WORLD NEWS

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

Egypt

Geographical Information:
Egypt has a total area of about 385,000 sq. miles and sits on the North Eastern corner of Africa. It is bounded by the Mediterranean Sea and on the East by Israel and the Red Sea. The Southern border is with Sudan (the large
t country in Africa) and on the West it shares a border with Libya. The country extends about 675 miles from north to south and is widest at its southern border where it covers 780 miles. Egypt is well known for the great Nile river which courses throughout its length. It is the longest river in the world and has historic links stretching back to at least 3200BC.
Climate:
The hot season in Egypt is from May to September. During this time temperatures can easily reach 370C though northern winds can provide a very necessary respite. November to March is the cooler time of the year and typical temperatures reach 140C though, during the evenings, temperatures can occasionally fall to near freezing. The humidity is mainly along the Mediterranean coastline and the average rainfall here is only about 8".
Medical Facilities:
In the main towns and cities the level of medical care is very adequate for the tourist. English speaking doctors will be associated with all the larger hotels but nevertheless care should always before being admitted to a ‘clinic’ for further treatment should this ever become necessary. Travellers are encouraged to contact the Irish Embassy in Cairo for emergency assistance should the need ever arise.
Food & Water Hygiene:
A significant number of tourists visiting Egypt suffer stomach complaints. In many cases this is due to eating food from the market places or using the hotel tap water supply for drinking or brushing teeth. The hotter climate of the country and the poorer level of food hygiene leave the unwary tourist at particular risk. Salads and shellfish meals should particularly be avoided.
Cruising along the Nile:
Over the past number of years many Irish holiday makers have enjoyed themselves cruising along the Nile for a week and then visiting Luxor in the southern part of the country. In most cases these travellers remain very well with no particular health problems. Nevertheless, in a small number they appear to forget the basic rules of food and water hygiene and will sample the local foods in the market places on shore. This practice is frequently associated with a ruined second half of the holiday. Commonsense rules of looking but not touching are much wiser.
Sun Stroke:
The ambient temperatures in Egypt can be very high and tourists are frequently exposed to the strong sunlight during their time in Egypt. It is essential that an adequate fluid intake is maintained (much higher than at home) and that travellers remember they may need to increase their salt intake (if this is not contraindicated because of heart disease or blood pressure). Small children and the elderly are at special risk.
Malaria risk in Egypt:
The risk of malaria in Egypt is small. The disease is usually only found during the warmer summer months (June to October) in the El Faiyûm area. Travellers may require prophylaxis but they should continuously remember to use adequate protection against mosquitoes and other insects.
Swimming in Egypt:
The fresh water rivers of Egypt are commonly infected with a disease called Schistosomiasis (Bilharzia). This parasite penetrates through intact skin and can cause significant health problems. Travellers are encouraged to swim only in the Mediterranean, the Red Sea or in well maintained swimming pools to avoid exposure.
Health Care while Diving:
Many of the world's most beautiful sites for diving are situated along the Red Sea. These are common tourist destinations and generally the risk of significant health worries will be small. However, check out the professionalism of the diving company before you develop too close a relationship. Make sure their equipment is in good working order and that their instructors are insisting on standard safety procedures for any proposed dive. Never dive after a large meal or following alcohol intake. Remember that you can get significantly sunburnt while snorkeling so take care to cover your back and shoulders with either a suit or sufficient water repellent cream.
Diving at night may be a beautiful experience but take extra care. Never dive beyond your personal limits and ensure that the 'buddy system' is fully operational at all times. Even the most experienced divers can have problems at times so never let you guard down and stay alert.
Rabies:
This disease is widespread in Egypt and is normally transmitted through the bite of warm blooded animals. Any bites, licks or scratches from these animals should be treated seriously by washing out the wound, applying an antiseptic and the seeking urgent competent medical attention.
Vaccines for Egypt:
All Irish travellers to Egypt should ensure that their vaccines against Poliomyelitis, Typhoid, Tetanus and Hepatitis A are in date. Those staying for longer periods or trekking through the country may require further protection against diseases like Rabies, Meningitis and Hepatitis B.
Further Information:
Further general health information on staying healthy while travelling abroad may be obtained free-of-charge from the Tropical Medical Bureau at either of our centres. Please always remember that each traveller is distinct and so individual specific information will require a medical consultation.

Travel News Headlines WORLD NEWS

Date: Mon, 17 Feb 2020 10:59:27 +0100 (MET)

Cairo, Feb 17, 2020 (AFP) - Egypt's Sharm el-Sheikh has welcomed the first British charter flights since 2015, when the Islamic State group's bombing of a Russian airliner dealt a devastating blow to the Red Sea resort.   Britain halted flights to Sharm el-Sheikh following the attack, which killed all 224 people on board the plane that took off from the resort, long popular with British tourists.

After multiple airport inspections and visits by aviation security experts, Britain announced in October that it was lifting the flight restrictions.   "Sharm el-Sheikh airport received the first two direct charter flights... from London's Gatwick airport carrying 184 passengers and Manchester airport carrying 190 passengers," Egypt's civil aviation ministry said in a statement late Sunday.    The flights were operated by Britain's biggest travel agency, TUI.

The company has scheduled three flights a week between London's Gatwick Airport and Sharm el-Sheikh until late March, the statement said.   British budget airline easyJet said in January it would restart flights to the resort town in June.   On Sunday, flag carrier EgyptAir said it would start operating a weekly flight between London and Sharm el-Sheikh later this month.   British tourists have long been vital to the tourism industry in Sharm el-Sheikh, which was left reeling after the airliner bombing.

Egypt has since sought to lure tourists back, boosting airport security and allowing international inspections of security procedures there.   Russia, another major source of tourists to Egypt, initially suspended all direct flights to the North African country following the attack.   It resumed direct flights to Cairo in 2018 but has yet to restart them to popular Red Sea resorts.   Egypt's tourism industry has shown signs of recovery in recent years with arrivals reaching 11.3 million in 2018, compared with 5.3 million in 2016.
Date: Sat, 28 Dec 2019 20:16:40 +0100 (MET)

Cairo, Dec 28, 2019 (AFP) - At least 28 people including textile workers and several Asian tourists were killed Saturday in two separate road crashes in Egypt, official media and other sources said.   The deadliest accident occurred when a bus transporting textile workers collided with a car on the road between the cities of Port Said and Damietta in northern Egypt, state-run Al-Ahram newspaper said on its website.   At least 22 men and women who worked for a clothing factory were killed and eight others injured, the report said.   The accident came only hours after two buses carrying tourists collided with a truck east of Cairo on the road to the Ain Sokhna resort on the Red Sea, according to a security official.

A medical source said two Malaysian women and an Indian man were killed along with three Egyptians -- a bus driver, a tour guide and a security guard.   At least 24 others were injured, several of them tourists and some left in serious condition, the medical source said without giving further details.   Traffic accidents are common in Egypt where many roads are poorly maintained and regulations are laxly enforced.   But efforts by authorities to crack down on traffic violations, including speeding, appear to have borne fruit in recent years, with official figures showing a decline in road deaths.

In 2018 there were 8,480 road accidents compared with 11,098 the previous year, according to the bureau of statistics.   Deaths from traffic accidents fell from more than 5,000 in 2016 to 3,747 the following year and 3,087 in 2018, official figures show.   Ain Sokhna is a popular seaside resort town in the Suez governorate southeast of Cairo. It is also home to several petrochemical, ceramics and steel factories.
Date: Tue 30 Jul 2019
Source: Food Safety News [edited]

The public health institute in Germany has reported more than 30 people have been sick with _E. coli_ in 2019 after going to Egypt. The Robert Koch Institute (RKI) noted increased reports of enterohemorrhagic _E. coli_ (EHEC) related to or after staying in Egypt. Earlier in July 2019, Public Health England (PHE) also reported an increase in adults and children ill after coming back from Hurghada in Egypt.

In Germany, there are 31 cases of EHEC and 5 people with haemolytic uremic syndrome (HUS), a type of kidney failure associated with this form of _E. coli_ infection. This is significantly more than in the same period of previous years. In 2018, there were 21 EHEC and one HUS case. In 2017, 9 EHEC and 1 HUS case were recorded. The rise cannot be explained by the increase in travel to Egypt alone, according to RKI.

It follows a warning by PHE after 18 people fell ill with EHEC infection and one person developed HUS after returning from Egypt in 2019. 4 people needed hospital treatment. A PHE spokeswoman previously told Food Safety News that it was not a single outbreak as a variety of different EHEC strains had been detected in visitors to Egypt with EHEC O157 and EHEC O26 among them. The agency has told the European Centre for Disease Prevention and Control (ECDC) about the cases.

What caused the German cases is unknown and sick people have stayed at different hotels in separate places, according to RKI, which has informed Egyptian authorities about the increase.

Dr Nick Phin, deputy director of the National Infection Service at PHE, said there are precautions that travellers can take. "These include ensuring meat is cooked thoroughly, not drinking tap water or ice made from tap water and trying to avoid swallowing water when swimming. Anyone suffering from diarrhoea and vomiting should ensure they keep well hydrated and seek medical advice if their symptoms don't improve within 48 hours. They should also avoid preparing or serving food while they have symptoms and thoroughly wash their hands after using the toilet to stop the bug being passed to others" he said.  [Byline: Joe Whitworth]
=======================
[This is the 2nd European country to report a spike to travel-related cases of EHEC related to Egypt. The German report does not specifically relate the cases to the Red Sea area of the country.

As a review, the classical enterohaemorrhagic _E. coli_ is the O157:H7 serotype although some are non-motile, that is, H-. Most O157 strains do not ferment sorbitol and that characteristic was used to screen for the strain using a sorbitol MacConkey agar. However, since non-O157 EHEC strains such as O26, O45, O103, O111, O121, and O145 do ferment sorbitol and, as seen here, some O157 also ferment sorbitol, laboratories now look for these isolates using genetic assays for the Shiga toxin genes.

Around 1903 Smith and Reagh reported on the different behaviour of salmonella strains. Their work was mostly ignored until Weil and Felix, working on _Proteus_ cultures, noted 2 forms, the swarming form called the H form (_mit Hauch_, in English: "with breath") and the non-swarming form, called the O form (_ohne Hauch_, in English: "without breath"). The H form contained both O and H antigens (correctly termed the OH form). These parallels were transposed to other Enterobacteriaceae.

If O antiserum is added to a culture, motility is preserved, whereas if H antiserum is added the culture does not move. Therefore, H antigen was involved with swarming in the agar plate (breathing might have been used to imply the ability to move). (_E. coli_, of course, do not swarm on certain agar plates like _Proteus_ bacteria do). - ProMED Mod.LL]

[HealthMap/ProMED-mail maps:
Date: Wed 17 Jul 2019
Source: Food Safety News [edited]

Public Health England has issued a warning after almost 20 cases of Shiga toxin-producing _Escherichia coli_ infection [also called enterohemorrhagic _E. coli (EHEC)] were found in people returning from Egypt in 2019.

All travellers had been to the Hurghada region [Red Sea governorate] of Egypt. A variety of different EHEC strains have been detected in visitors to Egypt with serotypes O157 and O26 identified among them. One person developed haemolytic uremic syndrome (HUS), a type of kidney failure associated with _E. coli_ infection.

Public Health England (PHE) scientists are investigating to understand the cause of the infections. The agency has given advice to those going to Egypt after 18 people, including children, returned with serious illnesses caused by EHEC infections. In 2018, there were 22 cases of EHEC in the whole year, and 11 infections in 2017. A PHE spokeswoman told Food Safety News that it cannot provide any further information about patients when asked about onset dates and the demographics of those affected.

"So far this year [2019], 4 cases have been hospitalized and 1 case has developed HUS. In 2018, 5 of 22 cases were hospitalized. We use whole genome sequencing to type all strains of EHEC in England, and the results do not indicate this is an outbreak, as multiple different strains of EHEC have been detected," she said. "Each case is individually followed up. We do not know the specific source of these infections in Egypt. However, the most common ways people get infected with EHEC is through eating contaminated food or water, through person to person spread or through contact with animal faeces."

The spokeswoman added the agency has told the European Centre for Disease Prevention and Control (ECDC) about the cases and notified the Egyptian public health authorities to provide them with information for their investigations.

There have been 16 cases of HUS in people, including children, who have been to the Hurghada region of Egypt between 2009 and 2019.

Dr Nick Phin, deputy director of the National Infection Service at PHE, said it was aware of people returning from Egypt with _E. coli_ infections. "We are gathering information about those affected to better understand the cause. There are simple precautions that travellers can take. These include ensuring meat is cooked thoroughly, not drinking tap water or ice made from tap water and trying to avoid swallowing water when swimming," he said. "Anyone suffering from diarrhoea and vomiting should ensure they keep well hydrated and seek medical advice if their symptoms don't improve within 48 hours. They should also avoid preparing or serving food while they have symptoms and thoroughly wash their hands after using the toilet to stop the bug being passed to others."

PHE recommendations to travelers include:
- where possible, avoid eating salads and uncooked vegetables and only eat fruit they can peel;
- avoid unpasteurized milk, cheese and ice cream;
- avoid food left uncovered in warm environments and exposed to flies;
- ensure all meat is cooked thoroughly before eating, avoid meat that is pink or cold;
- only drink bottled water or use ice made from bottled/filtered water;
- wash hands thoroughly after visiting the toilet, and always before preparing or eating food. Alcohol gel can be helpful but not entirely effective when hand washing facilities are not available

The advice also applies to other countries where _E. coli_ infections are common such as Turkey and Spain.
=======================
[Clearly this is not one organism as multiple serotypes of the EHEC have been found. It is not clear what factors involving the tourists have put them at risk for this potentially fatal infection. ProMED-mail previously posted about a case in the UK from this region of Egypt in 2016 (E. coli EHEC - UK (02): (England) ex Egypt http://promedmail.org/post/20160707.4330782).

Hurghada is a beach resort town stretching some 40km along Egypt's Red Sea coast. It is renowned for scuba diving, and has numerous dive shops and schools in its modern Sekalla district. - ProMED Mod.LL]

[HealthMap/ProMED-mail maps
England, United Kingdom: <http://healthmap.org/promed/p/279>
Date: Sun, 19 May 2019 21:55:33 +0200

Giza, Egypt, May 19, 2019 (AFP) - A bomb blast hit a tourist bus near Egypt's famed Giza pyramids on Sunday, wounding some of them, including South Africans, in the latest blow to the country's tourism industry.   The roadside bomb went off as the bus was being driven in Giza, also causing injuries to Egyptians in a nearby car, medical and security sources said.   Security and medical sources in Egypt said 17 people were injured, without giving a breakdown of their nationalities. No deaths were reported.   South Africa said in a statement that the "bus explosion" injured three of its 28 citizens who were part of the tourist group.   They would remain in hospital while the rest would return home on Monday, said the statement from the department of international relations.   "A device exploded and smashed the windows of a bus carrying 25 people from South Africa and a private car carrying four Egyptians," the security source said.

Video footage captured by AFP showed the bus and car with broken windows on the side of the road.   According to the security source, the wounded were being treated for scratches caused by the broken glass.   Sunday's incident comes after three Vietnamese holidaymakers and their Egyptian guide were killed when a roadside bomb hit their bus as it travelled near the Giza pyramids outside Cairo in December.   It also comes just little more than a month before the African Cup of Nations hosted by Egypt is to kick off.   Egypt has been battling an insurgency that surged especially in the turbulent North Sinai region following the 2013 military ouster of Islamist president Mohamed Morsi, who was replaced by former army general Abdel Fattah al-Sisi.   In February 2018, the army launched a nationwide operation against militants, focusing mainly on the North Sinai region.

- Tourism recovery -
Some 650 militants and around 45 soldiers have been killed since the start of the offensive, according to separate statements by the armed forces.   Since first being elected in 2014, Sisi has presented himself as a bulwark against terrorism, promising stability and increased security.   Recently, the country's vital tourism industry has started to slowly rebound after suffering strong blows due to deadly attacks targeting tourists following the turmoil of the 2011 uprising that toppled longtime ruler Hosni Mubarak.   Figures by the official statistics agency showed that tourist arrivals reached 8.3 million in 2017, compared with 5.3 million the previous year.    Authorities have gone at great lengths to lure tourists back, touting a series of archaeological finds and a new museum next to the pyramids, as well as enhanced security at airports and around ancient sites.    But that figure was still far short of the record influx of 2010 when more than 14 million visitors flocked to see the country's sites.
More ...

World Travel News Headlines

Date: Wed, 19 Feb 2020 11:20:59 +0100 (MET)

Dhaka, Feb 19, 2020 (AFP) - Bangladesh on Wednesday kicked off a drive to vaccinate more than a million people against cholera, which infects tens of thousands a year, as part of an international campaign to eliminate transmission by 2030.   The delta nation has sought to reduce the impact of the disease -- which causes acute diarrhoea and spreads through contaminated food and water -- through vaccines and by setting up a dedicated treatment hospital.   "We have brought down the mortality rate in cholera to almost zero in Bangladesh," said senior scientist Firdausi Qadri at the Dhaka-based International Centre for Diarrhoeal Disease Research.   But she admitted that the number of infections was still very high.   According to the World Health Organisation, cholera infects about 1.3 to five million people every year, and kills an estimated 21,000 to 143,000.

Bangladesh has an estimated 100,000 cases a year, according to authorities, but plans to immunise half its 168 million people in the next decade.   Daisy Akter, who lost two sisters and a brother to cholera in the 1970s, was one of the first recipients of the oral vaccine at a Dhaka neighbourhood on Wednesday.   "No villager came to offer funeral prayers for them fearing they might get the disease," she told AFP.   "We had to bury them in the front yard of our home."   UN agencies and Bangladesh authorities have already carried out a massive cholera vaccination drive in the country's southeast, where nearly one million Rohingya refugees have lived in overcrowded camps since 2017.   Some 800,000 Rohingya and 600,000 locals were vaccinated in that campaign.
Date: Tue, 18 Feb 2020 17:16:35 +0100 (MET)

Juba, Feb 18, 2020 (AFP) - Swarms of locusts which are wreaking havoc across East Africa have now arrived in South Sudan, the government said Tuesday, threatening more misery in one of the world's most vulnerable nations.   Billions of desert locusts, some in swarms the size of Moscow, have already chomped their way through Ethiopia, Somalia, Kenya, Djibouti, Eritrea, Tanzania, Sudan and Uganda.   Their breeding has been spurred by one of the wettest rainy seasons in the region in four decades.

Experts have warned the main March-to-May cropping season is at risk. Eggs laid along the locusts' path are due to hatch and create a second wave of the insects in key agricultural areas.    The arrival of the locusts could be catastrophic in South Sudan, where war  followed by drought and floods has already left six million people -- 60 percent of the population -- facing severe hunger.   Agriculture Minister Onyoti Adigo Nyikiwec said the locusts had crossed the eastern border with Uganda on Monday.   "The report came that these are matured. As you know locusts are like human beings, they send their reconnaissance ahead of time to make sure that whether there is food or not and if the area is good for breeding."

Meshack Malo, the Food and Agriculture Organization (FAO) representative in South Sudan, said about 2,000 locusts had been spotted so far, and if not controlled quickly, could have a devastating impact.   "These are deep yellow which means that they will be here mostly looking at areas in which they will lay eggs."    He said the FAO was training locals and acquiring sprayers and chemicals to try and combat the locusts. It is the first locust invasion in 70 years in the country.   Other countries have employed aircraft to spray the swarms, while desperate locals have employed tactics like banging pots and pans or shooting at them.    Nyikiwec said the government had prepared a contingency plan.   "We are training people who will be involved in spraying and also we need chemicals for spraying and also sprayers. You will also need cars to move while spraying and then later if it becomes worse, we will need aircraft."

Earlier this month Somalia declared a national emergency over the invasion.   The FAO says the current invasion is known as an "upsurge," the term for when an entire region is affected.   However, if the invasion cannot be rolled back and spreads, it becomes known as a "plague" of locusts.   There have been six major desert locust plagues in the 1900s, the last of which was in 1987-89. The last major upsurge was in 2003-05.
Date: Tue, 18 Feb 2020 15:26:41 +0100 (MET)
By Ismail BELLAOUALI

AIT-BEN-HADDOU, Morocco, Feb 18, 2020 (AFP) - Millions worldwide may have seen the desert fortress in the hit fantasy series "Game of Thrones", but fewer know they can visit the Moroccan village of Ait-Ben-Haddou.   The fortified old settlement at the foot of the majestic Atlas mountains enchanted audiences in the HBO series and also served as a dusty backdrop in Ridley Scott's epic swords-and-sandals film "Gladiator".

But unlike other famous locations from movie and television history, this UNESCO World Heritage Site has so far missed out on a mass influx of tourism -- something some of its inhabitants are eager to change.    "Several people have told me that they came here to see the filming location of 'Game of Thrones'," said Ahmed Baabouz, a local tour guide. "There is tourism linked to cinema here but frankly we have not developed it to the extent it could be."   Ait-Ben-Haddou is southern Morocco's most famous fortress. Time seems to have stopped at the site overlooking a valley some 30 kilometres (18.6 miles) from the town of Ouarzazate.

After passing through the imposing entrance way, visitors navigate a labyrinth of winding alleys that eventually lead onto a public square where the settlement's inhabitants once gathered.    There is a mosque and two cemeteries -- one for Muslims and one for Jews. Most inhabitants have long since departed though, with a few homes converted into stalls selling handicrafts.    The fortress is an ideal film setting, located a short distance from the studios of Ouarzazate, the "Mecca" of Moroccan cinema. Productions ranging from "Lawrence of Arabia" to "The Mummy" have been filmed here.

More recently, scenes from the cult series "Game of Thrones" were shot at Ait-Ben-Haddou, with the site standing in for the fictional Yellow City of Yunkai which is conquered by Daenerys Targaryen, a key character in the "GOT" universe.   Hammadi, 61, is a privileged witness to the location's cinematic history.   "All of these productions have contributed to the reputation of the region," he said, grinning widely.    Hammadi himself has appeared as an extra in a number of films. And while like most people he lives in a more modern home in a village on the other side of the valley, he continues to return to Ait-Ben-Haddou to welcome tourists.

-'House of the Dragon' -
On a wall at the entrance to Hammadi's former home, photos bear witness to the projects he has worked on.    One shows him dressed as an ancient Roman with director Ridley Scott on the set of "Gladiator".    "We have a very rich cinematic heritage that we hope to use to attract tourists," said tour guide Baabouz, who is 29.   But "nothing indicates that 'Game of Thrones' was shot here," he added.    On Morocco's Atlantic coast, the city of Essaouira also formed the backdrop to scenes from the series.    But there too, Moroccan tourism promoters are yet to capitalise on the connection.

In comparison, Northern Ireland, Malta and Dubrovnik in Croatia have attracted hordes of fans from around the world, drawn by their links to the franchise.    To remedy this, Baabouz and other young people in the village are pooling their limited resources towards an ambitious project: a museum in the fortress, gathering photography from the productions that have been filmed here.    US channel HBO has commissioned a prequel to "GOT", called "House of the Dragon". George R.R. Martin, the author of the books on which the series is based, wrote on his blog that shooting would also take place in Morocco.
Date: Tue, 18 Feb 2020 09:44:12 +0100 (MET)

Macau, Feb 18, 2020 (AFP) - Macau's casinos will reopen Thursday after authorities lifted a city-wide two-week closure aimed at stopping the spread of the deadly new coronavirus.    The resumption of the lynchpin industry comes after the city reported no new infections in the last two weeks, with the number confirmed cases at just ten people.

The former Portuguese colony took the unprecedented step of shutting down almost all of its lucrative entertainment sector earlier in the month, including casinos, nightclubs and many bars.   The vast majority of Macau's tourists are mainland Chinese travellers, drawn to the city's casinos.

As the only place in China where casinos are allowed, Macau's gambling houses account for about 80 percent of government revenue.   But arrivals tanked as the epidemic spread.   Authorities said casinos that don't want to reopen because of low tourist numbers could apply to extend the closure, but they must be up and running within 30 days.

Macau's government has been keen to ensure the casinos keep employing staff through the downturn and are trying to avoid lay-offs.   Officials said all gamblers and casino staff must wear face masks.   First found in the city of Wuhan in central China, the new coronavirus has infected over 72,000 people on the mainland and 60 in Hong Kong.    It has also taken over 1,800 lives on the mainland and one in Hong Kong.
Date: Tue, 18 Feb 2020 09:07:42 +0100 (MET)

Athens, Feb 18, 2020 (AFP) - Greece was hit with a 24-hour strike Tuesday over a pension reform encouraging people to stay longer in the workforce.   The labour action paralysed public transport in Athens, intercity trains and ferry ship services.   Civil servants are also walking off the job and journalists will stage a three-hour work stoppage against the pension reform.   "This bill is practically the continuation of (austerity) laws introduced in 2010-2019," civil servants' union ADEDY said.

Unions will hold street protests in Athens, Thessaloniki and other major cities later in the day.   The new conservative government says the reform, to be voted by Friday, will make the troubled Greek pension system viable to 2070.   The labour ministry says the overhaul -- the third major revamp in a decade -- will contain pension increases and reduce penalties for pensioners still working.

Successive governments have attempted to reform the pension system, whose previously generous handouts are seen as one of the causes of the decade-long Greek debt crisis.   Chronic overspending and the inaccurate reporting of the budget deficit spooked creditors in 2010, and required three successive bailouts by the European Union and the International Monetary Fund to avert a Greek bankruptcy.   In return for billions of euros in rescue funds, Greece had to adopt unpopular austerity reforms and pension cuts.
Date: Tue, 18 Feb 2020 08:50:55 +0100 (MET)

Peshawar, Pakistan, Feb 18, 2020 (AFP) - A policeman was killed and two others wounded Tuesday by a roadside bomb aimed at polio vaccination workers in Pakistan's restive northwest, officials said.    The attack came a day after Islamabad launched a nationwide anti-polio drive, aiming to immunise tens of millions of children in Pakistan -- one of only three countries, along with Afghanistan and Nigeria, where the crippling disease remains endemic.

Opposition to inoculations grew after the CIA organised a fake vaccination drive to help track down Al-Qaeda's former leader Osama Bin Laden in the Pakistani city of Abbottabad.   According to Captain Wahid Mehmood, a district police chief, a police van monitoring the polio team was hit on the outskirts of the north-western city of Dera Ismail Khan.   "It was an IED (improvised explosive device) explosion in which one of our policemen got martyred while two others were wounded", Mehmood told AFP.   Sadaqat Khan, a local police official, confirmed the toll.   There was no immediate claim of responsibility, but the Pakistani Taliban and other militants have targeted polio vaccinators in the past.

The nationwide polio vaccination campaign aims to vaccinate some 39 million children.  Tuesday's attack follows a devastating year in Pakistan's long fight against polio, with at least 17 cases reported in 2020 so far.   In 2019, the number of polio cases jumped to 144 from just 12 in 2018.

Even as Pakistan has tried to eliminate polio, a new challenge has emerged in the form of a growing global movement against vaccinations.   The phenomenon has attracted adherents worldwide, fuelled by medically baseless claims and proliferated on social media resulting in a resurgence of once-eradicated, highly contagious diseases.
Date: Mon, 17 Feb 2020 21:19:05 +0100 (MET)
By Joe JACKSON

London, Feb 17, 2020 (AFP) - Britain on Monday battled the fallout from Storm Dennis after the second severe storm in seven days left one woman dead over the weekend.   Winds of more than 90 miles (140 kilometres) an hour, along with more than a month's worth of rain in 48 hours in some places, led officials to issue rare "danger to life" warnings.   A 55-year-old woman was found dead after being swept away by near the flood-prone town of Tenbury Wells in western England.   "We are all devastated," her family said in a statement after a body was discovered.

James Bevan, chief executive of the Environment Agency, which is responsible for flood protection, said more than 400 homes in England had been flooded while at least 1,000 agency staff were working "to protect and support those communities which have been hit".   "This is not yet over," he told BBC radio.   "We still have many flood warnings in force and we may still see significant flooding in the middle of this week from larger rivers."   The storm also pummelled much of France, with some 20,000 people without electricity on Monday after suffering power cuts in the northwest.

- 'More extreme' -
In Britain, more than 600 warnings and alerts -- a record number -- were issued on Sunday, extending from the River Tweed on the border of England and Scotland to Cornwall in the southwest.   After a day of torrential rain, major flooding incidents were declared in south Wales and parts of west central England.  In northern England, the defence ministry deployed troops in West Yorkshire, which had also been hit by flooding from last weekend's Storm Ciara.   There were fears that rivers there could burst their banks.

Newly appointed environment secretary George Eustice said the government had done "everything that we can do with a significant sum of money" to combat increased flooding.    "We'll never be able to protect every single household just because of the nature of climate change and the fact that these weather events are becoming more extreme," he said.   Youth climate activists gathering for a national conference in Staffordshire, west central England, were forced to cancel the event because of the storm.   "There's a bleak irony in our being beaten back by climate change," 15-year-old attendee Sophia said in a statement released by organisers.

- 'Supercomputer' announced -
Two rivers in south Wales burst their banks on Sunday, prompting rescue workers to launch operations to evacuate hundreds of people and their pets trapped in their homes.   Police said a man in his 60s died after entering the River Tawe, north of the Welsh city of Swansea, but later clarified that the death was not "linked to the adverse weather".

Meanwhile the bodies of two men were pulled from rough seas off the south coast of England on Saturday as the storm barrelled in.   Britain's Coastguard said it had sent a helicopter and rescue team to join navy and other search vessels after receiving reports of a man overboard in the sea near Margate, Kent.   "After many hours of searching, a body was sadly found in the water... and was brought to shore," it added.

Around the same time in nearby Herne Bay, emergency responders discovered another dead man following reports a person had been pulled from the sea, according to Kent police.   In a timely announcement the Met Office, Britain's national weather service, said Monday it would invest £1.2 billion ($1.6 billion) in a state-of-the-art supercomputer to improve forecasting.   The government claims it is the world's "most powerful weather and climate supercomputer".
Date: Sun 16 Feb 2020, 5:00 PM
Source: WHO, Weekly Bulletin on Outbreaks and Other Emergencies, page 9 [abridged, edited]

During week 4 [week ending 26 Jan 2020], a total of 73 suspected cases including one death were reported across the country, compared to 46 suspected cases and no deaths in the previous week. The majority of cases in week 4 were reported from Sankuru province (78%).

In the past 4 weeks (weeks 1 to 4 of 2020) a total of 222 suspected cases with 4 deaths (CFR: 1.8%) were notified in the country, with the majority of cases being reported from the provinces of Sankuru (31%), Bas-Uele (18%), Equateur (15%) and Mai-Ndombe (9%). There has been an increase in the weekly case incidence since week 2 of 2020.

Between weeks 1 and 52 of 2019 a cumulative total of 5288 monkeypox cases, including 107 deaths (CFR 2%) were reported from 133 health zones in 19 provinces.
======================
[Monkeypox (MPX) virus is endemic and widespread geographically in the DR Congo, with cases occurring sporadically in several provinces. January 2020 is off to a similar start with 222 suspected cases and 4 deaths reported in 4 provinces. The 2% CFR is relatively low for the clade of MPX that occurs in the DRC, which can reach 10% or more. The 222 cases are suspected, and there is the possibility that without laboratory confirmation some of them may be varicella cases misdiagnosed as MPX. There is no additional information about the circumstances under which these cases acquired their infection. Monkeys are not the reservoirs of the virus, despite the name that the virus has received. Studies of prevalence of MPX virus in populations of rodent hosts are not mentioned in this or previous reports. The main reservoirs of MPX virus are suspected to be rodents, including rope squirrels (_Funisciurus_ spp., an arboreal rodent) and terrestrial rodents in the genera _Cricetomys_ and _Graphiurus_. Halting the bushmeat trade and consumption of wild animals to halt MPX virus exposure will be culturally and economically difficult, so continued occurrence of cases can be expected. MPX virus can be transmitted between people but not readily. - ProMED Mod.TY]

[HealthMap/ProMED map available at:
Date: Fri 31 Jan 2020
Source: Nigeria CDC Situation report, yellow fever [edited]

Highlights
----------
In this reporting period:
- A total of 139 suspected cases were reported in 90 LGAs across 27 states
- All 139 suspected cases had blood samples collected
- 2 presumptive positive and 1 inconclusive case were reported; the inconclusive case was reported from Katsina State
- No confirmed case was recorded from Institute Pasteur Dakar
- No death was recorded from all the cases reported

Yellow fever response activities are being coordinated by the multi-agency yellow fever Technical Working Group (YF TWG).

Off-site support is being provided to all states.

Yellow fever preventive mass vaccination (PMVC) campaigns are planned for implementation in Oyo, Delta, Benue, Osun, Bauchi and Borno in the 3rd and 4th quarters.

Graphs and a map accessible at the above URL;
Figure 1 [graph]: Epidemic Curve of All Cases of Yellow Fever in Nigeria from Week 1 - Week 5, 31 Jan 2020
Figure 2 [graph]: Trends of Confirmed Cases in Nigeria - 2018, 2019 and January 2020
Figure 3 [graph]: Yellow fever Attack rate by State in Nigeria from Week 1 - Week 5, 31 Jan 2020
Figure 4: Map of Nigeria Showing States with Suspected and Presumptive confirmed Cases from Week 1 - Week 5, 31 Jan 2020
====================
[This report is not clear about the number of confirmed yellow fever (YF) cases that there have been in Nigeria this year (2020). The above report indicates that there are 139 suspected cases and all have had blood samples taken but does not state if all samples have been tested for YF by the Institute Pasteur in Dakar. The report does state that no confirmed case was recorded by the Institute Pasteur Dakar. The report states that 2 cases are presumptive and 1 is inconclusive. The graph in Figure 2 shows no confirmed cases in 2020.

It is curious that a 19 Jan 2020 report indicated that there were 141 suspected yellow fever cases in Jos North, Wase, Bassa, Kanam and Riyom Local Governments of Plateau State, of which 25 cases had been confirmed (see Yellow fever - Africa (02): Nigeria (PL) http://promedmail.org/post/20200121.6903167). A 29 Dec 2019 The World Health Organization (WHO) report confirmed 13 cases of yellow fever (YF), with 3 deaths in 4 local government areas of Plateau State (see Yellow fever - Africa (01): Nigeria (PL) http://promedmail.org/post/20200101.6862783). It is possible that all of these Plateau state cases occurred in 2019 and, hence, are not included in the above 2020 report which does not mention any cases in Plateau state. - ProMED Mod.TY]

[HealthMap/ProMED map available at:
Date: Sat 15 Feb 2020 2:34:10 PM AFT
Source: MENAFN, Afghanistan Times News report [edited]

At least 35 people including women and children have died in the past few weeks due to pneumonia outbreak in Badakhshan Province in the north-western mountainous area, the provincial health department confirmed.

Dr Noor Khawari, head of the provincial public health department, said [Sat 15 Feb 2020] that the people had died in the Wakhan district, a remote area surrounded by high and impassable mountains.

He said that 15 of the dead were children, calling malnutrition and cold weather as the main reasons for the fatalities. A medical team had been dispatched to Wakhan to prevent further outbreak of the disease, according to Dr Khawari.

The provincial council had earlier said that at least 10 people had lost their lives since an unknown disease had broken out in the Yomgan district [Badakhshan Province].

The report caused panic and concerns among the residents as coronavirus [infection, COVID-19] in China that borders Badakhshan takes the lives of people every day.

But the ministry of public health denied outbreak of any unknown disease in Badakhshan, saying that the recent deaths happened only due to pneumonia and pertussis (whooping cough) as well as malnutrition. Badakhshan is one of the provinces where seasonal diseases like pneumonia and whooping cough break out during winter. The diseases claim the lives of people in the remote areas behind high mountains as the roads connecting them to the provincial capital are blocked by heavy snowfalls.

The provincial health department has deployed medical teams to the borders with China and Tajikistan to examine those entering from the neighbouring states and to prevent coronavirus [infection, COVID-9].
===========================
[We are told in the news report above that at least 35 people, including 15 children, died in the past few weeks due to a "pneumonia" outbreak in Wakhan district, a remote area surrounded by high and impassable mountains, with a population of about 14 000 residents. Wakhan is a narrow strip about 350 km (220 mi) long and 13-65 km (8-40 mi) wide that extends from Badakhshan Province in Afghanistan in the west to Xinjiang Autonomous Region in China in the east, separating the Pamir Mountains and Tajikistan to the north and the Karakoram Mountains and Pakistan to the south  (<https://en.wikipedia.org/wiki/Wakhan_Corridor>).

A trade route through this valley has been used by travellers since antiquity
(<https://caravanistan.com/afghanistan/wakhan-corridor/>).

A map of this region can be found at

The local residents are concerned that the novel coronavirus infection, COVID-19, may be the cause of the outbreak of pneumonia in Wakhan district. There are about 70 500 total cases of COVID-19 in China, mainly concentrated in Hubei Province in Central China.

Although Xinjiang in Western China has reportedly 75 confirmed cases of COVID-19 and 1 death (assessed 16 Feb 2020 at 9:43 PM EST) (<https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6>), spread of COVID-19 to this very remote region in Afghanistan, that is easily cut off from the rest of the world especially in winter, seems unlikely. Also, 43% of deaths (15/35) occurred in children, which would be unusual for COVID-19. However, we are not told the clinical presentation of the illness, nor how a diagnosis of "pneumonia" was made in this undeveloped region. Other diagnoses, such as influenza, are also possible. More information from knowledgeable sources would be appreciated. - ProMED Mod.ML]

[Maps of Afghanistan: