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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: Thu, 21 Feb 2019 07:52:47 +0100
By Amelie BARON

Port-au-Prince, Feb 21, 2019 (AFP) - With flaming barricades and widespread looting, 10 days of street violence in Haiti have all but buried a tourism industry that managed to resurrect itself after a devastating earthquake in 2010.   Ugly, violent footage beamed around the world has again sent the message that this impoverished Caribbean country is politically unstable and no place to go on vacation.

The final straw was the helicopter evacuation last week of 100-odd Canadian tourists trapped as angry protesters demanded the resignation of the president, whom they accuse of corruption.   "We have been through 12 days of hell. We managed the crisis but today we are suffering from the aftershocks," said Tourism Minister Marie-Christine Stephenson.

- Blacklist -
Beside the direct effects of the demonstrations, the United States delivered another crushing blow on February 14 when it urged its citizens not to travel to Haiti, which thus joined a no-go list with war-torn countries like Syria, Yemen and Afghanistan.

The minister said the US travel alert for Haiti was too harsh, calling the riots something that flared up unexpectedly and are now over.   "OK, they lasted 12 days but I am not sure that other Caribbean countries, which have had riots of their own, have been punished as severely and quickly as we have," said Stephenson.   Overnight, the decision by the US State Department hit the tourism industry hard. Travel web sites simply stopped offering flights to Haiti's two international airports.   Hotels are reporting cancellation of reservations and many empty rooms.

Officials in the industry have yet to tally up the damage but say that for the second time in less than a year, they will have to lay off workers.   In July of last year, three days of riots over a government attempt to raise fuel prices ruined the summer vacation season for Haiti's tourism industry.   It is not just hotels that will suffer again, said Beatrice Nadal-Mevs, president of the Haitian Tourism Association.   "This is going to affect everyday people because these are direct jobs that are going to be lost and supply chains will be threatened: farming, fishing, crafts, transport," Nadal-Mevs said.

- Mardi Gras cancelled -
With the opposition planning more demonstrations to seek the resignation of President Jovenel Moise, the sector got yet more bad news with word that Carnival celebrations have been called off in the Haitian capital, Port-au-Prince.   City Hall said it could not guarantee revelers' safety.   The festivities, which this year were planned for March 3-5, usually draw many Haitians living abroad and fleeing the winter cold in Canada and the eastern US.

Another major Carnival celebration is scheduled to take place in the city of Gonaives, but the government has not said if it will go ahead.   As grim as things are, some foreign tourists have gone ahead with visits to Haiti.   On Wednesday, a group of Australians under police escort visited a square featuring statues of heros of Haiti's independence from France. Days ago, demonstrators at the same plaza were throwing rocks at police, who responded with volleys of tear gas grenades.

A woman named Carole, who did not want to give her last name, said, "I trust the company we're traveling with. They not only want to take us but they want to bring us back."   Kevin McCue, another of the people in the group of 20, said he was glad that their tour operator had not opted for Plan B, which would have meant skipping Haiti and spending the whole week in the neighboring Dominican Republic.   "Tourism is alive and well here. People should come. The more they come, the better they spread some money among people who need it and the better for Haiti," said McCue.
Date: Sun, 17 Feb 2019 23:37:22 +0100

Ottawa, Feb 17, 2019 (AFP) - A group of 25 school students from Quebec and three chaperones were able to leave Haiti on Sunday, where they had been stuck due to violent anti-government protests.   "We are on the plane" back to Montreal, one of the chaperones confirmed in a message to AFP.   Canadian tour operator Transat also confirmed that the group of students was aboard flight TS663, which departed at 3:59 pm (2059 GMT) from Port-au-Prince.   In addition to the students, employees of Canada's temporarily-shuttered embassy were also heading home aboard the aircraft.   The day before, a group of 131 Canadian tourists were evacuated via helicopter from their beachside resort in Haiti after being trapped for one week at the site due to the ongoing unrest.   The tourists were ferried in shifts to the Port-au-Prince international airport, where they boarded a flight to Canada, Transat said.

On Friday, Canada officially warned its citizens against all travel to Haiti, an advisory issued after the temporary closure of its embassy in Port-au-Prince.   Since February 7, at least seven people have died as Haiti has been plunged into political crisis, with everyday life paralyzed by protests and barricades in the largest towns.   The protesters, angry at soaring inflation and the alleged theft of nearly $2 billion in Venezuelan oil relief, are demanding President Jovenel Moise's resignation.   Canada is one of Haiti's largest international donors and is home to a large Haitian diaspora, located mostly in French-speaking Quebec.
Date: Thu, 14 Feb 2019 20:37:05 +0100

Ottawa, Feb 14, 2019 (AFP) - Canada on Thursday temporarily closed its embassy in Haiti as violent protests against President Jovenel Moise's government trapped hundreds of Canadian tourists in the Caribbean island nation.   "Due to the current volatility, the Port-au-Prince embassy is closed today and we will continue to assess the situation in the coming days to ensure that our diplomats and their families are safe," Canada's foreign ministry said in a statement.   Clashes between police and protesters left at least one dead on Wednesday in Port-au-Prince, bringing to at least seven the number of people killed since protests began a week earlier.   The protesters, angry about skyrocketing inflation and the alleged theft of nearly $2 billion in Venezuelan oil relief to the island, are demanding Moise's resignation.

Gun violence and blocked roads prevented about 100 Canadian tourists staying at the all-inclusive Royal Decameron Indigo Beach resort to get to the airport on Sunday.   "At present, it is not safe to organize a trip to the airport, so for the moment our customers are at the hotel, they are perfectly safe," said Christophe Hennebelle, vice president of tour operator Transat.   "We are in constant contact with the Canadian embassy in Haiti and with the government authorities to assess the situation," he said, adding that he hoped that "in the coming days" the Canadians would be repatriated. An airplane remains on standby in Canada to go pick them up.   Ottawa, meanwhile, is urging Canadians to avoid all non-essential travel to Haiti.
Date: Tue 18 Dec 2018
Source: Pan American Health Organization (PAHO), WHO [edited]

Epidemiological update: diphtheria
----------------------------------
Between epidemiological week (EW) 1 [31 Dec 2017-6 Jan 2018] and EW 49 [2 Dec-8 Dec 2018] of 2018, 3 countries in the region of the Americas (Colombia, Haiti, and the Bolivarian Republic of Venezuela) have reported confirmed cases of diphtheria. In Haiti and Venezuela, the outbreaks are ongoing.

The following is a summary of the epidemiological situation in these countries:

Colombia
--------
In Colombia: 8 confirmed cases, including 3 deaths, were reported this year [2018]; however, since July 2018, no additional cases of diphtheria have been reported.

Haiti
-----
In Haiti: between EW 51 [14 Dec-20 Dec] of 2014 and EW 49 [2 Dec-8 Dec] of 2018, 774 probable cases were reported, including 105 deaths; of these, 261 were confirmed (254 by laboratory criteria and 7 by epidemiological link) (see table 1 at the source URL).

The number of probable cases reported in 2018 is higher than the total number of cases reported in 2017 and 2016 -- an increase that is attributed to greater sensitivity of the national surveillance system. The case fatality rate among cases confirmed by laboratory or epidemiological link was 23% in 2015, 39% in 2016, 8% in 2017, and 15% in 2018.

In 2018, there were 362 probable cases reported (between EW 1 and EW 49), including 96 confirmed cases (91 by laboratory and 5 by epidemiological link). During the same period, there were 28 deaths reported (14 confirmed by laboratory or epidemiological link, 8 with no viable laboratory samples, 5 that remain under investigation, and one that was discarded).

Among confirmed cases in 2018, the highest incidence is observed in the age group of 6-14 year olds, followed by 1-5 year olds. The majority of deaths (63%) occurred among those aged 6-14 years, followed by 1-5 year olds.

In 2018, the highest cumulative incidences per 100 000 population were reported in the municipalities of Gros-Morne, Artibonite Department (19.9), Valliere, Nord-Est Department (17), La Victoire, Nord Department (9.5), and Cerca-Carvajal (12.9), Thomonde (9.7), and Savanette (8.3) in Centre Department.

Venezuela
---------
In Venezuela: the diphtheria outbreak that began in July 2016 continues (see figure 2 at the source URL). Since the beginning of the outbreak until EW 48 of 2018, a total of 2360 suspected cases were reported (324 cases in 2016, 1040 in 2017, and 996 in 2018); of these, 1310 were confirmed. A total of 238 deaths were reported (17 in 2016, 103 in 2017, and 118 in 2018 [see ref. 2 at the source URL]); 345 cases were discarded in 2018. The case fatality rate was 18.2% in 2016, 13% in 2017, and 21% in 2018.

In 2016, cases were reported in 5 [Venezuelan] states (Anzoategui, Bolivar, Delta Amacuro, Monagas, and Sucre), while in 2017, cases were reported in 22 states and the Capital District. In 2018, 22 federal entities and 99 municipalities have reported confirmed cases. Cases have been reported among all age groups, but the most affected age group is 1-39 years, among whom the highest incidence is reported among 11-39 year olds. In EW 48 of 2018, there were 17 federal entities and 35 municipalities affected; accordingly, vaccination and control activities continue to be implemented.

[The full report, including all figures, table, references, advice for member states, and footnotes can be found at the source URL. - ProMED Mod.ML]
==========================
[HealthMap/ProMED-mail maps:
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.
More ...

World Travel News Headlines

Date: Thu, 21 Feb 2019 07:52:47 +0100
By Amelie BARON

Port-au-Prince, Feb 21, 2019 (AFP) - With flaming barricades and widespread looting, 10 days of street violence in Haiti have all but buried a tourism industry that managed to resurrect itself after a devastating earthquake in 2010.   Ugly, violent footage beamed around the world has again sent the message that this impoverished Caribbean country is politically unstable and no place to go on vacation.

The final straw was the helicopter evacuation last week of 100-odd Canadian tourists trapped as angry protesters demanded the resignation of the president, whom they accuse of corruption.   "We have been through 12 days of hell. We managed the crisis but today we are suffering from the aftershocks," said Tourism Minister Marie-Christine Stephenson.

- Blacklist -
Beside the direct effects of the demonstrations, the United States delivered another crushing blow on February 14 when it urged its citizens not to travel to Haiti, which thus joined a no-go list with war-torn countries like Syria, Yemen and Afghanistan.

The minister said the US travel alert for Haiti was too harsh, calling the riots something that flared up unexpectedly and are now over.   "OK, they lasted 12 days but I am not sure that other Caribbean countries, which have had riots of their own, have been punished as severely and quickly as we have," said Stephenson.   Overnight, the decision by the US State Department hit the tourism industry hard. Travel web sites simply stopped offering flights to Haiti's two international airports.   Hotels are reporting cancellation of reservations and many empty rooms.

Officials in the industry have yet to tally up the damage but say that for the second time in less than a year, they will have to lay off workers.   In July of last year, three days of riots over a government attempt to raise fuel prices ruined the summer vacation season for Haiti's tourism industry.   It is not just hotels that will suffer again, said Beatrice Nadal-Mevs, president of the Haitian Tourism Association.   "This is going to affect everyday people because these are direct jobs that are going to be lost and supply chains will be threatened: farming, fishing, crafts, transport," Nadal-Mevs said.

- Mardi Gras cancelled -
With the opposition planning more demonstrations to seek the resignation of President Jovenel Moise, the sector got yet more bad news with word that Carnival celebrations have been called off in the Haitian capital, Port-au-Prince.   City Hall said it could not guarantee revelers' safety.   The festivities, which this year were planned for March 3-5, usually draw many Haitians living abroad and fleeing the winter cold in Canada and the eastern US.

Another major Carnival celebration is scheduled to take place in the city of Gonaives, but the government has not said if it will go ahead.   As grim as things are, some foreign tourists have gone ahead with visits to Haiti.   On Wednesday, a group of Australians under police escort visited a square featuring statues of heros of Haiti's independence from France. Days ago, demonstrators at the same plaza were throwing rocks at police, who responded with volleys of tear gas grenades.

A woman named Carole, who did not want to give her last name, said, "I trust the company we're traveling with. They not only want to take us but they want to bring us back."   Kevin McCue, another of the people in the group of 20, said he was glad that their tour operator had not opted for Plan B, which would have meant skipping Haiti and spending the whole week in the neighboring Dominican Republic.   "Tourism is alive and well here. People should come. The more they come, the better they spread some money among people who need it and the better for Haiti," said McCue.
Date: Thu, 21 Feb 2019 07:20:54 +0100
By Shafiqul ALAM

Dhaka, Feb 21, 2019 (AFP) - At least 70 people were killed when fire tore through crumbling apartment blocks in a historic part of Dhaka, setting off a chain of explosions and a wall of flames down nearby streets, officials said Thursday.    It started in one building where chemicals for deodorants and other household uses were illegally stored and spread at lightning speed to four nearby buildings, the fire service said.    People became trapped by the flames at a nearby bridal party and a restaurant. TV images showed the gates to one building were chained up so residents were unable to escape.

Traffic jams in the clogged narrow streets held up the rescue operation.   Bangladesh fire chief Ali Ahmed said at least 70 people were killed but that the toll would likely rise.    "The number of bodies may increase. The search is still going on," he told AFP.   Doctors said at least 10 of the scores of injured were in critical condition.   Firefighters who took almost 12 hours to bring the fire under control, went through the blackened floors of the building, littered with spray cans, looking for bodies.

The fire started at about 10.40pm (1640 GMT) on Wednesday at Chawkbazar in the old Mughal part of the capital.   Ahmed said it may have been started by a gas cylinder and quickly spread through the building where chemicals were stored in rooms alongside the apartments.   Chemicals used for household products were also stored in the nearby buildings. They exploded as the fire spread, witnesses said.     "There was a traffic jam when the fire broke out. It spread so quickly that people could not escape," the fire chief said.   Another fire official told reporters the blaze was under control but was not extinguished despite the efforts of more than 200 firefighters.   "It will take time. This is not like any other fire," he said, adding that the inferno had been made more devastating by the "highly combustible" chemicals.   Fire trucks had struggled in the narrow streets to reach the scene and there was also a lack of water for the battle, officials said.   The main gate of one five storey building was chained up, trapping residents inside, according to images shown on Bangladesh television.

- 'Flames were everywhere' -
Members of a bridal party in a nearby community centre were also caught in the fire and many were injured. Others were caught in small restaurants.   Dhaka deputy police commissioner Ibrahim Khan said at least two cars and 10 cycle rickshaws were burned in the fire.   "The victims included passersby, some people who were eating food at a restaurants and some members of the bridal party," he told AFP.   "I saw the charred body of a woman who was holding her daughter in her lap as their rickshaw was caught in the fire," said one witness.

Haji Abdul Kader, whose shop was destroyed, said he only survived the blaze as as he had left to go to a pharmacy.   "When I was at the pharmacy, I heard a big bang. I turned back and saw the whole street, which was jam packed with cars and rickshaws, in flames. Flames were everywhere," he told AFP.   "I got burned and rushed to hospital," he said.

Doctors at Dhaka Medical College Hospital said at least 55 people were injured, including 10 in a critical condition.   Hundreds of people rushed to the hospital looking for missing relatives.  However, most of the bodies of the dead were charred beyond recognition.    Sohag Hossain, one of the injured, told the Daily Star that he and two friends were working at a plastic factory in one of the buildings at the time of the fire.    They heard an explosion and could not escape the flames.

A similar blaze in 2010 in an old Dhaka building, which was also used as a chemical warehouse, killed more than 120 people in one of the worst fire disasters in the city of 20 million people.      Dhaka authorities launched a crackdown on chemical warehouses in residential areas following the blaze, but efforts to rein in the practice have waned.   Many buildings in Bangladesh lack adequate fire safety measures and the enforcement of fire regulations in factories and apartment buildings is lax.  
Date: Wed 20 Feb 2019, 2:13 PM CET
Source: El Pais in English [edited]
<https://elpais.com/elpais/2019/02/20/inenglish/1550655774_604104.html>

An investigation has been opened to determine the cause of death of a 46-year-old woman, who became ill after eating at a one-star Michelin restaurant called RiFF in Valencia. A total of 23 other patrons, including the victim's husband and 12-year-old son, also fell sick after the meal but their symptoms were mild and they have reportedly all recovered. The case was confirmed by regional health chief Ana Barcela, who expressed her condolences to the family and said that an investigation was already underway. "We've conducted a primary inspection of the establishment and everything appears to be normal," she said. "Analytical tests will now be carried out on the food products."

Barcela explained that the regional public health department will be in charge of the investigation and for determining the causes behind the woman's death. According to sources from the regional health department, the food poisoning outbreak was reported on [Sun 17 Feb 2019], after the 3 family members fell ill. They began to show symptoms of food poisoning - vomiting and diarrhoea - on [Sat 16 Feb 2019]. According to Europa Press, the father and son recovered but the woman's symptoms were more severe, and she died in her home early on the following morning. The investigation into the death revealed that a total of 9 patrons had experienced illness, mainly vomiting, after eating at the same restaurant.

Subsequently, it emerged that a further 14 people had also suffered light symptoms. "17 people have been interviewed, of whom 14 stated that they had some kind of mild symptoms," explained regional health chief Ana Barceló today, [Wed 20 Feb 2019]. "The samples that have been collected over the last few days have been sent to the National Toxicology Institute to be analyzed." Public health officials inspected the restaurant on [Mon 18 Feb 2019], but did not find any problems that could have contributed to the food poisoning. Investigators also collected samples of ingredients and raw food products that were part of the menu, and are currently analyzing them.

Barcela added that at this point she could not confirm whether the sickness had been caused by morel mushrooms that were on the restaurant's menu. "We will have to wait for the autopsy to be carried out on the woman before we can determine whether it was the ingestion of a food that directly caused her death, or whether it prompted a state that led to this fatal outcome, or if she had an existing condition," she explained on [Wed 20 Feb 2019].

Forensic teams are working to determine whether she could have been poisoned by something she ate, or whether she may have choked on her own vomit. In a statement, the owner of RiFF, Bernd H. Knaller, announced that the restaurant will remain closed until the cause of the food poisoning outbreak is determined and "activities can resume with full assurances for the staff and the patrons." The owner said he has been cooperating with the regional health department on the investigation and pointed out that the inspection "showed that the restaurant complies with all sanitary regulations." He added: "Regardless of what caused the situation, I want to convey my deep regret for what happened, and I hope all of the facts will be clarified shortly." [Byline: Cristina Vazquez]
Date: Mon 18 Feb 2019
Source: The News International [edited]

An elderly man died due to complications of the Crimean-Congo haemorrhagic fever (CCHF), commonly known as Congo virus, at the Jinnah Postgraduate Medical Centre (JPMC) on early [Sun 17 Feb 2019] morning, becoming the 2nd victim of the deadly tick-borne disease in the city [Karachi] in 2019.

"MUY, an elderly person of 75 years of age, died due to CCHF complications at JPMC on early [Sun 17 Feb 2019] morning," said JPMC Executive Director Dr. Seemin Jamali while taking to The News. She added that the deceased had earlier been taken to a private hospital from where he was shifted to Jinnah hospital.

It is the 2nd death in the city caused by the CCHF within a week as earlier on [Tue 12 Feb 2019] morning, a 35-year old woman from Orangi Town had died of Congo virus at an isolated ward of the JPMC.

CCHF is a tick-borne viral disease, which is caused when a person comes in contact with an animal infected with the Congo virus due to the presence of the parasite on its skin. Mostly butchers, sheep and animal herders and those who are associated with cattle farming become victims of the CCHF, which has a 40 to 50% mortality rate.

Dr. Jamali said both the woman from Orangi Town and the latest CCHF victim, who lived in the Landhi area of the city, were brought to the JPMC from Liaquat National Hospital where they had tested positive for the lethal disease.

She said the 2nd victim had a history of dealing with cattle and was in a serious condition when brought to the JPMC. He was suffering from high grade fever as well as internal and external bleeding, low platelets count and other comorbidities.

"We had moved both the patients to an isolation ward where they were given antiviral drugs, mega units [blood/platelets?] and other symptomatic treatment, but they could not survive due to the complications of the lethal ailment. All precautionary measures had also been adopted to prevent other patients and the medical staff from contracting the viral infection," she said.

"There were many people who contracted this disease in Karachi during their interaction with cattle, but they survived due to their strong immunity and the medical care they received at hospitals, including the JPMC. People should take precautionary measures while dealing with cattle and livestock," Dr. Jamali said. She added that in case the symptoms of red spots on the body, high-grade fever and blood oozing from mouth and nose are found in any patient, they should be rushed to a major hospital.

According to Dr. Kamran Rizvi, district officer (preventive) of Karachi Metropolitan Corporation, around 16 people died at various hospitals in Karachi last year [2018] due to CCHF, a majority of whom were residents of different areas of Balochistan, including Quetta, as people from the province are now regularly brought to Karachi for treatment.

He said a total of 41 Congo virus patients were brought to different hospitals in Karachi last year [2018], of whom 16, mostly males, could not survive while the others were successfully cured.
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[The CCHF virus is now endemic in both rural and urban parts of the country, and he best safeguard on the human side is to inform the public regarding the risks and provide education on the use of appropriate practices and protection measures.

Persons working in close contact with animals are at risk for CCHF due to presence of ticks that can transmit the virus through bites or crushing during removal through skin cuts, etc. The animals do not show clinical disease during viraemia and the virus can be transferred in butchering, handling of meat and hides, etc.  The veterinary aspect of the problem requires establishment of animal screening with measures for tick control. Collaborative work by health and veterinary sectors with support of entomologists for setting up CCHF surveillance can help plan prevention and control programs - ProMED Mod.UBA]
[HealthMap/ProMED map available at:
Date: Tue 19 Feb 2019, 1:32 PM
Source: KCRG-TV9 [edited]

TV9 has learned the Johnson County Public Health Department and the Iowa Department of Public Health are investigating reports of food poisoning following an event in Swisher, Iowa.

The illnesses have been linked to the Swisher Men's Club's Game Feast Dinner this past weekend [16-17 Feb 2019]. The group's Facebook page says the fundraiser has been going on for 15 years and features dishes that include meat from animals that are often hunted. The health departments are looking for anyone who may have attended the meal to try to track down the source of the illnesses. It's asking attendees to email <diana.vonstein@idph.iowa.gov> with their contact information.

Johnson County Public Health Director Dave Koch tells TV9 part of their investigative efforts have included taking part in a conference call with officials from the Iowa Department of Public Health on [Tue 19 Feb 2019]. Koch says part of the investigation will also include testing samples of the food that was served along with conducting tests on any individuals who think they may have contracted an illness.

It is unclear how many people may be claiming to be sick however the club posted the following message to their Facebook page which reads in part: "The Swisher Men's Club is aware of a number of illnesses as a result of our Game Feast Dinner. We are actively working with the county and state health departments to determine the cause of these illnesses."

TV9 has reached out to the Swisher Men's Club for comment. President Mike Brown, Jr. referred back to the statement provided on Facebook. Brown declined TV9's offer for an on-camera interview, but did say they are relaying all necessary information to the Iowa Department of Public Health.  [Byline: Josh Scheinblum & Aaron Scheinblum]
Date: January 2019
Source: Nigeria CDC: Nigeria monkeypox monthly situation report

Nigeria monkeypox -- monthly situation report
---------------------------------------------
Key indicators / Numbers
New suspected cases reported / 6
New confirmed cases / 3
Total deaths / 0
Healthcare worker infection / 0

Epidemiological summary
- Nigeria continues to report sporadic cases of monkeypox after the index case reported in September 2017.
- In the reporting month (January 2019), 6 new suspected monkeypox cases were reported in 4 states (Bayelsa - 2; Rivers - 1; Bauchi - 1; Lagos - 1; Borno - 1; Delta - 1) out of which 3 confirmed cases were recorded in 2 states (Rivers - 1, Bayelsa - 2). - No death recorded.
- All reported cases (suspected and confirmed) are males.
- The confirmed cases are all between 32-39 years of age.
- The South-South region of the country has the highest burden of monkeypox.
- Since the beginning of the outbreak in September 2017, 311 suspected cases and 7 deaths have been reported in 26 states. Of this, 132 were confirmed in 17 states (Rivers, Bayelsa, Cross River, Imo, Akwa Ibom, Lagos, Delta, Edo, FCT [Federal Capital Territory], Abia, Oyo, Enugu, Ekiti, Nasarawa, Benue, Plateau, Anambra)
- Results of animal surveillance carried out in 2 states are awaited.

[Available at the source URL above]:
Figure 1 [graph]: weekly trend of Nigeria monkeypox cases as at 31 Jan 2019
Figure 2 [graph]: line graph of Nigeria monkeypox cases weeks 31-52, 2017; 1-52, 2018 and 1-2, 2019
Figure 2 [map]: map of Nigeria showing distribution of monkeypox cases by LGA [local government area], September 2017-January 2019
=======================
[The number of monkeypox cases in Nigeria continues to increase slowly but steadily, with 6 new suspected and 3 new confirmed cases in January 2019. Interestingly, all cases are male individuals. Monkeypox virus transmission continued over a broad geographic area in Nigeria last year (2018). The report above provides the most recent update of the monkeypox situation in Nigeria. This outbreak has been unusual. Rather than sporadic or rare cases, there have been over 100 cases scattered over a large geographic area since 2017 and again this year (2019). The reasons for this relatively sudden appearance are not clear. Perhaps there has been an epizootic of monkeypox virus infections among its rodent hosts, with spill-over to people. As mentioned earlier, prevention will require a proactive public education effort to convince local people to take measures to prevent contact with the infected rodents and their excreta to avoid transmission, a difficult task involving so many local people over such a large geographic area.

Interested readers can see the graphs of cases by week and a map showing the location of cases by state.

Non-human primates are not monkeypox virus reservoirs. The main reservoirs of monkeypox virus are suspected to be rodents, including rope squirrels (_Funisciurus_ spp, an arboreal rodent) and terrestrial rodents (genera _Cricetomys_ and _Graphiurus_). - ProMED Mod.TY]

[Maps of Nigeria:
Date: Wed 20 Feb 2019
Source: Daily Times [edited]

The Sindh Health Department, on Tue 19 Feb 2019, admitted its failure to formulate an action plan to prevent the spread of the extensively drug-resistant (XDR) strain of typhoid fever in the province. The provincial minister for health, Dr Azra Fazal Pechuho, sighed that the health department still awaited vaccines for XDR typhoid from the federal government as the province battles the outbreak caused by a bacterial strain resistant to most known antimicrobials. She added that the strain had claimed 4 lives since its outbreak from Hyderabad [Sindh] in November 2016, which later spread to Karachi and other cities and towns of the province.

Dr Pechuho said that the Sindh Health Department had asked the local governments to improve the chlorination in water supplies, noting that the disease had spread due to the lack of sanitation and the presence of open garbage dumps in Karachi and other places. More than 5000 children have been affected by this typhoid strain, she continued. XDR typhoid is caused by antimicrobial resistant (AMR) strains of _Salmonella enterica_ serotype Typhi (or _S._ Typhi) and has been declared by WHO as a notable public health concern.

A report by the Provincial Disease Surveillance and Response Unit (PDSRU) reported 5274 cases of XDR typhoid out of 8188 typhoid fever cases in Sindh from 1 Nov 2016 through 9 Dec 2018. 69 percent of these cases was reported in Karachi, while 27 per cent in Hyderabad district, and 4 percent in other districts across the province.

The WHO recommended typhoid vaccination in response to confirmed outbreaks of typhoid fever. These vaccinations should be implemented in combination with other efforts to control the disease. At present, azithromycin remains the only affordable first-line oral therapeutic option to manage patients with XDR typhoid in low-resource settings.
====================
[The following is extracted from the CDC notice regarding this multiply-resistant typhoid strain in Pakistan

"The XDR strain of _Salmonella_ Typhi is resistant to most antibiotics (ampicillin, chloramphenicol, trimethoprim-sulfamethoxazole, ciprofloxacin, and ceftriaxone) used to treat typhoid fever. Healthcare providers should:
- Obtain a complete travel history (asking about travel to South Asia, including Pakistan) from patients with suspected typhoid fever.
- Collect stool and blood cultures from patients with suspected typhoid fever and request antimicrobial susceptibility testing on isolates.
- Be aware that the Pakistan outbreak strain remains susceptible to azithromycin and carbapenems. Azithromycin is effective for uncomplicated (diarrhea or bacteremia without secondary complications) typhoid fever and should be used to treat patients with suspected uncomplicated typhoid fever who have traveled to Pakistan. When culture and sensitivity results are available, adjust treatment accordingly. Adult azithromycin dosage is usually 1000 mg orally once, then 500 mg orally daily OR 1000 mg orally once daily for at least 5-7 days. Pediatric azithromycin dose is 20 mg/kg orally, once then 10-20 mg/kg orally once per day (maximum 1000 mg per day) for at least 5-7 days.
- Carbapenems should be used for patients with suspected severe or complicated typhoid fever who have traveled to Pakistan. Severe or complicated typhoid fever would include, but not be limited to, patients with gastrointestinal complications (such as typhoid-related intestinal perforation, peritonitis, intestinal haemorrhage, hepatitis), neurologic complications (such as typhoid encephalopathy, including altered consciousness, delirium, confusion), or bacteraemia with sepsis or shock. When culture and sensitivity results are available, adjust treatment accordingly. Consider getting an infectious diseases consultation for these patients.
- Be aware that relapses can occur, often 1-3 weeks after clinical improvement.
- Be aware that most (90%) _S._ Typhi isolates from patients coming from South Asia have decreased susceptibility or resistance to fluoroquinolones, including ciprofloxacin; therefore, fluoroquinolones should not be used as empiric treatment for suspected typhoid fever in patients who have traveled to this area.
- Report all cases of confirmed typhoid fever to the appropriate local or state health departments." - ProMED Mod.LL]

[HealthMap/ProMED-mail map of Pakistan:
Date: Tue, 19 Feb 2019 21:26:43 +0100

Geneva, Feb 19, 2019 (AFP) - An avalanche left four skiers injured Tuesday at a resort in the Swiss Alps where rescue operations went on after dark with police fearing people could still be trapped under the snow.   The authorities held a press conference to announce the injuries, including one person seriously hurt, after local reports said up to a dozen people were engulfed by the avalanche.   Police officers said that based on witness reports other skiers could still be buried and the search would continue into the night.

Swiss RTS television said the army had set up lighting to aid the 240 rescue workers at the site.   The police had earlier tweeted that several people were under the avalanche that hit early afternoon on a slope 2,600 metres (8,600 feet) up at Crans-Montana, which was busy with skiers during school holidays.   A local newspaper, Le Nouvelliste, had quoted the head of Crans-Montana's municipal government, Nicolas Feraud, as estimating that "between 10 and 12 people" were buried under the snow.   "We are shocked and hope for good news about these people," Feraud was quoted as saying. 

A first attempt at locating victims using sniffer dogs was unsuccessful, a rescue worker told Le Nouvelliste, with four helicopters joining the search from the air.   Pierre Huguenin, of the Institute for Snow and Avalanche Research, described the snow in the area as damp and dense.   According to statistics from his institute, after 15 minutes under an avalanche, the chances of survival are no more than 50 percent.   Le Nouvelliste said the avalanche swept over 300 to 400 metres (yards) of the lower section of the Kandahar piste.   It quoted rescue workers as saying the snow was compacted and more than two metres (seven feet) thick.

Crans-Montana's website had listed the risk of an avalanche at two on a scale that runs from one (lowest risk) to five.    As the victims were on a designated ski slope, they were unlikely to have detector equipment to help rescue workers locate them.   The vast majority of deadly avalanches in the Alpine nation hit people skiing off-piste.    "We don't know yet whether the avalanche detached by itself or was set off by skiers, or a rockfall," Swiss avalanche expert Robert Bolognesi told the daily 20 Minutes.
Date: Wed, 20 Feb 2019 16:17:29 +0100

Prague, Feb 20, 2019 (AFP) - Czech authorities said Wednesday they would slap checks on beef imported from Poland after veterinarians found the dangerous Salmonella bacteria in a 700-kilogramme batch of Polish beef.   "Tests have shown the presence of Salmonella enteritidis, which can cause serious diarrhoea and affect human health, in beef imported from Poland on February 13," Agriculture Minister Miroslav Toman told reporters.

Czech veterinary authorities have warned the European Commission and Polish authorities through a rapid warning system, he said, adding that they are also checking whether any of the meat has been consumed.   "The State Veterinary Administration (SVS) will immediately adopt an extraordinary measure -- all beef imported from Poland must be tested in a lab before hitting the market," Toman added.

SVS head Zbynek Semerad said meat from the 700-kilo (1,500-pound) batch had been distributed to five "places" in the Czech Republic and one in Slovakia.   "I will inform my Slovak counterpart. As far as we know, not all of the meat has been distributed to the end customer," Semerad said.   The case comes on the heels of a scandal which saw Poland export a total of 2.7 tonnes of suspect beef to around a dozen fellow EU members, triggering an EU probe.

The scandal erupted in January when the TVN24 commercial news channel aired footage of apparently sick or lame cows being butchered at a small slaughterhouse in northeast Poland in secret late at night when veterinary authorities were unlikely to visit.   Poland is a leading producer and exporter of meat in Europe, turning out around 600,000 tonnes of beef per year and exporting most of it mainly to the EU, according to meat producer associations.
Date: Wed, 20 Feb 2019 09:56:54 +0100

Kuala Lumpur, Feb 20, 2019 (AFP) - Six people, including three foreigners, were killed when a fire broke out Wednesday in a Malaysian karaoke centre, with rescuers describing scenes of chaos as the blaze engulfed the building.   The fire erupted before dawn on the fourth floor of an eight-storey building in the city of Ipoh, northern Perak state.

Firefighters rushed to the scene and found the bodies of six people who had died of smoke inhalation, Perak fire department acting director Sayani Saidon told AFP.   "We came across two locals, two Vietnamese women and a Bangladeshi man. We are still determining the identity of the sixth person," she said.

Firefighters rescued eight people alive, including two in critical condition, she added.     People inside were unable to find the way out after the fire erupted as exit lights did not come on, she said. Those that survived had run to an upper level to escape the flames.   "When the fire happened, all the electricity went out, and it was dark, so the exit signs weren't clear," she said.   The building was originally an office block, and had 30 karaoke rooms on the fourth and fifth floors.