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Travel News Headlines WORLD NEWS

Date: Tue, 24 Sep 2019 07:27:34 +0200 (METDST)

Miami, Sept 24, 2019 (AFP) - A strong 6.0 magnitude struck off the northwest coast of Puerto Rico late Monday, the United States Geological Survey said, although no casualties or damage were reported.   The quake struck 62km northwest of San Antonio at 11:23 pm local time (03:20 GMT) at a depth of 10km, the agency said.  San Antonio is home to Rafael Hernandez Airport, a key air link to the mainland US.    In 2010 nearby Haiti was struck by a devastating 7.0 magnitude earthquake that killed more than 250,000 people and crippled the nation's infrastructure.
Date: Mon, 12 Feb 2018 05:54:19 +0100

San Juan, Feb 12, 2018 (AFP) - Most of San Juan and a strip of northern Puerto Rico municipalities were plunged into darkness Sunday night after an explosion at a power station, five months after two hurricanes destroyed the island's electricity network.

The state electric power authority (AEE) said the blast was caused by a broken-down switch in Rio Piedras, resulting in a blackout in central San Juan and Palo Seco in the north.   "We have personnel working to restore the system as soon as possible," the AEE said.   San Juan's mayor, Carmen Yulin Cruz, said on Twitter that emergency services and local officials attended the scene in the neighbourhood of Monacillos, but no injuries were reported.

Meanwhile, the Puerto Rican capital's airport said it was maintaining its schedule using emergency generators.   The blackout comes as nearly 500,000 of AEE's 1.6 million customers remain without power since Hurricanes Irma and Maria struck the US territory in September 2017.   AEE engineer Jorge Bracero warned on Twitter that the outage was "serious," and advised those affected that power would not be restored until Monday.
Date: Wed, 13 Dec 2017 03:08:12 +0100
By Leila MACOR

Fajardo, Puerto Rico, Dec 13, 2017 (AFP) - Until Hurricane Maria hit Puerto Rico, Jose Figueroa did brisk business renting kayaks to tourists itching to see a lagoon that lights up by night thanks to millions of microorganisms.   Today, things are so dire he's considering selling water to motorists stopped at red lights.   "Now we are trying to survive," the 46-year-old tour guide said.

It used to be that visitors had to reserve a month in advance to get one of his kayaks and paddle around in the dark on the enchanting, bioluminescent body of water called Laguna Grande.   But tourists are scarce these days as the Caribbean island tries to recover from the ravages of the storm back in September.   "We do not know if we will have any work tonight," Figueroa said. "Last week, we worked only one day."    He and another employee of a company called Glass Bottom PR are cleaning kayaks on the seaside promenade of Fajardo, a tourist town in eastern Puerto Rico whose main attraction is the so-called Bio Bay.

The year started off well for Puerto Rico, with the global success of the song "Despacito" by local musicians Luis Fonsi and Daddy Yankee.   The catchy tune helped promote the US commonwealth island of 3.4 million people, which is saddled with huge debts and declared bankruptcy in May.    But the hurricane turned what should be an island bustling with tourists into one with deserted beaches, shuttered restaurants and hotels full of mainland US officials working on the rebuilding of the island.   "What few tourists we have are the federal officials themselves," said Figueroa.

- Locals only -
The grim outlook spreads up and down the seaside promenade of Fajardo, where many restaurants are closed because there is no electricity.   On this particular day around noon, the only restaurant open is one called Racar Seafood. It has its own emergency generator.   "We get by on local tourists," said its 61-year-old owner, Justino Cruz.   "Our clients are local -- those who have no electricity, no generator, cold food or no food."

Puerto Rico's once-devastated power grid is now back up to 70 percent capacity, but this is mainly concentrated in the capital San Juan.   So while inland towns that depend on tourism are struggling mightily, things are getting better in San Juan as cruise ships are once again docking.   On November 30, the first cruise ship since the storm arrived with thousands of vacationers on board. They were received with great fanfare -- quite literally, with trumpet blaring and cymbals crashing.

- Pitching in to help -
The World Travel & Tourism Council, based in London, says tourism accounted for about eight percent of Puerto Rico's GDP in 2016, or $8.1 billion.   Hurricane Maria's damage has been uneven. Although some tour guides now have no work and many eateries are shut down, hotels that have their own generators are doing just fine.   Thanks to the thousands of US government officials and reconstruction crew members that came in after the storm, the hotels that are open -- about 80 percent of the total -- are pretty much full.

These people are starting to leave the island this month but hotels may receive tourists around Christmas, at least in San Juan, where power has for the most part been restored.   The hurricane "undoubtedly cost billions in lost revenue," said Jose Izquierdo, executive director of the Puerto Rico Tourism Company.    But Izquierdo nevertheless says he is "optimistic" and suggests an alternative: put tourists to work as volunteers in the gargantuan reconstruction effort that the island needs.   "We want to look for travellers who want to travel with a purpose, who might have the commitment to help rebuild," said Izquierdo.

The program, called "Meaningful Travel" and launched in mid-November, organizes trips on which residents, Puerto Ricans living abroad and tourists are invited to help the island get back on its feet.   "The plan aims to create empathy with this tourist destination," said Izquierdo.    "We want to be like New Orleans after Katrina, where 10 years after the hurricane, tourism is the driving force of its economy. We want to build that narrative of recovery," he added.   "There are different ways in which the world wants to help Puerto Rico. The best way is to visit us."
Date: Thu, 9 Nov 2017 12:39:04 +0100
By Marcos PÉREZ RAMÍREZ

San Juan, Nov 9, 2017 (AFP) - Andrea Olivero, 11, consults her classmate Ada about an exercise during their daily English class at San Juan's Sotero Figueroa Elementary School. The task: list the positive and negative aspects of Hurricane Maria's passing almost two months ago.

The girls only have to look around. There is no electricity and they "roast" in the heat, Andrea says. At the back of the room, computers and televisions collect dust.   "We would like to move past the topic of the hurricane a bit. It is already getting repetitive," Andrea told AFP.   She is one of more than 300,000 pupils in the public education system, although only half of schools are functioning. Barely 42 per cent of Puerto Ricans have electricity seven weeks after Maria struck, killing at least 51 in the American territory.

The lack of power has prompted disorienting timetable changes on the tropical island, to avoid both the hottest hours of the day and the use of dining facilities.   "The children are very anxious. We manage to make progress in lessons and they change the hours again. Everything is messed up and we fall behind," English teacher Joan Rodriguez explained.   "We can't use the computers to illustrate classes," she said. "They are reading the novel "Charlotte's Web," and we wanted to do exercises comparing it to the film version. But we cannot use the television.

- Suspicions -
From October 23, some directors reopened their schools in the western region of Mayaguez and San Juan.   But last Thursday, the Department of Education ordered their closure, insisting they must be evaluated by engineering and architectural firms, then certified by the US Army Corps of Engineers.   One of those schools was Vila Mayo, also in San Juan. The community presumed it would open, as it had been used as a shelter, its electrical infrastructure had been inspected and it had not suffered structural damage.

But Luis Orengo, the education department's director in San Juan, told protesters outside the school it was closed as inspectors' findings had not reached the central government.   "This is unacceptable! The school is ready to give classes but they don't want to open it. Our children cannot lose a year," fumed Enid Guzman, who protested with her 11-year-old son, Reanny De la Cruz.   There are suspicions the stalled reopening of schools is, in part, related to the prior closure of 240 schools over the past year during Puerto Rico's long-running financial crisis.   The fiscal difficulties have seen the island's population drop over the past decade by 14 percent, leading in turn to a fall in school enrolment.

Before the storms, 300 schools were at risk of closure -- and for the president of Puerto Rico's federation of teachers, Mercedes Martinez, the government's aim is clear.   "Secretary (Julia) Keleher seems to have an orchestrated plan to close schools," she said, referring to the education secretary. "Why do you have to wait 30 days to get a certification so a school can open?"   Keleher has announced she expects most schools to be open by the middle of November.
Date: Tue 24 Oct 2017
Source: KFOR Oklahoma News4 [edited]

Puerto Rico has reported at least 76 cases of suspected and confirmed leptospirosis, including a handful of deaths, in the month after Hurricane Maria, said Dr. Carmen Deseda, the state epidemiologist for Puerto Rico.

Two deaths involved leptospirosis confirmed through laboratory testing, and "several other" deaths are pending test results, Deseda said. The 76 cases, up from 74 last week, also include one patient with confirmed leptospirosis who is currently hospitalized.

The island typically sees between 63 and 95 cases per year, she said. Health officials had expected that there would be a jump after the hurricane. "It's neither an epidemic nor a confirmed outbreak," Public Affairs Secretary Ramon Rosario Cortes said at a news conference Sunday [22 Oct 2017]. "But obviously, we are making all the announcements as though it were a health emergency."

Leptospirosis may be treated with antibiotics, but many people recover on their own. "The majority of leptospirosis cases is a mild, subclinical disease with no complications," Deseda said. "But one out of 10 people who have leptospirosis develop severe illness." In the 1st stage of leptospirosis, symptoms vary widely from fever and headache to red eyes and rashes. Some people may have no symptoms at all. But a small number will develop dire complications: meningitis, kidney and liver damage, bleeding in the lungs and even death.

Doctors are required to report any potential leptospirosis cases to health authorities, Deseda said. Those cases must then be tested to confirm the bacteria, since the symptoms can be difficult to tell apart from other illnesses. After that, health officials may look for patterns or clusters and determine whether there is an outbreak.

The lab tests on the suspected cases have been sent to the US Centers for Disease Control and Prevention, Deseda said. The turnaround time is about 5-6 days.

Doctors on the island have expressed concerns about burgeoning health crises amid hospitals that are overwhelmed, undersupplied and sometimes burning hot. Influenza is another concern on the horizon, Deseda said. Drinking water is also hard to come by on many parts of the island.

Dr. Raul Hernandez, an internist in San Juan, told CNN that people were drinking water from whatever sources they could find, such as rivers and creeks. If that water contains urine from a [leptospirosis-infected rat], those people will be at risk, he said.

Deseda said people should be discouraged from walking barefoot, drinking or swimming in potentially leptospirosis-contaminated waters.

"These diseases are everywhere, and there's a way to prevent them," she said.
=====================
[Leptospirosis is a zoonotic, spirochetal infection that occurs worldwide and is transmitted to humans by exposure to soil or fresh water contaminated with the urine of wild and domestic animals (including dogs, cattle, swine, and especially rodents) that are chronically infected with pathogenic _Leptospira_. _Leptospira_ may survive in contaminated fresh water or moist soil for weeks to months. Outbreaks of leptospirosis frequently follow heavy rainfall, flooding with fresh water, and increasing rodent numbers.

Parts of Puerto Rico saw more than 30 inches of rain and consequent flooding with recent Hurricane Maria. A map showing the estimated rainfall across Puerto Rico with this hurricane is available at <https://twitter.com/NWSSanJuan/status/910983698597777409/photo/1?ref_src=twsrc%5Etfw&ref_url>.

With continued absence of potable water, inadequate sanitation, and flooding in the streets for a large proportion of the population in Puerto Rico, food- and water-borne diseases, like leptospirosis, will be a major problem. - ProMED Mod.ML]

[A HealthMap/ProMED-mail map can be accessed at:
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Benin

Benin - US Consular Information Sheet
April 28, 2008

COUNTRY DESCRIPTION:
Benin is a developing country in West Africa. Its political capital is Porto Novo. However, its administrative capital, Cotonou, is Benin's largest city and the
site of most government, commercial, and tourist activity. Read the Department of State Background Notes on Benin for additional information.

ENTRY/EXIT REQUIREMENTS: A passport and visa are required. Visas are not routinely available at the airport. Visitors to Benin should also carry the WHO Yellow Card (“Carte Jaune”) indicating that they have been vaccinated for yellow fever. Contact the Embassy of Benin for the most current visa information. The Embassy is located at: 2124 Kalorama Road NW, Washington, DC 20008; tel: 202-232-6656.

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 avoid crowds, political rallies, and street demonstrations and maintain security awareness at all times.
U.S. citizens should not walk on the beach alone at any time of day. It is also highly recommended not to carry a passport or valuables when walking in any part of the city. Travelers should carry a notarized photocopy of the photo page of their passport (see Crime section). They should not walk around the city after dark, and should take particular care to avoid the beach and isolated areas near the beach after dark.
The ocean currents along the coast are extremely strong and treacherous with rough surf and a strong undertow, and several people drown each year.

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: Street robbery is a significant problem in Cotonou. Robbery and mugging occur along the Boulevard de France (the beach road by the Marina and Novotel Hotels) and on the beaches near hotels frequented by international visitors. Most of the reported incidents involve the use of force, often by armed persons, with occasional minor injury to the victim. Travelers should avoid isolated and poorly lit areas and should not walk around the city or the beaches between dusk and dawn. Even in daylight hours, foreigners on the beach near Cotonou are frequent victims of robberies. When visiting the beach, travelers should not bring valuables and should carry only a photocopy of their passport. If you are a victim of crime, you should contact the U.S. Embassy immediately. There has been a continued increase in the number of robberies and carjacking incidents after dark, both within metropolitan Cotonou and on highways and rural roads outside of major metropolitan areas. Motorists are urged to be wary of the risk of carjacking. Keep the windows of your vehicle rolled up and the doors locked. Stay alert for signs of suspicious behavior by other motorists or pedestrians that may lead to carjacking, such as attempts to stop a moving vehicle for no obvious reason. Travelers should avoid driving outside the city of Cotonou after dark and should exercise extreme caution when driving in Cotonou after dark (see Traffic Safety and Road Conditions below). Overland travel to Nigeria is dangerous near the Benin/Nigeria border due to unofficial checkpoints and highway banditry.
Travelers should avoid the use of credit cards and automated teller machines (ATMs) in Benin due to a high rate of fraud. Perpetrators of business and other kinds of fraud often target foreigners, including Americans. While such fraud schemes in the past have been largely associated with Nigeria, they are now prevalent throughout West Africa, including Benin, and are more frequently perpetrated by Beninese criminals. Business scams are not always easy to recognize, and any unsolicited business proposal should be carefully scrutinized. There are, nevertheless, some indicators that are warnings of a probable scam. Look out for:

Any offer of a substantial percentage of a very large sum of money to be transferred into your account, in return for your "discretion" or "confidentiality";

Any deal that seems too good to be true;
Requests for signed and stamped, blank letterhead or invoices, or for bank account or credit card information;
Requests for urgent air shipment, accompanied by an instrument of payment whose genuineness cannot immediately be established;
Solicitations claiming the soliciting party has personal ties to high government officials;
Requests for payment, in advance, of transfer taxes or incorporation fees;
Statements that your name was provided to the soliciting party either by someone you do not know or by "a reliable contact";
Promises of advance payment for services to the Beninese government; and
Any offer of a charitable donation.
These scams, which may appear to be legitimate business deals requiring advance payments on contracts, pose a danger of both financial loss and physical harm. Recently more American citizens have been targeted. The perpetrators of such scams sometimes pose as attorneys. One common ploy is to request fees for “registration” with fictitious government offices or regulatory authorities. The best way to avoid becoming a victim of advance-fee fraud is common sense – if it looks too good to be true, it probably is. Travelers should carefully check out any unsolicited business proposal originating in Benin before committing any funds, providing any goods or services, or undertaking any travel. For additional information, please see the Department of State’s Bureau of Consular Affairs brochure, International Financial Scams.

Scams may also involve persons posing as singles on Internet dating sites or as online acquaintances who then get into trouble and require money to be "rescued." If you are asked to send money by someone you meet online please contact the U.S. Embassy before doing so.

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 Benin are limited and not all medicines are available. Travelers should bring their own supplies of prescription drugs and preventive medicines. Not all medicines and prescription drugs available in Benin are USFDA-approved. Malaria is a serious risk to travelers to Benin. For information on malaria, its prevention, protection from insect bites, and anti-malarial drugs, please visit the CDC Travelers' Health web site at http://www.cdc.gov/malaria/.

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

With the exception of the road linking Cotonou in the south to Malanville on the border with Niger in the north, and from Parakou in central Benin to Natitingou in the northwestern part of the country, roads in Benin are generally in poor condition and are often impassable during the rainy season. Benin's unpaved roads vary widely in quality; deep sand and potholes are common. During the rainy season from mid-June to mid-September, dirt roads often become impassable. Four-wheel drive vehicles with full spare tires and emergency equipment are recommended.
Most of the main streets in Cotonou are paved, but side streets are often dirt with deep potholes. Traffic moves on the right, as in the United States. Cotonou has no public transportation system; many Beninese people rely on bicycles, mopeds, motorbikes, and zemidjans (moped taxis). All official Americans are required to wear safety helmets when on a motorcycle and are strongly discouraged from using zemidjans. Travelers using zemidjans, particularly at night, are much more vulnerable to being mugged, assaulted or robbed. Buses and bush taxis offer service in the interior.
Gasoline smuggled from Nigeria is widely available in glass bottles and jugs at informal roadside stands throughout Cotonou and much of the country. This gasoline is of unreliable quality, often containing water or other contaminants that can damage or disable your vehicle. Drivers should purchase fuel only from official service stations. There are periodic gas shortages, which can be particularly acute in the north of the country where there are few service stations.
U.S. citizens traveling by road should exercise extreme caution. Poorly maintained and overloaded transport and cargo vehicles frequently break down and cause accidents. Drivers often place branches or leaves in the road to indicate a broken down vehicle is in the roadway. Undisciplined drivers move unpredictably through traffic. Construction work is often poorly indicated. Speed bumps, commonly used on paved roads in and near villages, are seldom indicated. Drivers must be on guard against people and livestock wandering into or across the roads. Nighttime driving is particularly hazardous as vehicles frequently lack headlights and/or taillights, and brake lights are often burned out.
With few exceptions, Cotonou and other cities lack any street lighting, and lighting on roads between population centers is non-existent. The U.S. Embassy in Cotonou prohibits non-essential travel outside of metropolitan areas after dusk by official Americans and strongly urges all U.S. citizens to avoid night driving as well. There have been numerous carjackings and robberies on roads in Benin after dark, several of which resulted in murder when the driver refused to comply with the assailants' demands. The National Police periodically conduct vehicle checks at provisional roadblocks in an effort to improve road safety and reduce the increasing number of carjackings. When stopped at such a roadblock, you must have all of the vehicle's documentation available to present to the authorities.
Please refer to our Road Safety page for more information. Visit the website of the country’s national tourist office at http://www.benintourisme.com.

AVIATION SAFETY OVERSIGHT: As there is no direct commercial air service to the United States by carriers registered in Benin, the U.S. Federal Aviation Administration (FAA) has not assessed Benin’s Civil Aviation Authority for compliance with International Civil Aviation Organization (ICAO) aviation safety standards. For more information, travelers may visit the FAA’s web site at http://www.faa.gov/safety/programs_initiatives/oversight/iasa.

SPECIAL CIRCUMSTANCES:
U.S. citizens are advised to keep a notarized photocopy of the photo page of their passport with them at all times when traveling in Benin.
The Embassy has had a few reports of officials requesting a "gift" to facilitate official administrative matters (e.g., customs entry). Such requests should be politely but firmly declined.
It is prohibited to photograph government buildings and other official sites, such as military installations, without the formal consent of the Government of Benin. In general, it is always best to be courteous and ask permission before taking pictures of people. Beninese citizens may react angrily if photographed without their prior approval.
Obtaining customs clearance at the port of Cotonou for donated items shipped to Benin from the United States may be a lengthy process. In addition, to obtain a waiver of customs duties on donated items, the donating organization must secure prior written approval from the Government of Benin. Please contact the U.S. Embassy in Cotonou for more detailed information.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 Benin laws, even unknowingly, may be expelled, arrested or imprisoned. Penalties for possession, use, or trafficking in illegal drugs in Benin 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 Benin are encouraged to register with the U.S. Embassy through the State Department’s travel registration web site so that they can obtain updated information on travel and security within Benin. Americans withoutInternet access may register directly with the U.S. Embassy. By registering, American citizens make it easier for the Embassy or Consulate to contact them in case of emergency. The U.S. Embassy is located at Rue Caporal Anani Bernard in Cotonou. The Embassy's mailing address is B.P. 2012, Cotonou, Benin. The 24-hour telephone numbers are (229) 21-30-06-50, 21-30-05-13, and 21-30-17-92. The Embassy’s general fax number is (229) 21-30-06-70; the Consular Section’s fax number is (229) 21-30-66-82; http://cotonou.usembassy.gov/.
* * *
This replaces the Country Specific Information for Benin dated August 17th, 2007 to update sections on Safety and Security and Traffic Safety and Road Conditions.

Travel News Headlines WORLD NEWS

Date: Fri, 10 May 2019 19:38:30 +0200
By Hazel WARD and Daphne BENOIT

Paris, May 10, 2019 (AFP) - French special forces have freed two French hostages, an American and a South Korean in northern Burkina Faso in an overnight raid in which two soldiers died, authorities announced Friday.   The operation was launched to free two French tourists who had disappeared while on holiday in the remote Pendjari National Park in neighbouring Benin on May 1.

But during the raid, the French troops were surprised to discover two women also in captivity, with top officials saying they had been held for 28 days.    The French tourists were identified as Patrick Picque, 51, and Laurent Lassimouillas, 46, but the women's identities were not immediately clear.     "No one was aware of (the women's) presence," French Defence Minister Florence Parly told reporters, while French armed forces chief Francois Lecointre said.   "We know little about these other two hostages," Parly told reporters, saying that even Seoul and Washington did not appear to be aware the pair were in increasingly unstable Burkina Faso.    The raid was approved by French President Emmanuel Macron in what was seen as the last opportunity to stop the hostages being transferred to lawless territory in Mali to the north.

Parly said it was "too early to say" who had snatched the two French nationals from Benin, which has long been an island of stability in a region where Islamist militants are increasingly active.   "The message to terrorists and criminal gangs is clear: those who attack France and its nationals know that we will not spare any effort to track them down, find them and neutralise them," she said.   Four of the six kidnappers were killed in the raid.    French forces, helped by intelligence provided by the United States, had been tracking the kidnappers for several days as they travelled across the semi-desert terrain of eastern Burkina Faso from Benin to Mali.   They seized the opportunity to prevent "the transfer of the hostages to another terrorist organisation in Mali," Lecointre said, referring to the Macina Liberation Front (FLM).   The FLM is a jihadist group formed in 2015 and headed by a radical Malian preacher, Amadou Koufa. It is aligned with Al-Qaeda in the region.

- US intelligence support -
In a statement, Macron congratulated the special forces on the operation, in which he also expressed sorrow over the death of the two soldiers "who gave their lives to save those of our citizens".   And Parly thanked authorities in Benin and Burkina Faso for their help with the "complex operation", as well as the United States which provided intelligence and support.

The operation was also made possible by the presence of France's Operation Barkhane, which counts some 4,500 troops deployed in Mali, Burkina Faso, Niger and Chad to help local forces battle jihadist groups.   American special forces and drones are also known to operate in the violence-wracked Sahel region, which France fears could become further destabilised as jihadist groups are pushed out of north Africa, Iraq and Syria.   Burkina Faso has suffered from increasingly frequent and deadly attacks attributed to a number of jihadist groups, including the Ansarul Islam group, the Group to Support Islam and Muslims (GSIM) and Islamic State in the Greater Sahara.

- Relief and sadness -
The French tourists -- Patrick Picque who works in a Paris jewellery shop, and Laurent Lassimouillas a piano teacher, -- went missing with their guide on the last leg of their holiday in usually peaceful Benin.   The Pendjari wildlife reserve, which is famed for its elephants and lions, lies close to the porous border with Burkina Faso.   The badly disfigured body of their guide was found shortly after they disappeared, as well as their abandoned four-wheel Toyota truck.   The two freed men will be flown back to France on Saturday, alongside the South Korean woman, where they will be met on arrival by Macron and other top French officials.   Washington thanked the French forces for freeing the American hostage, with France saying she would likely be "repatriated independently" from the other three. 

The two dead French soldiers were named as Cedric de Pierrepont and Alain Bertoncello, decorated naval special forces members born in 1986 and 1991 respectively.   They were part of the prestigious Hubert commando unit of the French naval special forces which was deployed to the Sahel at the end of March.   A total of 24 French soldiers have died in the region since 2013 when France intervened to drive back jihadist groups who had taken control of northern Mali. The last death was on April 2.
Date: Tue 15 Jan 2019
Source: Punch [edited]

The Kwara state government has confirmed 2 cases of Lassa fever infecting a husband and wife in the state.

Speaking with newsmen on Tuesday [15 Jan 2019] at a news briefing, the Kwara commissioner for health, Alhaji Usman Rifun-Kolo, said the outbreak of Lassa fever was identified in a farm settlement in Taberu, Baruten local government area.

He explained that the 2 cases of the disease affected a husband and wife, natives of Benin republic, which shares a border with the state. He added that the husband and wife are farming in Baruten. "These cases of Lassa fever originated from Benin republic, whose citizen have interrelations with people in the Baruten area," he said.

According to him, the husband and wife were diagnosed in a health facility, and the state government had already deployed a disease-surveillance team to identify those who have been in contact with the patients.

Rifun-Kolo further explained that the surveillance team identified 4 people with a history of fever in the area. He said that the 4 cases raised suspicion of Lassa fever, which prompted them to take samples from the individuals for further investigation. He noted that the 4 individuals have commenced treatment in Taberu, Baruten LGA.
=====================
[The above report states that the couple was infected in Benin, although the timeline when that may have occurred is not given. The report also mentions 4 individuals in the Kwara state who had a history of Lassa fever, implying that the virus is present in that state in Nigeria as well. In December [2018], there were Lassa fever cases in Benin that were imported from Nigeria as well as infections that were locally acquired in Benin, so the Lassa fever cases cross the border in both directions. The source of the infecting virus for any of these cases is not mentioned. - ProMED Mod.TY

[HealthMap/ProMED-mail maps:
Kwara state, Nigeria: <http://healthmap.org/promed/p/19690>]
Date: Wed 26 Dec 2018
Source: Quotidein Le Matinal [in French, trans. ProMED Corr.SB, edited]

Minister of health Benjamin Hounkpatin confirmed on Wednesday [26 Dec 2018] 4 new cases of Lassa haemorrhagic fever in Benin, including one in Cotonou. This occurred in the period from 15-26 Dec 2018.

In the case of Cotonou, a 28-year-old (has been infected). His case was detected on 24 Dec [2018], but his illness commenced the previous week. He had a fever, a cough, a cold, and fatigue. Due to the persistence of the cough and cold, and with the appearance of traces of blood in nasal discharge on 24 Dec 2018, the alert was given.

The patient was placed in isolation on [Tue 25 Dec 2018], and on the morning of Wed 26 Dec 2018, his result from the laboratory came back positive [for Lassa fever]. Subsequently, the patient was isolated and put on treatment.

According to the details provided by Hounkpatin, there is no indication of travel [by the patient] to an epidemic locality of Lassa fever. According to the patient's statements, there is no known contact with rodents.

Taking advantage of this opportunity, the minister reassured the public that public health measures are underway. He also reminded people of the behaviours that will help avoid becoming infected. This involves washing hands regularly with soap and water; avoiding contact with stool, sperm, urine, saliva, vomit, and contaminated objects from a person suspected to be ill or dead from Lassa; and protecting food and keeping it in a safe place, out of reach of rodents.

It should be recalled that 7 cases have been recorded since the beginning of the epidemic to date, including 5 positive cases.
=======================
[One case is located in Cotonou on the Benin coast and apparently was locally acquired, perhaps from contact with the rodent host or its excrement. The location of the other 3 cases is not mentioned, but a 13 Dec 2018 report indicated that there were 3 cases in the municipality of Parakou in Borgou Department, in the northern part of Benin. Perhaps these 3 cases, which came from the village Taberou (in Nigeria), located 5 km [3.1 mi] from Tandou in the commune of Tchaourou, are the ones mentioned in this report.

The previous Lassa fever cases in Benin this year [2018] occurred in January and also involved case importation from Nigeria. A previous WHO report stated that Lassa fever is endemic in bordering Nigeria, and, given the frequent population movements between Nigeria and Benin, the occurrence of additional cases is not unexpected. Strengthening of cross-border collaboration and information exchange between the 2 countries is, therefore, needed. - ProMED Mod.TY]

[Images of the rodent reservoirs of Lassa fever virus can be seen as follows:
For _Mastomys natalensis_, see
For _M. erythroleucus_ and _Hylomycus pamfi_, see

HealthMap/ProMED-mail maps:
Date: Fri, 29 Jun 2018 13:37:32 +0200

Cotonou, June 29, 2018 (AFP) - Benin's Constitutional Court has banned the right to strike by workers in the country's defence, security, justice and health sectors, sparking concern among union officials and legal observers.   The ruling, issued late on Thursday, came after months of wrangling between the government and the court, which had previously said the measure was unconstitutional.

"Civil servants, public security forces and equivalents should fulfil their duties in all circumstances and not exercise their right to strike," the court said in its new ruling.   "There should be no disruption to the duties of public sector defence, security, justice and health workers."   The decision was taken "in the public interest" and for "the protection of citizens", it said.

Speaking on Friday, one senior union leader, who asked to remain anonymous, described the ruling as shocking and a "hammer blow".   And Benin legal affairs expert Albert Medagbe told AFP the decision was a "worrying sudden legal U-turn".   Earlier this month, a close ally of President Patrice Talon, Joseph Djogbenou, was elected to lead the Constitutional Court during a vote held behind closed doors.   Djogbenou is Talon's former personal lawyer and was previously  Benin's attorney general.

Until his arrival, the court had strained relations with Talon, and had criticised the government for misunderstanding and failing to respect the constitution.   The small West African nation was last year hit by a wave of public sector strikes, which brought the education, health and justice system to a near halt.   The industrial action was sparked by Talon's attempts to introduce free-market reforms.
Date: Wed, 21 Feb 2018 17:31:52 +0100

Cotonou, Feb 21, 2018 (AFP) - Nine people appeared in a Benin court Wednesday on charges of selling fake drugs at the start of a landmark trial in a regional campaign against illicit medicines.   The suspects, who include executives from major pharmaceutical companies operating in the West African nation, were remanded in custody until March 6 on technical grounds.   They are accused of "the sale of falsified medicines, (and) display, possession with a view to selling, commercialisation or sale of falsified medical substances."   A tenth defendant, the head of the Directorate for Pharmacies, Medications and Diagnostic Evaluation (DPMED) under the control of the ministry of health, was not in court on the trial's opening day.   He is accused of failing to prevent the offences.

Benin launched the crackdown last year after mounting alarm about the scale of the trafficking of expired and counterfeit drugs in West Africa.   Fake medicines are drugs that are bogus or below regulatory standards but often are outwardly indistinguishable from the genuine product.   Taking them may do nothing to tackle an illness or -- in the case of antibiotics -- worsen the problem of microbial resistance.   According to an investigation by the Paris-based International Institute of Research Against Counterfeit Medicines (IRACM), West African markets are awash with fake drugs made in China and India.

In 2015, the American Society of Tropical Medicine and Hygiene estimated that 122,000 children under five died due to taking poor-quality antimalarial drugs in sub-Saharan Africa.   A 15-nation regional body, the Economic Community of West African States (ECOWAS), last April announced an investigation into the fake drugs business.   A lawyer for the civilian plaintiffs told AFP that the trial in Benin was adjourned until March 6 at their request "in order to incorporate another case, of illegal pharmaceutical practice".
More ...

Sweden

Sweden - US Consular Information Sheet
14th October 2008
COUNTRY DESCRIPTION:
Sweden is a highly developed, stable democracy with a modern economy.
Read the Department of State Background Notes on Sweden for additional information.
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ENTRY/EXIT REQUIREMENTS:
Sweden is a party to the Schengen agreement.
As such, U.S. citizens may enter Sweden for up to 90 days for tourist or business purposes without a visa.
The passport should be valid for at least three months beyond the period of stay.
For further details about travel into and within Schengen countries, please see our Schengen Fact Sheet.
Contact the Swedish Embassy at 901 30th Street, NW, Washington, DC
20007, tel: (202) 467-2600 (mailing address 2900 K Street, N.W., Washington, DC), or the Swedish Consulate General in New York at (212) 583-2550. Visit the Sweden Abroad web site at www.swedenabroad.com for the most current visa information.
Sweden’s immigration authorities (Migrationsverket) also maintain a home page at http://www.migrationsverket.se/english.jsp.

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:
Sweden remains largely free of terrorist incidents.
However, like other countries in the Schengen area, Sweden’s open borders with its Western European neighbors allow the possibility of terrorist groups entering/exiting the country with anonymity.
Americans are reminded to remain vigilant with regard to their personal security and to exercise caution.

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

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

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

CRIME:
Sweden has a low crime rate with rare, but increasing, instances of violent crime.
Most crimes involve the theft of personal property from cars or residences or in public areas. Pickpockets and purse-snatchers are becoming more prevalent. Many American citizens fall victim to these highly skilled thieves, especially at the main train stations in Stockholm and Gothenburg and during bus or train transit to and from airports. Do not put any bags containing valuables, such as your passport, down on the ground. Computer bags are particularly desirable.
Pickpockets and purse-snatchers often work in pairs or groups with one distracting the victim while another grabs valuables.
Often they operate in or near major tourist attractions such as Stockholm’s Old Town, restaurants, amusement parks, museums, bars, buses, long distance trains, subway trains, train and bus stations, and airports.
Hotel breakfast rooms and lobbies attract professional, well-dressed thieves who blend in with guests and target purses and briefcases left unguarded by unsuspecting tourists and business travelers.
Valuables should not be left in parked vehicles.

INFORMATION FOR VICTIMS OF CRIME:
The loss or theft abroad of a U.S. passport should be reported immediately to both 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, contact the nearest U.S. Embassy or Consulate for assistance.
The Embassy/Consulate staff can, for example, assist you in finding appropriate medical care, contacting family members or friends, and explaining how funds can be transferred.
Although the investigation and prosecution of a crime abroad 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.

Sweden has a limited criminal injuries compensation program for victims of violent, personal, and property crime.
Foreign citizens who are victims of crime on Swedish territory are eligible to apply for compensation, but if the victim and offender’s affiliation to Sweden is transitory in nature, compensation may not be awarded even though the crime occurred on Swedish soil.
Application forms in English are available at local police stations and other government agencies as well as on the Internet at
http://www.brottsoffermyndigheten.se/default.asp?id=1345.
Claimants are generally notified of the program’s decision within four months.

The local equivalent to the “911” emergency line in Sweden is 112.
See our information for Victims of Crime.
MEDICAL FACILITIES AND HEALTH INFORMATION:
Medical care is comparable to that found in the United States.
The Swedish medical system is a state-run system, so instead of visiting a local private general practitioner, travelers can visit a local medical center or clinic, called an “Akutmottagning” or “Vardcentral.”
Patients should be prepared to present their passports.
In case of a medical emergency, use the emergency telephone number “112” (see above) to contact the appropriate emergency service.

Travelers with special medical needs should consult with their personal physician and take appropriate precautions, including bringing adequate supplies of necessary medication.
Medicines may be brought into the country as long as they are intended for the traveler’s personal use.
Medications categorized as narcotics may only be brought into the country to cover the traveler's personal use for a maximum of five days and must be accompanied by a medical certificate stating why the traveler needs them.
In addition, stringent Swedish customs regulations prohibit travelers from receiving drugs from abroad after having arrived in the country.
Travelers may also find local physicians reluctant to prescribe equivalent quantities or dosages.
Prescriptions are dispensed at state-run pharmacies called “Apotek” in Swedish.
Most pharmacies are open during normal shopping hours but major cities have a 24-hour pharmacy.

The U.S. Department of State is unaware of any HIV/AIDS entry restrictions for visitors to or foreign residents of Sweden.
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
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 Sweden is provided for general reference only, and may not be totally accurate in a particular location or circumstance.


A valid U.S. driver’s license may be used while visiting Sweden, but drivers must be at least 18 years of age.
Driving in Sweden is on the right.
Road signs use standard international symbols and Swedish text.
Many urban streets have traffic lanes reserved for public transportation only.

Swedish roads are comparable to those in the U.S., though secondary roads may be less heavily traveled.
These secondary routes often narrow to two lanes with a wider shoulder.
Slower vehicles are expected to move onto the shoulder to allow faster moving vehicles to pass.
All vehicles must have headlights lit when on the road, no matter what time of day.
The use of snow tires is mandatory between December 1 and March 31 and, experience in driving on ice and snow is recommended before navigating Sweden’s winter roads.

Public transport in Sweden is of good quality and is the recommended method of travel.
Passenger trains, intercity buses, and plane flights provide regular service over longer distances.
Public transportation in urban centers includes buses, subways, trams, suburban trains, and taxis.
Taxis are more expensive than in major U.S. cities.
Most local residents use public transport in Stockholm as parking can be hard to find and expensive.
The bus, train, and subway systems are relatively safe.

Use of seat belts is mandatory for drivers and all passengers, and children under the age of seven must be seated in approved child or booster seats.
The maximum speed limit is 110 kilometers per hour.
Driving under the influence of alcohol or drugs, including prescription drugs, is considered a very serious offense.
The rules are stringently enforced and fines can be severe.
Violations can result in severe fines and possible jail sentences.

Emergency services for traffic accidents can be reached by calling 112 (the equivalent to 911 in the U.S.).
Please refer to our Road Safety page for more information.
Visit the website of the country’s national tourist office and national authority responsible for road safety at www.visitsweden.se and at http://www.vv.se/templates/page2_2____13172.aspx?epslanguage=EN
AVIATION SAFETY OVERSIGHT:
The U.S. Federal Aviation Administration (FAA) has assessed the Government of Sweden’s Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for oversight of Sweden’s air carrier operations.
For more information, travelers may visit the FAA’s web site at http://www.faa.gov/safety/programs_initiatives/oversight/iasa
SPECIAL CIRCUMSTANCES:
Please see our information on Customs Information and the Swedish web site www.tullverket.se/en for customs information specific to Sweden.
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 Sweden’s laws, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in Sweden are severe, and convicted offenders can expect long jail sentences and heavy fines.
There is no bail system in Sweden and non-resident Americans who are arrested may be held in custody until the trial is complete.
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 Sweden are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department’s travel registration web site, https://travelregistration.state.gov, so that they can obtain updated information on travel and security within Sweden.
Americans without Internet access may register directly with the nearest U.S. Embassy or Consulate.
By registering, American citizens make it easier for the Embassy or Consulate to contact them in case of emergency. The U.S. Embassy is located at
Dag Hammarskjoldsvag 31, telephone: (46) (8) 783-5300, fax:
(46) (8) 783-5480, and after-hours telephone: (46) (8) 783-5310.
The Embassy’s web site is http://stockholm.usembassy.gov/
* * *
This replaces the Consular Information Sheet dated March 4, 2008 to update the sections on Entry Requirements, Information for Victims of Crime and Medical Facilities and Health Information.

Travel News Headlines WORLD NEWS

Date: Sun 1 Dec 2019
Source: Outbreak News Today [edited]

In a follow-up on a previous report on the _Cryptosporidium_ outbreak in Sweden, the Public Health Authority, or Folkhalsomyndigheten, reports more than 300 cases of cryptosporidiosis in October and November [2019].

The good news is while the number of cases is still unusually high, the number of reported cases has decreased.

Adults have been the most affected age group and most cases have been reported from Stockholm, Ostergotland, Halland, Uppsala, Jonkoping, and Vastra Gotaland.

Health officials say of the 140 samples analyzed so far, 73 have been shown to belong to the same subtype (A ) of _Cryptosporidium parvum_. In addition to this subtype, a number of different subtypes have been detected, of which 35 cases with subtype B.

As part of the investigation, cases are interviewed about what they ate and drank before they became ill. The analysis shows that it was much more common among the cases with subtype A to drink pre-purchased freshly pressed fruit and vegetable drinks compared to the cases with subtype B.

Such beverages have not been heat-treated and can, therefore, contain harmful microorganisms. The investigation indicates that it is the spinach in the beverage, delivered in October [2019], which is the source of infection for the cases with subtype A. Since spinach is a fresh product, the contaminated beverage is no longer in store.

However, it is still unknown what the cases with subtype B have been infected with, so far the investigation indicates that it is a different source of infection than for subtype A.
======================
[The case-control investigation confirms that the outbreak is food-related stating that "that it was much more common among the cases with subtype A to drink pre-purchased freshly pressed fruit and vegetable drinks." The source of subtype B still has to be defined. - ProMED Mod.EP]

[HealthMap/ProMED-mail map of Sweden:
Date: Wed 13 Nov 2019
Source: Swedish Public Health Agency [in Swedish, trans. ProMED Mod.EP, edited]

The Public Health Agency of Sweden is investigating an increase in notified cases of infection with _Cryptosporidium_.

During the autumn and in particular during weeks 44 and 45 [28 Oct-8 Nov 2019], an increase in the number of reported cases of cryptosporidiosis, infected in Sweden, was noted. Half of the regions in Sweden have reported cases in all age groups but mostly in adults. Most cases have been seen in the Stockholm region.

The Agency has initiated an outbreak investigation in collaboration with regional authorities and the Swedish Food Agency to identify a possible common source. The investigation will focus on food and water consumption in cases and controls and samples will be analysed by the agency.
=====================
[The graph in the article (see source URL above] shows that approximately 85 cases were recorded in week 45, compared to 20 to 30 cases weekly from week 32 (5-11 Aug 2019]. All cases were infected in Sweden.

Infection with _Cryptosporidium_ spp. is a zoonosis with a natural reservoir in ruminants from which surface water such as in lakes and rivers, is contaminated.

This outbreak is observed in half of the regions in Sweden, which strongly suggests that the infection is foodborne and not related to contaminated drinking water. The concentration of cases in Stockholm most probably reflects the distribution of the population between the regions. - ProMED Mod.EP]

[HealthMap/ProMED-mail map of Sweden:
Date: 10 Oct 2019
Source: Food Safety News [edited]

Livsmedelsverket has warned people to correctly soak and cook dried legumes such as beans, peas and lentils after they were linked to a large food poisoning outbreak at a school.

Dried legumes naturally contain lectins which can cause nausea, vomiting and diarrhea around 1-7 hours after consumption.

Illness occurred in the canteen at lunchtime in early September 2019 at Baldergymnasiet school in Skelleftea, a city in Vasterbotten County. Swedish media reported that almost 280 people were affected, and samples were sent to a laboratory in the United Kingdom.

Sandra Wallstrom, a food inspector at Skelleftea municipality, said it was thought to be the 1st time elevated levels of lectin have been shown to have caused food poisoning in Sweden.

Follow-up checks will be made at the school to ensure the handling of beans and similar foods is safe in the future.

Swedish officials urged people to follow instructions on the packaging and in recipes. They should be soaked for at least 12 hours, rinsed and cooked for at least half an hour. Canned beans are already cooked and can be eaten directly without soaking and boiling.  [Byline: Joe Whitworth]
=======================
["Lectins are proteins selectively binding carbohydrates and, importantly, the carbohydrate moieties of the glycoproteins decorating the surface of most animal [and mammal] cells. They are found in a wide range of vegetables (29 out of 88 tested; [1]). Plant lectins not efficiently degraded by digestive enzymes, and that have an affinity for the surface of gut epithelial cells, such as those present in the Leguminosae family, can be poisonous [2]. Acute symptoms following ingestion include nausea, vomiting and diarrhea.

"Ingestion of the lectins present in certain improperly cooked vegetables [especially beans and lentils] can result in acute gastrointestinal (GI) tract distress, but the mechanism of toxicity is unknown. _In vivo_, gut epithelial cells are constantly exposed to mechanical and other stresses and consequently individual cells frequently experience plasma membrane disruptions. Repair of these cell surface disruptions allows the wounded cell to survive: failure results in necrotic cell death. Plasma membrane repair is mediated, in part, by an exocytotic event that adds a patch of internal membrane to the defect site. Lectins are known to inhibit exocytosis.

"Repair of plasma membrane disruptions and exocytosis of mucus was assessed after treatment of cultured cell models and excised segments of the GI tract with lectins. Plasma membrane disruptions were produced by focal irradiation of individual cells, using a microscope-based laser, or by mechanical abrasion of multiple cells, using a syringe needle. Repair was then assessed by monitoring the cytosolic penetration of dyes incapable of crossing the intact plasma membrane. We found cell surface-bound lectins potently inhibited plasma membrane repair, and the exocytosis of mucus normally accompanies the repair response."

1. Nachbar MS, Oppenheim JD. Lectins in the United States diet: a survey of lectins in commonly consumed foods and a review of the literature. Am J Clin Nutr. 1980;33:2338-2345.
2. Vasconcelos IM, Oliveira JT. Antinutritional properties of plant lectins. Toxicon. 2004;44:385-403.

The full article may be found at:

One note: Be sure to discard the water the lentils or beans were soaked in. Fresh water should be added for cooking the lentils/beans. The taste of soaked vs. unsoaked beans may not vary much, but apparently the effect on the GI tract is much different. - ProMED Mod.TG]

[HealthMap/ProMED map available at:
Date: Wed 25 Sep 2019
Source: Food Safety News [edited]

Authorities in Sweden are investigating a national outbreak of monophasic _Salmonella_ Typhimurium, which has affected almost 40 people.

Folkhalsomyndigheten (Public Health Agency of Sweden) reported that the source of the infections is still unknown. During September [2019], there was an increase in the number of cases of salmonellosis. The outbreak was identified, thanks to Folkhalsomyndigheten's microbial surveillance program. The latest date of illness onset is 6 Sep [2019].

To date, 36 illnesses from 10 counties have been linked by whole-genome sequencing. Most patients live in Vastra Gotaland, Jonkoping, Halland, and Dalarna. Those ill come from all age groups, including children and the elderly. More women, 22, than men, 14, have become ill.

Local authorities, Livsmedelsverket (Swedish Food Agency) and Folkhalsomyndigheten are investigating the outbreak to identify the source of infection that is suspected to be a food widely distributed in Sweden. People are being interviewed about what they ate the week before illness, with the aim of identifying common suspect foods.

The outbreak strain has multilocus variable-number tandem-repeat analysis (MLVA) pattern 3-12-11-N-211.

In 2018, isolates from 864 _Salmonella_ infections were typed; 91% were infected in Sweden, and 18% had been infected abroad. Among cases infected in Sweden, Enteritidis, Typhimurium, and monophasic Typhimurium were the most common serotypes.  [Byline: Joe Whitworth]
==========================
[The source of this outbreak is as yet unknown. By monophasic, it is meant that the organism does not have the complete set of flagellar serotypes. - ProMED Mod.LL]

[HealthMap/ProMED-mail map:
Date: Fri 6 Sep 2019
Source: Rikard Dryselius rikard.dryselius@folkhalsomyndigheten.se
[edited] [re: ProMED-mail Tularemia - Sweden (04): further increase, RFI
http://promedmail.org/post/20190905.6659382]
--------------------------------------------------------------------------------
According to clinical reports, a majority (over 70%) of the reported cases during the ongoing outbreak of tularemia in Sweden appear to have contracted the infection through insect bites, mainly mosquito bites. For about 1/4 of the disease cases no path of infection is indicated, while mainly animal contact and in some cases drinking water is indicated as route of infection for the remaining cases. -- Rikard Dryselius Folkhalsomyndigheten rikard.dryselius@folkhalsomyndigheten.se
=====================
[ProMED thanks Rikard Dryselius for this clinical information. - ProMED Mod.LL]
 
[HealthMap/ProMED-mail map of Sweden: <http://healthmap.org/promed/p/108>]
More ...

Ireland

Ireland US Consular Information Sheet
December 2, 2008
COUNTRY DESCRIPTION:
Ireland is a highly developed democracy with a modern economy. Tourist facilities are widely available.
Read the Department of State Background Notes on Irela
d for additional information.
ENTRY/EXIT REQUIREMENTS:
A passport is necessary, but a visa is not required for tourist or business stays of up to three months.
Visit the Embassy of Ireland web site (www.irelandemb.org/) for the most current visa information, or contact the Embassy at 2234 Massachusetts Avenue, NW, Washington, DC
20008, tel: 1-202-462-3939, or the nearest Irish consulate in Boston, Chicago, New York or San Francisco.

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:
Ireland remains largely free of terrorist incidents.
While the 1998 ceasefire in Northern Ireland is holding, there have been incidents of violence in Northern Ireland associated with paramilitary organizations.
These have the potential for some spillover into Ireland.
Travelers to Northern Ireland should consult the Country Specific Information sheet for the United Kingdom and Gibraltar.

Several Americans have reported incidents of verbal abuse, apparently in reaction to U.S. policy on the war on terrorism.
As elsewhere in Europe, there have been public protests, which for the most part were small, peaceful and well policed.
Americans are advised, nonetheless, to avoid public demonstrations in general and to monitor local media when protests occur.
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 United States and Canada, or for callers outside the United States and Canada, a regular toll line at 1-202-501-4444.
These numbers are available from 8:00 a.m. to 8:00 p.m. Eastern Time, Monday through Friday (except U.S. federal holidays).

The Department of State urges American citizens to take responsibility for their own personal security while traveling overseas.
For general information about appropriate measures travelers can take to protect themselves in an overseas environment, see the Department of State’s A Safe Trip Abroad.
CRIME:
Ireland has a low rate of violent crime.
There have been a limited number of incidents in which foreigners and tourists have been victims of assault, including instances of violence toward those who appear to be members of racial minority groups.
In addition, there have been several reported assaults in Dublin by small, unorganized gangs roaming the streets in the early morning hours after the pubs close.
There is a high incidence of petty crime – mostly theft, burglary and purse snatching – in major tourist areas.
Thieves target rental cars and tourists, particularly in the vicinity of tourist attractions, and some purse and bag snatching incidents in these areas have turned violent, especially in Dublin.
Travelers should take extra caution to safeguard passports and wallets from pickpockets and bag snatchers.

Crimes involving credit and debit cards and automated teller machines (ATMs) are also a concern.
Travelers should protect their PIN numbers at all times and avoid using ATM machines that appear to have been tampered with.
There has been an increase in Ireland of the use of “skimmers” on ATM machines, especially in tourist areas.
Skimmers are usually small electronic devices that are attached to the outside of an ATM machine in order to “skim” the ATM or credit card data for later criminal use.
Most ATMs in Ireland now have electronic warnings about their use and advise customers to look closely at the ATM before using it.


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 in Ireland, in addition to reporting to local police (Gardai), please contact the U.S. Embassy in Dublin for assistance.
The Embassy staff can, for example, assist you in finding appropriate medical care, contacting family members or friends, and learning how funds can be transferred.
Although the investigation and prosecution of the crime are solely the responsibility of local authorities, consular officers can help you to understand the local criminal justice process and to find an attorney if needed.
The Irish Tourist Assistance Service (ITAS) is a free nationwide service offering support and assistance to tourists who are victimized while visiting Ireland. If you are a tourist victim of crime, report the incident to the nearest Garda Station (police station), which will contact ITAS.
All tourist victims of crime are referred to ITAS by the Gardai. To learn about possible compensation in the United States if you are a victim of a violent crime while overseas, see our information on Victims of Crime
The local equivalent to the “911” emergency line in Ireland is 999 or 122.
MEDICAL FACILITIES AND HEALTH INFORMATION:
Modern medical facilities and highly skilled medical practitioners are available in Ireland.
Because of high demand, however, access to medical specialists can be difficult and admissions to hospitals for certain non-life-threatening medical conditions may require spending significant periods of time on waiting lists.
Those traveling to or intending to reside in Ireland who may require medical treatment while in the country should consult with their personal physicians prior to traveling.
Over-the-counter medication is widely available.
Irish pharmacists may not be able to dispense medication prescribed by your U.S. physician and may direct you to obtain a prescription from an Irish doctor before providing you with your required medication.
A list of Irish general practitioners in each area of Ireland may be obtained from the web site of the Irish College of General Practitioners at http://www.icgp.ie/go/find_a_gp. Emergency services usually respond quickly.
The U.S. Department of State is unaware of any HIV/AIDS entry restrictions for visitors to or foreign residents of Ireland.

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’s) web site at http://www.who.int/en.
Further health information for travelers is available at http://www.who.int/ith/en.
FOOT AND MOUTH DISEASE: The Irish Department of Agriculture and Food advises all incoming passengers to Ireland that the current foot and mouth situation in Great Britain represents a high risk of the spread of disease to Ireland.
If you are traveling from Great Britain to Ireland and have visited a farm with cattle, sheep, goats or pigs on your travels, you must report to the Irish Department of Agriculture and Food office at the port of entry.
Fresh meat or unpasteurized milk products purchased in Great Britain may not be brought into Ireland.
If you are carrying any of these products, they must be disposed of in the bins provided at the port of entry.
For further information, please visit the Irish Department of Agriculture, Fisheries and Food at www.agriculture.gov.ie.
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 following information concerning Ireland is provided for general reference only and may not be totally accurate in a particular location or circumstance.
As driving is on the left side of the road in Ireland, motorists without experience in left-drive countries should be especially cautious.
Tourists driving on the wrong side of the road are the cause of several serious accidents each year.
Turning on red is not legal in Ireland.
The vast majority of rental cars are manual transmission; it can be difficult to find automatic transmission rental cars.
Road conditions are generally good, but once travelers are off main highways, country roads quickly become narrow, uneven and winding.
Roads are more dangerous during the summer and on holiday weekends due to an increase in traffic. As in the United States, police periodically set up road blocks to check for drunk drivers.
Penalties for driving under the influence can be severe.
More information on driving in Ireland can be found on the U.S. Embassy in Dublin‘s web site at http://dublin.usembassy.gov/service/other-citizen-services/other-citizen-services/driving.html.

For specific information concerning Irish driving permits, vehicle inspection, road tax and mandatory insurance, please visit the official tourism guide for Ireland at http://www.tourismireland.com.

Taxis are reasonably priced but availability varies with time of day and where you are in the country.
Bus service in the cities is generally adequate, although many buses are overcrowded and frequently late.
Intercity bus and train services are reasonably good.

AVIATION SAFETY OVERSIGHT:
The U.S. Federal Aviation Administration (FAA) has assessed the Government of Ireland’s Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for oversight of Ireland’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:
Most Irish banks will not accept U.S. $100 bills.
ATMs are widely available, but some, particularly in rural areas, may not accept cards from U.S. banks.
Credit cards are widely accepted throughout Ireland.
A number of travelers have been told by their airline that their passport must remain valid for six months after their entry into Ireland.
The Government of Ireland has advised that this is a recommendation of the airline industry and is not an Irish legal requirement. Travelers must be in possession of a valid passport to travel.
Please see 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 Ireland’s laws, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession, use or trafficking in illegal drugs in Ireland 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 Ireland 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 Ireland.
Americans without Internet access may register directly with the Embassy in Dublin.
By registering, American citizens make it easier for the Embassy to contact them in case of emergency.
The U.S. Embassy is located at 42 Elgin Road, Ballsbridge, Dublin 4.
The Embassy can be reached via phone at 353-1-668-8777, after hours number 353-1-668-9612, fax 353-1-668-8056, and online at http://dublin.usembassy.gov
*

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This replaces the Country Specific Information for Ireland dated May 12, 2008, and updates sections on Information for Victims of Crime, Medical Facilities and Health Information, and Special Circumstances.

Travel News Headlines WORLD NEWS

Date: Thu 10 Oct 2019
Source: Vax-Before-Travel [edited]

The Health Protection Surveillance Centre in Ireland reported an increase in typhoid fever notifications in travellers returning from Pakistan [<http://ndsc.newsweaver.ie/epiinsight/1npbbpsg5wm>]. According to the Irish authorities on [9 Oct 2019], there have been 23 cases of _Salmonella enterica_ serovar Typhi (_S._ Typhi) in 2019. This is the 1st time that cases of XDR typhoid fever have been identified by the national reference laboratory in Ireland.

The European Centre for Disease Prevention and Control (ECDC) reported 12 of these cases had a recent travel history to Pakistan [see item [2] below]. Unfortunately, 3 of these 12 cases of typhoid fever with travel history in Pakistan were infected with extensively drug-resistant (XDR) strains.

According to the WHO/EMRO bulletin, Pakistan is experiencing a continuous surge of XDR _S._ Typhi since 2016. As of August 2019, 10 365 cases of XDR typhoid fever were reported from 23 districts in Sindh province, with the Karachi district being the most affected, having 67 percent of the cases. Pakistan is the world's 6th-most populous country with a population exceeding 210 million people, located in South Asia.

The XDR _S._ Typhi strain acquired a plasmid that confers resistance to multiple antibiotics, including the 1st-line antibiotics chloramphenicol, ampicillin, and trimethoprim-sulfamethoxazole, as well as fluoroquinolones and 3rd-generation cephalosporins, says the ECDC. The strain remained susceptible to azithromycin and carbapenems. The increased resistance in typhoid fever limits treatment options and poses a threat to international spread.

In response, the US Centers for Disease Control and Prevention (CDC) issued a Level 1 Travel Alert regarding traveling to Pakistan in 2019 [<https://wwwnc.cdc.gov/travel/notices/watch/xdr-typhoid-fever-pakistan>]. This 'Practice Usual Precautions' Travel Alert published on [30 Sep 2019], is very important since, in rare cases, typhoid fever can be fatal.

According to the Pakistan Tourism Development Corporation, about 1.75 million tourists visited Pakistan in 2017 alone.

The CDC says 'if you are going to South Asia, including Pakistan, protect yourself against typhoid infection by getting a typhoid fever vaccination.' The CDC's Advisory Committee on Immunization Practices (ACIP) recommends 2 typhoid fever vaccines, an oral vaccine, Vivotif, and an injectable vaccine, Typhim VI. The oral vaccine Vivotif is approved for people 6 years of age or older and should be taken as directed, at least one week before departure. The injectable vaccine is approved for people 2 years of age or older. Travelers should receive the injectable vaccine Typhim VI at least 2 weeks before departure. Neither vaccine is 100 percent effective, so travellers should also practice safe eating and drinking while traveling abroad, says the ACIP.

Typhoid fever is a serious disease caused by the bacterium _Salmonella_ Typhi, spread by contaminated food and water. Humans are the only source of these bacteria. The incubation period of typhoid and paratyphoid infections is 6-30 days, says the CDC. Symptoms of typhoid fever often include high fever, weakness, stomach pain, headache, cough, and loss of appetite. People may have diarrhoea or constipation.

If you travel abroad and get sick while traveling, seek medical care ASAP. If you get sick after returning to the United States, seek medical care and tell your health care provider where and when you traveled. Do not prepare food for other people, says the CDC.

An estimated 26 million cases of typhoid fever and 5 million cases of paratyphoid fever occur worldwide each year, causing 215,000 deaths.

Also, the CDC says to ensure you are up-to-date on several vaccinations before visiting Pakistan. These vaccines and related medications can be found at most travel pharmacies in the USA.

Travel Alert news is published by Vax-Before-Travel
Date: Sun 8 Sep 2019
Source: Irish Mirror [abridged, edited]

A TD [member of the Irish Parliament] has warned of "serious repercussions" after it was revealed the child vaccination uptake has dropped into the World Health Organisation (WHO) red zone. Statistics from the Health Protection Surveillance Centre show up to 25% of infants and toddlers are not receiving shots in parts of Ireland.

Sinn Fein spokeswoman Louise O'Reilly said: "We need to get past all the misinformation on social media and the anti-vaxxers and talk to parents face to face."

Fears are growing that highly contagious diseases such as measles could run rampant again, with experts warning of a possible epidemic.

Officials from the European Centre for Disease Prevention and Control have recorded 10,958 cases of the illness -- which can prove fatal -- across the continent from January to [14 Jul] this year [2019]. It is the worst performance in over a decade and the 1st time the country has been in the range since the anti-vax movement began.

EU countries worst affected are France, Bulgaria, Italy, Poland and Lithuania -- but the slump in Ireland means we could soon be facing an epidemic of our own. The number of measles cases reported tripled last year [2018] with 77 cases -- up from just 25 in 2017.  [Byline: Ailbhe Daly]
Date: Fri 17 May 2019 16:33 IST
Source: Breaking News Irish Examiner Reporter [abridged, edited]

There have been 58 reports of measles recorded so far this year [2019], according to the HSE's [Health Service Executive] Health Protection Surveillance Centre [HPSC].

Another 2 cases were reported to the HPSC in the past week -- one from the Eastern Regional Health Authority and the other from the Southern Health Board. The 2 people affected were both female and aged between 15 and 34 years.

The HSE's assistant national director of health protection, Dr Keven Kelleher, has warned that cases of measles are set to rise over the summer [2019].

There has been an increase in measles, an acute viral disease, throughout the world and cases are spreading because people are travelling more.

Dr Kelleher said measles is very active throughout southern Europe.

Current vaccination rates are not good enough currently, with take-up rates up to 8% below what they should in some parts of the country.  [Byline: Evelyn Ring]
========================
[HealthMap/ProMED-mail map of Ireland:
Date: Wed 17 Apr 2019
Source: Leitrim Observer [abridged, edited]

The HSE [Ireland's national health service] says it "had not seen diseases like measles in Donegal, Sligo or Leitrim for a number of years, because 95% of children were vaccinated against them. Last year [2018], the uptake of childhood vaccinations dropped slightly in Donegal, and this resulted in an outbreak of measles in January this year [2019]."

The HSE says "There is also an ongoing mumps outbreak across Donegal, Sligo and Leitrim. The HSE has been notified of 116 cases so far.

"As soon as vaccination rates fall, diseases like measles and mumps return. Fortunately, the majority of people in Donegal, Sligo and Leitrim are protecting their children with vaccination. The most recent figures for 2018 show that 90% of children in Donegal received the MMR and 93% of children in Sligo and Leitrim received it.

"However, over 95% of children need to be vaccinated with the MMR in order to prevent the spread of measles in our community. This is the goal for 2019, as it is really important for 'herd immunity'. In this way, we can protect new-borns and vulnerable children, including those with cancer or immune problems who can't get vaccinated, from coming in contact with measles and other diseases like meningitis."

This year [2019] European Immunisation Week runs 24-30 Apr. The goal is to raise awareness of the benefits of vaccination and to celebrate the vaccine heroes who contribute to protecting lives through vaccination. Vaccine heroes include health workers who administer vaccines, parents who choose vaccination for their children, and everyone who promotes vaccination.

"Every parent wants to protect their child and do what's right for them. Sometimes it can be difficult to know what to do, now that there is so much false and misleading information on the internet and social media when it comes to vaccination," says Dr. Laura Heavey, Specialist Registrar in Public Health Medicine in HSE North West, "I would really encourage parents to look for information in the right places. Two good sources of reliable, evidence-based information are <www.immunisation.ie> and the Vaccine Knowledge Project at <http://vk.ovg.ox.ac.uk/>. Essentially all of the vaccines on the infant, child and adolescent schedule in Ireland are backed up with years of data on their safety."

Another goal for the HSE in 2019 is to continue to increase the uptake of the HPV vaccine in teenagers. In 2018, 70% of teenage girls in Ireland got the vaccine. In Scotland, where HPV vaccination started over 10 years ago and 90% of teenage girls get the HPV vaccine, researchers have found that the vaccine has nearly wiped out cases of cervical pre-cancer in young women. We want to see as many Irish teenagers as possible getting vaccinated in 2019, so that we can see those same results here. This year [2019], the vaccine will also be offered to teenage boys. If all our young people receive the vaccine, cervical cancer could be eliminated in Ireland in the future.
========================
[HealthMap/ProMED-mail map of Ireland:
Date: Wed 27 Feb 2019
Source: The Times [abridged, edited]

A total of 384 cases mumps have been reported this year [2019] from Irish Universities, HSE figures have shown.

There were 64 new cases reported last week, bringing the total to 384 since the start of the year [2019]. The number of cases has been rising steadily in recent weeks, with 278 in the 1st 6 weeks of the year. Last year [2018] there had been 52 cases by the end of February. There were 576 cases in total last year [2018].  [Byline : Catherine Sanz]
===================
[Also see ProMED-mail Mumps update (02): USA (CO, TX), Europe (Ireland) http://promedmail.org/post/20190221.6329434 for more on the outbreak in Ireland. - ProMED Mod.LK]

["Before the U.S. mumps vaccination program started in 1967, about 186,000 cases were reported each year, but the actual number of cases was likely much higher due to underreporting. Since the pre-vaccine era, there has been a more than 99% decrease in mumps cases in the United States. Since the 2-dose vaccination program was introduced in 1989, mumps cases have ranged year to year from a couple of hundred to several thousand.

However, in recent years, there has been an increase in the number of reported cases, from 229 cases in 2012 to 6366 cases in 2016. The recent increase has been mainly due to multiple mumps outbreaks reported across the country in settings where people often have close contact with one another, like college campuses." CDC (<https://www.cdc.gov/mumps/outbreaks.html>). - ProMED Mod.LK]
More ...

Ghana

Ghana US Consular Information Sheet
23rd September 2008
DESCRIPTION:
Ghana is a developing country on the West Coast of Africa. The capital is Accra. Facilities for tourism are available in the population centers of the greater Accra regio
, Kumasi in the Ashanti region, and in the Cape Coast area of the Central region, but they are limited in the more remote areas of the country. Read the Department of State Background Notes on Ghana for additional information.
ENTRY/EXIT REQUIREMENTS:
A passport and visa are required, as is evidence of a yellow fever vaccination. Travelers should obtain the latest information and details from the Embassy of Ghana, 3512 International Drive NW, Washington, DC
20008; telephone (202) 686-4520. Consular services are also available at the Ghana Permanent Mission to the UN at 19 East 47th Street, New York, NY
10017, telephone (212) 832-1300, and the Honorary Consulate of Ghana, 3434 Locke Lane, Houston, TX, telephone (713) 960-8806. Overseas, inquiries should be made at the nearest Ghanaian embassy or consulate. Visit the Embassy of Ghana web site at www.ghanaembassy.org for the most current visa information.
Information about dual nationality or the prevention of international child abduction can be found on our web site.
For further information about customs regulations, please read our Customs Information sheet.
SAFETY AND SECURITY:
Due to the potential for violence, U.S. citizens should avoid political rallies and street demonstrations and maintain security awareness at all times. There will be frequent political rallies across Ghana in the run-up to the presidential and parliamentary elections on December 7, 2008.

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 other callers, 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:
Pick-pocketing, purse snatching, and various types of scams are the most common forms of crime confronting visitors. U.S. travelers have reported these types of theft at crowded markets, beaches, parks, and tourist attractions. Incidences of violent crime, such as armed robbery, are on the rise, including reports of armed robberies in expatriate residential areas. Victims who resist attackers run a high risk of serious physical injury. Take security measures, such as traveling in groups and avoiding travel at night. Avoid travel in communal taxis. Travelers who limit their display of jewelry and handle their cash discreetly reduce their vulnerability to crime. Travelers are advised to carry limited amounts of cash and only photocopies of key documents.

Use of credit cards in Ghana should be avoided if possible, as a growing number of travelers have been victims of credit card fraud.

In recent years, U.S. citizens have reported substantial financial losses from questionable transactions involving gold and other precious metals. The Government of Ghana maintains strict regulations on these natural resources. All agents must be licensed and all transactions must be certified. (See Special Circumstances below).

Perpetrators of business fraud often target foreigners, including Americans. Such fraud schemes are now prevalent throughout West Africa, including Ghana.
Please refer to the Country Commercial Guide for Ghana at http://www.buyusa.gov/ghana/en/doing_business_in_ghana.html, for further information.

American citizens frequently consult the Embassy regarding questionable business offers sent by people in Ghana. These are scams and typically begin with an unsolicited communication (usually by e-mail) from an unknown individual who describes a situation that promises quick financial gain, often by assisting in the transfer of a large sum of money or valuables out of the country.
A series of “advance fees” must be paid in order to conclude the transaction, such as fees to open a bank account or to pay certain taxes.
In fact, the final payoff does not exist; the purpose of the scams is simply to collect money from the victim.
The Embassy has also received reports of fraudulent charities soliciting contributions through the Internet or direct mail. If you receive such business offers or charity requests, carefully check them out before you commit any funds, provide any goods or services, or undertake any travel. Check with the U.S. Embassy in Ghana at telephone (233-21) 741-100 for an assessment of the offer’s credibility.

Another type of fraud is committed by persons claiming to live in Ghana or who claim to be traveling to Ghana on business, and who profess friendship or romantic interest over the Internet. Once a relationship has been established, the correspondent typically asks the American to send money for living expenses, travel expenses, or visa costs. Sometimes a “hospital” or “doctor” telephones to say that the friend has suffered an “accident” and needs immediate financial assistance to cover medical bills. There are other variations of this scam, but the common goal is to fraudulently obtain as much money as possible from the victim.
Americans have reported losing thousands of dollars through such scams. The anonymity of the Internet means that the victim cannot be sure of the real name, age, marital status, nationality, or even gender of the correspondent. In most cases reported to the Embassy, the correspondent turned out to be a fictitious persona created to lure Americans into sending money.

Visitors to Ghana should also be wary of overly-friendly locals offering tours, discounted lodging or other services that seem too good to be true.
Tourists are often targeted by touts and scam artists.
Some Americans have been the victims of false criminal accusations and have found themselves separated from time, money and trust as they seek to resolve these difficult situations.

For additional information, please see the Department of State brochure International Financial Scams.

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.
Ghana maintains a specialized Domestic Violence Victim Support Unit (DOVVSU) within the Ghana Police Service to assist victims of domestic violence, especially women and children. In addition to its law enforcement responsibilities, the Unit can refer victims to medical providers and counselors, as well as to community support services. Further information is available by following the DOVVSU link at www.ghanapolice.org
The local equivalent to the “911” emergency line in Ghana is: 191
See our information on Victims of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION:
Medical facilities in Ghana are limited, particularly outside Accra, the capital. Travelers should carry adequate supplies of any needed prescription medicines, along with copies of their prescriptions, the generic name of the drugs, and a supply of preferred over-the-counter medications. For information on avian influenza (bird flu), please refer to the Department of State's Avian Influenza Fact Sheet.
Documentation of Yellow fever vaccination is required upon arrival from all countries.
There are no HIV/AIDS entry restrictions for visitors to or foreign residents of Ghana.

Motor vehicle accidents, drownings and water-related accidents due to Ghana’s rough surf, muggings and other violent attacks, and the development of sexually transmitted diseases—including HIV—are
health and safety concerns that have been reported by U.S. citizens and can be at least partially mitigated by using common-sense safety precautions.

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 Ghana is provided for general reference only, and may not be totally accurate in a particular location or circumstance.
Primary roads are generally paved and well maintained. However, some side roads within major cities and roads outside of major cities are in poor condition. The road from Accra to the central region tourist area of Cape Coast continues to be the site of many accidents. Travel in darkness, particularly outside the major cities, is extremely hazardous, due to poor street lighting and the unpredictable behavior of pedestrians, bicyclists and farm animals, particularly goats and sheep. Aggressive drivers, poorly maintained vehicles and overloaded vehicles pose serious threats to road safety.

The safety standards of the small private buses that transit roads and highways are uncertain. Travelers are encouraged to consider this when making travel arrangements.

Travelers are routinely stopped at police checkpoints throughout Ghana, and vehicles and passengers may be searched. Drivers must possess an international driver’s license (available from AAA and the American Automobile Touring Alliance). Foreign nationals should carry documentation of their status, such as a passport and visa.

Please refer to our Road Safety page for more information. Visit the website of Ghana’s national tourist office at http://www.touringghana.com/default.asp and the national authority responsible for road safety at http://www.mrt.gov.gh/
AVIATION SAFETY OVERSIGHT:
The U.S. Federal Aviation Administration (FAA) has assessed the Government of Ghana’s Civil Aviation Authority as not being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for the oversight of Ghana’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.

Service provided by a number of regional air carriers is reported to be unreliable. The airlines may alter scheduled stops, cancel or postpone flights on short notice, and regularly overbook flights. Travelers may experience unexpected delays even after checking in. Passengers should get the required seat reconfirmation stamped on the ticket, have enough emergency funds for food and lodging in case of unexpected delays, and arrive at the airport at least two hours before the scheduled departure time.

SPECIAL CIRCUMSTANCES:
Effective July 1, 2007, the Government of Ghana redenominated the local currency, the cedi, introducing new banknotes (Ghana Cedi) and coins (Ghana Pesewa). 10,000 cedis = 1 Ghana Cedi = 100 Ghana Pesewas. The old cedi was taken out of circulation on December 31, 2007, and as of January 1, 2008, can be converted only at commercial banks or the Bank of Ghana. Travelers should be alert to persons who may try to defraud them with the old and new bills. The Government of Ghana established a web site in 2007, www.ghanacedi.gov.gh, to inform the public about the redenomination exercise. The web site includes a useful currency converter.

Visitors arriving or departing Ghana with more than $5,000 in cash are required to declare the amount at the border. Currency exchange is available at most banks and at licensed foreign exchange bureaus, but currency transactions with private citizens are illegal. The Government of Ghana also prohibits departing travelers from carrying more than 5,000,000 cedis (500 Ghana Cedis) out of the country. Ghanaian currency must either be spent or exchanged before departure, or it will be confiscated.

Strict customs regulations govern temporary importation into or export from Ghana of items such as gold, diamonds and precious natural resources. Only agents licensed by the Precious Metals and Mining Commission, telephone (233-21) 664-635 or 664-579, may handle import-export transactions of these natural resources. Any transaction without the commission’s endorsement is illegal and/or fraudulent. All transactions must be completed through the commission at the price set daily by the London exchange. Any transaction that discounts this price, or includes a previously negotiated price, is either illegal or fraudulent. Export of gold dust is rare as it encourages dangerous and environmentally destructive practices, and transactions involving the export of gold dust are probably fraudulent. Attempts to evade regulations are punishable by imprisonment. It is advisable to contact the Embassy of Ghana in Washington, DC, or one of the Ghanaian consulates in the United States, for specific information regarding customs requirements.

In rare instances, visitors arriving in Ghana with sophisticated electronic equipment (video cameras and laptop computers) may have to deposit 17.5 per cent of the item's value with the Customs and Excise office at the airport. To get the deposit refunded, visitors must apply to the Customs and Excise Office in central Accra 48 hours before departure.

Taking pictures near sensitive installations, including military sites and some government buildings, is prohibited. These sites are not always clearly marked and application of these restrictions is subject to interpretation. Permission may be obtained from Ghanaian security personnel. Permission should also be obtained before photographing anyone in uniform (e.g., police officers and military officers). In some cases, film and cameras have been confiscated. For security reasons, taking photographs of the U.S. Embassy is also prohibited.

It is strictly prohibited to wear any military apparel such as camouflage jackets or trousers, or any clothing or items that may appear military in nature.

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 Ghana laws, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in Ghana 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 Ghana 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 Ghana. Americans without Internet access may register directly with the nearest U.S. Embassy or Consulate. By registering, American citizens make it easier for the Embassy or Consulate to contact them in case of emergency. The U.S. Embassy is located at No. 24 Fourth Circular Road, Cantonments, Accra; telephone (233-21)741-000. The public entrance to the Consular Section is No. 19 Fifth Link Road, Cantonments, Accra; telephone (233-21) 741-100; fax (233-21) 741-362 or 741-426; after-hours (233-21) 741-775.
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This replaces the Country Specific Information for Ghana dated February 21, 2008, to update sections on safety and security, crime, information for victims of crime, and medical facilities and health information.

Travel News Headlines WORLD NEWS

Date: Fri, 18 Oct 2019 15:43:29 +0200 (METDST)

Accra, Oct 18, 2019 (AFP) - Floods caused by eight days of torrential downpours in north-eastern Ghana have left 28 people dead and displaced hundreds, officials said Friday.     "At the moment the death toll is 28. About 640 people in some six communities have been displaced and we are providing shelters for them," George Ayisi, spokesman for the National Disaster Management Organisation, told AFP.    "We've counted about 286 collapsed houses during this disaster and that is making life difficult for the people."

Relief items were being transported 800 kilometres (500 miles) by road from the capital Accra to the affected region on the border with Burkina Faso as meteorologists warned the rains could last into November.    "We have to just prepare for anything," Ayisi said.   So far this year 46 people have been killed in floods in the West African nation, the disaster relief agency said.   Flooding in northern and other parts of Ghana happens each year during the rainy season.    Last year, 34 people died in northern Ghana during flooding caused by heavy rains and waters spilling from a dam in Burkina Faso.
Date:   August 30th 2019
Received from HPSC (Ireland)
HPSC website: https://www.hpsc.ie/a-z/vaccinepreventable/polio/

HPSC has received an alert through IHR regarding a recent case of cVDPV2 in a 2 year old female in Ghana who presented with AFP. Hence the cVDPV2 outbreak originating in Jigawa state, Nigeria, continues to spread in West Africa.  Given cross-border population movements with Nigeria and across West Africa, subnational immunity and surveillance gaps, Ghana is considered at high-risk for further transmission of the isolated cVDPV2. In Ghana, the last wild poliovirus was reported in 2008 and this is the first ever cVDPV2 outbreak reported in the country.  [Authorities in] G

WHO’s International Travel and Health recommends that all travellers to polio-affected areas be fully vaccinated against polio. Residents (and visitors for more than 4 weeks) from infected areas should receive an additional dose of OPV or inactivated polio vaccine (IPV) within 4 weeks to 12 months of travel.

cVDPV2 outbreak originating in Jigawa state, Nigeria, continues to spread in West Africa.  In Ghana, cVDPV2 was isolated from an acute flaccid paralysis (AFP) case in Ando-Nyamanu, Chereponi district, Northern Region, bordering Togo.  The case is a two-year and eight-month old girl who had onset of paralysis on 27 July 2019. Stool samples were taken on 27 and 28 July 2019 and were sent to the National Polio Laboratory at Noguchi Memorial Institute for Medical Research for laboratory investigations. The sample tested positive for cVDPV2 as per result received on 17 August 2019.   The sequencing information of the AFP case revealed 25 nucleotide differences compared to the reference Sabin 2 and 6 nucleotides with the closest matching sequence of the AFP case from Kwara State of Nigeria in 2018. Earlier, a related cVDPV2 had been isolated from an environmental sample, collected on 11 June 2019, from Northern Region in Ghana.  Both isolated viruses are linked to an outbreak originating in Jigawa, Nigeria, in 2018.  This same strain has already spread within Nigeria, and internationally to the Republic of Niger, Benin and Cameroon.

On 25 August 2019, the Polio Laboratory reported the isolation of polio virus type 2 in an environmental surveillance (ES) site at Agbogbloshie in Accra, Greater Accra Region, from routine surveillance. This was confirmed as cVDPV2 on 26 August.

Public health response
The Ministry of Health has declared detection of this virus to be a national public health emergency, in line with temporary recommendations issued by the International Health Regulations Emergency Committee regarding the international spread of poliovirus. The Ministry of Health and its Partners are working tirelessly to contain the situation and to prevent the spread of the disease.

An emergency meeting with key stakeholders and partners of the Global Polio Eradication Initiative (GPEI) was held on the 19 August 2019, to discuss response measures in response to this, the Ministry of Health / Ghana Health Service has taken these immediate actions:

1. A national team made up of the Ghana Health Service and the WHO has been deployed to support the regional and district teams carry out detailed investigations and response measures
2. A full epidemiological and field investigation is ongoing, active surveillance is being strengthened, subnational population immunity levels are being analysed and outbreak response actions are being planned
3. Areas at risk are mapped conduction of reactive vaccination campaign in the affected and adjoining high risk districts and planned following approval from the Polio Advisory Group for monovalent Oral Polio Vaccine Type 2 (mOPV2)

WHO risk assessment
Given cross-border population movements with Nigeria and across West Africa, subnational immunity and surveillance gaps, Ghana is considered at high-risk for further transmission of the isolated cVDPV2.  As the current detected case is in a district sharing international land border with Togo where there is a very low population immunity against type 2 poliovirus (IPV coverage of 20% in 2018), there is an increased risk of further international spread of this outbreak. As this outbreak, originating in Jigawa Nigeria has already spread to Niger, Cameroon and Benin the risk of further international spread across West Africa associated with this virus, remains high.
WHO advice
It is important that all countries, in particular those with frequent travel and contacts with polio-affected countries and areas, strengthen surveillance for AFP cases in order to rapidly detect any new virus importation and to facilitate a rapid response. Countries, territories and areas should also maintain uniformly high routine immunization coverage at the district level to minimize the consequences of any new virus introduction.
As per the advice of an Emergency Committee convened under the International Health Regulations (2005), efforts to limit the international spread of poliovirus remains a Public Health Emergency of International Concern (PHEIC).  Countries affected by poliovirus transmission is subject to Temporary Recommendations.  To comply with the Temporary Recommendations issued under the PHEIC, any country infected by poliovirus should declare the outbreak as a national public health emergency and consider vaccination of all international travellers.

Further Information:
Polio is a highly infectious disease and can cause permanent paralysis or death. The risk of paralytic polio due to exposure to cVDPV2 remains high due to the low population immunity against polio type-2 virus, after the global switch from trivalent oral poliovirus vaccine (tOPV) to bivalent OPV (bOPV). The national immunization coverage for Inactivated Poliovirus Vaccine (IPV) in Ghana was 55% for 2018 (WHO/UNICEF estimation). Poliovirus is a pathogen slated for global eradication. In July 2019, cVDPV2 has been confirmed in Ghana in an environmental sample and the last wild poliovirus was reported in 2008. Any detected Poliovirus subtype either in humans or the environment after the global synchronized withdrawal of tOPV in April 2016 is unusual and unexpected and remains to be of a huge cause of concern.  Poliovirus spreads easily and across large distances. There is evidence of genetic linkage of polio virus isolated from Ghana with polio viruses originating in, Nigeria which has already spread to Niger, Cameroon and Benin. The Chereponi district from where the case is reported also shares an international border with Togo that has low population immunity to type 2 Polio (IPV coverage was 20% for 2018). The risk of further spread to Togo cannot be ruled out.

WHO does not recommend any restriction on travel and/or trade to Ghana based on the information available for the current polio outbreak.
https://www.hpsc.ie/a-z/vaccinepreventable/polio/
Date: Tue, 30 Apr 2019 16:30:41 +0200
By Stacey KNOTT

Cape Coast, Ghana, April 30, 2019 (AFP) - Ghana on Tuesday rolled out the world's only proven malaria vaccine for infants as part of a landmark campaign against the deadly mosquito-borne disease, one week after Malawi became the first country to do so.   Malaria kills hundreds of thousands of people each year, mainly in Africa, and it is hoped a vaccine will bring down the toll.    Children are especially at risk, and babies were Ghana's first vaccine recipients Tuesday in the town of Cape Coast, 150 kilometres (90 miles) west of the capital Accra.   "I hope this will help us to be able to eliminate malaria, so Ghana can be a malaria-free country," said Justice Arthur, the doctor running the clinic.

The vaccines will be given to children between the ages of six months and two years, in a project run by Ghana's health ministry and the World Health Organization (WHO).   "I am really hopeful that the vaccine is going to help me and my family," said Abigail Aguanyi, a woman waiting to get her child, Blessing, vaccinated. Many of her family members had previously been stricken.   The vaccine, known by its lab initials RTS,S, has passed lengthy scientific trials which found it to be safe and effective at preventing about four in ten cases of malaria in infants -- the best ever recorded.   To achieve this level of partial protection, four successive doses must be administered on a strict timetable -- a challenge for rural Africa.

- 'Exciting' -
The rollout in Ghana, Malawi, and soon also Kenya, will seek to evaluate the vaccine's effectiveness as a complementary tool, augmenting -- but not replacing -- measures such as insecticide-treated bed nets and the use of sprays.   It will also test the feasibility of administering the four required doses in children in areas of the world with limited access to healthcare.   Data from the programme will inform a WHO policy on the broader use of RTS,S.   Malaria is spread to people by mosquitoes, which transfer the parasite while sucking blood from humans. RTS,S is effective against the Plasmodium falciparum parasite most prevalent in Africa.   In Ghana alone, there were 5.5 million confirmed cases of malaria last year, and many more suspected.

Worldwide, the WHO says malaria killed 435,000 people worldwide in 2017.    The number of cases climbed to 219 million in 2017, two million more than in 2016. Over 90 percent of cases occurred in Africa.   "This is an exciting and long-awaited step forward to fight malaria and its devastating effects on the most vulnerable," said WHO boss in Ghana, Owen Kaluwa.
Date: Sat 3 Nov 2018
Source: Ghana Web [edited]
<https://www.ghanaweb.com/GhanaHomePage/health/Doctors-announce-Apollo-outbreak-in-Tamale-697640>

A new surge of the contagious viral eye disease known [locally] as "apollo" or haemorrhagic conjunctivitis has been confirmed by doctors at the Tamale Central Hospital in the northern regional capital. Apollo is an infection caused by the Coxsackie virus and presents with painful swollen red eyes, purulent discharges and headache, and affects the lining of the eyelids and eyeball. It usually affects both eyes but may affect one eye and later spread to the other. The disease affects people of all ages, particularly those in crowded living conditions (i.e., homes, schools, daycare centres, and work places) and those who engage in poor handwashing practices.

Apollo is spread by contact with the hands, towels, face cloths, goggles and other surfaces exposed to secretions that contain the virus. The symptoms of apollo include sore eyes, feeling of grittiness or burning, redness, watery discharge, swelling of eyelids and light sensitivity. The disease has damaged eyes of many people since its last outbreak 7 years ago in the country. A report of the outbreak has been issued by the senior optometrist of the hospital, Dr. Daniel Opoku, to the National Health Directorate in the region. The report said the hospital had received an increasing number of cases of the disease since last month [October 2018], without specifying a figure.

The statement also confirms some of the hospital staff have been affected in the outbreak and have been asked to visit the eye clinic for treatment. The hospital staff have been cautioned to be careful in their contact with patients and their folders. The staff have also been advised to practice proper hand hygiene to avoid being infected. The Ophthalmological Society of Ghana (OSG) in the region has not commented on the report, and there have not been any comments from the Red Cross Society. The Regional Health Service has confirmed the report but said the situation is being contained.
===========================
[Acute haemorrhagic conjunctivitis (AHC) was 1st described in Ghana in 1969 [1]. Its appearance coincided with the 1st Apollo moon landing, prompting the Ghanaians to give it the name Apollo 11 disease [2]. The etiological agent in this outbreak was identified as enterovirus 70 (EV70) [2, 3]. In the following year [1970], an outbreak of apollo was described in Singapore [4]; however, in this case, the cause was determined to be a Coxsackie virus A24 variant (CVA24v) [5].

Since then, numerous reports of AHC have emerged from across the world, associated with either EV70 or CVA24v. These 2 viruses are now recognized as the primary agents of AHC [6]. ... AHC usually resolves without sequelae, although secondary corneal infection has been reported after treatment with topical steroids [8].

References
1. Chatterjee S, Quarcoopome CO, Apenteng A. Unusual type of epidemic conjunctivitis in Ghana. Br J Ophthal 1970;54:628-630.
2. Kono R. Apollo 11 disease or acute hemorrhagic conjunctivitis: a pandemic of a new enterovirus infection of the eyes. Am J Epidemiol 1975;101:383-390.
3. Mirkovic RR, Kono R, Yin-Murphy M, et al. Enterovirus type 70: the etiologic agent of pandemic acute haemorrhagic conjunctivitis. Bull World Health Org 1973;49:341-346.
4. Mirkovic RR, Schmidt NJ, Yin-Murphy M, Melnick JL. Enterovirus etiology of the 1970 Singapore epidemic of acute conjunctivitis. Intervirology A 1974;4:119-127.
5. Line KH, Yin-Murphy M. An epidemic of conjunctivitis in Singapore in 1970. Singapore Med J 1971;12:247-249.
6. Wright PW, Strausss GH, Langford MP. Acute hemorrhagic conjunctivitis. Am Fam Phys 1992;45:173-178. …
8. Vajpayee RB, Sharma N, Chand M, et al. Corneal superinfection in acute hemorrhagic conjunctivitis. Cornea 1998;6:614-617. Excerpted from Burr SE, Sillah, Joof H, et al. An outbreak of acute haemorrhagic conjunctivitis associated with coxsackievirus A24 variant in The Gambia, West Africa. BMC Res Notes 2017;10:692. - ProMED Mod.LK]
 
[HealthMap/ProMED-mail map:
Ghana: <http://healthmap.org/promed/p/53>]
Date: Thu, 20 Sep 2018 22:11:23 +0200

Accra, Sept 20, 2018 (AFP) - At least 34 people have died in northern Ghana during flooding caused by heavy rains and waters spilling from a dam in neighbouring Burkina Faso, relief agency officials said Thursday.   Bagre Dam is located on the White Volta river that begins in Burkina Faso and which converges with the Black Volta downstream and feeds into Lake Volta in southern Ghana.  The authorities open the dam's spillways during annual rains, but the excess volumes of water regularly flood communities along the rivers.

People living along the White Volta have been urged to stay away from its banks.Others have been told to move to higher ground.   Seji Saji, deputy head of Ghana's National Disaster Management Organisation, said the situation was under control and teams were working flat out to reach those affected.   "In all we have on record 34 deaths and two people missing. The affected people are over 52,000 and we are still assessing the situation," he added.   "All these happened during the time that the river overflowed its banks but the rate of spillage has reduced considerably and fortunately since last week and this week there has not been any heavy rainfall."

Ghana's President Nana Akufo-Addo and his government have been criticised for not visiting victims of the floods.  Aid agency Oxfam's inequality programmes and campaign manager in Ghana, Zakaria Sulemana, said the situation required "high-powered political attention".   "People want to hear the president, in fact we should have seen the president visit the area to console them or better still initiate an action to ensure that this does not happen again," he added.   Saji said Vice-President Mahamudu Bawumia will be visiting flood victims this weekend.   In 1999, flooding in the Upper West, Upper East, Northern and Brong Ahafo and Volta regions of northern Ghana affected more than 300,000 people, according to NADMO.
More ...

Zimbabwe

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

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

Travel News Headlines WORLD NEWS

Date: Wed, 4 Dec 2019 15:50:07 +0100 (MET)
By Ish MAFUNDIKWA, with Zinyange AUNTONY in Bulawayo

Harare, Dec 4, 2019 (AFP) - The floor is dusty, the walls filthy and the furniture decrepit, but for two weeks last month a tiny flat in a Harare township was transformed into a maternity clinic where scores of babies were born.   Its owner, 69-year-old Esther Gwena, says she helped to deliver 250 infants as Zimbabwe's health sector tottered -- a feat that earned comparisons to Florence Nightingale, the pioneer of modern nursing.

Hundreds of junior medics at state hospitals began a strike three months ago because their salaries -- less than $200 a month -- are not enough to live on in a country gripped by 500 percent inflation.   Nurses are only working two days a week.   Those who can't afford private care -- the majority of the 14 million people reeling under an economic crisis compounded by acute food shortages -- suffer at home or seek help from people like Gwena.   Senior doctors, in a letter last week, said state hospitals had become a "death trap" and warned of a "slow genocide".   Gwena, a widow and member of the local Apostolic Faith sect, is a self-taught midwife.   When the health services strike peaked last month, she came to the rescue.

- 'I had to do something' -
"A man came to me and said there were two women in advanced labour at (a nearby clinic) but the place was closed because the nurses were on strike," she told AFP in her two-room flat in Mbare township.   She rushed there and found that one of the women had a baby which had died.   "I took the other one to my place, where I helped her. The baby survived. From that time, I knew I had to do something," she said.   Word that she was helping deliver babies for free spread quickly.

The state-owned television ZBC described her as "a modern Zimbabwean version of Florence Nightingale" and First Lady Auxillia Mnangagwa visited Gwena and donated food, detergents and blankets.   A funeral services company chipped in with a mobile water tank and pitched a tent outside to serve as a waiting room for women before they went into advanced labour.   "I helped to deliver 250 babies ... (they) are alive and kicking and at home with their mothers," Gwena said.   Two weeks later, the government asked her to stop after a nearby maternity clinic reopened.   Winnie Denhere, 35, cradled her two-day-old baby boy outside the clinic, where she had taken him for an immunisation injection.   "Everything went very well, she didn't ask us for money," she said, speaking of Gwena, who brought her child into the world.

- 'People dying' -
But while some laud Gwena as a selfless do-gooder, doctors worry that she exposed herself, the mothers, the babies to infection.   "We need to do something about our facilities so no one goes to her," Harare's director of medical services Prosper Chonzi, said.   Medicines have been in short supply and broken machines go unrepaired.   The government has fired 448 junior octors for striking.    Senior doctors last week also stopped work in protest over the sacking of junior colleagues. Dozens marched in Harare on Monday.   "People dying has become the order of the day in our hospitals," said the vice-president of the Senior Hospital Doctors Association Raphael Magota.

He told AFP machines were breaking down and that intensive care units were only able to treat two or three people "due to lack of equipment".     A senior doctor, speaking on condition of anonymity, said the situation has become untenable.   "There is no public health in Zimbabwe at the moment; everything has come to a standstill," he said.   Even the scarce equipment is often not right.   "One needs gloves that fit just right when performing delicate operations, but we get old gloves that are too big," said another doctor.   A UN special rapporteur on food security, Hilal Elver, last week spoke of "disturbing information" that public hospitals had exhausted food stocks, forcing them to seek humanitarian aid and that medical equipment in some cases was "no longer operational".

In the second largest city of Bulawayo, Zimbabweans living abroad are helping in a small way by crowdfunding and sending money back home to offer health care for the vulnerable.   One such initiative is Citizwean Clinic, which opened its doors last month and attended to hundreds of patients in the first five days -- providing free consultation and drugs.   "We go to the hospital these days it's bad, there are no doctors. We heard that there were doctors here," said hypertensive patient Elina Dzingire, 63.    "We've really been helped here," she told AFP from the clinic in the city's Cowdray Park township.    Health Minister Obadiah Moyo admitted the situation in hospitals is constrained but says the government will soon advertise the posts left vacant by the sacked doctors.
Date: Tue, 26 Nov 2019 05:04:53 +0100 (MET)
By Ish MAFUNDIKWA

Mhondoro Ngezi , Zimbabwe, Nov 26, 2019 (AFP) - Miller Chizema walked through the forest near his home and came across a pile of freshly-cut logs -- a sight that spurred the 82-year-old villager to dismay and anger.   The logs were arranged in such a way that they were ready to be burnt into charcoal -- a fuel that has become a substitute for Zimbabwe's energy shortages, at a terrible cost to its forests.   "It hurts to see forests decimated like this," said Chizema, who lives in Mhondoro Ngezi, in the centre of the country, 150 kilometres (90 miles) southwest of Harare.

Some loggers come from as far as Harare, "where we hear there is a big demand for charcoal," he said.   "We, as elders, try to discourage the practice, but it's all about money and survival."   For nearly six months, Zimbabwe has been in the grip of chronic power cuts, sometimes running to 19 hours a day.   The price of cooking gas has increased more than six-fold since the start of the year, placing it beyond the reach of many.   For many lower-income urbanites, firewood and charcoal have become the go-to sources of substitute energy -- and rogue logging is the result.

Zimbabwe is losing more than 330,000 hectares (815,000 acres) of forest annually, according to Abednigo Marufu, general manager of the Zimbabwe Forestry Commission.    That's the equivalent to nearly half a million football pitches.   "Zimbabwe is losing quite a lot of trees and forests... everywhere because there is no electricity and our people need to feed themselves, they need heating in their homes," he told AFP.   Even so, "agriculture is still the number one driver of deforestation," he said.   A controversial land reform programme launched in 2000 saw a surge in the loss of forest cover as people cleared land for cultivation.    "Some of them started growing tobacco and cut down trees to use for curing their crop."    The practice continues, as farmers view wood to be free compared to other options.

- Dilemma -
Authorities are confronted with an enforcement conundrum.  Charcoal production is outlawed in Zimbabwe but it can be imported from neighbouring Mozambique, Zambia and Malawi, with special permits.   But Marufu said no such licences had been issued for over a year, yet Zimbabwe was awash with charcoal.   "How do you then know what charcoal is imported and locally produced?" Marufu asked rhetorically.

A lot of the older indigenous mopani trees have been reduced to stumps. AFP journalists saw numerous darkened patches where the logs had been piled and burnt into charcoal in the forests at Mhondoro-Ngezi.   Best Muchenje has been the district's forestry officer for the past two years.   "Deforestation was already bad when I came here," he told AFP.   "But the power crisis has worsened the situation, (and) the mopani tree is a target because it is hard and produces quality charcoal."   Mopani is one of the country's iconic indigenous trees that easily survive hot and dry conditions.   The law allows those living in the sparsely populated villages to cut trees for personal use and not for commercial purposes.

- 'Forests or humans' -
But for unemployed villagers like Enia Shagini, lack of money forces them to risk being fined or even jailed for cutting down trees for charcoal.   She sells a 50-kilogram (110-pound) bag for the equivalent of less than 50 US cents (40 euro centimes).   "We have children to send to school," said the mother of three, bemoaning a crackdown on illicit charcoal production which has widely been ignored.    In the capital, charcoal vendors at the Mbare market, just a few minutes' drive from downtown Harare, display dozens of 50-kilo polythene bags of charcoal for sale.

Prudence Mkonyo claimed she got her charcoal from Nyamapanda, near the border with Mozambique.   "It's difficult bringing the stuff to Harare," she said.   "We ferry it on trucks at night but sometimes you have to deal with the police at roadblocks. You need to be prepared to pay them bribes when you get stopped."   She sold her charcoal at the equivalent of between US$2.50 and US$3.00 a bag, but sales are slow.   People are struggling with unemployment and the country's worst economic crisis in a decade.   "There isn't much money going around so business is really bad. Some people are burning discarded plastic soft drink bottles for cooking."

While the law is clear on production of charcoal, the government is in a dilemma.   "It's a very complicated issue," Nqobizitha Ndlovu, newly-appointed minister for the environment and climate change, told AFP.   "We acknowledge the shortage of electricity and that gas is expensive, so wood and charcoal are alternatives. So while we are worried about forests, we also worry about human beings."
Date: Fri 8 Nov 2019
From: CBS News [edited]

Weak from hunger and thirst, the elephant struggled to reach a pool of water in this African wildlife reserve. But the majestic mammal got stuck in the mud surrounding the sun-baked watering hole, which had dramatically shrunk due to a severe drought. Eventually park staff freed the trapped elephant, but it collapsed and died. Just yards away lay the carcass of a Cape buffalo that had also been pulled from the mud but was attacked by hungry lions.

Elephants, zebras, hippos, impalas, buffaloes and many other wildlife are stressed by lack of food and water in Zimbabwe's Mana Pools National Park, whose very name comes from the 4 pools of water normally filled by the flooding Zambezi River each rainy season, and where wildlife traditionally drink. The word "mana" means 4 in the Shona language. At least 105 elephants have died in Zimbabwe's wildlife reserves, most of them in Mana and the larger Hwange National Park in the past 2 months, according to the Zimbabwe National Parks and Wildlife Management Authority. Many desperate animals are straying from Zimbabwe's parks into nearby communities in search of food and water.

Mana Pools, a UNESCO World Heritage Site for its splendid setting along the Zambezi River, annually experiences hot, dry weather at this time of year. But this year [2019] it's far worse as a result of poor rains last year [2018]. Even the river's flow has reduced.

The drought parching southern Africa is also affecting people. An estimated 11 million people are threatened with hunger in 9 countries in the region, according to the World Food Program, which is planning large-scale food distribution. The countries of southern Africa have experienced normal rainfall in only one of the past 5 growing seasons, it said.

Seasonal rains are expected soon, but parks officials and wildlife lovers, fearing that too many animals will die before then, are bringing in food to help the distressed animals. The extremely harsh conditions persuaded park authorities to abandon their usual policy of not intervening. Each morning, Munyaradzi Dzoro, a parks agency wildlife officer, prays for rain. "It's beginning to be serious," he said, standing next to the remains of the elephant and buffalo. "It might be worse if we fail to receive rains" by early November [2019]. The last substantial rains came in April, he said.

An early end to a "very poor rainy season" has resulted in insufficient natural vegetation to see the animals through, said Mel Hood, who is participating in the Feed Mana project, which is providing supplementary feeding. Most of the animals in Mana Pools "are more or less confined to the barren flood plains," where temperatures soar to 113 deg F (45 deg C), she said.

Separated from neighboring Zambia by the Zambezi, the region's once reliable sources of water have turned into death traps for animals desperate to reach the muddy ponds. Like the elephant and buffalo, many other animals in the park have gotten stuck in the clay while trying to reach Long Pool, the largest of the watering holes at 3 miles (5 km) long.

The animals were pulled out by rangers, but they could not survive predators on the pounce for weak prey. "The carnivores attacked it from behind," Dzoro said of the buffalo. The elephant carcass had been there for almost a week and emitted a strong stench as flies feasted on it.

At just 5% of its normal size, Long Pool is one of the few remaining water sources across the park's plains. On a recent day, hippos were submerged in some puddles to try to keep their skin from drying out in the extreme heat while birds picked at catfish stranded in the mud.

Two others of Mana's pools have completely dried up, while the 3rd is just 20% to 30% of its usual size and dwindling, Dzoro said.

There are more than 12 000 elephants roaming Mana's flood plains, as well as an abundance of lions, buffaloes, zebras, wild dogs, hyenas, zebras and elands. The animals are visibly affected by the drought. Some impalas show signs of skin mange. In addition to the land animals, the park has 350 bird and aquatic species, according to the parks agency.

In other parts of Mana, park authorities are pumping water from deep boreholes, but the supplies are barely enough, he said. "We used to say nature should take its course," Dzoro said of the park's normal policy of not intervening and allowing the ecosystem to find its own balance. "We are now forced to intervene, which is manipulative conservation, because we are not sure when and how we will receive the rain. To avoid losing animals we have to intervene to maintain population sizes," Dzoro said.

With the acacias, other indigenous trees and grasses that provide the bulk of food for herbivores like elephants and buffaloes also decimated by the drought, authorities began supplementary feeding in July [2019].

Trucks and tractors ferry hay to various locations in the 2196-square km (848-square mi) park. In some spots, elephants, buffaloes and zebras are fed next to each other. The Feed Mana project has so far trucked 14 000 bales to the park, said Hood, the animal welfare campaigner. The group has been appealing for "urgent" donations of items such as soy bean hay, grass and cubes made of nutritious grains and molasses. "Although it may not be enough to stave off all the hunger pangs, it is certainly giving these animals a chance to survive until conditions improve," Hood said.

Zimbabwe has an estimated 85,000 elephants and neighbouring Botswana has more than 130,000. The 2 countries have the largest elephant population in the world. Zimbabwe says it's struggling to cope with booming numbers of wild elephants and is pushing to be allowed to sell its ivory stockpile and export live elephants to raise money for conservation and ease congestion in the drought-affected parks.

Other African countries, especially Kenya, are opposed to any sale of ivory. And earlier this year [2019] the meeting of the Convention on International Trade in Endangered Species voted to continue the ban on all ivory sales.

At Mana Pools, saving the animals is a challenge, and officials say Zimbabwe is severely affected by climate change that has changed weather patterns. In past years, Mana Pools would get up to 24 inches (600 mm) of rain per year, said Dzoro, the wildlife officer. Now it's lucky to get half that. With such a dramatic reduction, "we can't have perennial sources to sustain animals and some of the perennial springs have dried up. Climate change is affecting us. That's why the manipulative way now is the only way to rescue our fauna," Dzoro said.  "Climate change is real for sure, we are witnessing it," he said.
-------------------------------------
Communicated by:
ProMED-mail Rapporteur Joseph P. Dudley, PhD
Research Scientist II
Institute of Arctic Biology - University of Alaska Fairbanks
=====================
[Previous severe droughts associated with significant levels of elephant mortality also occurred in this region during the early 1980s and mid-1990s (1980-1984, 1993-1995). As much as 10% or more of the total population of Hwange National Park may have died during the 1993-1995 drought (1).

It appears that there has been a delay in the onset of the rainy season onset this year (2019). Rainfall data from Hwange National Park in western Zimbabwe, one of the areas mentioned in this article, show that the onset of the rainy season in Zimbabwe usually occurs in October, peaks during December and January, and tapers off during March and April (based on 80-year dataset spanning the period from 1918 to 1998).

Temperature data from Hwange National Park for the period from 1951 through 1994 indicate a progressive warming trend with an increase in the mean monthly maximum temperature of approximately 1.5 deg C in the park for the period between 1950 and 2000.

Satellite monitoring data for precipitation during the past 90 days support drought references in the CBS article. Precipitation anomaly maps indicate rainfalls have been on order of 25% to 50% below the historical average. And mature trees -- especially baobab and mopane -- will likely be getting really hammered this year (2019) from debarking and ring-barking by elephants.

Reference
1. Dudley JP, Craig GC, Gibson DStC, et al. Drought mortality of African bush elephants in Hwange National Park, Zimbabwe. Afr J Ecol 2001;39:187-94.  - JP Dudley]

[Our thanks to Joe [JP Dudley] for his informed rapporteur's information and comments. While we concentrate on infectious disease, we must not forget that nature can effective cull populations on its own. This drought is affecting the whole of southern Africa, so we can fully parallel die-offs elsewhere. - ProMED Mod.MHJ]

[HealthMap/ProMED-mail map:
Date: Mon, 21 Oct 2019 18:48:23 +0200 (METDST)

Harare, Oct 21, 2019 (AFP) - At least 55 elephants have died in a month in Zimbabwe  due to a lack of food and water, its wildlife agency said Monday, as the country faces one of the worst droughts in its history.   More than five million rural Zimbabweans -- nearly a third of the population -- are at risk of food shortages before the next harvest in 2020, the United Nations has warned.

The shortages have been caused by the combined effects of an economic downturn and a drought blamed on the El Nino weather cycle.   The impact is being felt at Hwange National Park, Zimbabwe's largest game reserve.   "Since September, we have lost at least 55 elephants in Hwange National Park due to starvation and lack of water," Zimbabwe National Parks spokesman Tinashe Farawo told AFP.   Farawo said the park was overpopulated and that food and water was scarce "due to drought".

Africa's elephant numbers have dropped from around 415,000 to 111,000 over the past decade, mainly due to poaching for ivory, according to the International Union for Conservation of Nature (IUCN).   But Zimbabwe, like other countries in the southern African region, is struggling with overpopulation.   "Hwange was meant for 15,000 elephants but at the moment we are talking of more than 50,000," Farawo said.   "The situation is dire. We are desperately waiting for the rains."   An adult elephant drinks 680 litres (180 gallons) of water per day on average and consumes 450 kilogrammes (990 pounds) of food.

Hungry elephants have been breaking out of Zimbabwe's game reserves and raiding human settlements in search for food, posing a threat to surrounding communities.   Farawo said 200 people have died in "human-and-animal conflict" in the past five years, and "at least 7,000 hectares (17,300 acres) of crop have been destroyed by elephants".   The authorities took action earlier this year by selling nearly 100 elephants to China and Dubai for $2.7 million.   Farawo said the money had been allocated to anti-poaching and conservation projects.   Botswana, Namibia, Zambia and Zimbabwe have called for a global ban on elephant ivory trade to be relaxed in order to cull numbers and ease pressure on their territories.
Date: Mon, 14 Oct 2019 17:55:47 +0200 (METDST)

Harare, Oct 14, 2019 (AFP) - Striking Zimbabwe doctors on Monday defied a court order to return to work, saying a pay rise offered by the government failed to meet everyday costs.   Doctors remained home for a 43rd consecutive day, striking for better pay after their salaries were eroded by the country's spiralling inflation.   Zimbabwe's labour court ruled the action "unlawful" on Friday and ordered the medics back to their wards within 48 hours.

The Zimbabwe Hospital Doctors Association (ZHDA) announced Sunday it would appeal to the Supreme Court.    "We noted the court order but unfortunately we don't have the means by which to comply," said ZHDA spokesman Masimba Ndoro on Monday.   "We remain incapacitated... There is nothing we can do when we don't have the means to go to work and to meet our basic needs," he told AFP.   The doctors say the value of their pay shrank 15-fold over the past year -- a legacy of hyperinflation caused by economic mismanagement under ex-president Robert Mugabe.   His successor Emmerson Mnangagwa has so far failed to redress the situation.    Fuel prices have increased by more than 400 percent since the start of the year, and the ZHDA said that doctors had to use their savings just to show up to hospital each morning.

Negotiations with the government have been deadlocked since the ZHDA rejected a 60-percent salary rise offer.   With pay slips worth less than the equivalent of $100 (91 euros) in some cases, they are demanding doctors' salaries be pegged to the US dollar and have appealed to international bodies to supplement their wages.   "While doctors would want nothing more than to return to work in service of their patients, they continue to be incapacitated and lack the resources to comply with the Labour Court judgement," the ZHDA said in a statement on Sunday.   Nurses joined in the action last week.   "We have reduced the number of days we are coming to work initially to three days a week now we are down to two days," Zimbabwe Nurses Association spokesman Enoch Dongo told AFP.   "If the issue of salaries is not urgently addressed we will soon have a situation where nurses will no longer be able to come to work," he said, adding that nurses were "taking turns" in coming to hospital.      Rural teachers also embarked on strike action on Monday with a stay-at-home protest "against underpayment".   "We urge the government to respect our right to engage in job actions and peacefully protest demanding a living wage," the Amalgamated Rural Teachers Union of Zimbabwe posted on Twitter.
More ...

World Travel News Headlines

Date: Fri, 6 Dec 2019 10:30:54 +0100 (MET)

Moscow, Dec 6, 2019 (AFP) - More than 50 polar bears have gathered on the edge of a village in Russia's far north, environmentalists and residents said, as weak Arctic ice leaves them unable to roam.   The Russian branch of the World Wildlife Fund said climate change was to blame, as unusually warm temperatures prevented coastal ice from forming.   The WWF said 56 polar bears had gathered in a one-square-kilometre (0.4-square-mile) area near the village of Ryrkaipy in Chukotka on the north-eastern tip of Russia.

There were concerns they could enter the village, home to fewer than 1,000 people, and patrols had been set up to monitor their movements.   "The number of human and predator encounters in the Arctic is increasing," the WWF said in statement.    "The main reason is the decline of sea ice area due to the changing climate. In the absence of ice cover, animals are forced to go ashore in search of food."

Residents had gathered walrus carcasses in the area to try to keep the bears from wandering into the village.   "We have created a feeding point with walrus carcasses that we gathered along the coast," Tatyana Minenko of the local "Bear Patrol" told news agency RIA Novosti.   "As long as there is no big freeze, the sea ice will not form and the bears will stay on the coast," she said.

Russia's weather service said temperatures in the region should fall from Saturday and that coastal ice should freeze by December 11.    Polar bears regularly visit areas inhabited by humans in Arctic Russia to search for food, often in rubbish tips.   But the number of visits has been growing as the melting of Arctic ice from climate change forces the bears to spend more time on land where they compete for food.
Date: Fri, 6 Dec 2019 10:28:26 +0100 (MET)
By Joseph Schmid

Paris, Dec 6, 2019 (AFP) - Travellers across France endured a second day of chaos on Friday as unions vowed to keep up their strike until President Emmanuel Macron backs down on controversial pension overhauls.   Rail operator SNCF said 90 percent of high-speed TGV trains were again cancelled, and several airlines dropped flights including Air France, EasyJet and Ryanair.

Nine of the capital's 16 metro lines were shut and most others severely disrupted, sparking some 350 kilometres (220 miles) of traffic jams in the Paris region, well above the usual 200 km, the traffic website Sytadin reported.   Many employees were unable to get to work and several schools again provided only daycare, though fewer teachers were on strike compared with Thursday when some 800,000 people demonstrated across the country according to the interior ministry.   Bike paths were crowded with bikes and electric scooters, with metro operator RATP sponsoring special deals for commuters with a range of ride-hailing companies and other transportation alternatives.

The walkout is the latest test for Macron after months of protests from teachers, hospital workers, police and firefighters as well as the "yellow vest" movement demanding improved living standards.   Unions say his "universal" pension system, which would eliminate dozens of separate plans for public workers, forces millions of people in both public and private sectors to work well beyond the legal retirement age of 62.   Health Minister Agnes Buzyn said Friday that the government had "heard" the protesters' anger and would meet with union leaders to discuss the reform on Monday.   The government has yet to lay out the details of its plan, and Buzyn told Europe 1 radio that "there is indeed a discussion going on about who will be affected, what age it kicks in, which generations will be concerned -- all that is still on the table".

- Macron 'determined' -
Yves Veyrier, head of the hardline FO union, warned Thursday the strike could last at least until Monday if the government did not take the right action.   But it remains to be seen if the protests will match the magnitude of the 1995 strikes against pension overhauls, when France was paralysed for three weeks from November to December in an action that forced the government to back down.

Macron, a former investment banker, has largely succeeded in pushing through a series of controversial reforms, including loosening labour laws and tightening access to unemployment benefits.   But this is the first time the various disgruntled groups have come together in protest.   So far Macron has not spoken publicly on the stoppages though a presidential official, who asked not to be named, said Thursday that the president was "calm" and "determined to carry out this reform" in a mood of "listening and consultation".

While most of Thursday's rallies were peaceful, police fired tear gas to disperse dozens of black-clad protesters smashing windows and throwing stones during the Paris march, with one construction trailer set on fire. Sporadic clashes were also reported in some other cities.   Many people were bracing for further disruptions over the weekend, including the prospect of fuel shortages as unions blocked most of the country's eight oil refineries.

The minimum pension age in France is 62, one of the lowest among developed countries, but there are 42 "special regimes" for railway workers, lawyers, opera employees and others offering earlier retirements and other benefits.   The government says a single system will be fairer for everyone while ensuring its financial viability while acknowledging that people will gradually have to work longer.
Date: Fri, 6 Dec 2019 04:23:51 +0100 (MET)

Sydney, Dec 6, 2019 (AFP) - Three hundred animals have been evacuated from a wildlife park north of Sydney as massive bushfires encircled Australia's largest city and foreign firefighters arrived to relieve beleaguered local forces.   Walkabout Wildlife Park said it had shipped out lizards, dingoes, peacocks and marsupials, as firefighters battled more than 100 fires up and down the eastern seaboard.   "This fire has been doing some crazy things, so we have to be prepared," general manager Tassin Barnard told AFP.

Prolonged drought has left much of eastern Australia tinder dry and spot fires have raged every day for the past three months, leaving firefighters struggling to cope.   New South Wales rural fire chief Shane Fitzsimmons said Friday that some US and Canadian firefighters had arrived to help out, easing the strain on the exhausted largely volunteer Australian force.

The incident-management and aviation specialists will help ease "fatigue and crew rotations" he said.   "We are not only appreciative of their presence here today, but of their sacrifice," said Fitzsimmons -- who has become a fixture on Australian television screens for weeks, updating the public on blazes in towns, national parks and backwaters.    "They are volunteering to sacrifice time from loved ones, from families, to give up that special time of the year around Christmas and New Year to come down here and lend us a hand," he said.

More than 600 homes have been destroyed and six people have died since the crisis began in September. That is many fewer than Australia's deadliest recent fire season in 2009 when almost 200 people died, but 2019's toll belies the scale of devastation.    Millions of hectares have burned -- the size of some small countries -- across a region spanning hundreds of kilometres (miles).   Bushfires are common in Australia but scientists say this year's season has come earlier and with more intensity due to a prolonged drought and climatic conditions fuelled by global warming.

The fires have taken a toll in Sydney and other major cities, which have been blanketed in toxic smoke for weeks and occasionally sprinkled with snow-like embers.   Fitzsimmons said he could not "overstate the effect that this profound drought is having" as he warned of a long, painful summer ahead.   "There is an absolute lack of moisture in the soil, a lack of moisture in the vegetation... you are seeing fires started very easily and they are spreading extremely quickly, and they are burning ridiculously intensely."
Date: Fri, 6 Dec 2019 03:03:18 +0100 (MET)
By Pierre-Henry DESHAYES

Half Moon Island, Antarctica, Dec 6, 2019 (AFP) - The swimsuit-clad tourists leap into the icy water, gasping at the shock, and startling a gaggle of penguins.   They are spectators at the end of the world, luxury visitors experiencing a vulnerable ecosystem close-up.   And their very presence might accelerate its demise.   Antarctica, a vast territory belonging to no one nation, is a continent of extremes: the coldest place on Earth, the windiest, the driest, the most desolate and the most inhospitable.   Now, it's also a choice destination for tourists.

All around Half Moon Island, off the Antarctic Peninsula, blocks of ice of all sizes float by on a calm sea, their varying forms resembling weightless origami shapes.    On this strip of land, that juts out of the Antarctic Polar and towards South America, visitors can see wildlife normally only viewed in zoos or nature documentaries along with spectacular icy landscapes.   The ethereal shades of white that play across the pillowy peaks change with the light, acquiring pastel hues at dawn and dusk.   "Purity, grandeur, a scale that's out of this world," says Helene Brunet, an awestruck 63-year-old French pensioner, enjoying the scene.    "It's unbelievable, totally unbelievable. It's amazing just to be here, like a small speck of dust."

AFP joined the 430 passengers on board the Roald Amundsen, the world's first hybrid electric cruise ship, on its maiden voyage in the Southern Ocean.    "It's not your typical beach, but it's awesome to do it," says a numb Even Carlsen, 58, from Norway, emerging from his polar plunge in the three-degree C (37.4 F) water.   When tourists go ashore, bundled up in neon-coloured windbreakers and slathered in SPF50 sunscreen, they have to follow strict rules: clean your personal effects so you don't introduce invasive species, keep a respectful distance from wildlife to avoid distressing them, don't stray from the marked paths and don't pick up anything.   "We mucked up the rest of the world. We don't want to muck up Antarctica too," says an English tourist, as she vacuums cat hair off her clothes before going ashore.

- 'Heart of the Earth' -
The Antarctic peninsula is one of the regions on Earth that is warming the fastest, by almost three degrees Celsius in the past 50 years, according to the World Meteorological Organization -- three times faster than the global average.    In March 2015, an Argentinian research station registered a balmy 17.5 degrees Celsius, a record.    "Every year you can observe and record the melting of glaciers, the disappearance of sea ice... (and) in areas without ice, the recolonisation of plants and other organisms that were not present in Antarctica before," said Marcelo Leppe, director of the Chilean Antarctic Institute.

Antarctica is "like the heart of the Earth," he added, saying that it expands and contracts like a heart beating, while the mighty current which revolves around the continent is like a circulatory system as it absorbs warm currents from other oceans and redistributes cold water.   The Antarctic Treaty, signed 60 years ago by 12 countries -- it now has 54 signatories -- declared the area a continent dedicated to peace and science, but tourism has gradually increased, with a sharp rise in the past few years.   Tourism is the only commercial activity allowed, apart from fishing -- the subject of international disputes over marine sanctuaries -- and is concentrated mainly around the peninsula, which has a milder climate than the rest of the continent and is easier to access.

Cruise ships have roamed the region for around 50 years, but their numbers only started to increase from 1990, as Soviet ice-breakers found new purposes in the post-Cold War era.   Some 78,500 people are expected to visit the region between November and March, according to the International Association of Antarctica Tour Operators (IAATO).   That's a 40-percent increase from last year, due in part to short visits by a few new cruise ships carrying more than 500 passengers, too many to disembark under IAATO regulations.     "Some might say 'Well, 80,000 people, that doesn't even fill a national stadium'... (and that it) is nothing like Galapagos which welcomes 275,000 a year," says IAATO spokeswoman Amanda Lynnes.    "But Antarctica is a special place and you need to manage it accordingly."

- 'Leave Antarctica to the penguins' -
It is Antarctica's very vulnerability that is attracting more and more visitors.   "We want to see this fantastic nature in Antarctica before it's gone," Guido Hofken, a 52-year-old IT sales director travelling with his wife Martina, says.    They said they had paid a supplement to climate compensate for their flight from Germany.

But some question whether tourists should be going to the region at all.   "The continent probably would be better off being left to penguins and researchers, but the reality is, that is probably never going to happen," said Michael Hall, professor and expert on polar regions at the University of Canterbury in New Zealand.   "Vicarious appreciation never seems to be enough for humans. So with that being the case, it needs to be made as low risk to the Antarctic environment and as low carbon as possible," said Hall.    "However, when the average tourist trip to Antarctica is over five tonnes of CO2 emissions per passenger (including flights), that is a serious ask."

Soot or black carbon in the exhaust gases of the scientific and cruise ships going to the region is also of concern, said Soenke Diesener, transport policy officer at German conservation NGO Nabu.   "These particles will deposit on snow and ice surfaces and accelerate the melting of the ice because the ice gets darker and will absorb the heat from the sun and will melt much faster," he told AFP.   "So the people who go there to observe or preserve the landscape are bringing danger to the area, and leave it less pristine than it was," he added.

- Responsible tourism -
Antarctic tour operators insist they are promoting responsible tourism.   The trend is for more intimate, so-called expedition cruises, in contrast to popular giant cruise liners elsewhere which are criticised for being invasive and polluting.   With greener ships -- heavy fuel, the most commonly used for marine vessels, has been banned in Antarctica since 2011 -- cruise companies have sought to make environmental awareness a selling point, occasionally earning them accusations of greenwashing.

Global warming, pollution and microplastics are the result of human activities on other, faraway continents, say tour operators.   Here, their motto is "Take nothing but photographs, leave nothing but footprints, keep nothing but memories".   But before they've even set foot on the cruise ships departing from South America -- the most common itinerary -- visitors to Antarctica will already have flown across the world, causing emissions that harm the very nature they have come so far to admire.

Most visitors hail from the Northern Hemisphere, and almost half are from the United States and China, IAATO says.   "I'm a tourist who feels a little guilty about taking a flight to come here," admits Francoise Lapeyre, a 58-year-old globetrotter om France.   "But then again, there are priorities. There are some trips I just won't take, because they leave a big footprint and they're not worth it.   "Crisscrossing the planet to go to a beach for example," she says.

- Don't mention climate change -
Like other expedition cruises where accessible science is part of their trademark, the Roald Amundsen, owned by the Hurtigruten company, has no dance floor or casino.  Instead, there are microscopes, science events and lectures about whales and explorers like Charles Darwin.   But they steer clear of climate change, which is only mentioned indirectly.   That's a deliberate decision as the subject has proven "quite controversial", said Verena Meraldi, Hurtigruten's science coordinator.   "We held several lectures dedicated specifically to climate change but it leads to conflicts. There are people who accept it as a fact, others who don't," she said.   Onboard, "passengers" are referred to as "guests" and "explorers" rather than "cruisers".   "Explorers" are typically older, well-heeled, often highly travelled pensioners who are handed walking sticks as they step ashore.   "My 107th country," says a Dane, stepping ashore onto Antarctica.

The Roald Amundsen "guests" choose between three restaurants, from street food to fine dining -- a far cry from the conditions endured by the Norwegian adventurer for whom the ship is named, who had to eat his sled dogs to survive his quest to reach the South Pole in 1911.   They have paid at least 7,000 euros ($7,700) each for an 18-day cruise in a standard cabin, and up to 25,000 euros ($27,500) for a suite with a balcony and private jacuzzi.   Other cruises are banking on ultra-luxury, with James Bond-like ships equipped with helicopters and submarines, suites of more than 200 square metres (2,153 square feet) and butler services.   With a seaplane to boot, the mega-yacht SeaDream Innovation will offer 88-day cruises "from Pole to Pole" starting in 2021. The two most expensive suites, with a price tag of 135,000 euros per person, are already booked.
 
- Worlds collide -
Outside, in the deafening silence, wildlife abounds.   All around are penguins, as awkward on land as they are agile in water. Massive and majestic whales slip through the waves, and sea lions and seals laze in the sun.   On Half Moon Island, chinstrap penguins -- so called because of a black stripe on their chin -- strut about in this spring breeding season, raising their beaks and screeching from their rocky nests.   "This is to tell other males 'This is my space' and also, maybe, 'This is my female'," ornithologist Rebecca Hodgkiss, a member of the Hurtigruten's scientific team, explains, as a group of tourists stroll around ashore.   The colony of 2,500 penguins has been gradually declining over the years, but it's not known if that is man's fault or they have just moved away, according to Karin Strand, Hurtigruten's vice president for expeditions.   Invisible to the naked eye, traces of humankind are however to be found in the pristine landscape.   Not a single piece of rubbish is in sight but microplastics are everywhere, swept in on ocean currents.   "We've detected them in the eggs of penguins for example," Leppe told AFP.

- Venice under water -
The Antarctic, which holds the world's largest reserve of freshwater, is a ticking time bomb, warn experts and studies.   They say that the future of millions of people and species in coastal areas around the world depends on what is happening here.   As a result of global warming, the melting ice sheet -- especially in the western part of the continent -- will increasingly contribute to rising sea levels, radically re-drawing the map of the world, says climate scientist Anders Levermann, of the Potsdam Institute for Climate Impact Research.   This meltwater will contribute 50 centimetres (almost 20 inches) to the global sea level rise by 2100, and much more after that, he said.   "For every degree of warming, we get 2.5 metres of sea level rise. Not in this century, but in the long run," he said.

Even if the international community meets its obligations under the Paris Agreement to limit global warming to under two degrees Celsius, sea levels will still rise by at least five metres.   "Which means that Venice is under water, Hamburg is under water, New York, Shanghai, Calcutta," he said.   It's impossible to predict when, but the scenario appears unavoidable, says Levermann.   In the same way that a cruise ship powering ahead at full speed can't immediately stop, sea levels will continue to rise even if all greenhouse gas emissions were to cease immediately, a study has said.

- Changing the world? -
The tourism industry says it hopes to make "ambassadors" out of Antarctica visitors.   "It's good for the animal life and for the protection of Antarctica that people see how beautiful this area is, because you cherish what you know and understand," said Hurtigruten chief executive Daniel Skjeldam.   Texan tourist Mark Halvorson, 72, says he is convinced.   "Having seen it, I am that much more committed to having a very high priority in my politics, in my own inner core convictions to being as environmentally friendly in my life as I can," he said.   So, do Guido and Martina Hofken see themselves as future "ambassadors of Antarctica"?    "Just a little bit, probably. But I don't think I will change the world," Guido Hofken concedes.    "The best thing would be for nobody to travel to Antarctica."
Date: Thu, 5 Dec 2019 16:37:37 +0100 (MET)

Paris, Dec 5, 2019 (AFP) - French rail operator SNCF said Thursday that it had cancelled 90 percent of all high-speed TGV trains and 70 percent of regional trains for Friday due to a strike over the government's pension reforms.   SNCF said that services would "still be very disrupted" on the second day of the biggest transport strike in the country in years, with the Eurostar service to Britain and the Thalys service to northern Europe set to be "very heavily disrupted".   In Paris, where only two of 16 metro lines were operating normally Thursday, public transport workers voted to remain on strike until Monday.

France's civil aviation authority meanwhile told airlines to cut 20 percent of their flights in and out of airports in Paris, Beauvais, Lyon, Marseille, Toulouse and Bordeaux on Friday, the same proportion as on Thursday.   Striking transport workers, air traffic controllers, teachers, fire fighters, lawyers and other groups all fear they will have to work longer or receive reduced pensions under the government's proposal to scrap 42 special pension schemes and replace them with a single plan.   Anticipating the worst travel chaos in years, many employees opted to work from home on Thursday. Those who did venture out travelled mainly by car, bicycle, electric scooter or on foot.
Date: Thu, 5 Dec 2019 12:19:45 +0100 (MET)
By Sofia CHRISTENSEN

Johannesburg, Dec 5, 2019 (AFP) - South African Airways was placed under a state-approved rescue plan on Thursday to avoid the embattled airline's collapse following a costly week-long strike last month.   Thousands of South African Airways (SAA) staff walked out on November 15 after the flag carrier failed to meet a string of demands, including higher wages and job in-sourcing.   The strike was called off the following week after SAA management and unions eventually clinched a deal.

But the walkout dealt a severe blow to the debt-ridden airline, which has failed to make a profit since 2011 and survives on government bailouts.   "The Board of SAA has adopted a resolution to place the company into business rescue," said a statement by South Africa's Public Enterprises Minister Pravin Gordhan, adding that the decision was also supported by the government.   "It must be clear that this is not a bailout," said Gordhan. "This is the provision of financial assistance in order to facilitate a radical restructure of the airline."   The business rescue process will be directed by an independent practitioner. It is meant to prevent a "disorderly collapse of the airline", he added.   Gordhan said the government would provide 2 billion rand ($136 million) to SAA in "a fiscally neutral manner".   Existing lenders will also provide a 2 billion rand loan guaranteed by the government.

- 'Financial challenges' -
South Africa is struggling to get state-owned companies back on track after nine years of corruption and mismanagement under former president Jacob Zuma.   Its national airline -- which employs more than 5,000 workers and is Africa's second largest airline after Ethiopian Airlines -- had been losing 52 million rand ($3.5 million) a day during the strike.   SAA's board said the business rescue, scheduled to start immediately, was decided after consultations with shareholders and the public enterprises department "to find a solution to our company's well-documented financial challenges".

"The considered and unanimous conclusion has been to place the company into business rescue in order to create a better return for the company's creditors and shareholders," said the SAA board of directors in a statement.   The rescue plan will include a "new provisional timetable" and ensure "selected activities... continue operating successfully".   With a fleet of more than 50 aircraft, SAA flies to over 35 domestic and international destinations.   "SAA understand that this decision presents many challenges and uncertainties for its staff," said the board.   "The company will engage in targeted communication and support for all its employee groups at this difficult time.

- 'Lesser evil' -
Unions told AFP they would comment later on Thursday.   They have agreed to a 5.9-percent wage increase backdated to April, but which would only start to be paid out next March depending on funding.   SAA had initially refused any pay rise.    The cash-strapped airline needs two billion rand ($136 million) to fund operations through the end of March. But it was unable to cover all of its staff salaries last month.    "Business rescue allows for the airline to continue to operate while it is being restructured, as opposed to liquidation," analyst Daniel Silke told AFP.   He said the rescue was a "lesser evil for SAA" and would save more jobs than a "shutdown".

But Silke still expected jobs to be cut as SAA attempted to reduce costs.   "Various divisions that make of SAA could be privatised," he said. "There will be a review of SAA aircraft and routes covered by SAA."   Unions had already demanded a three-year guarantee of job security following an announcement last month that almost 1,000 SAA employees could lose their jobs as part of another restructuring plan.   SAA pledged to defer that process to the end of January as part of the deal that ended the strike.
Date: Wed 4 Dec 2019
Source: Stock Daily Dish [edited]

Bihar Health Minister Mangal Pandey on [Sat 30 Nov 2019] said the state government is doing its best to save children, as the death toll due to acute encephalitis syndrome [AES] in Muzaffarpur mounted to 73.

Pandey said doctors and nurses are being called in from Patna for additional help. "We are trying everything and anything that can save children's lives. Everything is being made available from medicines to doctors. We have even called doctors and nurses from AIIMS in Patna," he said. "There is a protocol regarding what kind of medicines and facilities should be given and we are doing the same. We are monitoring things regularly and trying to save our children."

Recalling the situation that prevailed 5 years ago, Pandey said a team that was formed to ascertain the cause of this disease concluded that sleeping empty stomach at night, dehydration due to humidity and eating lychee on empty stomach were some of the causes of encephalitis.

"Our government has tried to spread awareness which will be beneficial as well. Advertisement in newspapers, radio jingles, pamphlets and mic [microphone] announcements are going to spread awareness regarding the disease. Health ministry is also working on it," he said.

On being asked about spread of ASE in Gorakhpur last year [2018], he said, "From Gorakhpur to Muzaffarpur region, this disease had spread last year and the Union government had worked on this and we will continue to fight it now."

"This incident in Muzaffarpur is very saddening and we also feel bad when children of our nation die like this. Not the whole district is affected but a large part is suffering from it," he added.

From [1 Jan 2019], until now [5 Dec 2019], 220 children were admitted in Sri Krishna Medical College and Hospital in Muzaffarpur due to AES, out of which 62 lost their lives.

As per the data of SKMCH hospital, 235 children were admitted, of which 89 died; in 2013 - 90 children were admitted, of which 35 died; in 2014 - 334 children were admitted, of which 117 died; in 2015 - 37 children were admitted, of which 15 died; in 2016 - 31 children were admitted, of which 6 died; in 2017 - 44 children were admitted, of which 18 died; and in 2018 - 43 children were admitted, of which 12 died.

Meanwhile, Minister of State for Union ministry for home affairs, Nityanand Rai, visited Sri Krishna Medical College and Hospital to review the situation after the outbreak of AES.

Encephalitis is a viral disease, which causes mild flu-like symptoms such as high fever, convulsions and headaches and has been claiming lives in the district for the past few weeks.
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[The dates within which these AES cases have occurred is not stated. The urgency that has prompted Behar health officials to request the aid of physicians and nurses from adjoining Patna suggests that the AES outbreak is going on currently. The uncertainty about the etiology of AES continues. It is curious that the above report makes no mention of negative or positive tests for Japanese encephalitis among the AES patients, although that virus is endemic in northeastern India, including Bihar state. Neighboring Uttar Pradesh state has had JE cases as well this summer (2019) but has intensified its JE vaccination program.

The issue of the aetiology of AES has been under discussion for a long time. Lychee fruit contain toxins. Encephalopathy and hypoglycaemia have been associated with consumption of lychee fruit contains phytotoxins, specifically alpha-(methylenecyclopropyl)glycine (see ProMED-mail archive no. http://promedmail.org/post/20150201.3132842). However, the current cases cannot be due to lychee consumption, since the season for that fruit has passed.

AES has continued to be attributed to a variety of aetiologies, including Reye syndrome-like disease, possible enterovirus infection from polluted water, heatstroke, lychee fruit consumption, and scrub typhus (_Orientia tsutsugamushi_). A recent publication (reference below) states that dengue virus is one of the 3 most common agents identified in AES, but existing surveillance for AES does not include routine testing for dengue. Until the etiology (or etiologies) of these AES cases is determined, effective and efficient prevention of these cases will not be possible.

Reference:
Ravi V, Hameed SKS, Desai A, et al. Dengue virus is an under-recognised causative agent of acute encephalitis syndrome (AES): results from a 4-year AES surveillance study of Japanese encephalitis in selected states of India. Int J Infect Dis 2019;84 Suppl:19-24. <https://doi.org/10.1016/j.ijid.2019.01.008>.

Available at:

[Maps of India:
HealthMap/ProMED maps available
at:<http://healthmap.org/promed/p/364>, and Bihar, India:
Date: Thu 5 Dec 2019 6:11 PM EET
Source: Enab Baladi [edited]

[Leishmaniasis] is spreading widely among residents of Deir ez-Zor, and especially children. Some of the areas affected are controlled by the Kurdish self-administration while others are under the control of the Syrian regime. Medical sources counted hundreds of infected civilians and confirmed the disease's rapid spread.

According to Atef al-Tawil, a manager of the Leishmania & Environmental Health Programme at the Syrian regime's Ministry of Health, most infections in eastern Deir ez-Zor are spread among school children.

In a Facebook comment on a post by Twasol agency, al-Tawil claimed that cases of leishmaniasis were detected, at the end of November [2019], in primary schools in eastern Deir ez-Zor and its surrounding villages (al-Jalaa, al-Salihiyah, al-Tawtha, al-Abbas, al-Mujawdeh, al-Hasarat, al-Saial, al-Ghabrah).

According to al-Tawil, 455 infections of children were detected. A treatment team of 10 members was formed in the affected locations, to help control the disease to aid in early detection.

The Syrian Ministry of Health acted after several appeals by civilians residing in the area as they noticed the disease spreading among their children. Al-Tawil said that this rapid spread was due to the fact that all the infected people have lately returned to their original areas which lack medical centers.

Autonomous administration areas
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According to Euphrates Post network, leishmaniasis is also widely spread in areas controlled by the Syrian Democratic Forces (SDF). In its post on [Sun 1 Dec 2019], the network claimed that the spread of leishmaniasis is mostly concentrated in the eastern countryside of Deir ez-Zor.

According to the network, unofficial statistics by the SDF-affiliated local council shows more than 7000 leishmaniasis infections among children in al-Baghouz, Hajin, Diban, al-Sha'afa, al-Kishkiye, Abu Hamam, and Gharanij. The local councils' attempts of controlling the disease are still substandard, according to the Euphrates Post.

The network also quoted doctors and nurses calling for international organizations to interfere and provide hospitals and clinics with the required vaccine [there is no vaccine for leishmaniasis; ed.], and to train specialized medical staff in each clinic to deal with the disease.

The autonomous-administration-affiliated media center in Deir ez-Zor also confirmed the spread of leishmaniasis and pointed out that the authorities took actions, by the end of November [2019], to provide treatments.

According to the media center, special medical teams and cadres were distributed among the clinics to provide 12,000 ampoules of the required [medicine] to treat leishmaniasis with the support of the World Health Organization.

Leishmaniasis is a parasitic disease transmitted by the bite of infected female phlebotomine sandflies -- a very small yellow fly that is active at night and makes no sound when it bites -- and the main cause for its spread is dirt and lack of hygiene.  [Byline: Enab Baladi]
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[Deir ez-Zor is east and south of the locations in the previous ProMED reports (see below), indicating further increase in cases of cutaneous leishmaniasis beyond its historical concentration in western Syria (<https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4861536/>) and beyond the area of the MENTOR initiative in northern Syria (<https://wwwnc.cdc.gov/eid/article/24/11/17-2146_article>).

Cutaneous leishmaniasis is endemic in Syria with its reservoir in rodents. It has been a problem throughout the Syrian civil war and in ISIS controlled areas during the war due to a breakdown in rodent and vector control. - ProMED Mod.EP]

[Maps of Syria:
Date: Tue 3 Dec 2019
Source: Twitter feed in Arabic [machine trans., edited]

Taiz health official: 24 laboratory-confirmed cases of West Nile virus and more than 300 suspected cases. #Republic_Yemen
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[Any information on the actual number of WNV cases, their lab confirmation, and public health response activities in this regard will be highly appreciated. - ProMED Mod.UBA]

[HealthMap/ProMED-mail map of Yemen:
Date: Tue 3 Dec 2019
Source: Cordoba Epidemiology Report and Los Tiempos news article [in Spanish, trans., edited]
<http://www.reporteepidemiologico.com/wp-content/uploads/2019/12/REC-2264.pdf>

Los Tiempos, Bolivia, 2 Dec 2019 Confirmation of the 1st case of the year (2019) of human rabies in Cochabamba After confirming the death of rabies of a 7-year-old girl in the southern area of Cochabamba, the Departmental Health Service (SEDES) and the Zoonosis Unit of the Mayor's Office intensified prevention actions to prevent the proliferation of the virus. This would be the 1st case confirmed so far this year [2019].

The head of the Epidemiology Unit of SEDES, Arturo Fernando Quiaones Lapez, reported that in the last rabies vaccination campaign for dogs more 1000 doses were given. "We suspected rabies in the case of this minor. She tested positive by laboratory both in cerebrospinal fluid as well as in brain tissue," according to lab results obtained on 2 Dec 2019. The victim died on 26 Nov 2019 after being hospitalized in intensive care of the Children's Hospital for 2 days with signs of rabies," said Dr Manuel Ascencio Villarroel.

The patient's relatives reported the girl had contact with a puppy which died a month ago. The dog did not receive rabies vaccines and belonged to someone the family knows. Quiñones mentioned the family members of the girl and the owners of the animal are receiving preventive treatment. Meanwhile, the head of Zoonosis of the Mayor's Office, Javier Humberto Rodraguez Herrera, stated on 2 Dec 2019 a "massive focus blockade" will be held with the participation of 8 health centers to prevent the circulation of the virus in the area.

He commented that, to date, 11 cases of canine rabies have been recorded in the municipality. In more than 11 months of 2019, SEDES identified 25 positive cases of canine rabies, the majority in the metropolitan region. Quiaones asked the population to report the death of their pets with signs of rabies at health centers for follow-up to fight the disease. Meanwhile, from the City Hall, the owners of dogs were urged to have their dogs vaccinated. Javier Rodra­guez added another risk factor is when animals are collected from the street and they are not vaccinated.
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[The rabies virus attacks the nervous system in animals.  When a rabid animal bites a human being, it can transfer the virus, contained in saliva, to that individual. "After inoculation, rabies virus may enter the peripheral nervous system directly and migrates to the brain or may replicate in muscle tissue, remaining sequestered at or near the entry site during incubation, prior to central nervous system invasion and replication. It then spreads centrifugally to numerous other organs. The case-fatality ratio approaches unity [100%], but exact pathogenic mechanisms are not fully understood. "Susceptibility to lethal infection is related to the animal species, viral variant, inoculum concentration, location and severity of exposure, and host immune status.

Both virus-neutralizing antibodies and cell-mediated immunity are important in host defense. "Early diagnosis is difficult. Rabies should be suspected in human cases of unexplained viral encephalitis with a history of animal bite. Unvaccinated persons are often negative for virus-neutralizing antibodies until late in the course of disease. Virus isolation from saliva, positive immunofluorescent skin biopsies or virus neutralizing antibody (from cerebrospinal fluid, or serum of a non-vaccinated patient), establish a diagnosis. "Five general stages of rabies are recognized in humans: incubation, prodrome, acute neurologic period, coma, and death (or, very rarely, recovery).

No specific anti-rabies agents are useful once clinical signs or symptoms develop. The incubation period in rabies, usually 30 to 90 days but ranging from as few as 5 days to longer than 2 years after initial exposure, is more variable than in any other acute infection. Incubation periods may be somewhat shorter in children and in individuals bitten close to the central nervous system (such as the head).

Clinical symptoms are first noted during the prodromal period, which usually lasts from 2 to 10 days. These symptoms are often nonspecific (general malaise, fever, and fatigue) or suggest involvement of the respiratory system (sore throat, cough, and dyspnoea), gastrointestinal system (anorexia, dysphagia, nausea, vomiting, abdominal pain, and diarrhoea), or central nervous systems (headache, vertigo, anxiety, apprehension, irritability, and nervousness).

More remarkable abnormalities (agitation, photophobia, priapism, increased libido, insomnia, nightmares, and depression) may also occur, suggesting encephalitis, psychiatric disturbances, or brain conditions. Pain or paraesthesia at the site of virus inoculation, combined with a history of recent animal bite, should suggest a consideration of rabies. "The acute neurologic period begins with objective signs of central nervous system dysfunction.

The disease may be classified as furious rabies if hyperactivity (that is, hydrophobia) predominates and as dumb rabies if paralysis dominates the clinical picture. Fever, paraesthesia, nuchal rigidity, muscle fasciculations, focal and generalized convulsions, hyperventilation, and hypersalivation may occur in both forms of the disease. "At the end of the acute neurologic phase, periods of rapid, irregular breathing may begin; paralysis and coma soon follow. Respiratory arrest may occur thereafter, unless the patient is receiving ventilatory assistance, which may prolong survival for days, weeks, or longer, with death due to other complications.

"Although life support measures can prolong the clinical course of rabies, rarely will they affect the outcome of disease. The possibility of recovery, however, must be recognized, and when resources permit, every effort should be made to support the patient. At least 7 cases of human "recovery" have been documented." (<https://www.ncbi.nlm.nih.gov/books/NBK8618/>)

A very sad situation which could have been prevented if the animal had been vaccinated. Responsible owners vaccinate their animals. Condolences to the family. - ProMED Mod.TG]

[HealthMap/ProMED-mail map of Bolivia: <http://healthmap.org/promed/p/55162>]