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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: Tue, 13 Aug 2019 11:40:19 +0200 (METDST)

Athens, Aug 13, 2019 (AFP) - Dozens of firefighters Tuesday battled a major wildfire that forced the evacuation of a monastery on the Greek island of Evia as smoke from the blaze reached as far as Athens, authorities said.   Authorities also placed on alert two villages threatened by the blaze on the island, Greece's second largest after Crete and located northeast of Athens.   The fire started at about 3 am (0000 GMT) at the side of a road and was quickly spread by strong winds through the dry and dense vegetation in the centre of the island, the semi-official news agency ANA said.

The monastery of Panagia Makrymallis was evacuated as a precaution and residents of the villages of Kontodespoti and Stavros were told to be ready to leave also, TV SKAI said.   "Everything is ready in case it is necessary to evacuate the villages. The evacuation can be done in a few minutes. We are totally prepared," Fani Spanos, the governor of central Greece who was coordinating the operations, told SKAI.   He warned the fire was not yet under control and was spreading in an area that was inaccessible overland.

Around 80 firefighters were fighting the blaze backed by some 40 fire trucks and two water-bombing helicopters and a plane.   The strong winds blew the smoke from the blazing pine forest north toward the Magnesia region and south to the Attica peninsula and Athens.   ANA said the pine forests on Evia are part of the "Natura 2000" European network of protected areas and habitats.   Greece has been hit by a spate of wildfires since the weekend amid gale-force winds and temperatures of 40 degrees Celsius (104 F).

On Monday, a major forest fire threatening homes in Peania, an eastern suburb of Athens, was brought under control. At least two houses were burned but there were no reports of injuries.   On Sunday, a fire on the small island of Elafonissos, in the Peloponnese region, was brought under control after a two-day battle.   Two more fires were doused on Saturday in Marathon, close to Mati, the coastal resort where last year 102 people died in Greece's worst fire disaster.
Date: Sun, 11 Aug 2019 14:32:21 +0200 (METDST)

Athens, Aug 11, 2019 (AFP) - A French man was charged in Greece on Sunday over a boat accident that left two dead and another person seriously injured, state TV ERT reported.   The 44-year-old was charged with negligent manslaughter by a prosecutor and given 24 hours to prepare his defence, ERT said.  The man's lawyer Nikos Emmanouilidis had earlier told reporters that his client "will assist in every way any request by the Greek authorities."

The suspect has admitted to driving a 10-metre (32-foot) speedboat which struck a smaller wooden fishing boat on Friday evening near the Peloponnese resort of Porto Heli, 170 kilometres (105 miles) southwest of Athens.   The collision killed two elderly Greek men on board. A 60-year-old Greek woman, reportedly their sister, was seriously injured and taken to Athens for treatment.

The suspect could not be located for several hours after the incident before turning himself in on Saturday.   He has denied trying to evade arrest, and claims he was also injured in the incident and had sought first aid.   The suspect has said he did not see the fishing boat, which may have had insufficient lighting, state news agency ANA reported.   He has taken a blood alcohol test, with the results to be available on Monday.   "The first indications point to excessive speed by the powerboat driver," Merchant Marine Minister Yiannis Plakiotakis told ERT on Saturday.

Ten other French nationals who were also on the speedboat -- two men, three women and five children aged three to 14 -- were initially taken to Porto Heli for questioning after helping to bring the injured woman and one of the bodies to shore, the coastguard said.   They were all released on Saturday.   Speedboat accidents involving swimmers or other boats are common in Greece during the busy summer holiday season.

Another speedboat on Friday injured a 32-year-old swimmer at the Athens coastal suburb of Glyfada. The driver was arrested.   In 2016, four people including a four-year-old girl were killed when a speedboat sliced into their wooden tourist vessel near the island of Aegina.   Nobody was sanctioned as the prime suspect, an elderly Greek man, died a year after the accident.
Date: Sat, 10 Aug 2019 19:32:52 +0200 (METDST)

Athens, Aug 10, 2019 (AFP) - Greece on Saturday battled over 50 wildfires nationwide, including a major blaze near Athens, in a dangerous mix of high temperatures and strong winds unseen in nearly a decade.   The fire department said it had mobilised more than 450 firemen and 23 aircraft nationwide to tackle the fires, including one on the island of Elafonissos and two around Marathon, near Athens.   A camping site and a hotel on Elafonissos and a children's summer camp near Marathon were evacuated as a precaution, state news agency ANA reported.

Marathon is a short distance from Mati, the coastal resort where last year 102 people died in Greece's worst fire disaster.   Temperatures in some areas are expected to hit 40 degrees Celius (104 degrees Fahrenheit) on Sunday, accompanied by gale force winds.   On Friday, civil protection chief Nikos Hardalias said it was the first time since 2012 that the country had faced such a mix of high temperatures, strong winds and low humidity.   "We are called upon to manage extreme weather conditions over the next three days... we must all be careful," Hardalias told reporters as he placed emergency services on high alert.
Date: Fri 2 Aug 2019
Source: French.Cnina.org.cn [in French, trans. Corr.SB, edited]

Two people over 80 were the 1st victims of West Nile virus in Greece this year [2019], according to the weekly epidemiological surveillance report published by the National Public Health Organization (EODY).

From the beginning of epidemiological surveillance until today [2 Aug 2019], 25 cases of West Nile virus infection have been diagnosed and studied in Greece. In 17 of the patients reported, the central nervous system (CNS) was affected (encephalitis and/or meningitis/acute flaccid paralysis), while 8 had mild symptoms, such as fever.

The median age of patients with CNS symptoms is 77 years old. Of the 25 patients, 10 are hospitalized.

The areas where virus cases have been recorded in the country are Pieria, Katerini, Pella, Xanthi, Kavala, Larissa, Karditsa as well as East Attica and Mesogia.

West Nile virus is spread mainly through the bites of infected mosquitoes, experts say.

The implementation of mosquito control and personal protection programs is most appropriate for controlling the disease, the EODY noted.
====================
[Greece has had both human and equine cases of West Nile virus in recent years. Mosquito control can be difficult and expensive, especially over such a broad geographic area. For humans, the best preventive measure is avoidance of mosquito bites. There is a vaccine for equine animals, but not for humans. - ProMED Mod.TY]

[HealthMap/ProMED map available at:
Date: Sat, 3 Aug 2019 14:22:20 +0200 (METDST)

Athens, Aug 3, 2019 (AFP) - Another earthquake shook Greece on Saturday, this time off the Aegean island of Karpathos, the Greek Geodynamic Institute said, although there were no immediate reports of damage or injuries.    The epicentre of the 4.8-magnitude quake, which occurred at 0951 GMT, was 71 kilometres (44 miles) off the coast of Karpathos at a depth of around 10 kilometres, the institute said.    It came just three days after a 5.2-magnitude quake on the island of Crete and just under a week after a 4.2-magnitude tremor some 20 kilometres northwest of Athens.

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.
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Indonesia

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

Local Customs
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The laws against illegal drugs are severe and travellers should ensure that they carry sufficient well-marked medication that they may require for their time in Indonesia. Travellers are required to show identification at any time and so carrying photocopies of your passport is a wise precaution. Keep all valuable documents in a safe place and do not flaunt personal wealth while travelling around the island.
Night Activities
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The nightlife in Bali is one of the main attractions for many tourists but sensible precautions are required. Travelling alone is unwise. Take care to ensure that your drink could not be spiked at any stage and do not walk at night, use an authorised taxi where possible. The level of HIV infection among the bar workers is high and close personal contact is very unwise.
Medical Facilities
************************************
The level of available health facilities varies greatly through Bali and other parts of Indonesia. In general most of the main hotels will have English speaking doctors but care would be required if your illness requires hospitalisation.
Food and Water
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It is wise to maintain a high level of care with regard to your food and water while in Indonesia. This includes even those in high quality hotels but also particularly for those eating from street vendors. Bivalve shellfish (e.g. oysters, mussels, clams etc) should be avoided at all times due to inadequate cooking. Bottled water should be purchased from your hotel or good quality shops to ensure that it is pure.
Mosquitoes and Insect Bites
************************************
Malaria transmission occurs throughout Indonesia all year but the risk in Bali is so low that prophylaxis is not generally recommended for most tourists. Nevertheless for those visiting Lombok (overnight visits) the risk exists and prophylaxis should be considered. Other mosquito borne diseases also occur throughout Indonesia and care must be taken to avoid insect bites. In Jakarta and other main cities there is a particular problem with a viral disease called Dengue Fever. The mosquito, which transmits this disease, typically bites during the day and in main urban centres.
Sun Exposure
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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
************************************
The extent of jet lag, which you will experience, depends on the duration of your flight and the amount of rest you were able to get before arrival. Try to rest for the first 24 hours to allow your body to acclimatise and make sure you do not fall asleep beside the swimming pool during this initial period.
Vaccinations for Bali
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There are no essential vaccines or entry to Bali from Western Europe. However for your personal protection travellers are recommended to consider vaccination cover against;
*
Poliomyelitis (childhood booster)
*
Tetanus (childhood booster)
*
Typhoid (food & water disease)
*
Hepatitis A (food & water disease)
Other travellers planning a more rural or extensive trip may need to consider other vaccine cover against diseases like Hepatitis B, Japanese B Encephalitis, Rabies.
Summary
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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: Sat, 3 Aug 2019 22:33:09 +0200 (METDST)

Jakarta, Aug 3, 2019 (AFP) - Five people died and several were injured after a powerful undersea earthquake rocked Indonesia's heavily populated Java island, triggering a brief tsunami warning, the national disaster agency said Saturday.   The 6.9 magnitude quake on Friday evening sent residents fleeing to higher ground, while many in the capital Jakarta ran into the streets.

An official from Indonesia's national disaster agency warned the quake could generate a tsunami as high as three metres (10 feet), but the alert was lifted several hours later.   Three people died of heart attacks as the strong quake rocked the region, agency spokesman Agus Wibowo said on Saturday.   Another person fell to his death while trying to flee his house when the jolt happened, he said, while a fifth victim died from a panic attack.   Four more people were injured and more than 200 buildings were damaged, with about 13 houses destroyed, he added.

More than 1,000 people, who had earlier fled to temporary shelters, returned home after authorities convinced them it was safe to do so, Wibowo said.   "There was thundering noise -- it sounded like a plane overhead -- and I was just so scared that I ran," said 69-year-old Isah, who like many Indonesians goes by one name, at an evacuation shelter in Pandeglang at the southwest end of Java.   In December, the area was hit by a volcano-sparked tsunami that killed more than 400 people.

Indonesia experiences frequent seismic and volcanic activity due to its position on the Pacific "Ring of Fire", where tectonic plates collide.   Last year, a 7.5-magnitude quake and a subsequent tsunami in Palu on Sulawesi island killed more than 2,200 people, with another thousand declared missing.   On December 26, 2004, a 9.1-magnitude earthquake struck off the coast of Sumatra and triggered a tsunami that killed 220,000 across the Indian Ocean region, including around 170,000 in Indonesia.
Date: Sun, 14 Jul 2019 12:47:38 +0200

Labuha, Indonesia, July 14, 2019 (AFP) - A major 7.3-magnitude earthquake hit the remote Maluku islands in eastern Indonesia Sunday, sending panicked residents running into the streets, but no tsunami warning was issued.   The shallow quake struck about 165 kilometres (100 miles) south-southwest of the town of Ternate in North Maluku province at 6:28 pm (0928 GMT), according to the US Geological Survey.
 
"The earthquake was quite strong, sending residents to flee outside. They are panicking and many are now waiting on the roadside," said local disaster mitigation official Mansur, who like many Indonesians goes by one name.   Officials were assessing the situation but there were no immediate reports of casualties, he told AFP.

In the town of Labuha, one of the closest to the epicentre, panicked residents took to motorcycles in a bid to flee to higher ground, according to an AFP photographer in town when the earthquake hit.   Local disaster official Ihsan Subur told Metro TV that no damage or casualties had been reported there so far, but residents took to the streets and many evacuated to higher ground.   "Electricity went of during the earthquake, but now it's back to normal," ubur said, adding that at least seven big aftershocks were felt after the initial quake.

The province was also hit by a 6.9-magnitude tremor last week.   Indonesia experiences frequent seismic and volcanic activity due to its position on the Pacific "Ring of Fire", where tectonic plates collide.   Last year, a 7.5-magnitude quake and a subsequent tsunami in Palu on Sulawesi island killed more than 2,200 people, with another thousand declared missing.   On December 26, 2004, a devastating 9.1-magnitude earthquake struck off the coast of Sumatra and triggered a tsunami that killed 220,000 across the Indian Ocean region, including around 170,000 in Indonesia.
Date: Mon, 24 Jun 2019 05:38:33 +0200

Jakarta, June 24, 2019 (AFP) - A powerful magnitude 7.3 quake struck eastern Indonesia on Monday, US seismologists said, but no tsunami warning was issued and there were no immediate reports of major damage or casualties.   The quake hit at a depth of 208 kilometres (129 miles) south of Ambon island in the Banda Sea at 11:53 local time, the US Geological Survey said.

The Pacific Tsunami Warning Center said there was no threat of a tsunami as the quake was too deep.   The strong temblor came hours after a 6.1-magnitude earthquake hit Papua, also in the eastern part of the Southeast Asian archipelago.   That quake hit about 240 kilometres (150 miles) west of the town of Abepura in Papua province, at a relatively shallow depth of 21 kilometres, according to the USGS.

There were also no immediate reports of casualties after the earthquake.   A shallower 6.3-magnitude hit the area last week, but the damage was not extensive.   Indonesia experiences frequent seismic and volcanic activity due to its position on the Pacific "Ring of Fire", where tectonic plates collide.   Last year, a 7.5-magnitude quake and a subsequent tsunami in Palu on Sulawesi island killed more than 2,200 with a thousand more declared missing.   On December 26, 2004, a 9.1-magnitude earthquake struck Aceh province, causing a tsunami and killing more than 170,000.
31st May 2019

A volcano on the Indonesian island of Bali erupted Friday, spewing a plume of ash and smoke more than 2,000 metres (6,500 feet) into the sky. Mount Agung, about 70 kilometres from the tourist hub of Kuta, has been erupting periodically since it rumbled back to life in 2017, sometimes grounding flights and forcing residents to flee their homes.
Mount Agung is about 70 kilometres from the tourist hub of Kuta

The latest shortly before noon on Friday shot a cloud of volcanic ash high into the sky, but caused no disruption to flights, Indonesia's geological agency said.  Agung remained at the second highest danger warning level, and there is a four-kilometre no-go zone around the crater.

Last summer, dozens of flights were cancelled after Agung erupted, while tens of thousands of locals fled to evacuation centres after an eruption in 2017.

The last major eruption of Agung in 1963 killed around 1,600 people.

Indonesia is situated 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: Sat 11 May 2019
Source: The Jakarta Post [edited]

No one really knows what is spreading in the small village of Garonggong in Jeneponto regency, South Sulawesi. However, for the last couple of months, nearly all people living there have been experiencing mysterious symptoms, which started with a fever and pain all over the body, especially in their joints. The unknown disease killed 4 people from a total of 72 people that had experienced similar symptoms. The village administration has declared a health emergency. Several villagers have moved to avoid contagion.  "It has been going on for 2 months. They have experienced the same symptoms, and 4 people have died because of it, including my child, a local, said on Thursday [9 May 2019] as quoted by kompas.com.

The acting head of Jeneponto Health Agency, Syafruddin Nurdin, said it all began in April [2019] when a couple of villagers were infected. By 24 Apr [2019], 17 residents had been admitted to hospitals and community health centers for the same symptoms.  Syafruddin said most of them had experienced similar symptoms, such as a fever, headache, nausea and joint pain. "All of them came from the same village, Garonggong village," Syafruddin told The Jakarta Post on Friday [10 May 2019].

However, the health workers and agency have not been able to identify the disease or the cause of it, or why it had struck many people at the same time.  "The patients gradually lost consciousness. [...] When their blood was tested, all of the suspected diseases such as malaria, dengue fever, Zika, leptospirosis, anthrax, H5N1, were all ruled out. The tests came back negative for all of them," Syafruddin said.

The Health Ministry has yet to provide an explanation on this matter, but the ministry's disease control and prevention director general, Anung Sugihantono, said his side was investigating the outbreak.  A special team consisting of academics, health and environment experts, as well as veterinarians have been deployed to the village to carry out disease surveillance and epidemiology research.

Also, 3 patients have been moved to Makassar, the provincial capital, for further examination and treatment.  "Initial laboratory research had shown indication of typhoid, but further studies are needed," he added. South Sulawesi Health Agency acting head Bachtiar Baso said one of the deceased patients was pregnant. Doctors have been treating the patients using different approaches. "Most doctors treated those admitted to the hospitals for typhoid. Some of them saw their health improve, and some of them did not," he said.

Bachtiar said the investigative team had collected blood samples from the infected patients and animals in the area and had collected soil samples.  The team suspects those affected may have had either leptospirosis, meningitis or the hantavirus, Bachtiar said. "I hope the research results will be revealed soon and the team can gain a better understanding of the disease that has been spreading across Garonggong so we can prepare the necessary medicine and preventative measures," he added.
======================
[A comprehensive laboratory workup is necessary to establish a diagnosis. There is no indication that autopsies were carried out that might provide addition clues about the aetiology. Mention was made of hantaviruses, but no mention was made of supporting laboratory results that might point to Seoul hantavirus infections, but the large number of cases occurring in a single village in a short period of time would be unusual for hantavirus infections or for scrub typhus. There was an outbreak of Japanese encephalitis (JE) in North Sulawesi last year (2018). Although there is no specific mention of encephalitis in these patients, JE should be ruled out.

ProMED-mail would be interested in receiving further information about confirmation of typhus, any new cases, or laboratory results as they become available. - ProMED Mod.TY]

[HealthMap/ProMED map available at:
Sulawesi, Indonesia: <http://healthmap.org/promed/p/535>]
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Venezuela

Venezuela US Consular Information Sheet
May 05, 2008
COUNTRY DESCRIPTION:

Venezuela is a medium income country whose economy is dominated by a substantial oil industry.
The political climate in Venezuela is highly polarized and
olatile.
Violent crime is a continuing problem.
Assaults, robberies, and kidnappings occur throughout the country.
Scheduled air service and all-weather roads connect major cities and most regions of the country.
Venezuela’s tourism infrastructure varies in quality according to location and price.
For an in depth country description of Venezuela, please read the Department of State Background Notes on Venezuela.
ENTRY/EXIT REQUIREMENTS:
A valid passport and a visa or tourist card are required.
Tourist cards are issued on flights from the U.S. to Venezuela for persons staying less than ninety days.
Persons traveling for reasons other than tourism, however, should consult the Venezuelan Embassy or nearest Venezuelan consulate regarding possible visa requirements for their specific purpose of travel.
Venezuelan immigration authorities may require that U.S. passports have at least six months validity remaining from the date of arrival in Venezuela.
Some U.S. citizens have been turned back to the United States if their passports will expire in less than six months. Passports should also be in good condition, as some U.S. citizens have been delayed or detained overnight for having otherwise valid passports in poor condition.
U.S. citizens residing in Venezuela should be careful to obtain legitimate Venezuelan documentation appropriate to their status.
There have been numerous cases in the last several months of U.S. citizens who, having employed intermediaries, received what they believed to be valid Venezuelan resident visas and work permits.
They were subsequently arrested and charged with possessing fraudulent Venezuelan documentation.
ONIDEX, the Venezuelan government agency responsible for immigration documents, has informed the Embassy that the only valid resident visas are those for which the bearer has personally signed at ONIDEX headquarters in Caracas.

Venezuelan law requires Venezuelan citizens to enter and depart Venezuela using Venezuelan passports and Venezuelan immigration authorities are increasingly enforcing this requirement.
In order to comply with U.S. and Venezuelan law, persons who hold dual American-Venezuelan nationality must plan to travel between Venezuela and the United States with valid U.S. and Venezuelan passports.
Please see our information on dual nationality for entry and exit requirements pertaining to dual nationals.
Venezuela's child protection law mandates that minors (under 18) who are citizens or non-citizen residents of Venezuela and who are traveling alone, with only one parent, or with a third party, must present a copy of their birth certificate and written, notarized authorization from the absent parent(s) or legal guardian, specifically granting permission to travel alone, with one parent, or with a third party.
This authorization must reflect the precise date and time of the travel, including flight and/or other pertinent information.
Without this authorization, immigration authorities will prevent the child's departure from Venezuela.
The Venezuelan Government no longer recognizes blanket or non-specific travel authorizations.
When a parent is deceased, a notarized copy of the death certificate is required in lieu of the written authorization.
If documents are prepared in the United States, the authorization and the birth certificate must be translated into Spanish, notarized, and authenticated by the Venezuela Embassy or a Venezuelan consulate in the United States.
If documents are prepared in Venezuela, only notarization by a Venezuelan notary is required.
A permission letter prepared outside Venezuela is valid for 90 days.
A permission letter prepared in Venezuela is valid for 60 days.
Travelers entering Venezuela from certain countries are required to have a current yellow fever vaccination certificate.
The Venezuelan government recommends that all travelers, regardless of their country of departure, be vaccinated for yellow fever before entering Venezuela.
Mosquito-borne diseases such as malaria and dengue fever are also common in some areas and travelers should take precautions to prevent infection.

An exit tax and airport fee must be paid when departing Venezuela by airline.
The exit tax is currently 46 Bolívares Fuertes, and the airport fee is currently 115 Bolívares Fuertes (a total of approximately 75 USD calculated at the official exchange rate). In many instances, especially with non-U.S. airlines, the exit tax and airport fee are not included in the airline ticket price and must be paid separately at the airport upon departure.
Authorities usually require that payment be made in local currency.
Both the departure tax and the airport fee are subject to change with little notice.
Travelers should check with their airlines for the latest information.
For current information concerning entry, tax, and customs requirements for Venezuela, travelers may contact the Venezuelan Embassy at 1099 30th Street, NW, Washington DC
20007, tel: (202) 342-2214, or visit the Embassy of Venezuela web site at http://www.embavenez-us.org/.
Travelers may also contact the Venezuelan consulates in New York, Miami, Chicago, New Orleans, Boston, Houston, San Francisco, or San Juan.
Additional information about vaccination requirements for travel to Venezuela, as well as to other international destinations, 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); fax 1-888-CDC-FAXX (1-888-232-3299), or via CDC's Internet site at http://wwwn.cdc.gov/travel/default.aspx.

Information about dual nationality or the prevention of international child abduction can be found on our web site.
For further information about customs regulations, please read our Customs Information sheet.
SAFETY AND SECURITY:
Violent crime in Venezuela is pervasive, both in the capital, Caracas, and in the interior.
The country has one of the highest per-capita murder rates in the world.
Armed robberies take place in broad daylight throughout the city, including areas generally presumed safe and frequented by tourists.
A common technique is to choke the victim into unconsciousness and then rob them of all they are carrying.
Well-armed criminal gangs operate with impunity, often setting up fake police checkpoints.
Kidnapping is a particularly serious problem, with more than 1,000 reported during the past year alone.
Investigation of all crime is haphazard and ineffective.
In the case of high-profile killings, the authorities quickly round up suspects, but rarely produce evidence linking these individuals to the crime.
Only a very small percentage of criminals are tried and convicted.

Travel to and from Maiquetía Airport, the international airport serving Caracas, can be dangerous and corruption at the airport itself is rampant.
Travelers at the airport have been victims of personal property theft, as well as mugging and “express kidnapping” in which individuals are taken to make purchases or to withdraw as much money as possible from ATMs, often at gunpoint.
The Embassy has received multiple, credible reports that individuals with what appear to be official uniforms or other credentials are involved in facilitating or perpetrating these crimes.
For this reason, American citizen travelers should be wary of all strangers, even those in official uniform or carrying official identification.
There are also known drug trafficking groups working from the airport.
Travelers should not accept packages from anyone and should keep their luggage with them at all times.

Because of the frequency of robberies at gunpoint, travelers are encouraged to arrive during daylight hours.
If not, travelers should use extra care both within and outside the airport.
The Embassy strongly advises that all arriving passengers make advance plans for transportation from the airport to their place of lodging.
If possible, travelers should arrange to be picked up at the airport by someone who is known to them.
The Embassy has received frequent reports of armed robberies in taxicabs going to and from the airport at Maiquetía.
There is no foolproof method of knowing whether a taxi driver at the airport is reliable.
The fact that a taxi driver presents a credential or drives an automobile with official taxi license plates marked “libre” is no longer an indication of reliability.
Incidents of taxi drivers in Caracas overcharging, robbing, and injuring passengers are common.
Travelers should take care to use radio-dispatched taxis or those from reputable hotels.
Travelers should call a 24-hour radio-dispatched taxi service from a public phone lobby or ask hotel, restaurant, or airline representatives to contact a licensed cab company for them.
A list of transportation services used by members of the U.S. Embassy community is available on the U.S. Embassy web site at http://venezuela.usembassy.gov/.
The Embassy does not vouch for the professional ability or integrity of any specific provider.
The list is not meant to be an endorsement by the Department of State or the Embassy.
Likewise, the absence of any individual or company does not imply lack of competence.
While visiting Venezuela, Americans are encouraged to carry as little U.S. currency on them as possible and to avoid wearing expensive or flashy watches and jewelry.
Due to the poor security situation, the Embassy does not recommend changing money at the international airport.
Visitors should bring a major credit card, but should be aware of widespread pilfering of credit card data to make unauthorized transactions.
Travelers’ checks are not recommended as they are honored in only a few locations.
It is possible to exchange U.S. currency at approved exchange offices near major hotel chains in Caracas (personal checks are not accepted) and at commercial banks with some restrictions.
Due to currency regulations, hotels cannot provide currency exchange.
There are ATM machines throughout Venezuela.
Malfunctions are common, however, and travelers should be careful to use only those in well-lit public places.
ATM data has also been hacked and used to make unauthorized withdrawals from user’s accounts.
Popular tourist attractions, such as the Avila National Park, are increasingly associated with violent crime.
Americans planning to participate in outdoor activities in potentially isolated areas are strongly urged to travel in groups of five or more and to provide family or friends with their itineraries prior to departure.
Cross-border violence, kidnapping, drug trafficking, smuggling, and cattle-rustling occur frequently in areas along the 1,000-mile long border between Venezuela and Colombia.
Some kidnap victims have been released after ransom payments, while others have been murdered.
In many cases, Colombian terrorists are believed to be the perpetrators.
Colombia's National Liberation Army (ELN) has had a long history of kidnapping for ransom, and the Revolutionary Armed Forces of Colombia (FARC) are active in the kidnapping trade.
Common criminals are also increasingly involved in kidnappings, either dealing with victim's families directly or selling the victim to terrorist groups.

In-country travel by U.S. Embassy employees, both official and private, within a 50-mile area along the entire Venezuela/Colombia border, is prohibited.
The State Department warns American citizens not to travel within a 50-mile area along the entire Venezuela/Colombia border.
U.S. citizens who elect to visit areas along the border region with Colombia despite this warning, apart from the Colombian terrorist threat, could encounter Venezuelan military-controlled areas and may be subject to search and arrest.
The U.S. Embassy must approve in advance the official travel to Venezuela of all U.S. Government personnel.
Private travel by U.S. military personnel to Venezuela requires advance approval by the U.S. Embassy.
Please consult the Department of Defense Foreign Clearance Guide at https://www.fcg.pentagon.mil/ for further information.
Non-military employees of the U.S. Government do not need Embassy approval for private travel.
Political marches and demonstrations are frequent in Caracas and often pass without incident.
Nevertheless, travelers should be aware that violence, including exchanges of gunfire, has occurred at political demonstrations in the past.
Demonstrations tend to occur at or near university campuses, business centers, and gathering places such as public squares and plazas.
Marches generally occur on busy thoroughfares, significantly impacting traffic.
Most major tourist destinations, including coastal beach resorts and Margarita Island, have not in the past been generally affected by protest actions.
The city of Merida, however, a major tourist destination in the Andes, has been the scene of frequent student demonstrations, some of them violent, including the use of firearms.
Travelers should keep informed of local developments by following the local press, radio and television.
Visitors should also consult their local hosts, including U.S. and Venezuelan business contacts, hotels, tour guides, and travel organizers.
As circumstances warrant, the Embassy sends out messages to U.S. citizens who have registered on-line.
These messages are also posted on the U.S. Citizens page of the Embassy’s web site at http://venezuela.usembassy.gov/.
U.S. citizens traveling or residing in Venezuela are advised to take common-sense precautions and avoid large gatherings and demonstrations, no matter where they occur.
Harassment of U.S. citizens by pro-government groups, Venezuelan airport authorities, and some segments of the police occurs but is quite limited. Venezuela’s most senior leaders, including President Chavez, regularly express anti-American sentiment.
The Venezuelan government’s rhetoric against the U.S. government, its American culture and institutions, has affected attitudes in what used to be one of the most pro-American countries in the hemisphere.

Venezuela is an earthquake-prone country and is occasionally subject to torrential rains, which can cause major disasters such as the one in Vargas State in 1999.
Travelers who intend to rent or purchase long-term housing in Venezuela should choose structures designed for earthquake resistance.
Such individuals may wish to seek professional assistance from an architect or civil/structural engineer, as does the Embassy, when renting or purchasing a house or apartment in Venezuela.
Americans already housed in such premises are also encouraged to seek a professional structural assessment of their housing.

For further information on seismic activity, you may wish to visit:

1. The Multidisciplinary Center for Earthquake Engineering Research (MCEER) web site at http://mceer.buffalo.edu/infoservice/Quakeline_Database/default.asp
2. The Global Seismic Hazard Assessment Program web site at www.seismo.ethz.ch/GSHAP
3. The Caribbean Disaster Mitigation Project web site at www.oas.org/CDMP
For the latest security information, Americans traveling abroad should regularly monitor the Department of State, Bureau of Consular Affairs’ web site, where the current Travel Warnings and Travel Alerts 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. and Canada, or for callers outside the U.S. and Canada, a regular toll-line at 1-202-501-4444.
These numbers are available from 8:00 a.m. to 8:00 p.m. Eastern Time, Monday through Friday (except U.S. federal holidays).
The Department of State urges American citizens to take responsibility for their own personal security while traveling overseas.
For general information about appropriate measures travelers can take to protect themselves in an overseas environment, see the Department of State’s pamphlet A Safe Trip Abroad.
CRIME: Venezuela and its capital, Caracas, have one of the highest per capita murder rates in the world.
Virtually all murders go unsolved.
The poor neighborhoods that cover the hills around Caracas are extremely dangerous.
These areas are seldom patrolled by police and should be avoided.
Armed robberies are common in urban and tourist areas throughout Venezuela, even areas presumed safe and visited by tourists.
Crimes committed against travelers are usually money-oriented crimes, such as theft and armed robbery.
Incidents occur during daylight hours as well as at night.
Many criminals are armed with guns or knives and will use force.
Jewelry attracts the attention of thieves.
Travelers are advised to leave jewelry items, especially expensive-looking wristwatches, at home.
Gangs of thieves will often surround their victims and use a chokehold to disable them, even in crowded market areas where there is little or no police presence.
Theft from hotel rooms and safe deposit boxes is a problem, and theft of unattended valuables on the beach and from rental cars parked near isolated areas or on city streets is a common occurrence.
A guarded garage or locked trunk is not a guarantee against theft.
Pickpockets concentrate in and around crowded bus and subway stations in downtown Caracas.
Subway escalators are favored sites for "bump and rob" petty thefts by roving bands of young criminals.
Many of these criminals are well dressed to allay suspicion and to blend in with crowds using the subways during rush hour.
Travelers should not display money or valuables.
"Express kidnappings," in which victims are seized in an attempt to get quick cash in exchange for their release, are a problem.
Kidnapping of U.S. citizens and other foreign nationals, from homes, hotels, unauthorized taxis and the airport terminal has occurred.
U.S. citizens should be alert to their surroundings and take necessary precautions.
The Department has received reports of robberies during nighttime and early morning hours on the highways around and leading to Caracas.
Reports have specifically involved cars being forced off the La Guaira highway leading from Caracas to the Maquetía International Airport, and the "Regional del Centro" highway leading from Caracas to Maracay/Valencia, at which point the victims are robbed.
The Department recommends avoiding driving at night and in the early morning where possible.
Drivers traveling on highways during nighttime and early morning hours should exercise caution.
Police responsiveness and effectiveness in Venezuela vary drastically but generally do not meet U.S. expectations.
U.S. travelers have reported robberies and other crimes committed against them by individuals wearing uniforms and purporting to be police officers or National Guard members.
Incidents of piracy off the coast of Venezuela remain a concern.
Some of these incidents have been especially violent, including the severe beating of a U.S. citizen in 2002, the fatal shooting of an Italian citizen in January 2004, and a machete attack on a U.S. citizen in 2005.
U.S. citizen yachters should exercise a heightened level of caution in Venezuelan waters.
Please consult the U.S. Coast Guard web site at http://www.uscg.mil/hq/g-o/g-opr/g-opr.htm for additional information on sailing in Venezuela.

Rules governing the sale of fuel to foreign sailors in Venezuela vary by state.
U.S. citizen yachters should inquire about specific state procedures prior to attempting to purchase fuel in any given location.
Failure to comply with a state’s particular requirements can result in arrest and criminal charges.

The Embassy is aware of several instances where women lured American men to Venezuela after establishing “relationships” with them over the Internet.
Some of these men were robbed shortly after they arrived in Venezuela.
Others were recruited to act as narcotics couriers or “drug mules.”
In three instances, the Americans were arrested at the airport with narcotics in their possession and served extended jail terms in Venezuela.
In many countries around the world, counterfeit and pirated goods are widely available.
Transactions involving such products may be illegal under local law.
In addition, bringing them back to the United States may result in forfeitures and/or fines.
More information on this serious problem is available at http://www.cybercrime.gov/18usc2320.htm.
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 are solely the responsibility of local authorities, consular officers can help you to understand the local criminal justice process and to find an attorney if needed.
See our information on Victims of Crime.
MEDICAL FACILITIES AND HEALTH INFORMATION:
Medical care at private hospitals and clinics in Caracas and other major cities is generally good.
Public hospitals and clinics generally provide a lower level of care and basic supplies at public facilities may be in short supply or unavailable.
Cash payment is usually required in advance of the provision of medical services at private facilities, although some facilities will accept credit cards.
Patients who cannot provide advance payment may be referred to a public hospital for treatment.
Private companies that require the patient to be a subscriber to the service or provide cash payment in advance generally provide the most effective ambulance services.
Public ambulance service is unreliable.
U.S. citizens should be aware that due to the currency restrictions in effect in Venezuela they might find it difficult to receive wire transfers from abroad, whether through a bank or Western Union.
Such wire transfers cannot be used reliably as a source of emergency funds.
U.S. citizens traveling to Venezuela may also find it difficult to obtain certain prescription drugs, particularly name brands, and should ensure that they have sufficient quantities of all medications for the duration of their stay.
Information on vaccinations and other health precautions, such as safe food and water precautions and insect bite protection, may be obtained from the Centers for Disease Control and Prevention’s hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747) or via the CDC’s web site at http://wwwn.cdc.gov/travel/default.aspx.
For information about outbreaks of infectious diseases abroad consult the World Health Organization’s (WHO) web site at http://www.who.int/en.
Further health information for travelers is available at http://www.who.int/ith/en.
MEDICAL INSURANCE:
The Department of State strongly urges Americans to consult with their medical insurance company prior to traveling abroad to confirm whether their policy applies overseas and whether it will cover emergency expenses such as a medical evacuation.
Please see our information on medical insurance overseas.
TRAFFIC SAFETY AND ROAD CONDITIONS:
While in a foreign country, U.S. citizens may encounter road conditions that differ significantly from those in the United States.
The information below concerning Venezuela is provided for general reference only, and may not be totally accurate in a particular location or circumstance.
Driving regulations in Venezuela are similar to those in the United States, although many drivers do not obey them.
Defensive driving is a necessity.
Child car seats and seatbelts are not required and are seldom available in rental cars and taxis.
Outside the major cities, night driving can be dangerous because of unmarked road damage or repairs in progress, unlighted vehicles, and livestock.
Even in urban areas, road damage is often marked by a pile of rocks or sticks left by passersby near or in the pothole or crevice, without flares or other devices to highlight the danger.
Traffic jams are common within Caracas during most of the day and are frequently exploited by criminals. Stops at National Guard and local police checkpoints are mandatory.
Drivers should follow all National Guard instructions and be prepared to show vehicle and insurance papers and passports.
Vehicles may be searched.
Inexpensive bus service is available to most destinations throughout the country, but the high incidence of criminal activity on public transportation makes bus travel inadvisable.
Peak holiday travel occurs during summer and winter school breaks and major civil and religious holidays, including Carnival, Easter, Christmas and New Year's holidays.
Lengthy delays due to road congestion are common during these peak periods.
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 Venezuela’s Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for the oversight of Venezuela’s air carrier operations.
For more information, travelers may visit the FAA’s web site at http://www.faa.gov/safety/programs_initiatives/oversight/iasa/.
SPECIAL CIRCUMSTANCES: In February 2007, the National Assembly granted President Chavez the authority to rule by decree in 11 general areas for 18 months.
Laws issued by President Chavez under this authority become effective immediately after their publication in the government legislative gazette.
As a result, laws directly impacting U.S. Citizens or their interests in Venezuela may come into force with little or no warning.
U.S. Citizens are advised to carefully monitor changes in Venezuelan law. Venezuela is also slated to hold gubernatorial and mayoral elections nation-wide in late 2008.
These electoral races are expected to generate extensive political campaigning from pro-government and opposition parties.
The government of Venezuela implemented rigid foreign exchange controls in 2003, including a fixed official rate of exchange.
Foreign exchange transactions must take place through exchange houses or commercial banks at the official rate.
As of October 2005 it is no longer possible to exchange money at hotels.
Currency exchange for tourists can be arranged at "casas de cambio" (exchange houses).
There are exchange houses located near most major hotels.
It is also possible to exchange money at commercial banks; however, visitors should be aware that the exchange would not be immediate.
Exchanges through commercial banks must first be approved by the Commission for Administration of Foreign Currencies (CADIVI).
This requires a registration process, which delays the exchange.
The exchange control mechanisms also require the exchange houses and commercial banks to obtain authorization from CADIVI to trade Bolívares Fuertes (the local currency) into U.S. dollars.
Outside the major cities, a good supply of Venezuelan currency is necessary, as it may be difficult to find exchange houses.
The Embassy cannot provide currency exchange services.
Travelers will likely encounter individuals in Venezuela who are willing to exchange Bolívares Fuertes for U.S. dollars at a rate significantly higher than the official rate of exchange.
These "parallel market" currency exchanges are prohibited under the Venezuelan foreign exchange controls.
Travelers engaging in such activity may be detained by the Venezuelan authorities.
Additionally, in accordance with an October 2005 law, any person who exchanges more than 10,000 U.S. dollars in the course of a year through unofficial means is subject to a fine of double the amount exchanged.
If the amount exceeds 20,000 U.S. dollars the penalty is two to six years imprisonment.
Any person who transports more than 10,000 U.S. dollars into or out of Venezuela by any means must declare this amount to customs officials.
Credit cards are generally accepted at most upscale tourist establishments, but foreign exchange controls have made credit card acceptance less common than in the past.
Visa, MasterCard, and American Express have representatives in Venezuela.
Due to the prevalence of credit card fraud in Venezuela, travelers should exercise caution in using their credit cards and should check statements regularly to ensure that no unauthorized charges have been made.
Most major cities have ATMs with 24-hour service where users may withdraw local currency, but many of these ATMs will not accept U.S.-issued debit cards.
Venezuelan customs authorities may enforce strict regulations concerning temporary importation into or export from Venezuela of items such as plant and animal products, firearms, medications, archaeological or "cultural heritage" items, and pirated copies of copyrighted articles.
It is advisable to contact the Embassy of Venezuela in Washington or one of Venezuela's consulates in the United States for specific information regarding customs requirements.
Please see our Customs Information.
CRIMINAL PENALTIES:
While in a foreign country, a U.S. citizen is subject to that country's laws and regulations, which sometimes differ significantly from those in the United States and may not afford the protections available to the individual under U.S. law.
Penalties for breaking the law can be more severe than in the United States for similar offenses.
Persons violating Venezuela’s laws, even unknowingly, may be expelled, arrested, or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in Venezuela are severe, and convicted offenders can expect long jail sentences and heavy fines.
Engaging in sexual conduct with children or using or disseminating child pornography in a foreign country is a crime, prosecutable in the United States.
Please see our information on Criminal Penalties.
CHILDREN'S ISSUES:
For information see our Office of Children’s Issues web pages on intercountry adoption and international parental child abduction.

REGISTRATION / EMBASSY LOCATION:
Americans living or traveling in Venezuela are encouraged to register with the U.S. Embassy in Caracas through the State Department’s travel registration web site so that they can obtain updated information on travel and security within Venezuela.
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 to contact them in case of emergency.
The Consular Section is open for American Citizen Services from 8:00 a.m. to 10:30 a.m. Monday through Friday, excluding U.S. and Venezuelan holidays.
The U.S. Embassy is located at Calle Suapure and Calle F, Colinas de Valle Arriba, Caracas.
The telephone number during regular business hours (8:00 a.m. to 5:00 p.m.) is (58) (212) 975-6411.
In case of an after-hours emergency, callers should dial (58) (212) 907-8400.
The Embassy’s web site, http://venezuela.usembassy.gov/ , contains complete information about services provided and hours of operation.
A part-time consular agent in Maracaibo provides services for U.S. citizens in western Venezuela.
The agent is available to the public every Monday from 8:15 am to 12:15 pm, at the Centro Venezolano Americano del Zulia (CEVAZ), Calle 63 No. 3E-60, Maracaibo; telephone 58)(0261) 793-2101 or 793-3488.
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This replaces the Consular Information Sheet dated November 1, 2007, and updates all sections.

Travel News Headlines WORLD NEWS

Date: Sat 20 Jul 2019
Source: El Pitazo [in Spanish, trans. ProMED KS, edited]

More than 10 cases of malaria have been reported in the Boyaca III sector of Barcelona (Anzoategui, Venezuela) in the past 2 weeks. Of these cases, 2 are young children aged 1 and 2 years old, infected after the bite of the _Aedes aegypti_ mosquito.

Maria Febres, a nurse and resident of the community, states that the malaria outbreak is due to the lack of weeding and cleaning in the channel that crosses the Boyaca III sector, where more than 500 families reside.  "We have 12 cases of malaria in the sector. We need them to come clean the canal, which has not received adequate maintenance for 2 years, putting many families at risk of contracting malaria due to the proliferation of mosquitoes," she said.

The nurse told the infociudadano [city correspondent] of El Pitazo [local media company], Eduardo Mora, that the sector has not been fumigated since 2018, and called on Public Health and Malariology officials to visit the area and verify what is happening.  "The most affected area is Boyaca III sector II, because we have a Simoncito [children's centre -- so-called in honour of Simon Bolivar] there and the children who go every day are the ones most at risk of being bitten by an infected mosquito and, thus, getting malaria," said Maria.  [Byline: Giovanna Pellicani]
===================
[Over the past 5 years, the malaria control programme in Venezuela has not be functioning, and malaria has resurged in most of the country, which is well illustrated by this report. - ProMED Mod.EP]

[HealthMap/ProMED-mail maps:
Anzoategui, Venezuela: <http://healthmap.org/promed/p/40477>]
Date: Sun, 7 Jul 2019 14:05:22 +0200
By Guillaume DECAMME

El Tucuco, Venezuela, July 7, 2019 (AFP) - The sweltering heat of the Venezuelan forest makes no difference to Jose Gregorio, who trembles with a cold chill. "I have pain everywhere, fever," he stammers.    Gregorio has the classic symptoms of malaria, a disease eradicated years ago among his Yukpa indigenous people, but it's back with a vengeance all across crisis-struck Venezuela.   "He had sore joints and then started vomiting, and it's been four or five days since he's eaten anything," says his worried wife Marisol.   Their four-month-old baby babbles beside his father on the bed.   "The baby and I also had malaria," says Marisol. "Before, that was not the case here, there was only chikungunya and dengue, malaria came back here last year."

She doesn't bat an eyelid at the mention of either of the other mosquito-borne viruses, whose spread has been fueled by the collapse of Venezuela's health system.   "Here" is El Tucuco, a small village at the foot of the mountains that form the border with Colombia, a three-hour drive from Maracaibo in Venezuela's western Zulia state.   With 3,700 people, El Tucuco is the Yukpas' "capital" and malaria is rapidly making its presence felt here as in the rest of Venezuela -- a country that could once boast of being the first to have eradicated the disease in 1961.

- 'Pandemic' -
There are no official statistics on malaria's reach into El Tucuco, nor on the number of deaths it causes.    But from his consulting room at the Catholic Mission, Dr Carlos Polanco is seeing a developing crisis.    "Out of 10 people who are tested for malaria in the village laboratory, four to five come out with a positive test. This is an alarming figure."   Brother Nelson Sandoval, a Capuchin friar who presides over the mission, adds: "Before entering the order, I already knew this community and I had never seen a case of malaria. Today we are in the middle of a pandemic."   El Tucuco is affected by Plasmodium vivax, the most geographically widespread malarial species. The more lethal Plasmodium falciparum strain is prevalent in the Amazonian regions of southeastern Venezuela.

According to Sandoval and Polanco, the reason for malaria's sudden virulence in El Tucuco is simple: once-regular fumigation missions by the Venezuelan government stopped.   "And as the population of mosquitos increased, cases exploded," said Polanco.   Added to this is the malnutrition that weakens resistance to the disease, a new phenomenon since the economic crisis took hold at the end of 2015.    "Before, it was possible to vary one's diet, but with inflation the Yukpa cannot afford it," instead making do with what they can grow, like cassava and plantain, according to Polanco.   Rosa, 67, knows all about malnutrition. Lying on the floor of her house, she is battling malaria for the third time. "The doctor weighed me yesterday -- 37 kilograms. I was 83 kilos before."

A report published in British medical journal The Lancet in February warned of an epidemic of malaria and dengue fever as a result of the continuing crisis in Venezuela.   Between 2016 and 2017 alone, the number of malaria cases in the nation jumped 70 per cent.    "The situation is catastrophic," said Dr Huniades Urbina, secretary of the national Academy of Medicine. In 2018, "there were 600,000 cases of malaria and we, the scientific organizations, estimate that in 2019 we could reach a million cases" -- one in every 30 people.   But these figures are only estimates, "because the government conceals the statistics."

-'Nobody answers us'-
The malaria explosion has gone hand in hand with the worsening economic crisis. According to Nicolas Maduro's government, inflation reached a staggering 130,000 percent in 2018 and GDP halved between 2013 and 2018.    In the oil-rich state of Zulia, service stations have been dry for more than a month. Electricity blackouts are commonplace and residents flee abroad in their thousands.   Despite a poster of late president Hugo Chavez at the entry to the clinic, there is little sign of government presence in El Tucuco. Dr Luisana Hernandez despairs of ever seeing any state help.   "Every day, everything is deteriorating a bit more," she says, exasperated. Refrigerators intended to keep vaccines cold do not work "because we have no gasoline to run the generator," and both the clinic's broken-down ambulances are gathering rust in the garden.   "We've knocked on every door. But nobody answers us," said Hernandez.

Without fuel to bring drugs from the city, without resources to prevent illnesses, eradicating malaria in an almost impossible task.   Brother Nelson does what he can, with help from the Catholic charity Caritas and the Pan American Health Organization. His mission distributes the antimalarial drugs chloroquine and primaquine to sick Yukpa people.   Maria Jose Romero, 22, was able to benefit from treatment. "Repeated seizures are due to the fact that many people cannot follow the treatment," for lack of drugs, she said.   Romero now lives across the border in Colombia, having fled Venezuela. She is visiting El Tucuco to see her family. Soon she will return to the other side of the mountain, on foot.   "It's three days' walk," she says.
Date: Wed 19 Jun 2019
Source: InSight crime [edited]

Disease outbreaks show desperate Venezuelans have migrated to illegal gold mining areas for work.

Outbreaks of malaria and diphtheria in a region of Venezuela where these diseases are rare has revealed how armed groups are organizing a vast migration to illegal mines.

The outbreaks show that criminals operating in the state of Miranda found a way to make money amid the country's worsening crisis by moving into the illegal gold mines of Bolivar state, in the south of Venezuela.

In the middle of 2017, doctors witnessed an unusual, sustained, and inexplicable malaria outbreak in Valles del Tuy, a region in the state of Miranda located between the coast and the center of Venezuela where the mosquito-borne disease is seldom seen, Efecto Cocuyo reported.

The startling epidemic offered the 1st clue to the changing criminal dynamics in the region.

"Malaria was not a disease native to states in the center of the country, so this caught our attention. We started to ask patients about it to find out how they contracted it. The surprise came when one of the patients told me that he had caught it in the mining region in the state of Bolivar, where they went to work in gold mining," explained a doctor whose practice is in Charallave, the municipal seat in Cristobal Rojas municipality in Miranda state. The doctor asked to remain anonymous for security reasons.

Pressured by the economic situation and massive inflation, residents of the Valles del Tuy region began working during their vacations in the illegal mines in Bolivar, more than 500 kilometers [about 311 mi] away. The doctor said that they were recruited by 'pranes', or prison gang bosses, who had previously been the leaders of local 'megabandas' in Valles del Tuy.

The megabandas' grip on Valles del Tuy began in 2013, when various sites were converted into so-called peace zones, areas where security forces could not enter.

Later, when kidnappings and extortion stopped being profitable in the poor areas where they operated, members of the same megabandas migrated to the mining region in search of other sources of income, and to escape police and military raids.

InSight crime analysis
----------------------
Criminals are not immune to the effects of Venezuela's current economic, political, and social crisis.

Many criminals, primarily pranes and leaders of megabandas, have been forced to abandon their former strongholds and change the pattern of their criminal activities, according to investigations conducted by InSight Crime.

Criminals are trading robbery, petty theft, and kidnappings for drug trafficking and illegal mining. Additionally, they are migrating to states where these illicit economies are strongest: Sucre, Zulia, Tachira, and Bolivar. In the south of Venezuela, Bolivar has become the principal destination for the pranes of Valles del Tuy.

Ramon Teran Rico, alias "Monchi," for example, was the leader of one of the largest criminal organizations in the state of Miranda. Community representatives told InSight Crime that he fled to Bolivar's mines 2 years ago.

Monchi was the 1st crime boss to try his luck at the Orinoco Mining Arc, a transnational mining project created in 2016. He gradually moved his henchmen there from the Valles del Tuy. Sources in his circle of friends say that he even purchased his own dredge to extract gold.

Leaders of other criminal structures operating in the Valles del Tuy have also had to reinvent themselves in order to survive, and have moved into southern Venezuelan states where they operate comfortably.

Hundreds of residents of the towns in Valles del Tuy have migrated to the mining region. "All of the families here have at least one person that has gone to work in the mines," said a resident of Ocumare del Tuy in Miranda state, who reports seeing his neighbors' children and relatives head for the mines.

In November 2016, a case of diphtheria, an acute infectious disease [that most commonly affects the throat and the tonsils], was detected in the Sucuta sector of Ocumare del Tuy, alerting health authorities to the re-emergence of a disease rarely seen in the center of the country.

Follow-up with the patient found that he had contracted the infection in the Bolivar mines.

Health authorities developed prevention plans targeted at the neighborhoods where criminal groups operate. Investigations conducted by health authorities demonstrated that the men that go to work in the mines, as well sex workers or women who work in the kitchens there, carried these diseases back to the Valles del Tuy.

The public health problem shed light on the fact that an illegal gold mining fever had emerged -- an economic lifeline that is now strengthening organized crime.  [Byline: Venezuela Investigative Unit]
=======================
[Malaria has surged in Venezuela over the past 9 years (see ProMED reports below). Control measures have ceased to exist and drugs for treatment have become difficult to find. The association with illegal haphazard mining was reported from Bolivar state in 2012, and the present report underlines that such activities constitute high risk for malaria and other diseases.

The diphtheria outbreak that began in July 2016 remains ongoing. Through February 2019, Venezuela has seen a total of 2726 suspected cases (1612 confirmed), including 164 in 2019 to date (<http://outbreaknewstoday.com/diphtheria-update-venezuela-60872/>). - ProMED Mod.EP]

[Maps of Venezuela:
Date: Sat, 25 May 2019 03:37:38 +0200
By Andrea TOSTA

Caracas, May 25, 2019 (AFP) - If it weren't for the Center for Malaria Studies in Caracas, Francelis Pacheco would have been unable to get treatment for a disease she has contracted around 20 times.   Pacheco, 25, sells clothes and cigars in the claustrophobic tunnels of gold mines in southern Venezuela's Bolivar state, where a type of malaria-carrying mosquito is particularly active.   "If it weren't for (treatment) here, honestly I don't know what I would have done," Pacheco told AFP as she waited in the clinic for a new diagnosis, having spent several months in Bolivar state and neighboring Guyana, some 600 kilometres (370 miles) from her Caracas home.

The clinic, though, is not immune to Venezuela's economic crisis and is struggling to treat patients.   This is a country that lacks 85 percent of the medicines it needs, according to the pharmaceuticals industry.   With a tiny budget, the malaria clinic, which was opened in 1973, relies on donations.   Between 20 and 30 people a day from all over the country come get diagnosed and receive medication to alleviate the symptoms of a disease that can be fatal.

- 'Zero funding' -
Scientists who would later work for this clinic contributed in 1961 to helping Venezuela become the first country to eradicate malaria.   However, there was a resurgence seven years ago, worsening to become an epidemic in 2016, according to the Red de Epidemiologia NGO.   Today the clinic is in a sorry state: yellowed microscopes, a dishwasher stained by purple chemicals, refrigerators corroded by rust.   Over the years, fridges, freezers and air conditioners have stopped working and there's been no budget to  repair or replace them. Maintenance costs $1,000 a month.   Until 2007, the clinic received state funding for studies, but the money dwindled and then disappeared, Oscar Noya, the institution's director, told AFP.   "In Venezuela, scientific and investigative funding is zero!" he said.

The clinic has eight staffers who are paid salaries equivalent to $7 to $11 a month.   "We're at extreme poverty levels," said Noya, adding that "a full-time researcher should earn $4,000 to $5,000 a month."   Despite this, the center continues to propose malaria research projects to universities in France, Spain or Scotland, which allows them to secure funding.   According to the World Health Organization, Venezuela registered more than 400,000 malaria cases in 2017, making it one of the hardest-hit countries in the Americas.   Noya, though, believes the true extent of the epidemic is "close to two million" people affected.   The clinic treated 3,500 patients in 2018 alone, a figure that was "150 times greater than the past but with the same number of staff."

- Surviving on donations -
The government stopped publishing its epidemiology bulletins in 2016 when it acknowledged 240,000 cases.   Venezuela is blighted by the worst economic crisis in its recent history with basic necessities such as food and medicine in short supply.   Oil production, on which Venezuela is almost entirely dependent, has dropped alarmingly in the last decade while the International Monetary Fund predicts inflation will reach a staggering 10 million percent this year.

President Nicolas Maduro's government blames the country's woes on US sanctions, which the socialist leader claims have cost Venezuela $30 billion.   The malaria clinic survives on donations from NGOs such as Doctors Without Borders, Aid For Aids and the Rotary Club, as well as through international partnerships.   The money raised is spent on medicine, quick test kits, gloves and chlorine to clean the facilities.   In 2018, they also received anti-malaria medication from the Pan American Health Organization after two years without any, Noya said.   "Today, we're on the mat... but we're fighters and that's why we're still here, even though we've had many offers to leave the country" for work, he added.
Date: Sun, 10 Mar 2019 00:58:06 +0100

Caracas, March 9, 2019 (AFP) - Fifteen Venezuelans with advanced kidney disease have died after being unable to get dialysis during the country's extended power outage, an NGO reported Saturday.   "Between yesterday and today, there were 15 deaths for lack of dialysis," said Francisco Valencia, director of the Codevida health rights group.

"The situation of people with kidney failure is very difficult, critical, we are talking about 95 percent of dialysis units, which today likely hit 100 percent, are paralyzed, due to the power outage," Valencia added.   He warned that there are more than 10,200 dialysis-dependent people nationwide who were at risk by the blackout.   Venezuelans since Thursday afternoon have been in the grips of the worst blackout in the history of the oil-producing country.   President Nicolas Maduro government has charged that a US-led war on electric power supply was under way.

The United States backs the interim presidency of opposition leader Juan Guaido. He is now recognized as interim president for more than 50 countries.   Maduro told supporters Saturday that almost 70 percent of power had been restored but at midday there was another cyber "attack at one of the generators that was working perfectly and that disturbed and undid everything we had achieved."   Although Caracas and the states of Miranda and Vargas -- home to the country's international airport and main port -- had intermittent power, the western regions of Barinas, Tachira and Zulia remained without electricity.
More ...

World Travel News Headlines

Date: Mon, 19 Aug 2019 03:45:54 +0200 (METDST)

Lomo del Pino, Spain, Aug 19, 2019 (AFP) - A raging wildfire on the Spanish holiday island of Gran Canaria forced the evacuation of some 5,000 people, authorities said Sunday, warning it could take days for the blaze to be brought under control.   The fire, which has spread to the mountainous Cruz de Tejeda region popular with tourists for its breathtaking views, is "extremely fierce" and "unstable", said Canary Islands president Angel Victor Torres in a statement.   No fatalities have been reported.

More than 600 firefighters and 14 aircraft battled to contain the flames, hampered by strong winds and high temperatures.   With the temperature set to rise Monday, authorities estimate it could take days before the blaze is brought under control.   "The next few hours will be very important because the weather forecast for the night is not good," Torres said.   The fire broke out days after another wildfire in the same region forced the evacuation of hundreds.

Gran Canaria is the second most populous of the Canary Islands in the Atlantic off the northwest coast of Africa.   The Canary Islands received 13.7 million foreign visitors last year, over half of them from Britain and Germany.   Spain is frequently plagued by huge forest fires because of its arid summer climate.
Date: Sun, 18 Aug 2019 23:01:00 +0200 (METDST)

Lisbon, Aug 18, 2019 (AFP) - Portuguese fuel tanker drivers whose strike has caused fuel shortages at the summer holiday season on Sunday ended their industrial action.   Drivers have been staging a strike since Monday to demand further wage increases in 2021 and 2022, prompting the government to declare an energy crisis.   "Since all the conditions are now in place to negotiate, we decided to end the strike," Pedro Pardal Henriques, spokesman for the National Union of Dangerous Goods Carriers (SNMMP), told reporters.

A meeting is scheduled for Tuesday, the union President Francisco Sao Bento said, adding that the union did not "rule out new strikes being called if Antram (the employers association) adopts an uncompromising attitude".   Police had launched an operation to escort fuel tankers with extra supplies and Portugal also mobilised about 500 members of the security forces to replace the strikers and drive the trucks.   Despite the shortages, Energy Minister Joao Pedro Matos Fernandes said about two-thirds of the country's 3,000 or so petrol stations had not run dry.
Date: Sun, 18 Aug 2019 11:47:26 +0200 (METDST)
By By Emal Haidary and Mushtaq Mojaddidi

Kabul, Aug 18, 2019 (AFP) - Joy and celebration turned into horror and carnage when a suicide bomber targeted a packed Afghan wedding hall, killing at least 63 people in the deadliest attack to rock Kabul in months, officials and witnesses said Sunday.   The massive blast, which took place late Saturday in west Kabul, came as Washington and the Taliban finalise a deal to reduce the US military presence in Afghanistan and hopefully build a roadmap to a ceasefire.   The groom recalled greeting smiling guests in the afternoon, before seeing their bodies being carried out hours later.

The attack "changed my happiness to sorrow", the young man, who gave his name as Mirwais, told local TV station Tolo News.   "My family, my bride are in shock, they cannot even speak. My bride keeps fainting," he said.   "I lost my brother, I lost my friends, I lost my relatives. I will never see happiness in my life again."   Interior ministry spokesman Nasrat Rahimi said at least 63 people had been killed and 182 injured.   "Among the wounded are women and children," Rahimi said. Earlier he stated a suicide bomber carried out the attack.

Afghan weddings are epic and vibrant affairs, with hundreds or often thousands of guests celebrating for hours inside industrial-scale wedding halls where the men are usually segregated from the women and children.   "The wedding guests were dancing and celebrating the party when the blast happened," recounted Munir Ahmad, 23, who was seriously injured and whose cousin was among the dead.   "Following the explosion, there was total chaos. Everyone was screaming and crying for their loved ones," he told AFP from his bed in a local hospital, where he is being treated for shrapnel wounds.

Images from inside the hall showed blood-stained bodies on the ground along with pieces of flesh and torn clothes, hats, sandals and bottles of mineral water. The huge blast ripped parts of the ceiling off.   The wedding was believed to be a Shia gathering. Shia Muslims are frequently targeted in Sunni-majority Afghanistan, particularly by the so-called Islamic State group, which is also active in Kabul but did not immediately issue any claim of responsibility.

Wedding guest Hameed Quresh told AFP the young couple were saying their vows when the bomb went off.    "We fainted following the blast, and we don't know who brought us to the hospital," sobbed Quresh, who lost one brother and was himself wounded.   Another guest told Tolo that some 1,200 people had been invited. With low security, weddings are seen as easy targets.   The attack sent a wave of grief through a city grimly accustomed to atrocities. President Ashraf Ghani called it "barbaric", while Afghanistan's chief executive Abdullah Abdullah described it as a "crime against humanity".

- Withdrawal deal expected -
The attack underscores both the inadequacy of Afghanistan's security forces and the scale of the problem they face. While the police and army claim they prevent most bombings from ever happening, the fact remains that insurgents pull off horrific attacks with chilling regularity.   On July 28, at least 20 people were killed when attackers targeted Ghani's running mate Amrullah Saleh as he campaigned in presidential elections.    The incident showed how even amid tight security and known threats, insurgents can conduct brazen attacks.   The issue also goes to the heart of a prospective deal between the US and the Taliban that would see Washington begin to withdraw its approximately 14,000 soldiers from Afghanistan.

The deal relies on the Taliban providing guarantees they will stop jihadist groups such as Al-Qaeda and IS from using Afghanistan as a safe haven. Saturday's attack suggests any such promise would be tough to keep.   The "Taliban cannot absolve themselves of blame, for they provide platform for terrorists," Ghani said.   Few believe such a deal will bring quick peace.

Many Afghans fear the Taliban could return, eroding hard-won rights for women in particular and leading to a spiralling civil war.   Meanwhile, in the northern province of Balkh, 11 members of the same family were killed when their car hit a roadside bomb, officials said. The provincial governor blamed the Taliban for planting the device.
Date: Sun, 18 Aug 2019 05:28:47 +0200 (METDST)
By Amélie BOTTOLLIER-DEPOIS

Paris, Aug 18, 2019 (AFP) - Seafood lovers who prize the mussel for its earthy taste and succulent flesh may be unaware of its growing potential in the fight against water pollution.   The mussel is the hoover of the sea, taking in phytoplankton for nourishment along with microplastics, pesticides and other pollutants -- which makes it an excellent gauge.

One day, it may also be pressed into service to cleanse water.   "It's a super-filter in the marine world, filtering up to 25 litres of water a day," says marine biologist Leila Meistertzheim.   "It's a real model of bioaccumulation of pollutants generally speaking."   As they pump and filter the water through their gills in order to feed and breathe, mussels store almost everything else that passes through -- which is why strict health rules apply for those destined for human consumption.

Like canaries in a coal mine, mussels have long been used as "bio-indicators" of the health of the seas, lakes and rivers they inhabit.   Little-known pollutants can turn up to join the usual suspects, with increasing attention paid to microplastics containing bisphenol A and phthalates, both thought to be endocrine disruptors.

Meistertzheim heads a study for France's Tara Ocean Foundation using mussels to gauge the health of the estuaries of the Thames, Elba and Seine rivers.   The mussels, placed in fish traps, are submerged in the waters for a month before researchers dissect them to determine what chemical substances lurk in their tissues.   The idea of deploying mussels across the oceans to absorb ubiquitous microplastics is just a dream for now, but for other pollutants, the bivalves are already at work.   "In some places, mussels are used, as well as oysters, to cleanse the sea of pesticides, for example," Meistertzheim notes.

- E. coli busters -
Richard Luthy, an environmental engineer from California's Stanford University, says that, in most cases, mussels harvested from contaminated waters should not be eaten.   But if the contaminant is E. coli, mussels can be thanked for the "removal and inactivation" of the faecal material, he says, calling the service a "public health benefit".   The mussels are edible because they "excrete the bacteria as faeces or mucus," he says.   Mussels living in waterways affected by eutrophication -- often marked by abundant algae -- are also fit for human consumption, researchers say.   The phenomenon is often the result of waste dumped into the waterway containing phosphates and nitrites, such as detergents, fertilisers and sewage.   The nutrients in these substances encourage the proliferation of algae, which in turn starves the water of oxygen, upsetting the ecosystem.

Mussels "recycle" these nutrients by feeding on the algae, says Eve Galimany, a researcher of the US National Oceanic and Atmospheric Administration's Milford Laboratory who has experimented with mussels in the Bronx River in New York.   The recycling principle is already at work in a pilot project titled Baltic Blue Growth in Sweden, Denmark and the Baltic countries which grows mussels to be fed to animals such as poultry, fish and pigs.   "Eutrophication... is the biggest problem of the Baltic Sea, the most urgent one," says project head Lena Tasse. Mussels "could be part of a solution".   Why feed them to animals if they are safe for humans? Because Baltic mussels are too small to be of interest to seafood lovers, says Tasse, adding: "Swedes like big mussels."

Meanwhile, the jury is still out on the effects of microplastics on human health.   A recent report by WWF said that humans ingest an average of five grammes of microplastics a week -- about the weight of a credit card.   A 2018 study published in the journal Environmental Pollution, based on samples from British coastlines and supermarkets, estimated that every 100 grammes (3.5 ounces) of mussels contained 70 tiny pieces of plastic.   Should we be worried? Meistertzheim thinks not.   "I eat them," she says. "A dish of mussels is not necessarily worse than organic hamburger meat wrapped in plastic."
Date: Sat, 17 Aug 2019 20:51:48 +0200 (METDST)
By Ricky Ombeni and Marthe Bosuandole

Kinshasa, DR Congo, Aug 17, 2019 (AFP) - Measles has killed 2,758 people in the DR Congo since January, more than the Ebola epidemic in a year, medical NGO Doctors Without Borders said, and called Saturday for a "massive mobilisation of funds."   The disease, preventable with a vaccine, has infected over 145,000 people in the Democratic Republic of Congo between January and early August, it said in a statement.   "Since July, the epidemic has worsened, with a rise in new cases reported in several provinces," said the NGO that goes by its French acronym MSF.   "Only $2.5 million has been raised out of the $8.9 million required for the Health Cluster response plan  -- in stark contrast with the Ebola epidemic in the east of the country, which attracts multiple organisations and hundreds of millions of dollars in funding," it added.

MSF tweeted that without a "massive mobilisation of funds and response organisations, the current measles outbreak in #DRCongo could get even worse."   The NGO said it has vaccinated 474,860 children between the ages of six months and five years since the beginning of the year, and provided care to more than 27,000 measles patients.   In the country's east, Ebola has claimed more than 1,900 lives since erupting last August.

Measles is a highly-contagious diseased caused by a virus that attacks mainly children. The most serious complications include blindness, brain swelling, diarrhoea, and severe respiratory infections.   Last year, cases more than doubled to almost 350,000 from 2017, according to the World Health Organization, amid a rise in "anti-vaxxer" sentiment in some countries that can afford the vaccine, and lagging resources for the preventative measure in poor nations.   The DR Congo declared a measles epidemic in June.
Date: Sat, 17 Aug 2019 12:12:19 +0200 (METDST)

Toulouse, France, Aug 17, 2019 (AFP) - Nine people were injured during a fireworks display in a popular resort in southern France when one rocket misfired close to onlookers on the beach, firefighters said Saturday.   Three of those hurt in the incident in on Friday night in Collioure were taken to hospital after the device "exploded very low" and rained down sparks on some of the 80,000 crowd, firefighters and the local prefecture said.

One person remained in hospital after surgery for a shoulder fracture.   The misfiring rocket was part of a show on a barge just off the port of Collioure, a small picturesque seaside town near the Spanish border whose 3,000 population mushrooms around 30-fold with summer tourists.   Three doctors on site swiftly intervened to treat those injured, the local prefecture said, adding local police have opened an investigation into the incident.
Date: Fri, 16 Aug 2019 21:37:39 +0200 (METDST)
By Ricky Ombeni and Marthe Bosuandole

Bukavu, DR Congo, Aug 16, 2019 (AFP) - A woman has died of Ebola and her infant son was diagnosed with the virus in the first confirmed cases in DR Congo's South Kivu province, reviving fears Friday the highly contagious disease could spread through the region.

The Democratic Republic of Congo's Ebola epidemic has claimed more than 1,900 lives since erupting last August.   "Two cases which tested positive for Ebola were confirmed overnight in South Kivu, in Lwindi district in the Mwenga region," the provincial government said in a statement.   A woman in her twenties died while her seven-month-old child tested positive for the virus and is receiving treatment, the vast central African nation's pointman on Ebola, Jean-Jacques Muyembe, said in a statement.

The woman had been staying with a family in the North Kivu town of Beni, the epicentre of the outbreak, and was identified as a "high-risk contact" of one of the family members infected with Ebola, the statement said.   She then "escaped" movement controls in the area, changing identities four times and travelling from Beni through the North Kivu cities of Butembo and Goma to South Kivu's Bukavu and Mwenga, the statement added.    She died on Wednesday.   "We reassure neighbouring countries that all steps are being taken to strengthen surveillance at points of entry as well as sanitary control," the statement said.    South Kivu shares borders with Rwanda, Burundi and Tanzania.

World Health Organization (WHO) chief Tedros Adhanom Ghebreyesus tweeted that the outbreak in South Kivu "has sparked a rapid response... to provide treatment, identify all contacts, raise community awareness & begin vaccinating".   The International Federation of Red Cross and Red Crescent Societies (IFRC) said it was "rapidly deploying an expert team" to the area.   And South Kivu Governor Theo Ngwabidje told reporters: "Teams from the national anti-Ebola coordination campaign arrived yesterday to provide support."

- Risk of crossing border 'enormous' -
The outbreak of the haemorrhagic virus began in neighbouring North Kivu province on August 1, 2018 and spread to Ituri province.   The WHO declared the epidemic a "public health emergency of international concern" last month after cases were confirmed in the densely-populated North Kivu capital Goma.   The city's proximity to Rwanda and many transport links sparked fears of cross-border spread.    "Beni, Butembo and Goma are still containable," a Congolese professor and epidemiologist said of the three North Kivu cities.   "But with the disease in South Kivu, the risks of it spreading to (the eastern DR Congo town) of Kalemie, Tanzania and Burundi are enormous."

Residents in South Kivu's capital Bukavu said they were worried.   "At this time of year, we rarely have running water -- how are we going to avoid this disease if we have to frequently wash our hands?" asked mother-of-five Martine Mushagalusa.   Anselme Kangeta, 35, said: "Given the crowded way we live, movement is uncontrolled, people go from one place to another without taking precautions. The authorities must get involved otherwise we will all die."   South Kivu experienced an Ebola scare on July 31 when doctors briefly quarantined 15 people in the town of Birava over fears they were infected, but tests came back negative.

- Drug breakthrough -
Ebola is named after a river in northern DR Congo, formerly named Zaire, where the virus was first identified in 1976.   The latest outbreak is the second-deadliest on record after more than 11,000 people were killed in Guinea, Sierra Leone and Liberia between 2014-2016.   The pathogen causes fever, vomiting and severe diarrhoea, often followed by kidney and liver failure, and internal and external bleeding.   The disease is spread by contact with infected bodily fluids and is fought with the time-honoured but laborious techniques of tracing contacts and quarantining them.

The cases in South Kivu come on the heels of researchers announcing a possible breakthrough in the quest for drug to treat Ebola. Two prototype drugs, REGN-EB3 and mA114, slashed mortality rates among Ebola patients in a
trial in eastern DR Congo.   The authorities have also deployed a US-made vaccine called rVSV-ZEBOV, which is unlicensed but has been widely tested for safety.    Muyembe, appointed by President Felix Tshisekedi to coordinate the campaign against Ebola, predicted Thursday that with the new drugs and vaccine "we can manage to completely control the epidemic in three to four months".    Nearly 200,000 people have been vaccinated to date.   Burundi said Wednesday it had begun vaccinating frontline workers at its border with DR Congo.
Date: Fri 16 Aug 2019
Source: CBS Boston [edited]

The Massachusetts Department of Public Health has confirmed a 2nd human case of eastern equine encephalitis [EEE] in the state on Friday [16 Aug 2019]. Officials also raised the risk level for EEE to "critical" in 10 more towns in central and eastern Massachusetts.

The department said the new EEE case is in a man between the ages of 19-30 in Grafton. As a result, Grafton, Hopkinton, Northbridge, Shrewsbury, Southboro, Upton, and Westboro are all at "critical risk" for EEE.  The wife of the Grafton man diagnosed with EEE says he is in his late 20s and lives near a farm. The couple asked not to be identified but told WBZ he was diagnosed after having a seizure.  A goat in Bristol County has also tested positive for EEE, leading officials to put Easton, Norton and Raynham at critical risk as well. A total of 19 communities across the state are at critical risk now, and 18 are at high risk.

The department said it is working with local boards of health and mosquito control experts to work on "appropriate public health response activities."  "The most intense level of EEE activity is still being seen in Bristol and Plymouth Counties," said Public Health Commissioner Monica Bharel in a statement. "However, in active EEE years, the virus may move outside of southeastern Massachusetts. This is evidence of that movement, and residents in the area of increased risk should use mosquito repellent and avoid outdoor activities at night."  Less than a week ago, the department confirmed the 1st human case of EEE in Massachusetts since 2013. The infected man is over 60 and lives in southern Plymouth County.

So far, EEE has been found in 288 mosquito samples.  "[The] history here in Massachusetts [is that] the mosquitos test positive, but the people don't, so this is a little bit unusual," said Dr. Michael Hirsh of the Worcester Division of Public Health.  He said weather may be to blame. "Whenever there is a winter that doesn't have a really hard frost, if it's much more mild, the mosquitoes don't really ever knock off from last year."  Residents should make efforts to avoid mosquito bites, which can spread EEE, including using insect repellent, being aware of peak mosquito hours (dusk to dawn), wearing long sleeve shirts and pants when outside, draining standing water from around your home, replacing window screens, and protecting your animals from mosquitos.

EEE symptoms can range from a stiff neck, headache and lack of energy to dangerous complications like inflammation and swelling of the brain.  The risk of EEE will remain until the 1st killing frost.
========================
[There was a recent human eastern equine encephalitis (EEE) case in Massachusetts, the 1st human case that ProMED-mail has posted this year (2019), and now a 2nd case in that state and the 3rd in the eastern USA.

So far this year (2019), all of the EEE cases other than in humans posted on ProMED-mail have been in horses, indicating that this has been an active EEE virus transmission season. The case above again reminds us that human cases occur as well. As usual, the equine cases have occurred in the eastern states and a midwestern state in the USA. There is a vaccine available for equine animals, and their owners are wise to have them vaccinated. There is no commercially available vaccine for humans, so avoidance of mosquito bites is the best preventive measure.

Additional information on EEE is available on the CDC website at
<https://www.cdc.gov/EasternEquineEncephalitis/>. - ProMED Mod.TY]

[HealthMap/ProMED map available at:
Massachusetts, United States: <http://healthmap.org/promed/p/224>]
Date: Sun 18 Aug 2019
Source: Taipei Times [abridged, edited]

The Centers for Disease Control (CDC) yesterday [17 Aug 2019] confirmed 5 new measles cases associated with a cluster outbreak in Taipei, saying that 1981 people who had come into direct contact with the patients would be monitored for symptoms until 6 Sep 2019.

The cases are likely associated with a man in his 30s living in northern Taiwan who was infected with measles in Viet Nam, returned home on 29 Jul 2019, transmitted the disease to his flat-mate, and was confirmed to have measles on Wed 31 Jul 2019, the centres said.

One of the 5 cases confirmed yesterday [17 Aug 2019] is a man in his 30s who was on the same flight with the index case on 29 Jul 2019 and was in Viet Nam from 5 Aug to Wed 14 Aug 2019, so he might have been infected by the index case or by other people in Viet Nam, it added.

The other 4 patients are nurses who work at Cathay General Hospital's emergency room who had come into contact with the index case, the CDC said.

The nurses started experiencing symptoms between Friday last week [9 Aug 2019?] and Thursday this week [15 Aug 2019?], CDC Deputy Director-General Chuang Jen-hsiang said, adding that one of them was vaccinated for measles, mumps and rubella (MMR) in 2013, and 2 were vaccinated last year [2018], but the other has not been vaccinated.

The hospital held an emergency response meeting to discuss prevention measures and asked the medical practitioners who have had direct contact with the index case to have their measles antibody levels measured and receive an MMR vaccine if no antibodies are found, hospital deputy superintendent Lee Chia-long said. The hospital also asked medical practitioners with higher antibody levels to help screen patients with a fever, control the personnel who are allowed to enter the emergency room, take disinfection measures, and put up posters to warn people about clustered measles cases, he said.

One 119 measles cases have been confirmed this year [2019] -- 72 domestic cases, among whom 51 had come into contact with confirmed cases, and 47 imported -- the CDC said.  [Byline: Lee I-chia]
Date: Fri 16 Aug 2019
Source: 1 News Now [abridged, edited]

A spike in measles cases this week is the worst since the outbreak started, Auckland Regional Public Health Service said.

In the past week, there have been 81 new cases.

As of midday [16 Aug 2019], the total number of cases in Auckland this year [2019] was 456.