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Faroe Islands

http://en.wikipedia.org/wiki/Faroe_Islands
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The early history of the Faroe Islands is not very clear. According to Færeyinga Saga emigrants who left Norway to escape the tyranny of Harald I of Norway settled in the isla
ds about the beginning of the 9th century. There is also evidence that Irish monks settled the islands, introducing sheep in the process. Early in the 11th century Sigmund, whose family had flourished in the southern islands but had been almost exterminated by invaders from the northern islands, was sent from Norway, from which he had escaped, to take possession of the islands for Olaf Tryggvason, king of Norway. He introduced Christianity and, though he was subsequently murdered, Norwegian supremacy was upheld. Norwegian control of the islands continued until 1380, when Norway entered into a union with Denmark, which gradually evolved into the double monarchy Denmark/Norway. The reformation reached the Faroes in 1538. When Norway was taken away from Denmark at the Treaty of Kiel in 1814, Denmark retained possession of the Faroe Islands.
The monopoly trade over the Faroe Islands was abolished in 1856. Since then, the country developed towards a modern fishery nation with its own fleet. The national awakening since 1888 was first based on a struggle for the Faroese language, and thus more culturally oriented, but after 1906 was more and more politically oriented after the foundation of the political parties of the Faroe Islands.
On April 12, 1940, the Faroes were invaded and occupied by British troops. The move followed the invasion of Denmark by Nazi Germany and had the objective of strengthening British control of the North Atlantic (see Second Battle of the Atlantic). In 1942–43 the British Royal Engineers built the only airport in the Faroes, the Vágar Airport. Control of the islands reverted to Denmark following the war, but in 1948 a home rule regime was implemented granting a high degree of local autonomy. The Faroes declined to join Denmark in entering the European Community (now European Union) in 1973. The islands experienced considerable economic difficulties following the collapse of the fishing industry in the early 1990s, but have since made efforts to diversify the economy. Support for independence has grown and is the objective of the government.
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Denmark, Greenland and the Faeroe Islands US Consular Information Sheet
August 15, 2006
COUNTRY DESCRIPTION: Denmark is a highly developed stable democracy with a modern economy. Greenland is a self-governing dependency of Denmark. The Faroe Islands are a self-governing overseas administrative division of Denmark. Read the Department of State Background Notes on Denmark for additional information.

ENTRY REQUIREMENTS: Passport and visa regulations are similar for Denmark, Greenland, and the Faroes. A valid passport is required. U.S. citizen tourist and business travelers do not need visas for visits of up to 90 days. That period begins when entering any of the following countries which are parties to the Schengen agreement: Austria, Belgium, Denmark, Finland, France, Germany, Greece, Iceland, Italy, Luxembourg, The Netherlands, Norway, Portugal, Spain, and Sweden. See our Foreign Entry Requirements brochure for more information on Denmark and other countries. Contact the Royal Danish Embassy at 3200 Whitehaven Street, N.W. Washington, DC 20008, telephone (202) 234-4300 or visit its website at for the most current visa information.

Note: Although European Union regulations require that non-EU visitors obtain a stamp in their passports upon initial entry to a Schengen country, many borders are not staffed with officers carrying out this function. If an American citizen wishes to ensure that his or her entry is properly documented, it may be necessary to request a stamp at an official point of entry. Under local law, travelers without a stamp in their passports may be questioned and asked to document the length of their stay in Schengen countries at the time of departure or at any other point during their visit, and could face possible fines or other repercussions if unable to do so.

Find more information about Entry and Exit Requirements pertaining to dual nationality and the prevention of international child abduction .
SAFETY AND SECURITY: Denmark remains largely free of terrorist incidents, however the country shares, with the rest of Western Europe, an increased threat of Islamic terrorism. Like other countries in the Schengen area, Denmark's open borders with its Western European neighbors allow the possibility of terrorist groups entering and exiting the country with anonymity. Americans are reminded to remain vigilant with regard to their personal security and to exercise caution.

Public demonstrations occasionally occur in Copenhagen and other Danish cities and are generally peaceful events. Prior police approval is required for public demonstrations, and police oversight is routinely provided to ensure adequate security for participants and passers-by. Nonetheless, as with any large crowd comprised of diverse groups, situations may develop which could pose a threat to public safety. U.S. citizens are advised to avoid areas where public demonstrations are taking place.
For the latest security information, Americans traveling abroad should regularly monitor the Department of State's web site , where the current Worldwide Caution Public Announcement , Travel Warnings, and Public Announcements can be found.

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

The Department of State urges American citizens to take responsibility for their own personal security while traveling overseas. For general information about appropriate measures travelers can take to protect themselves in an overseas environment, see the Department of State's pamphlet A Safe Trip Abroad .
CRIME: Denmark, Greenland, and the Faroes all have very low violent crime rates, however, non-violent crimes of opportunity have slightly increased over the last few years, especially in Copenhagen and other major Danish cities, where tourists can become targets for pickpockets and sophisticated thieves. Criminals frequent airports, train stations, and cruise ship quays to take advantage of weary, luggage-burdened travelers. Thieves also operate at popular tourist attractions, shopping streets, and restaurants. In hotel lobbies and breakfast areas, thieves take advantage of even a brief lapse in attention to snatch jackets, purses, and backpacks. Women's purses placed either on the backs of chairs or on the floor are typical targets for thieves. Car and home break-ins are also on the rise.

INFORMATION FOR VICTIMS OF CRIME: The loss or theft abroad of a U.S. passport should be reported immediately to the local police and the nearest U.S. Embassy or Consulate. If you are the victim of a crime while overseas, in addition to reporting to local police, please contact the nearest U.S. Embassy or Consulate for assistance. The Embassy/Consulate staff can, for example, assist you to find appropriate medical care, 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.

Denmark has a program to provide financial compensation to victims who suffer serious criminal injuries. According to existing regulations, the victim must report the incident to the police within 24 hours. Danish police routinely inform victims of serious crime of their rights to seek compensation. The relevant forms can be obtained from the police or the Danish Victims' Compensation Board: Civilstyrelsen, Erstatningsnaevnet, Gyldenløvesgade 11, 1600 Copenhagen V, TEL: (45) 33-92- 3334; FAX: (45) 39-20-45-05; www.erstatningsnaevnet.dk ; Email: erstatningsnaevnet@erstatningsnaevnet.dk . Claim processing time is a minimum of 4 weeks. There is no maximum award limit.

See our information for Victims of Crime .
MEDICAL FACILITIES AND HEALTH INFORMATION: Excellent medical facilities are widely available in Denmark. In Greenland and the Faroe Islands, medical facilities are limited and evacuation is required for serious illness or injury. Although emergency medical treatment is free of charge, the patient is charged for follow-up care.

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 (CDC) hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747) or via the CDC's website at . 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 .

MEDICAL INSURANCE: The Department strongly urges Americans to consult with their medical insurance company prior to traveling abroad to confirm whether their policy applies overseas and whether it will cover emergency expenses such as a medical evacuation. Please see our information on medical insurance overseas .

TRAFFIC SAFETY AND ROAD CONDITIONS: While in a foreign country, U.S. citizens may encounter road conditions that differ significantly from those in the United States. The information below concerning Denmark is provided for general reference only, and may not be totally accurate in a particular location or circumstance.

A valid U.S. driver's license may be used while visiting Denmark, but the driver must be at least 18 years old. Driving in Denmark is on the right side of the road. Road signs use standard international symbols. Many urban streets have traffic lanes reserved for public transport only. Unless otherwise noted on traffic signs, the speed limit is 50 km/h in urban areas, 80 km/h on open roads, and 130 km/h on expressways.

Use of seat belts is mandatory for drivers and all passengers. Children under three years of age must be secured with approved safety equipment appropriate to the child's age, size, and weight. Children from three to six years of age may use approved child or booster seats instead of seat belts.

Driving under the influence of alcohol or drugs is considered a very serious offense. The rules are stringently enforced, and violations can result in stiff fines and possible jail sentences.

Copenhagen, the capital and largest city in Denmark, has an extensive and efficient public transportation system. Trains and buses connect Copenhagen with other major cities in Denmark and to Norway, Sweden, and Germany. Bicycles are also a common mode of transportation in Denmark. Passengers exiting public or tourist buses, as well as tourists driving rental cars, should watch for bicycles on their designated paths, which are usually located between the pedestrian sidewalks and the traffic lanes.

Danish expressways, highways, and secondary roads are of high quality and connect all areas of the country. It is possible to drive from the northern tip of Denmark to the German border in the south in just four hours. Greenland has no established road system, and domestic travel is performed by foot, boat, or by air. The majority of the Faroe Islands are connected by bridges or serviced by boat. Although the largest islands have roads, most domestic travel is done on foot, horseback, boat, or by air.

The emergency telephone number for police/fire/ambulance in Denmark and the Faroe Islands is 112. In Greenland contact the local police.

Please refer to our Road Safety page for more information. Visit the website of the country's national tourist office and national authority responsible for road safety at . See also additional information on driving in Denmark at .

AVIATION SAFETY OVERSIGHT: The U.S. Federal Aviation Administration (FAA) has assessed the government of Denmark's Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for the oversight of Denmark's air carrier operations. This rating applies to Greenland and the Faroe Islands as well. For more information, travelers may visit the FAA's Internet website at www.faa.gov/safety/programs_initiatives/oversight/iasa .

SPECIAL CIRCUMSTANCES: The official unit of currency in Denmark is the Danish krone. ATM machines are widely available throughout Denmark. Please see our information on customs regulations .

For information concerning the importation of pets into Denmark, please visit the following website:
.
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 protection 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 Denmark's laws, even unknowingly, may be expelled, arrested, or imprisoned. Penalties for possession, use, or trafficking in illegal drugs in Denmark are severe and convicted offenders can expect long jail sentences and heavy fines. Engaging in sexual conduct with children or using or disseminating child pornography in a foreign country is a crime, prosecutable in the United States. Please see our information on Criminal Penalties .

CHILDREN'S ISSUES: For information on international adoption of children and international parental child abduction, see the Office of Children's Issues website.

REGISTRATION/EMBASSY LOCATION: Americans living or traveling in Denmark are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department's travel registration website , and to obtain updated information on travel and security within Denmark. Americans without Internet access may register directly with the nearest U.S. Embassy or Consulate. By registering, American citizens make it easier for the Embassy or Consulate to contact them in case of emergency. The U.S. Embassy is located at Dag Hammarskjolds Alle 24; 2100 Copenhagen, telephone: (45) 33-41-71-00; Embassy fax: (45) 35-43-02-23; Consular Section fax: (45) 35-38-96-16; After-hours emergency telephone: (45) 35-55-92-70. Information is also available via the U.S. Embassy's website at http://www.usembassy.dk. The United States has no consular presence in Greenland or the Faroe Islands.
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This replaces the Consular Information Sheet dated February 10, 2006, to update the section on Entry Requirements and Traffic Safety and Road Conditions.

Travel News Headlines WORLD NEWS

Date: Thu, 14 Nov 2019 12:51:34 +0100 (MET)

Copenhagen, Nov 14, 2019 (AFP) - Authorities in the Faroe Islands have announced the archipelago in the North Atlantic will be "closed for maintenance" for two days in April when tourists won't be welcome, instead opening the doors to volunteer caretakers.   In practice, the self-governing Danish islands will keep hotels open and international flights running, but popular tourist sites will be temporarily closed on April 16 and 17 next year.   The event is a continuation of a pilot project run in the spring of 2019, when 100 volunteers from 25 countries were invited to the islands.

Registrations for eager volunteers opened on Wednesday at 1500 GMT and were to remain open for 24 hours, the Faroese tourism office said on its website.   One hundred people will then be randomly selected to be part of the maintenance crew, who will be offered housing and food during their stay although they will still need to pay for their own plane tickets.   "The fragile natural environment in some popular tourist locations has felt the effects of an increase of visitors," the head of the tourism office, Guri Hojgaard, told AFP in March shortly after the pilot project was launched.   "These areas need a helping hand to ensure they remain pristine".

For the first edition of the event they received about 3,500 applications and the selected volunteers helped with projects like creating walking paths, constructing viewpoints to help preserve nature and protect birdlife sanctuaries and re-building rock cairns.   A popular destination for its fascinating landscapes with 30-metre cliffs, the archipelago covers 1,400 square kilometres (540 square miles) and has 50,000 inhabitants and 80,000 sheep spread over 18 islands.   In 2018, 110,000 tourists visited the Faroe Islands and the number of tourists has increased by about 10 percent annually for the past five years.    According to Hojgaard, the "closed for maintenance, open for voluntourism" weekend can "contribute to the international discussion about overtourism by showing that tourists can actually be a part of the solution."
Date: Fri, 25 Nov 2011 12:19:28 +0100 (MET)

COPENHAGEN, Nov 25, 2011 (AFP) - A hurricane packing winds of almost 200 kilometres (125 miles) an hour tore through the Faroe Islands overnight, causing major damage and evacuations but no deaths, police said Friday.  "There was a hurricane... a lot of material damage has been reported but no deaths so far," said Rani Wardum, a police officer in Torshavn, the capital of the North Atlantic archipelago. "Winds reach up to 55 metres per second," or 198 kilometres per hour, in some places, meteorologist Mogens Roenebek of the Danish Meteorological Institute told AFP.

The Faroe Islands, an autonomous Danish province, are home to around 48,000 people. The extent of the damage was not immediately known. "Many roofs were blown off and we had to evacuate a retirement home. The seniors were moved into a hospital," Wardum said.

Some residents were also evacuated from their homes during the night and a number of boats came loose from their moorings and ended up on land, he added. "The winds are still raging, but it was particularly violent last night and overnight," Wardum said, noting that the southern coastal regions of the Faroes Islands were hardest hit. The storm was heading towards the west coast of Norway on Friday, with strong winds and heavy seas, according to Roenebek.
Date: Thu, 6 May 2010 16:55:58 +0200 (METDST)

REYKJAVIK, May 6, 2010 (AFP) - The quantity of ash spewed by Iceland's Eyjafjoell volcano increased overnight and the higher ash cloud could make it to the Faroe Islands Friday, Icelandic authorities said Thursday.   "Ash production did increase last night and the ash plume is going higher now than the last couple of days," Agust Gunnar Gylfason, who monitors the eruption's progress at Iceland's Civil Protection Department, told AFP.

The ash cloud "might reach the Faroe Islands around midnight (GMT Thursday) under 20,000 feet (6,000 meters)" and continue on south towards Ireland on Friday, he added.   "The plume went up to 30,000 feet (9,000 meters) for some time last night, and again this morning, due to an increase in explosive activity, but otherwise it's been around 18,000 and 20,000 feet" high, he said.

At the strongest period of the eruption, Eyjafjoell sent a plume around 30,000 feet into the air, but scientists have stressed that the height of the plume does not necessarily reflect a particular quantity of ash.   On Tuesday, the plume contained about only 10 percent of the ash it held at the beginning of the eruption.   European airspace and airports across the continent were open on Thursday, but intergovernmental air traffic controller Eurocontrol said the ash cloud could mean transatlantic flights might need to be re-routed.

Airspace above Ireland, Northern Ireland and Scotland was partly shut Wednesday for the second time in two days, causing the cancellation of hundreds of flights.   The fresh disruption came after Europe's skies were closed for up to a week last month by the eruption of the Eyjafjoell volcano. It was the biggest aerial shutdown in Europe since World War II, with more than 100,000 flights cancelled and eight million passengers affected.
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Sudan

Sudan US Consular Information Sheet
August 29, 2008
COUNTRY DESCRIPTION:
Sudan is a diverse, developing country in northeastern Africa. The capital city is Khartoum. The civil war between the northern and southern regions, which began in 1
83, ended in 2005. A multi-party conflict continues in the west in Darfur, and the armed Ugandan group known as The Lord’s Resistance Army is present in the south. Security conditions are adverse in these and some other regions. Transportation networks and other forms of infrastructure are poor and do not meet western standards. Even where available, water and electric services suffer frequent outages. Read the Department of State Background Notes on Sudan for additional information.

ENTRY/EXIT REQUIREMENTS: The Government of Sudan requires all travelers to present a passport and an entry visa. Most travelers must obtain the entry visa before arrival; only American citizens who also possess a Sudanese national identification document (such as a Sudanese passport or national identification card) may apply for an entry visa at Khartoum International Airport. The Government of Sudan routinely denies visas to travelers whose passports contain visas issued by the Government of Israel or other evidence of travel to Israel such as exit or entry stamps.

Travelers must obtain an exit visa before departure from Sudan as well as pay any airport departure tax not included in the traveler’s airline ticket. Visitors may obtain the latest information and further details from the Embassy of Sudan, 2210 Massachusetts Avenue NW, Washington, DC 20008, tel.: 202-338-8565.

Travel permits issued by the semi-autonomous Government of Southern Sudan (GOSS) or by the South Sudan Relief and Rehabilitation Commission (SSRRC) are not adequate for entry to the country, although travelers may find these documents useful to present to local authorities when in the south. Personal baggage, including computers, is routinely searched upon arrival to and departure from Sudan. The authorities will seize material deemed objectionable, such as alcohol or pornography, and may detain or arrest the traveler. Travelers intending to bring electronic items should inquire about entry requirements when they apply for a visa; restrictions apply to many devices, including video cameras, satellite phones, facsimile machines, televisions, and telephones. Travelers are not allowed to depart Sudan with ivory, some other animal products, or large quantities of gold.

All visitors must register with the authorities within three days of arrival. Travelers must register within 72 hours of arrival in Sudan at the Ministry of Interior. All foreigners traveling more than 25 kilometers outside of Khartoum must obtain a travel permit from the Ministry of Humanitarian Affairs in Khartoum. This applies to all travel, including private, commercial, and humanitarian activities. Americans risk detention by Sudanese authorities when traveling more than 25 kilometers outside of Khartoum without a travel permit issued by the Ministry of Humanitarian Affairs. Travelers must register again with the police within 24 hours of arrival. The government requires a separate travel permit for travel to Darfur. These regulations are strictly enforced and even travelers with proper documentation may expect delay or temporary detention from the security forces, especially outside the capital. Authorities expect travelers to strictly respect roadblocks and other checkpoints.

Travelers who wish to take any photographs must obtain a photography permit from the Government of Sudan, Ministry of Interior, Department of Aliens.

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

SAFETY AND SECURITY:
On January 1, 2008, unknown assailants shot and killed two U.S. Embassy employees - an American USAID officer and a Sudanese national driver. Terrorists are known to operate in Sudan and continue to seek opportunities to carry out attacks against U.S. interests. Terrorist actions may include suicide operations, bombings, or kidnappings. U.S. citizens should be aware of the risk of indiscriminate attacks on civilian targets in public places, which include tourist sites and locations where westerners are known to congregate, and commercial operations associated with U.S. or Western interests. Terrorists are known to have targeted both official facilities and residential compounds. Anti-American sentiment is prevalent and Americans should exercise utmost caution at all times.

The U.S. Embassy’s ability to provide consular services in Sudan, including emergency assistance, is severely limited. Many areas outside the capital of Khartoum are extremely difficult to access.

Travel in many parts of Sudan is hazardous. Outside the major cities infrastructure is extremely poor, medical care is limited, and very few facilities for tourists exist.

Conflict among various armed groups and government forces continues in western Sudan, in the states of North Darfur, South Darfur, and West Darfur. Banditry and lawlessness are also common in the west. Many local residents are in camps for internally-displaced persons, and receive humanitarian assistance for basic needs such as food, water, and shelter. Expatriate humanitarian workers have been the targets of carjackings and burglaries.

Land mines remain a major hazard in southern Sudan, especially south of the city of Juba. Visitors should travel only on main roads unless a competent de-mining authority such as the UN has marked an area as clear of mines. The armed Ugandan group known as The Lord’s Resistance Army is present along the southern border and reportedly has announced it will target Americans.
Occasional clashes between armed groups representing communal interests continue to occur in the centrally-located states of Upper Nile, Blue Nile, and Bahr al Ghazal. Banditry also occurs.
Sudan shares porous land borders with nine other countries, including Chad, the Central African Republic, Uganda, Democratic Republic of Congo, Ethiopia, and Eritrea. Conflict in these countries occasionally spills over into Sudan.

Americans considering sea travel in Sudan's coastal waters should exercise caution as there have been incidents of armed attacks and robberies by unknown groups in recent years, including one involving two American vessels. Exercise extreme caution, as these groups are considered armed and dangerous. When transiting in and around the Horn of Africa and/or in the Red Sea near Yemen, it is strongly recommended that vessels convoy in groups and maintain good communications contact at all times. Marine channels 13 and 16 VHF-FM are international call-up and emergency channels, and are commonly monitored by ships at sea. 2182 Mhz is the HF international call-up and emergency channel. Wherever possible, travel in trafficked sea-lanes. Avoid loitering in or transiting isolated or remote areas. In case of emergency, contact the nearest U.S. Embassy or Consulate. In the event of an attack, consider activating Emergency Position Indicating Radio Beacons.

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

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

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

CRIME: Crime is on the increase throughout Sudan. Additional security measures should be taken at places of residence to protect life and property. Anti-American sentiments can be found throughout the country. Americans should exercise caution by avoiding crowded public areas and public gatherings. Americans should avoid traveling alone. Report all instances of anti-American acts and crime targeting westerners to the American Embassy, and report incidents of crime to the Sudanese Police.

Americans should guard their backpacks or hand luggage. When traveling by air, travelers should maintain constant contact with their baggage and assure that they do not contain illicit items, such as alcohol or military ordinance. Americans have been removed from international airlines and detained when suspect items have been detected in checked baggage.

Carjacking and armed robbery continue to occur in western and southern Sudan. Sexual assault is more prevalent in the areas of armed conflict. Travelers who do not use the services of reputable travel firms or knowledgeable guides or drivers are especially at risk. Travel outside of Khartoum should be undertaken with a minimum of two vehicles so that there is a backup in case of mechanical failure or other emergency. Solo camping is always risky.

The Sudanese mail system can be unreliable. International couriers provide the safest means of shipping envelopes and packages, although anything of value should be insured.

INFORMATION FOR VICTIMS OF CRIME: The loss or theft abroad of a U.S. passport should be reported immediately to the local police and the nearest U.S. Embassy or Consulate. If you are the victim of a crime while overseas, in addition to reporting to local police, please contact the nearest U.S. Embassy or Consulate for assistance. The Embassy/Consulate staff can, for example, assist you to find appropriate medical care, contact family members or friends and explain how funds could be transferred. Although the investigation and prosecution of the crime is solely the responsibility of local authorities, consular officers can help you to understand the local criminal justice process and to find an attorney if needed.

See our information on Victims of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION: Individuals with medical conditions which may require treatment are discouraged from traveling to Sudan. Medical facilities in Khartoum fall short of U.S. standards; outside the capital, very few facilities exist and hospitals and clinics are poorly equipped. Travelers must pay cash in advance for any medical treatment. Ambulance services are not available. Medicines are available only intermittently; travelers should bring sufficient supplies of needed medicines in clearly-marked containers.

Malaria is prevalent in all areas of Sudan. The strain is resistant to chloroquine and can be fatal. Consult a health practitioner before traveling, obtain suitable anti-malarial drugs, and use protective measures, such as insect repellent, protective clothing, and mosquito nets. Travelers who become ill with a fever or a flu-like illness while in Sudan, or within a year after departure, should promptly seek medical care and inform their physician of their travel history and the kind of anti-malarial drugs used. For additional information about malaria and anti-malarial drugs please see the Center for Disease Control travelers’ health web site, http://www.cdc.gov/malaria/index.htm.

Officially, people with HIV are not granted a visa and are not permitted to enter Sudan. A negative HIV test result must be presented at a Sudanese embassy or at Khartoum airport in order to obtain a visa. However, anecdotal reports indicate this requirement is not enforced in practice. Please confirm this requirement with the Embassy of Sudan at www.sudanembassy.org.

Information on vaccinations and other health precautions, such as safe food and water precautions and insect bite protection, may be obtained from the Centers for Disease Control and Prevention’s hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747) or via the CDC’s web site at http://wwwn.cdc.gov/travel/default.aspx. For information about outbreaks of infectious diseases abroad consult the World Health Organization’s (WHO) web site at http://www.who.int/en. Further health information for travelers is available at http://www.who.int/ith/en.

MEDICAL INSURANCE: The Department of State strongly urges Americans to consult with their medical insurance company prior to traveling abroad to confirm whether their policy applies overseas and whether it will cover emergency expenses such as a medical evacuation. Please see our information on medical insurance overseas.

TRAFFIC SAFETY AND ROAD CONDITIONS: While in a foreign country, U.S. citizens may encounter road conditions that differ significantly from those in the United States. The information below concerning Sudan is provided for general reference only, and may not be accurate in a particular location or circumstance.

Road conditions throughout Sudan are hazardous due to erratic driver behavior, pedestrians and animals in the roadways, and the lack of basic safety equipment on many vehicles. Only major highways and some streets in the cities are paved; many roads are narrow, rutted, and poorly maintained. Local drivers do not observe conventions for the right-of-way, stop in the road without warning, and frequently exceed safe speeds for road, traffic, and weather conditions. Driving at night is dangerous and should be avoided if possible; many vehicles operate without lights.

In the north and west, dust storms and sand storms, known locally as haboobs, greatly reduce visibility when they occur. Roads in these areas can be quickly covered with shifting sand at any season of the year. Roads in southern Sudan often are impassable during the rainy season, from March to October.
U.S. citizens are subject to the laws of the country in which they are traveling, including traffic laws. In Sudan vehicles have the steering wheel on the left side and drivers use the right side of the road.

Traffic from side streets on the right has the right-of-way when entering a cross street, including fast-moving main streets. Traffic on the right has the right-of-way at stops. Right turns on a red light are prohibited. Speed limits are not posted, but the legal speed limit for passenger cars on inter-city highways is 120 kph (about 70 mph), while in most urban areas the limit is 60 kph (about 35 mph.) The speed limit in congested areas and school zones is 40 kph (about 25 mph).

Many local drivers carry no insurance despite the legal requirement that all motor vehicle operators purchase third-party liability insurance from the government. Persons involved in an accident resulting in death or injury must report the incident to the nearest police station or police officer as soon as possible. Persons found at fault can expect fines, revocation of driving privileges, and jail sentences, depending on the nature and extent of the accident. Persons convicted of driving under the influence of alcohol face fines, jail sentences, and corporal punishment.

Americans may use their U.S. driver's licenses for up to 90 days after arrival in Sudan, and then must carry either an International Driving Permit (IDP) or a Sudanese driver's license. There are no restrictions on vehicle types, including motorcycles and motorized tricycles.

Public transportation is limited to within and between major urban areas. Passenger facilities are basic and crowded, especially during rush hours and periods of seasonal travel. Schedules are unpublished and subject to change without notice. Vehicle maintenance does not meet U.S. standards. There is routine passenger train service on the route from Khartoum to Wadi Halfa (on the border with Egypt) and to Port Sudan (on the Red Sea.) Bus service between major cities is regular and inexpensive. Intra-city bus service in the major urban areas is regular, but most buses and bus stops are privately-operated and unmarked. Taxis are available in the major cities at hotels, tourist sites, and government offices. The motorized rickshaws in common use in Khartoum are unsafe. Travelers are encouraged to hire cars and drivers from reputable sources with qualified drivers and safe vehicles. Irregularly-scheduled mini-buses provide some public transit to rural communities; many areas lack any public transportation.

Please refer to our Road Safety page for more information.

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

Enforcement of aviation safety standards in Sudan is uneven; civil aviation in Sudan continues to experience air incidents and accidents, including 5 crashes with at least 64 fatalities between November 8, 2007, and June 30, 2008. Incidents included engine failures, collapsed landing gear, and planes veering off the runway. Whenever possible, Americans traveling to Sudan despite the ongoing travel warning are advised to travel directly to their destinations on international carriers from countries whose civil aviation authorities meet international aviation safety standards for the oversight of their air carrier operations under the FAA’s International Aviation Safety Assessment (IASA) program. Adverse seasonal weather conditions, such as dust or sand storms in the north between April and June and severe rain storms in the south between March and October, cause frequent flight cancellations.

Two hijackings originated in Sudan in 2007; no passengers were harmed.

SPECIAL CIRCUMSTANCES: In November 1997, the U.S. imposed comprehensive financial and commercial sanctions against Sudan, prohibiting U.S. transactions with Sudan. Travelers intending to visit Sudan despite the Travel Warning should contact the Department of the Treasury, Office of Foreign Assets Control (OFAC), Office of Compliance, telephone 1-800-540-6322 or 202-622-2490, regarding the effect of these sanctions.

Travelers must be prepared to pay cash for all purchases, including hotel bills, airfares purchased locally, and all other travel expenses. Major credit cards, including Visa, MasterCard, or American Express, cannot be used in Sudan due to U.S. sanctions. Sudan has no international ATMs. Local ATMs draw on local banks only.

Travelers, including journalists, must obtain a photography permit before taking any photographs. Even with a photography permit, photographing military areas, bridges, drainage stations, broadcast stations, public utilities, slum areas, and beggars is prohibited.

Sudan is a conservative society, particularly in the capital and other areas where the Muslim population is the majority. Alcohol is prohibited by law and modest dress is expected. Loose, long-sleeved shirts and full-length skirts or slacks are recommended attire for women visitors. Women who are not Muslim are not expected or required to cover their heads. Men may wear short-sleeved shirts but short pants are not acceptable in public.

Please see our information on 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 Sudanese laws, even unknowingly, may be expelled, arrested or imprisoned. Penalties for possession, use, or trafficking in alcohol or illegal drugs in Sudan are severe, and convicted offenders can expect long jail sentences and heavy fines. Engaging in sexual conduct with children or using or disseminating child pornography in a foreign country is a crime, prosecutable in the United States as well in Sudan.

Sudan’s Public Order Courts have continued to serve as the state mechanism for morality enforcement since the early 1980's. Today the court still issues punishments ranging from fines, to lashings, to lengthy prison sentences for offences such as drinking alcohol, wearing inappropriate clothing, or associating with unmarried women.

Please see our information on Criminal Penalties.

CHILDREN'S ISSUES: For information see our Office of Children’s Issues web pages on intercountry adoption and international parental child abduction.

REGISTRATION / EMBASSY LOCATION:
Americans living or traveling in Sudan are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department’s travel registration web site so that they can obtain updated information on travel and security within Sudan. Americans without Internet access may register directly with the nearest U.S. Embassy or Consulate. By registering, American citizens make it easier for the Embassy or Consulate to contact them in case of emergency. The U.S. Embassy is located at Sharia Ali Abdel Latif, Khartoum, Sudan; tel: 249 1 83 774-701, http://sudan.usembassy.gov/.
* * *
This replaces the Country Specific Information dated March 12, 2008, to update sections on Entry/Exit Requirements, Medical Facilities and Health Information, Aviation Safety Oversight, and Criminal Penalties.

Travel News Headlines WORLD NEWS

Date: Thu, 12 Dec 2019 15:59:23 +0100 (MET)

Juba, Dec 12, 2019 (AFP) - Devastating flooding in South Sudan following a fierce drought could tip parts of the country into famine in the next few months, the World Food Programme (WFP) warned on Thursday.   According to the UN refugee agency nearly one million people were affected by floodwaters that submerged entire towns, compounding an already dire humanitarian situation after six years of war.

The WFP said that 5.5 million people are expected to be going hungry in early 2020 -- the time at which the population is generally benefiting from their harvest in October and November of the previous year.   An earlier harvest failed due to drought. This time crops have been washed away.    "The number of people in need is likely to increase because of the catastrophic level of destruction caused by floods since October following a drought that hammered parts of the country earlier in the year," the agency said in a statement.

The floods wiped out 73,000 metric tons of potential harvests as well as tens of thousands of cattle and goats, said the WFP.   "We know the problems that we've been having in South Sudan, but the rains and the floods have led to a national disaster and are much worse than anyone could have anticipated," said WFP Executive Director David Beasley.    "In fact, if we don't get funding in the next few weeks and months, we are literally talking about famine. We need support, we need help and we need it now."   The agency estimated its needs at $270 million (242 million euros) for the first half of 2020.   South Sudan declared a "man-made" famine affecting around 100,000 people in 2017. 

The term "famine" is used according to a scientific system agreed upon by global agencies, when at least 20 percent of the population in a specific area has extremely limited access to basic food; acute malnutrition exceeds 30 percent; and the death rate exceeds two per 10,000 people per day for the entire population.   "Famine in South Sudan was defeated after four months in 2017 by a concerted large-scale humanitarian response," said the WFP.   "Experts now say the country's food security outlook has never been so dire."   Political instability is also high as President Salva Kiir and his rival Riek Machar have again delayed their formation of a power-sharing government, this time by 100 days until February 2020.
Date: Sat, 30 Nov 2019 18:41:31 +0100 (MET)
By Waakhe Simon Wudu

Juba, Nov 30, 2019 (AFP) - In Andrew Makech's home village near Rumbek in central South Sudan, few have ever heard of a condom, and broaching the topic of its use would be considered taboo.   However the 35-year-old on Saturday joined hundreds in the capital Juba to get tested for HIV/Aids and learn about the use of condoms to combat the disease, in a rare public sex education campaign in the country wracked by six years of war.   The campaign, launched by the Okay Africa Foundation NGO in partnership with government, comes ahead of World Aids Day on Sunday, and highlights that despite great strides made in raising awareness about the disease around the globe, many are still at risk.

In South Sudan, HIV rates are currently believed to be low, at around 200,000 people infected in a population of around 12 million, however few protect themselves or get themselves tested, and only 10 percent of those infected are receiving anti-retroviral treatment, according to the World Health Organisation.   Makech told AFP that in his village anyone using a condom would be considered a prostitute and that asking someone to use one would probably insult them.   At the campaign launch at the Kampala University College in Juba, demonstrations were carried out on how to use both male and female condoms -- as students listened attentively and took photos with their phones -- and around 5,000 condoms were distributed.   Data Emmanuel Gordon from the Okay Africa Foundation said the campaign was motivated by a lack of awareness on how to stop the spread of HIV/Aids.

In South Sudan "the use of condoms is attributed to immorality. When you use condoms you are immoral. People think the use of condoms is for... going outside your marriage to have sex with someone," said Gordon.   Chris Isa, who works on HIV prevention at the South Sudan Aids Commission said there was a perception that educating young people about sex exposed them to immorality.   "The fact that we don't talk about sex in this country doesn't mean it is not happening so we really need to accept that we need to condomise and not compromise," said Isa.

South Sudan plunged into war in 2013, two years after achieving independence, and the conflict has devastated health infrastructure in the country. A peace deal was signed in September 2018 which largely stemmed fighting, but a power-sharing government has yet to be formed.   Isa said HIV prevalence was particularly high in the military, with five in every 100 soldiers testing positive.   He said that if testing was more widely carried out, many more than the almost 200,000 currently recorded could be infected because "all the ingredients and the factors for the spread of the virus are evident in our society."
Date: Thu 14 Nov 2019
Source: WHO Emergencies preparedness, response, Disease Outbreak News (DONs) [edited]

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

5th November 2019
http://www.emro.who.int/sdn/sudan-news/who-scales-up-cholera-vigilance-in-khartoum-sudan.html

5 November 2019, Khartoum, Sudan -- To prevent a potential spread of the current cholera outbreak to Khartoum State – including to the country’s capital Khartoum City – and at the request of the Federal Minister of Health Dr Akram Eltoum, WHO is working closely with health partners, nongovernmental organizations, and at-risk communities to ensure that suspected cases are quickly identified and responded to, and that people can effectively protect themselves from infection.  “The risk of cholera spreading is very real. If not properly managed, this could have potentially serious consequences. More than eight million people live in Khartoum State, where the public health system is impacted by the economic crisis, recent flooding, and ongoing outbreaks of infectious diseases,” said Dr Naeema Al Gasseer, WHO Representative in Sudan.

As of 3 November, Sudan’s Ministry of Health reported 332 suspected cases of cholera, concentrated in Blue Nile and Sennar States. Two cases were confirmed in Khartoum State on 19 October.  Together with the Ministry of Health, WHO has conducted initial risk mapping in Khartoum State to identify which areas are more likely to be at increased risk of an outbreak. This will allow for more informed planning to ensure high-risk areas, including Sharq Elnil and Ombada localities, are better prepared to respond as needed.  Scaling up health capacities to detect and respond to cholera

To ensure that health facilities and cholera treatment centres in Khartoum State are equipped to diagnose and treat suspected patients, WHO has delivered cholera medicines and supplies sufficient for 400 severely dehydrated patients, and 500 Rapid Diagnostic Tests used for immediate detection and screening of cholera patients in health facilities.  WHO is also supporting the establishing of two cholera treatment centres in Ombada and Bahri localities by providing additional cholera medicines, medical supplies, and Rapid Diagnostic Tests.

To strengthen disease surveillance in Khartoum State, WHO, with support MSF, is providing refresher training for 271 health staff and paramedics from all 7 localities on cholera detection and management. An additional 35 health staff are being trained to form Rapid Response Teams who will be the first to respond to suspected cases at locality level.  Ensuring communities are aware of prevention and treatment actions.  “A key aspect of preventing and controlling cholera is how well at-risk communities are able to protect themselves by drinking safe water, properly handling food, avoiding defecation in open areas, handwashing, and knowing what to do when they see the first signs of infection,” said Dr Al Gasseer.

WHO and the Khartoum State Ministry of Health are working with more than 1700 male and female health promoters and volunteers who will play a critical role in raising awareness among communities on cholera, hygiene practices, and environmental health, as well as linking communities with available health services and involving them more in health planning activities.

WHO’s work to protect people from cholera in Sudan is made possible through the Sudan Humanitarian Fund.

For more information
Inas Hamam
Communications officer
WHO Regional Office
hamami@who.int
Date: Sun 27 Oct 2019
Source: Radio Dabanga and AllAfrica [edited]

According to the Sudanese Ministry of Health and the World Health Organization (WHO), 323 suspected cholera cases, including 10 deaths, were reported in Blue Nile state, Sennar and Khartoum between the end of August 2019 and [22 Oct 2019]. The 1st case was detected on [28 Aug 2019], the UN Office for the Coordination of Humanitarian Affairs in Sudan says in its latest Sudan Situation Report. Two cases were recently recorded in Ombadda locality in Omdurman, the twin-city of Khartoum.

On [6 Oct 2019], humanitarian partners in Sudan launched the Cholera Readiness and Response Plan, that targets 2.5 million people in 8 high-risk states (Blue Nile state, Sennar, El Gedaref, Kassala, El Gezira, White Nile state, Khartoum, and River Nile state).

An oral cholera vaccine campaign launched on 11 Oct 2019 is ongoing, targeting 1.6 million people in high risk communities in Blue Nile and Sennar states. The aim of the campaign is to contain the outbreak and prevent its spread to neighboring states.

Risk assessment
---------------
Sudan has been facing a continuous surge of acute watery diarrhea/suspected cholera cases since 2016. The current outbreak was reported following recent heavy rains and flooding in 17 out of 18 states across the country. As a result of the flooding, the country reported widespread damage to infrastructure, thus more cholera cases can be expected in the future.
======================
[As stated in Lutwick LI, Preis J, Choi P: Cholera. In: Chronic illness and disability: the pediatric gastrointestinal tract. Greydanus DE, Atay O, Merrick J (eds). NY: Nova Bioscience, 2018; pp 113-136, oral rehydration therapy can be life-saving in outbreaks of cholera and other forms of diarrhea:
"As reviewed by Richard Guerrant et al (1), it was in 1831 that cholera treatment could be accomplished by intravenous replacement, and, although this therapy could produce dramatic improvements, not until 1960 was it 1st recognized that there was no true destruction of the intestinal mucosa, and gastrointestinal rehydration therapy could be effective, and the therapy could dramatically reduce the intravenous needs for rehydration. Indeed, that this rehydration could be just as effective given orally as through an orogastric tube (for example, refs 2 and 3) made it possible for oral rehydration therapy (ORT) to be used in rural remote areas and truly impact on the morbidity and mortality of cholera. Indeed, Guerrant et al (1) highlights the use of oral glucose-salt packets in war-torn Bangladeshi refugees, which reduced the mortality rate from 30 per cent to 3.6 per cent (4) and quotes sources referring to ORT as "potentially the most important medical advance" of the 20th century. A variety of formulations of ORT exist, generally glucose or rice powder-based, which contain a variety of micronutrients, especially zinc (5).

"The assessment of the degree of volume loss in those with diarrhea to approximate volume and fluid losses can be found in ref 6 below. Those with severe hypovolemia should be initially rehydrated intravenously with a fluid bolus of normal saline or Ringer's lactate solution of 20-30 ml/kg followed by 100 ml/kg in the 1st 4 hours and 100 ml/kg over the next 18 hours with regular reassessment. Those with lesser degrees of hypovolemia can be rehydrated orally with a glucose or rice-derived formula with up to 4 liters in the 1st 4 hours, and those with no hypovolemia can be given ORT after each liquid stool with frequent reevaluation."

References
----------
1. Guerrant RL, Carneiro-Filho BA and Dillingham RA. Cholera, diarrhea, and oral rehydration therapy: triumph and indictment. Clin Infect Dis. 2003;37(3):398-405; available at: <http://cid.oxfordjournals.org/content/37/3/398.long>.
2. Gregorio GV, Gonzales ML, Dans LF and Martinez EG. Polymer-based oral rehydration solution for treating acute watery diarrhoea. Cochrane Database Syst Rev. 2009;(2):CD006519. doi: 10.1002/14651858.CD006519.pub2; available at: <http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD006519.pub3/full>.
3. Gore SM, Fontaine O and Pierce NF. Impact of rice based oral rehydration solution on stool output and duration of diarrhea: meta-analysis of 13 clinical trials. BMJ 1992; 304(6822): 287-91; available at: <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1881081/>.
4. Mahalanabis D, Choudhuri AB, Bagchi NG, et al. Oral fluid therapy of cholera among Bangladesh refugees. Johns Hopkins Med 1973; 132(4): 197-205; available at: <http://www.searo.who.int/publications/journals/seajph/media/2012/seajph_v1n1/whoseajphv1i1p105.pdf>.
5. Atia AN and Buchman AL. Oral rehydration solutions in non-cholera diarrhea: a review. Am J Gastroenterol. 2009; 104(10): 2596-604, doi: 10.1038/ajg.2009.329; abstract available at: <http://www.ncbi.nlm.nih.gov/pubmed/19550407>.
6. WHO. The treatment of diarrhea, a manual for physicians and other senior health workers. 4th ed. 2005; available at: <http://whqlibdoc.who.int/publications/2005/9241593180.pdf>. - ProMED Mod.LL]

[HealthMap/ProMED maps available at:
Adamawa State, Nigeria: <http://healthmap.org/promed/p/6479>
More ...

Faroe Islands

http://en.wikipedia.org/wiki/Faroe_Islands
=========================
The early history of the Faroe Islands is not very clear. According to Færeyinga Saga emigrants who left Norway to escape the tyranny of Harald I of Norway settled in the isla
ds about the beginning of the 9th century. There is also evidence that Irish monks settled the islands, introducing sheep in the process. Early in the 11th century Sigmund, whose family had flourished in the southern islands but had been almost exterminated by invaders from the northern islands, was sent from Norway, from which he had escaped, to take possession of the islands for Olaf Tryggvason, king of Norway. He introduced Christianity and, though he was subsequently murdered, Norwegian supremacy was upheld. Norwegian control of the islands continued until 1380, when Norway entered into a union with Denmark, which gradually evolved into the double monarchy Denmark/Norway. The reformation reached the Faroes in 1538. When Norway was taken away from Denmark at the Treaty of Kiel in 1814, Denmark retained possession of the Faroe Islands.
The monopoly trade over the Faroe Islands was abolished in 1856. Since then, the country developed towards a modern fishery nation with its own fleet. The national awakening since 1888 was first based on a struggle for the Faroese language, and thus more culturally oriented, but after 1906 was more and more politically oriented after the foundation of the political parties of the Faroe Islands.
On April 12, 1940, the Faroes were invaded and occupied by British troops. The move followed the invasion of Denmark by Nazi Germany and had the objective of strengthening British control of the North Atlantic (see Second Battle of the Atlantic). In 1942–43 the British Royal Engineers built the only airport in the Faroes, the Vágar Airport. Control of the islands reverted to Denmark following the war, but in 1948 a home rule regime was implemented granting a high degree of local autonomy. The Faroes declined to join Denmark in entering the European Community (now European Union) in 1973. The islands experienced considerable economic difficulties following the collapse of the fishing industry in the early 1990s, but have since made efforts to diversify the economy. Support for independence has grown and is the objective of the government.
================
Denmark, Greenland and the Faeroe Islands US Consular Information Sheet
August 15, 2006
COUNTRY DESCRIPTION: Denmark is a highly developed stable democracy with a modern economy. Greenland is a self-governing dependency of Denmark. The Faroe Islands are a self-governing overseas administrative division of Denmark. Read the Department of State Background Notes on Denmark for additional information.

ENTRY REQUIREMENTS: Passport and visa regulations are similar for Denmark, Greenland, and the Faroes. A valid passport is required. U.S. citizen tourist and business travelers do not need visas for visits of up to 90 days. That period begins when entering any of the following countries which are parties to the Schengen agreement: Austria, Belgium, Denmark, Finland, France, Germany, Greece, Iceland, Italy, Luxembourg, The Netherlands, Norway, Portugal, Spain, and Sweden. See our Foreign Entry Requirements brochure for more information on Denmark and other countries. Contact the Royal Danish Embassy at 3200 Whitehaven Street, N.W. Washington, DC 20008, telephone (202) 234-4300 or visit its website at for the most current visa information.

Note: Although European Union regulations require that non-EU visitors obtain a stamp in their passports upon initial entry to a Schengen country, many borders are not staffed with officers carrying out this function. If an American citizen wishes to ensure that his or her entry is properly documented, it may be necessary to request a stamp at an official point of entry. Under local law, travelers without a stamp in their passports may be questioned and asked to document the length of their stay in Schengen countries at the time of departure or at any other point during their visit, and could face possible fines or other repercussions if unable to do so.

Find more information about Entry and Exit Requirements pertaining to dual nationality and the prevention of international child abduction .
SAFETY AND SECURITY: Denmark remains largely free of terrorist incidents, however the country shares, with the rest of Western Europe, an increased threat of Islamic terrorism. Like other countries in the Schengen area, Denmark's open borders with its Western European neighbors allow the possibility of terrorist groups entering and exiting the country with anonymity. Americans are reminded to remain vigilant with regard to their personal security and to exercise caution.

Public demonstrations occasionally occur in Copenhagen and other Danish cities and are generally peaceful events. Prior police approval is required for public demonstrations, and police oversight is routinely provided to ensure adequate security for participants and passers-by. Nonetheless, as with any large crowd comprised of diverse groups, situations may develop which could pose a threat to public safety. U.S. citizens are advised to avoid areas where public demonstrations are taking place.
For the latest security information, Americans traveling abroad should regularly monitor the Department of State's web site , where the current Worldwide Caution Public Announcement , Travel Warnings, and Public Announcements can be found.

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

The Department of State urges American citizens to take responsibility for their own personal security while traveling overseas. For general information about appropriate measures travelers can take to protect themselves in an overseas environment, see the Department of State's pamphlet A Safe Trip Abroad .
CRIME: Denmark, Greenland, and the Faroes all have very low violent crime rates, however, non-violent crimes of opportunity have slightly increased over the last few years, especially in Copenhagen and other major Danish cities, where tourists can become targets for pickpockets and sophisticated thieves. Criminals frequent airports, train stations, and cruise ship quays to take advantage of weary, luggage-burdened travelers. Thieves also operate at popular tourist attractions, shopping streets, and restaurants. In hotel lobbies and breakfast areas, thieves take advantage of even a brief lapse in attention to snatch jackets, purses, and backpacks. Women's purses placed either on the backs of chairs or on the floor are typical targets for thieves. Car and home break-ins are also on the rise.

INFORMATION FOR VICTIMS OF CRIME: The loss or theft abroad of a U.S. passport should be reported immediately to the local police and the nearest U.S. Embassy or Consulate. If you are the victim of a crime while overseas, in addition to reporting to local police, please contact the nearest U.S. Embassy or Consulate for assistance. The Embassy/Consulate staff can, for example, assist you to find appropriate medical care, 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.

Denmark has a program to provide financial compensation to victims who suffer serious criminal injuries. According to existing regulations, the victim must report the incident to the police within 24 hours. Danish police routinely inform victims of serious crime of their rights to seek compensation. The relevant forms can be obtained from the police or the Danish Victims' Compensation Board: Civilstyrelsen, Erstatningsnaevnet, Gyldenløvesgade 11, 1600 Copenhagen V, TEL: (45) 33-92- 3334; FAX: (45) 39-20-45-05; www.erstatningsnaevnet.dk ; Email: erstatningsnaevnet@erstatningsnaevnet.dk . Claim processing time is a minimum of 4 weeks. There is no maximum award limit.

See our information for Victims of Crime .
MEDICAL FACILITIES AND HEALTH INFORMATION: Excellent medical facilities are widely available in Denmark. In Greenland and the Faroe Islands, medical facilities are limited and evacuation is required for serious illness or injury. Although emergency medical treatment is free of charge, the patient is charged for follow-up care.

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 (CDC) hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747) or via the CDC's website at . 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 .

MEDICAL INSURANCE: The Department strongly urges Americans to consult with their medical insurance company prior to traveling abroad to confirm whether their policy applies overseas and whether it will cover emergency expenses such as a medical evacuation. Please see our information on medical insurance overseas .

TRAFFIC SAFETY AND ROAD CONDITIONS: While in a foreign country, U.S. citizens may encounter road conditions that differ significantly from those in the United States. The information below concerning Denmark is provided for general reference only, and may not be totally accurate in a particular location or circumstance.

A valid U.S. driver's license may be used while visiting Denmark, but the driver must be at least 18 years old. Driving in Denmark is on the right side of the road. Road signs use standard international symbols. Many urban streets have traffic lanes reserved for public transport only. Unless otherwise noted on traffic signs, the speed limit is 50 km/h in urban areas, 80 km/h on open roads, and 130 km/h on expressways.

Use of seat belts is mandatory for drivers and all passengers. Children under three years of age must be secured with approved safety equipment appropriate to the child's age, size, and weight. Children from three to six years of age may use approved child or booster seats instead of seat belts.

Driving under the influence of alcohol or drugs is considered a very serious offense. The rules are stringently enforced, and violations can result in stiff fines and possible jail sentences.

Copenhagen, the capital and largest city in Denmark, has an extensive and efficient public transportation system. Trains and buses connect Copenhagen with other major cities in Denmark and to Norway, Sweden, and Germany. Bicycles are also a common mode of transportation in Denmark. Passengers exiting public or tourist buses, as well as tourists driving rental cars, should watch for bicycles on their designated paths, which are usually located between the pedestrian sidewalks and the traffic lanes.

Danish expressways, highways, and secondary roads are of high quality and connect all areas of the country. It is possible to drive from the northern tip of Denmark to the German border in the south in just four hours. Greenland has no established road system, and domestic travel is performed by foot, boat, or by air. The majority of the Faroe Islands are connected by bridges or serviced by boat. Although the largest islands have roads, most domestic travel is done on foot, horseback, boat, or by air.

The emergency telephone number for police/fire/ambulance in Denmark and the Faroe Islands is 112. In Greenland contact the local police.

Please refer to our Road Safety page for more information. Visit the website of the country's national tourist office and national authority responsible for road safety at . See also additional information on driving in Denmark at .

AVIATION SAFETY OVERSIGHT: The U.S. Federal Aviation Administration (FAA) has assessed the government of Denmark's Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for the oversight of Denmark's air carrier operations. This rating applies to Greenland and the Faroe Islands as well. For more information, travelers may visit the FAA's Internet website at www.faa.gov/safety/programs_initiatives/oversight/iasa .

SPECIAL CIRCUMSTANCES: The official unit of currency in Denmark is the Danish krone. ATM machines are widely available throughout Denmark. Please see our information on customs regulations .

For information concerning the importation of pets into Denmark, please visit the following website:
.
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 protection 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 Denmark's laws, even unknowingly, may be expelled, arrested, or imprisoned. Penalties for possession, use, or trafficking in illegal drugs in Denmark are severe and convicted offenders can expect long jail sentences and heavy fines. Engaging in sexual conduct with children or using or disseminating child pornography in a foreign country is a crime, prosecutable in the United States. Please see our information on Criminal Penalties .

CHILDREN'S ISSUES: For information on international adoption of children and international parental child abduction, see the Office of Children's Issues website.

REGISTRATION/EMBASSY LOCATION: Americans living or traveling in Denmark are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department's travel registration website , and to obtain updated information on travel and security within Denmark. Americans without Internet access may register directly with the nearest U.S. Embassy or Consulate. By registering, American citizens make it easier for the Embassy or Consulate to contact them in case of emergency. The U.S. Embassy is located at Dag Hammarskjolds Alle 24; 2100 Copenhagen, telephone: (45) 33-41-71-00; Embassy fax: (45) 35-43-02-23; Consular Section fax: (45) 35-38-96-16; After-hours emergency telephone: (45) 35-55-92-70. Information is also available via the U.S. Embassy's website at http://www.usembassy.dk. The United States has no consular presence in Greenland or the Faroe Islands.
* * *
This replaces the Consular Information Sheet dated February 10, 2006, to update the section on Entry Requirements and Traffic Safety and Road Conditions.

Travel News Headlines WORLD NEWS

Date: Thu, 14 Nov 2019 12:51:34 +0100 (MET)

Copenhagen, Nov 14, 2019 (AFP) - Authorities in the Faroe Islands have announced the archipelago in the North Atlantic will be "closed for maintenance" for two days in April when tourists won't be welcome, instead opening the doors to volunteer caretakers.   In practice, the self-governing Danish islands will keep hotels open and international flights running, but popular tourist sites will be temporarily closed on April 16 and 17 next year.   The event is a continuation of a pilot project run in the spring of 2019, when 100 volunteers from 25 countries were invited to the islands.

Registrations for eager volunteers opened on Wednesday at 1500 GMT and were to remain open for 24 hours, the Faroese tourism office said on its website.   One hundred people will then be randomly selected to be part of the maintenance crew, who will be offered housing and food during their stay although they will still need to pay for their own plane tickets.   "The fragile natural environment in some popular tourist locations has felt the effects of an increase of visitors," the head of the tourism office, Guri Hojgaard, told AFP in March shortly after the pilot project was launched.   "These areas need a helping hand to ensure they remain pristine".

For the first edition of the event they received about 3,500 applications and the selected volunteers helped with projects like creating walking paths, constructing viewpoints to help preserve nature and protect birdlife sanctuaries and re-building rock cairns.   A popular destination for its fascinating landscapes with 30-metre cliffs, the archipelago covers 1,400 square kilometres (540 square miles) and has 50,000 inhabitants and 80,000 sheep spread over 18 islands.   In 2018, 110,000 tourists visited the Faroe Islands and the number of tourists has increased by about 10 percent annually for the past five years.    According to Hojgaard, the "closed for maintenance, open for voluntourism" weekend can "contribute to the international discussion about overtourism by showing that tourists can actually be a part of the solution."
Date: Fri, 25 Nov 2011 12:19:28 +0100 (MET)

COPENHAGEN, Nov 25, 2011 (AFP) - A hurricane packing winds of almost 200 kilometres (125 miles) an hour tore through the Faroe Islands overnight, causing major damage and evacuations but no deaths, police said Friday.  "There was a hurricane... a lot of material damage has been reported but no deaths so far," said Rani Wardum, a police officer in Torshavn, the capital of the North Atlantic archipelago. "Winds reach up to 55 metres per second," or 198 kilometres per hour, in some places, meteorologist Mogens Roenebek of the Danish Meteorological Institute told AFP.

The Faroe Islands, an autonomous Danish province, are home to around 48,000 people. The extent of the damage was not immediately known. "Many roofs were blown off and we had to evacuate a retirement home. The seniors were moved into a hospital," Wardum said.

Some residents were also evacuated from their homes during the night and a number of boats came loose from their moorings and ended up on land, he added. "The winds are still raging, but it was particularly violent last night and overnight," Wardum said, noting that the southern coastal regions of the Faroes Islands were hardest hit. The storm was heading towards the west coast of Norway on Friday, with strong winds and heavy seas, according to Roenebek.
Date: Thu, 6 May 2010 16:55:58 +0200 (METDST)

REYKJAVIK, May 6, 2010 (AFP) - The quantity of ash spewed by Iceland's Eyjafjoell volcano increased overnight and the higher ash cloud could make it to the Faroe Islands Friday, Icelandic authorities said Thursday.   "Ash production did increase last night and the ash plume is going higher now than the last couple of days," Agust Gunnar Gylfason, who monitors the eruption's progress at Iceland's Civil Protection Department, told AFP.

The ash cloud "might reach the Faroe Islands around midnight (GMT Thursday) under 20,000 feet (6,000 meters)" and continue on south towards Ireland on Friday, he added.   "The plume went up to 30,000 feet (9,000 meters) for some time last night, and again this morning, due to an increase in explosive activity, but otherwise it's been around 18,000 and 20,000 feet" high, he said.

At the strongest period of the eruption, Eyjafjoell sent a plume around 30,000 feet into the air, but scientists have stressed that the height of the plume does not necessarily reflect a particular quantity of ash.   On Tuesday, the plume contained about only 10 percent of the ash it held at the beginning of the eruption.   European airspace and airports across the continent were open on Thursday, but intergovernmental air traffic controller Eurocontrol said the ash cloud could mean transatlantic flights might need to be re-routed.

Airspace above Ireland, Northern Ireland and Scotland was partly shut Wednesday for the second time in two days, causing the cancellation of hundreds of flights.   The fresh disruption came after Europe's skies were closed for up to a week last month by the eruption of the Eyjafjoell volcano. It was the biggest aerial shutdown in Europe since World War II, with more than 100,000 flights cancelled and eight million passengers affected.
More ...

Botswana

Botswana - US Consular Information Sheet
August 29, 2008
COUNTRY DESCRIPTION:
Botswana is a country in southern Africa with a stable democratic government and a growing economy. Facilities for tourism are widely available. Read the Departm
nt of State Background Notes on Botswana for additional information.

ENTRY/EXIT REQUIREMENTS: A passport with at least six months of validity remaining is required. U.S. citizens are permitted stays up to 90 days without a visa. For additional information on entry requirements, travelers may contact the Embassy of the Republic of Botswana, 1531-1533 New Hampshire Avenue NW, Washington, DC 20036, telephone (202) 244-4990/1, fax (202) 244-4164 or the Permanent Mission of the Republic of Botswana to the United Nations, 103 E. 37th St., New York, NY, 10016, telephone (212) 889-2277, fax (212) 725-5061. There are also honorary consuls in Los Angeles, San Francisco and Houston. Visit the Embassy of Botswana’s web site at http://www.botswanaembassy.org/ for the most current visa information. As a general precaution, all travelers are advised to carry a photocopy of the photo/bio information page of their passport and keep it in a location separate from the passport.

Visitors to Botswana who also intend to visit South Africa should be advised that the passports of all travelers to South Africa must contain at least two blank (unstamped) visa pages each time entry to South Africa is sought; these pages are in addition to the endorsement/amendment pages at the back of the passport. Otherwise, the traveler, even when in possession of a valid South African visa, may be refused entry into South Africa, fined, and returned to their point of origin at the traveler’s expense.

Information about dual nationality or the prevention of international child abduction can be found on our web site. For further information about customs regulations, please read our Customs Information sheet.
SAFETY AND SECURITY:
Civil unrest and disorder are rare. U.S. citizens should avoid crowds, political rallies, and street demonstrations and maintain security awareness at all times.

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

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

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

CRIME: Crime is a serious concern in Botswana. Visitors must be vigilant and take common-sense security precautions. The criminal threat is very similar to that of any large urban area. Petty street crime and crimes of opportunity, primarily the theft of money and personal property, are not uncommon. Home invasions ‘smash and grabs’ from vehicles, and cell phone thefts, often at knife point, are routinely reported to the police. Visitors should use care when talking on a cell phone while walking. Urban areas are particularly dangerous at night; pedestrians are advised to avoid walking in Gaborone and other urban areas in Botswana at night. Except for visits to the Gaborone Yacht Club during daylight hours, U.S. Embassy personnel are prohibited from traveling to the area surrounding the Gaborone Dam and to the Kgale Hill area, a popular Gaborone hiking venue, because of multiple incidents of violent crime. American citizens are urged to avoid these areas.

Travelers arriving in Botswana via South Africa should be aware that there is a serious baggage pilferage problem at OR Tambo (Johannesburg) and Cape Town International Airports. Travelers are encouraged to use an airport plastic wrapping service and to avoid placing electronics, jewelry, cameras, designer athletic gear, or other valuables in checked luggage. Also, make an inventory of items in checked baggage to aid in claims processing if theft does occur.

INFORMATION FOR VICTIMS OF CRIME: The loss or theft abroad of a U.S. passport should be reported immediately to the local police and the nearest U.S. Embassy or Consulate. If you are the victim of a crime while overseas, in addition to reporting to local police, please contact the nearest U.S. Embassy or Consulate for assistance. The Embassy/Consulate staff can, for example, assist you to find appropriate medical care, contact family members or friends and explain how funds could be transferred. Although the investigation and prosecution of the crime is solely the responsibility of local authorities, consular officers can help you to understand the local criminal justice process and to find an attorney if needed.

Botswana has three numbers equivalent to the “911” emergency line. For police assistance, dial “999.” For an ambulance, dial “997.” In the event of a fire, dial “998.”

See our information on Victims of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION: Medical facilities in Gaborone are adequate for simple medical problems, but facilities outside of Gaborone are limited. Adequately equipped emergency rooms and trained physicians are available in the capital but services are rudimentary elsewhere. Professional private emergency rescue services operate air and ground ambulances throughout the country, but care is rendered only after a patient’s ability to pay is established. Response times are often slow in less populated areas. Outside of Gaborone, most airports are either not equipped or have frequently malfunctioning night lighting capability, so airborne medical evacuations can usually only be conducted during daylight hours. Malaria is prevalent only in the north of the country, particularly around the Chobe and Okavango National Parks. Malaria prophylaxis is not required in Gaborone but is suggested for travel to the north. For advanced care Americans often choose to travel to South Africa. Many South African manufactured prescription drugs are available in Gaborone.

Approximately one-quarter of the population of Botswana is infected with HIV, the virus that causes AIDS. Travelers are advised to exercise appropriate precautions if engaging in sexual activity, or if exposed to blood products through injuries or rendering assistance to accident victims. Tuberculosis is also endemic to Botswana. Two cases of extensively drug resistant tuberculosis (XDR-TB) have been identified in Botswana since January 2008 when Botswana first obtained the ability to test for this form of TB. Individuals who plan to reside or stay in Botswana for extended periods are advised to obtain a tuberculosis skin test (PPD test) prior to arrival and again upon departure from Botswana.

There are occasional diarrhea outbreaks in areas affected by heavy rains. Travelers are encouraged to take necessary precautions when handling food and drinking water.

The Department of Immigration of Botswana does not impose any HIV/AIDS entry restrictions for visitors to or foreign residents of Botswana.

Information on vaccinations and other health precautions, such as safe food and water precautions and insect bite protection, may be obtained from the Centers for Disease Control and Prevention’s hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747) or via the CDC’s web site at http://wwwn.cdc.gov/travel/default.aspx. For information about outbreaks of infectious diseases abroad consult the World Health Organization’s (WHO) web site at http://www.who.int/en. Further health information for travelers is available at http://www.who.int/ith/en.

MEDICAL INSURANCE: The Department of State strongly urges Americans to consult with their medical insurance company prior to traveling abroad to confirm whether their policy applies overseas and whether it will cover emergency expenses such as a medical evacuation. Please see our information on medical insurance overseas.

TRAFFIC SAFETY AND ROAD CONDITIONS: While in a foreign country, U.S. citizens may encounter road conditions that differ significantly from those in the United States. The information below concerning Botswana is provided for general reference only, and may not be totally accurate in a particular location or circumstance.

Driving in Botswana is challenging and motorists must drive defensively. Traffic circulates on the left in Botswana, as elsewhere in the region. While the roads in major population centers in Botswana are generally good, many roads have been damaged by heavy rains in December and January. Travel by automobile outside of large towns may be dangerous. The combination of long, tedious stretches of two-lane highways without shoulders, high speed limits, and poor lighting make driving at night on rural highways particularly hazardous. Recent rolling power outages mean that many traffic lights and street lamps do not work properly. Free-range domestic animals, even in urban centers, and large numbers of pedestrians and hitchhikers in the roadways make fatal accidents a frequent occurrence.

‘Smash and grab’ robberies from vehicles are not uncommon in Botswana, particularly in urban areas at traffic lights. Motorists should avoid carrying anything of value (hand bags, briefcases, purses, cell phones, etc.) in the passenger compartment that could attract potential assailants.

Please refer to our Road Safety page for more information. Visit the web site of Botswana’s national tourist office and national authority responsible for road safety at http://www.botswana-tourism.gov.bw.

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

SPECIAL CIRCUMSTANCES:
Since February 2008, rolling electric power outages have left many areas without power for several hours each week. This situation is likely to continue. Visitors are urged to carry flashlights. American citizens are also urged to be aware of how power outages might affect home security systems, garage doors and gates, and kitchen equipment, such as stoves and refrigerators. The power fluctuations could cause power surges that might harm computers, televisions, or other electrical appliances.

Botswana strictly enforces its laws controlling the trade in animal products. The hunting of lions is explicitly prohibited and leopards and elephants are covered under a strict quota regime. Botswana's Wildlife Conservation and National Parks Act makes it illegal to possess or remove from Botswana without a government permit any living or dead animal or animal trophy. A trophy is any horn, ivory, tooth, tusk, bone, claw, hoof, hide, skin, hair, feather, egg, or other durable portion of an animal, whether the item has been processed or not. Curio shops and vendors throughout the country sell items such as animal skins, plain and decorated ostrich eggs and eggshells, and carved bones or teeth of animals protected by this law. All of the souvenirs, although widely sold, are subject to this act. Travelers departing the country with a trophy must have a receipt from a store licensed to sell such items. Ivory and endangered rhinoceros horn products obtained in Botswana may not be removed from the country under any circumstances; elephant hair jewelry may be removed only with the appropriate license from the Department of Wildlife and National Parks. Trophies may not be taken from the wild without a permit. Violators are subject to arrest and may face a penalty of up to five years imprisonment and a substantial fine.

Wild animals may pose a danger to tourists. Tourists should bear in mind that, even in the most serene settings, the animals are wild and can pose a threat to life and safety. Tourists should use common sense when approaching wildlife, observe all local or park regulations, and heed all instructions given by tour guides. In addition, tourists are advised that potentially dangerous areas sometimes lack fences and warning signs. Exercise appropriate caution in all unfamiliar surroundings. 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 Botswana’s laws, even unknowingly, may be expelled, arrested or imprisoned. Penalties for possession, use, or trafficking in illegal drugs in Botswana are severe, and convicted offenders can expect long jail sentences and heavy fines. Engaging in sexual conduct with children or using or disseminating child pornography in a foreign country is a crime, prosecutable in the United States. Please see our information on Criminal Penalties.

CHILDREN'S ISSUES: For information see our Office of Children’s Issues web pages on intercountry adoption and international parental child abduction.

REGISTRATION / EMBASSY LOCATION:
Americans living or traveling in Botswana are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department’s travel registration web site so that they can obtain updated information on travel and security within Botswana. Americans withoutInternet access may register directly with the nearest U.S. Embassy or Consulate. By registering, American citizens make it easier for the Embassy or Consulate to contact them in case of emergency. The U.S. Embassy is located in Gaborone on Embassy Drive in the Government Enclave. The mailing address is P.O. Box 90, Gaborone, telephone +267 395-3982; fax +267 318-0232; email consulargaborone@state.gov, and the after-hours emergency telephone is +267 395-7111.
* * *
This replaces the Country Specific Information for Botswana dated March 5, 2008, to update the sections on Information for Victims of Crime and Medical Facilities and Health Information.

Travel News Headlines WORLD NEWS

Date: Tue, 22 Oct 2019 18:42:15 +0200 (METDST)

Gaborone, Botswana, Oct 22, 2019 (AFP) - More than 100 elephants have died in two months in Botswana's Chobe National Park due to drought, which has also affected wildlife in other countries in the region, the government said Tuesday.   Several southern African countries are enduring one of the worst droughts in decades, caused by months of over-average temperatures and erratic rainfall.   The drought has wilted grasslands and dried up water holes, making it increasingly difficult for animals to survive.    Botswana's environment ministry said it has recorded a spike in the number of elephant and other animal deaths since May.    "More than one hundred elephants are estimated to have died naturally in the past two months," the ministry said in a statement, adding that 13 deaths were recorded just this week.

In neighbouring Zimbabwe, Its wildlife agency has recorded at least 55 elephant deaths over the past month due to lack of food and water.  Preliminary investigations in Botswana have also suggested some of the elephants may have died from anthrax.   "Due to the severe drought, elephants end up ingesting soil while grazing and get exposed to the anthrax bacteria spore," the ministry said in a statement.   "The animals are also travelling long distances in search of food which leaves some highly emaciated, ending in death."   Anthrax is an infectious disease found naturally in soil. It is generally contracted by herbivores and is a common cause of death for both wild and domestic animals around the world.      The environment ministry said it would be burning "anthrax related carcasses" to prevent the disease from spreading to other animals.   It warned the public not to touch any animal carcasses they might find and report them to the authorities.
Date: Tue 22 Oct 2019 9:28 PM CAT
Source: Reuters [edited]

More than 100 elephants have died in Botswana in the past 2 months partly because of a suspected anthrax outbreak, the government said on [Tue 22 Oct 2019]. "Preliminary investigations suggest the elephants are dying from anthrax whilst some died from drought effects," a Department of Wildlife and National Parks statement said. "Due to the severe drought, elephants end up ingesting soil while grazing and get exposed to the anthrax bacteria spore," it said.

Elephants Without Borders said an aerial survey showed fresh elephant carcasses increased by 593% between 2014 to 2018, mostly from poaching and illegal hunting, with drought also a contributing factor. The wildlife authority said the latest deaths were in the Chobe River front and Nantanga areas in northern Botswana, where 14 dead elephants were found this week. It said it would be burning the carcasses to prevent the anthrax infection from spreading to other animals.

According to the Centers for Disease Control and Prevention in the United States, anthrax is a bacterium found naturally in soil and commonly affects domestic and wild animals when they breathe in or ingest spores in contaminated soil, plants, or water. Anthrax is not contagious and humans can only get infected by ingesting the bacteria. It can be prevented in animals via regular vaccination.

Botswana is home to almost 1/3 of Africa's elephants, around 130,000.  Botswana has lifted a ban on big-game hunting to combat a growing conflict between humans and wildlife. Botswana and its neighbors in southern Africa are experiencing a severe drought because of below-average rainfall since an El Nino weather system struck in 2015.  [Byline: Brian Benza, writing: Mfuneko Toyana; editing: Grant McCool)
====================
[Check CBC
which has a nice picture of 2 Okavango Delta bull elephants.

Elephants can graze, although they are usually browsers of branches and vegetation off trees. They are attracted to water. So the source is presently uncertain but might have been a secondary spread from a prior wildlife case that resulted in contaminated browse from blow flies or water from a contaminating carcass. Until a cheap and effective wildlife oral vaccine can be developed, these cases in Chobe will be a constant sporadic event. As elsewhere, the best control is to burn any carcasses and disinfect any contaminated soil. -

Chobe is on the northern border of Botswana abutting the Caprivi Strip of Namibia; see

[HealthMap/ProMED-mail map of Botswana:
Date: Fri, 30 Aug 2019 11:13:54 +0200 (METDST)

Maun, Botswana, Aug 30, 2019 (AFP) - A calf struggles neck-high in the stew-like mud, kicking frantically to make its way across the mire.   Around 38,000 livestock depend on the waters of Lake Ngami in northern Botswana, but the animals -- like the lake itself -- have been stricken by a crippling drought.   Grazers have to walk long distances in hopes of finding anything to eat. Some succumb to the heat and vultures can be seen feasting on their corpses in the sludge of the lake bed.

In May, President Mokgweetsi Masisi officially declared Botswana to be in drought after months of unevenly distributed rains, heat waves and dry spells.   Rural households have been especially hit, and are looking to the government for help.   Southern Africa has been hard hit by intensifying extreme weather conditions such as drought and floods, leaving millions in need of food aid.

Zambia is in the throes of a drought which has affected the 2018/19 farming season. Around 2.5 million people are facing food shortages, according to official figures.

In Zimbabwe, nearly a third of the 16 million population are in need of aid and at least half of these face acute hunger, according to the World Food Programme (WFP).   Lake Ngami is also home to around 100 hippos, half of whom have cannily migrated to parts where life is easier.   "Only the livestock is trapped in the muddy waters," the acting director of wildlife and national parks,  Moeti Batshabang, told AFP.
Date: Wed 15 Nov 2017 20:00 pm (GMT +2)
Source: MMEGI online [edited]

Dozens of Nthompe Koma Primary School pupils on Monday night [13 Nov 2017] thronged Mahalapye health facilities following a food poisoning incident allegedly caused by rape they ate at school.

Classes came to a halt yesterday [14 Nov 2017] as more students showed signs of food poisoning while health workers were present at the school and hospital to establish what could have caused the incident that led to at least 26 pupils being admitted at Mahalapye Hospital. According to a source, it is suspected that the students were fed rape, which was recently sprayed with pesticides.

"The students started vomiting and having diarrhoea at their homes after school. A huge number of them were rushed to the hospital and it was said that the newly treated vegetable was given to them," the source said.

Mahalapye Hospital Superintendent, Dr Kumal Bose said they are yet to establish the cause of diarrhoea and vomiting, whether it is the food they ate or not. "We attended to a total of 82 students of whom 26 were admitted and others discharged. More students were coming in this morning [15 Nov 2017].

We have sent our public health team to the school to investigate all possible causes," he said. Mahalapye chief education officer,

Maria Dikeme [Principal Education Officer] confirmed the incident. "It is true that a lot of students from the school were taken to various health facilities yesterday [14 Nov 2017].

The students were fed sorghum and rape at break time and the sorghum has been taken for tests by the public health team. All of the rape was cooked yesterday. We will, however, go to the source if there is still any left so that it can be tested," she said.

Dikeme said more students were taken to the hospital the following day as some developed signs late.

"We do not have a certain number currently, but we have recorded over 100 cases with 11 pupils still admitted at the hospital," she said.

She said they kept the pupils within the school so they could monitor them rather than sending them home while parents are at work.

Dikeme said there were some pupils who were in school yesterday [14 Nov 2017] who were not affected and that there was no report of any adult person having been diagnosed with the same problem.  [Byline: Innocent Selatlhwa]
===================
[Rape seed and soybeans are both grains. This article says a possible pesticide. The class of chemicals causing these clinical signs would be organophosphates. Grains are often treated with chemicals to prevent insect infestation and ruination of the crop. Therefore it is possible an organophosphate was used on the grain, and not washed or cleaned before being put into human consumption, could produce vomiting and diarrhoea. These could be signs associated with organophosphates. There are likely other crop chemicals capable of producing this, but the organophosphate class is large with numerous chemicals.

The article does not tell us if the pupils are being treated or if they are, what they are being treated with.

Consequently, the results of the testing is very important. Hopefully the testing will reveal the cause of this situation. - ProMED Mod.TG]

[A HealthMap/ProMED-mail map can be accessed at:
Date: Tue 10 Oct 2017 15:55 pm (GMT + 2)
Source: MmegiOnline [edited]

The Department of Wildlife and National Parks (DWNP) has noted a high number of dead hippopotamuses along the Okavango River near Mohembo.

A statement from the from DWNP says the carcases are floating in the river from Namibia into Botswana. "The cause of death is not known at the moment. The veterinarians are working hard to establish it," says the statement.

The public is therefore warned not to touch any carcass found along the river or anywhere else. "Eating meat of these animals will be very dangerous as Anthrax is suspected to be causing the mortalities. Any sightings are to be reported to the nearest DWNP office, police station or kgotla".
=====================
[Mohembo is on the Botswana/Namibian border, and the Okavango river comes straight from the Bwabwata NP; see:

According to Wikipedia: "Before it enters Botswana, the river drops 4 metres in a series of rapids known as Popa Falls, visible when the river is low, as during the dry season." [<https://en.wikipedia.org/wiki/Okavango_River>] So these carcasses may be poor condition. But either way, the warning to the locals not to butcher them is very wise. - ProMED Mod.MHJ]

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

General Information
************************************
Tunisia is situated in Northern Africa and is a common tourist destination for Irish travellers. It is bordered by Algeria to the west and southwest, Libya to the south east and the Medite
ranean Sea to the east and north. It has a Mediterranean climate with mild rainy winters and hot dry summers. Costal temperatures are less extreme than the inland regions ranging from an average daily low in January of 70C to an average daily high in August of 320C. Rainfall throughout the country varies considerably from about 40" in the northwest down to only 4" in the southwest.
Safety & Security
************************************
Most tourists will not have any significant difficulties in this regard but criminals have targeted tourists and business travellers for thefts, pickpocketing, and scams.
Care should be taken with wallets and other valuables kept in handbags or backpacks that can be easily opened from behind in crowded streets or marketplaces.
Harassment of unaccompanied females occurs rarely in hotels, but more frequently elsewhere.
Health Facilities
************************************
The level of health care facilities in Tunisia will usually be found to be below that normally accepted at home in Ireland. In general the larger hotels will have English speaking doctors in attendance. Unfortunately the hospital/clinic backup for these practitioners is usually very limited.
Food & Water Facilities
************************************
The World Health Organisation statistics suggest that close to 35% of all travellers to these regions will develop significant diarrhoea during their stay. In almost all cases this can be traced back to unwise eating and drinking habits by tourists not taking sufficient care. Most significantly, travellers should stay away from cold foods (especially lettuce) and also all undercooked shell fish (mainly prawns, oysters, mussels and shrimps).
Hotel tap water will frequently not be potable and should not be used for drinking or brushing teeth. Sealed mineral water should be used at all times.
Fruit juice drinks sold by street traders should always be avoided as frequently the drink will have been supplemented with straight tap water.
Malaria in Tunisia
************************************
It is fortunate that this disease is not endemic in Tunisia and so travellers do not require to take prophylactic tablets. Nevertheless there are plenty of mosquitoes and sandflys during the hotter summer months and travellers will need to use insect repellents to protect against these uncomfortable bites. (see Protection against Insect Bites - Tropical Medical Bureau )
Jiggers & Chiggers
************************************
These are uncomfortable parasitic diseases which usually occur on the feet and often present looking like an ingrown toenail. Travellers returning home with unexplained skin rashes should always attend for medical assessment.
Rabies
************************************
This viral disease occurs throughout Africa and is evident in Tunisia. The disease can be transmitted by the bite (or lick or scratch) of any infected warm-blooded animal. Dogs will be the main risk animal but cats and monkeys can also transmit the disease. Any contact must be treated seriously and washed out immediately. An antiseptic should then be applied and further medical attention must always be sought.
Leishmaniasis
************************************
This is a parasitic disease transmitted by the bite of an infected sandfly. The disease occurs in Tunisia mainly during the summer and autumn months. Sandflys are much smaller than mosquitoes and are mainly found hovering around your ankles usually first thing in the morning or during the cooler evening hours. In most cases the bites cause little harm but occasionally deep infection can occur with more serious consequences. Again, travellers should wear sensible clothing and use adequate insect repellent. A bite which is slow to heal needs to be medically checked.
Sunbathing
************************************
One of the common health complaints associated with Tunisia relates to travellers becoming sun burnt while there on holidays. This is particularly the case with smaller children and toddlers. It is essential that travellers use high factor protection creams to lessen the risk of burning and to remember that skin cancer is commonly associated with burnt skin.
Anthrax from Leather Goods
************************************
This bacterial disease has been reported in Tunisia and travellers need to be aware that the disease can be transmitted through unprepared leather goods usually bought in the local market places. Even though this will be rare, any unusual sore should be medically checked after you return home.
Vaccinations for Tunisia
************************************
There are no essential vaccinations for Tunisia but travellers from Ireland are strongly recommended to have vaccination cover against
*
Poliomyelitis (childhood booster)
*
Typhoid (food & water borne disease)
*
Tetanus (childhood booster)
*
Hepatitis A (food & water borne disease)
Those spending longer periods in the country, or trekking, may need to consider vaccination cover
against
Rabies
and
Hepatitis B.
Summary
************************************
Be careful of the intense sun during the summer months. Care with food and water consumption will also be essential at all times.
Further Information
************************************
If you require any further information on staying healthy while overseas please contact either of the help lines at the numbers below.

Travel News Headlines WORLD NEWS

Date: Sun, 1 Dec 2019 17:56:57 +0100 (MET)

Ain Snoussi, Tunisia, Dec 1, 2019 (AFP) - At least 24 Tunisians were killed and 18 more injured Sunday when a bus plunged off a cliff into a ravine in the country's north, officials said.   The bus had set off from Tunis to the picturesque mountain town of Ain Draham, a popular autumn destination for Tunisians near the Algerian border, the tourism ministry said.   Twenty-four people were killed and 18 injured, the victims aged between 20 and 30, said the health ministry, releasing updated information on the tragedy.   Pictures and video footage shared online and posted on the websites of private radio stations showed the mangled remains of the bus with its seats scattered in the bed of a river.

Bodies, some in sports clothes and trainers, and personal belongings were strewn across the ground.   The bus with 43 people on board was travelling through the Ain Snoussi region when it plunged over the cliff, the interior ministry said.   The vehicle had "fallen into a ravine after crashing through an iron barrier," it said on its Facebook page.   The injured were transferred to nearby hospitals, the interior ministry said.   Forensic experts were deployed to investigate the crash, said AFP correspondents at the scene.   It was not immediately clear what caused the accident but Tunisian roads are known to be notoriously dangerous and run-down.

Tourism Minister Rene Trabelsi told a private radio station Mosaique FM that the "unfortunate accident took place in a difficult area" and just after the bus had taken a "sharp bend".  An civil defence official, speaking on state television, said there had previously been deadly accidents at the same spot.   Social network users bemoaned the tragedy, as Tunisian President Kaid Saied and Prime Minister Youssef Chahed arrived at the site of the accident.   "What a heavy toll," one of them said.   Another denounced the "roads of death" in Tunisia and wrote: "24 dead and no one from the government has declared a national catastrophe".

The World Health Organization in 2015 said Tunisia had the second worst traffic death rate per capita in North Africa, behind only war-torn Libya.   Experts blamed run-down roads, reckless driving and poor vehicle maintenance for a rise in accidents the following year.   The authorities recognise the scale of the problem but have said the country's security challenges, including jihadist attacks, have kept them from giving it more attention.
Date: Wed, 27 Nov 2019 20:35:51 +0100 (MET)
By Akim Rezgui

iles Kuriat, Tunisie, Nov 27, 2019 (AFP) - Between plastic chairs on a crowded Tunisian tourist beach, a sign indicates where another species shares the sand: a nest is buried below.   On this paradisaical island off the coast of Monastir -- a resort town south of the capital Tunis -- tourists co-exist with loggerhead turtles thanks to a novel initiative.   Since 2017, the Tunisian government and a local NGO have jointly run a turtle conservation programme under the noses of bathing-suited beach-goers, who are offered an environmental education along with their holiday.

The Kuriat islands are the westernmost permanent loggerhead turtle breeding site on the Mediterranean's south coast, and are in the process of being listed as a protected nature reserve.   But while the islands are an important turtle sanctuary, the white sand beaches and crystal waters of little Kuriat are irresistible to holidaymakers.   During turtle hatching season from July to October, day-trippers arrive daily in their hundreds, transported on pirate-themed boats for barbecues and swimming.   "I thought that this was just an island where I'd go to swim, eat and return," said holidaymaker Souad Khachnaoui.   "I'd never imagined that this site was so important for turtles, birds and other species."

Rather than ban visitors, the authorities work with local volunteers to brief arriving tourists on the local fauna, including the jellyfish-eating turtles, which can live for a century.   "Many people are stunned on arrival, they didn't think that we had these kinds of animals in our country," said Manel Ben Ismail, co-founder of the environmental NGO Notre Grand Bleu, which means "Our great blue (ocean)".   And if they are lucky, tourists can watch as volunteers help defenceless hatchling turtles -- measuring just five centimetres (two inches) across -- on their journey from the nest to the sea.   Loggerheads are classified as vulnerable by the International Union for the Conservation of Nature. They do not become fertile until about 20 years old and breed only every two to three years.    Female loggerheads return to the same beach where they were born to lay their clutch of about 100 eggs. But it is a perilous life cycle and only one in a thousand juveniles lives to reproductive age.

The Kuriat islands -- the largest of which is a military zone and the smaller is not permanently settled -- offer young turtles slightly better survival odds.   Both are far from the light pollution of the mainland, which can disorientate hatchlings.    This year 42 nests were recorded on the islands. Layings have increased since monitoring started in 1997.   If managed correctly, tourism can be a boon for the islands as visitors learn about conservation, the government believes.   "We try to strike a balance between ecological activities and the economic activities of people on this site," said Ahmed Ben Hamida, head of the Kuriat Marine Protected Area for the government agency for coastal protection.
Date: Thu, 27 Jun 2019 14:23:48 +0200

Tunis, June 27, 2019 (AFP) - Two suicide bombers attacked security forces in the Tunisian capital on Thursday, killing a police officer and wounding at least eight people including several civilians, the interior ministry said.   One attack on the main street of Tunis wounded three civilians and two police personnel, the interior ministry initially said.   "Five (are) wounded -- three civilians and two police officers", Interior Ministry spokesman Sofiene Zaag told AFP, before later saying that a police officer had died of his wounds.

Body parts were strewn in the road around a police car on Habib Bourguiba avenue near the old city, according to an AFP correspondent.   "It was a suicide attack, which took place at 10:50 (0950 GMT)," Zaag said.   The second attack targeted a base of the national guard in the capital and wounded four security personnel, the ministry said.   "At 11:00 am (1000 GMT) an individual blew himself up outside the back door" of the base, wounding four security personnel, Zaag said.   Civil protection units and police rapidly deployed to Habib Bourguiba avenue, where the interior ministry is located.    People initially fled in panic, before some crowded around the scene of the attack, expressing anger against the authorities. Shops and offices were closed by police.

Tunisia, the cradle of the Arab Spring uprisings, has been hit by repeated Islamist attacks since the 2011 overthrow of longtime dictator Zine El Abidine Ben Ali.   On October 29, 2018 an unemployed graduate blew herself up near police cars on Habib Bourguiba, killing herself and wounding 26 people, mostly police officers, according to the interior ministry.   The Tunisian authorities said the suicide bomber had sworn allegiance to IS.

The attack was the first to rock the Tunisian capital for over three and a half years.   In March 2015, jihadist gunmen killed 21 tourists and a policeman at the National Bardo Museum in Tunis.   And in June that year, 30 Britons were among 38 foreign holidaymakers killed in a gun and grenade attack on a beach resort near the Tunisian city of Sousse.
Date: Thu, 9 May 2019 17:43:55 +0200
By Caroline Nelly Perrot

Tunis, May 9, 2019 (AFP) - As holidaymakers flock to Tunisia once more following a series of attacks, the country's tourism minister has his sights set on diversifying the industry and taking visitors beyond the beach.   "Practically all the big tour operators here have returned," said Rene Trabelsi, six months into his ministerial post.   He credits "huge efforts" for making the country safe for visitors again, after attacks in 2015 targeting tourists.   Gunmen killed 21 foreign visitors and a Tunisian security guard at the capital's Bardo National Museum, followed by a shooting rampage at a Sousse beach resort which left 38 people dead -- mostly British tourists.

Britain, France and other countries have recently eased their travel warnings, deeming most of Tunisia now safe.   Two million holidaymakers have visited Tunisia so far this year, according to government figures touted by the tourism minister.   That marks a 24 percent jump on the same period last year, and a 7 percent increase compared to the 2010 industry reference point.   But despite tourists returning, revenue has so far failed to reach that of nearly a decade ago.

The indebted industry is heavily reliant upon cheap "all-inclusive" holidays and the government is trying to diversify the tourism sector, which accounts for around 7 percent of GDP.   "During the high season, Tunisia will be packed, but we're interested in the low season, from September to March," said Trabelsi, sitting behind his large desk in the capital Tunis.   The minister wants to attract tourists over the winter months who are also interested in activities away from the beach.   "We're negotiating with the tour operators" to offer charter flights after the summer, said Trabelsi who hopes visitors will sign up for golf, spa treatments and cultural activities.   "This year already, a lot of hotels which closed during winter after the crisis, want to stay open," he said.   An electronic music festival in southern Tunisia is due to take place in September, while a jazz festival is planned in Tabarka near the Algerian border.

- No 'right to fail' -
Whereas half the holidaymakers in 2010 were European, they now make up less than a third of visitors amid an increasing number of tourists from other North African countries and further afield.   The government aims to welcome nine million visitors this year, but Trabelsi said Tunisians still need to tackle "environmental terrorism" to avoid scaring tourists away.   "I'm using that word to shock and alert," said the minister, warning that poor environmental standards can put tourists off "like when there's an attack".

Following Tunisia's 2011 revolution, authorities failed to keep atop of waste management. Municipal councils were elected for the first time a year ago but the clean-up is far from complete.   "We also have a cultural problem," said Trabelsi. "If each person swept outside their front door, that would already be huge."   Trabelsi has for years been co-organiser of an annual Jewish pilgrimage to Djerba, where his father is president of the island's synagogue, and in the 1990s he set up his own travel agency.   But months into his first political post, he said he has no intention of staying in government long-term.   "I want to make a mark, and Tunisians expect a lot from me. I come from the private sector, I have a different religion, so I don't have the right to fail," Trabelsi said.   "But once my mission is accomplished, I'll return to my own affairs."
Date: Sun 16 Feb 2019
Source: Realites Online [in French, trans. ProMED Corr.SB, edited]
<https://www.realites.com.tn/2019/02/tunisie-1318-cas-de-leishmaniose-enregistres-a-gafsa>

As of Sat 15 Feb 209, the Metlaoui Regional Hospital in Gafsa governorate has hosted 1318 patients with leishmaniasis, following the proliferation of mosquitoes [actually leishmania is transmitted by sandflies] near the lakes and wastewater. According to Shems Fm, citing its correspondent in the region, the number of leishmaniasis cases has tripled compared to the year 2017.
============================
[We presume these cases are cutaneous leishmaniasis. Cutaneous leishmaniasis, CL, caused by _Leishmania major_ is a major public health problem in Tunisia. It occurs mainly in central and southwestern Tunisia (semi-arid and arid areas), with thousands of cases. There are foci with a permanent active transmission, so, from time to time, outbreaks occur, related to new agricultural projects or large population movements (introduction to a non-immune population).  In some villages, up to 60 percent of the population is infected.

For a detailed discussion of _Leishmania_ in Tunisia please see Alvar J, Valez ID, Bern C, et al. Leishmaniasis worldwide and global estimates of its incidence.
PLoS One. 2012; 7(5): e35671; <https://doi.org/10.1371/journal.pone.0035671> - ProMED Mod.EP]

[HealthMap/ProMED-mail map of Gafsa, Tunisia:
<http://healthmap.org/promed/p/8782>]
More ...

World Travel News Headlines

Date: Fri, 13 Dec 2019 16:41:23 +0100 (MET)
By Mariëtte Le Roux and Joseph Schmid

Paris, Dec 13, 2019 (AFP) - French commuters gritted their teeth for a ninth day of public transport strikes Friday, with unions vowing to keep up their protest against a pension overhaul through the holidays unless the government backs down.   Officials have said they are ready to negotiate, with Education Minister Jean-Michel Blanquer meeting teachers' representatives on Friday to try and stave off another day of class shutdowns.   "It was an intense and frank meeting... but we still need details, and maintain our call to strike on Tuesday," Stephane Crochet of the SE-Unsa union said.

Unions are hoping for a repeat of 1995, when they forced a rightwing government to back down on pension reforms after three weeks of metro and rail strikes just before Christmas.   The prospect of a protracted standoff has businesses fearing big losses during the crucial year-end festivities, and travellers worried that their Christmas plans may be compromised.   "Right now it's a catastrophe here, but we're hoping there will be a solution before Christmas," Frederic Masse, a foie gras producer at the huge Rungis wholesale food market south of Paris, told AFP on Friday.

The capital city was again choked by huge traffic jams as most metro lines remained shut, only a handful of buses and trams were running, and one in four TGV trains were cancelled.   "I'm sick of this, and I won't be able to keep working if it goes on," Zigo Makango, a 57-year-old security agent, told AFP onboard a bus in the Bobigny suburb northeast of Paris.   To get home at night Makango said he has to use taxis, but "my boss doesn't reimburse me for that".

- 'Historic reform' -
President Emmanuel Macron on Friday expressed his "solidarity" with people impacted by the strike, "but I want the government to continue its work" in forging a single pension system, a key campaign promise.   "It's a historic reform for the country," he told journalists at an EU summit in Brussels. 

The overhaul unveiled by Prime Minister Edouard Philippe would do away with 42 separate regimes, some of which offer early retirement and other benefits to public-sector employees such as train drivers, dockers and even Paris Opera employees.   But Philippe angered unions further by proposing a reduced payout for people who retire at the legal age of 62 instead of a new, so-called "pivot age" of 64.

They have called for new mass demonstrations for next Tuesday, the third since the action started on December 5 in the biggest show of strength in years by France's notoriously militant unions.   Philippe insisted on Twitter that "My door is open and my hand outstretched".   But Laurent Brun of the hard-line CGT union, the largest among public-sector workers including those at rail operator SNCF, has already warned "There won't be any Christmas truce" unless the government drops the plan entirely.

- France divided -
A poll released Thursday by the Elabe institute found France evenly divided on Philippe's plan, with 50 percent for and 49 percent against.  But 54 percent rejected the mooted 64-year cutoff for a full pension, and 54 percent supported the protest.

Staff at four of France's eight oil refineries were on strike Friday, affecting output and raising fears of shortages down the line.   And both Paris operas, the Garnier and the Bastille, again cancelled Friday performances and others through the weekend.   Macron's government insists the changes will make for a fairer system and help erase pension system deficits forecast to reach as much as 17 billion euros ($19 billion) by 2025.   The average French person retires at just over 60, years earlier than most in Europe or other rich OECD countries.
Date: Fri, 13 Dec 2019 14:05:22 +0100 (MET)

Milan, Dec 13, 2019 (AFP) - More than 300 flights were cancelled Friday in Italy due to a planned one-day strike by workers from Alitalia and Air Italy.   Alitalia said in a statement that 315 flights were cancelled on Friday, with another 40 cancelled Thursday night and Saturday morning. It was not immediately clear how many flights were cancelled at Air Italy.   The 24-hours strike, which involves pilots, flight attendants and ground personnel, was called by three unions to draw attention to what they called "the ongoing crisis at Alitalia and Air Italy."

The strike was felt most in Sardinia, with about 30 flights cancelled.    Money-losing Alitalia has been under special administration since 2017 when employees rejected a restructuring plan that would have laid off 1,700 workers out of an approximately 11,000.   The government has so far looked for buyers without success.    Unions plan to meet on Tuesday with Economy Minister Stefano Patuanelli.    A potential consortium of buyers for the ailing carrier fell apart last month after Atlantia, which operates Rome's airports, pulled out.
Date: Fri, 13 Dec 2019 05:24:44 +0100 (MET)
By Neil SANDS

Wellington, Dec 13, 2019 (AFP) - Adventure tourism is a key part of New Zealand's international appeal but the White Island volcano eruption is a tragic reminder that such activities carry genuine risk that must be better explained to travellers, experts say.   The South Pacific nation offers a wealth of adrenaline-fuelled pursuits, from heli-skiiing on snow-capped mountains to ballooning and blackwater rafting through caves.

Some, such as bungee-jumping, jet-boating and zorbing -- where you hurl yourself down a hill inside an inflatable ball -- were invented or popularised in a country that prides itself on catering to intrepid visitors.   The tourism industry as a whole is among New Zealand's biggest earners, generating about NZ$16.2 billion ($10.7 billion) and attracting 3.8 million international visitors annually.     "Adventure tourism is a massive sector in New Zealand. We are promoting ourselves as the adventure capital of the world," professor Michael Lueck, a tourism expert at Auckland University of Technology, told AFP.

New Zealand is also renowned for its rugged landscapes, which feature prominently films such as Kiwi director Peter Jackson's "Lord of the Rings".   Day-trips to White Island combined both, taking tourists including cruise ship passengers to a desolately beautiful island off the North Island coast where they could experience the thrill of standing on an active volcano.   Instead, at least 16 people are believed to have died and dozens suffered horrific burns when 47 tourists and guides were caught on the island during Monday's eruption.

The disaster has raised questions about why tourists were allowed on a volcano where experts had recently raised threat levels, as well as broader issues about the regulation of risky activities in the tourism sector.   "There will be bigger questions in relation to this event," Prime Minister Jacinda Ardern told parliament after the eruption.   "These questions must be asked, and they must be answered."

- 'Slapdash' or world's best? -
The disaster on White Island -- also known as Whakaari -- is not the first mass-fatality accident to affect tourists in New Zealand.   In 2015, seven people were killed when a scenic helicopter flight crashed into Fox Glacier. Two years earlier, a hot-air balloon claimed 11 lives and in 2010 nine died when a plane carrying skydivers plunged into a paddock.

Briton Chris Coker's son Brad, 24, died in the skydive plane crash and since then he has campaigned from afar for tighter regulations in New Zealand's adventure tourism sector.   "In my opinion, the New Zealand authorities... are still slapdash about tourist safety," Coker told news website stuff.co.nz after the White Island eruption.   "To run tourists there is insane. I know they signed a waiver and so on, but it's not really taking care of people."

Trade body Tourism Industry Aotearoa disputes such assessments, saying operators are "working within a world's best regulatory framework", but could not eliminate risk completely.   "Operators put safety first, but adventure activity inherently carries some risk and it's critical that 'adventure' remains in adventure tourism," TIA chief executive Chris Roberts told AFP.   "Operators take all practical actions to minimise the risks and the safety culture of individual operators remains the key factor in preventing accidents."

Roberts said the issue was not tourism operators, but the alert system they relied on at volcanic destinations such as White Island, which attracts about 17,000 visitors a year.   The GeoNet monitoring agency raised White Island's threat level in the week before the eruption but also advised current activity "does not pose a direct hazard to visitors".   "The reviews need to look at the science and specifically the guidance provided about volcanic activity, and whether the operating practices followed for the past 30 years need to change," Roberts said.

- 'Understand the risks' -
Travel companies such as White Island Tours brief customers before setting off and require them to sign a waiver declaring they understand the risk, as well as supplying equipment such as hard-hats and gas masks.   However, some relatives of those affected by the eruption have expressed scepticism that their loved ones truly appreciated the potential danger they faced.   Options for legal redress are limited under New Zealand's Accident Compensation Commission scheme, which covers victims' medical bills and provides modest compensation but does not allow civil suits for damages.

Neither Roberts nor Lueck expected the White Island eruption to hit international arrivals in New Zealand, which have continued to climb despite major earthquakes in 2011 and 2016.   The nature of any review arising from White Island remains uncertain, but Lueck said at the very least tourists needed to be better informed about any risks.   "Operators and tourism boards should have tourists understand what these risks are, and not brush over quickly signing a waiver," he said.   "Only then can tourists make an informed decision and decide whether or not they want to take that particular risk."
Date: Thu, 12 Dec 2019 21:25:36 +0100 (MET)

Kinshasa, Dec 12, 2019 (AFP) - Twenty-three cases of Ebola have been recorded in four days in eastern Democratic Republic of Congo, where deadly violence is hampering efforts to end the 16-month-old epidemic, authorities said on Thursday.   Ten cases were recorded on Tuesday alone in Mabalako in North Kivu province, after six on Monday, according to the Multisectoral Committee for Epidemic Response (CMRE).   Three out of the six were practitioners of traditional medicine, it said.

On Wednesday, three cases were recorded in North Kivu, including one in the Biena neighbourhood -- which has had no new Ebola cases for the last 85 days.   More than 2,200 people have died since the epidemic was declared on August 1, 2018.   As of November 22, the rate of new cases had fallen to 10 per week.   CMRE said "security reasons" -- attacks on Ebola health workers and sites by armed groups and angry youths -- had "paralysed" work in the key zones of Beni, Biakato and Mangina.   The attacks led to a pullout of locally-employed Ebola workers in Biakato by the UN's World Health Organization (WHO) and Doctors Without Borders (MSF).
Date: Thu, 12 Dec 2019 15:59:23 +0100 (MET)

Juba, Dec 12, 2019 (AFP) - Devastating flooding in South Sudan following a fierce drought could tip parts of the country into famine in the next few months, the World Food Programme (WFP) warned on Thursday.   According to the UN refugee agency nearly one million people were affected by floodwaters that submerged entire towns, compounding an already dire humanitarian situation after six years of war.

The WFP said that 5.5 million people are expected to be going hungry in early 2020 -- the time at which the population is generally benefiting from their harvest in October and November of the previous year.   An earlier harvest failed due to drought. This time crops have been washed away.    "The number of people in need is likely to increase because of the catastrophic level of destruction caused by floods since October following a drought that hammered parts of the country earlier in the year," the agency said in a statement.

The floods wiped out 73,000 metric tons of potential harvests as well as tens of thousands of cattle and goats, said the WFP.   "We know the problems that we've been having in South Sudan, but the rains and the floods have led to a national disaster and are much worse than anyone could have anticipated," said WFP Executive Director David Beasley.    "In fact, if we don't get funding in the next few weeks and months, we are literally talking about famine. We need support, we need help and we need it now."   The agency estimated its needs at $270 million (242 million euros) for the first half of 2020.   South Sudan declared a "man-made" famine affecting around 100,000 people in 2017. 

The term "famine" is used according to a scientific system agreed upon by global agencies, when at least 20 percent of the population in a specific area has extremely limited access to basic food; acute malnutrition exceeds 30 percent; and the death rate exceeds two per 10,000 people per day for the entire population.   "Famine in South Sudan was defeated after four months in 2017 by a concerted large-scale humanitarian response," said the WFP.   "Experts now say the country's food security outlook has never been so dire."   Political instability is also high as President Salva Kiir and his rival Riek Machar have again delayed their formation of a power-sharing government, this time by 100 days until February 2020.
Date: Wed, 11 Dec 2019 09:33:13 +0100 (MET)
By Holly ROBERTSON

Sydney, Dec 11, 2019 (AFP) - Up to 20,000 protesters rallied in Sydney on Wednesday demanding urgent climate action from Australia's government, as bushfire smoke choking the city caused health problems to spike.   Sydney has endured weeks bathed in toxic smoke as hundreds of blazes have raged across the countryside, with hospitals recording a 25 percent increase in the number of people visiting emergency departments last week.   On Tuesday smoke alarms rang out across Australia's biggest city, with thick haze triggering smoke alarms and forcing buildings to be evacuated, school children to be kept indoors, and ferries to be cancelled.   The devastating fires have focused attention on climate change, with scientists saying the blazes have come earlier and with more intensity than usual due to global warming and a prolonged drought.   Police estimated the crowd size at 15,000, organisers put the figure at 20,000.

Many of the protestors voiced anger at the government's silence in the face of the crisis.   "The country is on fire" said 26-year-old Samuel Wilkie attending his first climate protest. He described politicians' response as "pathetic".    "Our government is not doing anything about it," said 29-year-old landscape gardener Zara Zoe. "No one is listening, no one is doing anything."   Prime Minister Scott Morrison -- a staunch backer of Australia's vast coal industry -- has said little about the smoke since the crisis began, preferring to focus on fire-hit rural communities.   Organiser Chloe Rafferty said that had created anger at the conservative government's inaction.   "I think the wider public can see that we are not expecting the climate crisis in the future but we are facing the climate crisis now," she told AFP.   "People are experiencing it in their day-to-day lives."   As well as a rise in people visiting hospitals with smoke-related health symptoms, the number of emergency calls for ambulances spiked 30 percent last week.    "For most people, smoke causes mild symptoms like sore eyes, nose and throat," top health department official Richard Broome said.   "However, people with conditions like asthma, emphysema and angina are at greater risk because the smoke can trigger their symptoms."

Smoke from bushfires is one of the biggest contributors to air pollution in Australia, releasing fine particles that can lodge deep within people's lungs and cause "severe" health impacts over time, according to scientist Mick Meyer from government-funded scientific research agency CSIRO.   "The impact of smoke on people remote from the fires may, on occasion, substantially exceed the direct injury to people within the fire zone," he wrote in The Conversation.   "But we currently lack the operational tools to understand the extent of these impacts or to manage them."   Six people have been killed and more than 700 houses destroyed in bushfires this fire season.   Though the human toll has been far lower than the deadliest fire season in 2009 -- when almost 200 people died -- the scale of this year's devastation has been widely described as unprecedented.   Three million hectares (7.4 million acres) of land has been burnt -- the size of some small countries -- and vast swathes of koala habitat scorched.   Official data shows 2019 is on track to be one of the hottest and driest years on record in Australia.
Date: Tue 3 Dec 2019
Source: Trinidad Express [abridged, edited]

The number of local deaths from the influenza virus has risen to 24. At the Health Ministry's update last week, 16 fatalities were reported from the flu, with Health Minister Terrence Deyalsingh appealing to citizens -- especially those considered at-risk -- to get vaccinated.
Date: Sat 30 Nov 2019
Source: The New Indian Express, Express News Service [edited]

According to official data, 14 swine flu [influenza A/H1N1] deaths across the state were recorded this year [2019] till [17 Nov 2019]. The figure is slightly less than the previous year's [2018] toll of 17. The total number of H1N1 swine flu-positive cases [has] also come down this year [2019] compared with 2018 from 402 to 325. Health officials are setting up isolation wards in hospitals as a preventive measure.

As the winter season has set in and the minimum temperatures are coming down, health officials are instructing the public to take precautions in order to stay away from being infected by swine flu. The health department has initiated steps to set up district-[wide] swine flu testing facilities and isolation wards in every district hospital, area hospital, and community health centre.

As per the requirement of treatment procedure, the government has to set up special isolation wards in all government hospitals and provide protection kits to the healthcare staff, especially to those who will attend to the patients suffering from the flu. Across the state, Visakhapatnam registered the highest number of positive swine flu cases and deaths. Out of 325 positive cases, 180 alone were reported from Visakhapatnam, of which 8 died. West Godavari district registered 3 deaths, and Anantapur, East Godavari, and Srikakulam registered one death case each.

All the district health officials have been instructed to intensify awareness camps and screening centres. As part of the action plan, isolation wards with 5-10 beds are to be set up in every teaching, district, and area hospital. A sufficient stock of drugs, masks, and PPE [personal protective equipment] kits are to be made available. Currently, there are 18 labs eligible for conducting confirmation test in the state. "We are creating awareness by distributing pamphlets and putting up screening centres at bus stops and railway stations," DMHO [district medical and health officer] Dr. TSR Murthy said.

Symptoms of swine flu are generally similar to that of seasonal flu. These include cough, fever, sore throat, stuffiness, runny nose, body aches, headache, chills, fatigue, diarrhoea, and vomiting. Later on, breathlessness, chest pain, drowsiness, low blood pressure, sputum mixed with blood, and bluish discoloration of nails also develops.
Date: Thu 28 Nov 2019
Source: GDN Online [edited]

Two expatriates living in Oman died after contracting the seasonal influenza (H1N1) or swine flu in the governorate of Dhofar -- the 1st in July and the 2nd in August [2019]. They were among 78 confirmed cases of swine flu registered at the Sultan Qaboos Hospital over the first 9 months of 2019 in the governorate.

The hospital authorities reported a total of 599 registered suspected cases of H1N1 between January and last September [2019]. Doctors working at Sultan Qaboos Hospital dealt overall with 1779 cases of respiratory infections during the same period.

Patients most vulnerable to the respiratory viruses are those over 18 years, particularly pregnant women; those suffering from chronic illnesses, kidney and heart diseases, liver problems, diabetes, asthma, blood disorders, and HIV/AIDS; and even health workers, according to Muscat Daily.
Date: Wed 11 Dec 2019
Source: UNICEF/WHO Situation report 11 Dec 2019 [edited]

Highlights
- 5 new human cases reported in the past week
- In response to 1st human vaccine-derived poliovirus type 1 (VDPV1) case from the island province of Basilan, in the Bangsamoro Autonomous Region in Muslim Mindanao (BARMM), outbreak immunization was conducted
in Maluso, Basilan, with bivalent oral polio vaccine (bOPV) against polio type 1, vaccinating 13 547 children under 10 years old (102% of the target).
- Currently 9 human cases confirmed with circulating VDPV type 2 (cVDPV2), 1 case with VDPV1, 1 case with cVDPV1, and 1 case with immunodeficiency-related VDPV type 2 (iVDPV2).
- A case with VDPV1 from Sultan Kudarat is pending genetic analysis; 1 case of cVDPV1 from Malaysia was confirmed as genetically linked to the Basilan case.
- Synchronized polio vaccination campaign conducted on [25 Nov 2019 - 10 Dec 2019] (including 2 days of extension) vaccinated 4 309 566 children under 5, which is 98% of the target total of 4.4 million children under 5. A total of 1 395 365 children under 5 were vaccinated in National Capital Region (NCR), which is 109% of the target, and 2 914 201 (94%) in Mindanao.
- DOH planning to conduct outbreak immunization with bOPV targeting 710,296 children under 10 in the Sulu Archipelago, Zamboanga City, and Lambayong, Sultan Kudarat, on [6-12 Jan 2020].
- Current polio outbreak resulting from persistently low routine immunization coverage, and poor sanitation and hygiene.
- Philippines is affected by both cVDPV1 and cVDPV2. cVDPV is considered a public health emergency of international concern (PHEIC).

cVDPV1
---------
- In response to the 1st human case confirmed with VDPV1 from Maluso, Basilan (BARMM), outbreak immunization was conducted in the area with bOPV for children under 10 years old, vaccinating 13,547 children under 10 years of age (102% of the target).
- A cVDPV1 case in Sabah state, Malaysia, was confirmed to be genetically linked to the Basilan case by the Victorian Infectious Diseases Reference Laboratory (VIDRL) in Australia. Since the 2 viruses are genetically linked, they are both classified as circulating.
- A new VDPV1 case from Sultan Kudarat (Region XII) was confirmed on [6 Dec 2019] and is pending further genetic analysis.
- All 13 cVDPV1 environmental samples found in Manila are genetically linked.

cVDPV2
---------
- All 9 human cases and 17 environmental samples confirmed with cVDPV2 are genetically linked. All human cases were reported from Mindanao (BARMM and Region XII), whereas environmental samples were found in NCR and Davao.
- All samples were tested by the National Polio Laboratory at the Research Institute for Tropical Medicine (RITM), whereas sequencing and genetic analysis is done at the NIID in Japan, and additional genetic characterization is provided by the United States Centers for Disease Control and Prevention (CDC).
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[Given the identification of the cVDPV1 case in Malaysia that is genetically related to the VDPV1 case in Basilan, it is now clear there are at least 2 separate cVDPV outbreaks in the Mindinao region of the Philippines: one of the outbreaks is associated with cVDPV2, and the other with cVDPV1 and one outbreak of cVDPV1 in the Manila Metropolitan area (although only environmental samples have been positive without AFP (acute flaccid paralysis) cases as yet.) What all these areas have in common is pockets of populations with suboptimal vaccination coverages. Clearly, we await further information on the genetic profiling of the newly identified VDPV1 case in Sultan Kudarat, also located in southern Philippines. Note that Basilan Island, Sultan Kudarat, and Sabah state in Malaysia, while all in the same general area, are not contiguous, each being on a different island. In. total, there are 11 cases of AFP in the Philippines that are attributable to infection with a VDPV.

A map showing the provinces in the Philippines can be found at

HealthMap/ProMED-mail map of the Philippines: