WORLD NEWS

Getting countries ...
Select countries and read reports below or

Burundi

Burundi US Consular Information Sheet
April 21, 2008
COUNTRY DESCRIPTION:
One of the poorest countries in the world, Burundi is a small, densely populated central African nation bordering Lake Tanganyika, Rwanda, Tanzania and the Democrati
Republic of Congo. After more than 12 years of civil and ethnic strife, an electoral process deemed free and fair resulted in the installation of a democratic government in 2005. Years of fighting have devastated a historically fragile economy that depends largely on subsistence agriculture. Poor public health and education, weather disasters such as drought and floods, crop diseases and lack of infrastructure exacerbate the effects of conflict and delay recovery. Facilities for tourism, particularly outside the capital, are limited. Read the Department of State Background Notes on Burundi for additional information.

ENTRY/EXIT REQUIREMENTS: A passport, visa and evidence of immunization against yellow fever are required for entry. Travelers with an expired visa are not permitted to leave the country without acquiring an exit visa prior to departure. The latest information about visas may be obtained from the Embassy of the Republic of Burundi, Suite 212, 2233 Wisconsin Avenue NW, Washington, DC 20007, telephone (202) 342-2574, or from the Permanent Mission of Burundi to the United Nations in New York at telephone (212) 499-0001 thru 0006.
For information about dual nationality or the prevention of international child abduction, please refer to related web pages at http://travel.state.gov. For further information about customs regulations, please read our Customs Information sheet.

SAFETY AND SECURITY:
See the Department of State’s Travel Warning for Burundi.
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 personal security while traveling overseas. For general information about appropriate measures travelers can take to protect themselves in an overseas environment, see the Department of State’s pamphlet A Safe Trip Abroad.

CRIME: Crime, often committed by groups of armed bandits, poses a high risk for foreign visitors to Bujumbura and Burundi in general. Common crimes include mugging, purse-snatching, pick pocketing, burglary, automobile break-ins and carjacking. Many criminal incidents involve armed attackers. Armed criminals often ambush vehicles, particularly on the roads leading out of Bujumbura. Criminals in Bujumbura often operate in pairs or in small groups involving six or more individuals. Due to insufficient resources, local authorities in any part of Burundi are often unable to provide timely assistance in case of need.
U.S. Government personnel are prohibited from walking on the streets during the hours of darkness and using local, public transportation. Foreigners, whether in vehicles or at home, are always potential crime targets. Americans should exercise common sense judgment and take the same precautions as one would in any major city.

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 the local police, please contact the nearest U.S. Embassy or Consulate for assistance. The Embassy/Consulate staff can, for example, help 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 Burundi generally do not meet Western standards of care. Travelers should carry an ample supply of properly-labeled prescription drugs and other medications with them, as certain medications and prescription drugs are unavailable or in short supply. Sterility of equipment is questionable, and treatment is unreliable. Ambulance assistance is non-existent. Hospital care in Burundi should be considered in only the most serious cases and when no reasonable alternatives are available.
Malaria prophylaxis is recommended for travel to all parts of Burundi.

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 companies prior to traveling abroad to confirm whether their policies apply overseas and/or cover emergency expenses such as a medical evacuation. Please see our information on medical insurance overseas.

TRAFFIC SAFETY AND ROAD CONDITIONS: When in a foreign country, U.S. citizens may encounter road conditions that differ significantly from those in the United States. The information below concerning Burundi is provided for general reference only, and may not be totally accurate in a particular location or circumstance.
While travel on most roads is generally safe during the day, travelers must maintain constant vigilance. There have been regular reports of violent attacks on vehicles traveling the roads throughout the country outside of Bujumbura. U.S. Government personnel are required to travel upcountry via two-vehicle convoys and have their trips pre-approved by the Regional Security Officer. The Embassy recommends that Americans not travel on the national highways from dusk to dawn. Drivers without valid permits, and the ease with which a driver's license can be acquired without training, make Burundian drivers less careful, predictable, or mindful of driving rules than Western drivers may expect.
There are no traffic signals in Bujumbura, and virtually nothing of the kind elsewhere in the country. Roadways are not marked, and the lack of streetlights or shoulders makes driving in the countryside at night especially dangerous. Additionally, drivers may encounter cyclists, pedestrians, and livestock in the roadway, including in and around the capital. Mini-vans used as buses for 18 persons should be given a wide berth as they start and stop abruptly, often without pulling to the side of the road.
Large holes or damaged portions of roadway may be encountered anywhere in the country, including in Bujumbura; when driving in the countryside, it is recommended that travelers carry multiple spare tires. During the rainy season, many side roads are passable only with four-wheel drive vehicles. Burundi’s supply of gasoline and diesel fuel are imported predominantly from Kenya and Tanzania, and are relatively expensive due to high transportation costs. Service stations are rare outside of the major cities.

Third-party insurance is required, and it will cover any damages (property, injury, or death). If you are found to have caused an accident, you automatically will be fined 10,000 Burundian francs (approximately $10 U.S.) and your driver's license will be confiscated until the police investigation is completed. Although the law provides for the arrest of drunk drivers, in practice, the police do not act on this law. In the city of Bujumbura, the number for police assistance is 22-22-37-77; there is no comparable number outside the capital. If you are involved in an accident causing death, it is advised that you leave the scene of the accident and proceed to the nearest police station.

Please refer to our Road Safety page for more information.

AVIATION SAFETY OVERSIGHT: As there is no direct commercial air service to the United States by carriers registered in Burundi, the U.S. Federal Aviation Administration (FAA) has not assessed Burundi’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:
There are no ATMs located in the country and most Burundian hotels and businesses do not accept credit cards. Many hotels in Bujumbura accept payment in U.S. dollars or Euros from non-Burundians. Travelers should be aware that Burundian banking practices prohibit acceptance of U. S. currency printed before the year 2003.
The Embassy recommends that visitors do not photograph airports, military installations, or other government buildings, and obtain permission from individuals before taking their photographs. 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 Burundian laws, even unknowingly, may be expelled from the country, arrested or imprisoned. Penalties for possession, use, or trafficking in illegal drugs in Burundi 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 on intercountry adoption and international parental child abduction see our Office of Children’s Issues web pages

REGISTRATION / EMBASSY LOCATION:
Americans living or traveling in Burundi are encouraged to register with the U.S. Embassy through the State Department’s travel registration website so that they can obtain updated information on travel within Burundi and the Embassy’s current security policies, including areas that are off-limits to U.S. Government personnel for security reasons. Americans without Internet access may register directly with the U.S. Embassy. By registering, American citizens make it easier for the Embassy to contact them in case of emergency. The U.S. Embassy is located on Avenue des Etats-Unis, telephone (257) 22-22-34-54, fax (257) 22-22-29-26. The Embassy's web site is http://burundi.usembassy.gov/.
* * *
This replaces the Country Specific Information for Burundi dated July 18, 2007, to update sections on Country Description, Entry/Exit Requirements, Medical Facilities and Health Information, and Traffic Safety and Road Conditions.

Travel News Headlines WORLD NEWS

Date: Wed, 14 Aug 2019 17:49:51 +0200 (METDST)

Nairobi, Aug 14, 2019 (AFP) - The World Health Organization (WHO) said Wednesday that Burundi had begun vaccinating frontline workers against Ebola at its border with the Democratic Republic of Congo, where an outbreak of the virus has killed close to 1,900 people.   The campaign to vaccinate at-risk staff against the deadly hemorrhagic fever started Tuesday at Gatumba, the main crossing point from Burundi to its much-larger neighbour, WHO said.

Burundi has received doses of the rVSV-ZEBOV vaccine, an unlicensed product that has been shown to be effective against the Zairian strain of the virus raging in DR Congo.   It would be administered to those at greatest risk such as health workers along the border, laboratory staff and burial teams, WHO said.   "The vaccination of health and frontline staff is a significant step forward in preparing for the response to this disease," said Dr Kazadi Mulombo, WHO representative in Burundi. 

The vaccine, developed by US pharmaceutical group Merck, proved "highly effective" in a trial conducted in Guinea in 2015 during the Ebola epidemic in West Africa, he added.    The vaccination campaign will be overseen by WHO and Burundi's health ministry.   The Ebola outbreak in eastern DR Congo is the second-worst in history. A total of 1,892 deaths have been recorded since the outbreak began on August 1 2018.   No cases of Ebola have been recorded so far in Burundi, a tiny nation of 11 million.    But its border with DR Congo is 236 kilometres (147 miles) long and considered highly porous, and the whole region is on high alert.

In June, three people from one family died in Uganda from Ebola after returning from DR Congo via an unofficial crossing point.   Burundi also shares a border with Rwanda and Tanzania.   The Congo outbreak is the first where vaccines have been rolled out on a large-scale.   The rVSV-ZEBOV vaccine has already been administered to some 170,000 people, especially frontline workers, in DR Congo.   This week, US researchers announced that two prototype drugs being tested among Ebola patients in eastern DR Congo boost chances of surviving the disease.
Date: Thu 8 Aug 2019 05.00 BST
Source: The Guardian [edited]

A serious outbreak of malaria in Burundi has reached epidemic proportions, killing almost as many people as the Ebola crisis in the nearby Democratic Republic of the Congo.  The outbreak in the tiny Great Lakes country has infected almost half the total population, killing about 1800 people since the beginning of the year [2019].  According to figures gathered by the World Health Organisation, almost 6 million cases have been recorded since the 1st week of January to the end of July [2019], with infections reaching crisis levels in May. The figures look on course to outstrip the epidemic of 2017, when more 6 million cases were recorded for the whole year. The situation has continued to worsen as the government of Burundi has refused to declare an emergency.

The scale of the outbreak was described in the latest report for the UN's office for the Coordination of Humanitarian Affairs, which warned that the outbreak had reached "epidemic" proportions.  "The national malaria outbreak response plan, which is currently being validated, has highlighted a lack of human, logistical, and financial resources for effective response," reported the organisation.  The organisation and other experts have blamed a number of issues for the crisis, including low use of preventative measures and a vulnerable population with low levels of resistance. Experts have also noted an increase in drug resistant strains of the disease in common with other parts of the world.

The climate crisis has been cited as a contributing factor. Mosquitoes, which spread the disease, are reaching higher altitudes in the mountainous country, and have displayed behavioural changes including more aggressive feeding habits.  The country's agricultural policies have also encouraged an increase in rice production that has seen farmers encroach on mosquito-infested areas.  While Burundi has long struggled with malaria, the figures for the current outbreak suggest a 50% increase compared to the equivalent period last year [2018]. The UN organisation noted bleakly that the number of health districts that have passed the epidemic threshold had continued to increase.

Although Burundi declared a national health emergency in 2017 after 1.8 million cases and 700 deaths were recorded, it has declined to declare one for the current outbreak, apparently concerned of the potential impact ahead of elections slated for next year [2010]…  [Byline: Peter Beaumont]
========================
[The WHO profile of malaria in Burundi can be found at

In 2017, the entire population of an estimated 10.9 million people lived in _Plasmodium falciparum_ high-endemic areas. In 2017 the annual incidence of _P. falciparum_ was estimated at 800 cases per 1000 population (WHO 2017 as above).

In 2017 there was an estimated 2.1M [range: 1.3M, 3.4M] cases with an estimated number of deaths of 5300 [range: 4300, 6200] (WHO). The 1st line treatment is artesunate-amodiaquine (AS-AQ) introduced in 2003. Malaria control relies on insecticide treated nets (ITN) but only around 30% of the population used a net the previous night one survey found (WHO 2017 as above) and it was also found that 80% of the mosquitoes were resistant to pyrethroids, the usual class of insecticides used for impregnating nets.

In 2005 the annual incidence was estimated at less than 50 cases per 1000 population (WHO 2017 as above) illustrating that since then the national malaria control programme has failed to improve the situation.

It is particularly worrying that the report above mentions treatment failure and possible drug resistance. With artemisinin resistance spreading in southeast Asia (see ProMED post http://promedmail.org/post/20190723.6583616) any signs of a slow parasite clearance need to be followed up by molecular analysis looking for mutations in key genes. No studies have looked at mutations in key genes predicting reduced susceptibility to the artemisinins or the 4-aminoquinolones (amodiaquine).

Since Burundi's independence in 1962, 2 genocides have taken place in the country: the 1972 mass killings of Hutus by the Tutsi-dominated army (<http://www.preventgenocide.org/edu/pastgenocides/burundi/resources/>), and the mass killings of Tutsis in 1993 by the Hutu majority. Both were described as genocides in the final report of the International Commission of Inquiry for Burundi presented in 2002 to the United Nations Security Council (<https://en.wikipedia.org/wiki/Burundi>). - ProMED Mod.EP]

[HealthMap/ProMED-mail map of Burundi:
Date: Tue, 6 Aug 2019 10:38:45 +0200 (METDST)

Nairobi, Aug 6, 2019 (AFP) - Malaria has killed more than 1,800 people in Burundi this year, the UN's humanitarian agency says, a death toll rivalling a deadly Ebola outbreak in neighbouring Democratic Republic of Congo.   In its latest situation report, the United Nations Office for the Coordination of Humanitarian Affairs (OCHA) said 5.7 million cases of malaria had been recorded in Burundi in 2019 -- a figure roughly equal to half its entire population.   Of those cases, a total of 1,801 died from the mosquito-born disease in Burundi between January 1 and July 21, OCHA said.

The tiny country of 11 million people in the African Great Lakes region has still not declared a national emergency, despite OCHA saying the outbreak crossed "epidemic proportions" in May.   "The national malaria outbreak response plan, which is currently being validated, has highlighted a lack of human, logistical and financial resources for effective response," OCHA said in its latest weekly bulletin on humanitarian emergencies.   "All stakeholders, including the national authorities and partners are called upon to provide the requisite resources to mount a robust response to this event before it escalates."   A lack of preventative measures like mosquito nets, climatic changes and increased movements of people from mountain areas with low immunity to malaria were driving the crisis, OCHA said.

- 'Many crises' -
An OCHA official told AFP that "the decision to declare an epidemic is the sovereignty of the Burundian state".   The country declared a malaria epidemic in March 2017, when the country had recorded 1.8 million cases and 700 deaths, but was resisting doing the same now.   A senior government official, who declined to be named, said the government did not want to admit weakness with elections set for 2020.   "We are less than a year away from the presidential election. (President Pierre) Nkurunziza, who is facing many crises, does not want to recognise what could be considered a failure of his health policy," the official told AFP.   Burundi has been in crisis since 2015, when Nkurunziza ran for a third term and was re-elected in elections boycotted by most of the opposition.

At least 1,200 people were killed and more than 400,000 displaced in violence the UN says was mostly carried out by state security forces.   Nkurunziza announced in 2018 that he would not stand again, confounding critics who accused him of working to extend his grip on power.   UN investigators said in July that "drastic" steps were needed to boost democratic freedoms in Burundi if the government wanted the elections to be considered credible.

Burundi, one of the poorest countries in the region, abuts DR Congo, where the second-worst Ebola outbreak in history has killed more than 1,800 people amid fears the infectious fever could spread beyond its borders.   But malaria is a much bigger killer on the continent.   The World Health Organization recorded nearly 220 million cases of the parasitic illness in 2017, with an estimated 435,000 deaths. More than 90 percent of malaria cases and deaths were in Africa.
Date: Fri, 16 Mar 2018 14:39:07 +0100

Nairobi, March 16, 2018 (AFP) - Nine workers at a construction site outside Burundi's capital Bujumbura were killed in a landslide on Friday, police said.   Heavy seasonal rains caused the hillside next to the Gasenyi river, east of the city, to collapse burying the workers who were building a channel to redirect the river's floodwaters.   Police said in a statement that nine bodies had so far been found, while rescue efforts continue.
Date: Sat 7 Oct 2017 11:52:12 CAT
Source: Global Times, Xinhua News Agency report [edited]

At least 5 cases of cholera were reported this week [week of 2 Oct 2017] in Rugombo town in Cibitoke province, 72 km [about 45 mi] northwest of the Burundian capital Bujumbura, the Burundi News Agency reported Fri 6 Oct 2017. All those 5 cholera cases were reported at Rusiga, adding that lack of clean water is the origin of the propagation of cholera in that area, the state-run agency reported.

The Burundi Red Cross has deployed its agents to distribute drugs in infected households at Rusiga to avoid the propagation of the epidemic, it reported. Cibitoke Governor Joseph Iteriteka on [Fri 6 Oct 2017] held a meeting with health and administration officials based in Cibitoke province to look at ways of curbing the propagation of cholera in Rugombo and Cibitoke town, according to the report. During the meeting, they urged the country's Water and Electricity Company (REGIDESO) to supply water to the 2 towns -- Rugombo and Cibitoke -- as they are the worst threatened, reported the agency.

The Burundian Imbo western lowlands extending from the north in Cibitoke province to the south in Makamba Province near Lake Tanganyika are vulnerable to cholera every year in the dry season, especially between August and October. By the end of August 2017, the east African country's health ministry confirmed 24 cholera cases in Nyanza-Lac in the south-western province of Makamba, which originated from a fisherman who had come from the Democratic Republic of the Congo with symptoms of cholera.
===================
[Cibitoke province is one of the 18 provinces of Republic of Burundi. It is located in extreme northwest Burundi and can be seen on a map at <http://www.un.org/Depts/Cartographic/map/profile/burundi.pdf>. - ProMED Mod.LL]

[A HealthMap/ProMED-mail map can be accessed at
More ...

World Travel News Headlines

Date: Wed, 20 Nov 2019 22:35:51 +0100 (MET)

Manila, Nov 20, 2019 (AFP) - Philippine police were ordered Wednesday to arrest anyone caught vaping in public, just hours after Philippine President Rodrigo Duterte announced he would ban e-cigarettes.   The abrupt prohibition, revealed by Duterte late Tuesday adds to a growing global backlash against a product once promoted as less harmful than tobacco smoking.

Duterte, a former smoker, called the devices "toxic" and said vaping introduced "chemicals" into the user's body.   He ordered the arrest of anyone vaping publicly in a country that already has some of Asia's toughest anti-smoking rules.    No formal, written order has been made public that spells out the scope of the ban or penalties for violations.   Duterte is notorious internationally for his deadly anti-narcotics crackdown, but he has also targeted tobacco with a wide-ranging ban on smoking in public.   Citing "the order of the president", on Wednesday a statement from the head of the Philippine police ordered "effective today, all police units nationwide to enforce the ban on use of vapes; ensure that all violators will be arrested".

The ban came days after Philippine health authorities reported the nation's first vaping-related lung injury, which resulted in a 16-year-old girl being hospitalised.   Vaping has taken off in the Philippines, with speciality shops and vapers puffing away in public a common sight.     E-cigarette users were caught off guard by the ban and questioned the utility of arresting people who, at worst, were hurting themselves.   "It's inappropriate. In any case, we don't hurt people, the environment or animals," said 22-year-old student Alexis Martin.   "Why are vapers being targeted?"

E-cigarettes warm flavoured liquid to produce vapour that is free of the estimated 7,000 chemicals in tobacco smoke, but does contain a number of substances that could potentially be harmful.  Critics say that apart from being harmful in themselves, the multiple exotic flavours of e-cigarette liquids appeal particularly to youngsters and risk getting them addicted to nicotine.

The devices have become hugely popular in the past decade but a rash of vaping-linked deaths and illnesses in the United States is feeding caution about the product, already banned in some places.   In September 2019 India became the latest country to ban the import, sale, production and advertising of e-cigarettes, citing in particular concerns for its youth.   The devices are already banned in several places such as Brazil, Singapore, Thailand and the US state of Massachusetts.
Date: Wed, 20 Nov 2019 17:17:39 +0100 (MET)

Lagos, Nov 20, 2019 (AFP) - Nigerian President Muhammadu Buhari on Wednesday announced a campaign to end defecation in public, in a country where tens of millions of people going to the toilet outside poses a major health risk.    "Nigeria has committed to end open defecation throughout the country by 2025," a statement by the presidency said a day after the United Nations marked World Toilet Day.     The decree set up a new body called the Clean Nigeria Campaign Secretariat to ensure "that all public places including schools, hotels, fuel stations, places of worship, market places, hospitals and offices have accessible toilets and latrines within their premises". 

According to the United Nations children agency, UNICEF, Nigeria has amongst the highest number of people practising open defecation in the world, estimated at over 46 million people -- almost a quarter of the population.   Around Nigeria each year 87,000 children die from diarrhoea, with more than 90 per cent of deaths caused by a lack of water, sanitation and hygiene, according to the World Bank.   The new agency will be disbanded when the goal of ending open defecation has been met, the presidency said.
Date: Wed, 20 Nov 2019 12:59:15 +0100 (MET)

Kampala, Nov 20, 2019 (AFP) - Global health charity Marie Stopes said Wednesday it had recalled hundreds of thousands of faulty condoms on sale in Uganda, where HIV rates are among the highest in the world.   The recall followed a warning from Uganda's National Drug Authority (NDA) that the Life Guard brand condoms had failed manufacturing "quality tests" because they contained holes and may burst.   The affected condoms were manufactured by India-based MHL Healthcare in April 2019 and have an expiry date of April 2024, the government regulator said.   Marie Stopes Uganda spokesman David Kamu told AFP on Wednesday that the two affected batches each contained "around 400,000" condoms.

Earlier reports had suggested millions of condoms could have been involved but NDA spokesman Fred Ssekyana told AFP the figure was below one million.   Marie Stopes Uganda said more than half of the condoms of concern had been recalled.   "While the LifeGuard brand follows strict quality controls, unfortunately two recent batches have fallen short of the quality we demand," the charity's country director, Carole Sekimpi, said in a statement Tuesday.   Marie Stopes is the largest and most specialised sexual reproductive health organisation in Uganda, the charity says on its website.   According to UNAIDS, 1.4 million Ugandans are living with HIV.   Last year 53,000 people were newly infected with the disease in the East African country, the UN agency said.
Date: Wed, 20 Nov 2019 15:08:18 +0100 (MET)

Luanda, Nov 20, 2019 (AFP) - Angola recorded an outbreak of polio this week after almost a decade without cases of the paralysing viral disease, the government said.   The highly infectious condition mainly affects children under the age of five. It attacks the nervous system and can lead to total paralysis, or in some cases death.   "After seven years without polio we are unfortunately confronted with a difficult situation," Angola's health minister Sante Silvia Lutucuta said on Monday, at the launch of a new vaccination campaign in the capital Luanda.   "We have recorded 44 new cases in ten of the country's 18 provinces," she added.

The vaccination campaign is expected to reach 2.5 million children aged five and under.   "All children must be protected by three doses of the oral anti-poliomyelitis vaccine," said Lutucuta, adding that the campaign would span over two weeks to "control the epidemic".   Two out of three strains of the wild polio virus have been eradicated so far, according to the World Health Organization (WHO).           While only 33 wild polio cases were reported globally last year, vaccine-derived polio still breaks out sporadically in some parts of Africa and Asia.    The Centers for Disease Control and Prevention has recommended that all travellers to Angola be fully vaccinated against the virus.
Date: Thu, 21 Nov 2019 01:34:32 +0100 (MET)

Bangkok, Nov 21, 2019 (AFP) - A 6.1-magnitude earthquake hit north-western Laos near the Thai border early Thursday, the United States Geological Survey reported.    The shallow quake hit at 6:50 am local time (2350 Wednesday GMT), USGS said. 
Date: Thu, 21 Nov 2019 01:25:15 +0100 (MET)

Sydney, Nov 21, 2019 (AFP) - The fire danger was elevated across wider swathes of southern Australia on Thursday, with residents warned to avoid at-risk areas as smoke from bushfires choked Sydney and other major cities.   Devastating fires along the country's east coast have claimed six lives and destroyed more than 500 homes since mid-October, with climate change and unseasonably hot, dry conditions fuelling the unprecedented blazes.   Now the fire danger has moved into states further south, with a so-called "Code Red" -- the highest possible fire risk in Victoria -- being declared in the state's northwest for the first time in a decade.   "What that means is that if we see fires in those areas they will be fast moving, they will be unpredictable, they will be uncontrollable," emergency management commissioner Andrew Crisp told reporters.

Country Fire Authority chief Steve Warrington told people living in rural areas to leave for the safety of cities.   "We are saying, 'do not be there, do not be there when a fire occurs, because you will not survive if you are there'," he said.   "There is a good chance if a fire occurs that your home will be destroyed."   The fire danger was also elevated to "severe" in the island state of Tasmania off mainland Australia's southeastern coast,  where a total fire ban was declared.   Two bushfires in the state's northeast did not pose an immediate threat to residents, the Tasmania Fire Service said.

For the second time in two days, smoke from bushfires blanketed Sydney, Australia's biggest city and home to more than five million people, sending air quality plummeting to hazardous levels.   More than 110 fires are still burning in worst-hit New South Wales and neighbouring Queensland, while in South Australia more than 40 fires broke out during catastrophic fire conditions Wednesday.    A South Australia Country Fire Service spokeswoman said all of those blazes had been brought under control or extinguished by Thursday, with the exception of a major fire on the Yorke Peninsula that had come perilously close to a small town.

Conditions were expected to ease in the coming days in South Australia, where the state capital Adelaide was also shrouded in bushfire smoke and residents were being told to stay indoors for health reasons.   Bushfire-prone Australia has experienced a horror start to its fire season, which scientists say is beginning earlier and becoming more extreme as climate change pushes temperatures higher and saps moisture from the environment after months of severe drought.   Growing calls to curb fossil fuels and drastically cut greenhouse gas emissions are being ignored by the country's conservative government, which is eager to protect its lucrative mining industry.   The country is bracing for challenging fire conditions to continue throughout the Southern Hemisphere summer.
Date: Mon 18 Nov 2019
Source: 112.UA [edited]

Eight school classes in Odesa [Odessa] have been closed for quarantine. More than 30% of school students in these classes are sick with Coxsackie virus, a highly contagious respiratory disease, said Olena Buynevych, the director of the city hall's department for science and education, as quoted by UNN news agency.

"More than 30% of students in these classes are sick wi h acute
respiratory diseases, which include cases of cases and Coxsackievirus," the official said. She urged the parents to keep the children away from schools in case they have any symptoms of acute respiratory diseases.

The symptoms are basically the same as flu; the key difference is the rash on the palms, in case of the Coxsackievirus.

Coxsackievirus is a member of a family of viruses called enteroviruses. Enteroviruses are made up of a single strand of ribonucleic acid (RNA). The enteroviruses are also referred to as picornaviruses ("pico" means "small," so, "small RNA viruses"). They are present all over the world and spread by fecal-oral route. About 90% of infections don't cause symptoms or present with a fever only. Infants and young kids are particularly susceptible to symptomatic coxsackie.
======================
[Coxsackievirus belongs to a family of nonenveloped, linear, positive-sense, single-stranded RNA viruses, Picornaviridae and the genus _Enterovirus_, which also includes poliovirus and echovirus. Enteroviruses are among the most common and important human pathogens, and ordinarily its members are transmitted by the fecal-oral route. Coxsackieviruses share many characteristics with poliovirus. With control of poliovirus infections in much of the world, more attention has been focused on understanding the nonpolio enteroviruses such as coxsackievirus.

Coxsackieviruses are divided into group A and group B viruses based on early observations of their pathogenicity in neonatal mice. In general, group A coxsackieviruses tend to infect the skin and mucous membranes, causing herpangina, acute hemorrhagic conjunctivitis, and hand, foot, and mouth (HFM) disease. Both group A and group B coxsackieviruses can cause nonspecific febrile illnesses, rashes, upper respiratory tract disease, and aseptic meningitis.

Group B coxsackieviruses tend to infect the heart, pleura, pancreas, and liver, causing pleurodynia, myocarditis, pericarditis, and hepatitis (inflammation of the liver not related to the hepatotropic viruses). Coxsackie B infection of the heart can lead to pericardial effusion.

The development of insulin-dependent diabetes (IDDM) has recently been associated with recent enteroviral infection, particularly coxsackievirus B pancreatitis.

It is common for the coxsackievirus to cause a febrile upper respiratory tract infection with sore throat and/or a runny nose. Some patients have a cough resembling bronchitis. Less commonly, coxsackievirus may cause pneumonia. Some people with coxsackievirus have a rash. In many, this is a nonspecific generalized red rash or clusters of fine red spots. The rash may not appear until the infection has started to get better.

Coxsackievirus is spread from person to person. The virus is present in the secretions and bodily fluids of infected people. The virus may be spread by coming into contact with respiratory secretions from infected patients. If infected people rub their runny noses and then touch a surface, that surface can harbor the virus and become a source of infection. People who have infected eyes (conjunctivitis) can spread the virus by touching their eyes and touching other people or surfaces. Conjunctivitis may spread rapidly and appear within one day of exposure to the virus. Coxsackieviruses are also shed in stool, which may be a source of transmission among young children. The virus can be spread if unwashed hands get contaminated with fecal matter and then touch the face. This is particularly important for spread within  day-care centers or nurseries where diapers are handled. Diarrhoea is the most common sign of coxsackievirus intestinal infection.

Most infections are self-limiting, and no specific treatment is required or available. Some options include intravenous immune globulin (IVIG), which contains antibodies and may be somewhat effective.

HealthMap/ProMED-mail map:
Odesa oblast, Ukraine: <http://healthmap.org/promed/p/51897>]
Date: Tue 19 Nov 2019 6:07 AM GMT
Source: 3 FM [edited]

There's been an outbreak of a highly contagious disease among wood pigeons on [Isle of Man]. That's according to Manx Wild Bird Aid (MWBA) which says its already taken in a number of the animals from Douglas, Groudle, and Crosby which are suffering with 'canker'.

The infection isn't harmful to humans or mammals but the organisation says it can cause growths in the birds' mouths which can lead them to starve to death.

MWBA is offering advice to people about how to help stop it spreading, including strict hygiene on bird-feeding tables and if you come across a sick pigeon to take it to the nearest vet as soon as possible.  [Byline: Rob Pitchard]
========================
[_Trichomonas gallinae_ is a common protozoan parasite of pigeons (Columbiformes) which principally infects the upper alimentary tract where it can cause necrotic ingluvitis. Epidemic mortalities in columbiform species are sporadically reported, and the parasite may infect other avian taxa such as birds of prey and songbirds. (<http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0012215>). - ProMED Mod.PMB]

[HealthMap/ProMED-mail map of the Isle of Man:

HealthMap/ProMED map available at:
Date: Tue 19 Nov 2019
Source: Caracas Chronicles [edited]

The Venezuelan Public Health Society and the Let's Defend The National Epidemiology Network issued an alert after a case of yellow fever was confirmed in the state of Bolivar, after 14 years without the disease. The Health Ministry hasn't published information about the case or issued an alert, but Venezuela must formally report it to international institutions, due to the risk to a population that isn't vaccinated, having the vector (mosquitoes) in all of the territory (increasing the odds of an epidemic), and the poor access to an epidemiologic report [about the case]. Doctor Julio Castro wrote about the case for Prodavinci.  [Byline: Naky Soto]
======================
[There is little information about this case: where and when it occurred in Bolivar state, tests used to diagnose the case, condition of the patient, and any follow-up measures taken by public health authorities. Yellow fever (YF) virus is endemic in Venezuela as it is in many South American countries.

The most recent ProMED-mail report of YF in Venezuela was in 2010, in Anzoategui state, where there were 3 probable YF cases in monkeys. This outbreak was enzootic, as determined by the Ministry of Health (see Yellow fever - South America: Venezuela (AN) monkey, susp http://promedmail.org/post/20101112.4114).

Presumably, this current case is one of spill-over from the sylvan (forest) transmission cycle. Maintenance of a high level (80-90%) of coverage is essential to prevent cases and avoid outbreaks involving the urban cycle with _Aedes aegypti_ transmission. - ProMED Mod.TY]

[HealthMap/ProMED-mail map of Venezuela:
Date: Thu 14 Nov 2019
Source: WHO Emergencies preparedness, response, Disease Outbreak News (DONs) [edited]

On 10 Oct 2019, the National IHR Focal Point for Sudan notified WHO of 47 suspected [human] cases of Rift Valley fever (RVF), including 2 deaths in Arb'aat Area, Towashan Village, in El Qaneb locality, Red Sea State. The suspected cases presented with high-grade fever, headaches, joint pain, vomiting. There were no hemorrhagic signs or symptoms observed. The 1st case presented to the health facility on 19 Sep 2019.

On 28 Sep 2019, a total of 14 samples were sent to the National Public Health Laboratory in Khartoum, and 5 tested positive for RVF by immunoglobulin M (IgM) enzyme-linked immunosorbent assay (ELISA) and reverse-transcriptase polymerase chain reaction (RT-PCR). These samples were also tested for malaria and were found negative.

On 13 Oct 2019, a total of 10 suspected RVF cases were recorded in Barbar and Abu Hamed localities, of River Nile State. Of the 10 suspected RVF cases, 5 samples were tested and 4 were found positive for RVF. From 19 Sep 2019 until 11 Nov 2019, a total of 293 suspected human RVF cases, including 11 associated deaths have been reported from 6 states; including the Red Sea (120), River Nile (168), Kassala (2), White Nile (1), Khartoum (1), and Al Qadarif (1) States. The most affected age group is 15-45 years old, which accounts for 83% of the total suspected cases. The male to female ratio is 2.6, with a high proportion of the cases being farmers (37.5%).

These human RVF cases are concomitant with abortions and deaths among goats in the areas where the human suspected and confirmed cases have been reported. From 25 Sep through 3 Nov 2019, 21 goats in Red Sea State were reported as positive for RVF, including 4 deaths; and in River Nile State 16 goats, with 3 deaths, and 37 sheep, with 5 deaths, were confirmed positive for RVF by ELISA test at the Central Veterinary Research Laboratory in Khartoum.

Public health response
----------------------
Red Sea State
-------------
- Activation of RVF task force committee;
- printing and distribution of RVF guidelines;
- deployment of surveillance teams for daily reporting and active case finding in the affected areas;
- establishment of 2 health centers and one dispensary with a capacity of 11 beds, laboratory items, drugs, and supplies to provide health services in the affected villages;
- conducting household inspections and fogging: In Arb'aat area, a total of 452 households were inspected, out of which 30 were found positive for the presence of a competent vector; in Port Sudan, out of 1225 households inspected, 29 were found positive for the competent vector, and fogging was provided to 1949 households;
- the Veterinary Epidemiology Department of the Ministry of Animal Resources conducted vector control in 4 animal enclosures in the affected villages.

River Nile State
- A joint investigation conducted by the State Ministry of Health (SMoH) and WHO on 12 Oct 2019;
- initiation of an RVF Action plan by the SMoH and WHO;
- initiation of Integrated Vector Management (IVM), surveillance, case management, and Rapid Response Team (RRT) activities.

WHO risk assessment
-------------------
RVF is endemic in Sudan. There have been 3 outbreaks affecting humans previously documented in 1973, 1976, and 2008. During the outbreak in 2008, a total of 747 laboratory-confirmed cases were reported, including 230 deaths.

The recent floods, following heavy rains on 13 Aug 2019, caused flash floods in 17 of the 18 states, including Abyei area in West Kordofan State. These floods have favored vector abundance, distribution, and longevity. The current RVF outbreak started on 19 Sep 2019 and has affected states impacted by the floods.

The uncontrolled movements of animal populations within and outside the country borders may increase the spread of the disease to new areas.

RVF can cause significant economic losses due to livestock travel and trade restrictions, as well as high mortality and abortion rates among infected animals.

In a country where the export of livestock is one of the major sources of the national income, the current RVF outbreak, in the context of political unrest and a debilitated health system requires an urgent need for external assistance.

WHO advice
----------
Rift Valley fever (RVF) is a mosquito-borne viral zoonosis that primarily affects animals but also has the capacity to infect humans. The majority of human infections result from direct or indirect contact with the blood or organs of infected animals. Herders, farmers, slaughterhouse workers, and veterinarians have an increased risk of infection.

Awareness of the risk factors of RVF infection and measures to prevent mosquito bites is the only way to reduce human infection and deaths. Public health messages for risk reduction should focus on:
- reducing the risk of animal-to-human transmission resulting from unsafe animal husbandry and slaughtering practices;
- practicing hand hygiene as well as wearing gloves or other personal protective equipment when handling sick animals or their tissues and when slaughtering animals;
- reducing the risk of animal-to-human transmission arising from the unsafe consumption of raw or unpasteurized milk or animal tissue. in endemic regions, all animal products should be thoroughly cooked before eating;
- reducing the risk of mosquito bites through the implementation of vector control activities (e.g. insecticide spraying and use of larvicidal to reduce mosquito breeding sites), use of insecticide-impregnated mosquito nets and repellents, light-coloured clothing (long-sleeved shirts and trousers);
- restricting or banning the movement of livestock to reduce the spread of the virus from infected to uninfected areas;
- routine animal vaccination is recommended to prevent RVF outbreaks. Vaccination campaigns are not recommended during an outbreak as they may intensify transmission among the herd through needle propagation of the virus;
- outbreaks of RVF in animals precede human cases, thus the establishment of an active animal health surveillance system is essential in providing early warning for veterinary and public health authorities.

WHO advises against the application of any travel or trade restrictions with the affected country based on the current information available on this event.
=====================
[The report above provides a good overview of the development of the current Rift Valley fever outbreak. Surveillance and responses require a One Health approach since both humans and animals are affected and environmental change, in this situation extensive flooding, has promoted vector abundance. Effective vector control over extensive geographical areas is difficult to achieve and is expensive. Maintenance of herd immunity through vaccination of animals can be a successful preventive measure prior to the occurrence of cases. - ProMED Mod.TY]

[Neighbouring Egypt, which suffered introductions of RVF from Sudan in the past, has undertaken preventive measures. This relates initially to the 2 governorates bordering Sudan, namely the Red Sea and the New Valley governorates. In the Red Sea governorate, vaccination has already started. Reportedly, as of 18 Nov 2019, a total of 12 801 animals have been vaccinated, including 11 568 sheep and goats, 712 camels, and 421 cows and buffalo. The vaccination, which is free of charge, is being continued. In the New Valley governorate, 62 guidance seminars about RVF for animal breeders in the 5 provincial centers have been undertaken; the implementation of a "magnified immunization campaign for a month" is said to commence "next Saturday" (23 Nov 2019), "aimed at immunizing 120 000 cattle, goats, and sheep." Intensified surveillance in animals has, reportedly, been applied in both governorates; no suspected cases detected. - ProMED Mod.AS]