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Greece

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

Travel News Headlines WORLD NEWS

6th December, 2019
HSE Health Protection Surveillance Centre

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Anguilla US Consular Information Sheet
March 03, 2009
COUNTRY DESCRIPTION: Anguilla is a British overseas territory in the Caribbean, part of the British West Indies. It is a small but rapidly developing island with particularly well-developed
ourist facilities.

ENTRY/EXIT REQUIREMENTS:
The Intelligence Reform and Terrorism Prevention Act of 2004 requires all travelers to and from the Caribbean, Bermuda, Panama, Mexico and Canada to have a valid passport to enter or re-enter the United States. U.S. citizens must have a valid U.S. passport if traveling by air, including to and from Mexico.
If traveling by sea, U.S. citizens can use a passport or passport card. We strongly encourage all American citizen travelers to apply for a U.S. passport or passport card well in advance of anticipated travel.
American citizens can visit travel.state.gov or call 1-877-4USA-PPT (1-877-487-2778) for information on how to apply for their passports.

In addition to a valid passport, U.S. citizens need onward or return tickets, and sufficient funds for their stay.
A departure tax is charged at the airport or ferry dock when leaving. For further information, travelers may contact the British Embassy, 19 Observatory Circle NW, Washington, DC
20008; telephone (202) 588-7800; or the nearest consulate of the United Kingdom in Atlanta, Boston, Chicago, Dallas, Los Angeles, New York, Denver, Houston, Miami, Orlando, Seattle, or San Francisco. Visit the British Embassy web site for the most current visa information.

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

SAFETY AND SECURITY:
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, as well as the Worldwide Caution, can be found.

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

The Department of State urges American citizens to take responsibility for their own personal security while traveling overseas.
For general information about appropriate measures travelers can take to protect themselves in an overseas environment, see the Department of State’s A Safe Trip Abroad.

CRIME:
While Anguilla's crime rate is relatively low, both petty and violent crimes
do occur. Travelers should take common-sense precautions to ensure their personal security, such as avoiding carrying large amounts of cash or displaying expensive jewelry. Travelers should not leave valuables unattended in hotel rooms or on the beach. They should use hotel safety deposit facilities to safeguard valuables and travel documents. Similarly, they should keep their lodgings locked at all times, whether they are present or away, and should not leave valuables in their vehicles, even when locked.

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

The local emergency line in Anguilla is 911.
See our information on Victims of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION:
There is only one hospital, Princess Alexandra Hospital (telephone: 264-497-2551), and a handful of clinics on Anguilla, so medical facilities are limited.
Serious problems requiring extensive care or major surgery may require evacuation to the United States, often at considerable expense.

There are no formal, documented HIV/AIDS entry restrictions for visitors to and foreign residents of Anguilla, but there have been anecdotal reports of exclusion.
Please verify this information with the British Embassy before you travel.

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.
For information about outbreaks of infectious diseases abroad, consult the World Health Organization’s (WHO) web site.
Further health information for travelers
is available from the WHO.

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

Unlike the U.S., traffic in Anguilla moves on the left. The few roads on the island are generally poorly paved and narrow. While traffic generally moves at a slow pace, with the increasing number of young drivers in Anguilla, there are occasional severe accidents caused by excessive speed. Although emergency services, including tow truck service, are limited and inconsistent, local residents are often willing to provide roadside assistance. For police, fire, or ambulance service dial 911.

Please refer to our Road Safety page for more information.
Visit the Government of Anguilla web site for further road safety information.

AVIATION SAFETY OVERSIGHT:
Civil aviation operations in Anguilla fall under the jurisdiction of British authorities. The U.S. Federal Aviation Administration (FAA) has assessed the Government of the United Kingdom’s Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for oversight of Anguilla’s air carrier operations.
For more information, travelers may visit the FAA web site.

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 Anguilla laws, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in Anguilla 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 Anguilla are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department's travel registration web site and to obtain updated information on travel and security within Anguilla. Americans without Internet access may register directly with the nearest U.S. Embassy or Consulate. By registering, American citizens make it easier for the Embassy or Consulate to contact them in case of emergency. The U.S. Embassy with consular responsibility over Anguilla is located in Bridgetown, Barbados in the Wildey Business Park in suburban Wildey, southeast of downtown Bridgetown.
The main number for the Consular Section is (246) 431-0225; after hours, the Embassy duty officer can be reached by calling (246) 436-4950.
Visit the U.S. Embassy Bridgetown online for more information.
Hours of operation are 8:30 a.m. – 4:30 p.m. Monday through Friday, except Barbadian and U.S. holidays.
* * *
This replaces the Country Specific Information for Anguilla dated April 2, 2008, to update sections on Country Description, Entry/Exit Requirements, Information for Victims of Crime, and Medical Facilities and Health Information.

Travel News Headlines WORLD NEWS

Date: Sat, 9 Sep 2017 19:31:32 +0200

Paris, Sept 9, 2017 (AFP) - France's meteorological agency on Saturday issued its highest warning for the Caribbean islands of St Martin and St Barts as Hurricane Jose bore down, three days after they were hit by Hurricane Irma.   The alert warned of a "dangerous event of exceptional intensity," with winds that could reach 120 kilometres (75 miles) per hour, and strong rains and high waves.

St Barts is a French overseas territory, as is the French part of St Martin, which is divided between France and the Netherlands.   Twelve people were killed on the two islands by Hurricane Irma, thousands of buildings were flattened and the authorities are struggling to control looting.   The French state-owned reinsurer CCR on Saturday estimated the damage at 1.2 billion euros ($1.4 billion).   Irma is now heading for Florida, where a total of 6.3 million people have been ordered to evacuate, according to state authorities.
Date: Tue 29 Apr 2014
Source: National Institute for Public Health and the Environment [edited]

1 Oct 2013-29 Apr 2014 (week 18) St Maarten - Since the last report (week 15 [17?]) 52 new cases have been confirmed among St Maarten residents. Up to 29 Apr 2014, now a total of 343 confirmed cases have been reported. One of these confirmed cases was hospitalized.

The median age of the confirmed patients was 44 years, range 4-92 years. Of those cases for which gender was available, 201 were female and 130 were male.

- On 6 Dec 2013, the 1st indigenous chikungunya [virus infection] case of St Maarten was reported. Retrospectively, the 1st patient with suspected complaints was reported in mid-October 2013 in St Martin.
------------------------------------
Communicated by:
Roland Hubner
Superior Health Council
Brussels
Belgium
=====================
[The report also has graphs showing case numbers over time.

Maps of St Martin/St Maarten can be accessed at
Date: 5-11 May 2014
Source: Institut de Veille Sanitaire (French Institute for Public Health Surveillance, InVS) [edited]

Cases since the beginning of the outbreak in December 2013:
- St Martin: (susp) 3240 cases; deaths 3; stable.
- St Barthelemy: (susp) 500 cases; stable.
- Martinique: (susp) 24 180; deaths 3; increasing.
- Guadeloupe: (susp) 13 600 cases; deaths 1; increasing.
- French Guiana: (susp) not available; (probable or confirmed) 122 cases with 83 locally acquired; increasing, with a new cluster in Kourou and 2 near Cayenne.
======================
[The 16 May 2014 report from Guyaweb (<http://www.guyaweb.com/actualites/news/sciences-et-environnement/le-chik-revient-kourou-setend-cayenne-desormais-saint-laurent/>) states that there are 2 new cases in Saint-Laurent-du-Maroni, overlooking the Suriname River, of which one is certainly autochthonous, and a new focal point occurred in Kourou with 4 cases.

Maps of the area can be seen at
and <http://healthmap.org/promed/p/35574>. - ProMed Mod.TY]
Date: 7-13 Apr 2014
Source: INVS Point Sanitaire No. 14 [in French, trans. ProMed Mod.TY, edited]

Cases since the beginning of the outbreak in December, 2013:
- St. Martin: (susp.) 2980 cases, (probable and conf.) 793 cases; Deaths 3; Decreasing.
- Saint Barthelemy: (susp.) 460 cases, (probable or confirmed) 135 cases; Decreasing.
- Martinique: (susp.) 16 000, (probable or confirmed) 1473 cases; Deaths 2; Increasing.
- Guadeloupe: (susp.) 4710 cases, (probable or confirmed) 1261 cases; Deaths 1; In epidemic status.
- French Guiana: (susp.) 7 cases with 4 locally acquired, (probable or confirmed) 39 cases with 26 locally acquired) 30 cases; (imported) 16 cases; Moderate to increasing; Half of probable and confirmed cases are located in Kourou; however indigenous cases have also been recorded from the Cayenne Matoury, Remire and Macouria communities.
=================
[Maps showing case distributions on each island can be accessed at the above URL. - ProMed Mod.TY]
Date: Thu 27 Mar 2014
Source: The Daily Herald [edited]

As St. Maarten continues to take measures to combat the spread of the chikungunya virus, the number of cases continues to climb.

Health Minister Cornelius de Weever announced on Wednesday [26 Mar 2014], that the total number of confirmed chikungunya cases thus far stood at 224.

De Weever also announced that government will be signing a Memorandum of Understanding (MOU) with French St. Martin as a means of collectively responding to the mosquito threat that puts the population at risk. He said both sides have been working closely together to address the dengue and chikungunya threats.

The MOU will cover, amongst other things, a regular exchange of epidemiological information on vector-borne diseases and collectively publishing and representing data collected under the agreement.

The need for collective information campaigns and enhancement of the mosquito vector-control programme will also be included in the MOU. The MOU also describes the need for planning execution and evaluation of collective responses to the chikungunya threat.
=========================
[The increase in the number of chikungunya virus infections over the past week in St. Maarten is of concern, rising from 123 cases to 224 cases. This number is confirmed in another report that also indicates that there are an additional 325 suspected cases (<http://www.rivm.nl/dsresource?type=pdf&disposition=inline&objectid=rivmp:239786>).  - ProMed Mod.TY]

[A HealthMap/ProMED-mail map can be accessed at:
<http://healthmap.org/promed/p/35574>.]
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Norway

Norway US Consular Information Sheet
November 10, 2008
COUNTRY DESCRIPTION:
Norway is a highly developed stable democracy with a modern economy.
The cost of living in Norway is high and tourist facilities are well developed and widely
available.
Read the Department of State Background Notes on Norway for additional information.

ENTRY/EXIT REQUIREMENTS:
Norway is a party to the Schengen agreement.
As such, U.S. citizens may enter Norway for up to 90 days for tourist or business purposes without a visa.
The passport should be valid for at least three months beyond the period of stay.
For further details about travel into and within Schengen countries, please see our fact sheet.

Contact the Royal Norwegian Embassy at 2720 34th Street NW, Washington, DC
20008-2714, Tel: 1-202-333-6000, web site: http://www.norway.org or the nearest Norwegian Consulate.
Consulates are located in Houston, Minneapolis, New York City, and San Francisco.
Information can also be obtained from the Norwegian Directorate of Immigration at http://www.udi.no.

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:
Norway remains largely free of terrorist incidents.
However, like other countries in the Schengen area, Norway’s open borders with its European neighbors allow the possibility of terrorist groups entering/exiting the country with anonymity.
The U.S. government remains deeply concerned about the heightened threat of terrorist attacks against U.S. citizens and interests abroad.
In the post-9/11 environment, Norway shares with the rest of the world an increased threat of international Islamic terrorism. Norway was among a list of countries named as legitimate targets in al-Qa’ida audiotapes released as recently as, 2006.
Americans are reminded to remain vigilant with regard to their personal security and to exercise caution.

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

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

The Department of State urges American citizens to take responsibility for their own personal security while traveling overseas.
For general information about appropriate measures travelers can take to protect themselves in an overseas environment, see the Department of State’s A Safe Trip Abroad.

CRIME INFORMATION:
Norway has a relatively low crime rate.
Most crimes involve the theft of personal property.
Residential burglaries, auto theft, and vandalism to parked cars also occur.
Most high-end value vehicles, especially in Oslo, have visible alarm system indicators to discourage joy riders or thieves.
Persons who appear affluent or disoriented may become targets of pick-pockets and purse-snatchers, especially during the peak tourist season (May-September).
Thieves frequently target tourists in airports, train stations, and hotels, particularly lobby/reception and restaurant areas.
Often such thieves work in pairs and use distraction as a method to steal purses or briefcases.
While passports are frequently stolen in the course of these thefts, money, credit cards, and jewelry are the actual objects of interest.
In some cases stolen passports are recovered.
Violent crime, although rare, occurs and appears to be increasing.
Some thieves or burglars may have weapons.

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, to contact family members or friends and explain how funds could be transferred.
Although the investigation and prosecution of the crime is solely the responsibility of local authorities, consular officers can help you to understand the local criminal justice process and to find an attorney, if needed.

Norway has a program to provide financial compensation to victims who suffer serious criminal injuries.
Claimants can obtain application forms from the Norwegian Criminal Injuries Compensation Authority at http://www.voldsoffererstatning.no/index.php?id=10.
Please contact the U.S. Embassy in Oslo for further information. For further information about possible U.S. compensation, see our information for Victims of Crime.

The national emergency telephone numbers in Norway, equivalent to the “911” emergency line, are: Police 112, Fire 110, Ambulance 113.

MEDICAL FACILITIES AND HEALTH INFORMATION:
Medical facilities are widely available and of high quality, but may be limited outside the larger urban areas.
The remote and sparse populations in northern Norway, and the dependency on ferries to cross fjords of western Norway, may affect transportation and ready access to medical facilities.
The U.S. Embassy in Oslo maintains a list of emergency clinics in major cities.

The U.S. Department of State is unaware of any HIV/AIDS entry restrictions for visitors to or foreign residents of Norway.
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:
Healthcare in Norway is very expensive and healthcare providers sometimes require payment at time of service.
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 Norway is provided for general reference only, and may not be totally accurate in a particular location or circumstance.


Public transportation in Norway is generally safe, and the maintenance and condition of urban roads are generally good.
Rural road conditions are fair and the availability of roadside assistance is limited.
Most roadways beyond the city limits of Oslo and other major cities tend to be simple two-lane roads.
In mountainous areas of Norway, the roads also tend to be narrow and winding, with many tunnels.
The northerly latitude can also cause road conditions to vary greatly, depending on weather and time of year.
Many mountain roads are closed due to snow from late fall to late spring.
The use of winter tires is mandatory on all motor vehicles from November to April.

Norwegian law requires that drivers always use their vehicle headlights when driving.
Norwegian law also requires drivers to yield to vehicles coming from the right.
In some, but not all, instances, major roads with “right of way” are marked.
Seatbelts are mandatory for drivers and passengers.

Norway has some of the strictest laws in Europe concerning driving under the influence of alcohol; those laws prescribe heavy penalties for drivers convicted of having even a low blood alcohol level.
Frequent road checks with mandatory breathalyzer tests and the promise of stiff jail sentences encourage alcohol-free driving.
The maximum legal blood alcohol content level for driving a car in Norway is .02 per cent.

Automatic cameras placed by the police along roadways help to maintain speed limits, which are often lower than in other European countries.
Fines – and sometimes even jail time – are imposed for violations.


Please refer to our Road Safety page for more information.
For specific information concerning Norwegian driver's permits, vehicle inspection, road tax and mandatory insurance, contact the Norwegian Tourist Board office at P.O. Box 4649, Grand Central Station, New York, New York 10163-4649 (tel.: 212-885-9700; fax: 212/885-9710) or visit their web site at http://www.norway.org/travel
AVIATION SAFETY OVERSIGHT:
The U.S. Federal Aviation Administration (FAA) has assessed the Government of Norway’s Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for oversight of Norway’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:
Please see our information on customs regulations.

CRIMINAL PENALTIES: While in a foreign country, a U.S. citizen is subject to that country's laws and regulations, which sometimes differ significantly from those in the United States and may not afford the protections available to the individual under U.S. law.
Penalties for breaking the law can be more severe than in the United States for similar offenses.
Persons violating Norway’s laws, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in Norway are strict and convicted offenders can expect long jail sentences and heavy fines.
Engaging in illicit 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 in or visiting Norway are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department’s travel registration web site, https://travelregistration.state.gov, and to obtain updated information on travel and security within Norway. Americans without Internet access may register directly with the nearest U.S. Embassy or Consulate.
By registering, American citizens make it easier for the Embassy or Consulate to contact them in case of emergency.
The U.S. Embassy is located in Oslo near the Royal Palace at Henrik Ibsensgate 48; tel. 47/2244-8550 (24 hours), consular fax 47/2256-2751.
The Embassy’s web site is http://norway.usembassy.gov
*
*
*
*
*
This replaces the Consular Information Sheet dated April 23, 2008 to update the sections on Crime, Safety and Security, Information for Victims of Crime, and Medical Facilities and Health Information.

Travel News Headlines WORLD NEWS

Date: Tue 3 Sep 2019
Source: Food Safety News [edited]
-------------------------------------------------------------
More than 100 people have fallen ill in Norway from norovirus likely in a frozen seaweed salad from China. The 1st outbreak of norovirus suspected to be linked to the seaweed salad occurred in mid-June 2019 and the most recent was at the beginning of August 2019. The implicated product was also shipped to Denmark.

"It is suspected that seaweed from China was the cause of more than 100 cases of gastroenteritis from at least 11 eateries in different areas of Norway. Most of the outbreaks were in June and July 2019. Investigations are still ongoing. Norovirus was detected in patients from at least 2 of these eateries," Guri Aanderud, senior adviser in the seafood section at the Norwegian Food Safety Authority (Mattilsynet) told Food Safety News.

"We have no information regarding individual cases such as age, sex, place of residence, or hospitalization related to these outbreaks as norovirus is not notifiable in Norway. However, symptoms of norovirus are generally mild and self-limiting. All involved restaurants have received and served seaweed salad from two different lots in the relevant time period. Many of the people who reported illness have stated that they have eaten dishes containing seaweed salad."

On 22 Aug 2019, Goma Wakame Seaweed salad bags of 1000-gram imported into Norway by Ostlandske Formidling AS (Ofas) were withdrawn from the market due to suspected norovirus. Product was sold to the food service sector in Norway but distribution may have included several stores across the country. It was imported into Denmark by World Seafood and is produced by Dalian Kowa Foods Co. in China. Affected bags have item number 8032 and lot number 1904, which was manufactured on 14 Mar 2019, and lasts until 13 Mar 2021, and lot number 1811, which was made on 8 Nov 2018 and lasts until 7 Nov 2020.

Since withdrawing the product, no further outbreaks linked to seaweed salad have been reported.

The Norwegian Food Safety Authority took product samples that have not yet been fully analyzed and the Norwegian Institute of Public Health (FHI) has informed the European Centre for Disease Prevention and Control (ECDC) via the Epidemic Intelligence Information System (EPIS).

Aanderud added it also knew of a Spanish RASFF [Rapid Alert System for Food and Feed] alert from 13 Aug 2019 related to a foodborne outbreak caused by norovirus GI and GII in frozen seaweed salad from China, via Germany. Countries part of this notice include Austria, Germany, Greece, Italy, Portugal, Romania, Slovakia, Spain, and the United Kingdom. The International Food Safety Authorities Network (INFOSAN) was mentioned in both RASFF notifications.

Adam Bradshaw, technical officer in the Department of Food Safety and Zoonoses at the World Health Organization, said INFOSAN was working with colleagues at the European Commission's RASFF because the frozen seaweed salad suspected to be responsible for the outbreak was distributed from China. He added it does not have the authority to disclose non-public information on behalf of countries involved in the outbreak when asked which countries had reported cases and how many.

"To better understand the potential international aspects of this event, we have been in contact with the INFOSAN emergency contact point in China to seek details as to whether the implicated frozen seaweed salad has been distributed from China to any other countries. Once further information is available, we will update all INFOSAN members through the INFOSAN community website," said Bradshaw.  [Byline: Joe Whitworth]
===========================
[It should be noted that the prototypic norovirus, Norwalk virus, was originally isolated in Norwalk, Ohio, the state where an outbreak popped up at the Republican National Convention in 2016. Norovirus infections and outbreaks are usually more common in cooler, winter months. About half of all cases occur from December through February in countries above the equator and June through August in countries below the equator. However, in places closer to the equator, norovirus may be less seasonal. This may be because of temperature or the timing of the rainy season, but may also be associated with the birth rate. Worldwide, norovirus is the leading cause of gastroenteritis outbreaks. New norovirus strains emerge about every 2 to 4 years. Often, but not always, these new strains lead to an increase in outbreaks worldwide. - ProMED Mod.LL]

[HealthMap/ProMED-mail maps:
Date: Tue 11 Jun 2019
Source: Associated Press [edited]

Norwegian authorities said Tuesday [11 Jun 2019] they were trying to identify the source of water contamination that has sent dozens of people in southern Norway to the hospital. Since Thursday [6 Jun 2019], 55 people, including 13 children from Askoy, an island north of Bergen, have been hospitalized following the contamination. All have been discharged. Norwegian news agency NTB reported that in all, some 2000 people had fallen sick.

A one-year-old child on the island died last week [week of Mon 3 Jun 2019] of an infection in the digestive tract, but it was not clear whether it was linked to the contamination.

"None of the patients are critically ill," said Oeyvind Kommedal, a doctor with the Haukeland university hospital that carried out laboratory tests. "We have a good control of the situation." He said tests showed that the bacterium _Campylobacter_ has been found in 36 cases.

On Monday [10 Jun 2019], Baard Espeli, deputy mayor of the municipality of Askoy, also said that _E. coli_ was found in a reservoir that supplied part of the area's drinking water. Espeli said that reservoir has been closed, but it remains unclear how the bacteria contaminated it in the 1st place.

_Campylobacter_ is one of the main causes of diarrheal diseases and is considered the most common bacterial cause of human gastroenteritis. Infections are generally mild but can be fatal among very young children and the elderly.
========================
[It is not specifically stated that all the cases are on the island. The finding of _E. coli_ in the water reflects faecal contamination but not necessarily that _E. coli_ was a pathogen. The outbreak, as many from contaminated water, may be related to multiple pathogens.

Askoy is a municipality in Hordaland county, Norway. The island municipality is located in the Midhordland district of the county, sitting in a large group of islands immediately northwest of the city of Bergen. The administrative centre of the municipality is the urban village of Kleppesto on the south-eastern shore of the island of Askoy. Its location can be found on a map at <https://en.wikipedia.org/wiki/Ask%C3%B8y>. - ProMED Mod.LL]

[HealthMap/ProMED-mail map:
Hordaland county, Norway: <http://healthmap.org/promed/p/32342>]
Date: Mon 6 May 2019
Source: News in English (Norway) [edited]

A Norwegian woman in her 20s who was bitten by a dog while travelling in Southeast Asia 2 months ago died Monday night [6 May 2019]. Hospital officials confirm that the woman was infected with the deadly rabies virus.

She's the 1st person to have [died of] rabies on the Norwegian mainland since 1815. Rabies is extremely seldom on the Scandinavian peninsula.

The woman was originally from Hordaland but lived in the county of Sogn og Fjordane. She died at the hospital in Forde, where she'd been in intensive care since last week [week of 29 Apr 2019].

Norwegian Broadcasting (NRK) reported that she was bitten by a dog while on a tour of Southeast Asia 2 months ago. The hospital wasn't alerted to her case until last [2 May 2019], when she was admitted after falling seriously ill. Test results confirmed the rabies virus on [Sat 4 May 2019].

There were several other Norwegians in her tour group from various places around the country. All of them have been alerted to her rabies infection and are being followed up by their local health care centres.
=======================
[This tragic event lacks detail. Reportedly, the victim was in a "tour group" to "South East Asia" (which country/ies?) including participants from various places in Norway.

Travellers must be aware of the rabies status in countries they are to visit. And a tourist, or, as a matter of fact, anybody getting bitten by a (stray?) dog in a rabies-endemic country, should immediately seek medical treatment, after thoroughly washing the bite wound.

Several worrying questions arise. Had the participants been informed, prior to travel, about health risks, rabies being just one of the potential hazards? Were medical care and advice sought following the bite? Were other co-travellers bitten as well?... - ProMED Mod.AS]

[HealthMap/ProMED-mail maps:
Date: Mon 1 Apr 2019
Source: GIDEON (Global Infectious Disease Epidemiology Network) [edited]

re: ProMED-mail Tick-borne encephalitis - Norway: cattle
----------------------------------------------------------------------
Tick-borne encephalitis (TBE) is one of 8 zoonoses carried by ticks in Norway (the others are anaplasmosis, babesiosis, louping ill, Lyme borreliosis, relapsing fever, rickettsial spotted fever, and tularemia). As displayed in the following graphs, rates of human TBE are considerably lower than those of other tick-borne diseases in Norway, and below TBE rates reported by neighbouring countries. [1-3]

See graphs at

References
----------
1. Berger S. Infectious Diseases of Norway, 2019. 387 pages , 138 graphs, 858 references. Gideon e-books
2. Berger S. Tick-borne Encephalitis: Global Status, 2019. 89 pages , 49 graphs , 787 references. Gideon e-books
3. Gideon multi-graph tool,
-----------------------------------------------
Communicated by:
Prof Steve Berger
Geographic Medicine
Tel Aviv Medical Center
Israel
==========================
[ProMED-mail thanks Dr Berger for pointing out that TBE virus is not the only tick-borne zoonotic pathogen in Norway. The objective of the author's study, as they defined it, was narrowly focused on TBE in cattle. They chose to analyse unpasteurized cow milk for TBEV RNA and to study the presence of IgG antibodies to TBEV in the same animals. They found evidence for TBE virus infection in cattle in certain areas and pointed out potential risk of infection of humans who consume unpasteurized milk from positive herds. - ProMED Mod.TY]

[HealthMap/ProMED-mail map:
Date: Tue 15 Jan 2019
Source: Food Safety News [abridged, edited]

A traditional Norwegian fish dish has been recalled due to a link with a case of botulism. Torpet Fiskeoppdrettsanlegg AS recalled rakfisk due to suspicions that consumption can cause botulism. Rakfisk is a traditional Norwegian fish dish made from trout or char, salted and then fermented for up to a year before being eaten without cooking. The withdrawal applies to all varieties of the product that the company produced in 2018.

Rakfisk was sold via various market stalls in Trondelag, direct delivery from Torpet Fiskeoppdrettsanlegg AS, and via COOP stores in Alen, Brekken, Roros, and Os, according to the Norwegian Food Safety Authority (Mattilsynet). The one reported case is in a person who lives in Trondelag, in central Norway.

The Norwegian Institute of Public Health (Folkehelseinstituttet) said rakfisk from the company is the suspected source for the case of foodborne botulism. People who have rakfisk of this type in the refrigerator should throw the product out and not eat it. Those who have eaten it and have symptoms consistent with botulism should consult a doctor. The agency said toxins can develop under certain adverse conditions in the production of certain foods, such as rakfisk, cured meats, and canned items.

Previous botulism cases in Norway have been associated with rakfisk and home canned meats.

Botulism is a rare but life-threatening condition caused by toxins produced by _Clostridium botulinum_ bacteria. Onset of symptoms varies from a few hours to several days after exposure to the bacteria or toxins. Symptoms can include blurred or double vision, facial muscle weakness, difficulty swallowing, slurred speech and breathing difficulties.  [Byline: Joe Whitworth]
===================
[Given the vehicle, botulism type E is the likely culprit here.

The following was extracted from ProMED-mail Botulism, smoked fish - Finland ex Canada http://promedmail.org/post/20060721.2000: _Clostridium botulinum_ type E is naturally highly prevalent in aquatic environments and fish, leading to a high risk of contamination. The hot-smoking processes are usually too low to eliminate botulinum spores. Growth and toxin production from spores in vacuum-packed smoked fish products with anaerobic atmosphere and limited preservative factors is likely during extended storage at temperatures above 3 deg C (37.4 deg F). Therefore the most important factors controlling _C. botulinum_ growth and toxin production are efficient heat treatments, restricted shelf life, and continuous storage below 3 deg C (37.4 deg F). - ProMED Mod.LL]

[HealthMap/ProMED-mail map of Norway:
More ...

Ecuador

Ecuador US Consular Information Sheet
November 05, 2008
COUNTRY DESCRIPTION:
Ecuador is a Spanish-speaking country about the size of Colorado.
It has a developing economy and a democratically elected government.
Ecuador is geogra
hically and ethnically diverse.
In general, tourist facilities are adequate but vary in quality.
Ecuador adopted the U.S. dollar in 2000.
Both U.S. coins and Ecuadorian coins, which are equivalent to the value of the U.S. coins, are used.
Read the Department of State Background Notes on Ecuador for additional information.

ENTRY/EXIT REQUIREMENTS:
A U.S. passport with remaining validity of at least six months is required to enter Ecuador. A valid U.S. passport is required to depart Ecuador.
Tourists must also provide evidence of return or onward travel.
U.S. citizens traveling on regular passports for tourism or business do not need a visa for a stay of 90 days or less.
Those planning a longer visit must obtain a visa in advance of arrival.
Travelers who stay in Ecuador beyond the allowed entry time are charged a substantial fee and are barred from re-entering Ecuador for six months from the date of departure.
An airport exit tax is required when departing Ecuador.

U.S. citizens whose passports are lost or stolen in Ecuador must obtain a new passport at the U.S. Embassy in Quito or the U.S. Consulate General in Guayaquil and present it, together with a police report of the loss or theft, to the main immigration offices in those cities prior to arriving at the airport in order to obtain permission to depart.

Ecuador’s exit procedures mandate that minors (under the age of 18) who are citizens or residents of Ecuador and who are traveling alone, with one parent, or with a third party, must present a copy of their birth certificate and written authorization from the absent parent(s) or legal guardian.
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 Ecuadorian Embassy or an Ecuadorian consulate within the United States.
It is not uncommon for some local authorities to insist these documents be apostilled (authenticated).
Documents must be apostilled by the same State that issued the document.
For a list of State Authentication Authorities go to http://travel.state.gov/about/info/customer/customer_312.html; if documents are prepared in Ecuador, only notarization by an Ecuadorian notary is required.
This paragraph does not apply to children who enter Ecuador with U.S. passports as tourists, unless they hold dual U.S./Ecuadorian citizenship.

For further information regarding entry, exit, and customs requirements, travelers should contact the Ecuadorian Embassy at 2535 15th Street NW, Washington, DC 20009; telephone (202) 234-7166; web page http://www.ecuador.org/; or the Ecuadorian Consulate in Chicago (312) 338-1002/03; fax (312) 338-1004, Houston (713) 572-8731, Jersey City (201) 985-1700, Los Angeles (323) 658-5146; (323) 658-1068; fax (323) 658-1198, Miami (305) 539-8214, New Orleans (504) 523-3229, New York (212) 808-0211, or San Francisco (415) 982-1819.
Visit the Embassy of Ecuador’s web site at http://www.ecuador.org
for the most current visa information.

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

SAFETY AND SECURITY: The U.S. Embassy in Quito advises caution when traveling to the northern border region of Ecuador, to include areas in the provinces of Sucumbios, Orellana and Carchi, northern Esmeraldas, and southern Esmeraldas, south of Atacames.
U.S. government personnel are under limitations with respect to traveling alone and over-nighting in these areas due to the spread of organized crime, drug trafficking, small arms trafficking, and incursions by various Colombian terrorist organizations.
Since 1998, at least ten U.S. citizens have been kidnapped near Ecuador's border with Colombia.
One U.S. citizen was murdered in January 2001 by kidnappers holding him for ransom. Violent crime has significantly increased in 2007 and 2008 with American citizens being victims of crimes, to include but not limited to, homicides, armed assaults, robberies, sexual assaults, and home invasions.
American citizens have also been the victims of violent crime on beaches regardless of whether the beach is a popular tourist destination or remote.

Political demonstrations occur frequently throughout Ecuador for various reasons. Protesters often block city streets and rural highways, including major arteries such as the Pan American Highway. Public transportation is often disrupted during these events. Protesters may burn tires, throw rocks and Molotov cocktails, engage in destruction of property and detonate small improvised explosive devices during demonstrations. Police response may include water cannons and tear gas. U.S. citizens and U.S. affiliated interests are not usually targeted, but U.S. citizens are advised to avoid areas where demonstrations are in progress and to be prepared with backup transportation plans. Although political demonstrations have not been directed at foreigners in the past, visitors are reminded that peaceful demonstrations can turn violent with little or no warning.
Additionally, foreigners are prohibited from protesting in Ecuador and may be subject to arrest for participating in demonstrations of any kind.
Please see the following links for the local information in Quito and Guayaquil's Consular Districts, respectively at http://ecuador.usembassy.gov/security-and-safety/warden-messages.html and http://guayaquil.usconsulate.gov/warden_messages.html . U.S. citizens may also keep informed of daily happenings by following the local news and police reports.

Ecuadorian authorities may declare states of emergency in provinces and regions affected by civil unrest, natural disaster, or other disruptions. During states of emergency, authorities have expanded powers to restore order, including suspension of some constitutional rights, expanded detention powers, and imposition of curfews.

Radicals in various locations in Ecuador, including Quito, Guayaquil, and Cuenca, have occasionally placed small explosive devices that release political literature, known locally as pamphlet bombs. Targets have included local and international businesses and various Government of Ecuador buildings. Although no foreign tourists have been injured in these explosions, American citizens visiting or residing in Ecuador are urged to take common-sense precautions and avoid suspicious looking packages.

U.S. citizens should carry identification at all times, including proof of U.S. citizenship.
Travelers to Ecuador’s beach areas should be aware that strong currents, undertow, and underwater hazards may exist and are not always posted.
Most beaches lack staffed lifeguard stations.

For information on the Galapagos Islands, please see the “Special Circumstances” section of this Country Specific Information.
For the latest security information, Americans traveling abroad should regularly monitor the Department of State, Bureau of Consular Affairs’ web site at http://travel.state.gov , where the current Travel Warnings and Travel Alerts, as well as the Worldwide Caution, can be found.

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

The Department of State urges American citizens to take responsibility for their 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:
Crime is a serious problem in Ecuador, and visitors should be alert and cautious.
Non-violent crime is common: hundreds of Americans are robbed every year in Ecuador.
Violent crime has increased in recent years.
Thieves and small gangs armed with guns or knives are now sometimes active even in smaller cities such as Otavalo, Manta, and Cuenca.
Tourists have been robbed at gunpoint on beaches and along hiking trails, including on the well-populated trail to the summit of Pichincha Volcano in Quito.
Incidents of rape have increased, even in well-traveled tourists areas and when the victims traveled in groups for safety. Shootings, kidnappings, and carjackings are still relatively rare, but American citizens have been victimized by those crimes.
The Ecuadorian government has increased police patrols in tourist areas, but travelers should remain alert to their surroundings and maintain constant control of personal belongings.

Travelers should avoid wearing expensive-looking jewelry and watches.
Avoid deserted beaches, hiking trails, and infrequently traveled roads, as well as the interior regions of large city parks, particularly at night. Robberies on public buses are a continuing problem.
The Embassy recommends that visitors use legitimate taxicabs (yellow, with meters) to travel around the larger cities.
Public buses can be dangerous – from both a traffic safety and a personal security point of view.

Pickpockets and other petty thieves are particularly active in public markets, airports, bus terminals, restaurants, and crowded streets.
Backpackers are frequently targeted for robbery and “snatch and grabs”; business travelers carrying laptop computer bags are similarly targeted.
Many travelers who travel by bus store their luggage below the bus, where it is sometimes stolen.
Therefore, we recommend that you do not store your passport in your luggage. Always be aware of your surroundings, and try to not travel alone.
Thefts from vehicles are common.
Do not leave anything of value in plain view in a car, including sunglasses or sports equipment.
Carjackings have occurred in both rural and urban areas.
Visitors are advised to drive with doors locked and windows rolled up.

In Quito, travelers should be particularly alert on the crowded streets of south Quito, at the Panecillo, in Old Quito, and in the areas of El Tejar, Parroquia San Sebastian, Avenida Cristobal Colon, and Gonzalez Suarez.
The U.S. Embassy strongly discourages hiking to the summit of Pichincha as violent crime is sharply rising.
Groups as large as eight have been robbed at gunpoint by masked men; female hikers have been sexually assaulted.
The Mariscal Sucre District is a popular tourist area in Quito with numerous restaurants, bars, hotels, and shopping sites.
Since 1999, U.S. government employees and private U.S. citizens have been victimized there, prompting the U.S. Embassy to put certain bars off-limits and to declare a nighttime curfew in the area for its employees.
Increased police presence and better lighting in prime tourist squares of Old Quito have improved safety, but similar measures in the Mariscal district have not been as effective.

In Guayaquil, take extra caution in the downtown area at night, in the street market area of La Bahia, at the Christ Statue (Sagrado Corazon de Jesus) on Cerro del Carmen, in the airport area, and in the southern part of the city.
The riverfront park area called the Malecon 2000 and the passage up to the lighthouse in the Las Penas area are generally safe and well patrolled although at night caution should be observed.
There have been repeated instances of travelers followed from the airport and intercepted by robbers using two vehicles to cut off the traveler.
There is some evidence that those most at risk are people who appear to be returning from family visits laden with gifts and large amounts of cash.
There have been armed robberies of restaurants and their patrons, including in the fashionable areas of Guayaquil.
Guayaquil has also experienced an increase in kidnappings for ransom, often in connection with hijackings, although tourists have not been targeted.

Criminals sometimes use incapacitating drugs such as scopolamine on unsuspecting tourists in order to rob them.
These so-called date rape drugs are put into drinks in order to drug the unsuspecting victim.
This drug can render the victim disoriented and can cause prolonged unconsciousness and serious medical problems.
Never allow a stranger to “buy” you a drink and never leave your drink unattended.
Several American citizens have reported thefts of property following ingestion of such substances.

Every year, 15 to 20 American citizens are arrested for attempting to traffic drugs between Ecuador and the United States, or between mainland Ecuador and the Galapagos.
Suitcases with false bottoms and other packages are common methods of transporting illegal substances. Many of these citizens claim to have been unaware that they were transporting drugs.
As in any other country, do not accept gifts, packages, or suitcases from other persons; even trusted travel companions have been known to take advantage of their friends and family to traffic drugs through Ecuador’s airports. See the Criminal Penalties section below for more details about Ecuador strict laws and sentences regarding illegal drug trafficking.

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 is solely the responsibility of local authorities, consular officers can help you to understand the local criminal justice process and to find an attorney if needed.
Female victims of crime may receive assistance from the Comisaria de la Mujer at Ave. 24 de Mayo y Calle Loja, telephone 593 2 228 4016 or the Oficina de Derechos de la Mujer, Guayanas E-331 y Inglaterra, Quito 593 2 252 9909.
The local equivalent to the emergency line in Ecuador is the same as the U.S., dial “911”. The operators typically speak Spanish only. Victims should also call the Embassy or Consulate to report the crime and for assistance.

See our information on Victims of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION:
Adequate medical and dental care can be readily obtained in the major cities of Ecuador.
In smaller communities and in the Galapagos Islands services are limited, and the quality is variable and generally below U.S. standards.
Ambulances, with or without trained emergency staff, are in critically short supply.
Acute surgical and cardiac services are not available on the Galapagos Islands.
Serious cases must be evacuated to the Ecuadorian mainland or the United States for treatment.
Pharmacies are readily available in any city.
However, the availability of some medications is sporadic, and formulations and brand names will differ from products available in the U.S.
Narcotics and tranquilizers are extremely limited in availability.
“Pharmacists” sometimes prescribe and dispense medications.
These individuals often have little training and prescribe broad-spectrum antibiotics and other inappropriate medications.
Travelers should not seek their advice.
Folk healers and traditional markets offer herbal and folk remedies which should be avoided as formulations are questionable and some components may interact with other prescription medications.

Travelers to Quito (close to 10,000 feet) and other highland areas may require some time to adjust to the altitude, which can adversely affect blood pressure, digestion, and energy level.
Travelers are encouraged to consult with their personal health care providers before undertaking high-altitude travel.
In particular, travelers with heart or lung problems and persons with sickle cell trait may develop serious health complications at high altitudes.

Scuba divers in the Galapagos Islands should be aware of limited facilities for decompression.
A privately owned decompression chamber is available on Santa Cruz Island in the Galapagos Islands.
The Ecuadorian Navy operates a second decompression chamber at the San Eduardo Naval Base in Guayaquil.
Due to the high costs for these services and associated emergency transportation, divers are advised to obtain adequate medical evacuation and divers insurance.

Travelers should be aware of the presence of malaria, dengue fever, and yellow fever in areas of Ecuador below 4,500’ elevation.
Historically there has not been dengue or malaria in the Galapagos archipelago, and yellow fever has only occurred in the Amazon Basin.
Travelers who are on an appropriate anti-malarial drug have a greatly reduced chance of contracting malaria, while vaccine can provide protection against yellow fever.
Avoiding mosquito bites is the only effective prevention for dengue and personal protective measures, such as the use of insect repellents, help to reduce the risk of contracting all of these illnesses.
Travelers who become ill with a fever or flu-like illness while traveling in a high-risk area, and for up to one year thereafter, should seek prompt medical attention.
For additional information on malaria or dengue, protection from insect bites, and anti-malarials, consult the Center for Disease Control and World Health Organization web sites listed below.

The U.S. Department of State is unaware of any HIV/AIDS entry restrictions for visitors to or foreign residents of Ecuador.
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 web site at http://www.who.int/en.
Further health information for travelers is available at http://www.who.int/ith .

MEDICAL INSURANCE:
The Department of State strongly urges Americans to consult with their medical insurance company prior to traveling abroad to confirm whether their policy applies overseas and whether it will cover emergency expenses such as a medical evacuation.
Please see our information on medical insurance overseas.

TRAFFIC SAFETY AND ROAD CONDITIONS:
While in a foreign country, U.S. citizens may encounter road conditions that differ significantly from those in the United States.
The information below concerning Ecuador is provided for general reference only, and may not be totally accurate in a particular location or circumstance.

Road travel throughout Ecuador can be dangerous, especially at night.
Many roads are poorly maintained or unmarked.
Heavy rains and mudslides often close or wash out roads.
Heavy fog is common in mountainous areas.
Driving practices differ from U.S. standards.
Inter-urban and inter-provincial bus passengers are often targets of crime, including robbery and sexual assault.

Highways are often unmarked and do not have signs indicating destinations.
Road safety features such as crash barriers and guardrails along steep mountainsides are rare.
In the countryside livestock are often herded along roads or graze on roadsides.
Many roads are used for pedestrian and animal traffic as well as vehicular traffic.
Driving habits vary from region to region.
In general, drivers in Quito and the mountain areas and the Oriente (eastern jungle) drive more slowly, observe traffic signals, and slow down for speed bumps.
Vehicles are reasonably well maintained.
On the coast, drivers have a more liberal approach to vehicle maintenance and traffic regulations.
In all areas buses, both intra-city and intercity, will stop at any point on their route to pick up or drop off passengers.
Speed bumps abound, even on major highways such as the Pan American Highway, to slow traffic.
Drivers turn right and left from any lane and do not yield for pedestrians and cyclists.

Intoxicated drivers can be encountered at any time, but they are especially prevalent on weekends and holidays.
Ecuador’s frontier regions are largely rural, poor, and lack police presence.
Because drug traffickers, criminal organizations, and smugglers of all types use clandestine border crossings to move their goods, the U.S. Embassy advises against driving on all but the most traveled highways.

If you are the driver of a vehicle involved in an automobile accident, you will likely be taken into police custody, especially if injuries are involved.
You are almost certain to spend some time in jail until all parties are satisfied that responsibility has been assigned and adequate financial satisfaction received.
Drivers may face criminal charges if injuries or damages are serious.
When driving your own vehicle or a rented vehicle, be sure to have proper vehicle registration papers with you.
Please refer to our Road Safety page for more information.
Visit the web site of the country’s national tourist office at http://www.turismo.gov.ec/ and the Ministerio de Transporte y Obras Publicas, the national authority responsible for road safety, at http://www.mtop.gov.ec/ .

AVIATION SAFETY OVERSIGHT:
The U.S. Federal Aviation Administration (FAA) has assessed the Government of Ecuador's Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for oversight of Ecuador'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
GALAPAGOS ISLANDS: A significant number of Ecuadorian tour vessels operating in the Galapagos Islands are neither inspected nor operated in accordance with U.S. regulations, and do not meet U.S. safety standards.
The Government of Ecuador requires that vessels carrying more than sixteen passengers comply with the International Safety Management (ISM) code established by the International Maritime Organization.
However, the quality of inspections, oversight, crewmember proficiency evaluation, and other requisites for safe vessel operation may vary substantially.
Tour boat accidents are more frequent among small vessels (those carrying fewer than sixteen passengers), but travelers should inquire about safety features of any vessel, regardless of size. When boarding vessels be sure to look for the life boats, floatation devices and if possible take a moment to inspect the life vest you would be using if there were an accident.

There have been at least three cases in 2004-2006 in which small quantities of drugs have been placed by unknown persons in unsecured pockets of tourists' checked bags, including backpacks, en route to the Galapagos.
Upon arrival, these drugs have been detected by police canine units, and the owners of the bags have been arrested and detained for months while the cases are resolved.
Travelers are advised to secure all parts of their bags thoroughly before checking them on flights to the Galapagos.

Strikes and disturbances by local fisherman in the Galapagos Islands have become violent on occasion.
While tourists have not been targeted, the incidents affected their movement and access to some sites.
Such disturbances have been minimal since April 2004, but the issue remains unsettled and could resurface at any time.

The islands are over 600 miles from the mainland and help may be slow in arriving in case of emergency.
The Government of Ecuador has very limited search and rescue capabilities.
Travelers to the Galapagos are encouraged to contact tour operators and visit the Bureau of Consular Affairs' web site for the most recent information when planning their trips to the Galapagos.

OTHER LEGAL ISSUES: Under Ecuadorian law, business disputes that normally would be handled by civil litigation in the United States may be converted into criminal proceedings.
This provision of the law has been used to impose travel prohibitions against resident U.S. citizens, and it also has led to the arrest and incarceration of U.S. business people while they were awaiting a hearing on the civil matter.

When considering purchasing property in Ecuador, Americans should be aware that competing claims to property might only surface after an apparently legal sale has been made.
Deficiencies in the Ecuadorian system for surveying and registering property and weaknesses in the judicial system mean that these disputes can last years.
The Mission is aware of several cases of American citizen land owners in Ecuador being threatened with physical harm and/or confiscation of their property by individuals claiming rights to the land, and, in at least one case, buildings have been razed.
American citizens considering buying property in Ecuador should engage a competent attorney and carefully research land title issues before making a purchase.

DISASTER PREPAREDNESS: Ecuador has 19 potentially active volcanoes, including nine that have shown recent activity.
Earthquakes occur frequently.
Three active volcanoes within 50 kilometers of Quito pose a significant threat to the city: Guagua Pichincha, Cotopaxi, and Reventador.
The primary threat is from failures of transportation, water, communications, and power systems due to heavy ash fall and damage to infrastructure outside the city.
Air transportation is especially vulnerable.
Potentially serious respiratory problems are caused by inhalation of ash.

The town of Banos, a popular tourist destination approximately 120 kilometers south of Quito, is at the base of the Tungurahua Volcano.
Tungurahua has erupted explosively several times since 1999, most recently in February of 2008, causing deaths and forcing thousands to evacuate their homes.
Explosive eruptions can occur with little warning.
The resulting flows of mud and lava could pose a significant and immediate threat to Banos and other population centers in the vicinity.
Travelers should to be aware of these conditions when choosing to stay overnight in Banos, especially on the western side of the town, and should be ready to evacuate on short notice.

Other volcanoes active in Ecuador include Reventador, 100 kilometers east of Quito, and Cotopaxi, 50 kilometers south of Quito.
In 2002, lava and mudflows caused by Reventador volcano closed a major Quito/northern-border highway and volcanic ash blanketed Quito, shutting down the Quito airport for several days.

The Quito City Government and the Ecuadorian Geophysical Institute monitor these volcanoes and issue regular reports on their activity.
In the event of eruptions, travelers should pay close attention to the news media for updates on the situation.
Other volcanoes in Ecuador may also exhibit increased activity at any time.
Further information is available via the Internet from the Ecuadorian Geophysical Institute at http://www.igepn.edu.ec/ and the National Oceanic and Atmospheric Administration at http://www.ssd.noaa.gov/VAAC/guag.html .

CUSTOMS REGULATIONS:
Ecuadorian customs authorities may enforce strict regulations concerning temporary importation into or export from Ecuador of items such as firearms, religious materials, antiquities, medications, electronic equipment, and currency.
Contact the Embassy of Ecuador in Washington, D.C., or one of Ecuador’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 Ecuadorian laws, even unknowingly, may be expelled, arrested, or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in Ecuador 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.

The Ecuadorian government is required by international law to notify the U.S. Embassy or the nearest U.S. Consulate promptly when an American citizen is arrested and requests such notification.
Delays in notification can limit the assistance the U.S. Government can provide an arrested American citizen.
Therefore, Americans should promptly identify themselves as such to arresting officers and request that the U.S. Embassy in Quito or the U.S. Consulate in Guayaquil be notified immediately.

Prison conditions in Ecuador are extremely poor.
In many facilities food is insufficient in both quantity and quality, and prisoners must pay for adequate nutrition from their own funds.
Most Ecuadorian prisons provide poor medical care, and urgent medical conditions may receive only minimal attention.
The Guayaquil penitentiary medical clinic does not have medicine but is staffed with medical personnel. Prisoners must personally pay to have someone outside of the prison obtain medicine and prescriptions. Those accused of crimes in Ecuador can expect lengthy delays before trial and sentencing.
The accused are usually incarcerated while awaiting trial and sentencing, and in the case of serious crimes, bail is generally not an option.

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

The U.S. Embassy in Quito is located at Avigiras E12-170 y Eloy Alfaro.
The telephone during business hours (8:00a.m. to 5:00 p.m.) is (011) 593 2 398 5000.
For after-hours emergencies use (011) 593 2 398 5000. Within the same city use the last seven digits.
Add the city code for intercity telephone calls.
The Embassy's web site is http://ecuador.usembassy.gov/
The U.S. Consulate General in Guayaquil is located at the corner of 9 de Octubre and Garcia Moreno (near the Hotel Oro Verde); telephone (011-593-4) 232-3570 during business hours (8:00 a.m. to 5:00 p.m.) or 232-1152 for after-hours emergencies; fax (011-593-4) 232-0904.
The Consulate General's web site is http://guayaquil.usconsulate.gov/.

Consular services for U.S. citizens in the Galapagos Islands are provided by the Consulate General in Guayaquil with assistance from a U.S. Consular Agent in Puerto Ayora, Galapagos, at (05) 2526-330 or (05) 2526-296.

The Consular Section in Quito is open for American Citizen Services, including registration, from 1:30 to 4:00 p.m., Monday through Thursday, excluding U.S. and Ecuadorian holidays.
In order to provide better customer service and reduce waiting times, the American Citizen Services section in Guayaquil uses an online appointment system. Appointments are available from 12:00 noon to 4:00 p.m., Monday through Thursday. Notary appointments are Friday, 8:00 a.m. to 12:00 p.m., excluding U.S. and Ecuadorian holidays. Walk-in service remains available, but customers with appointments take precedence.
To make an appointment, go to http://guayaquil.usconsulate.gov/online_appointments.html
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This replaces the Country Specific Information for Ecuador dated March 28, 2008, to update the sections on Entry/Exit Requirements, Information for Victims of Crime, and Traffic Safety and Road Conditions.

Travel News Headlines WORLD NEWS

Date: Tue, 14 Jan 2020 09:19:55 +0100 (MET)

Quito, Jan 14, 2020 (AFP) - A volcano erupted on an uninhabited island in the Galapagos, Ecuadorian authorities said, spewing lava on the ecologically sensitive environment.   La Cumbre volcano on Fernandina island, one of the youngest in the archipelago, began erupting Sunday evening, Galapagos National Park (PNG) officials said in a statement.   The 1,467 metre high (4,813 feet) volcano has a crack along its south-eastern flank and "a lava flow descends to the coast", PNG added.

The island is home to a number of species including iguanas, penguins, flightless cormorants, snakes and an endemic rat, and has "very important" ecological value, PNG said.   Before the eruption, an earthquake with a magnitude of 4.7 was felt, according to the local Ecuadorian Geophysical Institute, followed by 29 aftershocks.

The volcano also erupted in June 2018.  The unique fauna of the UNESCO-listed Galapagos Islands -- located 1,000 kilometres (620 miles) east of mainland Ecuador -- helped English naturalist Charles Darwin develop his theory of evolution by natural selection.
Date: Sun, 31 Mar 2019 11:14:25 +0200

Washington, March 31, 2019 (AFP) - A strong 6.2 magnitude earthquake struck just off the coast of Ecuador early Sunday, the US Geological Survey said, but there were no immediate reports of damage and there was no tsunami warning.   The quake occurred at a shallow depth of 18.5 kilometres (11.5 miles), in the Pacific Ocean west of Guayaquil and 27 kilometres north of Santa Elena, the agency reported.
Date: Fri, 7 Sep 2018 12:17:58 +0200

Quito, Sept 7, 2018 (AFP) - A deep 6.2 magnitude earthquake struck Ecuador on Thursday night, causing damage to buildings and injuring two people.   The quake hit at 9:12 pm local time (0212 GMT on Friday) at a depth of 93.5 kilometres, near the center of the South American country.   It was felt across several provinces, according to Twitter users. Two people were injured in the town of Cumanda.

The walls of homes cracked and ceilings caved in, mayor Marco Marquiasca said.   Local authorities recorded its magnitude as 6.5.   Ecuador suffered a 7.8 magnitude earthquake on April 16, 2016, which devastated villages in the coastal provinces of Manabi and Esmeraldas and killed 673 people.   The losses amounted to more than $3 billion, according to authorities.    Located on the boundary of the Nazca and South America tectonic plates, Ecuador is very prone to seismic activity.
Date: Thu, 16 Aug 2018 03:58:11 +0200

Quito, Aug 16, 2018 (AFP) - Colombia's government said Wednesday that 19 of the victims of a deadly bus crush in Ecuador were its citizens, as Quito lowered the overall death toll from the accident.   Ecuador's foreign ministry said in a statement that 23 people were killed in the Tuesday crash, instead of 24 as previously announced.   Twelve Colombians, four Venezuelans and two Ecuadorans who died in the accident have been identified, the statement said.

The bus, which had foreign license plates, overturned and crashed into three houses after a collision with an all-terrain vehicle near Quito.   Ecuador transport colonel Julio Barba said the driver "probably overused the brakes... which produced an overheating of the brake system leading to a loss of control of the vehicle."   Colombia's Transport Ministry had said on Tuesday that the bus was not authorized to carry tourists.  One of the two drivers, who was injured in the crash, has been arrested.

Traffic accidents are among the leading causes of death in Ecuador. According to the watchdog group Justicia Vial, on average seven people are killed and some 80 people injured each day in traffic accidents.   And 96 percent of those accidents are due to human error, according to the group's figures.   On Sunday, 12 people were killed and 30 injured when a bus carrying fans of Barcelona SC, Ecuador's most popular football club based in Guayaquil, ran off the highway and flipped.
Date: Mon, 11 Jun 2018 22:10:52 +0200

Quito, June 11, 2018 (AFP) - A Lebanese man has been stuck in immigration purgatory at an airport in Ecuador for 42 days after losing his passport and being returned there from Spain.   Nizam Hussein Shalak, 56, who does not speak Spanish, has been residing in the international terminal of the Jose Joaquin de Olmedo airport in Guayaquil, El Universo newspaper reported.   "It is a case of inadmissibility because he has no documents," a foreign ministry source said.   "The only legal body to issue a travel document is the Lebanese consulate in Bogota," which has not responded to requests that it do so, the source said.   "We are closely following the case and are working with the interior (ministry) to get Lebanon to issue him a travel document so he can return to his country."   The situation resembles that of an Iranian refugee who lived in a Paris airport from 1988 to 2006 and was portrayed in the film "The Terminal" starring Tom Hanks.

Shalak visited Guayaquil two months ago and stopped on the way back to Lebanon in Lima, Peru, and Barcelona, Spain, where he was detained after losing his passport as well as his credit cards, El Universo newspaper reported.   He stayed in Barcelona for 10 days and Lima for another 11 before being returned to Guayaquil, where he had to make a makeshift a bed on the seats of the terminal.   "He eats with the coupons that the airline... gives him from time to time" and showers "every three or four days, when they take him to a bathroom in another part of the terminal," the newspaper said.   The foreign ministry source said that while Shalak left with a passport, he did not have one upon his return and could not pass immigration.   Therefore, "he is not legally in the country."
More ...

Guinea Bissau

Guinea Bissau - US Consular Information Sheet
July 8, 2008
COUNTRY DESCRIPTION:
The Republic of Guinea-Bissau, a small country in western Africa, is one of the world’s poorest nations.
The capital is Bissau and the official language
is Portuguese.
The country underwent a civil war in 1998-99 that devastated the economy.
Tourist facilities and infrastructure in general are very limited and not up to American standards.
Read the Department of State Background Notes on Guinea-Bissau for additional information.
ENTRY/EXIT REQUIREMENTS:
A valid passport, visa, and proof of onward/return ticket are required.
As of January 2007, the Bissau-Guinean Embassy in Washington, DC is temporarily closed.
The Embassy of Guinea-Bissau does not have a web site.
Due to lack of consular representation in the U.S., it is difficult to obtain the required visa for entry into Guinea-Bissau.
Since most flights destined for Guinea-Bissau must pass through Dakar, Senegal or Lisbon, Portugal, most travelers are able to apply for visas at the Bissau-Guinean embassies in those countries.
Although it is possible to obtain a visa upon arrival in Bissau if arrangements are made in advance, there are no clear instructions for how to make those arrangements.

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.
As of the date of publication of the Country Specific Sheet, the Bissau-Guinean Embassy is closed.
Travelers needing information about customs regulations should contact Bissau-Guinean authorities in Dakar, Senegal or Lisbon, Portugal before traveling.

SAFETY AND SECURITY:
There is no permanent U.S. diplomatic or consular presence in Guinea-Bissau.
The U.S. Embassy in Bissau suspended operations on June 14, 1998.
While officials from the U.S. Embassy in Dakar, Senegal, make periodic visits to Guinea-Bissau, their ability to provide consular services, including emergency assistance, is very limited.
The U.S. maintains a liaison office in Bissau, located at Edifício SITEC, Rua José Carlos Schwarz 245, Bairro d’Ajuda (tel/fax 245-256382, 245-5954647).
This office is staffed by locally employed staff and, while not equipped to provide consular services, may be contacted in the event of an emergency.
The nearest U.S. Embassies are located in Banjul, the Gambia; Conakry, Guinea; and Dakar, Senegal.
Although the civil war that led to the closure of the U.S. Embassy ended in 1999 and elections were held in June and July 2005, travelers should be aware that political tensions persist.
Sporadic politically-motivated violence remains an issue.
Due to the potential for violence, U.S. citizens should avoid political gatherings and street demonstrations, and maintain security awareness at all times.
With legislative elections scheduled for late 2008, the potential for future political unrest remains high.
In December 2004, the Government of Senegal and some factions of the Movement of Democratic Forces of the Casamance (MFDC), a Senegalese separatist movement, instituted an end to hostilities and agreed to negotiate with the goal of achieving a definitive end to the armed conflict in the Casamance.
This conflict has not yet been resolved, however, and its effects reach into Guinea-Bissau.
In the spring of 2006, Bissau-Guinean military forces conducted offensive operations near the town of Sao Domingos to expel elements of the MFDC.
The fighting reportedly resulted in dozens of military and civilian casualties, mostly from landmine explosions.
There are currently instances of fighting in the Casamance region (composed of the Ziguinchor and Kolda regions) involving factions of the Casamance separatist MFDC (Mouvement des Forces Démocratiques de la Casamance) in southern Senegal and the Senegalese military.
Although the recent escalation in hostilities has not spilled over into Guinea-Bissau, the potential for conflict along the border remains.

Unexploded military ordnance and landmines remain scattered throughout the country.
Although the capital city of Bissau was declared “mine-free” in June 2006 by the national de-mining center (CAAMI), occasional findings or unintentional explosions do occur.
There are two non-governmental organizations (NGOs) active in successfully removing mines.
To minimize the risks posed by both bandits and landmines, U.S. citizens are encouraged to limit driving outside of towns to daylight hours only and to remain on well-traveled roads at all times.

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

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

The Department of State urges American citizens to take responsibility for their own personal security while traveling overseas.
For general information about appropriate measures travelers can take to protect themselves in an overseas environment, see the Department of State’s pamphlet A Safe Trip Abroad.
CRIME:
Although there is a fairly low incidence of normal daytime street crime, travelers should observe security precautions in the city, particularly with regard to pickpocket activity in marketplaces.
Travelers should refrain from walking alone at night.
The lack of reliable public electricity means that urban streets are dark at night, even in Bissau.
There have been periodic incidents of bandits accosting travelers in rural areas.
INFORMATION FOR VICTIMS OF CRIME:
The loss or theft abroad of a U.S. passport should be reported immediately to the local police and the nearest U.S. Embassy or Consulate.
If you are the victim of a crime while overseas, in addition to reporting to local police, please contact the nearest U.S. Embassy or Consulate for assistance.
The Embassy/Consulate staff can, for example, assist you to find appropriate medical care, contact family members or friends and explain how funds could be transferred.
Although the investigation and prosecution of the crime is solely the responsibility of local authorities, consular officers can help you to understand the local criminal justice process and to find an attorney if needed.

See our information on Victims of Crime.
MEDICAL FACILITIES AND HEALTH INFORMATION:
While modern medical facilities are virtually nonexistent in Guinea-Bissau and travelers should not rely on them, limited emergency medical care is available at a new hospital in Bissau operated by the Sant’Egidio Community.
Monday to Saturday there are flights from Bissau to Dakar, Senegal, where more acceptable levels of medical care are available.
Malaria, a serious and sometimes fatal disease, is a risk for travelers to Guinea-Bissau.

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 Guinea-Bissau is provided for general reference only, and may not be totally accurate in a particular location or circumstance.
The public transportation system, urban and rural road conditions, and the availability of roadside assistance are all poor.
There is no consistent public electricity in the capital, and the lack of lighting at night makes careful driving essential.
Since there are minefields left over from the civil war and the war of independence, travelers should not leave designated roads and pathways.
The landmines are scattered in several areas throughout Guinea-Bissau, including Bafata, Oio, Biombo, Quinara and Tombali regions.
While there has been significant progress in locating and removing landmines, an estimated 46,000 landmines remain.
Speak with local authorities first and use caution if leaving a main road or highway to enter a trail network or to make other types of cross-country movement.
Please refer to our Road Safety page for more information.

AVIATION SAFETY OVERSIGHT:
As there is no direct commercial air service to the United States by carriers registered in Guinea- Bissau, the U.S. Federal Aviation Administration (FAA) has not assessed Guinea-Bissau’s Civil Aviation Authority for compliance with International Civil Aviation Organization (ICAO) aviation safety standards.
For more information, travelers may visit the FAA’s web site at http://www.faa.gov/safety/programs_initiatives/oversight/iasa.
SPECIAL CIRCUMSTANCES:
Guinea-Bissau's customs authorities may enforce strict regulations concerning the temporary import or export of items such as firearms, antiquities, medications, and business equipment. (See contact information in the section on Entry Requirements.)
International banking and finance is problematic due to a limited formal banking sector.
ATMs are rarely available, credit cards are rarely accepted, currency exchange outside of the black market is almost non-existent, wire transfer possibilities are extremely limited, and repatriation of funds is problematic.

As there is currently no U.S. Embassy in Guinea-Bissau, U.S. consular officials may not be properly notified when an American citizen is arrested or detained in Guinea-Bissau.
Because notification would have to be made to consular officers at U.S. Embassies in neighboring countries, there may be a delay in consular access to such citizens.
U.S. citizens are encouraged to carry a notarized copy of their U.S. passports with them at all times so that, if questioned by local officials, proof of identity and U.S. citizenship is readily available.
Taking photographs of anything that could be perceived as being of military or security interest may result in problems with authorities.
Guinea-Bissau has a cash-only economy, so travelers should not count on using credit cards and ATMs. 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 Bissau-Guinean laws, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in Guinea-Bissau 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 Guinea-Bissau are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department’s travel registration web site so that they can obtain updated information on travel and security within Guinea-Bissau.
Americans without Internet access may register directly with the nearest U.S. Embassy or Consulate.
By registering, American citizens make it easier for the Embassy or Consulate to contact them in case of emergency.
The U.S. Embassy in Guinea-Bissau remains closed.
U.S. citizens who plan to enter Guinea-Bissau are encouraged to register with the Consular Section of the U.S. Embassy at Avenue Jean XXIII, Dakar, Senegal.
The mailing address is B.P. 49, Dakar, Senegal.
The telephone number is (221) 33 829-2100 and the fax is (221) 33 822-2991.
The e-mail address is consulardakar@state.gov.
The web site is http://dakar.usembassy.gov/.
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This replaces the Country Specific Information for Guinea-Bissau dated September 12, 2007 to update sections on Country description, Special Circumstances, Safety and Security, and Registration/Embassy Location.

Travel News Headlines WORLD NEWS

Date: Thu, 18 Oct 2018 12:44:14 +0200

Bissau, Oct 18, 2018 (AFP) - Guinea-Bissau's government on Thursday signed a deal with a federation of truckers, bus owners and taxi drivers to end a strike that had brought the West African state to a standstill, officials said.   The federation launched the strike on Tuesday in protest at the many problems facing transporters, including police bribery.

The protocol agreement was signed on the government's side by the General Directorate for Land Transport (DVGTT), which is in charge of Guinea-Bissau's roads; the National Traffic Police; and the National Guard.   Under the deal, the government pledged to cut the number of checkpoints -- a major source of kickbacks and delays -- within two months.

DVGTT chief Bamba Banjai, speaking to journalists after the signature, hailed the accord.    Bus traffic swiftly began to return to the streets Bissau, the capital, which had been virtually deserted.   Private schools, which depend on minibuses and taxis to drop off and pick up children, had told students to stay at home, and many civil servants did not go to work.

As the strike ran into its second day on wednesday, the head of the transporters' federational, Bubacar Felix Frederico, warned that the protest would only be lifted "with the official undertaking" of Prime Minister Aristides Gomes.   Among the federation's demands were improvement to the country's notoriously poor roads, but the issue is not addressed in the protocol and has been placed to one side.

Guinea-Bissau, a former Portuguese colony, ranks among the poorest countries in the world, according to the UN's development index.   It has just 4,400 kilometres of roads, of which only 10 percent (453 km) are paved. Non-paved roads are notoriously slow and dangerous, and prone to being washed out during the rainy season.
Date: Fri, 3 Aug 2018 13:51:38 +0200

Bissau, Aug 3, 2018 (AFP) - Public-sector workers in the West African state of Guinea-Bissau have called off a strike after securing a pay increase in talks with the government, their main trade union said Friday.   The strike, launched on July 24, ended after the government agreed on Thursday to increase minimum monthly pay from 19,200 CFA francs ($33.91, 29.28 euros) to 50,000 francs from September, Julio Mendonca, head of the UNTG union, told AFP.   However, Prime Minister Aristide Gomes was somewhat more cautious.   In a statement to AFP late Thursday, he said, "all parties have accepted the principle" of a pay rise.   "We are still in negotiations," he said. "We are all going to work at finding a definitive solution to this situation."

The strike, which affected a sector with 13,000 employees, was also followed by state media organisations. Public radio and television went silent and there were strikes at the daily newspaper No-Pintcha and news agency ANG.   Guinea-Bissau, a former Portuguese colony with a population of 1.8 million, is one of the poorest and most unstable countries in the world.   It has experienced years of volatility, marked by coups and soldiers' mutinies.   The country plunged into a power struggle in August 2015, when President Jose Mario Vaz sacked his then prime minister, Domingos Simoes Pereira.   After lawmakers did not meet for nearly two years, an agreement was reached in April at a summit of the Economic Community of West African States (ECOWAS), which led to Gomes's appointment as prime minister.
Date: Tue, 17 Jul 2018 18:32:36 +0200

Bissau, July 17, 2018 (AFP) - Public radio and television in Guinea-Bissau went quiet on Tuesday as state media workers joined an ongoing civil servants' strike.   Daily newspaper No-Pintcha and news agency ANG, both state-funded, also took part in a planned three-day strike over pay and working conditions.   "We have interns who have worked in newsrooms for over three years without pay," union leader Julciano Balde told AFP.   "We work with the little we have, with no means of transport, old computers, while ministers drive brand new cars."   The journalists want better working conditions, including "decent" salaries, the hiring of all interns and means of transportation, according to their representatives.   The minimum wage is 45,000 CFA francs (around 68 euros) at the No Pintcha newspaper, 60,000 CFA francs (90 euros) at the national radio and 120,000 CFA francs (180 euros) at the state television channel.

Civil servants launched regular strikes in June and their largest union UNTG confirmed it will keep asking workers to stay home from Tuesday to Thursday every week.    "We will keep the pressure on and paralyse the administration until we get what we want," UNTG leader Julio Antonio Mendonca told AFP.   Guinea-Bissau, with a population of 1.8 million, has experienced periods of political and military instability marked by coups and mutinies of soldiers for several years.   The former Portuguese colony had been in the grip of a power struggle since August 2015, when President Jose Mario Vaz sacked his then prime minister Domingos Simoes Pereira.   After lawmakers did not meet for nearly two years, an agreement was reached in April at a summit of the Economic Community of West African States (ECOWAS) and a new prime minister, Aristides Gomes, was appointed.
Date: Wed, 11 Jul 2018 17:40:43 +0200

Bissau, July 11, 2018 (AFP) - Hundreds of civil servants took to the streets of Guinea-Bissau on Wednesday to demand a hike in the minimum wage and better living conditions.   The protest was organised by the Union of Guinea-Bissau workers (UNTG), which regroups 8,000 out of the West African country's 13,000 civil servants.  Demonstrators marched from the outskirts of the capital Bissau to its centre, chanting "Down with lawmakers paid to do nothing" and "We demand decent wages and better conditions," an AFP journalist saw.   "It is intolerable for government to raise the wages of ministers and parliamentarians while at the same time other public servants are paid next to nothing," UNTG Secretary General Julio Antonio Mendoca said.

UNTG is calling for the minimum monthly salary to be upped from 19,200 CFA francs (29 euros) to 59,000 CFA francs (90 euros).   "We will carry on until we succeed," Mendoca added.   It is the fifth action organised by UNTG in six weeks, including a three-day strike in June.   "The civil servants' claims are fair but the method used is inappropriate because the government cannot afford to meet the claims," Prime Minister Aristides Gomes told reporters last week.   "The government was formed to organise elections and deal with day-to-day matters."

Parliament last month adopted its first budget after nearly three years of political instability ahead of legislative elections set for November.   The former Portuguese colony was plunged into a power struggle in August 2015, when President Jose Mario Vaz sacked his then prime minister, Domingos Simoes Pereira.   Lawmakers did not meet for nearly two years -- a crisis that was defused in April under an agreement reached at a summit in Togo of the Economic Community of West African States (ECOWAS).   Under it, Gomes was appointed as a consensus prime minister and tasked with steering the country to the November 18 polls.
Date: Tue, 26 Jun 2018 21:40:25 +0200

Bissau, June 26, 2018 (AFP) - Civil servants in Guinea-Bissau went on strike Tuesday, days after the country passed its first budget following a three-year political crisis, their union told AFP.   The workers, who plan to strike for three days, are demanding a higher minimum wage and better working conditions, according to the National Union of Guinea-Bissau Workers (UNTG), the largest civil servants' union.   The small West African country's parliament just unanimously adopted its first budget after nearly three years of political instability ahead of legislative elections set for November.   Guinea-Bissau, with a population of 1.8 million, has experienced periods of political and military instability marked by coups and mutinies of soldiers for several years.

In the capital Bissau, ministries and public offices were closed on Tuesday and hospital services were reduced to a minimum, an AFP journalist said.   UNTG -- which says 90 percent of the country's estimated 13,000 civil servants are striking -- is calling for the minimum monthly salary to be upped from 19,200 CFA francs (29 euros) to 59,000 CFA francs (90 euros).   The government can increase civil servants' salaries as MPs and ministers recently received a raise, UNTG leader Julio Antonio Mendoca told AFP.   The former Portuguese colony had been in the grip of a power struggle since August 2015, when President Jose Mario Vaz sacked his then prime minister Domingos Simoes Pereira.   After lawmakers did not meet for nearly two years, an agreement was reached in April at a summit of the Economic Community of West African States (ECOWAS) and a new prime minister, Aristides Gomes, was appointed.
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Zimbabwe

General
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This southern African country is a popular destination for travellers from Ireland. Victoria Falls must be one of the main tourist attractions but many other visitors will explore the rich s
fari parks and many other attractions, which Zimbabwe has to offer. Unfortunately the stability throughout the country has decreased considerably during the past two years and it will be essential that travellers stay within well defined itineraries agreed with recognised tour operators.
Safety & Security
**********************************************
The level of petty crime is increasing throughout the country as stability decreases. Muggings and pickpocketing occur too often in the main urban areas and especially in the capital - Harare. Care should be taken when getting money from ATM’s or when leaving the banks. Try to have a companion with you and avoid busy market places and crowded local transport. Use hotel safe boxes and don’t leave personal belongings on view where possible. Avoid flaunting personal wealth, only use authorised taxis and take care if visiting late-night bars etc. Credit care fraud is becoming more common so ensure that your card never leaves your sight.
Travel in Zimbabwe
**********************************************
Hiring cars or motorbikes is unwise as the number of serious accidents involving tourists is considerable. Many hazards occur along the roads including unlit abandoned trucks, stray livestock and pedestrians and poor fuel supplies. Many roads are in a poor state of repair and those requiring assistance may have to wait many hours in a deserted location. Car jacking and theft from cars is increasing. If driving long distances you should ensure that you have sufficient fuel and adequate supplies of food and water in case of emergency. A torch and sensible medical kit are also prerequisites.
Health Facilities
**********************************************
Outside of the main urban centres of Harare and Bulawayo the level of healthcare for tourists may be very limited. Even in the cities shortages of some main medications may lead to inadequate treatment and evacuation to South Africa may become necessary. Any tourist on personal medication (asthma, diabetes, contraceptive pill etc) should make certain that they have sufficient supplies with them to complete their journey through Zimbabwe.
Rabies
**********************************************
The risk of rabies occurs throughout the country for those exposed to infected warm-blooded animals. This will be mainly following a bite from an infected dog but cats and monkeys and many other animals also carry the disease. Returning to Harare and possibly to South Africa will be essential to ensure adequate early treatment.
Playing Golf in Zimbabwe
**********************************************
Many tourists visiting Zimbabwe will play golf on some of their many courses. Golf tends to be played during the hours soon after dawn and towards dusk when mosquitoes may abound. They should be aware that there is an increased risk of malaria from mosquito bites (in infected regions) but also of wandering into the rough to retrieve a ball and being bitten by snakes or ticks or stung by scorpions. Avoiding the rough is a wise precaution!

White Water Rafting & Bungee Jumping
**********************************************
Many tourists to the Zambezi region partake of adventure sports including white water rafting and bungee jumping. Check whether of not your travel insurance covers these activities and be aware that both activities can carry significant risks. The bungee jump at Victoria Falls is recognised as one of the highest in the world at 111 metres. Generally the safety and security is good but accidents do occur. The risks of serious injury from white water rafting are also present both from direct trauma (eg bruising, drowning, fractures etc) and also from exposure to Schistosomiasis in the calm fresh water regions along the Zambezi. This parasitic disease is more common in those who swim in Lake Malawi but does occur in Zimbabwe. Serious long-term effects are regularly reported in those returning after fresh water contact in Africa.
Food & Water Facilities
**********************************************
Despite the diminishing security situation throughout the country and the food shortages which have been reported among the local population, the main tourist hotels are still receiving sufficient supplies. This situation may change and travellers should be aware that the level of service may be affected. Lettuce and cold foods may not be adequately treated and should be avoided. Unpeeled fruits should be fine but tap water should not be used for brushing your teeth unless you can easily smell chlorine.
Insect & Mosquito Bites
**********************************************
The Zambezi valley region (including Victoria Falls) is probably the single highest risk region for tourists developing malaria throughout the world. It is essential that adequate malaria prophylaxis is used at all times of the year for those visiting this region. Those remaining in the central highlands (cities of Harare and Bulawayo) will not need prophylaxis as the risk of this mosquito borne disease is very small. Tsetse flies transmit sleeping sickness and this may be a risk for those visiting some of the safari parks. Good repellent and adequate light coloured clothing is essential.
Sun Exposure & Dehydration
**********************************************
It is important to increase your intake of fluids and salt while perspiring significantly in a hot climate. Wearing a wide-brimmed hat is also important.
Vaccines for Zimbabwe
**********************************************
There are no essential vaccines for entry into Zimbabwe from Ireland. However those crossing into Zambia at Victoria Falls (and having their passport stamped) may find that the authorities demand evidence of cover against Yellow Fever before re-entry. Otherwise most tourists are advised to consider adequate cover against:
*
Poliomyelitis (childhood booster)
*
Tetanus (childhood booster)
*
Typhoid (food and water disease)
*
Hepatitis A (food and water disease)
Those planning a longer or more rural trip will also need to consider cover against diseases like Hepatitis B and Rabies.
Summary
**********************************************
The majority of tourists visiting Zimbabwe will remain very healthy and well providing they remain conscious of the prevailing local uncertainty and follow some simple precautions against food and water disease, mosquito bites, and accidents.

Travel News Headlines WORLD NEWS

Date: Fri 17 Jan 2020
Source: The Herald [edited]

At least 177 cattle have died from anthrax while 87 people were treated for the disease in various clinics and hospitals after eating meat from cattle that died from the infection during this season. Anthrax is a bacterial disease that affects a wide range of animals and human beings.

Livestock, particularly cattle, take up anthrax bacteria during grazing, while people get infected when they handle or eat anthrax-infected meat. Anthrax disease occurs throughout the year, but in Zimbabwe, most cases start from onset of rainy season. It is rare to see an animal showing signs of the disease; animals are often found dead. [Actually once it gets started, ranchers will start seeing sick animals; watching more carefully, longer incubation periods. - ProMED Mod.MHJ]

Division of Veterinary Field Services, Acting Director, Dr. Wilmot Chikurunhe has told The Herald that anthrax outbreaks have been recorded in Gokwe, Nkayi, Gutu, Bikita, Marondera, Mazowe, Chegutu, Makonde and Sanyati. He said the disease is being detected in traditional outbreak areas and not affecting the whole district as it may seem from information circulating. "Even in the affected dip tanks, the disease is restricted to certain areas, although the vaccination coverage is then extended to a wider area to contain the outbreak.

"Cattle owners in anthrax areas need to ensure that their cattle are vaccinated against the disease once a year before the rainy season starts. The Department of Veterinary Services comes in to prevent massive outbreaks, but the primary responsibility for disease prevention lies with the owner," he said.

Dr. Chikurunhe said anthrax carcasses must be disposed of safely in a manner that does not leave the bacteria exposed to air. "The best method is to burn the carcasses in a pit, then bury the ashes. However, some parts of the country have firewood problems. In these areas it is recommended to dig a pit 6 feet [1.8 m] deep, bury the carcass, cover the carcass completely with soil and apply a layer of agricultural lime before filling the rest of the pit with soil. This is best done under supervision of veterinary personnel," said Dr. Chikurunhe.  [Byline: Elita Chikwati]
==================
[For maps clearly showing the locations of the individual provinces, go to <https://en.wikipedia.org/wiki/Provinces_of_Zimbabwe>. The districts mentioned are in the following provinces: Bikita (Masvingo), Chegutu (Masonaland West), Gotwe (Midlands), Gutu (Masvingo), Makonde (Masonaland West), Marondera (Masonaland East), Mazowe (Masonaland Central), Nkayi (Matabeleland North), and Sanyati (Masonaland West).

The survival of anthrax spores is location dependent, and this facilitates mapping where the disease might be found and where control should be centered. For some relevant maps, see:
1. Carlson CJ, Kracalik IT, Ross N, et al. The global distribution of _Bacillus anthracis_ and associated anthrax risk to humans, livestock, and wildlife. Nat Microbiol 2019;4:1337-43. doi:10.1038/s41564-019-0435-4
2. Blackburn JK, Odugbo MO, Van Ert M, et al. _Bacillus anthracis_ diversity and geographic potential across Nigeria, Cameroon and Chad: further support of a novel West African lineage. PLOS Negl Trop Dis

As Dr. Wilmot Chikurunhe comments, while vaccination should center on these enzootic areas, one should extend the vaccination cover outwards because of the risk from female biting tabanid flies with contaminated mouthparts and non-reporting neighbours. Annual vaccination prior to the anthrax season protects the livestock at a minimal cost, as Sterne vaccine is extraordinarily cheap. And eradication follows from successful control. Country after country, province after province are realising the truth of this. I just wish the ranchers would be as enthusiastic. It is the procrastinators' livestock that come down, demonstrating a local persistence of risk. Experience shows that once you have gone 8-10 years without outbreaks, you can step back to just high awareness of unexpected deaths (for checking).

The spores have a reputation for "immortality", which is exaggerated. Archived spores have a 3% annual mortality. On my 1st field investigation of this disease, Max Sterne told me that in his experience the contaminated soil will present a risk for 3 months to 3 years; we repeatedly sampled the bloody soil site at that outbreak and found no live spores after 90 days, but we might have just run out of contaminated soil thanks to the repeated sampling. A study by one of my students showed the spore count decreasing by 30% per year. But in general this is an aspect of the epidemiology of this disease that is understudied. And another aspect is that over 5 to 6 years the spores in the soil lose their plasmids and become apathogenic.

The genetics of spore survival depend on a matching of the strain with the soil, Darwin again.

See: Mullins JC, Garofolo G, Van Ert M, et al. Ecological niche modeling of _Bacillus anthracis_ on three continents: evidence for genetic-ecological divergence? PLoS One 2013;8:e72451. <https://doi.org/10.1371/journal.pone.0072451>

Remember, graduate students need fresh air and mud on their boots. - ProMED Mod.MHJ]

[HealthMap/ProMED-mail map:
Date: Sat, 11 Jan 2020 03:28:20 +0100 (MET)
By Ish MAFUNDIKWA

Hwange, Zimbabwe, Jan 11, 2020 (AFP) - Zimbabwean villager Dumisani Khumalo appeared to be in pain as he walked gingerly towards a chair under the shade of a tree near his one-room brick shack.   The 45-year-old was attacked by a buffalo days earlier, and he was lucky to be on his feet.   Wild animals in Zimbabwe were responsible for the deaths of at least 36 people in 2019, up from 20 in the previous year.    "I thank God that I survived the attack," said Khumalo with a laugh, making light of the fact that the buffalo almost ripped off his genitals.   Authorities recorded 311 animal attacks on people last year, up from 195 in 2018.

The attacks have been blamed on a devastating drought in Zimbabwe which has seen hungry animals breaking out of game reserves, raiding human settlements in search of food and water.   "The cases include attacks on humans, their livestock and crops," said national parks spokesman Tinashe Farawo.   He said elephants caused most fatalities, while hippos, buffalos, lions, hyenas and crocodile also contributed to the toll.   Hwange National Park, which is half the size of Belgium, is Zimbabwe's largest game park and is situated next to the famed Victoria Falls. The park is not fenced off.   Animals breach the buffer and "cross over to look for water and food as there is little or none left in the forest area," Farawo said

- Starving animals -
Khumalo vividly remembers the attack. He was walking in a forest near his Ndlovu-Kachechete village to register for food aid, when he heard dogs barking.   Suddenly a buffalo emerged from the bush and charged, hitting him in the chest and tossing him to the ground.    It went for his groin and used its horn to rip off part of the skin around his penis.   Khumalo grabbed the buffalo's leg, kicked it in the eye and it scampered off.   Villagers in Zimbabwe's wildlife-rich but parched northwestern region are frequently fighting off desperately hungry game.   More than 200 elephants starved to death over three months last year.

Despite suspecting that Khumalo was hunting illegally when he was attacked, Phindile Ncube, CEO of Hwange Rural District Council admitted that wild animals are killing people and that the drought has worsened things.   "Wild animals cross into human-inhabited areas in search of water as … sources of drinking water dry up in the forest," said Ncube.   He described an incident that took place a few weeks earlier, during which elephants killed two cows at a domestic water well.   Armed scouts have been put on standby to respond to distress calls from villagers.   But it was while responding to one such call that the scouts inadvertently shot dead a 61-year-old woman in Mbizha village, close to Khumalo's.   "As they tried to chase them off one (elephant) charged at them and a scout shot at it. He missed, and the stray bullet hit and killed Irene Musaka, who was sitting by a fire outside her hut almost a mile away."

- Chilli cake repellant -
Locals are encouraged to play their part to scare off animals. One way is to beat drums.   But the impact is limited.   "Animals, such as elephants get used to the noise and know it... won't hurt them, so it does not deter them in the long term," said George Mapuvire, director of Bio-Hub Trust, a charity that trains people to respond to animal attacks.   Bio-Hub Trust advocates for a "soft approach" that encourages peaceful co-existence between humans and wildlife.

Mapuvire suggested burning home-made hot chilli cakes to repel wildlife.   "You mix chilli powder with cow or elephant dung and shape it into bricks, once the bricks dry, you can burn them when elephants are approaching. They can't stand the smell!"   Villagers have created an elephant alarm system by tying strings of empty tin cans to trees and poles.   When the cans click, they know an elephant is approaching and they light chilli cakes to keep it away.   Another way of keeping elephants at bay is the chilli gun, a plastic contraption loaded with ping-pong balls injected with chilli oil.    "When it hits an elephant, it disintegrates, splashing the animal with the chilli oil," Mapuvire explained.
Date: Fri 10 Jan 2020
Source: The Herald [edited]

Three people are battling for their lives after consuming meat from animals that died of anthrax in Mahusekwa, Marondera district. The 3 cases were picked at Chimbwanda Clinic last week and were confirmed at Mahusekwa Hospital on Monday [6 Jan 2020].

Marondera District Veterinary Officer Dr. Kramer Manyetu said, on investigation, it was established that the affected 3 people consumed meat from 2 cattle that died on [30 Dec 2019]. "No meat was still available when the affected property was visited. The 2 cattle deaths were reported at Chimbwanda West Dip Tank, which has a census of 800 cattle. The combined census for a 10-kilometre (6.2 mi) radius is 4500 cattle covering a total of 3 dip tanks, namely, Chimbwanda West (800), Chimbwanda communal area (2276) and Nyandoro (1458)," he said. Dr. Manyetu said they had secured 5000 doses required to cover the 3 dip tanks.

"Our staff and the Ministry of Health and Child care are in the area and, so far, we can confirm that it is only one homestead affected. The community has secured poles to build races on 3 dip tanks and vaccinations will start Friday [10 Jan 2020]," he said.

The Department of Veterinary Services has received 811,000 doses of anthrax vaccine from Botswana's Vaccine Institute to deal with outbreaks during the rainy season.

Anthrax is a life-threatening infectious disease caused by bacteria that normally affects animals, especially ruminants. The disease affects all warm-blooded animals, including humans. Signs of anthrax include sudden death of livestock, rapid decomposition of the bloated carcasses and tarry blood coming out of all natural openings. The blood of the carcass is brownish and does not clot. During the rainy season, the country usually experiences more anthrax outbreaks because of the rains that wash away the top soil and expose spores. [If this were the case, the spores would be washed away. The rain, following the dry season, encourages the forage to grow, and, in grazing, cattle consume significant amounts of soil, some of which might be contaminated. Also the rain floats the hydrophobic spores to the soil surface. Tabanid hatch will occur, and these blood-feeding flies will spread the infection to more cattle, increasing the risk. - ProMED Mod.MHJ]

There have been cases of farmers who get infected after eating meat from cattle that would have died of anthrax. People may also get infected thorough contact with the infected animals. "Opening an anthrax carcass will lead to formation of anthrax spores that are resistant to environmental changes, heat, cold and will contaminate the soil or area for [a significant period].

"The public should not handle, buy or eat meat that has not been inspected. Anthrax carcasses should never be opened, skinned or eaten. Instead, they should be buried deep into the ground," said Dr. Manyetu. [Preferably, they should be burnt. - ProMED Mod.MHJ]

"It is also an offense to sell to the public, meat that has not been processed in an abattoir and inspected and certified as unconditionally fit for human consumption."

Farmers were advised to report all cattle deaths to their nearest veterinary officers.  [Byline: Elita Chikwati]
========================
[Marondera is in the center of Mashonaland East

This is an update on the previous report of 2 Jan 2020 (Anthrax - Zimbabwe: (ME) cattle, human cases

"Dip tanks" take us back to Southern Rhodesia, when a major veterinary disease control activity was tick control. Community cattle were swum through the deep pesticide at regular intervals throughout the year. This was tightly supervised. This provided a good opportunity for individual animals to be checked, pregnancy status confirmed, and generally one-on-one contact with the veterinary assistants. Thus, the census centered on these collecting points. - ProMED Mod.MHJ]

[HealthMap/ProMED-mail map:
Mashonaland East, Zimbabwe: <http://healthmap.org/promed/p/6141>]
Date: Tue 7 Jan 2020
Source: News Day [edited]

A deadly anthrax outbreak has hit Gokwe North district in the Midlands province, with farmers losing large herds of cattle while several people were reportedly hospitalised after eating infected meat.

Midlands veterinary officer Munyaradzi Chigiji confirmed the development and said his department had since moved in to put the outbreak under control. "We have had great losses of livestock to date, and our tests confirmed that it was anthrax. Farmers have lost huge numbers of cattle due to the outbreak so far. We have also recorded cases of human beings who have been treated of the disease in the affected areas. Although we cannot confirm the number of deaths of the livestock, what we can say is that farmers have lost out," Chigiji said.

"During my visit to the area, I arrived at a homestead which had lost 15 cattle. I also visited another one which had lost 4. We also have several other farmers who have lost their livestock due to anthrax." The hardest hit areas are Nembudziya, Simchembo and Chireya.

Southern Eye yesterday [6 Jan 2020] spoke to farmers at Nembudziya Growth Point who confirmed that the outbreak was wreaking havoc in the area. "I lost a herd of 11 cattle due to the outbreak. In my village alone, over 80 cattle have perished in the recent past due to the outbreak. Here, our main economic activity has been cotton growing, but lately we had shifted to cattle ranching because the cotton has become less profitable due to falling prices," said Nomore Machivenyika, a farmer in Maserukwe village. "This outbreak has, therefore, come as a big blow for us."

Another farmer told this paper that several people in Nembudziya had been hospitalised after eating infected meat. "There are people who have been selling cheap meat around this area, and little did people know that it was from cattle that died of anthrax. Several of them have been going to Nembudziya Hospital for treatment," Nomore Musundire said.

Chigiji said measures to control the outbreak had since been put in place. "As we speak, we have dispatched 10 400 (vials of) vaccines to Gokwe North so that cattle can be vaccinated. We have also been carrying out awareness campaigns in conjunction with the Ministry of Health. In terms of humans, no one has died from anthrax," he said.

Chigiji also revealed that another livestock disease, heartwater, had been wiping out cattle in the same district. "We had shortages of dipping chemicals, so heartwater also caught up with the livestock. However, we are working to normalise the situation," he said.
======================
[For a brief description of Gokwe North & South in Midlands Province west of Harare, go to: <https://en.wikipedia.org/wiki/Gokwe_region>. For a map of Zimbabwe showing the various provinces, click on "Subdivision of Zimbabwe" in the Wikileaks link.

It would appear that this disease has got away from any control efforts by the Midlands veterinary officer and his people. The actual extent and intensity of those efforts is not obvious from the quoted statements. And being the holiday season, a number of owners of sick and dead cattle did not miss the opportunity to sell contaminated meat from their butchered sick stock. To control and stop an anthrax epizootic in livestock, one must be aggressive and have your feet on the ground. - ProMED Mod.MHJ]

[HealthMap/ProMED map available at:
Midlands Province, Midlands, Zimbabwe:
Date: Wed 1 Jan 2020
Source: Pindula News [edited]

Three people were diagnosed and treated for Anthrax in Mashonaland East's Bosha Clinic in Chikwaka after they had consumed the meat of a dead cattle the Herald reports. DVS chief director, Dr. Josphat Nyika revealed the incident and said they couldn't find a carcass for sample collection because people consumed all the meat.

Suspicion of anthrax was consolidated by human contacts. There were 3 patients who were diagnosed of anthrax after they had consumed the meat of dead cattle. They were admitted and treated at Bosha Clinic.

Meanwhile, the government has received 800 000 doses of anthrax vaccines from Botswana and vaccinations are currently underway according to Dr. Nyika.
More ...

Mali

Mali - US Consular Information Sheet
December 19, 2008
COUNTRY DESCRIPTION:
Mali is a developing country in western Africa with a stable and democratic government.
The official language is French.
The capital is Bamako.
Faci
ities for tourism are limited.
Read the Department of State Background Notes on Mali for additional information.
ENTRY/EXIT REQUIREMENTS:
A passport and visa are required.
All travelers must have international vaccination cards with a current yellow fever immunization.
Travelers should obtain the latest visa information and entry requirements from the Republic of Mali Embassy at 2130 R Street NW, Washington, DC
20008, telephone (202) 332-2249.
Inquiries can be made at the nearest Malian embassy or consulate.
Visit the Embassy of Mali web site at http://www.maliembassy.us/ for the most current visa information.
Information about dual nationality or the prevention of international child abduction can be found on our web site. For further information about customs regulations, please read our Customs Information sheet.

SAFETY AND SECURITY: The U.S. Embassy in Bamako strongly advises American citizens to avoid traveling to the northern regions of Mali.
U.S. Government employees serving in Mali, including those on temporary duty, are required to have approval from the Chief of Mission prior to traveling to areas north of the Niger River, including Timbuktu and areas or north of Timbuktu.
Travelers should exercise caution when traveling in any isolated areas.

In August 2007, Tuareg dissidents attacked and kidnapped civilian and military convoys near the Mali-Niger border.
On January 3, 2008, four Italians were robbed at gunpoint near Araouane, 150 miles north of Timbuktu, by assailants whose affiliation remains unknown.
Tuareg rebels in the Kidal region attacked Malian military units in Tinzawaten and Boughessa in March 2008, in Abeibara in May 2008, and in Tessalit in July 2008.
On October 16, 2008, bandits in the Kidal region of Mali carjacked two vehicles belonging to the International Committee for the Red Cross.

Al-Qaeda in the Land of the Islamic Maghreb (AQIM) has a presence in northern Mali.
AQIM began as a terrorist group seeking the overthrow of the Algerian government, and has been designated as a terrorist organization by both the United States and the European Union.
On October 31, 2008, in northern Mali, AQIM freed two Austrian tourists kidnapped in Tunisia eight months earlier.
The group has declared its intention to attack Algerian and Western targets.

This recent activity and the porous nature of Mali’s northern borders with Mauritania and Algeria, as well as its eastern border with Niger, reinforce long-standing concerns about security for travel in northern Mali.
The Department of State strongly urges citizens to reconsider traveling to northern Mali, including Timbuktu and Essakane.
Northern Mali hosts several annual music festivals in the desert, including one north of Timbuktu at Essakane, one north of Kidal at Essouk, and another near Menaka.
These are official events sanctioned by the Government of Mali.
Americans planning to attend these festivals or otherwise travel to the northern regions of Mali, despite this caution, are urged to notify the U.S. Embassy about their plans by e-mail at consularbamako@state.gov.
For the latest security information, Americans traveling abroad should regularly monitor the Department of State, Bureau of Consular Affairs’ web site at http://travel.state.gov, where the current Travel Warnings and Travel Alerts, as well as the Worldwide Caution, can be found.
Current information on safety and security can also be obtained by calling 1-888-407-4747 toll-free within the U.S. and Canada, or, for callers outside of the U.S. and Canada, on a regular toll line at 1-202-501-4444.
These numbers are available from 8:00 a.m. to 8:00 p.m. Eastern Time, Monday through Friday (except U.S. federal holidays).
The Department of State urges American citizens to take responsibility for their own personal security while traveling overseas. For general information about appropriate measures travelers can take to protect themselves in an overseas environment, see the Department of State’s pamphlet A Safe Trip Abroad.
CRIME:
Violent crime in Mali is infrequent, but petty crimes, such as pick pocketing and simple theft, are common in urban areas.
Passports and wallets should be closely guarded when in crowded outdoor areas and open-air markets.
Individuals traveling on the Bamako-Dakar railroad are advised to be vigilant for pickpockets, especially at night.
Criminals will not hesitate to use violence if they encounter resistance from their victims.
There are sporadic reports of nighttime robberies occurring on the roads outside of the capital; tourists should not drive outside of Bamako at night.
Travelers should stay alert, remain in groups, and avoid poorly lit areas after dark.

Sporadic banditry and random carjacking have historically plagued Mali's vast desert region and its borders with Mauritania and Niger.
While banditry is not seen as targeting U.S. citizens specifically, such acts of violence cannot be predicted.

On July 1, 2008, six people working as USAID contractors were robbed of their vehicle and all belongings, at gunpoint, by three bandits between the villages of Temera and Bourem, approximately 120 km (75 miles) northeast of Gao along the Niger River.

From May 2008 until July 2008, there were a series of attacks at various Malian government installations.
While most of these have been in eastern Mali, on May 6, bandits attacked a military outpost in Diabali, 175 km (110 miles) north of Segou.
While these actions appear directed exclusively at government security facilities, including military, gendarmerie and national guard bases, bandits have been known to stop cars at gunpoint while making their escape.
Those traveling or living in Mali are strongly encouraged to register with the Embassy to allow e-mail notification should further attacks occur.
Please see the Registration/Embassy Location information at the end of this article.

INFORMATION FOR VICTIMS OF CRIME: The loss or theft abroad of a U.S. passport should be reported immediately to the local police and the nearest U.S. Embassy or Consulate.
If you are the victim of a crime while overseas, in addition to reporting to local police, please contact the nearest U.S. Embassy or Consulate for assistance. The Embassy/Consulate staff can, for example, assist you to find appropriate medical care, contact family members or friends and explain how funds could be transferred. Although the investigation and prosecution of the crime is solely the responsibility of local authorities, consular officers can help you to understand the local criminal justice process and to find an attorney if needed.

The local equivalent to the “911” emergency line in Mali is:
1212
See our information on Victims of Crime.
MEDICAL FACILITIES AND HEALTH INFORMATION:
Medical facilities in Mali are limited, especially outside of the capital, Bamako.
Psychiatric care is non-existent.
The U.S. Embassy in Bamako maintains a list of physicians and other healthcare professionals who may see U.S. citizen patients.
The Embassy cannot guarantee these services or specifically recommend any physicians.

The U.S. Department of State is unaware of any HIV/AIDS entry restrictions for visitors to, or foreign residents of, Mali.
Many American medicines are unavailable; French medications are more easily found.
Available medications can be obtained at pharmacies throughout Bamako, and are usually less expensive than those in the U.S.
Travelers should carry with them an adequate supply of needed medication and prescription drugs, along with copies of the prescriptions, including the generic names for the drugs.
Caution should be taken to avoid purchasing potentially dangerous counterfeit medications when buying on the local market in Mali.
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 Mali is provided for general reference only, and may not be totally accurate in a particular location or circumstance.
U.S. citizens traveling by road in Mali should exercise caution.
Mali has paved roads leading from Bamako to Segou, Mopti and Sikasso.
During the rainy season from mid-June to mid-September, some unpaved roads may be impassable.
On many roads outside of the capital, deep sand and ditches are common.
Four-wheel drive vehicles with spare tires and emergency equipment are recommended.
The Embassy strongly urges all travelers to avoid traveling after dark on roads outside of urban centers.
The roads from Gao to Kidal and Menaka, and the roads around Timbuktu, are desert tracks with long isolated stretches.
Travelers must be prepared to repair their vehicles should they break down or become stuck in the sand.
Travelers should also carry plenty of food and water.
Drivers drive on the right-hand side of the road in Mali.
Speed limits range from 40-60 km per hour (25-40 miles per hour) within towns, to 100 km per hour (60 miles per hour) between cities.
Road conditions often require lower speeds.
Due to safety concerns, the Embassy recommends against the use of motorbikes, van taxis, and public transportation.
Excessive speeds, poorly maintained vehicles, lack of street lighting and roving livestock pose serious road hazards.
Many vehicles are not maintained well and headlights are either extremely dim or not used.
Driving conditions in the capital of Bamako can be particularly dangerous due to limited street lighting, the absence of sidewalks for pedestrians, and the number of motorcycles, mopeds and bicycles.
Please refer to our Road Safety page for more information.
The Malian authority for road safety is the Compagnie Nationale de Circulation Routiere in Bamako at telephone (223) 20-22-38-83.
AVIATION SAFETY OVERSIGHT:
As there is no direct commercial air service to the United States by carriers registered in Mali, the U.S. Federal Aviation Administration (FAA) has not assessed Mali’s Civil Aviation Authority for compliance with International Civil Aviation Organization (ICAO) aviation safety standards.
For more information, travelers may visit the FAA’s web site at http://www.faa.gov/safety/programs_initiatives/oversight/iasa.

SPECIAL CIRCUMSTANCES:
Mali is signatory to the Treaty on Cultural Property, which restricts exportation of Malian archeological objects, in particular those from the Niger River Valley.
Visitors seeking to export any such property are required by Malian law to obtain an export authorization from the National Museum in Bamako.
It is advisable to contact the Embassy of Mali in Washington or the nearest Malian consulate for specific information regarding customs requirements.
U.S. Customs and Border Protection may impose corresponding import restrictions in accordance with the Convention on Cultural Property Implementation Act.
Currency exchange facilities are slow and often involve out-of-date rates.
The U.S. Embassy cannot provide exchange facilities for private Americans.
There are a few ATMs in Bamako that accept American credit cards and debit cards with a Visa logo only.
Maximum withdrawals are generally limited to $400, and local banks charge up to $20 per transaction for use of their ATMs.
There are no ATMs outside of Bamako.
Credit cards are accepted only at major hotels, a few travel agencies, and select restaurants.
Cash advances on credit cards are available from only one bank in Mali, the BMCD Bank in Bamako, and the only card they accept for this is Visa.

The U.S. Embassy does not always receive timely notification by Malian authorities of the arrest of Americans.
U.S. citizens are encouraged to carry a copy of their passport with them at all times, so that proof of identity and citizenship are readily available in the event of questioning by local authorities.
If arrested, U.S. citizens should always politely insist they be allowed to contact the U.S. Embassy (see section on Registration/Embassy Location below).
Photographing military subjects is restricted.
One should also obtain explicit permission from the Malian government before photographing transportation facilities and government buildings.
Taking a photograph without permission in any public area may provoke a response from security personnel or offend the people being photographed.
Taking photos of the U.S. Embassy is also prohibited.
International telephone calls are expensive, and collect calls cannot be made from outside of Bamako.
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 that are available to individuals under U.S. law. Penalties for breaking the law can be more severe than in the United States for similar offenses. Persons violating Mali’s laws, even unknowingly, may be expelled, arrested or imprisoned. Penalties for possession, use, or trafficking in illegal drugs in Mali 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 Mali are encouraged to register with the U.S. Embassy or through the State Department’s travel registration web site so that they can obtain current information on travel and security within Mali.
Americans without Internet access may register directly with the U.S. Embassy.
By registering, American citizens make it easier for the Embassy to contact them in case of emergency.
The U.S. Embassy is located in ACI 2000 at Rue 243, Porte 297.
The Embassy's mailing address is B.P. 34, Bamako, Mali.
The telephone number is (223) 20-70-2300.
The consular fax number is (223) 20-70-2340.
The Embassy web page is at http://mali.usembassy.gov
* * *
This replaces the Country Specific Information for Mali dated February 7, 2008, to update the sections on Safety and Security, Crime, Information for Victims of Crime, and Traffic Safety and Road Conditions.

Travel News Headlines WORLD NEWS

Date: Thu 26 Dec 2019
Source: WHO Emergencies preparedness, response [edited]

From 3 Nov through 8 Dec 2019, 3 laboratory-confirmed cases of yellow fever including 2 deaths (case fatality rate = 67%) were detected through the national surveillance system in Mali. The 1st case-patient was a 15-year-old girl from a village in Kati district, Koulikoro region, Mali. The 2nd and 3rd cases were in 17- and 25-year-old men, nationals from Cote d'Ivoire, living in the district of Bouguimi, Sikasso region, Mali. All 3 cases tested positive for yellow fever by immunoglobulin M (IgM) and reverse-transcriptase polymerase chain reaction (RT-PCR) on 3 Dec 2019 at Institute Pasteur Dakar (IPD). The 1st case was not vaccinated against yellow fever and had no travel history outside of Kati district. Meanwhile, the vaccination status for the other 2 cases was unknown.

Additionally, there were 9 suspected and 3 probable cases reported from the Bouguimi district, including 3 deaths among the probable cases. The age of the suspected, probable, and confirmed cases ranges between 1 and 33 years, and the male-to-female ratio is 2:1. Among the reported symptoms, fever, jaundice, and vomiting were the most common. There are 8 health areas of Bouguimi health district that have been affected, with Manakoro (4 cases) and Mafele (3 cases) reporting the highest number. One suspected case is pending for confirmation at the Institute Pasteur Dakar laboratory.

On 5 Dec 2019, the government of Mali officially declared a yellow fever outbreak in 2 regions of Sikasso and Koulikoro.

Public health response
- An emergency operations centre (EOC) for public health coordination of the outbreak in the regions of Sikasso, Koulikoro, and the affected districts has been set up. In addition, an EOC has been activated in
Bamako city.
- A multidisciplinary rapid response team was deployed to conduct investigations in the affected districts of Sikasso and Koulikoro regions. A plan to conduct an in-depth entomological survey is underway.
- Enhanced epidemiological surveillance, including active case finding in both the affected districts, has been strengthened.
- A comprehensive response plan is being developed with specific objectives, including the preparation for an international-coordination-group (ICG) request to conduct a yellow fever reactive mass-vaccination campaign.
- Risk communication capacity through involvement of relevant stakeholders [is being provided], as well as public communication and awareness efforts on yellow fever (signs, symptoms, and vaccinations), including prevention measures.
- On 3 Dec 2019, a joint investigation team (WHO Country Office and Ministry of Health) was deployed to characterize the risk and develop an intervention plan. Field investigations indicate vaccination coverage under 80% in Kati and 88% in Manakoro districts.

WHO risk assessment
Although population immunity in the southern regions of Mali has benefited from large-scale preventive mass vaccination campaigns in 2008 (5.8 million people protected) combined with nationwide children routine immunization since 2002, the overall national routine immunization coverage for yellow fever in 2018 was estimated to be 67%, with estimates nearly 80% in the non-desert areas (including the recently affected Koulikoro and Sissako regions). This is below herd immunity thresholds and may indicate the presence of pockets of low immunity in the country. Kati district in Koulikoro region is located proximal to the capital city, Bamako, an urban city with more than 2 million inhabitants, and Bouguimi district in Sikasso region borders with Cote d'Ivoire.

The high population movements within Mali and across borders increases the risk of national and regional spread, and this may have diluted the population immunity. The geographical distribution of the virus, coupled with suboptimal vaccination coverage, and the presence of susceptible populations presents a risk of amplification. Furthermore, the protracted humanitarian crisis and concomitant ongoing outbreaks of epidemic-prone diseases (measles, dengue) may impact the response due to competing limited resources.

Based on available information, WHO assesses the overall risk as high at the national level, moderate at the regional level, and low at the global level.

WHO advice
Yellow fever is an acute viral haemorrhagic disease transmitted by infected mosquitoes and has the potential to spread rapidly and cause serious public health impact. There is no specific treatment, although the disease is preventable using a single dose of yellow fever vaccine, which provides immunity for life. Supportive care to treat dehydration, respiratory failure, and fever, and antibiotic treatment for associated bacterial infections, is recommended.

Mali is a high-priority country for the Eliminate Yellow Fever Epidemic (EYE) strategy. Vaccination is the primary intervention for prevention and control of yellow fever. In urban centres, targeted vector control measures are also helpful to interrupt transmission. WHO and partners will continue to support local authorities to implement interventions necessary to control the current outbreak.

WHO recommends vaccination against yellow fever for all international travellers more than 9 months of age going to areas south of the Sahara Desert in Mali. The vaccine is contraindicated in children aged less than 6 months and is not recommended for those aged 6-8 months, except during epidemics when the risk of infection with yellow fever virus may be very high. Other contraindications for yellow fever vaccination are severe hypersensitivity to egg and severe immunodeficiency. Caution is recommended before vaccinating people aged above 60 years against yellow fever.

WHO does not recommend vaccination for travellers whose itineraries are limited to areas within the Sahara Desert. Vaccination is recommended, if indicated, for pregnant or breastfeeding women travelling to endemic areas when such travel cannot be avoided or postponed. Mali requires as a condition of entry a yellow fever vaccination certificate for all travellers aged one year or over.

Yellow fever vaccines recommended by WHO are safe and highly effective and provide life-long protection against infection. In accordance with the IHR (2005) 3rd edition, the validity of the international certificate of vaccination against yellow fever extends to the life of the person vaccinated with a WHO-approved vaccine. For both existing or new certificates, revaccination or a booster dose of yellow fever vaccine cannot be required of international travellers as a condition of entry into a state party, regardless of the date their international certificate of vaccination was initially issued.

On 1 Jul 2019, WHO updated the areas at risk of yellow fever transmission and the corresponding recommendations for vaccination of international travelers. The list of countries at risk and revised recommendations for vaccination against yellow fever are available on the WHO website (International travel and health (ITH),  <https://www.who.int/ith/en/>).

WHO encourage its member states to take all actions necessary to keep travellers well informed of risks and preventive measures including vaccination. Travellers should also be made aware of yellow fever signs and symptoms and instructed to seek rapid medical advice should they develop signs of illness. Travellers returning to Mali who may be infected with possible high levels of the virus in the blood may pose a risk for the establishment of local cycles of yellow fever transmission in areas where the competent vector is present.

WHO does not recommend any restrictions on travel or trade to Mali on the basis of the information available on this outbreak.
=======================
[This updated report includes information about 9 suspected and 3 probable yellow fever (YF) cases that were not mentioned in previous reports, indicating that the outbreak was more extensive than originally stated, with an outbreak declared by government authorities in the 2 regions. These additional cases may have been a result of the additional surveillance that has been undertaken. Since vaccination coverage has been found to be less than 80% and 88% in Kati and Manakoro districts, respectively, presumably the preventive measures mentioned will include vaccination. The entomological survey will be an important factor in risk assessment. The presence of abundant populations of the mosquito vector, _Aedes aegypti_, would be of concern, raising the possibility of urban transmission of YF virus that might get out of hand quickly. - ProMED Mod.TY]

[HealthMap/ProMED-mail maps:
Date: Sun 8 Dec 2019
Source: WHO Weekly Bulletin on Outbreaks and Other Emergencies [edited]

On 3 Dec 2019, WHO was informed through internal communication of 3 yellow fever cases in Mali, including one death. Of these, 2 of the cases are from Wogouna and Keregoura villages, Bougoni district, Sikasso region in the South of Mali and one from Nanakenieba village, Kati district, Koulikoro region in the south west of Mali.

The reported cases are young adults (15-25 years), one female and 2 males, with onset of symptoms in early November 2019.

The cases tested yellow fever IgM and PCR positive at Institute Pasteur Dakar on 3 Dec 2019.

The vaccination status of the cases is being investigated (2 of the cases reported vaccination in the past). The latest vaccination campaign in the country was performed in 2008 including the affected areas where the vaccination coverage was reported to be between 50 and 9% in 2008. The average national vaccination coverage for 2017 has been reported at 65% (data from Imperial College). The YF routine vaccination in the country was introduced in 2002.

A field investigation is ongoing. According to historical data, 10 cases were detected in Mali in 2015.
======================
[This report provides some additional details in that 2 patients were male and one female along with their vaccination status, which were not included in the original post (see Yellow fever - Africa (25): Mali (BA, SK), Cote d'Ivoire http://promedmail.org/post/20191207.6827680). As in the original report, no mention is made of plans to vaccinate in the localities where the cases became infected. Vaccination in those areas is an effective preventive measure especially since, as the report notes, the mosquito vector, _Aedes aegypti_, is abundant enough to transmit dengue viruses. Yellow fever can spread rapidly and quickly get out of hand in susceptible populations with abundant mosquito vectors, as it did in Angola in 2016. - ProMED Mod.TY]

[HealthMap/ProMED-mail maps:
Date: Thu 5 Dec 2019
Source: Ministry of Health and Social Affairs [in French, trans.,
edited]

Communication from the Ministry of Health and Social Affairs on yellow fever cases in Mali
-----------------------------------------------------
The Ministry of Health and Social Affairs declares the occurrence of 3 confirmed cases of yellow fever on Tue 3 Dec 2019.

Of the 3 cases, one resides in Sirakoro-Meguetana in the health district of Kati [Bamako region, Mali], the 2nd in Manankoro in the health district of Bougouni [Sikasso region, Mali], and the 3rd in the village of Keregouana in Cote d'Ivoire [unable to locate this village on a map, but presumably it is near the border of Mali and Cote d'Ivoire. - ProMED CopyEd.TW].

In accordance with International Health Regulations, the outbreak has been reported to the World Health Organization.

The Ministry of Health and Social Affairs immediately analyzed the situation and took the following necessary measures:
- sending investigative teams to the field to better understand the epidemiological situation in order to quickly halt the spread of the epidemic,
- strengthening epidemiological surveillance,
- strengthening the response capacity of health workers, and
- disseminating awareness messages.

The Ministry of Health and Social Affairs invites people to observe the following measures:
- destroy larval breeding sites (old tires or any other abandoned objects containing water),
- protect against mosquito bites,
- sleep under insecticide-impregnated mosquito nets,
- keep households and housing clean, and
- get vaccinated before any trips abroad.

The Minister of Health and Social Affairs calls for calm and vigilance and reassures the population that appropriate measures are underway to control the situation.

Bamako, 4 Dec 2019
P / The Minister / PO
The Secretary General
Dr Mama Coumare
Knight of the National Order
===================
[An outbreak of yellow fever has been recognized in Mali by official sources. The statement from the Ministry of Health specifies the number of cases, the location of the cases detected, the measures taken, the recommendations, and the notification of the outbreak to WHO, as stipulated by International Health Regulations.

Cases of haemorrhagic fevers have recurred in Mali. Last month [November 2019], cases of dengue were diagnosed in Bamako, the capital of Mali.

_Aedes aegypti_, (but also to a lesser extent _Aedes albopictus_) is the vector that transmits these haemorrhagic fevers (dengue, chikungunya, yellow fever, and Zika).

Health authorities must use all channels of communication to raise awareness and get people to seek consultation in case of fever or muscle aches. Caregivers, especially clinicians, should consider haemorrhagic fevers (dengue or yellow fever) in any case of fever with a negative thick smear (or negative RDT) for malaria, or in any case of presumptive malaria that does not respond to appropriate antimalarial treatment. - Mod.BM, from ProMED-FRA archive no. http://promedmail.org/post/20191205.6824988, in French, trans., edited]

[The occurrence of yellow fever (YF) in different locations is a serious concern, and the measures to increase surveillance are prudent. It is curious that no mention is made of vaccination, whether the population of individuals is already vaccinated or whether there are plans to vaccinate in the localities where the cases became infected. Vaccination in those areas is an effective preventive measure especially since, as the report notes, the mosquito vector, _Aedes aegypti_, is abundant enough to transmit dengue viruses. YF can spread rapidly and quickly get out of hand in susceptible populations with abundant mosquito vectors, as it did in Angola in 2016. - ProMED Mod.TY]

[HealthMap/ProMED-mail maps:
Date: Tue, 3 Sep 2019 21:09:12 +0200 (METDST)

Bamako, Sept 3, 2019 (AFP) - Fourteen bus passengers were killed Tuesday by a road mine in central Mali, the bus company said, in an attack bearing the hallmarks of jihadists who plague the region.   The vehicle was en route from the central town of Douentza to the northern town of Gao, Oumar Ould Mamoud of the Sonef bus company told AFP.   "The new toll is 14 dead and eight injured," he said, adding that there had been about 50 people on the bus.

Police earlier had given a toll of eight dead and 13 injured, and said the blast occurred 30 kilometres (18 miles) from Douentza.   Another police official said "terrorists" had set down the mine.   A Malian military unit by coincidence had been travelling on the same road and was able to provide assistance to the passengers, the source said, and Sonef said it had sent a second bus to pick up them up.   The UN stabilization force in Mali, MINUSMA, condemned the attack which it said had caused "many deaths and 30 injuries," adding that some of the injured were helicoptered out.

MINUSMA spokesman Olivier Salgado said on Twitter that two women and two children were among the injured.   Northern Mali fell into the hands of jihadists in 2012 before the militants were forced out by a French-led military intervention.   But much of the region remains chronically unstable and since 2015 violence has spread to the centre of the country, an ethnic mosaic.   Jihadists have carried out dozens of hit-and-run raids and mine attacks, striking troops as well as civilians.   In January 2018, 24 Malian and Burkinabe citizens, including women and children, were killed in a blast in central Mali as they headed to a weekly fair.   The insurgents have also inflamed tensions between rival communities, particularly nomadic Fulani herders and sedentary farmers. Hundreds of lives have been lost in tit-for-tat assaults.
Date: Thu, 16 May 2019 18:37:39 +0200

Bamako, May 16, 2019 (AFP) - Heavy floods claimed 15 lives Thursday in the Malian capital Bamako along with serious property damage, authorities said.   A statement said the flooding claimed a "provisional toll" of 15 dead and two injured.   "Teams are in place to rescue the distressed people," the government said, calling on residents to be "prudent" in the face of the disaster.   Flooding is common in Mali, located in the semi-desert Sahel region.
More ...

World Travel News Headlines

Date: Thu, 23 Jan 2020 17:57:34 +0100 (MET)
By Eva XIAO

Beijing, Jan 23, 2020 (AFP) - The first fatality of China's new virus would come to represent a common set of traits for those who died to the disease: he was over the age of 60 and in poor health.   Since China reported the emergence of a new coronavirus at the end of December, the SARS-like virus has infected more than 500 and killed 17.   So far, the majority of the victims were elderly individuals with pre-existing health conditions, such as diabetes and liver cirrhosis.   All hailed from central Hubei province, where a local seafood market in the capital city of Wuhan is believed to be the epicentre of the epidemic.   But while older individuals have died from the Wuhan virus, some younger patients -- including a 10-year-old boy -- have since been released from the hospital.   Here's what we know so far about the deaths:

Most victims were over 60
According to details released by China's National Health Commission (NHC) on Thursday, the 17 victims of the virus were between 48 and 89 years old.   Only two were under the age of 60, while the average age of the victims was 73.   Most of them died this week, according to the NHC.   Among those who have been discharged from the hospital were younger patients, including a 35-year-old man from Shenzhen, a bustling tech hub in southern Guangdong province.   He was released from the hospital on Thursday, according to the local health commission, as well as the 10-year-old boy who had visited relatives in Wuhan before falling ill.

Many had pre-existing health conditions
Many of those who died from the virus also had pre-existing health issues before contracting the Wuhan disease, such as diabetes and hypertension.   One man, an 86-year-old who was hospitalised on January 9, had surgery for colon cancer four years prior, on top of suffering from high blood pressure and diabetes.   Another, an 80-year-old woman surnamed Hu, had Parkinson's Disease and more than 20 years of high blood pressure and diabetes in her medical history.

Some were hospitalised for weeks before dying
Several of the 17 victims were hospitalised for weeks before dying -- raising questions on the preparedness of hospitals that may have to treat patients for long periods of time.   The youngest victim of the Wuhan virus, a woman surnamed Yin, was hospitalised for more than a month before succumbing to the virus.   On December 10, the 48-year-old woman reported a fever, coughing, body soreness, and fatigue, and underwent anti-infection treatment for two weeks, according to the NHC.   Later in the end of the month, Yin suffered shortness of breath and chest tightness, and she passed away on January 20.

Not all of them had a fever
Currently, Wuhan authorities are screening passengers for fever at the airport, railway stations, and bus terminals.   At four airports in Thailand, authorities introduced mandatory thermal scans of passengers arriving from high-risk areas of China.   But not all those who died after being infected reported a fever before being hospitalised, according to the NHC.   A 66-year-old man surnamed Luo reported a "mainly dry cough" but no fever on December 22 before suffering from shortness of breath more than a week later.

By mid-January, Luo required a ventilator to help him breathe.   "A major concern is the range of severity of symptoms this virus is causing," said Dr Jeremy Farrar, Director of the Wellcome Trust.   "It is clear some people are being affected and are infectious while experiencing only very mild symptoms or possibly without experiencing symptoms at all," he said in an emailed statement.   "This may be masking the true numbers infected and the extent of person to person transmission," he added.
Date: Thu, 23 Jan 2020 16:05:30 +0100 (MET)

Singapore, Jan 23, 2020 (AFP) - Singapore Thursday confirmed its first case of the new SARS-like virus which has killed 17 people in China and spread to multiple countries including the United States.   The Ministry of Health (MOH) said the patient was a 66-year-old man from Wuhan who arrived in Singapore with his family on Monday.    He was immediately isolated after arriving at a hospital with a fever and cough, and test results later confirmed he was infected with the coronavirus.   One of his travelling companions, a 37-year-old man from Wuhan, has also been admitted to hospital as a suspect case.

Prior to admission, they had stayed at a hotel on the resort island of Sentosa, the ministry said.   It added that Singapore was expecting more cases and alarms "given the high volume of international travel".   Singapore's Changi Airport started screening flights from Wuhan at the beginning of the month, and on Wednesday extended the checks to all flights from China.   The travel hub receives over 430 flights from China every week.   The virus has caused alarm in China and abroad because of its genetic similarities to Severe Acute Respiratory Syndrome (SARS), which killed nearly 650 people across mainland China and Hong Kong in 2002-2003.

Singapore was among the hardest hit by SARS with 33 deaths.   Prime Minister Lee Hsien Loong, who is in Davos for the World Economic Forum, said there was "no need to panic".   Speaking to reporters travelling with him, Lee said Singapore has beefed up its hospital facilities and laid out response measures since the SARS epidemic.   "I think we are much better prepared now," he said in remarks carried by the Straits Times newspaper.
Date: Thu, 23 Jan 2020 14:43:33 +0100 (MET)

Barcelona, Jan 23, 2020 (AFP) - The death toll from a violent storm which has wrought havoc on huge swathes of Spain's eastern and southern coastline rose to nine on Thursday as rescuers pressed the hunt for at least five missing people.    The latest death was that of a man whose body was found in a flooded river near Jorba, some 70 kilometres (45 miles) northwest of Barcelona, the emergency services said.    Rescuers in Catalonia had been searching for a missing person in the same area but said it was too early to confirm if it was him.

Catalan rescuers had late on Wednesday found another body of a man who died after falling into the water in Palamos, a port town about 100 kilometres up the coast from Barcelona.    They are also searching for a man who went missing from a merchant ship in the same area, as well as a person in Cadaques near the French border.   Earlier on Thursday, regional officials confirmed the death of a 75-year-old woman whose house collapsed because of heavy rain in Alcoi, a town in the eastern Alicante region.

Storm Gloria hit the region on Sunday, bringing strong winds, torrential rains and heavy snow, battering Spain's southern and eastern flanks before moving north.   Gale-force winds and huge waves smashed into seafront towns, with dramatic images showing massive flooding that has damaged shops, houses and restaurants.   National weather agency Aemet had on Wednesday said the storm was starting to abate although it kept Catalonia and the Balearic Islands on alert.   As the storm eased, Prime Minister Pedro Sanchez was on Thursday visiting some of the worst-hit areas, overflying parts of Catalonia before heading to the Balearic Islands which on Tuesday were hit by record waves, the port authority said.

Rescuers on the islands are still searching for three people, including a 25-year-old Briton who went missing on a beach in northern Ibiza, and a 27-year-old Spaniard who disappeared in Mallorca while practising canyoning -- a mix of rappelling, climbing and watersliding through deep gorges.   Rescuers had found three other bodies on Wednesday, including that of a 67-year-old man who went missing in his car near the southeastern resort town of Benidom.    They also found two bodies in the southern Andalusia region, one of a 77-year-old man who died when a greenhouse collapsed on him in a hailstorm in Nijar as well as that of a homeless man who died of hypothermia.
Date: Wed 22 Jan 2020 1:04 PM EAT
Source: Uganda Red Cross Twitter [edited]

One confirmed case of Crimean-Congo haemorrhagic fever, 4 others suspected, in Kagadi [western Uganda]

A district Task Force has been formed to manage and coordinate the cases across the district @MinofHealthUG @robert_kwesiga @inakasiita1
========================
[Crimean-Congo haemorrhagic fever (CCHF) can cause serious disease in humans, with a case fatality rate of 10-40%. It can be responsible for severe outbreaks in humans, but it is not pathogenic for ruminants, their amplifying hosts. WHO states that the onset of symptoms in humans is sudden, with fever, myalgia, (muscle ache), dizziness, neck pain and stiffness, backache, headache, sore eyes and photophobia (sensitivity to light). There may be nausea, vomiting, diarrhoea, abdominal pain, and sore throat early on, followed by sharp mood swings and confusion. After 2-4 days, the agitation may be replaced by sleepiness, depression, and lassitude, and the abdominal pain may localize to the upper right quadrant, with detectable hepatomegaly (liver enlargement). Other clinical signs include tachycardia (fast heart rate), lymphadenopathy (enlarged lymph nodes), and a petechial rash (a rash caused by bleeding into the skin) on internal mucosal surfaces, such as in the mouth and throat, and on the skin.

Public education, especially among individuals in contact with livestock or their products, is needed to prevent cases of CCHF infection. A One Health approach is needed for effective surveillance, with effective communication between animal health and human health professionals.

The information in the tweet above indicates that there is one confirmed and at least 4 suspected cases of CCHF in Kagadi district, in the western region of Uganda.  Any updates on the epidemiology of these cases, occupational exposure, and public health response measures to control the transmission will be highly appreciated. - ProMED Mod.UBA]

[Maps of Uganda:
Date: Mon 20 Jan 2020
Source: Global News [edited]

A doctor working with Indigenous Services Canada (ISC) in Saskatchewan is urging caution to residents in and around Onion Lake First Nation following 2 people contracting a rare, deadly bacterial infection. Medical health officer Dr. Ibrahim Khan wrote a letter to the chief of the Onion Lake First Nation that said both patients were admitted to medical facilities shortly after New Years Day with diphtheria. He said one patient is under 18, while the other is an adult and was suffering from skin abrasions [? cutaneous diphtheria], which Khan said is rare for that disease.

In the letter, he said the disease is very uncommon in the province and can lead to "severe complications like breathing problems, heart failure, and paralysis, and without appropriate treatment can result in death." He applauded the medical team in Onion Lake, saying they contained the infection and made sure everyone in the community was aware of the risk and vaccinated.

"Everybody gets that vaccination, and they have that protection. That's why we don't see it. We don't see that many measles cases. We don't see that many prostatitis [pertussis?] cases, and we do not see any tetanus cases, because there is a good immunization for it. A good vaccination for it (and) people are aware of it," he told Global News. He said other local agencies, like pharmacies, made sure those on the front lines were supplied if they came across someone who wasn't vaccinated.

The letter to Chief Henry Louis said vaccination is the best method for preventing diphtheria and that the disease could virtually be eradicated if everyone who could be vaccinated received the shot. He said the target is for 97% of the population to receive the vaccination to prevent further spread in the community and noted the rates in Onion Lake are below that benchmark.  [Byline: Kyle Benning]
=====================
[Although the news report above says that one of the 2 patients with diphtheria was an adult "suffering from skin abrasions, which is rare for that disease," perhaps implying that this patient had cutaneous diphtheria, we are not told specifically the patients' clinical manifestations, i.e., whether they had respiratory diphtheria, cutaneous diphtheria, or both; if the strains of _Corynebacterium diphtheriae_ were toxin-producers; or if the patients were vaccinated against diphtheria.

Diphtheria became nationally notifiable in Canada in 1924, and that year 9057 cases were reported, the highest annual number of cases ever recorded in Canada  (<https://www.canada.ca/en/public-health/services/immunization/vaccine-preventable-diseases/diphtheria/health-professionals.html>).

The diphtheria vaccine was 1st introduced in 1926, and routine immunization in infancy and childhood has been widely practiced since 1930 in Canada. By the mid-1950s, routine immunization had resulted in a remarkable decline in the morbidity and mortality of the disease. Another steep decline in cases occurred in 1980, which has been attributed, in part, to a change in case definition to exclude carriers from reported cases in all provinces and territories. Since 1993, a total of 19 cases have been reported with a range of 0-4 cases annually  (<https://www.canada.ca/en/public-health/services/immunization/vaccine-preventable-diseases/diphtheria/health-professionals.html>).

In the USA, the case definition for reporting to the National Notifiable Diseases Surveillance System includes only respiratory diphtheria
(<https://wwwn.cdc.gov/nndss/conditions/diphtheria/case-definition/2010/>).

Similarly, the WHO case definition for reporting diphtheria only includes clinical respiratory diphtheria. Although no longer reportable, cutaneous diphtheria still occurs in the USA and has been most often associated with homelessness, poor sanitation, poverty, and crowded living conditions  (<https://www.cdc.gov/vaccines/pubs/pinkbook/dip.html>).

However, the Canadian case definition includes both respiratory diphtheria and infection at another site (e.g., wound, cutaneous)
(<https://www.canada.ca/en/public-health/services/immunization/vaccine-preventable-diseases/diphtheria/health-professionals/national-case-definition.html>).

Cutaneous diphtheria is contagious and can be a source of both respiratory and cutaneous infections in contacts. Acquisition of _Corynebacterium diphtheriae_, the cause of diphtheria, can occur even in vaccinated contacts, as vaccine-induced immunity is anti-toxin. - ProMED Mod.ML]

[HealthMap/ProMED-mail map:
Saskatchewan province, Canada: <http://healthmap.org/promed/p/262>]
Date: Wed, 22 Jan 2020 17:37:27 +0100 (MET)
By Helen ROXBURGH

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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