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Kuwait

Kuwait US Consular Information Sheet
September 2, 2008
COUNTRY DESCRIPTION:
Kuwait is a small, oil-rich constitutional monarchy with 10% of proven world oil reserves. Foreign workers constitute approximately 90% of the labor force. Kuwaiti
citizens constitute only 34% of the country's population of three million, and enjoy the benefits of a generous social welfare system that guarantees employment, housing, education and medical care. Facilities for travelers are widely available. Read the Department of State Background Notes on Kuwait for additional information.

ENTRY/EXIT REQUIREMENTS:
Passports and visas are required for U.S. citizens traveling to Kuwait. U.S. citizens can obtain visitor visas for a fee at the port of entry in Kuwait. Travelers who overstay their visas may be required to pay large fines before leaving Kuwait. Travelers who leave Kuwait without completing Kuwaiti exit procedures may also be required to pay large fines if they return to and attempt to depart from Kuwait. This includes travelers proceeding via Kuwait to and from Iraq and Afghanistan. Effective May 15, 2007, the Government of Kuwait no longer admits travelers with a contractor identification card. All contractors entering or transiting the State of Kuwait should have a valid passport. Visas can be obtained upon arrival in Kuwait for a fee of 3 Kuwaiti Dinar (KD). For further information on entry and exit requirements, travelers may contact the Embassy of Kuwait at 2940 Tilden Street NW, Washington, DC 20008, telephone (202) 966-0702, or the Kuwaiti Consulate in New York City, telephone (212) 973-4318.

Kuwaiti officials are extremely sensitive about travel to Iraq. There have been instances in which Americans, especially those of Iraqi descent, have been detained for questioning at ports of entry/exit. Americans seeking to travel to Iraq through Kuwait have also on occasion been turned around and/or detained. On a number of occasions the border between Iraq and Kuwait has been closed without notice, stranding Americans on either side of the border.

Kuwaitis and non-Kuwaitis, including Americans, who have been charged with criminal offenses, placed under investigation, or involved in unresolved financial disputes with local business partners are subject to travel bans. These bans, which are rigidly enforced, prevent the individual from leaving Kuwait for any reason until the matter is resolved. Travel bans can be initiated by any person for almost any reason and may remain in place for a substantial period of time while the case is being investigated. Expatriates have been detained in Kuwait for cases with seemingly little or no evidence or legal merit. A person who has influence with the Kuwaiti government can ensure that a travel ban remains in place even if a judge or government official states the ban should be lifted. In the case of purely financial disputes, it may be possible to depart the country if a local sponsor pledges funds equal to the amount in dispute. Once such legal orders are in place, the U.S. Embassy can assist American citizens in obtaining legal representation, but cannot overcome the ban on exit from the country until the matter is resolved.

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:
Americans in Kuwait should exercise a high level of security awareness. The Department of State remains concerned about the possibility of further terrorist actions against U.S. citizens and interests abroad, specifically in the Middle East, including the Persian Gulf and Arabian Peninsula. Americans considering travel to Kuwait should review the Worldwide Caution.

All U.S. citizens in Kuwait should exercise caution, maintain a low profile, and avoid areas where Westerners are known to congregate. Heightened security awareness should be exercised at all hotels and residential complexes, as terrorists in the past have specifically targeted hotel chains perceived as Western along with a variety of Western housing facilities. Military members, as well as civilians and contractors related to military interests, are also potential targets.

Terrorists do not distinguish between official and civilian targets. Terrorist actions may include bombings, hijackings, hostage taking, kidnappings and assassinations. Increased security at official U.S. facilities may lead terrorists and their sympathizers to seek softer targets such as public transportation, residential areas and apartment complexes, schools and places of worship, oil-related facilities and personnel, and public areas where people congregate including restaurants, hotels, clubs, and shopping areas. U.S. citizens are advised to immediately report any unusual or suspicious activity in Kuwait to the Kuwaiti police or to the U.S. Embassy.

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 U.S. Embassy in Kuwait has an active warden program and records warden notices in both English and Arabic for audio playback. The English-language notices can be heard by calling +965-259-1048; Arabic-language notices are available at +965-259-1049.

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.

Additional information regarding security and crime in Kuwait can be found in the Overseas Security Advisory Council’s Crime and Safety Report.
This document can be found at www.osac.gov.
CRIME: The crime threat in Kuwait is assessed as low. Violent crimes against expatriates are rare, but do occur. The U.S. Embassy advises all U.S. citizens to take the same security precautions in Kuwait that one would practice in the United States or any other large city abroad. Physical and verbal harassment of women are continuing problems. The Kuwaiti police accept crime reports at the police station with jurisdiction where the crime occurred. If filing a crime report, it is advisable that an American citizen be accompanied by a person who speaks Arabic or a local attorney. The Embassy’s List of Attorneys is available on the Embassy web site at http://kuwait.usembassy.gov/attorneys.html. Filing a crime report can take several hours as a police investigator will take the victim’s statement orally while composing his investigative report. In all cases of abuse, the victim must obtain a medical report from a Kuwaiti hospital in order to file a police report.

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.

The local equivalent of the “911” emergency line in Kuwait is “777” and can be reached 24 hours a day, seven days a week.
The quality and range of services provided by the emergency line are not equivalent to those provided in the U.S. and response times may vary greatly depending on the time of day and the location of the emergency.
See our information on Victims of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION: The health care system continues to develop, with many government and private medical facilities available in Kuwait. Medical care at government-run clinics and hospitals is provided at low cost to residents of Kuwait. Private physicians and hospitals charge fees for services, and some do not accept local health insurance. Many hospital and clinic services do not compare to U.S. standards, and staff often have no U.S. experience or training. For information on avian influenza (bird flu), please refer to the Department of State's Avian Influenza Fact Sheet.

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.

The government of Kuwait has strict regulations regarding certain diseases such as HIV/AIDS and Hepatitis.
Medical examinations are required for all residency applications and any applicants who are found positive for these restricted diseases will be asked to leave the country immediately and will be permanently barred from re-entry.
Please inquire directly with the Embassy of Kuwait at http://www.embassy.org/embassies/kw.html before you travel.
MEDICAL INSURANCE: The Department of State strongly urges Americans to consult with their medical insurance company prior to traveling abroad to confirm whether their policy applies overseas and whether it will cover emergency expenses such as a medical evacuation. Please see our information on medical insurance overseas.

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

Driving in Kuwait is hazardous. Although Kuwait has an extensive and modern system of well-lit roads, excessive speeding on both primary and secondary roads, coupled with lax enforcement of traffic regulations and a high density of vehicles (one vehicle for every 2.8 residents), leads to frequent and often fatal accidents. In 2006, the government of Kuwait reported 60410 vehicular accidents with 460 deaths and 9100 serious injuries.
However, these numbers are approximations and the actual numbers are believed to be much higher.
The average age of death was between 21 and 30 years. There are now over one million motor vehicles registered in Kuwait. Incidents of road rage, inattention and distraction on the part of drivers, poor driving skills, and highway brinksmanship are common in Kuwait, and can be unsettling to Western drivers in Kuwait who are accustomed to more rigid adherence to traffic laws.

The government-owned Kuwait Public Transportation Company operates bus services throughout the Kuwait City metropolitan area on 50 different routes, which are widely used by the low-income expatriate labor force. Taxis are available at major hotels and pick up passengers at other locations upon telephonic request. Unaccompanied women should not use taxis after dark. It is now possible to hail taxis on streets. Taxis have meters, but fares are more commonly negotiated.

Visitors can use international driving permits issued by their respective countries within the time limit of their visas; however, the visitor must also have liability insurance. It is illegal to drive in Kuwait without a license and car registration documents. If you are stopped and cannot produce them, you may be taken to a police station and held until they are presented on your behalf.

The Government of Kuwait may provide American citizens with a Kuwaiti driver’s license if their valid American driver’s license is first certified by the American Embassy. This service costs 9 KD and is available from the American Citizens Services Unit of the Consular Section. The Embassy’s certification must be authenticated by the Ministry of Foreign Affairs and the American permit must be translated by an approved translation service. Additional information is available at the Embassy’s Consular Section.

If you are in an accident, Kuwaiti law mandates that you must remain at the scene until the police arrive. The use of front seat belts is mandatory in Kuwait. Driving is on the right side of the road. Speed limits are posted. Making a right turn on a red light is not permitted unless there is a special lane to do so with a yield sign. Parking is not allowed where the curb is painted black and yellow. Digital cameras for registering traffic violations, including speeding, are in use on Kuwaiti roads.

Driving while under the influence of alcohol (possession and consumption of alcohol is illegal in Kuwait) is a serious offense, which may result in fines, imprisonment, and/or deportation. Repeat traffic violations or violations of a serious nature may also result in the deportation of an expatriate offender. When a driver flashes his/her high beams in Kuwait, it is meant as a request to move your car into a slower lane to allow the driver with the flashing beams to proceed ahead.

Kuwait has one of the highest per capita rates of cellular telephone ownership in the world and using a cellular telephone while driving remains legal. Local emergency service organizations may be contacted by dialing 777. Ambulance crews do not respond as quickly as in the United States and do not often include trained paramedics.

Please refer to our Road Safety page for more information. Visit the web site of the Kuwaiti Ministry of Interior at www.moi.gov.kw for information and statistics in Arabic about traffic safety and road conditions in Kuwait.

AVIATION SAFETY OVERSIGHT: The U.S. Federal Aviation Administration (FAA) has assessed the Government of Kuwait’s Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for oversight of Kuwait’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:
The workweek in Kuwait is Sunday through Thursday for most businesses, government offices and commercial banks.

Kuwaiti customs authorities may enforce strict regulations concerning temporary importation into or export from Kuwait of items such as firearms, religious materials, pornography, and alcohol. Alcohol, pork products, and pornography are illegal in Kuwait. Travelers with prescription medications should carry them in their original packaging or bottle, as dispensed, and carry a copy of their prescription in case customs authorities question their importation into Kuwait. Kuwaiti customs authorities screen the baggage of all travelers entering Kuwait. It is advisable to contact the Embassy of Kuwait in Washington, D.C. or Kuwait's Consulate in New York for specific information regarding customs requirements.

Photographing government and public buildings, military installations and economic infrastructure, particularly that related to the oil industry, is against the law and can result in arrest, investigation, and prosecution. Also, some traditionally-dressed women find being photographed to be offensive and may complain to the local police. If photographing public scenes or persons, visitors should take care to ask permission beforehand and not to inadvertently cause offense that could lead to an official complaint to the authorities.

Humiliating a person, including a police officer or a public official, is a crime in Kuwait similar to disorderly conduct or harassment in the United States. A person charged with humiliating another is subject to police investigation and possible prosecution. Persons under investigation can be prevented from departing Kuwait. Proselytizing is prohibited for all religions except Islam.

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 Kuwaiti laws, even unknowingly, may be expelled, arrested or imprisoned. Penalties for possession, use, or trafficking in illegal drugs in Kuwait 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 Kuwait 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 Kuwait. 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 Kuwait is located at Al-Masjid Al-Aqsa Street, Block 6, Plot 14, Bayan, Kuwait. The mailing address is PO Box 77, Safat 13001, Kuwait. The primary telephone numbers are 965-259-1001 or 259-1002. The fax number is 965-259-1438 or 538-0282. The after-hours number is 965-538-2097. Additional information may also be obtained through the Embassy's web site at http://kuwait.usembassy.gov
* * *
This replaces the Country Specific Information for Kuwait dated January 16, 2008 to update the sections on Information for Victims of Crime and Medical Facilities and Health Information.

Travel News Headlines WORLD NEWS

Date: Thu 12 Apr 2018
Source: Arab Times Kuwait English Daily [edited]

Almost 270 cases of scabies disease have been recorded lately in the country. Among them, 200 cases were recorded in Adan Hospital and the remaining 70 were recorded in Jahra Hospital.

The recorded cases are within Ahmadi and Jahra governorates, while it is widespread in Khafji and Hafr Al-Baten areas along Saudi border. This revelation coincided with a series of cases recorded in several regions of Saudi Arabia, especially along the border of Kuwait.

There are growing concerns that the disease could spread massively across the country if not handled properly in accordance with the rules and regulations. This includes providing necessary treatment to the affected people and raising awareness among citizens and expatriates.

According to spokesperson of Ministry of Health Dr. Ahmad Al-Shatti, individual cases within the country cannot be regarded as an epidemic.

He [Dr. Ahmad Al-Shatti] assured that the authority will take necessary steps to wipe out the disease, raise the level of awareness and instruct doctors to treat affected people with authorized medications. Dr Al-Shatti did not rule out the possibility that several cases could be recorded without reaching the level of epidemic, especially since the ministry has enough medicines to deal with the disease.  [Byline: Stephanie McGehee]
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[Just a week ago [week of Sun 1 Apr 2018] ProMED reported a widespread outbreak of Scabies in schools in Mecca, which was not related to the Umrah. This report suggests that at least some cases have links to Saudi Arabia. Further epidemiological mapping is needed. As discussed in our posting the [Fri 6 Apr 2018], scabies is highly contagious and outbreaks are usually seen in cramped conditions with poor hygiene. It is important to treat both patients and close contacts for instance the entire household. Classical treatment with for instance a whole body cream containing a pyrethroid has been replaced by treatment with oral ivermectin.

A map of Kuwait: <http://healthmap.org/promed/p/129>. - ProMED Mod.EP]
Date: Mon, 6 Feb 2017 14:40:12 +0100

Kuwait City, Feb 6, 2017 (AFP) - A fire broke out Monday at a cultural centre in Kuwait that houses the Gulf state's opera house, the fire department said.   The blaze started during maintenance work on the titanium roof, the department said in a statement on Twitter.   It said the fire was put out and caused no injuries.

Parts of the roof were seen to be missing after the blaze but it was unclear if that was the result of the maintenance work or the fire.   The centre was launched in October with a performance at the 2,000-seat opera house by Italian tenor Andrea Bocelli.   The sprawling 214,000-square-metre (2.3 million square feet) centre, located in the heart of the capital Kuwait City, cost $750 million.
Date: Thu 14 Apr 2016
Source: Arab Times [edited]

Assistant Undersecretary for Public Health Affairs at Ministry of Health Dr Majdah Al-Qattan revealed that Kuwait recorded 5 cases of cholera in people who came from Iraq and they have been treated. On the sidelines of the inaugural ceremony of the Scientific Conference on Latest Surgeries for Breast and Kidney Cancers, Dr Al-Qattan affirmed that the precautionary measures taken so far for preventing the spread of cholera in the country are being closely monitored to complement the previous steps.

She said it was decided during that meeting of the GCC [Gulf Cooperation Council] Epidemic Committee last month [March 2016] that the GCC member states must take proactive steps to prevent incursion and spread of cholera, indicating that this is the reason why the Customs officers have been screening travelers from Iraq and other affected countries.

Dr Al-Qattan revealed that the import of food items from these countries has also been banned till further notice. She stressed the ministry's keenness to bring new vaccines for the disease and take all necessary steps in that regard, stating that the Higher Committee on Vaccination follows certain procedures with the concerned companies and storage facilities for approving the import of new vaccines.  [Byline: Marwa Al-Bahrawi]
====================
[A map showing Kuwait and Iraq is available at

The mortality from cholera is related to non-replacement of fluid and electrolytes from the diarrheal illness.

As cited in Lutwick LI, Preis J: Cholera. In: Tropical Pediatrics. Roach RR, Greydanus DE, Patel DR, Homnick DN, Merrick J (eds), 2014, Nova Science Publishers, 2015, oral rehydration therapy can be life-saving in outbreaks of cholera and other forms of diarrhea:

"As reviewed by Richard Guerrant and colleagues (1), it was in 1831 that cholera treatment could be accomplished by intravenous replacement and, although this therapy could produce dramatic improvements, not until 1960 was it 1st recognized that there was no true destruction of the intestinal mucosa, and gastrointestinal rehydration therapy could be effective, and the therapy could dramatically reduce the intravenous needs for rehydration. Indeed, that this rehydration could be just as effective given orally as through an orogastric tube (for example, references 2 and 3) made it possible for oral rehydration therapy (ORT) to be used in rural remote areas and truly impact on the morbidity and mortality of cholera. Indeed, Guerrant (1) highlights the use of oral glucose-salt packets in war-torn Bangladeshi refugees, which reduced the mortality rate from 30 percent to 3.6 percent (4) and quotes sources referring to ORT as "potentially the most important medical advance" of the 20th century. A variety of formulations of ORT exist, generally glucose- or rice powder-based, which contain a variety of micronutrients, especially zinc (5).

The assessment of the degree of volume loss in those with diarrhea to approximate volume and fluid losses can be found in reference 6 below. Those with severe hypovolemia should be initially rehydrated intravenously with a fluid bolus of normal saline or Ringer's lactate solution of 20-30 ml/kg followed by 100 ml/kg in the 1st 4 hours and 100 ml/kg over the next 18 hours with regular reassessment. Those with lesser degrees of hypovolemia can be rehydrated orally with a glucose or rice-derived formula with up to 4 liters in the 1st 4 hours, and those with no hypovolemia can be given ORT after each liquid stool with frequent reevaluation."

References
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1. Guerrant RL, Carneiro-Filho BA, Dillingham RA: Cholera, diarrhea, and oral rehydration therapy: triumph and indictment. Clin Infect Dis 2003; 37: 398-405.
2. Gregorio GV, Gonzales MLM, Dans LF, Martinez EG: Polymer-based oral rehydration solution for treating acute watery diarrhoea. Cochrane Database Syst Rev. 2009; (2): CD006519. doi: 10.1002/14651858.CD006519.pub2.
3. Gore SM, Fontaine O, Pierce NF: Impact of rice based oral rehydration solution on stool output and duration of diarrhoea: meta-analysis of 13 clinical trials. BMJ 1992; 304(6822): 287-91.
4. Mahalanabis D, Choudhuri AB, Bagchi NG, et al: Oral fluid therapy of cholera among Bangladesh refugees. Johns Hopkins Med 1973; 132(4): 197-205.
5. Atia AN, Buchman AL: Oral rehydration solutions in non-cholera diarrhea: a review. Am J Gastroenterol 2009; 104(10): 2596-604.
6. WHO: The treatment of diarrhoea, a manual for physicians and other senior health workers. 4th ed. 2005.

An illustration (supplied by ProMED Mod.JW) of how to make a "home brew" oral rehydration solution can be found at
Date: Mon 23 Nov 2015
Source: Kuwait Times [edited]

Minister of Health Dr Ali Saad Al-Obaidi yesterday [22 Nov 2015] said the incidence of swine flu in Kuwait is nothing to worry about, according to WHO global health estimates, stressing the ministry's keenness to speak frankly with citizens and residents about all similar situations.

Speaking after opening the Haya Abdulrahman Al-Mujil Kidney Center yesterday [22 Nov 2015], Obaidi said the ministry is seeking to apply the strategies and protocols developed by the World Health Organization (WHO) in order to ensure the safety and health of citizens and residents. He explained that swine flu has been widespread since 2009, adding that the number of casualties began to decline after a global fight against the virus. He said the ministry of health is taking all preventive precautions to halt the spread of infection, pointing to the success of the ministry's efforts in dealing with more serious diseases such as Ebola and MERS. The minister said flu vaccinations given in August and November [2015] have reduced much of the incidence of the disease.
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[Excerpted from WHO

Most swine influenza viruses (SIVs) do not cause disease in humans. However, some countries have reported cases of human infection with SIVs. Most of these human infections have been mild and the viruses have not spread further to other people. The H1N1 virus that caused the influenza pandemic in 2009-2010, thought to have originated in swine, is an example of an SIV that was able to spread easily among people and also cause disease.

Because pigs can become infected with influenza viruses from a variety of different hosts (such as birds and humans), they can act as a "mixing vessel," facilitating the reassortment of influenza genes from different viruses and creating a "new" influenza virus. The concern is that such "new" reassortant viruses may be more easily spread from person to person, or may cause more severe disease in humans than the original viruses. WHO and animal health sector partners are working at the human-animal interface to identify and reduce animal health and public health risks within national contexts.

Manifestations of H1N1 influenza are similar to those of seasonal influenza. Patients present with symptoms of acute respiratory illness, including at least 2 of the following: fever, cough, sore throat, body aches, headache, chills and fatigue, diarrhea and vomiting.

There is no evidence that this current set of cases of H1N1, most likely H1N1pdm09, originated with pigs. This influenza strain is now a seasonal flu that spreads from human to human. - ProMed Mod.LK]

[A HealthMap/ProMED-mail map can be accessed at:
Date: Thu 19 Nov 2015
Source: Gulf News [edited]

Public schools in Kuwait have been put on alert after the discovery of 4 cases of the swine flu [H1N1; probably not truly a swine flu, see below - ProMed Mod.LM] at facilities in the Hawalli and Adeiliya areas, said Minister of Education Dr Bader Al Eisa on Thu [19 Nov 2015].

Those who contracted the disease are being given treatment, and the necessary precautions have been taken to prevent the spread of the disease, the minister told the Kuwait News Agency (Kuna). The cases were reported by the families.

"The Ministry of Education will continue to coordinate with the Ministry of Health, and schools that record more than 5 swine flu [H1N1] cases will be shut down," he said. "There are steady and regular contacts with the health ministry for advice and guidance, and doctors are visiting all the schools," he said. Reports said there is not enough vaccine available for all students.

On 10 Nov [2015], Al Eisa said there was one confirmed case of swine flu [H1N1] in a 6-year-old student in a private school.

Reports emerging from Kuwait said that a University of Kuwait teacher tested positive for the swine flu.

The case at the social sciences college triggered an alert among the teachers and staff and the preparation of a special room for suspected cases. A hotline was set up to help with queries and assistance. However, the college dean denied rumours that courses were being suspended, insisting that the staff were working normally.

According to Kuwaiti daily Al Jareeda, several parents have refused to allow their children to go to school citing concerns about health risks. Schools where suspected cases were noticed have not been willing to inform parents for fear they will keep their children at home. However, several parents have been exchanging information on social media and agreed that the school has suspected cases and that their children should not attend classes.

A hospital in Kuwait City has received 69 swine flu [H1N1] cases in the last 2 months, reports said. Health officials told local daily Al Jareeda that 58 patients left Al Adan Hospital after receiving the necessary treatment while the remaining 11 are still being treated. Some of the cases are in the intensive care unit, while others are in isolated rooms, the officials said.

One patient, a 68-year-old Kuwaiti, died on Wed [18 Nov 2015] from the disease, while an Indian expatriate passed away 3 days earlier, the officials said.

However, the hospital is taking all the measures possible whenever they are dealing with any suspected case, including contacting families and friends and providing them with the necessary vaccine while monitoring their health for 10 days, the officials added.  Byline: Habib Toumi
More ...

World Travel News Headlines

Date: Mon, 10 Sep 2018 07:28:56 +0200

Wellington, Sept 10, 2018 (AFP) - A strong 6.9 magnitude earthquake struck New Zealand's remote Kermadec Islands on Wednesday but authorities said there was no tsunami threat.   The quake struck at 4.19pm (0419GMT) at a depth of 111 kilometres (69 miles), with its epicentre 770 kilometres northeast of Auckland, the US Geological Survey said.   "Based on all available data, there is no tsunami threat from this earthquake," the Hawaii-based Pacific Tsunami Warning Center said.   The uninhabited Kermadecs are New Zealand's northernmost islands.   They are part of the Pacific Ring of Fire, a hotbed of volcanic and earthquake activity at the intersection of several tectonic plates.
Date: Mon, 10 Sep 2018 07:17:20 +0200

Tokyo, Sept 10, 2018 (AFP) - The death toll from a powerful earthquake that triggered massive landslides in northern Japan rose to 44 on Monday with tens of thousands of police and troops still on the ground to support survivors.   Chief Cabinet Secretary Yoshihide Suga said no one was left on a missing list, which suggested the figure could be the final death toll.   Around 40,000 police, fire fighters, troops and maritime safety officials were providing assistance, with more than 2,700 people still forced to stay in shelters after the killer quake struck the northern Japanese island of Hokkaido last week.

The majority of the dead are from the small rural town of Atsuma, where a cluster of dwellings were wrecked when a hillside collapsed from the force of the 6.6-magnitude quake, causing deep brown scars in the landscape.   "The government will strive to get hold of what is needed on the ground and take every possible measure so that people can return to a normal, safe life as soon as possible," Suga told a news conference.   He also warned that islanders should remain on alert as rainfall was forecast in the region, which could trigger fresh landslides.

The quake was the latest in a string of natural disasters to batter the island nation.   Western parts of the country are still recovering from the most powerful typhoon to strike Japan in a quarter of a century, which claimed 11 lives and shut down the main regional airport.   Launching a campaign for another term as head of his ruling party, Prime Minister Shinzo Abe reiterated his government will "do its best" to restore the disasters-hit regions.
Date: Mon, 10 Sep 2018 07:13:22 +0200
By Gregory DANEL, Romain FONSEGRIVES

Paris, Sept 10, 2018 (AFP) - Seven people including two British tourists were wounded in Paris late Sunday by a knife-wielding man, a terrifying attack that bystanders tried to stop by throwing petanque balls at the assailant.   Four of the victims were in a critical condition, police said, after the man brandishing a large blade and and iron bar went on the rampage next to a canal in the northeast of the capital.   The suspect is believed to be an Afghan national and has been arrested, said a source close to the enquiry, adding he had targeted "strangers" but that "nothing at this stage shows signs of a terrorist nature".

Chaos erupted on the banks of the Bassin de la Villette, an area popular with locals and visitors who frequent the cafes, cinemas and other cultural venues along its banks, just after 11:00pm (2100 GMT).   Eyewitness Youssef Najah, 28, said he was walking beside the canal when he saw a man running and holding a knife about 25-30 cm (10-11 inches) long.   "There were around 20 people chasing him. They started throwing petanque balls at him," Najah said, referring to the sport popular in France also known as boules.   "Around four or five balls hit him in the head, but they weren't able to stop him," he added.

According to the same witness, the attacker then dived into an alleyway, where the man "tried to hide behind two British tourists. We said to them: 'Watch out, he has a knife". But they didn't react".    The pair were then attacked, he said.   A security guard at one of two cinemas on either side of the water said he had seen the attacker running away from two men who were trying to stop him.   "He had an iron bar in his hand which he threw at the men chasing him, then he took out a knife," he told AFP.   The UK foreign office said it was aware of reports of the attack and was "urgently investigating this incident" in cooperation with French authorities, British media reported.

- High alert -
A police investigation has been launched for attempted murder, according to a judicial source.   It is the latest of several knife attacks France has seen in recent months, with terrorism being ruled out in most cases.   On August 23, a man stabbed his mother and sister to death and seriously injured another person in a town near Paris before being shot dead by police.

The motive for the violence remained unclear despite a claim by the Islamic State (IS) group that it was an attack by one of its fighters responding to the terror organisation's propaganda.   Authorities said the 36-year-old had serious mental health problems and had been on a terror watch list since 2016.   That attack came days after an Afghan asylum-seeker was arrested in town of Perigueux for a drunken rampage with a knife in which four people were wounded, one seriously.   Police said investigators had "very quickly" dismissed a terrorist motive after the August 13 incident.

And on June 17, two people were hurt in another southern town when a woman shouting "Allahu akbar" (God is greatest) attacked them in a supermarket with a boxcutter knife.   France has been on high alert following a string of jihadist attacks in recent years, often by people who have become radicalised or claim to have acted in the name of the IS group.   More than 240 people have been killed by Islamist extremists since a massacre at the Charlie Hebdo satirical magazine in Paris in January 2015.
Date: Mon, 10 Sep 2018 06:41:23 +0200

Miami, Sept 10, 2018 (AFP) - Hurricane Florence is expected to become a dangerous "major hurricane" by late Monday as it heads toward the US East Coast, the National Hurricane Center said, as states of emergency were declared in preparation for the storm.   The center of Florence was located about 685 miles (1,100 kilometres) southeast of Bermuda, the NHC in its 0300 GMT Monday advisory.   Florence had maximum sustained winds of 90 miles per hour, making it a Category 1 storm on the five-level Saffir-Simpson hurricane scale.

The NHC warned that Florence "is forecast to rapidly strengthen to a major hurricane by Monday night, and is expected to remain an extremely dangerous major hurricane through Thursday."   The storm is moving towards the west at seven miles per hour, and is forecast to drench a large swath of the US East Coast running from northern Florida to New Jersey.   On its current track Florence is expected to slam the Carolinas and Virginia the hardest -- and all three states have issued emergency declarations to speed preparations.

Virginia Governor Ralph Northam's office described Florence as possibly the state's "most significant hurricane event in decades," warning of "catastrophic inland flooding, high winds and possible widespread power outages."   It added: "The largest threat to life from hurricanes is not the high winds. Flooding is the deadliest result of these storms."   The US navy has ordered ships at its major base in Hampton Roads, Virginia, base to put to sea, saying "the forecasted destructive winds and tidal surge are too great to keep the ships in port."

- Two more hurricanes -
North Carolina Governor Roy Cooper's office said that Florence is already being felt along the state's coast, with large sea swells resulting in life-threatening rip currents and surf.   "Everyone in North Carolina needs to keep a close eye on Florence and take steps now to get ready for impacts later this week," Cooper said.

The storm "is too powerful and its path is too uncertain to take any chances," South Carolina Governor Henry McMaster said in issuing his state's emergency declaration.   Florence was producing large swells expected to reach from the northern Caribbean to the southern coasts of Canada's Maritime provinces.   At this statistical height of the Atlantic hurricane season, Florence was being trailed on east-to-west paths by two hurricanes, Helene and Issac.   Helene -- currently just southeast of the Cabo Verde islands off the African coast -- had winds of 85 miles per hour, and was expected to turn northwest and then north into the open Atlantic by midweek, the NHC said.

Hurricane Isaac -- which late Sunday became the fifth hurricane of the season -- is heading west towards the Caribbean.   At 0300 GMT Issac was about 1,305 miles east of the Windward Islands -- a region still recovering from last year's powerful Hurricane Maria -- with winds of 75 miles per hour.   Issac is expected to gain strength in the next days, but then weaken by the middle of the week when it approaches the Caribbean.   Maria -- which killed at least 3,057 people, most in Puerto Rico -- is elieved to be the third costliest tropical cyclone on record.
Date: 9 Sep 2018
Source: ProMED-mail promed@promedmail.org

[There has been significant chatter on social media from individuals working in Haiti and their colleagues, friends and family, suggesting there is a "new, as yet undiagnosed outbreak," possibly of a mosquito-borne disease, in the expat and local Haitian communities. Some of the content of this social media chatter is excerpted below [edited for clarity/readability - CopyEd.MSP]. - ProMED Mod.MPP]

"...there is some sort of new mosquito-borne virus in Haiti. Do I know for sure that it is a virus caused by a flying insect? No. Do I have a lot of unqualified and under-documented personal research to back up my belief nonetheless? Yes. If you know a guy or gal at the CDC, tell them to come chat with me. Something is going around, and many people are not well. It is eerily similar to chikungunya and malaria."

"Mayaro virus?"

"I have been saying the same thing! Well, when my fever brain has been capable of putting thoughts together this week. 2014 was ChikV; 2016 was Zika, so it does seem time for a new one. This new one is no fun at all."

"My person is negative for everything, Zika, chikV, malaria, dengue. It started with high fever, aches, joint pain, then progressed to stomach ache, headache. Now it's just persistent joint aches and sharp stabbing pain."

"We have this all over Mirebalais as well. Here, it also seems to be often accompanied by severe lower abdominal pain."

"Yes! My son just asked me if there is another mosquito borne illness yesterday!"

"Several of our girls have been sick with these same symptoms! It's awful."

"We all had it too and are seeing a lot of patients at our clinic with it!"

"I was sick for days before the uprising in July [2018] ... totally felt like malaria but tested negative. My BP was 80/40 at best, and it was pa bon [not good]."

"Yes! I've been sick this week as well as a few others I know! Lots of body pain."

"People thought that I was crazy!"

"You're not crazy! Several cases showing up at the Maternity Center here, and I also think there is influenza A going around. Some cases have respiratory stuff (to me that is the flu/influenza A), and several cases have nothing respiratory but have the fever and aches and terrible headache."
======================
[According to Wikipedia (in an unsubstantiated report without references) "Mirebalais is a commune in the Centre department of Haiti, approximately 60 km northeast of Port-au-Prince on National Road 3. The city was established in 1702. During the United Nations occupation of 2005, Nepalese troops were stationed in the city, using the city jail as their headquarters,"  (<https://en.wikipedia.org/wiki/Mirebalais>).

"Mirebalais is served by the teaching hospital Hopital Universitaire de Mirebalais, the largest solar-operated hospital in the world," a hospital that is run by the US-based Partners in Health,  (<https://www.pih.org/pages/mirebalais>).

>From the sound of the social media chatter, there is an as yet undiagnosed outbreak affecting parts of Haiti. Trying to connect the dots, there is concern that it is malaria-like (fever, chills and headaches), but in those that have been tested for malaria, laboratory results have not supported the diagnosis, and possibly dengue- or chikungunya-like (fever, headache, joint pains) with the addition of complaints of lower abdominal pain (notably described in Mayaro virus disease.

If the symptoms are similar to those of dengue, chikungunya, and Zika virus infections, they need to be ruled out by laboratory testing. There is the possibility that Mayaro virus (MAYV) may be circulating in Haiti. Mayaro virus was isolated from a child with acute febrile illness in rural Haiti. The case report stated that "on 8 Jan 2015, an 8-year-old boy was examined at the school clinic because of fever and abdominal pain. His temperature was 100.4 F [38 C]; lung sounds were clear, and his abdomen was soft and not tender. He had no rash and no conjunctivitis. On the basis of this clinical presentation, the clinic physician empirically diagnosed typhoid and administered co-trimoxazole... MAYV was detected in viral RNA extracted from infected Vero cells.

A question now is: if this is another MAYV infection, is this a continuation of the 2015 transmission or a new introduction into Haiti? Clearly, laboratory follow up is needed to establish the etiology of the current cases of febrile disease to determine an etiology and rule out other pathogens. If MAYV presence is established, surveillance is needed to determine the extent of its distribution, and health care providers and laboratories in Haiti, the Dominican Republic, and other countries in the Caribbean Basin need to be informed to be on the alert and to be prepared to make a diagnosis should any cases occur there.

Of additional curiosity is a recent media report in the Jamaican Star relating a tale of 3 Haitians recently arrived claiming illness, with malaria suspected in one of them. Testing is still pending, but given the social media chatter, one can't help but wonder whether this isn't malaria. Could it be part of the same as of yet undiagnosed outbreak reported in the above chatter? ...

References:
1- Lednicky J, De Rochars V, Elbadry M, Loeb J, Telisma T, Chavannes S, et al. Mayaro Virus in Child with Acute Febrile Illness, Haiti, 2015. Emerg Infect Dis. 2016;22(11):2000-2002.

2- Mavian C, Rife BD, Dollar JJ, Cella E, Ciccozzi M, Prosperi MCF, Lednicky J, Morris JG, Capua I, Salemi M. Emergence of recombinant Mayaro virus strains from the Amazon basin. Sci Rep. 2017 Aug 18;7(1):8718. doi: 10.1038/s41598-017-07152-5.

A HealthMap/ProMED map of Haiti can be found at:

More information from knowledgeable sources would be greatly appreciated, especially results of laboratory testing on individuals presenting with the above-mentioned symptoms, and results of clinical as well as epidemiologic investigations. - ProMED Mods.MPP/TY]
Date: Sun, 9 Sep 2018 14:04:57 +0200

Rome, Sept 9, 2018 (AFP) - Authorities have issued health alert after 150 cases of pneumonia were recorded in a week, mainly in towns near the northern Italian city of Brescia.   Suspecting the presence of a pneumonia-causing virus in the water supply, they have taken samples from the distribution network for analysis.   Results are expected in several days.

Autopsies will be conducted on a 69-year-old woman and an 85-year-old man who died this week to determine whether they died from pneumonia, according to local media reports.   Pneumonia is usually caused when bacteria, viruses or fungi infect the lungs.   It can be life-threatening, especially among the elderly and those with serious health conditions.

Provincial health services have called on residents to take precautions, including disinfecting tap filters and shower hoses and to let hot water run for a period of time with the windows open before using it.   Hospital emergencies in several municipalities to the south and east of Brescia identified 121 cases of pneumonia, the health officer in the Lombardy region Giulio Galera said on television.   A survey of general practitioners found at least 30 other people had been affected.
Date: Sun, 9 Sep 2018 10:04:14 +0200

Tokyo, Sept 9, 2018 (AFP) - Japan is suffering its first outbreak of pig cholera in more than 25 years, authorities said Sunday after culling more than 600 animals and suspending pork exports.    A farm in central Japan saw 80 pigs die last week after catching the highly-contagious disease, an agricultural ministry official told AFP.

Early tests showed negative results for classical swine fever, as the illness is officially known.   But follow-up tests came out positive Sunday, prompting the cull of all 610 pigs at the farm, he added.   "We are now processing the livestock there and disinfecting the farm," he said, adding that officials had set up sterilisation points on access roads to the affected farm.

The government has set up a team of specialists to analyse possible infection routes, the agricultural ministry said in a statement.   Tokyo halted pork exports after the outbreak was confirmed. The nation sold roughly $9 million in raw pork meat to foreign markets last year.   Japan saw its last case of classic swine fever, which does not affect humans, in 1992.   The disease continues to rage in many parts of Asia, Europe and Latin America.
Date: Sat, 8 Sep 2018 21:58:47 +0200

Kinshasa, Sept 8, 2018 (AFP) - Health authorities in Kinshasa declared the Ebola virus under control five weeks after the latest outbreak left 89 people dead in eastern Democratic Republic of Congo.   The health ministry announced the outbreak on August 1 in North Kivu province and on Thursday revealed that it had spread to Butembo, a city of a million people.

But Health Minister Dr Oly Ilunga Kalenga said: "Since August 13, there have been practically no more cases, we can say that the situation has been brought under control at the epicentre (of Mabalako)."   The latest outbreak of the virus is 10th to strike DR Congo since 1976, when the disease was first identified and named after a river in the country's north.   "To date, we have 129 cases (31 probable and 98 confirmed), 89 deaths and 33 patients cured," Dr Oly Ilunga said.   Fears that the disease might  spread further had been expressed Thursday after news of two deaths in Butembo, a commercial hub and popular transit point for neighbouring Uganda.

A woman and one of the medical staff who had been treating her died ini the city.   "Even at Butembo, the situation is not critical," the minister told a news conference also attended by Congolese professor and leading Ebola researcher Professor Jean-Jacques Muyembe, who urged people to report any sign of the disease.   "The Ebola virus is circulating here and in Africa in general ... we must be vigilant," Muyembe said.

Complicating the battle against the spread of the disease is the fact it is afflicting an area of Congo wracked by insecurity owing to the presence of armed groups.   Even so, Dr Oly Ilunga said teams treating sufferers had enjoyed army and police backing as well as support from the UN mission Monusco.   The previous outbreak of Ebola, which left 33 people dead in the northwestern province of Equateur, was decreed over on July 24.
Date: Sat, 8 Sep 2018 13:02:52 +0200

Seoul, Sept 8, 2018 (AFP) - South Korea reported its first case of Middle East Respiratory Syndrome (MERS) in three years, health officials said on Saturday.   A 61-year-old businessman was diagnosed with the highly contagious viral respiratory illness, according to officials at the Korea Centers for Disease Control and Prevention (KCDC).   He returned to South Korea Friday from a business trip in Kuwait where he stayed for three weeks, the KCDC said a statement.

"Authorities have traced and separated 20 people who have come in close contact with the infected person," KCDC head Chung Eun-gyeong told journalists.   They include medical staff, flight attendants and passengers of the plane the man flew back to South Korea on, she said.    He was hospitalised with fever and phlegm and has been quarantined at a university hospital, she added.   It is the first case of MERS diagnosed in South Korea since 2015, when an outbreak killed 38 people and triggered widespread panic.
Date: Wed 5 Sep 2018
Source: El Comercio [in Spanish, machine trans. edited]
<https://elcomercio.pe/mundo/latinoamerica/chile-brote-hepatitis-suma-201-casos-region-antofagasta-noticia-nndc-554166>

Health authorities in the region of Antofagasta in northern Chile are on alert for an outbreak of hepatitis A that adds 201 cases so far in 2018, 2 more than those recorded throughout 2017, they said today, 5 Sep 2018. "Unfortunately, we are having about 5 cases every 2 weeks, which means that we are facing an epidemic," Cooperativa Rossana Díaz, ministerial regional Secretary of Health, told Radio. It is a situation "that is controllable with the help of the community," which, in his opinion, has a fundamental role in the prevention of this disease, which can "be fulminating, create a risk to life, and require organ transplantation." Diaz stressed that hepatitis A can be prevented with simple measures, such as constant hand washing and optimal handling and preparation of food.

The authorities must combat street food sales and control businesses, "but we do not get anything if people continue to consume food on the street or in places that do not have sanitary authorization for that," he said. The profusion of cases, according to the official, corresponds to the increase in the consumption of food in unauthorized places and the lack of vaccinated personnel or strict hygiene regulations in establishments that do have a permit.

The authorities have set up an Outbreak Response Committee in the region and questioned contacts of the confirmed cases and of the suspects in order to find the origin of transmission. The cases registered in Antofagasta range from 2 to 60 years, with an average of 23 years, of which 62% are men and 38% are women, and although the presence of immigrants is large in the region, 98% of the cases are Chileans, the regional authorities reported.

Hepatitis A, according to the Institute of Public Health, can be prevented with a vaccine, and its detection requires a medical diagnosis in addition to laboratory tests or diagnostic imaging studies. It is transmitted through water, contaminated food, or through contact with an infected person. It is considered a disease with worldwide distribution that occurs sporadically or epidemically with a seasonal cycle, which in Chile is an intermediate endemic, with epidemic outbreaks every 4 or 5 years, and there are no chronic carriers.
==============================
[It seems to be the case that the cases are occurring at a low, steady rate rather than from a specific recent exposure.

Antofagasta (<https://en.wikipedia.org/wiki/Antofagasta>) is a port city in northern Chile, about 1100 km (700 mile) north of Santiago. It is the capital of Antofagasta province and the Antofagasta region. Formerly part of Bolivia, Antofagasta was captured by Chile in the War of the Pacific (1879-83), and the transfer of sovereignty was finalized in the 1904 Treaty of Peace and Friendship between the 2 countries. - ProMED Mod.LL]

[HealthMap/ProMED map available at: Antofagasta, Antofagasta, Chile:
<http://healthmap.org/promed/p/11048>]