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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
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Haiti

Haiti US Consular Information Sheet
June 02, 2008
COUNTRY DESCRIPTION:
Haiti is one of the least developed and least stable countries in the Western Hemisphere. The availability of consumer goods and services is barely adequate in the capi
al, Port-au-Prince, but other parts of the country experience chronic shortages. Most consumer products are imported and expensive. Some tourism facilities in the large cities and resort areas are satisfactory, but many are rudimentary at best, and are difficult to find in most rural areas and small towns. Read the Department of State Background Notes on Haiti for additional information.
ENTRY/EXIT REQUIREMENTS: All Americans traveling by air outside of the United States are required to present a passport or other valid travel document to enter or re-enter the United States. Haitian law requires U.S. citizens to have a passport to enter and exit Haiti. Once in Haiti, an undocumented U.S. citizen can experience delays of several weeks for the issuance of a passport, as it is often more difficult to establish identity and citizenship overseas than in the United States. The Haitian government requires foreigners to pay a departure fee. U.S. citizens are encouraged to contact the Embassy of the Republic of Haiti for more details regarding current entry, departure and customs requirements for Haiti. The Embassy of the Republic of Haiti is located at 2311 Massachusetts Avenue NW, Washington, DC 20008; the telephone number is (202) 332-4090, and the Internet address is http://www.haiti.org/. There are Haitian consulates in Miami and Orlando, Florida; Boston, Massachusetts; New York, NY; Chicago, Illinois and San Juan, Puerto Rico.

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:
U.S. citizens should exercise extreme caution and are strongly encouraged to register online at https://travelregistration.state.gov prior to travel.
Travel in Haiti can be dangerous and all visitors are urged to exercise vigilance and caution. In some cities and towns ordinary services such as water, electricity, police protection and government services are either very limited or unavailable. While U.N. personnel from several countries have been in Haiti since 2004, their presence does not guarantee absolute security for residents or visitors.
During 2007 and early April 2008, the Embassy issued several security related messages warning U.S. citizens in Haiti of violent or unstable conditions. On occasion, the U.S. mission in Haiti was forced to suspend service to the public or close because of security concerns. These concerns have also prevented Embassy personnel from traveling to or through some areas. Since October 2004 Embassy personnel have been prohibited from entering central Port-au-Prince after dark due to security concerns. The Embassy has also imposed a curfew on its officers from time to time. If situations occur where the Embassy must suspend operations or when officers are unable to travel freely, the Embassy will continue to be available by telephone to offer emergency services to U.S. citizens.
In early April 2008, there were violent demonstrations, looting, transportation disruptions, and up to seven reported deaths in Les Cayes and Port-au-Prince. Some American citizens were temporarily stranded in isolated locations and could not safely travel until calm was restored. Because political and economic conditions precipitating the civil unrest have not been entirely resolved, American citizens should defer non-essential travel to Haiti.
U.S. citizens in Haiti should avoid all large gatherings, as crowd behavior can be unpredictable. Visitors encountering roadblocks, demonstrations, or large crowds should remain calm and depart the area quickly and without confrontation. Assistance from Haitian officials, such as the police, is often unavailable. Overseas visitors must be particularly cautious on the days of planned political activities. U.S. citizens are urged to take common-sense precautions and avoid any event where crowds may congregate.

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: There are no "safe areas" in Haiti. Crime, a chronic problem over the years, has increased in recent years and can be subject to periodic surges sometimes not obviously explained by other events or conditions. The U.S. estimates that up to 8% of the cocaine entering the United States passes through Haiti. The state of law and order has steadily deteriorated as a result. Reports of kidnapping, death threats, murders, drug-related shootouts, armed robberies, break-ins or carjackings are common. These crimes are primarily Haitian against Haitian, though several foreigners and U.S. citizens have been victimized. In 2007, there were 29 reported kidnappings of American citizens, including two victims who were killed. Many American citizens reported that they were beaten and or raped by their hostage takers. Kidnapping remains the most critical security concern; kidnappers frequently target children.
U.S. citizens who travel to Haiti should exercise extreme caution throughout the country. Travelers should keep valuables well hidden, ensure possessions are not left in parked vehicles, use private transportation, alternate travel routes, and keep doors and windows in homes and vehicles closed and locked. U.S. citizens should avoid all night-time travel due to poor road conditions and increased criminal activity after dark. They should be alert for suspicious onlookers when entering and exiting banks, as criminals often watch and subsequently attack bank customers. Withdrawals of large amounts of cash should be avoided.
Criminal perpetrators often operate in groups of two to four individuals, and are disposed occasionally to be confrontational and gratuitously violent. Criminals sometimes will seriously injure or kill those who resist their attempts to commit crime. In robberies or home invasions, it is not uncommon for the assailants to beat or shoot the victim in order to limit the victim's ability to resist. If an armed individual demands the surrender of a vehicle or other valuables, the U.S. Embassy recommends compliance without resistance. This recommendation also applies in the event of a kidnapping. Visitors to Haiti should exercise caution at all times and review basic personal security procedures frequently.
U.S. citizens in Haiti must be particularly alert when arriving from overseas at the Port-au-Prince airport, as criminals have often targeted arriving passengers for later assaults and robberies. Some recent incidents have resulted in death. The use of public transportation, including "tap-taps" (private transportation used for commercial purposes), is not recommended. Visitors to Haiti should arrange for someone known to them to meet them at the airport.
U.S. citizens should decline all requests to carry items for others to or from Haiti. Traffickers of illegal drugs have duped unsuspecting travelers into helping transport narcotics aboard commercial airlines.
Certain high-crime zones in the Port-au-Prince area should be avoided, including Croix-des-Bouquets, Carrefour, Martissant, the port road (Boulevard La Saline), urban route Nationale #1, the airport road (Boulevard Toussaint L'Ouverture) and its adjoining connectors to the New ("American") Road via Route Nationale #1 (which should also be avoided). This latter area in particular has been the scene of numerous robberies, carjackings, and murders. Embassy employees are prohibited from remaining in the downtown area after dark or entering Cite Soleil and La Saline and their surrounding environs due to significant criminal activity. Neighborhoods in Port-au-Prince once considered relatively safe, such as the Delmas road area and Petionville, have been the scenes of an increasing number of violent crimes.
Cameras and video cameras should only be used with the permission of the subjects; violent incidents have followed unwelcome photography. Their use should be avoided altogether in high-crime areas.
Holiday periods, especially Christmas and Carnival, often bring a significant increase in criminal activity. Haiti's Carnival season is marked by street celebrations in the days leading up to Ash Wednesday. In recent years, Carnival has been accompanied by civil disturbances, altercations and severe traffic disruptions. People attending Carnival events or simply caught in the resulting celebrations have been injured and killed. Random stabbings during Carnival season are frequent. Roving musical bands called “rah-rahs” operate during the period from New Year's Day through Carnival. Being caught in a rah-rah event may begin as an enjoyable experience, but the potential for injury and the destruction of property is high. A mob mentality can develop unexpectedly leaving people and cars engulfed and at risk. During Carnival, rah-rahs continuously form without warning; some rah-rahs have identified themselves with political entities, lending further potential for violence.
The Haitian police are understaffed, poorly equipped and unable to respond to most calls for assistance. There are continued allegations of police complicity in criminal activity. The unsatisfactory response and enforcement capabilities of the Haitian national police and the weakness of the judiciary frustrate many victims of crime in Haiti. In the past, U.S. citizens involved in business and property disputes in Haiti have been arrested and detained without charge, and have been released only after intervention at high levels of the Haitian Government.

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: Medical facilities in Haiti are scarce and for the most part sub-standard; outside the capital standards are even lower. Medical care in Port-au-Prince is limited, and the level of community sanitation is extremely low. Life-threatening emergencies often require evacuation by air ambulance at the patient's expense. Doctors and hospitals often expect immediate cash payment for health services.

Information on vaccinations and other health precautions, such as safe food and water precautions and insect bite protection, may be obtained from the Centers for Disease Control and Prevention’s hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747) or 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 Haiti is provided for general reference only, and may not be totally accurate in a particular location or circumstance. Cars are supposed to be driven on the right side of the road in Haiti, but few roads have lane indicators and drivers use whatever part of the road is open to them, even if it is not the correct side of the road. Traffic is extremely congested in urban areas, and hours-long traffic jams develop throughout the country.
Driving in Haiti must be undertaken with extreme caution. The situation on the roads can be described as chaotic at best, and it is advisable for those with no knowledge of Haitian roads and traffic customs to hire a driver through a local hotel. Roads are generally unmarked, and detailed and accurate maps are not widely available. Lanes are not marked and signs indicating the direction of traffic flow seldom exist. This lack of organization, along with huge potholes that occur without warning, may cause drivers to execute unpredictable and dangerous maneuvers in heavy traffic. The Haitian government lacks adequate resources to assist drivers in distress or to clear the road of accidents or broken-down vehicles blocking the flow of traffic. Drinking and driving is illegal in Haiti, but people frequently drive after drinking, especially at night.
Public transportation as it is usually defined does not exist in Haiti. While Haitians use buses, "tap-taps" and taxis, which may observe regular routes, much like public transportation, none of these should be considered reliable. The Embassy strongly discourages their use.
Those who drive in Haiti should do so defensively and conservatively, avoid confrontations such as jockeying for position, and remain aware of the vehicles around them. Drivers should carry the phone numbers of people to call for assistance in an emergency, as Haitian authorities are unlikely to respond to requests for assistance. When traveling outside of Port-au-Prince, drivers should caravan with other vehicles to avoid being stranded in the event of an accident or breakdown.
Although written and driving tests are required to qualify for driver's licenses, road laws are not generally known or applied. Signaling imminent actions is not widely practiced, and not all drivers use turn indicators or international hand signals properly. For instance, many drivers use their left blinker for all actions, including turning right and stopping in the road, and others flap their left arm out the window to indicate that they will be taking an unspecified action. Drivers do not always verify that the road is clear before switching lanes, turning, or merging.
Speed limits are seldom posted and are generally ignored. Speeding is the cause of many of the fatal traffic accidents in Haiti, as are overloaded vehicles on winding, mountainous roads and vehicles without brakes. Poor maintenance and mechanical failures often cause accidents as well. Drivers should be particularly cautious at night, as unlighted vehicles can appear without warning.
Right of way is not widely observed in Haiti, and there are few operational traffic lights or traffic signs. It is advisable at most intersections to stop and verify that there is no oncoming traffic even if it appears that you have the right of way. Drivers can be quite aggressive and will seldom yield. Walls built to the edge of roads frequently make it impossible to see around corners, forcing drivers to edge their cars into the road at intersections to check for oncoming traffic.
In addition to vehicles, a variety of other objects may appear on the road in Haiti, such as wooden carts dragged by people, small ice cream carts, animals, mechanics working on vehicles parked on the street, and even vendors and their wares. Vehicles are often abandoned in the road or by the side of the road. There are few marked crosswalks and sidewalks, and pedestrians often wend their way through traffic in urban areas. Please refer to our Road Safety page for more information.

AVIATION SAFETY OVERSIGHT: The U.S. Federal Aviation Administration (FAA) has assessed the Government of Haiti’s Civil Aviation Authority as not being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for the oversight of Haiti'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 official currency of Haiti is the gourde, which has a variable exchange rate. Visitors will notice that most establishments in Haiti price items in an unofficial currency known as the “Haitian dollar.” (One Haitian dollar is equivalent to five gourdes.) Others give prices in gourdes or even in U.S. dollars. It is always a good idea to clarify with vendors which currency -- the gourde, Haitian dollar, or U.S. dollar -- is being used in a given transaction, as price tags often bear a number without indicating currency. The currency itself shows a value in gourdes. U.S. dollars are the currency of choice at the Labadee Beach cruise ship port-of-call.
Travelers' checks are often difficult to change in Haiti, but credit cards are widely accepted and some establishments accept or cash personal checks. At least one local bank chain has ATMs around Port-au-Prince that are compatible with some U.S. ATM cards. These ATMs are frequently out-of-order, and there have been reports of over-charging accounts.
Haiti, like most Caribbean countries, can be affected by hurricanes and other storms. Hurricane season runs from approximately June 1 - November 30 each year. Extensive flooding as a result of heavy rainfall has occurred in the past. Daily weather information in Haiti is available from national and international media. The Haitian meteorological service provides hurricane warnings via national radio. Both media and government information is only in Kreyol and/or French. Warnings are also available on the internet from many sources among which is the National Oceanic and Atmospheric Administration (NOAA) at hurricanes.noaa.gov. General information about natural disaster preparedness is available via the Internet from the U.S. Federal Emergency Management Agency (FEMA) at http://www.fema.gov/.
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 offences. Persons violating Haiti's laws, even unknowingly, may be expelled, arrested or imprisoned. Penalties for possession, use, or trafficking in illegal drugs in Haiti are severe, and convicted offenders can expect long jail sentences and heavy fines. The judicial process in Haiti can be extremely long; progress is often dependent on considerations not related to the specific case. Detainees may wait months or years for their cases to be heard before a judge or to have legal decisions acted upon by the authorities. Bond is not usually available to those arrested for serious crimes with the result that often suspects remain in custody for many months before formal indictment. 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 or traveling in Haiti are encouraged to register with the nearest U.S. Embassy or Consulate through the State Departments travel registration web site so that they can obtain updated information on travel and security within Haiti. 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 Consular Section of the U.S. Embassy is located at Boulevard du 15 October, Tabarre 41, Tabarre, Haiti. The main Embassy switchboard number is: (509) (2) 229-8000. The America Citizens Services (ACS) Unit fax number is (509) (2) 229-8027, the email address is acspap@hotmail.com. Web site: http://haiti.usembassy.gov/. ACS Unit office hours are 7:00 a.m. to 3:30 p.m., Monday through Friday. The Consular Section is closed on U.S. and local holidays.
* * *
This replaces the Country Specific Information for Haiti dated April 27, 2007 to update sections on Exit/Entry Requirements, Safety and Security, Crime, and Registration/Embassy Location.

Travel News Headlines WORLD NEWS

Date: Tue, 9 Oct 2018 23:45:45 +0200

Port-au-Prince, Oct 9, 2018 (AFP) - The death toll from the earthquake that struck northwest Haiti over the weekend has risen to 17, with nearly 350 others injured, the interior ministry said Tuesday.   Nine people were killed in the coastal city of Port-de-Paix, the closest major town to the quake's epicenter.    Seven more died in Gros-Morne, about 50 kilometers (30 miles) to the southeast and one was killed in the city of Saint-Louis du Nord, the ministry said.

Emergency personnel deployed to the quake zone have said roughly 7,800 homes were either destroyed or damaged in the 5.9-magnitude tremor, according to the authorities.   In Haiti, the poorest country in the Americas, building codes are often not respected, meaning that an earthquake of even a moderate size can result in fatalities and level buildings.

The country's Nord-Ouest department, where Port-de-Paix is located, is the worst-off part of Haiti, with many areas isolated due to the dire state of the roads.   The quake and several aftershocks were felt as far away as the capital Port-au-Prince, sparking fear among residents still reeling from the massive 2010 earthquake that left at least 200,000 people dead.
Date: Mon, 8 Oct 2018 06:51:33 +0200
By Amelie BARON

Port de Paix, Haiti, Oct 8, 2018 (AFP) - In Port-de-Paix, the Haitian city hardest hit by a strong earthquake, medical personnel at the Immaculate Conception Hospital of Port-de-Paix are struggling to treat the wounded -- and helplessly looked on as some didn't make it.   Not only are doctors and nurses lacking the supplies they need, the damage caused by the 5.9-magnitude tremor late Saturday made conditions even more challenging.   "There was no electricity here, so we couldn't receive the huge crowd that came last night," said Paul Miclaude, a doctor working in the emergency room.

"It was really difficult for us to send them to another hospital," Miclaude added. "With time running out, some died here."   So far, the quake has claimed 12 lives, according to Haitian officials. Eight of the victims died in Port-de-Paix.   Miclaude said that even on Sunday, doctors were without needed supplies.   "Patients are out buying medications, gloves, you name it -- they have to, despite their trauma and their destroyed homes," he said.   "Clearly, we aren't ready for such a catastrophe."

- 'He died on the spot' -
Looking on with a blank stare, Pamelia Donne leaves a small room filled with stretchers, dragging her leg behind her. Her foot is bandaged.    She had arrived several hours before -- with the body of her 20-year-old son.    "When everything started to shake, my child was about to leave the room. Then all of a sudden, he flew in the air and because the walls were falling down, he fell on a piece of rebar," Donne recounted.   "It pierced his back and came out by his ribs. He died on the spot."   In the palm of her hand, she crumpled the prescription handed to her by the nurse who bandaged her foot into a ball.   "I'm going to go get the medicine," Donne said, her voice barely audible.   "Actually, I have no way to get there to buy them and my husband, who suffered a leg injury, also has a prescription."

- Fear of aftershocks -
Just as police began to restore order at the entrance to the hospital, and several crates of medicine arrived from the health ministry, the glimmer of hope was quickly dashed by a 5.3-magnitude aftershock -- and chaos reigned once again.   Both doctors and patients ran into the street, fearful that part of the building could collapse.

Standing near mattresses on the ground in the yard, where patients received IV drips, the hospital's medical chief Polycarpe Saaely says he hopes more help is on the way.   "With all the aftershocks, we can't really stay inside, so we are putting up tents to receive the various patients who arrive," said Saaely.    "These buildings date back to the American occupation (1915-1934).

We evacuated two patients from the surgical wing because the building is really falling apart."   Indeed, the building was completely empty -- the ceiling had caved in in several places.   As Sunday dragged on, residents followed the parade of ambulances that arrived, their sirens blaring, and then departed for the private hospital located about a 30-minute drive away.   President Jovenel Moise's visit to Port-de-Paix helped mitigate the public anger borne from years spent living in extreme poverty without any real signs of improvement.

Haiti is the poorest country in the Americas.   But residents were still angry.   "Everyone can see that we don't have a real hospital," one resident, Francois Lubensron, told AFP near the hospital entrance.   "This shows we have no government. The president came to the city but he didn't even stop by to see what is going on here," the 28-year-old added.   "This behavior must end. We've had enough of a small group privatizing the country while we die. We are human beings. We have the right to live like those in all nations."

As they listened to the passionate debates of the small group gathered around Lubensron, elderly residents shook their heads. Some of them spread out small plastic tarps under which they could take refuge. They will spend the night outside, with more aftershocks a near-certainty.
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, 8 Jul 2018 20:08:06 +0200
By Amelie BARON

Port-au-Prince, July 8, 2018 (AFP) - Fresh looting broke out on the streets of Haiti's capital Sunday as protestors called for a two-day general strike despite the government's climbdown over controversial fuel price hikes.   Facing unrest that has now left at least three dead, leaders of the Caribbean country suspended the price spikes "until further notice" -- but the about-face has failed to quell the anger of residents.

In the heart of Port-au-Prince, AFP journalists saw shops ransacked as protestors, some armed with knives, were met by police who fired weapons into the air and detonated tear gas.   Many Haitians are now demanding the immediate departure of President Jovenel Moise and calling for a two-day general strike to begin Monday.   "If the president stays one more day, the game will take on a new appearance: we will cut off the roads and burn everything, because we have nothing else to lose," said one masked protestor.   Moise had urged demonstrators late Saturday to "go home," saying the price hike suspension had "corrected what had to be corrected."

The televised speech disappointed much of the population and the political class: "We were expecting another speech, a serene analysis of the situation that has prevailed in the country in the last two days and caused so much loss of life and materials," lawmaker Jerry Tardieu told AFP.   The renewed violence follows two days of paralysis in the city, sparked Friday by a government announcement that gasoline prices would rise by 38 percent, diesel by 47 percent and kerosene by 51 percent starting this weekend.   Airlines including Air France and American Airlines canceled several Sunday morning flights, with additional cancellations possible into the afternoon over staffing shortages.

- 'Carried away' -
In announcing the suspension of the price hikes, Prime Minister Jack Guy Lafontant emphasized that "violence and democracy are fundamentally incompatible."   Even before the fuel price controversy, deputies had already begun a debate on his future, and Saturday's U-turn could lead to the government's fall.   On Friday night, the bodyguard of an opposition-party politician died in an altercation with demonstrators in central Port-au-Prince as he attempted to get through a roadblock. His body was then burned in the road. 

On Saturday afternoon, an AFP journalist saw a young man who had been shot dead.   Parliamentary discussions are underway to determine the next steps aimed at calming the crisis, with some elected officials urging the immediate resignation of the prime minister.   As protests gained pace Sunday one Haitian, Alphonse Charles, expressed both the frustrations and the sense of fatalism felt by many of his countrymen.

Standing next to the remains of his torched car near burned and looted shops, he laid blame on politicians but lamented that people had gotten "carried away."   "It's the reality of the country: when we live in Haiti we are angry, frustrated with the way things are managed by politicians."   But "I have to go on living," he added. "We will not get carried away just for that."
Date: Tue, 17 Apr 2018 18:35:53 +0200

Washington, April 17, 2018 (AFP) - International health authorities are reporting outbreaks of diphtheria in Venezuela and Haiti, and that cases of the potentially deadly illness have turned up in Colombia and Brazil as well.   Diphtheria is a bacteria that causes throat swelling and difficulty breathing in its victims. It can be deadly if untreated, but preventable with vaccines.   "In Venezuela, the diphtheria outbreak that began in July 2016 remains active," the Pan American Health Organization (PAHO) said in its April 16 report.

Since the start of the outbreak 1,602 suspected cases have been reported, of which 976 were confirmed while 142 victims died before the disease could be confirmed.   PAHO said that those most vulnerable to the disease are between the ages of five and 19.   Several of the diphtheria cases reported in Brazil and Colombia -- both countries that border Venezuela -- are either suspected or confirmed to have originated in Venezuela.   A three year-old Venezuelan was confirmed dead of diphtheria this year in Colombia's department of La Guajira, on its eastern border with Venezuela.

Separately in Haiti, an outbreak first reported in 2014 continues, with 410 probable cases, including 75 fatalities. More than half of the probable cases are of children under the age of 10, the report said.   Vaccination "is key to prevent cases and outbreaks," the report read, adding that PAHO and the World Health Organization urges member states "to continue their efforts to maintain high vaccination coverage."

Health authorities have reported a rise in vaccine-preventable diseases in Venezuela, currently in the midst of a deep economic and political crisis.   On April 6, Venezuela launched a campaign to vaccinate people against 14 diseases, including diphtheria, tuberculosis and measles.
More ...

World Travel News Headlines

Date: Thu, 13 Dec 2018 06:41:40 +0100

Hanoi, Dec 13, 2018 (AFP) - Floods caused by heavy downpours have killed 13 people in central Vietnam, officials said Thursday, as farmers scrambled to save crops and livestock ahead of more bad weather forecast for this week.   Torrential rains have lashed six provinces in the centre of the country since Saturday, killing thousands of cows and chickens and flooding several cities -- including the coastal resort town of Danang.    More than 50 centimetres (20 inches) of rain hit some areas, with more downpours expected in the coming days, the disaster management office said Thursday.   "Thirteen people were killed, while one remains missing in Quang Ngai province," the office said.    Around 12,000 hectares of crops were destroyed, and some 160,000 livestock killed, it added.

One farmer in Quang Nam province said he lost all his chickens in the flooding, costing him tens of thousands of dollars.       "The water receded but thousands of our chickens were dead. We had to collect them for burial as the smell was so bad," Nguyen Thanh said, quoted by state-run Tuoi Tre newspaper.    Several areas in Quang Nam and Quang Ngai provinces were still inundated on Thursday after hydropower plants discharged reservoir waters.    Vietnam is frequently hit by heavy downpours during the typhoon season from May to October, but forecasters said the rains arrived late this year.     More than 200 people have been killed in weather-related disasters in 2018, down from 389 last year.
Date: Wed, 12 Dec 2018 08:14:22 +0100

Bangkok, Dec 12, 2018 (AFP) - A French tourist was gunned down early Wednesday by an off-duty Thai cop after a drunken bar fight in a seedy Bangkok district, police said.   The 41-year-old Parisian was shot dead at a downtown apartment block after an altercation with the police sergeant major who had approached the tourist's Thai girlfriend.     "They were drunk... they started to argue and then had a fist fight but the policeman couldn't fight back," the Chief of Thailand's Immigration Police Surachate Hakpan told AFP.   "The policeman followed him back to his place and shot him twice," he said, adding the victim had been in Thailand for several months.

The officer has been arrested and "will be fired... and prosecuted on a murder charge", Surachate added.   Police are hunting a second suspect seen on CCTV.    Gruesome pictures circulated on Thai media showed the victim lying in a pool of blood in front of a doughnut shop at his apartment block.    Bangkok is one of the world's most visited cities, famed for its food and racy nightlife, much of it around Nana district where the murder took place.    Thailand as a grim reputation for its gun culture, with drunken arguments, business disputes and soured romances frequently resolved by violence.
Date: Wed, 12 Dec 2018 02:09:59 +0100

Mexico City, Dec 12, 2018 (AFP) - A massive fireworks explosion during a procession at a Mexican church killed eight people Tuesday and left some 50 wounded, authorities said.   Two children aged 11 and 12 were among those killed in the accident, which occurred around dawn at the San Jose parish atrium in Tequisquiapan, some 145 kilometres (90 miles) northwest of Mexico City.

Parishioners had donated the fireworks for a festival, but "something went wrong and they exploded," said Gabriel Bastarrachea, emergency response official for the state of Queretaro.   A video posted on social media showed people marching toward the church in a festive procession when suddenly a giant, fiery blast sent them running and screaming.

It was the latest in a string of deadly fireworks accidents in Mexico, where a thriving but dangerous cottage industry supplies a seemingly endless array of colourful explosives to celebrate holidays and festivals.   At least 24 people were killed in a series of fireworks explosions last July in the town of Tultepec in central Mexico, and 42 people were killed there when a rocket exploded in December 2016 at the height of the Christmas fireworks rush.
Date: Tue, 11 Dec 2018 22:14:43 +0100

Bogota, Dec 11, 2018 (AFP) - The abandoned building where Colombian drug lord Pablo Escobar lived will be covered in posters paying tribute to the victims of his Medellin Cartel before it is torn down next year.   The exhibition is part of a move by municipal authorities to tell the other side of Escobar's story -- that of his victims -- to counter a surge of television series glamorizing his life and that of his cartel.   "Respect our pain, honour our victims (1983-1994). 46,612 fewer lives," reads the message on one of the posters that now greet Medillin's "narco-tourists" flocking to the Monaco apartment block.

Portraits of slain journalist Guillermo Cano, gunned down in 1986, former presidential candidate Luis Carlos Galan and police chief Valdemar Quintero -- both murdered in 1989 -- are emblazoned over a message that reads, in English: "It is not fiction, it is reality."   Mayor Federico Gutierrez told reporters that the tourist site had become a "symbol of illegality."   "Now, there are messages that should lead us to reflect," he said.   The posters will remain affixed to the building until municipal workers tear it down on February 22, more than 25 years after Escobar was shot dead by police in 1993.     The former luxury block will be replaced by a municipal park.
Date: Tue, 11 Dec 2018 19:29:44 +0100

Beni, DR Congo, Dec 11, 2018 (AFP) - Children account for a third of Ebola cases in an outbreak of the disease in the Democratic Republic of Congo, with hundreds orphaned or isolated, the United Nations said on Tuesday.   Nearly 300 people have died from the highly contagious disease since August in the restive east around the city of Beni.

The UN children's agency UNICEF said the organisation and its partners had identified more than 400 children who have been orphaned or isolated during the outbreak.    "We are deeply concerned by the growing number of children confirmed to have contracted Ebola," said UNICEF's Regional Director for West and Central Africa, Marie-Pierre Poirier, returning from Beni.    "The earlier children infected with Ebola receive treatment in a specialised health facility, the greater their chances of survival. Community mobilisation and public awareness activities are also crucial."

After it was declared on August 1 -- the tenth outbreak in DR Congo since 1976 -- at least 285 people have died, according to the last health ministry update on December 9.   Nearly 44,000 people have been vaccinated.   The outbreak has hit an area already struggling with violence from armed groups.   In November, medical and vaccination efforts were briefly suspended and health workers evacuated after clashes between UN peacekeepers and fighters from the local Allied Democratic Forces militia.
Date: Tue, 11 Dec 2018 14:28:55 +0100

Paris, Dec 11, 2018 (AFP) - The soaring Arc de Triomphe at the top of the Champs-Elysees in Paris will reopen Wednesday after being covered in graffiti and ransacked during anti-government protests which rocked the capital on December 1, the French monuments commission said.   The arc, under which lies the tomb of the unknown soldier, commemorating France's war dead, has been a focal point of the "yellow vest" rallies against fuel tax increases and the cost of living which began on November 17.   But the demonstrations degenerated into daylong clashes with police early this month, with protesters spray-painting the arc with slogans such as "the yellow vests will win."

The protesters later managed to break into the monument where they smashed sculptures and display cases in an underground gallery and snatched commemorative medals and other items.   They also snuffed out the eternal flame burning on the tomb of the unknown soldier.    Some protesters were also seen on the top of the landmark building which offers panoramic views of the capital.   "All the networks and equipment essential for the security and proper functioning of the monument will have been restored and repaired," the commission said in a statement Tuesday.   "Some furniture, notably in the gift shop and library, have been temporarily repaired while awaiting new installations," it added.   It said the damage was estimated at several hundred thousands of euros (dollars).   Thirteen people were charged last week over the looting and destruction and investigations are continuing to identify other suspects.
Date: Tue, 11 Dec 2018 13:30:30 +0100

Madrid, Dec 11, 2018 (AFP) - Spanish railway workers will stage a nationwide strike on December 21 and January 7 during the busy Christmas holiday period over job cuts and working conditions, a union said Tuesday.   The "main reason" for the strike is the "continued reduction in the number of staff" at state train operator Renfe and state rail infrastructure company Adif, the CCOO union, one of the main trade unions representing rail workers, said in a statement.   "We are mobilising to recover the jobs which have been lost, improve purchasing power and ensure agreed pay increases come into effect," said Manuel Nicolas Taguas, general secretary of the railway workers sector at the CCOO.   The union says that since 2005 the workforce employed by the two companies in charge of Spain's rail network has been slashed by around 5,000 workers to roughly 26,000 employees.   The union representing Renfe rail guards has called a one day strike on December 14 to protest working conditions.
Date: Mon, 10 Dec 2018 14:05:06 +0100

Nairobi, Dec 10, 2018 (AFP) - South Sudan will vaccinate key health workers against Ebola close to the border with the Democratic Republic of Congo, which faces a new epidemic, the World Health Organization said Monday.   The ministry of health's vaccination campaign, with cooperation from the WHO, will target healthcare and frontline workers in the high-risk states of Juba, Yei, Yambio and Nimule, the UN agency said in a statement.   South Sudan is one of several countries bordering the vast DRC, where the new outbreak of the highly contagious viral disease had since August claimed 271 lives by December 6, according to Congolese Health Minister Oly Ilunga Kalenga.

A total of 2,160 doses of the experimental vaccine rVSV-ZEBOV have been allocated to South Sudan for a programme starting on December 19. This trial vaccine is not yet licenced but is considered safe and provided "under the compassionate-use guidelines in response to the ongoing Ebola outbreak in DRC", the WHO said.   Like neighbouring Uganda, where similar measures have been taken for health personnel, South Sudan has declared a state of alert because of the risk that Ebola may be carried into its territory. At present, no cases have been reported, according the WHO.   The experimental vaccine first went on trial during the terrible epidemic of Ebola that ravaged parts of West Africa between the end of 2013 and 2016, at a cost of more than 11,300 lives. The disease spreads through contact with bodily fluids from other people or infected animals.

The vaccine was created by Canadian public health specialists at the National Microbiology Laboratory and is considered highly effective by the WHO, but it works only against the Ebola virus-Zaire strain, confirmed in the outbreak in the DRC.   South Sudan has been torn by civil war for five years in a conflict that has left nearly 400,000 dead. More than four million people -- about a third of the population -- have fled.   The main belligerents signed a peace accord in September, but the work of humanitarian organisations remains complicated and dangerous.   Participants in the vaccination programme have been trained on rVSV-ZEBOV and undertaken a simulation exercise. Meanwhile, the Ebola preparedness contingency plan covers measures ranging from screening travellers, community engagement and provision for safe and dignified funerals, the WHO said.
Date: Mon, 10 Dec 2018 11:42:55 +0100

Bangkok, Dec 10, 2018 (AFP) - An Iranian man has been arrested after using travel freebies to lure an unsuspecting Japanese tourist into smuggling a bag of clothes laced with crystal meth, Thai police said Monday.   The tourist, whose name has not been disclosed, found the deal on a travel website that offered free getaways to Thailand, Shanghai and Frankfurt, complete with thousands in spending money.

But after arriving in Thailand last week, he was handed "suspicious" luggage for his next trip to Shanghai, Itthipol Itthisarnronnachai, deputy chief of Thailand's immigration department, told reporters.   "Inside the bag, he found clothes that felt more solid than usual. He then contacted the Japanese embassy," Itthipol said.   Police said the clothes had been coated with crystal methamphetamine -- known as ice.

Four bags of the drug were also found, adding up to 2.2 kilogrammes (4.9 pounds) in total.    Thailand gets 35 million tourists a year and some fall prey to low-level scams or robbery, but few are swept up in transnational drug-running.   "It's a never-seen-before method, luring tourists to traffick drugs out of the country," Itthipol added.

Demand for meth is surging in the region at a time when authorities are attempting to crack down on the lucrative business.   Police said the Iranian national was arrested when he went to retrieve the luggage after the Japanese man pretended to be sick and said he wanted to cancel the trip.   They found 10 kilogrammes of ice and ice-coated clothing in the suspect's apartment.   "We will pursue this case and investigate networks in Thailand and Japan to take down this scam," Itthipol said.
Date: Mon, 10 Dec 2018 08:53:28 +0100

Frankfurt am Main, Dec 10, 2018 (AFP) - Germany was plunged into transport chaos Monday as most train services were halted by a railworkers' strike over pay, affecting millions of passengers.   Inter-city and regional services as well as many urban commuter trains were cancelled throughout Europe's biggest economy by the four-hour stoppage from 5:00 am (0400 GMT), Deutsche Bahn (DB) said.   The strike halted all high-speed ICE trains and other inter-city services as well as most cargo trains, and its ripple effects and delays were expected to continue well into the afternoon.   In the capital Berlin, where additionally the entire public announcement system broke down, frustrated commuters were asked to switch from S-Bahn commuter trains operated by DB to subways, buses or trams.

The strike came after talks broke down Saturday between the DB and the EVG rail workers' union, which is demanding a 7.5-percent salary rise for 160,000 employees.   "The employer made offers which did not correspond to the demands of our members," said EVG negotiator Regina Rusch-Ziemba.   DB shot back and described the strike as a "completely unnecessary escalation", insisting its offer was "attractive and met the main demands" of employees.   DB had offered a pay rise of 5.1 percent in two phases, with an option for staff to take extra time off instead, and a one-off payment of 500 euros ($570), the DPA national news agency reported.   Deutsche Bahn in a tweet also denied it had broken off the negotiations, charging that "the EVG left the talks and went on strike".   "DB remains ready to continue the negotiations at any time. There is an open invitation for today."

The strike also impacted DB customer services offices, meaning that in many stations passengers were left without information over loudspeakers or display boards.   DB said that purchased tickets would remain valid until next Sunday or could be refunded and urged passengers to delay travel where possible.   It also called on the union -- which threatened follow-up strikes if necessary -- to return to the negotiating table quickly.   A DB spokeswoman said: "Parties that negotiate must be prepared to make concessions. DB has asked the EVG to continue the talks this afternoon."