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Germany

Germany US Consular Information Sheet
December 08, 2008
COUNTRY DESCRIPTION:
Germany is a modern and stable democracy. Tourist facilities are highly developed. In larger towns, many people can communicate in English.
Read the Departme
t of State Background Notes on Germany for additional information.

ENTRY/EXIT REQUIREMENTS: Germany is a party to the Schengen Agreement. As such, U.S. citizens may enter Germany 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 fact sheet. Further information on entry, visa and passport requirements may be obtained from the German Embassy at 4645 Reservoir Road N.W., Washington, D.C. 20007, telephone (202) 298-4000, web site: http://www.germany.info/Vertretung/usa/en/Startseite.html, or the German Consulates in Atlanta, Boston, Chicago, Houston, Los Angeles, Miami, New York, or San Francisco. Passengers transiting Germany en route to other countries should ensure that they are aware of and in compliance with the entry requirements for their final destinations as individuals not presenting appropriate documentation for their destination may be denied boarding on connecting flights.

Information about dual nationality or the prevention of international child abduction can be found on our website.
For further information about customs regulations, please read our Customs Information Sheet.

SAFETY AND SECURITY:
German authorities remain vigilant in combating the threat posed by foreign and resident extremists. Specific threats have been uncovered and persecutions undertaken, though Germany itself has been largely free of terror incidents. However, like other countries in the Schengen area, Germany’s open borders with its European neighbors allow the possibility of dangerous individuals entering/exiting the country with anonymity. Germany regularly experiences demonstrations on a variety of political and economic themes. Prior police approval is required for public demonstrations, and police oversight is routinely provided for participants and passersby. Nonetheless, these demonstrations can attract counter-demonstrators and have the potential to turn violent. In addition, hooligans, most often young intoxicated “skinheads” have been known to harass or even attack people whom they believe to be foreigners or members of rival groups. On occasion, American have reported that they were assaulted for racial reasons or because they appeared “foreign.” All Americans are cautioned to avoid the area around protests and demonstrations and to check local media for updates on the situation.

For the latest security information, Americans traveling abroad should regularly monitor the Department’s web site at http://travel.state.gov, where the current 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 U.S., 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 A Safe Trip Abroad.

CRIME:
Violent crime is rare in Germany- but can occur, especially in larger cities or high-risk areas such as train stations. Most incidents of street crime consist of theft of unattended items and pick-pocketing. There have been a few reports of aggravated assault against U.S. citizens in higher-risk urban areas. American travelers are advised to take the same precautions against becoming crime victims as they would in any American 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 local police, please contact the nearest U.S. Embassy or Consulate for assistance.
The Embassy or Consulate staff can, for example, assist you to find appropriate medical care, to 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. For more information on possible U.S. sources of assistance, see our information on Victims of Crime.

The local equivalent to the 911 emergency line in Germany is 112.
MEDICAL FACILITIES AND HEALTH INFORMATION:
Good medical care is widely available. Doctors and hospitals may expect immediate payment in cash for health services from tourists and persons with no permanent address in Germany. Most doctors, hospitals and pharmacies do not accept credit .

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. U.S. military facilities in Germany will not provide treatment to private American citizens who are not affiliated with the Department of Defense.

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 Germany is provided for general reference only, and may not be totally accurate in a particular location or circumstance. Individuals holding U.S. driver’s licenses may drive in Germany for up to six months without acquiring a German driver’s license.

Road conditions in general are excellent, although caution should be exercised while traveling on older roads in eastern Germany. The high speed permitted on the German autobahn, weather, and unfamiliar road markings can pose significant hazards, and driver error is a leading cause of accidents involving American motorists in Germany. Rules on right-of-way differ significantly from the U.S.
Notice should be taken that it is generally illegal in Germany to pass vehicles from the right and that the threshold for determining whether a person has been driving under the influence of alcohol is lower than in some U.S. states.

Many German streets and sidewalks have dedicated bike lanes for use by bicyclists. Pedestrians should be aware that bicycles have priority use of these lanes and should be careful to observe whether any bicyclist is approaching before crossing or stepping into the bike lane. Bicyclists also have priority over cars turning onto side streets, and motorists should always confirm whether a bicyclist is approaching from either direction before attempting to enter side streets, even when the light is in their favor. Motorists turning into a side street who hit a bicyclist who is using a marked bike lane will be held responsible for any injury or damage caused.
The use of cell phones while driving is prohibited in Germany. For specific information on travel within Germany contact the German National Tourist Board Office in New York at (212) 661-7200, fax (212) 661-7174 or via the Internet at http://www.germany-tourism.de/
Travelers should also note that railroad crossings are marked differently in Germany than in the U.S. There have been several accidents involving Americans in recent years at railroad crossings. In addition to the standard crossbuck (X-shaped) sign, railroad crossings are often marked by signal lights. Signal lights at a railroad crossing means that a train is approaching and that all vehicles should stop.

Please refer to our Road Safety page for information. Visit the website of the country’s national tourist office and national authority responsible for road safety at http://www.germany-tourism.de/
AVIATION SAFETY OVERSIGHT:
The U.S. Federal Aviation Administration (FAA) has assessed the Government of Germany’s Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for oversight of Germany’s air carrier operations. For more information, travelers may visit the FAA’s web site at www.faa.gov/safety/programs_initiatives/oversight/iasa
SPECIAL CIRCUMSTANCES:
Germany’s customs authorities may enforce strict regulations concerning temporary importation into or export from Germany of certain items such as firearms, military artifacts (particularly those pertaining to the Second World War), antiques, medications/pharmaceuticals and business equipment. Under German law it is also illegal to bring into or take out of Germany literature, music CDs, or other paraphernalia that glorifies fascism, the Nazi past of the former “Third Reich.” It is advisable to contact the German Embassy in Washington or one of the German consulates in the United States for specific information regarding customs requirements.

Automatic Teller Machines (ATMs) are widely available throughout Germany. They utilize many of the same account networks that are found in the U.S., so it is possible in most cases to get euros directly from your U.S. bank while you are in Germany without paying any inordinate fees for currency exchange. Credit cards are not accepted as widely as in the United States. 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 German laws, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in Germany are strict and convicted offenders can expect 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:
American citizen parents have at times encountered difficulties having visitation orders enforced in Germany. For information see our Office of Children’s Issues web pages on intercountry adoption and international parental child abduction.

REGISTRATION/EMBASSY AND CONSULATE LOCATIONS:
Americans living or traveling in Germany are encouraged to register with the nearest U.S. Embassy of Consulate through the State Department’s travel registration web site, https://travelregistration.state.gov/, and to obtain updated information on travel and security within Germany.
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.

U.S. Consular Sections are located at:
Berlin: Clayallee 170;
Tel: (49) (30)832-9233; Fax: (49) (30) 8305-1215
American Citizen Services Email: ACSBerlin@state.gov
Frankfurt: Giessner Str. 30,
Tel. (49) (69) 75350; Fax: (49) (69) 7535-2304.
American Citizen Services Email:GermanyACS@state.gov
Passport Inquiries Email: FrankfurtPassports@state.gov
Leipzig: Wilhelm-Seyfferth-Strasse 4,
Tel. (49) (341) 213-8418; Fax: (49) (341) 2138417 (emergency service only).

Munich: Koenigstrasse 5,
Tel. (49) (89) 2888-0; Fax: (49) (89) 280-9998.
American Citizen Services Email: ConsMunich@state.gov
There is also a U.S. consular agency in Bremen at Bremen World Trade Center,
Birkenstrasse 15,
Tel: (49) (421) 301-5860; Fax: (49) (421) 301-5861.

When calling another city from within Germany, dial a zero before the city code (for example, when calling Berlin from Munich, the city code for Berlin is 030).
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This replaces the Consular Information Sheet dated April 23, 2008 to update information on Entry Requirements, Safety and Security and Medical Insurance.

Travel News Headlines WORLD NEWS

Date: Mon 2 Sep 2019
Source: Onetz [in German, trans. Sabine Zentis, edited]

The 1st recorded death from [a] hantavirus [infection] may have occurred in Bavaria. The suspected case has not yet been confirmed.

The bank vole is the main carrier of [Puumala] hantavirus.

The deceased man had been infected with the virus. Whether the hantavirus was the cause of death is still to be clarified, according to the reports of the Bayerischer Rundfunk, the State Office of Health and Food Safety.

In Bavaria in 2019, 224 cases of hantavirus infection have so far been reported, 107 of which were in Lower Bavaria. Last year [2018], there were 31 cases in Bavaria.

The bank vole is the main carrier of the virus. Its spread in 2019 is due to a particularly large food supply. Virus transmission to humans occurs through inhalation or through contact of injured skin with virus-contaminated dust, and through bites.

According information from the State Office of Health and Food Safety (LGL), special caution is recommended for activities in sheds, cellars, attics, and garden sheds, where mice live. In case of visible mouse infestation, gloves and masks should be worn.

Information is available from the State Office for Health and Food Securities Unit (LGL) for Hantaviruses.
======================
[This has been an active year (2019) for hantavirus transmission and, in the recent past, in other parts of Germany as well. This year (2019), there were more than 200 registered cases in Baden-Wurttemberg (see ProMED-mail Hantavirus - Europe: Germany http://promedmail.org/post/20190523.6482626).

Although not stated in the report above, the hantavirus most likely involved in these cases is Puumala virus [PUUV], with the bank vole (_Myodes glareolus_) as the rodent reservoir host. Puumala virus is endemic to southwestern and western Germany and causes haemorrhagic fever with renal syndrome (HFRS).

The above report and the earlier one comment on the abundant food supplies (beech tree mast and acorns) as contributory to abundant bank voles. In a recent comment on the Baden-Wurttemberg cases, Dr. Jan Clement comments that the illness caused by PUUV is the so-called haemorrhagic fever with renal syndrome (HFRS), with extremely variable fatality rates, depending not only on the infecting hantavirus species, but also largely on the immune response itself of the infected patient. He further commented that more PUUV-infected voles equals more human PUUV infections. PUUV prevalence in bank vole populations depends on several changing factors, resulting sometimes in denser vole populations, but with lower PUUV prevalence, hence the recent Belgian study cited below, titled: "Why hantavirus prevalence does not always increase with host density: modelling the role of host spatial behaviour and maternal antibodies."

Reference:
Leirs H, et al; abstract no. 152 at the XI Int. Conf. on Hantaviruses, September 1-4, 2019, Leuven, Belgium.

An image of _Myodes glareolus_, the Puumala virus host, can be accessed at

Map of Germany: <http://tinyurl.com/ycbyuk5g>. - ProMED Mod.TY]

[HealthMap/ProMED map available at:
Date: Wed 14 Aug 2019
Source: Universitat Hohenheim [in German, trans. Britta Lassmann, edited]

The University of Hohenheim and the Bundeswehr Institute of Microbiology [IMB] have detected spotted fever in a hyalomma tick, the 1st time such a tick is suspected to have caused disease in a human in Germany.

This tick feeds on humans and can transmit a form of spotted fever in Germany. What were still unanswered questions about the tropical giant tick hyalomma is now certainty. At the beginning of August [2019], it was suspected that for the 1st time, a human in Germany had contracted a disease with the typical symptoms of rickettsiosis from the bite of a hyalomma tick. Experts from the University of Hohenheim in Stuttgart and the IMB in Munich were able to detect the pathogen _Rickettsia aeschlimannii_ in the tick. The number of hyalomma ticks in Germany increased significantly in 2019 compared to the previous year [2018]. In nearly half of the hyalomma ticks, _R. aeschlimannii_ can be detected. The tick researchers continue to ask the population to send them suspicious ticks.

It was probably no coincidence that this 1st case was in a horse owner. Tropical ticks of the genus _Hyalomma_ feed on large mammals. For several years, these ticks have been on the rise in Germany. Now tick researchers report the 1st suspected case of spotted fever transmitted in Germany. "Not only do we now know for sure that the hyalomma tick is also targeting humans," says Prof Dr Med Ute Mackenstedt, a parasitologist at the University of Hohenheim, "but also that there is the urgent suspicion that the transmission of spotted fever by these ticks is actually possible here in Germany."

The case: At the end of July [2019], the horse owner from near Siegen was bitten by a hyalomma tick. He sent the tick to the tick researcher in Hohenheim. He then presented to the hospital only a few days later with severe symptoms. Spotted fever caused by the bacterium _R. aeschlimannii_ was suspected. The tick was sent by courier service to the IMB in Munich, where the pathogen was detected in the tick. Thereafter, the patient received targeted antibiotic therapy, and his symptoms rapidly improved.

"We are talking about a suspected case, because direct detection of the pathogen from the patient was not possible," explains PD Dr Med Gerhard Dobler, medical doctor at the IMB. "The treatment of the patient came 1st. But the preceding tick bite, the typical symptoms
and, above all, the proof of the pathogen in the tick suggest that the case was spotted fever. The fact that the patient responded to targeted antibiotic therapy further supports this."

_R. aeschlimannii_ causes a feverish infection with headache and muscle pain, extreme joint pain, and a burning sensation. Typical for the disease, however, is the rash that gave the disease its name. This classic sign shows mainly on the extremities. The incubation period is about one week.

"If spotted fever is suspected after a hyalomma bite, a swab should be taken from the bite site and sent for examination," advises PD Dobler. "If there are questions, you are welcome to contact us. Ideally, we would also like to examine the tick."

About half of the hyalomma ticks, the researchers say, are infected with rickettsia. Transmission takes place exclusively via tick bite. "The number of hyalomma ticks in Germany is significantly higher this year [2019] than in the previous year [2018]," reports Prof Dr Med Mackenstedt, referencing the publication in which the situation was presented in 2018. The Hohenheim parasitologist not only cooperates closely with the IMB in Munich, but also with the working group of Prof Dr Med Christina Strube at the Veterinary University (TiHo) Hannover. "Together they already have found 50 such ticks in Germany in 2019. Last year [2018] there were a total of 35." Last year, these ticks had survived the winter in Germany for the 1st time.

"Rickettsia are the only pathogens that we have been able to detect so far," explains PD Dr. Dobler. "We have not found the virus that causes the dangerous Crimean Congo hemorrhagic fever, nor the pathogens _Theileria equi_ and _Babesia caballi_, both of which can be transmitted from ticks to horses."

The research team continues to ask the population for support to further explore the spread and potential dangers. In case of a tick bite, it's best to remove the tick with a tick remover, TickCard, or tweezers. Then send the animal in a small, tightly closed container to:
University of Hohenheim
Prof. Dr. Ute Mackenstedt
Department of Parasitology
Emil-Wolff-Strasse 34
70599 Stuttgart

Background: Tick genus _Hyalomma_
_Hyalomma marginatum_ and _Hyalomma rufipes_ are native to the dry and semi-arid areas of Africa, Asia, and southern Europe. Until recently, they did not occur in central and northern Europe. Their striped legs are striking, and they are much larger than the native ixodes ticks.

The adult ticks feed on large animals. They are active hunters and move quickly towards their host. They cover a distance of up to 100 m [328 ft]. Humans can serve as hosts. In contrast, tick larvae and nymphs mainly infest birds and small mammals and can stay up to 28 days with their hosts. Migratory birds can introduce larvae and nymphs to Germany.

In Eurasia, both _Hyalomma_ species are considered transmitters of the Crimean Congo hemorrhagic fever virus and the Arabic hemorrhagic fever virus (Alkhumra virus). They also transmit the bacterium _Rickettsia aeschlimannii_, which causes a form of spotted fever.

Reference:
Chitimia-Dobler L, et al. Imported _Hyalomma_ ticks in Germany in 2018. Parasites & Vectors. 2019; 12 (134).

More information:
Picture and video material [in German]
Press release: Tropical ticks in Germany: University of Hohenheim asks to send conspicuous tick finds [in German]
Press release: Tropical ticks: New immigrant species winters in Germany for the 1st time [in German]
-----------------------------------
communicated by:
Roland Hubner
Superior Health Council
Brussels
Belgium
====================
[Given that the ticks were found last year (2018) and that they overwintered and were found again this year (2019), it is likely that this genus of tick is becoming established in Germany. Although the species of _Hyalomma_ that infected the man with _Rickettsia aeschlimannii_ was not determined, there is a clear association of this rickettsia with the 2 species of _Hyalomma_ that were tested. The published report cited above states, "35 ticks with an unusual appearance or behaviour were reported to us during summer-autumn 2018. For 17 of them, the description or photos implied that they belong to the hard tick genus _Hyalomma_. The remaining 18 ticks were sent to us and were identified as adult _Hyalomma marginatum_ (10 specimens) or adult _Hyalomma rufipes_ (8 specimens). All ticks tested negative for CCHF virus, _Coxiella burnetii_, _Coxiella_-like organisms, _Babesia_ spp. and _Theileria_ spp. The screening for rickettsiae gave positive results in 9 specimens. The _Rickettsia_ species in all cases was identified as _R. aeschlimannii_." Given that these ticks can be transported by birds migrating from Africa, continued surveillance in Germany for the rickettsia and the other pathogens that were not found currently is prudent. - ProMED Mod.TY]

The first human case of _R. aeschlimannii_ infection was identified in a patient who had fever, rash, and an eschar similar to _R. conori_ infection (Mediaterrian spotted fever) after travel in Morocco (1). _R. aeschlimannii_ infections in humans have been previously confirmed in South Africa, in Algeria, and in Tunisia (2). To our knowledge, the first human case of _R. aeschlimannii_ infection reported in Europe occurred in Greece and was reported in 2013 (3).

1. Raoult D, Fournier PE, Abboud P, Caron F. First documented human Rickettsia aeschlimannii infection. Emerg Infect Dis. 2002; 8: 748-9. doi: 10.3201/eid0807.010480
2. Demoncheaux JP, Socolovschi C, Davoust B, Haddad S, Raoult D, Parola P. First detection of _Rickettsia aeschlimanii_ in _Hyalomma dromedarii_ ticks in Tunisia. Ticks Tick Borne Dis. 2012; 3: 398-402.
3. Germanakis A, Chochlakis D, Angelakis E, Tselentis Y, Psaroulaki A. _Rickettsia aeschlimannii_ infection in a man, Greece. Emerg Infect Dis. 2013; 19: 1176-7.  - ProMED Mod. LL]

[HealthMap/ProMED-mail map of Germany:
Date: Thu 1 Aug 2019
Source: Deutsche Welle [edited]

An unusually high number of students and teachers at a school in southwestern Germany have been infected with tuberculosis. Health officials are scouring the school for clues about why the disease spread.

Health officials on Thursday [1 Aug 2019] examined a school in the southwestern German town of Bad Schonborn where a tuberculosis outbreak has infected dozens of children and adults.

A total of 109 students, teachers and other school employees have been infected, the district administration of Karlsruhe said. Four people, including at least 2 students, have active cases of tuberculosis. That means they are presenting symptoms and could be contagious. The actively sick students have been removed from the school and are receiving medical treatment, the district administration said.

"We cannot rule out the possibility that there will be new cases of active illness," Ulrich Wagner from the Karlsruhe health department told the Badische Neueste Nachrichten newspaper.

At the beginning of July [2019], 2 children at 2 different schools in Bad Schonborn were found to have active tuberculosis. Since then, the number of infected people has continued to rise, particularly at the Michael Ende Gemeinschaftsschule, where a student in the 8th grade was initially infected. Officials said that some 56 students in the 8th grade -- 88% of the entire class -- are currently infected.

The case is concerning because several children from different grades as well as teachers who would not have been greatly exposed to the 8th grade students have also tested positive for the infection.

Health officials are now examining the school's classrooms to determine how the bacteria were able to spread to so many people, local public broadcaster SWR reported.

Local officials emphasized that tuberculosis is a treatable and curable illness, adding that not everyone who is infected with the disease will become sick.

Tuberculosis is caused by bacteria that spread from person to person through tiny droplets released into the air by coughing and sneezing. When active, tuberculosis most often affects the lungs -- resulting in chest pain, fever, weight loss, and coughing that lasts for weeks. Sometimes blood is coughed up. The World Health Organization (WHO) estimates that around a quarter of the world's population is infected with latent tuberculosis -- meaning they are not actively ill and cannot transmit the disease.

The WHO says that those who are infected with tuberculosis bacteria have a 5% to 15% chance of becoming sick.
=====================
[The news report above says that a total of 109 students, teachers and other school employees at possibly 2 schools in Bad Schonborn have been infected, but only 4 of the 109 people, including at least 2 students, have active cases of tuberculosis (TB), the others presumably having latent tuberculous infection (LTBI). LTBI is a non-contagious form of TB and is detected by tuberculin skin testing or interferon-gamma release assays.

We are told that the 2 students with active TB are at 2 different schools in Bad Schonborn, but we are not told anything about the 2 adults with active TB; adults are usually thought to be better disseminators of TB than young children. A total of 56 of the students in the 8th grade -- 88% of the entire class at one of the schools -- are infected, but the source for this outbreak has not as yet been identified.

Although transmission of tuberculosis is thought to usually require close, repeated or prolonged contact with a contagious individual in a poorly ventilated environment, such as households, homeless shelters or schools, outbreaks of cases with TB due to genetically linked TB strains who do not have anything in common other than living in the same neighborhood or using the same public facilities such as food markets or cybercafes at a shopping mall have been described. See ProMED-mail posts Tuberculosis, MDR - Singapore (03): (AMK) linked to 2012 cybercafe outbreak http://promedmail.org/post/20160622.4302632 and Tuberculosis - China: (SH) neighborhood transmission, residents, migrants http://promedmail.org/post/20180428.5771588.

Bad Schonborn, with a population of 13 028 residents, is a town in northern Karlsruhe district in Baden-Wurttemberg, a state in southwest Germany
(<https://en.wikipedia.org/wiki/Bad_Schonborn>).

A map showing the location of Bad Schonborn can be found at

More information on this outbreak would be appreciated from knowledgeable sources. - ProMED Mod.ML]

[HealthMap/ProMED-mail map:
Baden-Wurttemberg, Germany: <http://healthmap.org/promed/p/61075>]
Date: Wed, 17 Jul 2019 12:56:26 +0200

Berlin, July 17, 2019 (AFP) - Germany will make childhood measles vaccinations mandatory from March 2020, aiming to wipe out the resurgent and potentially deadly disease, Chancellor Angela Merkel's cabinet decided Wednesday.   Children will only be admitted to kindergarten or school if they have had the jabs, and vaccinations will also be compulsory for staff in day-care centres, educational institutions, medical facilities and refugee shelters.   "We want to protect as many children as possible from a measles infection," said Health Minister Jens Spahn, who is aiming for at least 95 percent coverage.

Violations will lead to fines of up to 2,500 euros ($2,800) under the bill that is expected to pass easily through the Bundestag lower house of parliament.   Germany's paediatricians' association has long demanded mandatory childhood vaccinations against measles and a range of other diseases.   The UN World Health Organization (WHO) has warned that global efforts to increase immunisation coverage against deadly diseases are stagnating.

Last year, 350,000 cases of measles were reported worldwide, more than double the number for 2017.   And they increased fourfold globally in the first quarter of 2019 compared to the same period last year, according to WHO.   Germany recorded 543 cases last year, and hundreds so far this year.   The resurgence of the disease in some countries has been blamed on the so-called "anti-vax" movement, which is largely based on a 1998 publication linking the measles vaccine and autism that has since been debunked.
Date: Tue, 2 Jul 2019 13:38:57 +0200

Schwerin, Germany, July 2, 2019 (AFP) - German fire-fighters were Tuesday battling a huge forest blaze ripping through a former military training area littered with unexploded munitions dating back to the Nazi era.   Hundreds of emergency personnel -- backed by helicopters, army vehicles and police water canon -- have been fighting the flames and evacuated four nearby villages with a total of over 1,000 residents in Mecklenburg-Western Pomerania state.   The acrid smell from the blaze, the largest recorded in the ex-communist northeastern state, has drifted as far as Berlin, 200 kilometres (125 miles) away, as much of Europe swelters in blistering summer temperatures.

The German army on Tuesday sent in armoured vehicles to clear pathways of dangerous unexploded ordnance (UXO) so that fire engines can enter the burning region that measured some 600 hectares (1,400 acres).   The former military training ground near the town of Luebtheen is littered with bombs, grenades and bullets from the Nazi era's Wehrmacht, the former Soviet army, and from reunited Germany's Bundeswehr.   Tests in the past had unearthed more than 45 tonnes of UXO per hectare, state environment minister Till Backhaus told local newspaper the Ostsee Zeitung, adding: "I pray to God that he sends us rain, as quickly as possible."
More ...

World Travel News Headlines

Date: Tue 17 Sep 2019
Source: Boston Globe [edited]

Rhode Island officials announced Tuesday [17 Sep 2019] that 2 more human cases of eastern equine encephalitis [EEE] were confirmed in the state.

The 2 people -- one a Coventry child younger than 10 and the other a person in their 50s from Charlestown -- have been discharged from the hospital and are recovering, according to a statement from the state's Department of Public Health.

Authorities think the 2 people contracted EEE in late August [2019]. The cases were confirmed by tests done at the Centers for Disease Control and Prevention. There have been 3 confirmed EEE cases in Rhode Island this year [2019]. A West Warwick resident diagnosed with the mosquito-borne illness died this month [September 2019].

All 3 people contracted EEE before areas at critical risk for the disease were aerially sprayed with pesticide, state officials said.

EEE is a rare but potentially fatal disease that can cause brain inflammation and is transmitted to humans bitten by infected mosquitoes, according to federal authorities. About 1/3 of infected people who develop the disease will die, officials have said, and those who recover often live with severe and devastating neurological complications. There is no treatment for EEE.

"This [2019] has been a year with significantly elevated EEE activity, and mosquitoes will remain a threat in Rhode Island until our 1st hard frost, which is still several weeks out," said Ana Novais, the deputy director for the state's health department. "Personal mosquito-prevention measures remain everyone's 1st defence against EEE. If possible, people should limit their time outdoors at sunrise and sunset. If you are going to be out, long sleeves and pants are very important, as is bug spray [repellent]."

EEE was also confirmed in a deer in Exeter this week [week of Mon 16 Sep 2019].

In Massachusetts, 8 human cases of EEE have been confirmed this year [2019]. Last month [August 2019], a Fairhaven woman with EEE died.
========================
[The 1st Rhode Island case died. Now there are 2 additional EEE cases who have recovered sufficiently to have been discharged from the hospital. Although most reported cases of EEE this year [2019] have occurred in horses, there have been several recent human cases as well. Individuals living in areas where human or equine EEE cases have occurred should heed the above recommendations to prevent mosquito bites. Avoidance of mosquito bites is the only preventive measure available. Fortunately, horses can be vaccinated, but there is no vaccine available for humans.

The risk of EEE virus infection for humans and horses will continue in Rhode Island and the other affected states until the 1st killing frosts occur, likely in October (2019). - ProMED Mod.TY]

[HealthMap/ProMED-mail map:
Rhode Island, United States: <http://healthmap.org/promed/p/241>]
Date: Tue 17 Sep 2019
Source: Detroit Free Press [edited]

State health officials said Tuesday [17 Sep 2019] that 3 Michiganders have died from the rare and dangerous mosquito-borne virus eastern equine encephalitis [EEE], and 4 others have been sickened by the disease, amid the biggest outbreak in more than a decade.

Those who live in all 8 of the affected counties -- Kalamazoo, Cass, Van Buren, Berrien, Barry, St. Joseph, Genesee, and Lapeer counties -- are urged to consider canceling, postponing, or rescheduling outdoor events that occur at or after dusk, especially those that involve children, according to the Michigan Department of Health and Human Services. This would include events such as late-evening sports practices or games or outdoor music practices "out of an abundance of caution to protect the public health, and applies until the 1st hard frost of the year [2019]," according to an MDHHS news release.

The 3 people who died were all adults and lived in Kalamazoo, Cass, and Van Buren counties, [respectively], said Bob Wheaton, a spokesman for the Michigan Department of Health and Human Services. The 4 other confirmed cases are in Kalamazoo, Berrien, and Barry counties.

Animals have also been confirmed to have the virus in St. Joseph, Genesee, and Lapeer counties.

The Kalamazoo County Health and Community Services Department also issued a recommendation to local communities and school districts to consider canceling outdoor events at dusk or after dark, when mosquitoes are most active, or move [the events] indoors.  "Michigan is currently experiencing its worst eastern equine encephalitis outbreak in more than a decade," said Dr. Joneigh Khaldun, MDHHS chief medical executive and chief deputy for health. "The ongoing cases reported in humans and animals and the severity of this disease illustrate the importance of taking precautions against mosquito bites."

EEE is one of the deadliest mosquito-borne viruses in the US. One in 3 people who are infected with the virus die. The only way to prevent it is to avoid mosquito bites. The MDHHS says residents should
- apply insect repellents that contain the active ingredient DEET or other US Environmental Protection Agency-registered product to exposed skin or clothing, and always follow the manufacturer's directions for use;
- wear long-sleeved shirts and long pants when outdoors. Apply insect repellent to clothing to help prevent bites;
- maintain window and door screening to help keep mosquitoes outside;
- empty water from mosquito breeding sites around the home, such as buckets, unused kiddie pools, old tires, or similar sites where mosquitoes may lay eggs; and
- use nets and/or fans over outdoor eating areas.

Symptoms of EEE include
- sudden onset of fever, chills;
- body and joint aches, which can progress to a severe encephalitis;
- headache;
- disorientation;
- tremors;
- seizures;
- paralysis; and
- coma.

Anyone experiencing these symptoms should visit a doctor.

[Byline: Kristen Jordan Shamus]
=======================
[The number of human cases remains at 7. However, 3 of these have died since the 6 Sep 2019 report (see Eastern equine encephalitis - North America (18): USA human, horse, deer http://promedmail.org/post/20190910.6667626). However, even among the survivors, there is a significant risk of permanent neurological damage following clinical encephalitis. CDC reports that many individuals with clinical encephalitis "are left with disabling and progressive mental and physical sequelae, which can range from minimal brain dysfunction to severe intellectual impairment, personality disorders, seizures, paralysis, and cranial nerve dysfunction. Many patients with severe sequelae die within a few years" (<https://www.cdc.gov/easternequineencephalitis/tech/symptoms.html>). - ProMED Mod.TY]

[HealthMap/ProMED-mail map:
Michigan, United States: <http://healthmap.org/promed/p/225>
Michigan county map:
Date: Mon 16 Sep 2019
Source: Patch [edited]

The state Department of Public Health is warning that an adult resident of East Lyme has tested positive for eastern equine encephalitis (EEE). This is the 1st human case of EEE identified in Connecticut this season [2019].  The patient became ill during the last week of August [2019] with encephalitis and remains hospitalized. Laboratory tests, which were completed today at the Centers for Disease Control and Prevention (CDC) Laboratory in Ft. Collins, Colorado, confirmed the presence of antibodies to the virus that causes EEE.  "EEE is a rare but serious and potentially fatal disease that can affect people of all ages," said DPH commissioner Renee Coleman Mitchell in a release. "Using insect repellent, covering bare skin, and avoiding being outdoors from dusk to dawn are effective ways to help keep you from being bitten by mosquitoes."  The EEE virus has been identified in mosquitoes in 12 towns and in horses in 2 other towns.

Towns where mosquitoes have tested positive for EEE include Chester, Haddam, Hampton, Groton, Killingworth, Ledyard, Madison, North Stonington, Plainfield, Shelton, Stonington, and Voluntown. Horses have tested positive for EEE virus in Colchester and Columbia this season, and the virus has been detected in a flock of wild pheasants.  Other states throughout the northeast are also experiencing an active season for EEE. In addition to the virus being found in mosquitoes, there have been a total of 8 human cases of EEE infection in Massachusetts and one human case in Rhode Island, with one case in each state resulting in a fatality. "This is the 2nd human case of EEE ever reported in Connecticut," said Dr. Matthew Cartter, director of infectious diseases for the DPH. "The 1st human case of EEE reported in Connecticut occurred in the fall of 2013."

The DPH advises against unnecessary trips into mosquito breeding grounds and marshes, as the mosquitoes that transmit EEE virus are associated with freshwater swamps and are most active at dusk and dawn. Overnight camping or other substantial outdoor exposure in freshwater swamps in Connecticut should be avoided. Even though the temperatures are getting cooler, the DPH is advising that mosquito season is not over, and residents should continue to take measures to prevent mosquito bites, including wearing protective clothing and using repellents.  Although EEE-infected mosquitoes continue to be detected in the south-eastern corner of the state, the numbers are declining, and we are not experiencing the excessively high levels of activity seen in Massachusetts. There are currently no plans to implement widespread aerial pesticide spraying in the state.

Severe cases of EEE virus infection (involving encephalitis, an inflammation of the brain) begin with the sudden onset of headache, high fever, chills, and vomiting. The illness may then progress into disorientation, seizures, and coma. Approximately 1/3 of patients who develop EEE die, and many of those who survive have mild to severe brain damage, according to the DPH.

There is no specific treatment for EEE. Antibiotics are not effective against viruses, and no effective anti-viral drugs have been discovered. Severe illnesses are treated by supportive therapy, which may include hospitalization, respiratory support, IV fluids, and prevention of other infections. It takes 4-10 days after the bite of an infected mosquito to develop symptoms of EEE.

The management of mosquitoes in Connecticut is a collaborative effort involving the Department of Energy and Environmental Protection, the Connecticut Agricultural Experiment Station, and the DPH, together with the Department of Agriculture and the Department of Pathobiology at the University of Connecticut. These agencies are responsible for monitoring and managing the state's mosquito population levels to reduce the potential public health threat of mosquito-borne diseases.

Information on what can be done to prevent getting bitten by mosquitoes and the latest mosquito test results and human infections is available online.  [Byline: Rich Kirby]
===========================
[This has been an active year for EEE virus transmission in the eastern USA from the upper Midwest to the northeastern states and south to Florida. Although historically, EEE human cases in Connecticut have been very rare, the occurrence of a human case in the state this year (2019) is not surprising. There have been equine and/or human EEE cases this summer (2019) in the 3 bordering states: Rhode Island, Massachusetts, and New York. Interestingly, pheasants are mentioned in the above report. They are susceptible and, after being infected with the virus from the bite of an EEE-carrying mosquito, become ill or moribund with viremia titers that can reach 10^9 per ml. Ill or moribund pheasant can be attacked and cannibalized by pen mates that, in turn, are infected orally and may become ill and die as well. As the above report cautions, the only way to avoid infection is for people to avoid mosquito bites. Although the incidence of EEE cases and virus-positive mosquitoes may be declining, there is a risk of infection until the 1st killing frost occurs in autumn, when the mosquitoes are no longer active. - ProMED Mod.TY]

[HealthMap/ProMED-mail map:
Connecticut, United States: <http://healthmap.org/promed/p/210>]
Date: Wed 11 Sep 2019
Source: BBC Afrique [In French, trans. Mod.LXL, edited]

At least 18 people died in 10 days after eating pesticide-contaminated food in 2 localities in Burkina Faso. A dozen still remain under observation in hospitals, according to the Minister of Health.  The 1st cases were reported on [1 Sep 2019] in the town of Didyr in the centre-west of the country, said Professor Claudine Lougue, Minister of Health.  About 15 members of the same families felt unwell after eating local dishes made from bean leaves and small millet seeds, which are actually seed remains. Thirteen died later despite medical care.

On Monday [2 Sep 2019], the ministry received another alert, this time from the central-eastern region. Here again, 14 people from the same family were admitted to the health centres. Five have lost their lives. After analysis, doctors diagnosed massive food poisoning, said the minister. Complementary examinations incriminate pesticides, she said.  "Investigations have been made on samples of biological products such as blood and urine, and we found an unusually high level of pesticides in foods that were consumed. There was an abnormally high level of pesticides, and these pesticides were strongly incriminated," said the minister.

The remains of food have been secured, announced Professor Lougue, who calls on citizens to observe strict hygiene measures in the use of plant leaves for consumption. Pesticides are used for the needs of field work, especially in the countryside during this period of wintering.
Date: Wed, 18 Sep 2019 16:44:19 +0200 (METDST)

London, Sept 18, 2019 (AFP) - British Airways pilots on Wednesday cancelled a strike that had been due September 27, the British Airline Pilots Association union said after two walkouts last week that cost the company dear.   "Someone has to take the initiative to sort out this (pay) dispute and with no sign of that from BA the pilots have decided to take the responsible course," BALPA General Secretary Brian Strutton said in a statement.    The union chief added that the airline's "passengers rightly expect BA and its pilots to resolve their issues without disruption and now is the time for cool heads and pragmatism to be brought to bear.    "I hope BA and its owner IAG show as much responsibility as the pilots," he added.   It was now "time for a period of reflection before the dispute escalates further and irreparable damage is done to the (BA) brand."

However the union added that should the airline "refuse meaningful new negotiations, BALPA retains the right to announce further strike dates".   British Airways, which likes to call itself "the world's favourite airline", flew into turbulence last week as pilots staged a costly and historic two-day strike, tarnishing its global reputation according to aviation analysts.   Pilots walked out for the first time in the company's 100-year history, sparked by a bitter and long-running feud over pay.   BA faced the embarrassment of grounding its entire UK fleet on September 9 and 10, causing the cancellation of about 1,600 flights.   The move sparked travel chaos for about 200,000 passengers who had been due to fly in and out of London's Gatwick and Heathrow airports.

The disruption continued into September 11 because half of BA's 300 aircraft and more than 700 pilots were mostly in the wrong place.   As a result, BA was forced to cancel approximately ten percent of its daily 850 flights in and out of Britain that day.    BALPA and its members are demanding a bigger share of British Airways profits.   The airline has offered a salary increase of 11.5 percent over three years, which it argues would boost the annual pay of some captains to £200,000 ($250,000 or 226,000 euros).   However, the union has rejected the proposal made in July.   BALPA meanwhile estimates that last week's 48-hour strike cost the airline £80 million.   BA is owned by IAG, which was formed in 2011 with the merger of British Airways and Spain's Iberia. IAG has since added other carriers, including Austria's Vueling and Ireland's Aer Lingus.
Date: Wed, 18 Sep 2019 12:26:37 +0200 (METDST)
By Sam Reeves

Kuala Lumpur, Sept 18, 2019 (AFP) - Toxic haze from Indonesian forest fires closed schools and airports across the country and in neighbouring Malaysia Wednesday, while air quality worsened in Singapore just days before the city's Formula One motor race.   Illegal fires to clear land for agriculture are blazing out of control on Sumatra and Borneo islands, with Jakarta deploying thousands of security forces and water-bombing aircraft to tackle them.

Indonesian blazes belch smog across Southeast Asia annually, but this year's are the worst since 2015 and have added to concerns about wildfire outbreaks worldwide exacerbating global warming.   On Wednesday, air quality deteriorated to "very unhealthy" levels on an official index in many parts of peninsular Malaysia, to the east of Sumatra, with the Kuala Lumpur skyline shrouded by dense smog.    Nearly 1,500 schools were closed across Malaysia due to the air pollution, with over one million pupils affected, according to the education ministry.

A growing number of Malaysians were suffering health problems due to the haze, with authorities saying there had been a sharp increase in outpatients at government hospitals -- many suffering dry and itchy eyes.   Indonesian authorities said hundreds of schools in hard-hit Riau province on Sumatra were shut, without providing a precise number, while about 1,300 were closed in Central Kalimantan province on Borneo.    Borneo is shared between Indonesia, Malaysia and Brunei.   Poor visibility closed seven airports in the Indonesian part of Borneo, the transport ministry in Jakarta said. Scores of flights have already been diverted and cancelled in the region in recent days due to the smog.

- Singapore smog race? -
Air quality in Singapore worsened to unhealthy levels and a white smog obscured the striking waterfront skyline, featuring the Marina Bay Sands casino resort with its three towers and boat-shaped top level.    The worsening pollution increased fears that this weekend's Formula One race may be affected. Organisers say the possibility of haze is one of the issues in their contingency plan for Sunday's showpiece night race, but have not given further details.

The city-state's tourism board said spectators would be able to buy masks as protection from the haze if conditions did not improve and assistance would be provided for those who feel unwell, the Today news portal reported.   The fires have sparked tensions between Indonesia and Malaysia.    Indonesia's environment minister initially suggested the haze was from Malaysian fires despite satellite data showing hundreds of blazes in Indonesia and only a handful in its neighbour, prompting anger from her Malaysian counterpart.

Indonesia later sealed off dozens of plantations where it said fires were blazing, including some owned by Malaysia-based firms, deepening the row.   But Prime Minister Mahathir Mohamad, who has struck a diplomatic tone throughout the crisis, said Malaysia may pass legislation forcing its companies to tackle fires on plantations abroad.   Malaysia wants its firms with sites overseas to put out blazes contributing to the haze, he said, adding: "Of course, if we find they are unwilling to take action, we may have to pass a law to make them responsible."

The Indonesian government has insisted it is doing all it can to fight the blazes. But this year's fires have been worsened by dry weather and experts believe there is little chance of them being extinguished until the onset of the rainy season in October.   Indonesia's meteorology, climate and geophysics agency said Wednesday that over 1,000 hotspots -- areas of intense heat detected by satellite that indicate a likely fire -- had been sighted, most of them on Sumatra.
Date: Wed, 18 Sep 2019 12:14:44 +0200 (METDST)
By Aishwarya KUMAR

New Delhi, Sept 18, 2019 (AFP) - India announced on Wednesday a ban on the sale of electronic cigarettes, as a backlash gathers pace worldwide due to health concerns about a product promoted as less harmful than smoking tobacco.   The Indian announcement, also outlawing production, import and distribution, came a day after New York became the second US state to ban flavoured e-cigarettes following a string of vaping-linked deaths.   "The decision was made keeping in mind the impact that e-cigarettes have on the youth of today," Finance Minister Nirmala Sitharaman told reporters in New Delhi.

E-cigarettes do not "burn" but instead heat up a liquid -- tasting of everything from bourbon to bubble gum and which usually contains nicotine -- that turns into vapour and is inhaled.   The vapour is missing the estimated 7,000 chemicals in tobacco smoke but does contain a number of substances that could potentially be harmful.   They have been pushed by producers, and also by some governments including in Britain, as a safer alternative to traditional smoking -- and as a way to kick the habit.

However critics say that apart from being harmful in themselves, the flavours of e-cigarette liquids appeal particularly to children and risk getting them addicted to nicotine.   Some 3.6 million middle and high school students in the United States used vaping products in 2018, an increase of 1.5 million on the year before.   The New York emergency legislation followed an outbreak of severe pulmonary disease that has killed seven people and sickened hundreds.   President Donald Trump's administration announced last week that it would soon ban flavoured e-cigarette products to stem a rising tide of youth users.

- Big E-Tobacco -
Although few Indians vape at present, the Indian ban also cuts off a vast potential market of 1.3 billion consumers for makers of e-cigarettes.   Tobacco firms have been investing heavily in the technology to compensate for falling demand for cigarettes due to high taxes and public smoking bans, particularly in the West.

In 2018 Altria, the US maker of brands such as Marlboro and Chesterfield, splashed out almost $13 billion on a stake in one of the biggest e-cigarette makers, Juul.   A few Indian states have already banned e-cigarettes although the restrictions have been ineffective since online sale of vaping products continue.   The new ban does not cover traditional tobacco products in India.   According to the World Health Organization, India is the world's second-largest consumer of tobacco products, killing nearly 900,000 people every year.

Nearly 275 million people over 15, or 35 percent of adults, are users, although chewing tobacco -- which also causes cancer -- is more prevalent than smoking.   India is also the world's third--largest producer of tobacco, the WHO says, and tobacco farmers are an important vote bank for political parties.   According to the Associated Chambers of Commerce and Industry, an estimated 45.7 million people depend on the tobacco sector in India for their livelihood.   Tobacco is also a major Indian export, and the government holds substantial stakes, directly or indirectly, in tobacco firms including in ITC, one of India's biggest companies.
Date: Wed, 18 Sep 2019 03:56:31 +0200 (METDST)

Washington, Sept 18, 2019 (AFP) - Hurricane Humberto strengthened to a major Category 3 storm on Tuesday and was expected to pass near Bermuda, threatening it with dangerous waves and heavy rain, the US National Hurricane Center said.   "Hurricane conditions are expected to reach Bermuda by Wednesday night and continue into early Thursday morning," the Miami-based NHC said.   "Some fluctuations in intensity are likely during the next day or so, but Humberto should remain a powerful hurricane through Thursday," it said.   As of 8:00 pm (0000 GMT), the storm had maximum sustained winds of 115 miles per hour (185 kilometers per hour) and was moving east-northeast at 12 miles per hour.
Date: Wed, 18 Sep 2019 01:36:21 +0200 (METDST)

Dakar, Sept 17, 2019 (AFP) - Four people died after a boat carrying dozens of tourists capsized during heavy storms in Senegal, authorities and emergency services said Tuesday.   The death toll could rise as three passengers were said to be missing after the accident.  The boat was carrying several Senegalese nationals, six French people, two Germans, two Swedes and one person from Guinea-Bissau, when it turned over Monday in driving rain and a heavy swell, fire department chief Papa Angel Michel Diatta said.   All the dead were Senegalese, officials and emergency services said.

Two worked in a national park, one was a woman and the other victim was a child, Diatta said.   The boat was heading for the Madeleine islands, site of an offshore national park popular with tourists who travel from Dakar, coastal capital of the West African country.   Senegalese President Macky Sall appealed for "greater caution and respect for existing security norms duing the rainy season" in a tweet.

Emergency services continued to look for those missing on Tuesday. AFP journalists saw a dozen divers at the scene. Distressed families were waiting on the shore to get news of their loved ones.    "The gendarmerie called us at 5:00 am (GMT and local time). My brother was on the boat. The worst thing is not knowing," said Aminata Diop, who was among the relatives on the beach.   There are "four dead bodies and between three and four people are missing. Thirty-five people were on the boat. Search and rescue operations are continuing this morning," Interior Minister Aly Ngouille Ndiaye told AFP by telephone.

The causes of the accident were unclear. The interior minister told Senegalese media overnight that several tourists were worried about the heavy rains and wanted to return to the pier but others wanted to stay on the boat.   The survivors spent the night on the island, Ndiaye told local radio on Tuesday. Blankets and food were sent to them and they were to be ferried back to the mainland in the morning, he added.   The rainy season arrived late this year and heavy storms have resulted in several casualties this month.    Two fishermen were killed on their canoe in the same area nearly two weeks ago.
Date: Tue, 17 Sep 2019 15:38:37 +0200 (METDST)

Jakarta, Sept 17, 2019 (AFP) - Massive forest fires in Indonesia that have caused a toxic haze to spread as far as Singapore and peninsular Malaysia are also seriously affecting endangered orangutans and their habitat, a rescue foundation said Tuesday.   Jakarta has deployed thousands of troops as temporary fireman and deployed dozens of water-bombing aircraft to battle blazes that are turning pristine forest into charred landscape in Sumatra and Borneo islands.   The fires -- usually started by illegal burning to clear land for farming -- have unleashed a choking haze across parts of southeast Asia.

The Borneo Orangutan Survival Foundation said Tuesday that the haze was affecting hundreds of great apes in its care at rescue centres and wildlife re-introduction shelters.   "The thick smoke does not only endanger the health of our staff... but also it affects the 355 orangutans we currently care for", the foundation said in a statement, referring to just once cetre in Kalimantan   "As many as 37 young orangutans are suspected to have contracted a mild respiratory infection," it added.   Conditions were so bad at their Samboja Lestari facility in East Kalimantan that outdoor activities for the animals had been restricted to a few hours a day.

Orangutans have been particularly vulnerable to commercial land clearances and have seen their natural habitat shrink dramatically in the last few decades.   The population of orangutan in Borneo has plummeted from about 288,500 in 1973 to about 100,000 today, according to the International Union for Conservation of Nature.   The toxic smoke caused by the forest fires is an annual problem for Indonesia and its neighbours, but has been worsened this year by particularly dry weather.   On Borneo island, which Indonesia shares with Malaysia and Brunei, pollution levels were "hazardous", according to environment ministry data.   Hundreds of schools across Indonesia and Malaysia were shut.