold. Americans sometimes complain that the timeshare units are not adequately maintained, despite generally high annual maintenance fees. Because of the large number of complaints about misuse of maintenance fees, particularly in St. Maarten, prospective timeshare owners are advised to review the profit and loss statement for maintenance fees. Investors should note that a reputable accounting firm should audit profit and loss statements.
Potential investors should be aware that failed land development schemes involving time-share investments could result in financial losses. Interested investors may wish to seek professional advice regarding investments involving land development projects. Real estate investment problems that reach local courts are rarely settled in favor of foreign investors.
An unusually competitive fee to rent vehicles or equipment could indicate that the dealer is unlicensed or uninsured. The renter is often fully responsible for replacement costs and fees associated with any damages that occur during the rental period. Visitors may be required to pay these fees in full before leaving the Netherlands Antilles and may be subject to civil or criminal penalties if they cannot or will not make payment.
Netherlands Antilles customs authorities may enforce strict regulations concerning temporary importation into or export from the Netherlands Antilles. For example, it is strictly prohibited to export pieces of coral and/or seashells. Please see our information on customs regulations.
CRIMINAL PENALTIES: While in a foreign country, a U.S. citizen is subject to that country's laws and regulations, which sometimes differ significantly from those in the United States and may not afford the protections available to the individual under U.S. law. Penalties for breaking the law can be more severe than in the United States for similar offences. Persons violating the laws of the Netherlands Antilles, even unknowingly, may be expelled, arrested or imprisoned. Penalties for possession, use, or trafficking in illegal drugs in the Netherlands Antilles are severe, and convicted offenders can expect long jail sentences and heavy fines. The Netherlands Antilles has strict gun control laws; even a stray bullet in a suitcase can trigger a fine or time in jail. Engaging in sexual conduct with children or using or disseminating child pornography in a foreign country is a crime, prosecutable in the United States. Please see our information on Criminal Penalties.
CHILDREN'S ISSUES: For information on international adoption of children and international parental child abduction, see the Office of Children’s Issues web site.
REGISTRATION / EMBASSY LOCATION:
American citizens residing or traveling in the Netherlands Antilles 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 the Netherlands Antilles. Americans without Internet access may register directly with the nearest U.S. Embassy or Consulate. By registering, American citizens make it easier for the Embassy or Consulate to contact them in case of emergency. The U.S. Consulate General is located at J.B. Gorsiraweg #1, Willemstad, Curaçao, telephone (599-9) 461-3066; fax (599-9) 461-6489; e-mail address: acscuracao@state.gov.
* * *
This replaces the Country Specific Information dated May 7, 2007, to update the Entry/Exit, Crime, Traffic Safety and Road Conditions, and Registry / Embassy Location sections.

Travel News Headlines WORLD NEWS

Date: Thu, 16 May 2019 23:41:35 +0200

Washington, May 16, 2019 (AFP) - The Church of Scientology said Thursday all the passengers from a cruise ship that was quarantined over a measles case had been cleared to leave.    "All passengers and crew (100%) of the Freewinds have been fully cleared of any possible risk of being infected by the measles or infecting others," the organization said in a statement.   "All passengers and crew are free to come and go as they wish," a spokesman added to AFP.

The infected individual was a member of the crew who, according to the Church, had fully recovered and was given a clean bill of health a week ago. She had been earlier confined on the ship.   The ship, which is based in Willemstad on the island of Curacao in the Dutch West Indies, was quarantined after its arrival in Saint Lucia on April 30.   It remained there for two days before returning to Willemstad on May 4 where local authorities ordered a fresh quarantine to give them time to confirm the passengers were either immunized or had no risk of contracting the virus.
Date: Sat, 4 May 2019 20:37:18 +0200
By Sara MAGNIETTE

The Hague, May 4, 2019 (AFP) - The Dutch territory of Curacao said Saturday it would do what is needed to prevent measles spreading from a Scientology cruise ship, after a crew member came down with the disease.   The Freewinds, which left the Caribbean island of St. Lucia on Friday, arrived back in its home port of Curacao at around 9:00 am (1300 GMT) Saturday, according to myshiptracking.com.

The Curacao government said in a statement that it would "take all necessary precautions to handle the case of measles on board of the Freewinds," including vaccinations.   "An investigation will also be done to determine who will be allowed to leave the ship without (posing) a threat to the population of Curacao," it said.   "It is imperative to make all efforts to prevent a spread of this disease internationally."   Dutch broadcaster NOS reported that three health officials had boarded the boat to examine those on board. Only people able to prove that they have been vaccinated against measles or had already had the disease would be able to leave the boat, its correspondent there reported.

- Anti-vaccine movement -
The Church of Scientology says the 440-foot (134-meter) vessel is used for religious retreats and is normally based in Curacao.   The vessel had arrived in St Lucia from Curacao on Tuesday, when it was placed under quarantine by health authorities there because of a measles patient, said to be a female crew member.   According to NOS, the crew member concerned is a Danish national, who arrived in Curacao from Amsterdam on April 17. It was only when the boat was at sea, on route to St Lucia, that a doctor discovered she had measles, their correspondent said.

The resurgence of the once-eradicated, highly contagious disease is linked to the growing anti-vaccine movement in richer nations, which the World Health Organization (WHO) has identified as a major global health threat.   The authorities in Curacao nevertheless urged local people not to panic, as the risk of the disease spreading in this case was fairly low.   Several people did however visit the cruise ship between April 22 and April 28 before it set sail for St Lucia and the authorities asked them to make themselves known to health officials.

Officials said the Freewinds had travelled between Curacao, St Lucia and another Dutch-held island, Aruba, several times towards the end of April.   There were about 300 people aboard the ship, according to Saint Lucia authorities, which placed the vessel in quarantine. They said they provided 100 doses of measles vaccine at no cost.   The Scientology church, founded by science fiction writer L Ron Hubbard in 1953, did not respond to requests for comment.   Its teachings do not directly oppose vaccination, but followers consider illness a sign of personal failing and generally avoid medical interventions.
Date: 4 Jul 2017
From: Harry Vennema <harry.vennema@rivm.nl> [edited]

On several of the Caribbean islands, epidemics of viral conjunctivitis are ongoing. Recently, general practitioners in the overseas territories of the Netherlands reported an increased incidence of this syndrome.

As of 26 May 2017, an outbreak of conjunctivitis occurred in a nursing home on Bonaire. In total, 14 patients and 13 healthcare workers presented with conjunctivitis. Patients were between 71 to 94 years of age. The number of new cases peaked in week 20 through 22. After week 22, a significant reduction was seen (1-3 new cases per week). Initially, conjunctival swabs from 5 patients were tested for the presence of adenovirus by PCR; all 5 were negative.

Subsequently, swabs from 4 patients were analyzed for the presence of enterovirus by RT-PCR, and all 4 were positive. The enterovirus from 3 samples was further characterized by partial VP1 sequence analysis. In all 3 samples, the enterovirus was characterized as Coxsackievirus A24, which belongs to Enterovirus C. Coxsackievirus A24 has been identified frequently as the causative agent of epidemic viral conjunctivitis. The strain from Bonaire is at least 5 percent different from any of the previously isolated and sequenced CV-A24 strains available in Genbank in a 330nt VP1 fragment. The strain involved in the most recent outbreak of CV-A24 conjunctivitis on La Reunion in 2015 is 6 percent different from the Bonaire 2017 strain.

[Andert Rosingh, Yingbin Celestijn-Wu, Fundashon Mariadal Hospital, Clinical Microbiology, Kralendijk, Bonaire, Caribbean Netherlands Annelies Riezebos, University Medical Centre Utrecht, Medical Microbiology, Utrecht, Netherlands Harry Vennema, Kim Benschop, Johan Reimerink, Hans van den Kerkhof, National Institute for Public Health and the Environment, Centre for Infectious Disease Control, Bilthoven, Netherlands]
--------------------------------------------
Harry Vennema
National Institute for Public Health and the Environment
Centre for Infectious Disease Control
Bilthoven, Netherlands
=========================
[ProMED thanks Harry Vennema and colleagues for this report.  Acute hemorrhagic conjunctivitis (AHC) is characterized by sudden onset of painful, swollen, red eyes with subconjunctival haemorrhages and excessive tearing. Most cases are self-limited but highly contagious, with the potential for causing considerable illness. Adenoviruses and picornaviruses can cause AHC outbreaks (1). Among picornaviruses, enterovirus 70 and coxsackievirus A24 variant (CA24v) have caused large outbreaks of AHC[2].

Coxsackieviruses are transmitted primarily via the fecal-oral route and respiratory aerosols, although transmission via fomites is possible. The viruses initially replicate in the upper respiratory tract and the distal small bowel. They have been found in the respiratory tract up to 3 weeks after initial infection and in feces up to 8 weeks after initial infection[3]. The potential for exponential spread is, therefore, quite considerable.

It is important to understand that sequential outbreaks of AHC due to CA24v might occur in the same location after a considerable period, and public health precautions are necessary to control these outbreaks.

References:
1. Hierholzer JC, Hatch MH. Acute hemorrhagic conjunctivitis. In: Darrell RW, editor. Viral diseases of the eye. Philadelphia: Lea & Febiger; 1985. p. 165-96.
2. Kono R. Apollo 11 disease or acute hemorrhagic conjunctivitis: a pandemic of a new enterovirus infection of the eyes. Am J Epidemiol. 1975;101:383-90.

[A HealthMap/ProMED-mail map can be accessed at:
Date: Published ahead of print 7 Dec 2015
Source: American Journal of Tropical Medicine & Hygiene Published on line doi:10.4269/ajtmh.15-0308 [edited]

Noellie Gay, Dominique Rousset, Patricia Huc, Severine Matheus, Martine Ledrans, Jacques Rosine, Sylvie Cassadou, and Harold Noel. Seroprevalence of Asian Lineage Chikungunya Virus Infection on Saint Martin Island, 7 Months After the 2013 Emergence.

Abstract
--------
At the end of 2013, chikungunya virus (CHIKV) emerged in Saint Martin Island, Caribbean. The Asian lineage was identified. 7 months after this introduction, the seroprevalence was 16.9 percent in the population of Saint Martin and 39.0 percent of infections remained asymptomatic. This moderate attack rate and the apparent limited size of the outbreak in Saint Martin could be explained by control measures involved to lower the exposure of the inhabitants. Other drivers such as climatic factors and population genetic factors should be explored. The substantial rate of asymptomatic infections recorded points to a potential source of infection that can both spread in new geographic areas and maintain an inconspicuous endemic circulation in the Americas.
--------------------------------
Communicated by:
Roland Hubner
Superior Health Council
Brussels
Belgium
===================
[Asymptomatic or very mild infections may be an important source of infectious blood meals for vector mosquitoes. These infections should not be overlooked in epidemiological assessments of chikungunya virus outbreaks and implementation of control measures in the field. - ProMed Mod.TY]
Date: Wed, 26 Aug 2015 16:43:59 +0200 (METDST)

Miami, Aug 26, 2015 (AFP) - Tropical storm Erika took aim at the Lesser Antilles Wednesday as storm warnings went up there and in Puerto Rico in anticipation of heavy rains, US forecasters said.   With winds of 75 kilometres (45 miles) per hour, Erika was 540 kilometres (335 miles) east of Antigua at 1200 GMT, the Miami-based National Hurricane Center reported.

Advancing at a speed of 28 kilometres (17 miles) per hour, it was expected to sweep over the Lesser Antilles Wednesday night and then head toward Puerto Rico and the Virgin Islands.   Tropical storm warnings were up in Puerto Rico, the Virgin Islands, Antigua and Barbuda, Guadeloupe, Montserrat, St Kitts and Nevis, Anguilla, Saba, St Eustacia and St Maarten.

A US Air Force hurricane hunter aircraft that flew into the storm found it was slightly increasing in strength.   "Some slow strengthening is forecast during the next 48 hours," the hurricane centre said.   According to the NHC's projections, Erika could become a hurricane by the end of the week, or early next, as it nears Florida.   But "the intensity forecast remains very uncertain," it said.

Erika is arriving on the heels of Danny, the season's first hurricane which petered out before reaching the Caribbean.   Experts said earlier this month that there was a 90 percent chance the 2015 hurricane season in the Atlantic would be less active than usual.
More ...

World Travel News Headlines

Date: Tue, 31 Mar 2020 10:27:16 +0200 (METDST)

Nairobi, March 31, 2020 (AFP) - Six of Africa's 54 nations are among the last in the world yet to report cases of the new coronavirus. The global pandemic has been confirmed in almost every country, but for a handful of far-flung tiny island states, war-torn Yemen and isolated North Korea.  In Africa authorities claim they are spared by god, or simply saved by low air traffic to their countries, however some fear it is lack of testing that is hiding the true impact.

- South Sudan -
The east African nation is barely emerging from six years of civil war and with high levels of hunger, illness and little infrastructure, observers fear the virus could wreak havoc.   Doctor Angok Gordon Kuol, one of those charged with overseeing the fight against the virus, said the country had only carried out 12 tests, none of which were positive.   He said the reason the virus has yet to reach South Sudan could be explained by the low volume of air traffic and travel to the country.   "Very few airlines come to South Sudan and most of the countries affected today they are affected by... people coming from abroad."   He said the main concern was foreigners working for the large NGO and humanitarian community, or people crossing land borders from neighbouring countries.   South Sudan has shut schools, banned gatherings such as weddings, funerals and sporting events and blocked flights from worst-affected countries. Non-essential businesses have been shuttered and movement restricted.   The country can currently test around 500 people and has one isolation centre with 24 beds.

- Burundi -
In Burundi, which is gearing up for general elections in May, authorities thank divine intervention for the lack of cases.   "The government thanks all-powerful God who has protected Burundi," government spokesman Prosper Ntahorwamiye said on national television last week.   At the same time he criticised those "spreading rumours" that Burundi is not capable of testing for the virus, or that it is spreading unnoticed.   Some measures have been taken, such as the suspension of international flights and placing handwashing stations at the entrances to banks and restaurants in Bujumbura.   However several doctors have expressed their concerns.   "There are zero cases in Burundi because there have been zero tests," a Burundian doctor said on condition of anonymity.

- Sao Tome and Principe -
Sao Tome and Principe -- a tiny nation of small islands covered in lush rainforest -- has reported zero cases because it is unable to test, according to World Health Organisation representative Anne Ancia.   However "we are continuing preparations," with around 100 people in quarantine after returning from highly-affected countries, and the WHO keeping an eye on cases of pneumonia.   With only four ICU beds for a population of 200,000 people, the country is desperate to not let the virus take hold and has already shut its borders despite the importance of tourism to the local economy.

- Malawi -
Malawi's health ministry spokesman Joshua Malango brushed aside fears that Malawi might not have registered any Covid-19 cases due to a lack of testing kits: "We have the testing kits in Malawi and we are testing."   Dr Bridget Malewezi from the Society of Medical Doctors told AFP that while "we may not be 100 percent ready", government was gearing up for the arrival of the virus.   She suggested it may only be a matter of time before the pandemic hits Malawi.    "It's only been in the past few weeks that it has been rampantly spreading across Africa so most people feel it will get here at some point...," she said.   Malawi has asked people coming from hard-hit countries to self-quarantine, which Malawezi said had helped "safeguard the country from any possible spread of the virus".

- Lesotho -
Tiny Lesotho, a kingdom encircled by South Africa with only two million inhabitants, went into national lockdown on Monday despite registering zero cases.   Until last week the country had no tests or testing centres, and received its first kits thanks to a donation by Chinese billionaire Jack Ma.   Authorities had reported eight suspected cases which they had not been able to test and the first results are expected soon.

- Comoros -
The Indian Ocean island nation of the Comoros, situated between Madagascar and Mozambique, has yet to detect a single case of the virus, according to the health ministry.   One doctor in the capital Moroni, Dr Abdou Ada, wonders if it may not be because of the wide use of the drug Artemisinin to treat malaria.   "I believe that the mass anti-malarial treatment explains the fact that the Comoros are, at least for now, spared from Covid-19. it is a personal belief that needs to be confirmed scientifically."
Date: Tue, 31 Mar 2020 09:50:04 +0200 (METDST)
By Sophie DEVILLER with Dene-Hern CHEN

Bangkok, March 31, 2020 (AFP) - Underfed and chained up for endless hours, many elephants working in Thailand's tourism sector may starve, be sold to zoos or be shifted into the illegal logging trade, campaigners warn, as the coronavirus decimates visitor numbers. Before the virus, life for the kingdom's estimated 2,000 elephants working in tourism was already stressful, with abusive methods often used to 'break them' into giving rides and performing tricks at money-spinning animal shows.   With global travel paralysed the animals are unable to pay their way, including the 300 kilograms (660 pounds) of food a day a captive elephant needs to survive.

Elephant camps and conservationists warn hunger and the threat of renewed exploitation lie ahead, without an urgent bailout. "My boss is doing what he can but we have no money," Kosin, a mahout -- or elephant handler -- says of the Chiang Mai camp where his elephant Ekkasit is living on a restricted diet.   Chiang Mai is Thailand's northern tourist hub, an area of rolling hills dotted by elephant camps and sanctuaries ranging from the exploitative to the humane.   Footage sent to AFP from another camp in the area shows lines of elephants tethered by a foot to wooden poles, some visibly distressed, rocking their heads back and forth.

Around 2,000 elephants are currently "unemployed" as the virus eviscerates Thailand's tourist industry, says Theerapat Trungprakan, president of the Thai Elephant Alliance Association. The lack of cash is limiting the fibrous food available to the elephants "which will have a physical effect", he added.  Wages for the mahouts who look after them have dropped by 70 percent.   Theerapat fears the creatures could soon be used in illegal logging activities along the Thai-Myanmar border -- in breach of a 30-year-old law banning the use of elephants to transport wood.  Others "could be forced (to beg) on the streets," he said. It is yet another twist in the saga of the exploitation of elephants, which animal rights campaigners have long been fighting to protect from the abusive tourism industry.

- 'Crisis point' -
For those hawking a once-in-a-lifetime experience with the giant creatures -- whether from afar or up close -- the slump began in late January.   Chinese visitors, who make up the majority of Thailand's 40 million tourists, plunged by more than 80 percent in February as China locked down cities hard-hit by the virus and banned external travel. By March, the travel restrictions into Thailand -- which has 1,388 confirmed cases of the virus -- had extended to Western countries.

With elephants increasingly malnourished due to the loss of income, the situation is "at a crisis point," says Saengduean Chailert, owner of Elephant Nature Park.   Her sanctuary for around 80 rescued pachyderms only allows visitors to observe the creatures, a philosophy at odds with venues that have them performing tricks and offering rides.   She has organised a fund to feed elephants and help mahouts in almost 50 camps nationwide, fearing the only options will soon be limited to zoos, starvation or logging work.  For those restrained by short chains all day, the stress could lead to fights breaking out, says Saengduean, of camps that can no longer afford medical treatment for the creatures.

Calls are mounting for the government to fund stricken camps to ensure the welfare of elephants. "We need 1,000 baht a day (about $30) for each elephant," says Apichet Duangdee, who runs the Elephant Rescue Park. Freeing his eight mammals rescued from circuses and loggers into the forests is out of the question as they would likely be killed in territorial fights with wild elephants. He is planning to take out a two million baht ($61,000) loan soon to keep his elephants fed.   "I will not abandon them," he added.
Date: Tue, 31 Mar 2020 07:10:34 +0200 (METDST)
By Bernadette Carreon

Koror, Palau, March 31, 2020 (AFP) - A coronavirus-free tropical island nestled in the northern Pacific may seem the perfect place to ride out a pandemic -- but residents on Palau say life right now is far from idyllic.   The microstate of 18,000 people is among a dwindling number of places on Earth that still report zero cases of COVID-19 as figures mount daily elsewhere.   The disparate group also includes Samoa, Turkmenistan, North Korea and bases on the frozen continent of Antarctica.

A dot in the ocean hundreds of kilometres from its nearest neighbours, Palau is surrounded by the vast Pacific, which has acted as a buffer against the virus.   Along with strict travel restrictions, this seems to have kept infections at bay for a number of nations including Tonga, the Solomons Islands, the Marshall Islands and Micronesia.   But remoteness is not certain to stop the relentless march of the new disease. The Northern Mariana Islands confirmed its first cases over the weekend, followed by a suspected death on Monday.

Klamiokl Tulop, a 28-year-old artist and single mum, is hopeful Palau can avoid the fate of Wuhan, New York or Madrid -- where better-resourced health services were overrun.   But she describes a growing sense of dread, a fear that the virus is coming or could already be on the island undetected.   "You can feel a rising tension and anxiety just shopping," she told AFP. "Stores are crowded even more during non-payday weeks."   There have been several scares on Palau, including a potential case that saw one person placed into quarantine this week as authorities await test results.

- Antarctic seclusion -
Inside Australia's four remote Antarctic research bases, around 90 people have found themselves ensconced on the only virus-free continent as they watch their old home transform beyond recognition.   There is no need for social distancing in the tundra.   "They're probably the only Australians at the moment that can have a large dinner together or have the bar still open or the gym still open," Antarctic Division Operations manager Robb Clifton told AFP.   The bases are now isolated until November, so the group is safe, but Clifton admits "the main thing that's on the mind of expeditioners is how their loved ones are going back home."

In some places, reporting no cases does not always mean there are no cases to report.   North Korea has portrayed emergency measures as an unqualified success in keeping COVID-19 out, despite sustained epidemics in neighbouring China and South Korea.   But state media also appears to have doctored images to give ordinary North Koreans face masks -- handing sceptics reason to believe the world's most secretive government may not be telling the whole truth.

- 'Waiting for the inevitable?' -
While Palau has no confirmed cases, it has still been gripped by the society-altering fears and economic paralysis that have affected the rest of the world.   Supermarket aisles in the country's largest town Koror have seen panic buying and there are shortages of hand sanitisers, masks and alcohol.   The islands depend heavily on goods being shipped or flown in, meaning supplies can quickly run low.

United Airlines used to fly six times a week from nearby Guam -- which has seen more than 50 cases -- but now there is just one flight a week.   "Look at how bad we coped when shipments were late before this pandemic happened," Tulop said. "Everyone was practically in uproar."   Residents have been practising social distancing. Doctors are waiting for test kits to arrive from Taiwan. The government is building five isolation rooms that will be able to hold up to 14 patients.   It all feels like waiting for the inevitable.   "I would like to be optimistic we won't get the virus," Tulop said. "But Palau would most definitely get it. We rely heavily on tourism and most of us even need to travel for work."

Rondy Ronny's job is to host big tourist events, but work has already dried up, and he admits to being "very anxious".   "I have loans and bills and payments due," he said. "This will definitely put me back, I hope the government will do something about our economy too, to help it recover."   Palau's biggest test may yet come with the first positive case.   But even in the most remote corners of the world, the impact of this truly global pandemic is already being felt.   Nowhere, it seems, is truly virus-free.
Date: Tue, 31 Mar 2020 04:46:26 +0200 (METDST)

Panama City, March 31, 2020 (AFP) - The government of Panama on Monday announced strict quarantine measures that separate citizens by gender in an effort to slow the spread of the novel coronavirus.   From Wednesday, men and women will only be able to leave their homes for two hours at a time, and on different days.   Until now, quarantine regulations were not based on gender.

Men will be able to go to the supermarket or the pharmacy on Tuesdays, Thursdays and Saturdays, and women will be allowed out on Mondays, Wednesdays and Fridays.   No one will be allowed to go out on Sundays.

The new measures will last for 15 days.   "This absolute quarantine is for nothing more than to save your life," security minister Juan Pino said at a press conference.   According to Pino, more than 2,000 people were detained last week for not abiding by the quarantine.   Since the first case was reported on March 10, Panama has confirmed 1,075 cases of the coronavirus, 43 of which are in intensive care, and 27 deaths.
Date: Tue, 31 Mar 2020 00:54:08 +0200 (METDST)
By Celia Lebur with AFP Africa Bureaux

Lagos, March 30, 2020 (AFP) - More than 20 million Nigerians on Monday went into lockdown in sub-Saharan Africa's biggest city Lagos and the capital Abuja, as the continent struggles to curb the spread of coronavirus.   President Muhammadu Buhari ordered a two-week "cessation of all movements" in key cities to ward off an explosion of cases in Africa's most populous country.

Businesses are being closed, non-food shops shut and people required to stay at home as officials look to track down possible carriers of the disease after reporting 131 confirmed cases and two deaths so far.   Enforcing the restrictions in sprawling Lagos will be a mammoth challenge as millions live crammed into slums and rely on daily earnings to survive.

In the ramshackle outdoor markets of Lagos Island, anxious locals complained they did not have the money to stock up, while at higher-end supermarkets better-off residents queued to buy supplies.    "Two weeks is too long. I don't know how we will cope," said student Abdul Rahim, 25, as he helped his sister sell foodstuffs from a stall in Jankarra market.    "People are hungry and they won't be able to stock food."

City officials have pledged to provide basic provisions to 200,000 households but the central government in Africa's largest oil producing nation is already facing financial strain as the price of crude  has collapsed.    The streets of Ghana's capital Accra were also empty as most people in two regions appeared to be following a presidential order to stay indoors after it went into force.

- Zimbabwe locks down -
Dozens of African nations have imposed restrictions ranging from night-time curfews to total shutdowns.    Zimbabwe, which is already suffering a recession, began enforcing a three-week lockdown after the disease left one person dead and infected six others.   Police mounted checkpoints on routes leading to Harare's central business district, stopping cars and turning away pedestrians who had no authorisation to be in the area.   "We don't want to see people here on the streets. We don't want to see people who have no business in town just loitering," a policewoman said through a loud hailer. "Everyone to their homes."

Some people were trying to head for villages.   "We would rather spend the 21 days at our rural home, where we don't have to buy everything. I can't afford to feed my family here when I am not working," said Most Jawure.   "We have been waiting here for more than two hours but there are no buses," Jawure told AFP while standing with his wife and daughter beside a bulging suitcase.

For many of Zimbabwe's 16 million people, the lockdown means serious hardship.   With the unemployment rate estimated at around 90 percent, most Zimbabweans have informal jobs to eke out a living and few have substantial savings.   As a similar scenario played out in other poor nations, the UN on Monday called for a $2.5-trillion aid package to help developing countries weather the pandemic, including debt cancellation and a health recovery "Marshall Plan".

- 'A matter of time' -
Experts warn that Africa is highly vulnerable to COVID-19 given the weak state of health systems across the continent.    The number of infections lags far behind Europe but testing has been limited and the figures are growing rapidly.    Angola and Ivory Coast on Sunday became the latest countries to record their first deaths, bringing the number of African fatalities to around 150 of nearly 4,800 recorded cases.

In Democratic Republic of Congo, two new cases were reported in the volatile South Kivu region and an adviser to the nation's president announced he had tested positive.

Ugandan President Yoweri Museveni ordered a 14-day lockdown in a bid to halt the spread of the disease after reporting 33 infections.    Police in South Sudan, one of a few nations in Africa yet to confirm a case, enforced strict new rules, shutting shops selling non-essential items and limiting passengers in public transport.   Mauritius, which has 128 cases -- the highest in East Africa -- has extended its lockdown to April 15.

South Africa's defence minister Nosiviwe Mapisa-Nqakula on Monday denounced alleged intimidation by security forces after videos emerged showing some forcing civilians to squat or roll on the ground for allegedly violating restrictions.   In an interview with local Newzroom Afrika television channel, she said she was aware of two videos "which have circulated where clearly there (is) some abuse".   "I'm saying I condemn that, we will not allow that to continue," she said.
Date: Mon, 30 Mar 2020 21:41:43 +0200 (METDST)

Kampala, March 30, 2020 (AFP) - Ugandan President Yoweri Museveni on Monday ordered an immediate 14-day nationwide lockdown in a bid to halt the spread of the coronavirus which has so far infected 33 people in the country.   Uganda last week banned public transport and sealed its borders and urged the population to stay home, but stopped short of a full shutdown.

Museveni said that from 10:00pm Monday private vehicles would also be banned, seeking to avoid give a more advanced warning that would see people flee the city, as has happened across the continent where many poor residents see better chances of survival in the countryside.   "I would have given the public time to adjust but... a longer time would give people time to go to the villages and in so doing they would transfer the very sickness we're trying to prevent. This freezing of movement will last for 14 days," he said in a televised address.

Museveni also ordered a 14-day nationwide curfew from 7:00pm.   Shopping malls and businesses selling non-food items were ordered to close.   Food market vendors who continue to trade are forbidden to return to their homes for the duration of the 14-day lockdown, while factories could stay open if remain on the premises for the duration of the shutdown.

People are still allowed to move around on foot but not gather in groups of more than five at a time.    In recent days, opposition leaders Kizza Besigye and Bobi Wine had undertaken small-scale food deliveries to people who had ost their incomes due to earlier restrictions but Museveni criticised such actions as "cheap politics".   "I direct the police to arrest the opportunistic and irresponsible politicians who tried to distribute food," he said.   "Anybody arrested in that effort will be charged with attempted murder."   Museveni said the government would begin distributing food to those who needed it, without providing details.

A weary looking Museveni, 75, pleaded with the population to change their behaviour in the face of the threat from the virus.   "This virus would not do much damage if it was not for the carelessness of people. Don't go into a group of people if you have a cold. Stay at home," he pleaded.   Last week police and Local Defence Units (LDUs) -- a uniformed militia under the control of the military - violently cleared streets in central Kampala.   Following a public outcry, army chief General David Muhoozi on Monday apologised for those actions, describing them as "high-handed, unjustified and regrettable" and said the culprits would be "dealt with".
Date: Sun 29 Mar 2020
Source: Spanish government COVID-19 update 58 [in Spanish, trans. ProMed Mod.MPP, edited]

COVID-19 update 59 [data as of 28 Mar 2020 21:00 CET]
-----------------------------------------------------
Situation in Spain
------------------
In Spain, to date [28 Mar 2020], 78 797 cases have been reported, of which 6528 have died and 14,709 recovered (table 1 and figure 1 -- at source URL above). The Autonomous Communities with the greater cumulative incidence in the last 14 days are La Rioja 419.5 per 100,000 population), Madrid 287.1 per 100,000 population), Navarre (279.4 per 100,000 population), and Castile-La Mancha (238.3 per 100,000 population) (figures 2, 3). The distribution by age groups of hospitalized patients, those admitted to the ICU, and deaths is found in table 2.

Autonomous Community:
Total / last 24 hours / Incidence per 100,000 population in past 14 days

  • Madrid: 22,677 / 1157 / 287.14
  • Catalonia: 15,026 / 763 / 186.46
  • Basque Country: 5740 / 604 / 231.45
  • Castile and Leon: 5414 / 623 / 213.46
  • Castile-La Mancha: 5246 / 734 / 238.33
  • Valencia: 4784 / 750 / 87.43
  • Andalusia: 4682 / 405 / 50.45
  • Galicia: 3139 / 367 / 109.06
  • Navarre: 2011 / 182 / 279.42
  • Aragon: 1858 / 266 / 129.69
  • La Rioja: 1629 / 193 / 419.51
  • Extremadura : 1456 / 62 / 127.47
  • Canary Islands: 1125 / 100 / 47.18
  • Asturias: 1088 / 84 / 92.98
  • Cantabria: 1023 / 86 / 167.28
  • Balearic Islands: 958 / 96 / 79.69
  • Murcia: 872 / 70 / 53.62
  • Melilla: 48 / 3 / 46.25
  • Ceuta: 21 / 4 / 23.59
********
Total: 78,797 / 6549 / 151.04
======================
[Spain has been rapidly accelerating in terms of transmission of the SARS-CoV-2. As of today (29 Mar 2020), there have been a total of 78 797 cases and 6528 deaths reported, an increase from 72 248 cases with and 5690 deaths confirmed in the preceding 24 hours. The countrywide 2-week incidence per 100 000 population is 151. It is now 2nd in Europe, behind Italy, and 4th globally behind the USA, Italy, and China, in terms of absolute numbers of cases.

Of the 78,797 cases, 43 397 (55.1%) were hospitalized, 4907 (6.2%) were admitted to the ICU. The crude reported death rate was 8.3% with more deaths occurring than reported ICU admissions.

A map of Spain showing provinces (autonomous communities) can be seen at
and a HealthMap/ProMED-mail map at <http://healthmap.org/promed/p/43>.

La Rioja, Navarre, and Basque Country are located together in the north of the country. Madrid is in the northern part of central Spain and Castilla de la Mancha is just to the south of Madrid, with Toledo as its capital. - ProMed Mod.MPP]
Date: Sun 29 Mar 2020
Source: Worldometer [accessed 10:30 PM EDT]

USA cases by state
State: Total cases / New cases

  • New York: 59,648 / 6193
  • New Jersey: 13,386 / 2262
  • California: 6312 / 653
  • Michigan: 5486 / 836
  • Massachusetts: 4955 / 698
  • Florida: 4950 / 912
  • Washington: 4483 / 173
  • Illinois: 4596 / 1105
  • Louisiana: 3540 / 225
  • Pennsylvania: 3419 / 668
  • Texas: 2808 / 479
  • Georgia: 2683 / 237
  • Colorado / 2307 / 246
  • Connecticut: 1993 / 469
  • Tennessee: 1720 / 208
  • Ohio: 1653 / 247
  • Indiana: 1514 / 282
  • Maryland: 1239 / 247
  • North Carolina: 1167 / 145
  • Wisconsin: 1154 / 165
  • Nevada: 920 / 299
  • Arizona: 919 / 146
  • Missouri / 903 / 65
  • Virginia: 890 / 151
  • Alabama: 827 / 125
  • South Carolina: 774 / 114
  • Mississippi: 758 / 179
  • Utah: 719 / 117
  • Oregon: 548 / 69
  • Minnesota: 503 / 62
  • Arkansas: 449 / 40
  • Kentucky: 439 / 45
  • Oklahoma: 429 / 52
  • District of Columbia: 401 / 59
  • Iowa: 336 / 38
  • Kansas: 319 / 58
  • Idaho: 310 / 49
  • Rhode Island: 294 / 55
  • New Hampshire: 258 / 44
  • Maine: 253 / 42
  • New Mexico: 237 / 29
  • Vermont: 235 / 24
  • Delaware: 232 / 18
  • Hawaii: 175 / 24
  • Montana: 161 / 32
  • West Virginia: 124 / 11
  • Nebraska: 120 / 24
  • Alaska: 102 / 17
  • North Dakota: 98 / 15
  • South Dakota: 90 / 22
  • Wyoming: 87 / 3
  • Guam / 56 / 5
  • Northern Mariana Islands: 2
  • Puerto Rico: 127 / 27
  • US Virgin Islands: 21 / 0
  • Wuhan repatriated: 3 / 0
  • Diamond Princess Cruise: 46 / 0
**************
Total: 142 321 / 38 179
Total reported deaths: 2484
====================
[The above are the latest breakdowns of confirmed cases of SARS-CoV-2 infection in the USA, as per Worldometer data. The total number of confirmed cases in the USA and territories is now 142 321 including 2484 deaths. New York state, with 59 648 (41.9%) cumulative cases reports and 6193 (33.3%) newly confirmed cases over the past 24 hours, is clearly the epicenter of the outbreak in the USA, although case reporting elsewhere is showing increases. Daily reported case counts are accelerating in New Jersey, Michigan, Florida, Louisiana, Massachusetts, and Illinois.

The Centers for Disease Control and Prevention website (<https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/cases-in-us.html>) has 2 epidemic curves. One focuses on date of confirmation of disease, the other on date of onset of illness. The curve of interest, by date of onset of disease, is based on 14.6% of the number of cases plotted on the epidemic curve using date of confirmation of disease.

A map of the United States can be seen at
<http://www.mapsofworld.com/usa/> and a HealthMap/ProMED-mail map at
Date: Sun 29 Mar 2020 11:46 AM GST
Source: Reuters [abridged, edited]

Iran's coronavirus death toll has risen to 2640, a health ministry official said on Sunday [29 Mar 2020], as the Middle East's worst-hit country grapples with the fast-spreading outbreak. "In the past 24 hours we had 123 deaths and 2901 people have been infected, bringing the total number of infected people to 38 309," Alireza Vahabzadeh, an adviser to the health minister, said in a tweet. "12,391 people infected from the virus have recovered." Health ministry spokesman Kianush Jahanpur told state TV that 3467 of those infected were in "critical condition".  "I am happy to announce that also 12,391 people who had been infected across the country have recovered," Jahanpur said. "The average age of those who have died of the disease is 69."

President Hassan Rouhani urged Iranians to adapt to their new way of life, which was likely to continue for some time. "We must prepare to live with the virus until a treatment is discovered ... The new measures that have been imposed are for everyone's benefit ... Our main priority is the safety and the health of our people," Rouhani said during a televised meeting.

The government has banned inter-city travel after warning of a potential surge in coronavirus cases because many Iranians defied calls to cancel travel plans for the Persian New Year holidays that began on [20 Mar 2020]. The authorities told Iranians to stay at home, while schools, universities, cultural, religious, and sports centres have been temporarily closed.

To stem the spread of the virus in crowded jails, Iran's judiciary on Sunday [29 Mar 2020] extended furloughs for 100,000 prisoners. On [17 Mar 2020], Iran said it had freed about 85,000 people from jail temporarily, including political prisoners. "The 2nd wave of (the) temporary release of prisoners had already started and their (100,000 prisoners) furloughs have been extended until [19 Apr 2020]," judiciary spokesman Gholamhossein Esmaili was reported as saying by state television. Iran said it had 189,500 people in prison, according to a report submitted by the UN special rapporteur on human rights in Iran to the Human Rights Council in January [2020].  [byline: Parisa Hafezi]
===================
[In the 24 hours from 28 to 29 Mar 2020, the number of cases of COVID-19 confirmed in Iran grew from 35 408 to, 38 309, an increase of 2901 newly confirmed cases. The number of deaths has also increased from 2517 to 2640 an increase of 123 deaths in the 24-hour period. In terms of total numbers of confirmed cases, Iran ranks 7th globally behind USA, Italy, China, Spain, Germany and France. In early March 2020, Iran and Italy were on the same trajectory with respect to daily growth in cumulative newly confirmed cases, but starting 8 Mar 2020, Italy's daily reported newly confirmed cases accelerated at an alarming speed. By 14 Mar 2020, Italy was reporting almost twice as many cases as Iran on a daily basis.

A map of Iran showing provinces can be seen at
HealthMap/ProMED-mail map at <http://healthmap.org/promed/p/128>. - ProMed Mod.MPP]
Date: Sun 29 Mar 2020
Source: Italian Government Health Ministry [in Italian, machine trans., edited]

Cases in Italy as of 6:00 pm 29 Mar 2020
----------------------------------------
Regarding health monitoring related to the spread of the new coronavirus [SARS-CoV-2] on the national territory, there are a total of 97,689 cases. At the moment 73,880 people are positive for the virus; 13,030 people have recovered. There are 27,386 patients hospitalized with symptoms, 3906 are in intensive care, and 42,588 are in home isolation.

There have been 10,779 reported deaths, however, this number can only be confirmed after the Istituto Superiore di Sanita has established the actual cause of the death.

Case distribution by province:
number of cases (number of new cases in past 24 hours)

  • Lombardy: 41 007 (1592)
  • Emilia-Romagna: 13 119 (736)
  • Veneto: 8358 (428)
  • Marche: 3558 (185)
  • Piedmont: 8206 (535)
  • Tuscany: 4122 (305)
  • Campania: 1759 (167)
  • Lazio: 2706 (201)
  • Liguria: 3076 (254)
  • Friuli Venezia Giulia: 1480 (44)
  • Sicily: 1460 (101)
  • Apulia: 1549 (91)
  • Umbria: 1023 (54)
  • Abruzzo: 1293 (160)
  • Molise: 127 (4)
  • Trento: 1594 (89)
  • Bolzano: 1214 (105)
  • Sardinia: 638 (14)
  • Basilicata: 202 (20)
  • Aosta Valley: 584 (73)
  • Calabria: 614 (59)
*********
Total: 97,689 (5217)
======================
[The tally of confirmed cases of COVID-19 in Italy is now 97,689 cases, including 10,779 deaths, up from 92,472 cases and 10,023 deaths reported on 28 Mar 2020. The 24-hour change between 28 and 29 Mar 2020 was 5217 newly confirmed cases, compared with 5974 newly confirmed cases between 27 and 28 Mar 2020. Cases continue to be concentrated in Lombardy (41 007), the epicenter of the outbreak, Emilia-Romagna (13 119), and Veneto (8358), all in the northern part of the country. Those 3 provinces combined account for 52.8% of newly confirmed cases in the past 24 hours, representing a drop from the previous 24 hours when they represented 56.% of nationally reported cases. Another active province is Piemonte with a total of 8206 cases and represents 10.3% of newly reported cases. In the past 24 hours Tuscany has reported 5.9% of newly reported cases, a slight drop from the preceding day when it was reporting 6.1% of newly confirmed cases. There is an excellent interactive map at <http://opendatadpc.maps.arcgis.com/apps/opsdashboard/index.html#/b0c68bce2cce478eaac82fe38d4138b1> to visualize the caseloads per region in near real time.

On 9 Mar 2020, Italy announced a lockdown for the northern provinces where the outbreak was concentrated. On 10 Mar 2020, this was expanded to be countrywide. On 11 Mar 2020, Italy announced the closure of non-essential businesses. It is now 19 days since the start of the lockdown in the north and 18 days since the countrywide lockdown.

A map of Italy showing regions can be seen at
HealthMap/ProMED-mail map at <http://healthmap.org/promed/p/75>. - ProMed Mod.MPP]