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Greenland

Located to the northeast of Canada, Greenland lies mostly within the Arctic Circle, extending to within less than 500 miles (800 km) of the North Pole. It is bordered on the north by the Lincoln Sea and the Arctic Ocean, and on the east and south by the G
eenland Sea, the Denmark Strait, and the Atlantic Ocean.

Its climate is bleak and Arctic, although rapid changes like bright sunshine and powerful blizzards are common. Average January and July temperatures in the south are 21°F (-6°C) and 45°F (7°C). In the north, average January and July temperatures are -31°F (-35°C) and 39°F (4°C). Average monthly precipitation decreases from 9 inches (24 cm) in the south to about half an inch (1.5 cm) in the north. Although summer rainfall is concentrated in the southwest, snow can fall in any month. Summers can be rather pleasant on the southwest coast, but the inland ice is uniformly cold, with a July average of 10°F (-12°C) and a February mean of -53°F (-47°C).

Health Precautions
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General Cautions
Recent medical and dental exams should ensure that the traveler is in good health. Carry appropriate health and accident insurance documents and copies of any important medical records. Bring an adequate supply of all prescription and other medications as well as any necessary personal hygiene items, including a spare pair of eyeglasses or contact lenses if necessary.

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, 17 Oct 2019 05:32:08 +0200 (METDST)
By Tom LITTLE

Kulusuk, Denmark, Oct 17, 2019 (AFP) - Kayaking past blue-white icebergs drifting along near a pristine harbour, wandering around colourful houses or trekking in the snow-capped wilderness: July and August are high season for tourists in eastern Greenland.   Many of the 85,000 tourists who visit each year head to the west coast, but eastern Greenland, with its glaciers, wilderness and wildlife starring whales and polar bears, is also drawing visitors.

Sarah Bovet, a 29-year-old Swiss artist, said it's hard to know what to expect.   "Thinking you're going to be surprised, you are even more so in reality," she said standing outside a hostel in the tiny village of Kulusuk.   Bovet was on an artistic residency in Greenland when she visited Kulusuk and its 250 souls.   Although she had imagined a small village before arriving, its stunning views and bright colours still came as a surprise.   With just one supermarket, an airport built in the 1950s by the US military to serve a Cold War radar base, and a harbour surrounded by brightly painted wooden houses, most of the villagers appreciate the extra revenue from tourism.

Justus Atuaq, a young hunter in Kulusuk, takes tourists out on sled tours in March and April -- the spring high season -- earning money that helps him feed and care for the dogs he uses for racing and hunting.   "Now I can take dogsleds for hunting, and sometimes tourists coming from other countries also want to dogsled," he said outside his wooden house.   Tourists also take boat trips during the summer high season from July to August.   Arrivals to the island grew 10 percent year-on-year from 2014 to 2017, and three percent in 2018, according to the tourist board, Visit Greenland.   Many adventure seekers and nature lovers arrive by plane, but cruise ships also bring admirers, hugging the picture perfect coastline.

- Growing strategic importance -
But they are not alone in taking an interest in the world's largest island.   The Danish territory's rich natural resources and growing strategic importance as the Arctic ice sheet melts have attracted the attention of US President Donald Trump.   The Arctic region has untapped reserves of oil, gas and minerals, as well as abundant stocks of fish and shrimp.   In August, Trump offered to buy Greenland, then called off a visit to Copenhagen over its refusal to sell.

Denmark colonised Greenland in the 1700s, granting it autonomy in 1979.    Today, many Greenlandic political parties advocate full independence.   The territory still receives an annual subsidy from Copenhagen, which was 4.3 billion Danish kroner (576 million euros) in 2017, and tourism could help it to become economically self-reliant.   Like many parts of Greenland, Kulusuk has no tarmac roads and visitors must travel by plane or boat.   The growth in tourism could put a strain on the village's infrastructure, and the sector faces unique challenges given Greenland's location, weather and the cost of travelling there.

Day tours of Kulusuk with flights from the Icelandic capital Reykjavik are 97,000 Icelandic kronur ($780, 700 euros).   Jakob Ipsen, a 48-year-old who grew up between Denmark and Greenland's west coast, runs Kulusuk's sole hotel.   The 32-room hotel stands beside a fjord, and from its dining room, guests can watch icebergs drift by during the summer.    But the region's isolation can be problematic, Ipsen admits.    "We have to get all our supplies in with the first ship for the whole summer season, and for the winter season when everything is frozen over, we have to get all our supplies in with the last ship for the whole winter," he said.

- 'They go back as different people' -
Greenland must tackle its infrastructure challenges if it wants to develop tourism, Visit Greenland says.   Government-funded work is under way to extend runways at the capital Nuuk and Ilulissat, both on the west coast, and a new airport is planned in the south.   The tourist body said it would weigh the environmental impact of boosting infrastructure, both on the environment and on local communities.    Ipsen worries about the effects of uncontrolled tourism to the region.   "We want to try to maintain it as it is, so it's not exploding," he said.

Already, said Johanna Bjork Sveinbjornsdottir, who runs tours in Kulusuk for an Iceland-based company, the rise in visitor numbers is making itself felt.   "In the campsites here out in nature where you used to be alone, there's two, three groups at a time," she said.   Like Ipsen, she is also concerned about the effect that rising visitor numbers could have on the wilderness around the village.    "If you want nature to survive that, you have to build up the infrastructure," she said, pointing to the lack of officially designated campsites around Kulusuk, with no rubbish bins or toilets for travellers outdoors and no one supervising the sites.   Despite the concerns, Sveinbjornsdottir hopes visitors will keep coming.   "They go back as different people," she said. "Everything is beyond what you ever imagined."
Date: Fri, 16 Nov 2018 14:19:01 +0100

Copenhagen, Nov 16, 2018 (AFP) - Greenland's parliament has adopted a plan to upgrade or build airports to serve the massive North Atlantic island, keen to attract more tourists to its pristine Arctic wilderness.   Two airports -- in the capital Nuuk and in the tourism centre Ilulissat -- will be substantially upgraded, making it possible to fly directly to Greenland from Europe and North America.

A new national airport will be built in Qaqortoq in the south.   Greenland is an autonomous Danish territory. The plans have been controversial because of Copenhagen's direct financial involvement.   The project is estimated to cost at least 3.6 billion kroner (482 millions euros, $546 million).   Almost 20 percent of the financing will be provided by Denmark, which contributes 3.6 billion kroner to the island's annual budget.   Parliament adopted the proposal late Thursday with 18 out of 29 votes.

In September, the project plunged Greenland into a three-week political crisis, with an independent supporting party quitting the government coalition in protest against Denmark's involvement.   The social democratic Siumut party, which has dominated Greenland politics for four decades, was ultimately able to cling to power with a new, narrower majority.   "We are creating lots of opportunities for Greenland's future. We are not selling out," Prime Minister Kim Kielsen insisted in parliament's debate, local television KNR reported.   The three airports will serve the main population centres of the island, which is home to 55,000 people spread out across an area more than four times the size of France.

Smaller communities have meanwhile complained they will remain isolated.   In addition, "other risks have also been raised, like the reaffirmed presence of the US military, which not everyone sees as a positive thing, and the environmental risks brought on by better international connections," Mikaa Mered, a professor of Arctic geopolitics at the ILERI School of International Relations in Paris, told AFP.

Since 2009, Greenland has been largely independent when it comes to its economic policy but foreign and defense issues remain under Copenhagen's control.   "The big winner in this affair is Copenhagen. Both on the political, economic and geopolitical levels, Copenhagen is strengthening its positions across the board, vis-a-vis China and the triangular alliance with Washington," Mered said, referring to Beijig's eagerness to invest in the Arctic which has raised concern in the US.   Construction of the airports is scheduled to be completed by 2023.
Date: Fri, 13 Jul 2018 14:25:42 +0200

Stockholm, July 13, 2018 (AFP) - A massive iceberg drifting near the coast of Greenland has triggered fears of flooding if it breaks up, leading the authorities to  evacuate a high-risk zone.    The authorities have urged residents of the Innarsuit island settlement with houses on a promontory to move away from the shore over fears that the iceberg, which was spotted on Thursday, could swamp the area.   "We fear the iceberg could calve and send a flood towards the village," Lina Davidsen, a security chief at the Greenland police, told Danish news agency Ritzau on Friday.

The settlement in northwestern Greenland has 169 inhabitants, but only those living closest to the iceberg have been evacuated, Ritzau reported.    "The iceberg is still near the village and the police are now discussing what do to next," Kunuk Frediksen, a police chief in the Danish autonomous territory, told AFP.   The incident comes weeks after scientists at New York University shot and released a video of a massive iceberg breaking free from a glacier in eastern Greenland in June.    Last year, four people died and 11 were injured after an earthquake sparked a tsunami off another island settlement called Nuugaatsiaq, sending several houses crashing into the sea.
Date: Mon, 14 Aug 2017 17:54:23 +0200

Stockholm, Aug 14, 2017 (AFP) - Police in Greenland warned people to stay away from western areas of the island as wildfires scorched swathes of scrubland.     In a statement, the police said it "still discourages all traffic -- including hiking and hunting -- in two areas around Nassuttooq and Amitsorsuaq."     "The fires are not expected to end within the next few days," the statement added.    Some of the blazes have been burning since July 31.

Denmark's meteorological service BMI said the island registered its hottest-ever temperature of 24.8 degrees (77 Fahrenheit) on August 10.   Last year was Greenland's hottest on record.    The Danish territory has lost about 4,000 gigatons of ice since 1995, British researchers said in June, making ice melt on the huge island the biggest single contributor to rising sea levels.
Date: Sun, 18 Jun 2017 16:10:26 +0200

Stockholm, June 18, 2017 (AFP) - Four people were listed as missing Sunday after an earthquake sparked a tsunami off Greenland and forced some residents to be evacuated.   "Four people are missing," local broadcaster KNR quoted local police chief Bjorn Tegner Bay as telling a news conference in the autonomous Danish territory.   There were no confirmed fatalities, but Bay said 11 houses had been swept away after a magnitude 4 overnight quake off Uummannaq, a small island well above the Arctic Circle.    "The huge waves risk breaking over Upernavik and its environs. The residents of Nuugaatsiaq are going to be evacuated," police said on Facebook, referring to nearby hamlets.

Some residents posted images to social media showing huge waves breaking over buildings in the town.   "A good explanation is that the quake created a fault at the origin of a tsunami," meteorologist Trine Dahl Jensen told Danish news agency Ritzau, warning of potential aftershocks.   "It's not normal, such a large quake in Greenland," she said.   KNR quoted Ole Dorph, mayor of Qaasuisup, a municipality in the area affected, as lamenting "a serious and tragic natural catastrophe which has affected the whole region."   Danish Prime Minister Lars Lokke Rasmussen tweeted news of what he termed a "terrible natural catastrophe at Nuugaatsiaq."   The world's largest island situated between the North Atlantic and Arctic oceans, Greenland, population 55,000, has an ice sheet particularly vulnerable to climate change.
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Japan

General
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Japan is a highly developed country with excellent tourist facilities. The country covers a number of islands and the population is estimated at over 125 million. English is widely spoken in the main tourist a
d urbanised centres.
Weather Profile
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Due to the strong influence from the sea, Japan tends to have a high rainfall but milder winters than the adjacent mainland of China. This is similar to the climate experienced in Ireland by comparison to the rest of Europe. Spring and Autumn are usually the most pleasant months but during the Summer the climate can be significantly humid and tiring. During this time it will be essential that fluid intake is increased and that salt (lost through perspiration) is replaced - usually by increasing the amount eaten on your food providing this is not contraindicated by any personal medical condition such as blood pressure etc.
Alcohol Consumption
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The Japanese authorities have limited patience with those arrested while under the influence of alcohol. For some travellers visiting the country this may mean a prolonged stay in the local jail and the subsequent missing of important appointments.
Natural Disasters
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Japan is situated in a region of the world which regularly experiences earthquakes and other climatic changes including typhoons. A number of relatively small earthquakes are reported each year but, to date, this has seldom affected any tourist itinerary. However, further information is available at http://www.tokyoacs.com
Safety and Security
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The risk to personal security for tourists while travelling throughout Japan is small though commonsense care of personal belongings is always essential. Where available, use the hotel safety boxes to store valuables and your passport, return air tickets. During the mid 1990’s a number of terrorist incidents occurred but no recent serious problems are being reported.
Airport Taxes
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Many countries now include the cost of their ‘departure tax’ within the ticket. In Japan this will depend on which airport you leave from. The fee is collected in Yen at Kansai - Osaka International Airport but usually included in the ticket cost if flying via Narita - Tokyo International Airport.
Cost of living
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Japan is not a cheap country for tourists. The cost of living is one of the highest throughout the world. Credit cards may be used in main cities but the ATM’s machines may not be available at all hours. Before taking a taxi from the airport it would be wise to check the costs and then assess whether or not it might be more prudent to use the local bus transport!
Medical Care
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The level of medical care throughout most tourist regions in Japan is excellent. However, there may be limited English-speaking doctors in some more rural areas and even where this facility is available in the main cities the cost of healthcare can be very expensive. It is wise to carefully check your travel health insurance premium before you leave home.
Local Medications
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Some commonly used European over-the-counter medications
may not be available in Japan. Also, there are strict laws governing the importation of certain medications which can be strictly enforced. Certain inhalers, sinus preparations etc may be confiscated on arrival. If you are taking any personal medications it may be wise to check before you leave. Obviously never carry packages for anybody else while travelling unless you are certain of the contents.
Avoiding Prickly Heat
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The term prickly heat is used in a variety of ways but the cause is generally the same. In a hot climate the body perspires to maintain the internal temperature at a correct level. In the perspiration there will be fluid and your personal salts. The fluid evaporates but the salt dries against the skin. It is your individual reaction to this salt that leads to the ‘prickly heat rash’. The reaction to these salts can be minimised by removing the salts from the skin surface as soon as possible. Change your clothes regularly, use plenty of talcum powder to absorb the perspiration and dry off well after showering.
Food & Water Care in Japan
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Any international traveller should recognise the risks of a ruined trip from unwise indulgence in local food and beverages. In Japan the level of food hygiene is high but the consumption of Sushi (uncooked raw fish) is unwise. Bivalve shellfish also carry a significant risk due to the limited level of sterilisation during the cooking process.
Malaria & Mosquitoes
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No malaria transmission occurs throughout Japan although avoiding mosquito bites during the humid months is wise.
Airborne Disease
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In any situation where you will be crowded together with many others the risk of a variety of airborne diseases will be higher. This will include serious diseases such as Meningococcal Meningitis but also others such as Influenza and the common cold. The risk of Meningococcal Meningitis in Japan is regarded as small and vaccine is not routinely recommended. However, having the Flu vaccine may be a wise precaution. It is also sensible to carry a small supply of lozenges to treat the inevitable sore throat which may occur.
Driving in Japan
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The road system throughout Japan is excellent but unfortunately the road signs may prove too much of a hurdle for those unfamiliar with the language! The congestion within the cities tends to be high and tolls on some of the major roads may be quite expensive. The traffic moves on the left side of the road but for many tourists it will be wiser to consider using local transportation rather than risking a ruined holiday.
English Help Lines
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Tourists can obtain important information and assistance in English while visiting Japan through the following numbers;
In Tokyo - 03-3968 4099
Rest of Japan - 0120-461 997
Vaccines for Japan
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For the majority of short-term travellers visiting Japan no particular vaccines will be recommended. Those planning to live for longer periods within the country will need to discuss this through in greater detail.

Travel News Headlines WORLD NEWS

Date: Thu, 16 Jan 2020 16:38:39 +0100 (MET)
By Hiroshi HIYAMA

Tokyo, Jan 16, 2020 (AFP) - Japan has confirmed a case of a mystery virus that first emerged in China and is from the same family as the deadly SARS pathogen, authorities said Thursday.   It appears to be only the second time the novel coronavirus has been detected outside China, after the World Health Organization (WHO) confirmed a case in Thailand.   Japan's health ministry said a man who had visited the central Chinese city of Wuhan, the apparent epicentre of the outbreak, was hospitalised on January 10, four days after his return to Japan. He reported a persistent fever.

Tests on the patient, who was released from hospital on Wednesday, confirmed he was infected with the new virus.   "This is the first domestic discovery of a pneumonia case related to the new coronavirus," the ministry said in a statement.   "We will continue active epidemiological research while also coordinating efforts with the World Health Organization and related agencies to conduct a risk assessment."   The outbreak has killed one person so far, with 41 patients reported in Wuhan.

The outbreak has caused alarm because the new virus is from the same family as the pathogen that causes SARS (Severe Acute Respiratory Syndrome), which killed 349 people in mainland China and 299 in Hong Kong in 2002 and 2003.   Authorities in Wuhan said a seafood market was the centre of the outbreak. It was closed on January 1.   Japanese authorities said the man had not visited the market and that it was possible he had been in contact with a person infected with the virus while in Wuhan.

- Outbreak in Japan 'unlikely' -
Health ministry official Eiji Hinoshita told reporters that the risk of the disease spreading from the patient was considered low, with careful checks done on those who had been in close contact with him.   "At this point, we feel it is unlikely this will lead to a dramatic outbreak," he said, adding that the patient was no longer suffering a fever and was recuperating at home.

Officials declined to give further information on the man, including his nationality, citing privacy concerns.   Local media said the patient was a Chinese national in his 30s living in Kanagawa, just southwest of Tokyo.   Public broadcaster NHK said he had already recovered and was resting at home, as quarantine officials at Tokyo's Narita airport boosted health checks on all travellers.

The health ministry urged people who develop a cough or fever after visiting Wuhan to wear a surgical mask and "swiftly visit a medical institution".   Hinoshita said Japan would need to be on guard ahead of the Lunar New Year, a popular travel period in China.   "It is expected that Japan will see many visitors from China," he said.   It is not yet clear whether the mystery virus can be transmitted between humans, but on Wednesday authorities said it was possible it had spread inside a family.

The woman diagnosed in Thailand, who is in a stable condition, also said she had not visited the Wuhan seafood market.   And WHO doctor Maria Van Kerkhove on Tuesday said she "wouldn't be surprised if there was some limited human-to-human transmission, especially among families who have close contact with one another".   Hong Kong authorities on Tuesday said several dozen people had been hospitalised with fever or respiratory symptoms after travelling to Wuhan, but no cases of the new virus have so far been confirmed.
Date: Tue 7 Jan 2020
Source: National Institute of Infectious Diseases Epidemiology Center for Infectious Diseases [in Japanese, trans. & summ. Rapp. KI, edited]

Urgent Information on Rubella Outbreak in Japan: as of 25 Dec 2019
------------------------------------------------------------------
Rubella reports in week 51 of 2019 [16 Dec - 22 Dec 2019], 6 cases were diagnosed with rubella and reported.

Rubella in weeks 1-51
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The cumulative number of reported cases was 2294, an increase of 6288 from 2288 in week 50 (Figures 1, 2-1, and 2-2). Even if diagnosed in the 51st week, reports reported late on or after [26 Dec 2019] are not included, so care must be taken in interpreting the number of reports.

Number of reported cases of congenital rubella syndrome
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The number of cases of rubella and congenital rubella syndrome reported since the start of notification of all cases in 2008 (Figure 3), 2014 report. Since then, there have been no reports of congenital rubella syndrome

A total of 4 people were reported, 1 each in weeks 4, 17, 24, and 44 in 2019
Presumed infected area: Saitama Prefecture 1 person, Tokyo 2 people, Osaka Prefecture 1 person.
Gender: 3 males, 1 female
Kuching vaccination history: Yes (1 time, vaccination year unknown, type unknown) 1 person, 3 unknown, maternal rubella history during pregnancy: Yes 1 person, unknown 2 people, none 1).

Rubella reports since 2013
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Since the epidemic of 2013 (14,344), there were 319 in 2014, 163 in 2015, 126 in 2016 and 91 in 2017.

Despite a downward trend (Figures 2-1, 2-2, 3), 2946 people were reported in 2018, and 2294 in week 51 in 2019.

Number of reports by region
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By region, Tokyo (854: no increase from week 50), Kanagawa (293: one increase from week 50), Yo-ken (200: no increase from week 50), Saitama (197: no increase from week 50), Osaka (130: no increase)

(No increase from 49 weeks), with more than 100 reports (Figures 4 and 7). Week 51 is for Aichi prefecture (3 people) (Figure 5).

The largest number was 250 from the Kinki region (11%), 168 from the Kyushu region (7%), 125 from the Chubu region (5%), 96 people (4%) from the Chugoku / Shikoku region and 72 (3%) from the Hokkaido / Tohoku region were reported. No report is high. Only in Chichi Prefecture (Figures 4 and 7).

Symptoms (with duplication)
----------------------------
In the descending order, rash 2262 (99%), fever 2035 (89%), lymphadenopathy 1324 (58%), conjunctival congestion 1066 (46%), cough 567 (25%), arthralgia / arthritis 542 (24%), nasal discharge 499 (22%), thrombocytopenic purple 7 (0.3%) had plaque disease and 1 (0.04%) had encephalitis. In addition; sore throat 41; headache 42; malaise 24; 11 people, diarrhea / watery / soft stools; 11 people, papular hemorrhage of hard palate / palate mucosa; 8 people, thrombocytopenia; 7 people, leukopenia; 3 people, hepatitis / hepatic dysfunction; meningitis in 1 person, and pneumonia in 1 person. Fever, rash, lymphadenopathy

All reported were 1182 (52%).

Laboratory diagnosis method (with duplication)
----------------------------------------------
Virus isolation was 26 (1%), 4 in 1E, and 2 in 2B. Detection of viral genes by PCR 1326. Of these (58%), of which 625 had been genotyped, 548 in 1E and 35 in 2B.  1207 (53%) of serum IgM antibodies were detected, of which both viral genes and serum IgM antibodies were detected; were 413 (34%). Rubella antibody seroconversion or significant increase with paired sera was found in 54 (2%) patients.  In addition, after being accepted by the public health center as measles (clinical diagnosis example), the result of the test diagnosis is reported to rubella (test diagnosis example): there were 136 cases in which this was changed.

Putative source of infection
----------------------------
Profession
In the occupation statement column added to the notification slip from January 2019, 837 (36%) were listed as company employees. The most common was 33 healthcare professionals (10 nurses, 5 medical clerks, 4 pharmacies, 3 doctors, 2 occupational therapists, 2 nursing assistants, 1 dentist, 1 pharmacist, 1 dental assistant, working at a dental clinic 1 person, 1 laboratory technician, 2 medical professionals), 12 childcare workers, 16 teachers, 11 police officers and police officers, 7 firefighters were reported, and 7 SDF personnel were reported.

Age and gender
94% (2166) of the reported cases are adults, with 3.6 times more men than women (1795 men, 499 women) (Figure 8, 9, 10). The median age of male patients is 40 years (0-76 years), especially for men in their 30s and 40s (59% of all men) (Figure 8). The median age of female patients is 30 (0-76), especially in their 20s and 30s (64% of all women). Figure 9).

Vaccination history
None (479: 21%) or unknown (1594: 69%) account for 90% of vaccination histories (Figures 8 and 9). Of those who had been inoculated (221 persons: 10%), both the date of inoculation and the lot number were reported... Estimated infected area
The estimated number of infected areas was 1774 (77%) in Japan, 460 (20%) unknown in Japan and abroad, 48 (2%) outside Japan, 12 people (0.5%) in Japan or abroad have low outbreaks overseas (Figure 11).  ...[continued]
******
IDWR Surveillance Data Table 2019 week 51 [16 Dec-22 Dec 2019], Japan
Date: Tue 7 Jan 2020
Source: National Institute of Infectious Diseases, Japan [edited]

Notifiable diseases, number of cases of the week and total number of cases by prefecture.
Total number of cases was updated with delayed reported and discarded cases.
- 2019, week 51:
- 2018, week 51:
- 2017, week 51:

Week 51; 2019/2018/2017
Rubella (FN, FO), current week 6/84/4; cum 2294/2806/91 (data of 2017 was checked. - Rapp.KI)
=====================
[Rubella, also called German measles, is a disease spread by the coughs and sneezes of infected people. Symptoms include rash and fever for 2-3 days. Rubella on its own is not a high-risk infection. But rubella is very dangerous for a pregnant woman and her developing baby. If a pregnant woman gets rubella virus, her baby could have birth defects such as deafness, cataracts (blurred vision), heart defects, mental disabilities, and organ damage. Pregnant women who are not protected against rubella through either vaccination with the MMR vaccine or previous rubella infection should not travel to Japan during this outbreak. (from <https://wwwnc.cdc.gov/travel/notices/alert/rubella-japan>). - ProMED Mod.LK]

[HealthMap/ProMED map available at:
Date: Tue 10 Dec 2019
Source: The Telegraph [edited]

A tick-borne virus that is rapidly spreading throughout Asia has such a high death rate that it should be treated on par with diseases such as Ebola, a Japanese virologist has warned.

The new virus -- severe fever with thrombocytopenia syndrome (SFTS) -- is spread by tick bites and was 1st identified by Chinese researchers 8 years ago.

It has a death rate of 30 percent, similar to diseases such as Crimean-Congo haemorrhagic fever, classified by the World Health Organization as having "epidemic potential."

Owners of pet cats and dogs have been warned to be especially vigilant, as they carry ticks.

SFTS was 1st identified in Japan in 2013, when 40 patients were identified. The number of cases has risen sharply since then, with 96 in the 1st 11 months of this year [2019], and experts are anticipating that the total will surpass 100 for the whole of 2019.

"SFTS is a tick-borne infection with a fatality rate around 30 percent, and it should be classified as a viral haemorraghic fever," said Dr Masayuki Saijo, director of Japan's National Institute of Infectious Diseases.

"The route of the virus infection is very similar to Ebola [Ebola virus is not tick-borne. - ProMED Mod.TY] and the fact that the fatality rate is so high means that SFTS should be treated as a biosafety level 3 pathogen," he added.

With a high mortality rate and no effective treatment available, experts are warning people to take precautions against ticks while they are in rural areas. Pets are also susceptible to carrier insects, such as the Asian longhorned tick, and owners are being cautioned to be vigilant.

"We have recently found that domestic cats and dogs show similar symptoms of the virus as humans when they are infected, and the fatality rate in cats exceeds 50 percent," Dr Saijo told the Telegraph.

"We have identified several cases in Japan in which pet owners have been infected by their pets and at least one case in which a vet died after being bitten by an infected cat," he said.

As well as being found in China and Japan, SFTS has now been confirmed on the Korean Peninsula, Taiwan and, last year [2018], in Viet Nam. The disease is believed to have evolved between 50 and 150 years ago, and previous deaths, particularly in developing parts of east Asia, were blamed on other illnesses or were simply recorded as being from unknown causes.

The primary clinical symptoms in humans are fever, vomiting, diarrhoea, low platelet count, a low white blood cell count, elevated liver enzyme levels, and, ultimately, multiple organ failure.

Most cases are reported in rural areas between March and November, with the virus believed to lie dormant in the host for between 6 days and 2 weeks before the symptoms become apparent. Anyone who finds a tick embedded in their body is being advised not to try to remove it themselves but to seek medical attention.

As of the end of October [2019], a total of 491 people had been treated in Japan for SFTS, with 70 patients dying. It appears that the illness is particularly dangerous to older people, with 90 percent of the recorded cases among people aged 60 or older.

The virus is carried by wild animals, primarily deer and boars in Japan, but also by hedgehogs, cattle, goats and sheep.

The institute is working on a treatment, with early indications suggesting that it can reduce fatalities by about 10 percent, Dr Saijo said.

"Viral zoonoses such as SFTS have become more prominent worldwide," he said. "With approximately 1/4th of the world's population and a vast diversity of wild and domestic animals living in close proximity to humans, it is very likely that China has the greatest potential for the emergence of infectious diseases worldwide.

"The frontline defense against such emerging infectious diseases continues to be careful clinical observation, heightened surveillance and rapid detection," said Dr Perlin.

While SFTS has not been recorded outside east Asia, tick-borne viruses are on the rise worldwide because of a combination of climate change and increased travel. Earlier this year [2019] a potentially deadly brain disease, tick-borne encephalitis virus, was found for the 1st time in the UK.

Japanese authorities have been conducting education programmes in areas that have reported a high number of cases, although there have been criticisms that the authorities are not taking adequate precautions.

In 2017, a press conference at the offices of the Miyazaki Prefectural Government descended into chaos when a live tick that had been brought in to show to journalists disappeared during the proceedings. A local government official placed the insect on a piece of paper to allow photographers to take close-up images, but it disappeared.

Officials searched for the tick but were unable to locate it. After the room was evacuated, 2 types of insecticide were sprayed on the carpet and the prefectural governor issued an apology the next day.  [Byline: Julian Ryall]
==================
[The above report indicates that SFTS virus has become established in Japan. There were cases every year from 2013 to present. Cases were widely disbursed geographically in 2018, with 24 prefectures reporting infected individuals. There were 96 cases in the 1st 11 months of 2019. Since there is no vaccine, the best way to avoid infection is to avoid tick bites and contact with infected pets, especially cats.

SFTS is a serious disease and of significant public health concern. Although SFTS virus infections may be serious, there is evidence for subclinical or mild infections as well, so the previous numbers may be an underestimate of the total number of infections. There is also some evidence for person-to-person direct transmission of the virus, but that appears to be a rare event. The virus is doubtless endemic in several countries in Asia, and cases have occurred previously in Japan. Apparently, there are 2 previously reported affected individuals who acquired their infections directly from an SFTS virus-infected cat. No mention was made of tick transmission in that instance. The possible route of transmission from the cat to the veterinarian and veterinary nurse via exposure to blood or other bodily fluids is not mentioned (see Severe fever w/ thrombocytopenia synd. - East Asia (02): Japan (MZ) http://promedmail.org/post/20181211.6204927).

SFTS virus is a tick-transmitted phlebovirus in the Bunyavirus family. Images of a longhorn tick, _Haemaphysalis longicornis_, the SFTS vector, can be seen at

[HealthMap/ProMED map available at:
Date: Thu 28 Nov 2019
Source: Mainichi Newspaper [in Japanese, machine trans, edited]

An announcement has been received that an employee of Kagoshima City and the drug development company Shin Nippon Kagaku (Shin Nippon Biomedical Laboratories (SNBL) in Tokyo) was infected with monkey-derived "B virus". The case concerns a technician, who was conducting animal experiments on monkeys at the research institute in Kagoshima City on the [28 Feb 2019]. The condition [of the infected individual] is not disclosed. This is the 1st time that infection has been confirmed in Japan, with about 50 cases overseas.

Most cases of past infections have come into contact with monkeys at animal testing facilities, and the National Institute of Infectious Diseases says that "normally there is no risk of spreading infection because it does not move from person to person."

B virus is a type of herpes virus, and most macaque monkeys such as rhesus monkeys and Japanese [cynomolgus macaque] monkeys have viruses. It does not cause airborne infection, but if one is bitten by a monkey with the virus, fever and sensory abnormalities [may] occur at the contact area. Severe infections may cause sequelae of neuropathy.

According to the city, a technician was infected at the Safety Laboratory, which uses monkeys to investigate safety during drug development. In February of this year [2019], she complained of headache and fever, and this month [November 2019], the National Institute of Infectious Diseases determined that it was a B virus. Technicians have never been bitten or scratched and are likely to have touched excrement and saliva.  [byline: Ran Kanno]
======================
[The timeline of the infection in the above patient is uncertain. The 2nd report above indicates that the patient initially became ill in February 2019 but was diagnosed as a herpes B virus infection this month (November 2019). The 1st report above indicates that the patient is currently in a critical condition, but not for how long in that condition. The incubation period for human herpes B virus infections is 3-30 days, although CDC notes that it may be months or even years after infection is initiated for symptoms to appear.

Herpes B virus is an alpha herpes virus. Although herpes B virus is relatively common among the 3 species of macaques affected, human cases over the years have been sporadic and few -- 50 confirmed cases (now 51 with the case above) with 21 deaths. For those humans infected CDC notes that "vesicular skin lesions sometimes occur at the exposure site. The patient may also have lymphadenitis (inflamed lymph nodes), lymphangitis (infection of lymph vessels), nausea and vomiting, abdominal pain, and hiccups.

"The virus can spread to the central nervous system (CNS) and cause the following symptoms:
- hyperesthesias (increase in sensitivity to stimuli);
- ataxia (lack of voluntary control of muscle movements);
- diplopia (double vision);
- agitation;
- ascending flaccid paralysis (extreme weakness due to reduced muscle tone).

Most patients with CNS complications will die, even with antiviral therapy and supportive care, and those who survive usually suffer serious long-term neurologic problems. Respiratory failure associated with ascending paralysis is the most common cause of death. Respiratory involvement and death can occur 1 day to 3 weeks after symptom onset." The CDC website for this virus can be found at <https://www.cdc.gov/herpesbvirus/healthcare-providers.html>. - ProMED Mod.TY]

[HealthMap/ProMED map available at:
Kagoshima City, Kagoshima, Japan:
Date: Mon 25 Nov 2019
Source: Outbreak News Today [edited]

In recent years, the number of syphilis cases has surged in Japan. In 2015, we reported on a big increase in syphilis cases in Japan where well over 2000 cases were recorded, a 4-fold increase from just 5 years earlier. In the past 2 years, more than 5500 cases were reported in 2017 and more than 6000 last year [2018]. Through [13 Nov 2019], the National Institute of Infectious Diseases (NIID) reported 5703 syphilis cases, including 1464 cases in Tokyo and 921 cases in Osaka.

Another issue the NIID has been looking at is syphilis in pregnant women in Japan. According to a report in The Mainichi [<https://mainichi.jp/english/articles/20191125/p2a/00m/0na/015000c>]: The NIID analyzed cases of syphilis reported from the 1st to the 26th week of 2019 [1-30 Jun 2019], a 6-month period from January, and found that a reported 106 of 1117 women with syphilis were pregnant. Of the 61 patients who gave their answers to a section on whether they had worked in the adult entertainment industry in the preceding 6 months, 56 said they had not done so. "It is possible that most of the expectant mothers suffering from syphilis were infected by their male partners," said Takuya Yamagishi, a doctor at the NIID. Through mid-October [2019], Japan has reported 17 congenital syphilis cases, the same as in all of 2018.
=====================
[Japan, as the United States and other countries, has experienced a rising incidence of primary and secondary syphilis that initially involved mainly men who have sex with men, but more recently has involved women in their 20s and 30s. See ProMED-mail: Syphilis - Japan (02): rising incidence, heterosexual women & men, urban  http://promedmail.org/post/20181202.6175741.

In the US and elsewhere, this increase in the incidence of syphilis in women of childbearing age has been associated with a rising incidence of congenital syphilis. However, we were not told in that prior ProMED-mail post if rates of congenital syphilis are similarly rising in Japan. Now, according to data compiled by Japan's National Institute of Infectious Diseases (NIID), the incidence of congenital syphilis in Japan is rising, with 17 cases reported by the 42nd week of 2019 (week ending 19 Oct 2019), which is as many as were reported in the whole of 2018  (<https://mainichi.jp/english/articles/20191125/p2a/00m/0na/015000c>). - ProMED Mod.ML]

[HealthMap/ProMED-mail map of Japan:
More ...

Jamaica

******
Healthy Travelling In Jamaica
*******
General Information;
Jamaica is the 3rd largest of the Caribbean islands and is situated about 600 miles south of Miami, Florida. The climate in Jamaica remains fairly steady throughout the
year with temperatures averaging 27 - 35 C during the summer months (May to September) and 21 - 27 C during their winter! The ambient temperature and rainfall are both affected markedly by the changes in elevation and geography throughout the island. Rainfall varies from an annual average of 25" in the capital, Kingston, to an average of 250" at Blue Mountain Peak. Most of the rain tends to fall between April/May or October/November. The relative humidity in Kingston ranges from an average low of 63% in February to 86% in October.
Health Care Facilities;
The US Department of State’s consular information sheet states that medical care may be limited. Doctors and hospitals often expect immediate cash payment for health services. A list of some of the IAMAT doctors in Jamaica follows;
- Dr. Luois S. Grant - Kingston - tel 927 1106
- Dr. B.A. Morgan - May Pen - tel 986 2370
- Dr. Noel Black - Ochos Rios - tel 972 2296
Sun Exposure;
Frequently travellers from Ireland to Jamaica will want to soak up the sunshine before returning to our rather less exposed shores. Some will tan easily but even they need to take care with the extent of their sun exposure. Many fair skinned Irish travellers will burn easily and so remember to limit your exposure especially during the first week. Use high sun blocking lotions (15+) while you acliamatise and then only drop down the protective factor (10+) if you are sure you will not burn. Watch out especially for the back of your neck, the front of your ankles and the top of your legs. Many of these areas will be unused to such exposure! Also remember if you are travelling in a car or coach watch out that you cover your exposed elbow which may be cooled by the passing breeze.
Sun Stroke / Dehydration;
In such a warm climate you can become quite significantly dehydrated without realising it. Make sure you drink plenty of fluids and, if you have no blood pressure problems or heart difficulties, then increase the amount of salt you put on your normal meals. This will help to maintain your energy levels.
Mosquito Borne Disease;
Malaria transmission does not normally occur in Jamaica so taking prophylactic tablets is not necessary. Nevertheless mosquitoes abound and so remember to use insect repellants, especially when there are mosquitoes about, day or night.
Animals;
Unfortunately Jamaica is not free of rabies and transmission is reported in some areas. The main animal appears to be the mongoose but obviously try and make sure that you have no exposure to any warm blooded animals. If by any chance you are bitten immediatly wash out the wound, apply an antiseptic and seek medical attention.
Asthmatics;
Because of the dense foliage and high pollen levels the climate may adversly affect some asthma sufferers.
Food & Water Borne Disease;
By comparison to many of the hotter areas throughout the world Jamaica has high health standards. Despite this it would be unwise to take risks so follow simple common- sense rules
* Drink only bottled water (and use it for brushing your teeth)
* Don’t use ice cubes in your drinks
* Eat only food served hot and avoid all shell fish
* Only pasturised dairy products should be consumed
* Don’t eat food from street vendors
Blood Borne Disease
Unfortunately, as in most other countries, AIDs does occur and the blood supply may not be adequately screened.
Swimming in Jamaica;
Beautiful beaches make swimming a must for your holiday but be careful of the coral and also jellyfish. The hot sand may burn your feet so always use flip flops when walking on the beach.
Vaccinations;
None are essential for entry/exit purposes but it is wise to at least protect yourself against * Polio
* Typhoid
* Tetanus
* Hepatitis A
Other vaccines may be required for travellers intending to trek through Jamaica or those who will be undertaking extensive adventure sports. Also remember that if you initially visit a Central or South American country before Jamaica then Yellow Fever vaccine may be required.
General Comments;
Some of the items above may seem too serious to consider a holiday in Jamaica. Nevertheless the vast majority of travellers have a marvellous holiday and develop no sickness following their visit. Some simple commonsense is mainly all that is required. For further information please contact the Tropical Medical Bureau - Dublin.

Travel News Headlines WORLD NEWS

21 Feb 2019

https://travelhealthpro.org.uk/news/390/dengue-outbreak-in-the-caribbean
Dengue outbreak in the Caribbean

Dengue outbreak in the Caribbean

Reported via Travel Health Pro:  As of 17 January 2019 and following a recent report of increased cases of dengue in Jamaica in January 2019 [1], the Caribbean Public Health Agency (CARPHA) has advised that there is a possibility of an outbreak of dengue in the Caribbean region [2]. The last major regional outbreak occurred in 2009 [1]. Countries in the region have been advised to increase their disease surveillance measures. Residents and travellers are advised to take measures to reduce mosquito breeding sites and follow mosquito bite prevention advice.

Dengue is a viral infection transmitted through the bite of an infected Aedes mosquito. Although most patients with dengue will recover spontaneously, a small number will develop more severe life-threatening forms of the disease. Dengue is common in the tropics including the Caribbean, South and Central America, Africa, SE Asia, the Indian sub-continent and the Pacific Islands.

Check our Country Information pages for individual country recommendations.

Date: Mon 14 ay 2918
Source: Loop [edited]

A new species of mosquito has been discovered in Jamaica. It is the Asian tiger mosquito or _Aedes albopictus_, which is similar to the _A. aegypti_ mosquito, which is endemic to Jamaica and which transmits the dengue, chikungunya, Zika, and other viruses.

Acting Chief Public Health Inspector for St Catherine, Grayston Hutchinson told last Thursday's [10 May 2018] monthly meeting of the St Catherine Municipal Corporation that the Asia tiger mosquito was discovered following surveillance throughout the island.

He was responding to questions from councillors attending the monthly meeting.

The tiger mosquito is so named because of its striped appearance, which resembles that of the tiger.

Similar to the _Aedes aegypti_ mosquito, the female is the carrier of several viruses, including yellow fever, dengue, chikungunya, and Zika.
===================
[_Aedes albopictus_ has been expanding throughout the world including in North, Central America, and Caribbean: Barbados (not established), Belize, Cayman Islands, Costa Rica, Cuba, Dominican Republic, El Salvador, Guatemala, Haiti, Honduras, Mexico, Nicaragua, Panama, Trinidad (not established), and USA (<https://ecdc.europa.eu/en/disease-vectors/facts/mosquito-factsheets/aedes-albopictus>). It is not surprising that it has been found in Jamaica. It was found last year (2017) in several locations in southern California and is distributed across the southern USA and more recently in the northern states.

Reference
---------
Bonizzoni M, Gasperi G, Chen X, James AA. The invasive mosquito species _Aedes albopictus_: current knowledge and future perspectives. Trends Parasitol. 2013; 29(9): 460-8. doi: 10.1016/j.pt.2013.07.003; <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3777778/> - ProMED Mod.TY]

[HealthMap/ProMED-mail map
Date: Fri 23 Oct 2015
Source: Jamaica Observer [edited]

Consultant congenital cardiologist Dr Sandra Williams-Phillips says she has treated at least 12 cases of the feared mosquito-borne Zika virus (ZIK-V) [infection] and that she has written to Health Minister Dr Fenton Ferguson on the matter.

Speaking on a daytime radio programme yesterday [22 Oct 2015], Dr Williams-Phillips said she had received no response to her e-mail to Dr Ferguson, although she could not confirm that the minister had received her correspondence.

The medical doctor of 34 years said she was among the 1st local doctors to identify the presence of the chikungunya virus, which wreaked havoc on the country last year [2014], but that her diagnoses had not been taken seriously.

Dr Williams-Phillips, who treats paediatric as well as adult cases of congenital heart disease, said some of her patients who presented symptoms of the Zika virus [infection] were children. She argued strongly that the symptoms she had seen were convincing enough to diagnose the virus even in the absence of lab tests.

Late yesterday afternoon [22 Oct 2015], on another radio programme, chief medical officer (CMO) in the health ministry, Dr Marion Bullock Ducasse, said the ministry would be launching an investigation into the matter. She said that, even if the patients had recovered, tests could still prove whether they had in fact been infected with the virus.

The CMO said she could not speak on whether Dr Ferguson was in receipt of a report about the cases, but that no official report had come to the ministry from St Catherine [parish], where Dr Williams-Phillips said she treated patients, via the standard reporting system for these types of events.

The CMO has maintained over the past several months, that there are no confirmed cases of the Zika virus in Jamaica. Earlier this month [October 2015], the ministry said a sample which it had sent to the Caribbean Public Health Agency (CARPHA) in September [2015] tested negative for chikungunya, dengue and Zika viruses. "Outside of Brazil [and more recently, Colombia], there have been no cases confirmed in any country in the Latin American and Caribbean region, including Jamaica," Dr Ferguson said at a hand, foot and mouth disease press conference on 2 Oct [2015].

The ministry has also refuted claims by Opposition spokesperson on health, Senator Marlene Malahoo-Forte, that she had been reliably informed about 3 confirmed cases of Zika virus. "I have heard that there are confirmed cases of the Zika virus here.... I got a call from someone whose employee was tested, and I'm reliably advised that it is a confirmed case," Malahoo-Forte stated at a press conference a few weeks ago.

The Pan American Health Organisation (PAHO) in May [2015] issued a warning about an outbreak of Zika in Brazil and said there was potential for it to spread to other countries.

The virus causes symptoms which are similar to CHIKV [chikungunya virus] and is transmitted by the same vector -- the _Aedes aegypti_ mosquito.

Communities have been plagued by mosquitoes over the past few weeks, with residents in Portmore [Saint Catherine parish] in particular complaining bitterly about the insects, which they say have descended on their homes in droves. The nuisance is also evident in the Corporate Area [Kingston area], and has citizens concerned about whether the country could soon find itself in the throes of yet another mosquito-borne disease.  [Byline: Alphea Saunders]
====================
[The situation in Jamaica is not clear at the moment. Because infections with Zika, dengue and chikungunya viruses are difficult to distinguish from each other clinically, laboratory confirmation is essential. One hopes that laboratory tests will be carried out to confirm or rule out Zika virus infections in these cases. It would be of interest to know where the confirmed cases reported by the Opposition Senator were tested, if they were tested at all. ProMED awaits further news from Jamaica with interest.

A HealthMap/ProMED-mail map of Jamaica can be accessed at
Date: Fri 11 Jan 2013
Source: Jamaica Gleaner [edited]

The health sector is in a frenzy after the revelation that a Jamaican was on the weekend diagnosed with the highly contagious disease malaria after a recent visit to a country on the African continent.

The infected man was hospitalised and isolated in order to be treated for the illness. "He has responded to treatment, and the region has contacted persons with whom he had close contact and advised those persons as well as the medical facilities in the areas (where) those persons are so that they can take the necessary precautions," he said.  [Byline: Nadisha Hunter]
*****************************
Date: 12 Jan 2013
Source: Caribbean 360 [edited]

The Jamaican government on Friday [11 Jan 2013] dismissed media reports that the island is on alert following an outbreak of malaria fever.

Chief Medical Officer Dr. Michael Coombs in a statement said that the island has had no locally transmitted cases of malaria since 2009.

Last year [2012], there were 5 imported cases of malaria and one confirmed case so far this year [2013].

Dr. Coombs said, regarding the media reports of the imported case, that so far this year [2013], the Ministry of Health has been managing the patient according to World Health Organization guidelines.

"Our public health team has visited the community to check persons with whom the patient had contact. The ministry is also continuing its routine surveillance, which will allow us to be in a position to quickly identify and treat persons if the need arises," Dr. Coombs said.

Malaria, caused by the malaria parasite, is spread when the _Anopheles_ mosquito bites an infected person and then bites others. There is no direct person-to-person transmission. Symptoms include fever, chills, headache, muscle aches, and fatigue. Nausea, vomiting, and diarrhoea are also possible.

Health authorities Friday [11 Jan 2013] urged residents to continue efforts to destroy mosquito breeding sites and protect themselves from mosquito bites.

Dr. Coombs is also advising people to check with the Ministry of Health or their Parish Health Department before they travel to ensure that they take the necessary health related precautionary measures.

There are some countries for which persons need certain vaccines or prophylaxis before they travel.

"We are urging persons to check with us if they are not sure about the requirements for a particular country. This is important to prevent illness and the spread of certain diseases among our population," Dr. Coombs said.
=========================
[The last case of autochthonous malaria in Jamaica was reported in ProMED in 2010. The outbreak started in 2006, and the peak was in 2007 (see reports below). Cases imported from highly endemic areas, such as tropical Africa, are recurrent events, and the last reported case from Jamaica was a patient infected in Haiti.

The outbreaks from 2006-2010 illustrate that transmission potential exists in Jamaica for the reintroduction of autochthonous malaria. Jamaica was declared malaria free in 1972. - ProMed Mod.EP]

[A HealthMap/ProMED-mail map can be accessed at:
<http://healthmap.org/r/1_g4>.]
Sunday 17th June 2012
A ProMED-mail post
<http://www.promedmail.org>

- Jamaica. 13 Jun 2012. Jamaican health officials have warned that there has been a spike in dengue fever cases, but says it is not at the level of an outbreak. Director of Emergency Services in the Ministry of Health, Dr. Marion Bullock-Duccase, said several cases have been reported in Kingston and St. Andrew and 2 other parishes, but adds this is not unusual at this time of the year.
===================
[A HealthMap/ProMED-mail interactive map showing the location of Jamaica can be accessed at <http://healthmap.org/r/00Vh>. - ProMed Mod.TY]
More ...

Moldova

Moldova - US Consular Information Sheet
October 10, 2008
COUNTRY DESCRIPTION:
Moldova is a republic with a freely elected government. It has been an independent nation since 1991. Its capital, Chisinau, offers adequate hotels and restauran
s, but tourist facilities in other parts of the country are not highly developed, and many of the goods and services taken for granted in other countries are not yet available. Read the Department of State Background Notes on Moldova for additional information.
ENTRY/EXIT REQUIREMENTS: Since January 1, 2007, citizens of the United States, EU member states, Canada, Switzerland, and Japan do not require visas to enter Moldova. For more information on entry requirements, please contact the Moldovan Embassy, 2101 S Street N.W., Washington, D.C. 20008, telephone: (202) 667-1130, (202) 667-1131, or (202) 667-1137, fax: (202) 667-1204, e-mail: moldova@dgs.dgsys.com. Travelers may also wish to consult the Embassy of Moldova’s web site at http://embassyrm.org/en/cons-serv/visas.html for general information on Moldovan visas and for application forms.

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:
The U.S. Government has no information related to the targeting of U.S. citizens, interests or facilities by terrorist organizations in Moldova, and no Americans have been killed or injured as a result of terrorist activity in Moldova. However, the U.S. government remains deeply concerned about the heightened threat of terrorist attacks against U.S. citizens and interests abroad. Americans are reminded to remain vigilant with regard to their personal security and to exercise caution. Because Moldovan Government authorities often ask to see identification on the street, Americans should carry a copy of their passport with them at all times.
There is a separatist regime in control of the Transnistria region that is not recognized by the United States. Consular assistance to American citizens in that region cannot be ensured. Travelers should exercise caution when visiting or transiting Transnistria. Travelers should be aware that there are numerous road checkpoints along roads leading into and out from Transnistria. Taking photographs of military facilities, public buildings, and security forces, including checkpoints along roads leading into and out from Transnistria, is strictly prohibited.

Racially motivated incidents against foreigners and persons of color have occurred in Moldova. Persons of African, Asian, or Arab heritage may be subject to various types of harassment, such as verbal abuse, and denied entrance into some clubs and restaurants. These Americans are also at risk for harassment by police authorities.

In some instances, Americans have become victims of harassment, mistreatment and extortion by Moldovan law enforcement and other officials. Low-level bribery attempts are commonplace in Moldova. These encounters should always be reported to the U.S. Embassy. Moldovan authorities have cooperated in investigating such cases, but those investigations enjoy the greatest chance of success when the officer is identified by name, physical description, or other identifying characteristics. Please note this information if you ever have a problem with police or other officials. Americans who have refused to pay bribes in Moldova generally report no consequences beyond being delayed or inconvenienced.
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: Moldova’s economic difficulties, as well as organized criminal activity and more frequent travel by foreigners to Moldova, contribute to the risk visitors face from street crime, some potentially violent. While this risk is no greater than in most cities in the United States, many Americans have reported theft of money and small valuables from hotel rooms and local apartments. Cases of breaking and entering into homes and offices have occurred. Sexual assault against foreigners is rare. Travelers are wise to exercise the same precautions with regard to personal safety and protection of valuables in Chisinau that they would in any major U.S. city.
Precautions should also be taken when using ATMs in Moldova. Some Americans have reported unauthorized withdrawals from their accounts after using ATMs. Instances have been reported of PIN theft from use of ATMs in Moldova, either by “skimming” devices, which record the ATM card information while in use, or by surreptitious observation.

Train and bus services are below Western European standards and some U.S. citizens have been victims of crimes involving thefts while traveling on international trains to and from Moldova.
Americans who use the Moldovan postal service report frequent losses from international letter and package mail.
Internet Fraud Warning: The Embassy is aware of various confidence schemes that have taken advantage of American citizens, frequently via the Internet. In some cases these involve the purchase or sale of items on the Internet in which the payment or shipment of goods was not completed by a Moldovan counterpart. In the spring of 2006, Moldovan police recovered over $250,000 in jewelry that was sent to “buyers” in Moldova from the United States via fake online escrow companies. Substantial criminal enterprises specializing in this type of crime (Internet auction fraud) have emerged in Moldova. In other cases, American citizens, particularly males, have met potential Moldovan fiancé(e)s on the Internet who have convinced them to send hundreds or even thousands of dollars, but have no intention of a serious relationship. Once the American citizen starts to question the reason for sending the money, the Moldovan fiancé(e)s suddenly ends his/her contact. On occasion, American citizens who come to Moldova to visit someone they have first met over the Internet have reported becoming subject to crimes such as extortion and involuntary detention. American citizens should be aware that any such activity committed by individuals in Moldova is subject to the Moldovan legal system and could prove difficult to prosecute. In the vast majority of cases, there is little that the U.S. Embassy can do to assist American citizens who are defrauded by Moldovans via the Internet.
Please see our information on International Financial Scams.
INFORMATION FOR VICTIMS OF CRIME: The loss or theft abroad of a U.S. passport should be reported immediately to the local police and the nearest U.S. Embassy or Consulate. If you are the victim of a crime while overseas, in addition to reporting to local police, please contact the nearest U.S. Embassy or Consulate for assistance. The Embassy/Consulate staff can, for example, assist you to find appropriate medical care, contact family members or friends and explain how funds could be transferred. Although the investigation and prosecution of the crime is solely the responsibility of local authorities, consular officers can help you to understand the local criminal justice process and to find an attorney if needed.

The local equivalent to the “911” emergency line in Moldova is: 9-0-2 (Police Assistance) or 9-0-3 (Ambulance Assistance)
See our information on Victims of Crime.
MEDICAL FACILITIES AND HEALTH INFORMATION: Medical care in Moldova is substandard throughout the country, including Chisinau. In the event of serious medical conditions every effort should be made to go to Western Europe. In the event of emergency, travelers should attempt first to contact the local ambulance service, which is trained to determine which medical facility is most appropriate for treatment and will transport the injured or sick person to that location. Hospital accommodations are inadequate throughout the country and advanced technology is lacking. Shortages of routine medications and supplies may be encountered. Elderly travelers and those with existing health problems may be at particular risk due to inadequate medical facilities. The U.S. Embassy maintains lists of medical facilities and English-speaking doctors, but cannot guarantee or endorse competence. Visitors to Moldova are advised to bring their own supply of both prescription and common over-the-counter medications. Pharmacies are not stocked to Western standards and products are not labeled in English. Poor quality and/or fraudulent medications have been reported.
HIV/AIDS restrictions: Some HIV/AIDS entry restrictions exist for visitors to or foreign residents of Moldova. Short term visitors (periods of less than 90 days) do not require HIV testing. Applicants for residence permits, however, are required to submit to a HIV test and demonstrate that they are HIV negative. Please verify this information with the Embassy of Moldova at www.embassyrm.org before you travel.

Medical Information: Tuberculosis is an increasingly serious health concern in Moldova; the World Health Organization (WHO) has placed it in its “highest risk” category. Travelers planning to stay in Moldova for more than 3 months should have a pre-departure PPD skin test status documented. Given the way TB is transmitted, travelers should consider limiting their exposure to TB by avoiding crowded public places and public transportation whenever possible. Domestic help should be screened for TB. For further information, please consult the CDC's Travel Notice on TB at http://wwwn.cdc.gov/travel/yellowBookCh4-TB.aspx.
Other major health concerns include Hepatitis A (food-borne), Hepatitis B, and Hepatitis C (blood- and body fluids-borne). The incidence of sexually transmitted diseases is as "high" as it is in most developing countries.

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 WHO’s 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 if 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 Moldova is provided for general reference only, and may not be totally accurate in a particular location or circumstance.
Moldova’s highway infrastructure consists mainly of two-lane roads that often lack markings or signage, are unevenly maintained, and seldom have lighting. Caution should be taken to prevent collisions with agricultural vehicles and/or livestock. Urban roads in Moldova are infrequently maintained and often lack clear signs or lane markings. Travel outside of urban areas before dawn and after dusk should be avoided if at all possible. Drivers and pedestrians should exercise extreme caution to avoid accidents, which are commonplace. Many Moldovan drivers would be considered aggressive or erratic by American standards. Many accidents involve drunk drivers. The quality and safety of public transportation vary widely. Trains, trolleybuses, and buses are often old and may frequently break down. Taxis are available in most urban areas, and vary from old Soviet-era vehicles to newer, Western European or American model vehicles. Emergency services are generally responsive. Police emergency assistance can be called at 902 and emergency ambulance at 903.
Please refer to our Road Safety page for more information. Visit the web site of the Moldova’s national tourist office at http://www.turism.md/
AVIATION SAFETY OVERSIGHT: As there is no direct commercial air service to the United States by carriers registered in Moldova, the U.S. Federal Aviation Administration (FAA) has not assessed Moldova’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: Travelers are advised to register any foreign currency brought into Moldova with customs authorities upon entering the country. It is advisable to contact the Embassy of Moldova in Washington for specific information regarding customs requirements. Please see our Customs Information.
Visas and residency: Current Moldovan Government (GOM) border registration procedures will remain unchanged under the new immigration law. As of January 1, 2007, U.S. and most other foreign nationals arriving in Moldova do not require a visa and are permitted stays of up to 90 days in any given six-month period. At the point of entry (i.e., airport or border), the Border Guard Service enters the traveler’s personal data into a computer program and transfers the data to the GOM’s Population Register. Visitors are not given a paper “registration receipt.” U.S. citizens are able to enter Moldova through Transnistria. However, because they will not have been registered at the border, they will still have to register with the nearest office of the Ministry of Information Development (MID) within three days of arrival in right-bank (western) Moldova.

For stays exceeding 90 days, foreign nationals are required to obtain “immigration certificates” and residence permits from the National Bureau for Migration. Foreign nationals planning to work in Moldova must also obtain a work permit. Immigration, residence and work permits usually need to be extended annually, but may be issued for up to five years.
For more information on registering with Moldovan authorities, U.S. citizens are encouraged to call the Consular section of the U.S. Embassy in Chisinau at (373) (22) 40-83-00.
Requirement to Carry Documentation: As noted above, Moldovan police have the right to request identity documents from any person. Individuals who fail to produce appropriate ID upon request may be subject to detention and fines. Therefore, Americans are advised to carry their U.S. passports (or a copy of their passport’s biographic information page) with registration card, if applicable, or a Moldovan-issued identification document when in public.
Consular Access: Moldovan law enforcement authorities, particularly in the Transnistria region, have an uneven record of reporting the arrest or detention of American citizens to the U.S. Embassy, as required under international agreements. American citizens are therefore advised that if they are detained or arrested by Moldovan authorities, they should immediately request that the U.S. Embassy be contacted. Moldovan authorities have generally respected such requests in a prompt manner.
Photography: Americans who choose to travel in Transnistria should be aware that foreigners have reported being detained or harassed by authorities for taking photographs of military facilities or public buildings. Photography of checkpoints along roads leading into and out from the Transnistria region, or the personnel working there, is prohibited.
Dual Nationality: Recent Moldovan legislation allows dual citizenship. There is no requirement that dual nationals enter Moldova on their Moldovan passports. For further questions, please contact the Moldovan Embassy in Washington, D.C.

Telephone and Postal Services: Outside of Chisinau, travelers may have difficulty finding public telephones and receiving or making international and local calls. Losses have been reported from international letter and package mail, both of which are subject to a customs inspection before delivery. “Express” mail services such as DHL and Federal Express are available in Chisinau, although in most instances prices are high, and shipments arrive from (or reach) the United States in no less than five (5) business days.
Disabled Access: Persons with disabilities should be aware that public facilities and transportation in Moldova are rarely designed or built in a way that allows for wheelchair access. Wheelchair entrances, ramps, lifts or similar accommodations are rare; those that do exist are often below Western standards and/or poorly maintained. Most streets, sidewalks and other public paths are not well maintained and can be hazardous, particularly in poor weather conditions.
Commercial Transactions: Although still generally a cash-only economy, traveler’s checks and credit cards may be accepted in Chisinau, although locations that will accept them outside the capital are still rare. Some vendors require the customer dial in a PIN to authorize a sale by credit card. Caution is advised, however, as some travelers have reported incidents of unauthorized expenditures made on credit cards during or following their use in Moldova, and there have also been reported incidents of fraud and account theft using bank machines (ATMs – see “CRIME” above).
Business in Transnistria: As noted in the Safety and Security section above, a separatist regime controls a narrow strip of land in eastern Moldova known as Transnistria ("Pridnestrovie" in Russian). Individuals considering doing business in Transnistria should exercise extreme caution. The Embassy may not be able to offer consular or commercial services to Americans in Transnistria. Moldovan law requires firms (including those located in Transnistria) to register with the Moldovan Government and to use Moldovan customs seals on their exports. Under a December 2005 agreement between Moldova and Ukraine, Ukrainian customs and border officials require Moldovan customs seals on goods exported from Moldova, including Transnistria, and are enforcing this requirement with EU assistance. Transnistrian firms not legally registered with Moldovan authorities operate in contravention of Moldovan law, which may complicate or prevent the import or export of goods. The Government of Moldova has indicated that it will not recognize the validity of contracts for the privatization of firms in Transnistria that are concluded without the approval of the appropriate Moldovan authorities. A number of Internet fraud schemes have originated in Transnistria.
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 Moldovan laws, even unknowingly, may be expelled, arrested or imprisoned. Penalties for possession, use, or trafficking in illegal drugs in Moldova are severe, and convicted offenders can expect long jail sentences and heavy fines. Engaging in illicit sexual conduct with children or using or disseminating child pornography in a foreign country is a crime, prosecutable in the United States. Please see our information on Criminal Penalties.

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

REGISTRATION / EMBASSY LOCATION:
Americans living or traveling in Moldova are encouraged to register with the U.S. Embassy through the State Department’s travel registration web site, and to obtain updated information on travel and security within Moldova. Americans without Internet access may register directly with the U.S. Embassy. By registering, American citizens make it easier for the Embassy to contact them in case of emergency. The U.S. Embassy is located in Chisinau, Moldova, Strada Alexei Mateevici 103; telephone: (373)(22) 23-37-72, after-hours telephone: (373)(22) 23-73-45; Consular Section Fax: (373)(22) 22-63-61. The Embassy’s web site is http://moldova.usembassy.gov
* * *
This replaces the Consular Information Sheet dated January 18, 2008, to update sections on Entry/Exit Requirements, Safety and Security, Medical Facilities and Health Information, and Special Circumstances.

Travel News Headlines WORLD NEWS

Date: Wed 10 Sep 2014
Source: Jurnal.md [in Romanian, transl., edited]

Cahul: 3 [more] people hospitalized with anthrax
------------------------------------------------
The number of cases of anthrax in the South [of Moldova] increased from day to day. According to the National Center for Public Health, a further 3 people infected with anthrax, cutaneous form, were admitted to the infectious diseases ward in Cahul District Hospital.

Two patients, one woman and her son, were infected from slaughtering a sick sheep. The case was registered for the village of Vadul Isaac, where 6 other people were earlier infected with the same disease after killing [and butchering] a sick calf.

The 3rd patient is a native of the village of Crihana. He became ill after visiting a cattle farm where an animal was slaughtered and butchered in Vad Isaac, which is under quarantine. He was also admitted to the District Hospital in Cahul.

Initially, a man infected with cutaneous anthrax came to the Crihana village hospital. Health of all patients is satisfactory. They are to be discharged after 2 weeks.
-------------------------------------
Communicated by:
Sabine Zentis
Castleview English Longhorns
Gut Laach
D-52385 Nideggen
Germany
======================
[To find Cahul district in south west Moldova on the Romanian border, go to:

So to date we have 9 cases, with one dying. This is probably a sound conservative set of numbers when considering what one sick animal, apparently a "calf", can do. Where more care is taken handling dead animals, the number can be flipped to have one human case for every 10 sick animals butchered or rendered. When there is a bias to only report human cases, it can be a guessing game as to the numbers of animals involved. With thanks, as usual, to Sabine. - ProMed Mod.MHJ]

[A HealthMap/ProMED-mail map can be accessed at:
Date: 5 Sep 2014
Source: Itar-Tass [edited]

A total of 6 workers of a livestock farm in the Cahul district of Moldova have been hospitalized on the suspicion of contracting anthrax, the national Healthcare Ministry said on Friday [5 Sep 2014].

"The patients are in a satisfactory condition, and the illness makes itself manifest mostly in skin lesions, but they have a normal temperature," Viktor Dyatishin, the head doctor of the infectious diseases hospital in Chisinau told reporters. "They will stay at hospital for about 2 weeks until full recovery."

The previous case of anthrax in Moldova was reported last year [2013]. The experts point to the numerous livestock burial sites -- from where anthrax spores can be washed out on to fields and into rivers by rainwater -- as the main source of the incident.

Moldova's sanitary, veterinary and epidemiological services were taking urgent steps on Friday [5 Sep 2014] to localize the dangerous infection.
-----------------------------
communicated by:
Sabine Zentis
Castleview English Longhorns
Gut Laach
D-52385 Nideggen, Germany
******************************
Date: 5 Sep 2014
Source: Press.try.md [edited]

Five people were diagnosed with anthrax yesterday [4 Sep 2014] at the Chisinau infectious diseases hospital. All patients are residents of the Cahul district.

The 1st ill person with symptoms of an open form of anthrax was delivered on Wednesday [3 Sep 2014] to a hospital in the Cahul village of Vadul. He is known to the employee of a private farm in the village.

Under suspicion of doctors were another 4 people. Their relatives say that the 1st symptoms appeared a few days ago, but local doctors gave them the wrong diagnosis. "[He had a fever]; he was sick; his appetite disappeared. [They] gave him headache tablets, but he still complained of feeling unwell."

The woman and her son ate food prepared from contaminated meat. Now they are under the supervision of doctors. "[We bought] half of the cow's head; someone took the other. He has some kind of sore on his leg."

Accidentally or not, one of the men who participated in the slaughter of cattle died. "He died at the hospital. We were not allowed to visit him. The cause of death not reported. He had some sores on his feet."

The mayor of the village said that the owner of the farm knew that the cows were sick but had not reported it to the authorities. "The 1st cases in animals appeared on 9 Aug 2014. Cows died, but the incident was [not] reported to any veterinary service or to the National Centre of Public Health," said the mayor of the village of Vadul.

All 5 were hospitalized in the capital hospital. "The patients are satisfactory; [their] temperature is normal. They will stay with us for about 2 weeks for treatment until they are cured," said the director of the hospital.

Representatives of the agency's food safety say that animals that carry the dangerous disease have not been vaccinated. "The animals were vaccinated. Still, cows were not vaccinated, because they have entered a period of maturation" [whatever that might mean. - ProMed Mod.MHJ], said the head of the agency's food security, Gregory Porchesku.

Epidemiologists went from Chisinau to study the situation on the ground in the Cahul district. Everyone who has been in contact with patients is under the supervision of physicians. A vaccination [campaign] for all the cattle in the village has still to occur.
---------------------------------------------------
communicated by:
Sabine Zentis
Castleview English Longhorns
Gut Laach
D-52385 Nideggen, Germany
==========================
[These Moldovan accounts are confused. The simplest explanation would be that 5 patients are in hospital under treatment doing well and for some reason will be released in 2 weeks time, which is a fair period if they are without a raised temperature. At some point, a 6th person died who had skin lesions. As "suspected" is used in relation to their diseased conditions, it would seem that if any samples were taken for laboratory analysis, the results are not back yet -- that is, the diagnoses were symptomatic, thus the prescription for headache. - ProMed Mod.MHJ]

[A HealthMap/ProMED-mail map can be accessed at:
Date: Sun, 27 Apr 2014 14:12:01 +0200 (METDST)

BRUSSELS, April 27, 2014 (AFP) - Citizens of Ukraine's neighbour Moldova will be granted visa-free travel from Monday to most European Union nations as part of the country's bid to sign an association deal with the EU bloc.

The decision shows that "closer relations with the European Union do bring tangible benefits to all," said the EU's home affairs commissioner Cecilia Malmstroem.   Under the deal, Moldovans carrying a biometric passport will be authorised to travel without a visa for short stays to the Schengen zone, which currently comprises 26 countries, 22 of them members of the 28-nation EU.   Between 50,000 and 55,000 Moldova nationals apply for short-term visas into the EU each year.

Moldova is one of the six former Soviet satellites that the EU hoped to draw into a wide-ranging Eastern Partnership programme on its eastern flank until Armenia, Azerbaijan and Belarus decided to turn back towards Moscow, and Ukraine's ousted leader Viktor Yanukovych too backed out in November at Russia's behest.

Moldova and Georgia however stood firm, initialling the partnership programme in November. They are expected to sign a final association deal with the EU in June.   Wedged between Romania to the west and Ukraine to the east, Moldova's 3.5 million people are Europe's poorest.   In the capital Chisinau there was a mixed response to the new visa-free travel, with a poll showing 50 percent of respondents underwhelmed on the grounds they were either too poor to travel or already owned a Romanian passport opening the door to the EU.
Date: Sun 7 Jul 2013
Source: Liga Novosti [in Russian, trans. ProMed Mod.NP, edited]

The Ministry of Health of Moldova has reported an outbreak of anthrax in the village of Veden, in Soroca district, located in northeast Moldova close to the border with Ukraine. Results of an epidemiological survey of several inhabitants of the village revealed the 4 patients were infected after a meal in which the main dish was freshly cooked beef.

All patients were hospitalized to the Republican Infectious Diseases hospital: one of them is in critical condition and the other 3 are in the moderately severe condition.

Specialists of Ministry of Agriculture of Moldova are providing the measures for the localization of the infection to prevent the spread of infection. [Presumably livestock vaccination and destruction of any contaminated meat. - ProMed Mod.MHJ]
==================
[This outbreak is to the north of the previous report of human cases in Dubasari district (Transnistria) and probably reflects an ongoing problem which gathers few reports.

>From their reports to OIE, anthrax in Moldova is sporadic with few outbreaks. And yet it receives considerable government attention via vaccination. For example, in 2012 vaccination coverage for cattle was 226 871/221 113 (103 percent), sheep & goats 937 421/908 079 (103 percent), horses 40 722/49 319 (83 percent), and pigs 3636/496 634 (0.7 percent). Outbreaks occur among pigs almost as frequently as reported for cattle. The last reported outbreak in sheep and goats was in 2004. With this level of vaccination the disease is clearly of concern, and possibly the problem is of poor reporting and poor usage of the vaccines distributed.

A HealthMap/ProMED-mail interactive map of Moldova can be seen at <http://healthmap.org/r/7ytP>.

To find Soroca district in northeastern Moldova, go to

Our thanks to Natalia for the translation. - ProMed Mod.MHJ]
Date: Tue 18 Jun 2013
Source: EVZ.ro [in Romanian, trans., edited]

A suspected case of anthrax has been recorded in Dubasari in Transnistria, in a private household.  According to Tiraspol press, the results of laboratory tests are currently expected to determine if it really is about the disease "mad cow". [Why is "mad cow" not explained? - ProMed Mod.MHJ]

The Regional Veterinarians normally take preventive measures to avoid the possible spread of the disease. Local media did not specify what it is, and the Dubasari President, Gregory Policinschi, did not know any details.

The last case of anthrax disease of animals in Moldova was registered in March last year [2012, in Riscani], and in 2011, 2 [porcine] cases were reported. Anthrax is a potentially fatal disease caused by the bacterium _Bacillus anthracis_. It occurs in cattle, horses, sheep, and goats.  [Byline: Roxana Roseti]
-----------------------------------------------
Communicated by:
Sabine Zentis
Castleview Pedigree English Longhorns
Gut Laach
52385 Nideggen
Germany
cvlonghorns@aol.com
=========================
[As at least one of the 2 cases in Dubasari has died I think we can presume that this report refers to livestock cases, and as they quote "mad cow" probably bovine.  A HealthMap/ProMED-mail interactive map of Moldova can be seen at <http://healthmap.org/r/7pn0>. For the location of Dubasari and Transnistria in a map of Moldova, go to <http://www.lib.utexas.edu/maps/commonwealth/moldova_pol01.jpg>; Dubasari Province is currently under the administration of the breakaway government of the Moldovan Republic of Transnistria. - ProMed Mod.MHJ]
More ...

Burkina Faso

Burkina Faso US Consular Information Sheet
May 07, 2008
COUNTRY DESCRIPTION:
Burkina Faso, previously known as Upper Volta, is a landlocked, developing country in the Sahel region of West Africa.
Its capital is Ouagadougou.
Burki
a Faso is a former French colony; the official language is French.
It is one of the world’s poorest countries, and tourism infrastructure is limited.
Please read the Department of State Background Notes on Burkina Faso for additional information.

ENTRY/EXIT REQUIREMENTS:
A valid passport, visa, evidence of yellow-fever vaccination are required for entry into the country. Visas valid for seven days are available at land borders and for 21 days at the airport; however, both can be converted into visas of up to five years validity at the Direction du Controle des Migrations, a government office in central Ouagadougou.
U.S. travelers should obtain longer-validity visas from the Embassy of Burkina Faso, 2340 Massachusetts Avenue NW, Washington, DC
20008, telephone (202) 332-5577. Overseas inquiries should be made at the nearest Burkinabe embassy or consulate.
Visit the Embassy of Burkina Faso web site at http://www.burkinaembassy-usa.org/ for the most current visa information.
Information about dual nationality or the prevention of international child abduction can be found on our web site.
For further information about customs regulations, please read our Customs Information sheet.

SAFETY AND SECURITY:
Ouagadougou occasionally experiences demonstrations and civil unrest.
U.S. citizens traveling to and residing in Burkina Faso are urged to exercise caution and maintain a high level of security awareness at all times.
Although most demonstrations are generally peaceful, there have been several incidents of violence and destruction within recent years.
U.S. citizens should avoid crowds, political gatherings, and street demonstrations, even if they appear to be peaceful.
There have been no known terrorist incidents (bombings, hijackings or kidnappings) directed against foreigners in Burkina Faso.
Up-to-date information on safety and security can also be obtained by calling 1-888-407-4747 toll free in the U.S., or for callers outside the U.S. and Canada, a regular toll-line at 1-202-501-4444.
These numbers are available from 8:00 a.m. to 8:00 p.m. Eastern Time, Monday through Friday (except U.S. federal holidays).

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

CRIME:
Street crime in Burkina Faso poses high risks for visitors. Most reported incidents involve purse-snatchers and street scam artists, who target wallets, jewelry, cell phones and other valuables. Thieves are especially active during international meetings or events, which draw large crowds to the capital. The areas near and around the U.N. Circle, Avenue Kwame N’Krumah, and the former Central Market in Ouagadougou experience the highest incidence of purse snatchings and muggings. Travelers should stay alert, remain in groups, and avoid poorly lit areas. Be especially cautious at night, when most reported incidents have taken place.
There continue to be frequent armed robberies and attacks on intercity roads throughout the country. Although these armed individuals and groups operate mostly at night, there have been daytime attacks. They have injured and/or killed individuals who refused their demands or attempted to drive through their roadblocks. Several attacks have been directed at intercity public buses. U.S. travelers should avoid all intercity travel at night. Check with the U.S. Embassy for the latest security information before setting out on your journey.

Perpetrators of business fraud often target foreigners.
Recent scams that have victimized U.S. citizens have taken many forms, including fraudulent transactions for gold and antiquities.
Typically these scams begin with an unsolicited communication (usually by e-mail) from an unknown person who describes a situation that promises quick financial gain, often involving the transfer of a large sum of money or valuables out of the country. A series of "advance fees" must be paid to conclude the transaction, such as fees to provide legal documents or to pay certain taxes. In fact, the final payoff does not exist; the purpose of the scam is simply to collect the advance fees. One common variation involves individuals claiming to be refugees or other victims of western African conflicts who contact U.S. citizens to request help in transferring large sums of money out of Burkina Faso. Another typical ploy involves persons claiming to be related to present or former political leaders who need assistance to transfer large sums of cash.

While such fraud schemes in the past have been associated with Nigeria, they are now prevalent throughout West Africa. The scams pose a danger of both financial loss and physical harm.
You should carefully check and research any business proposal originating in Burkina Faso or elsewhere before you commit any funds, provide any goods or services, or undertake any travel. For additional information on scams, see the Department of State’s publication, International Financial Scams.

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

MEDICAL FACILITIES AND HEALTH INFORMATION:
Medical facilities and emergency hospital care are very limited, particularly in areas outside the capital, Ouagadougou.
Some medicines are, however, available through local pharmacies.
Travelers requiring medicines should bring an adequate supply for the duration of their stay in Burkina Faso.
Malaria is a serious risk to travelers in Burkina Faso.
Travelers who become ill with a fever or flu-like illness while traveling in a malaria-risk area and up to one year after returning home should seek prompt medical attention and tell the physician their travel history and what anti-malarial drugs they have been taking. For additional information on malaria, including protective measures, see the CDC travelers’ health web site at http://www.cdc.gov/malaria/faq.htm.

Meningitis is endemic in Burkina Faso, and cases are most frequent during the drier, dustier months of January through June. Travelers should confirm that their meningitis A, C, Y, W, 135 inoculations are up to date.

There have been several confirmed cases of avian influenza (H5N1) in Burkina Faso over the last year, although in each case the disease was confined to birds, and was contained. A new outbreak could occur at any time. Travelers should avoid poultry farms and markets, avoid contact with visibly sick or dead birds and any raw poultry, and ensure poultry products are thoroughly cooked prior to consumption. For further information on avian influenza, consult the U.S. Department of State's Avian Influenza Fact Sheet , and the U.S. Centers for Disease Control and Prevention (CDC) web site at http://www.cdc.gov/flu/avian/index.htm. World Health Organization (WHO) guidance related to avian influenza is available at http://www.who.int/csr/disease/avian_influenza/en/.

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

MEDICAL INSURANCE:
The Department of State strongly urges Americans to consult with their medical insurance company prior to traveling abroad to confirm whether their policy applies overseas and whether it will cover emergency expenses such as a medical evacuation.
Please see our information on medical insurance overseas.
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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 Burkina Faso is provided for general reference only, and may not be totally accurate in a particular location or circumstance.
Public transportation is not safe.
While urban road conditions are fair, rural roads are in poor condition and roadside assistance is not available.
Travelers should exercise great caution when traveling by land in Burkina Faso.
All but a few roads are unpaved, narrow, and full of potholes.
Livestock and children often dart onto the road without warning.
Road travel at night is especially dangerous and, if at all possible, should be avoided.
At night, there is a high volume of truck traffic passing through the country and pedestrians, bicycles, and carts pose a major hazard on unlit, unmarked roads.
Vehicles are often dangerously overloaded and poorly maintained.
Drivers, including motorcyclists and bicyclists, are often careless.
The police rarely enforce traffic laws and are virtually absent on non-urban roads.
Emergency services are unreliable and overtaxed.

Please refer to our Road Safety page for more information.

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

SPECIAL CIRCUMSTANCES:
Burkina Faso’s customs authorities may enforce strict regulations concerning export from Burkina Faso of items such as masks, religious materials, and antiquities. The Director of the National Museum has stated that all exportation of objects of art (old or traditional artists’ works, and all old material of the national cultural patrimony) is subject to the prior approval of the Ministry of Culture. Contact the Embassy of Burkina Faso in Washington (see contact information in the Entry Requirements section) for specific information regarding customs requirements.
Foreigners should always carry an identity document, such as a passport or U.S. driver’s license.
Credit cards are accepted at only a few high-end establishments in Ouagadougou. Travelers' checks may be cashed at local banks, but euro-denominated traveler’s checks are much more widely accepted than dollar-denominated ones. There are a few ATMs in Ouagadougou and Bobo-Dioulasso, but they do not always accept cards from foreign banks.
ATMs generally accept Visa credit cards with a personal identification number.

Burkina Faso’s laws concerning photography have recently changed.
Photo permits from the Tourist Office are no longer required for tourists.
Film crews still do require permits.
Note that the Tourist Office publishes a list of buildings, installations, and areas that may not be photographed at all.
Contact the U.S. Embassy in Ouagadougou for more details regarding taking photographs in Burkina Faso.

Local telephone service is adequate but expensive.
Cell phone networks are available in most urban areas.
However, telephone coverage in rural areas is limited. International calls cannot always be made from hotels; it is often necessary to make international calls from a Post and Telecommunications Office, where only local currency is accepted.
Collect calls are not possible.
Cyber-cafes for Internet access are common in both Ouagadougou and Bobo-Dioulasso.

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 Burkina Faso laws, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in Burkina Faso 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 Burkina Faso 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 Burkina Faso.
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 on Avenue Raoul Follereau.
The Consular entrance is located on Avenue John F. Kennedy; consular telephone 50-30-67-23; consular fax: 50-30-77-75.
The Embassy hours of operation are Monday to Thursday from 07:30 to 12:00 and 12:45 to 17:00; Friday 07:30 to 12:30.
The Embassy’s website address is: http://burkinafaso.usembassy.gov/.
The Embassy is closed on both U.S. and Burkinabe holidays.
* * *
This replaces the Country Specific Information dated March 30, 2007 with some changes to the crime section, as well as changes under Country Description, Entry/Exit Requirements, and Medical Facilities and Health Information.

Travel News Headlines WORLD NEWS

Date: Wed, 27 Nov 2019 12:51:07 +0100 (MET)

Washington, Nov 27, 2019 (AFP) - The US State Department has urged Americans not to travel to Burkina Faso, which has been fighting an Islamist militant revolt since 2015.   Burkina Faso is now at the highest level of threat to travellers "because of terrorism, crime and kidnappings," said an updated travel advisory issued on Tuesday.   "The US government is unable to provide emergency services to US citizens throughout most of the country," the advisory added.

The country's jihadist insurgency, which came from neighbouring Mali, began in the north but has since spread to the east.   Combining guerrilla hit-and-run tactics with road mines and suicide bombings, the insurgents have killed nearly 600 people, according to a toll compiled by AFP. Civil society groups put the tally at more than 1,000.   In October, the UN High Commissioner for Refugees said that violence in Burkina Faso had caused more than a quarter of a million people to flee their homes over the previous three months.
Date: Fri, 18 Oct 2019 04:33:10 +0200 (METDST)
By Patrick FORT

Bobo-Dioulasso, Burkina Faso, Oct 18, 2019 (AFP) - "They've placed us in the red zone, which means the tourists aren't coming like before. Even the aid workers don't come," said Antoine Atiou, governor of Burkina Faso's Hauts-Bassins region.   The "red zone" refers to the risk of jihadist attacks -- a top-end warning by Western embassies to travellers wanting to visit southwest Burkina and the economic capital, Bobo-Dioulasso, once a popular tourist destination.   The impact has been brutal for local businesses. The city's hotels have emptied, its heritage sites are quiet and the souvenir shops shuttered.    "It's hard, hard, hard!... We haven't seen a tourist for a fortnight," said Sanou Moumouni, a guide at the city's mosque and in the historic Kibidwe district for 22 years.   In the past he could sometimes earn 100,000 CFA francs ($167, 150 euros) in two days, he said, but he has not made 5,000 francs in the last three months.    "I'm living on loans," he said. "We no longer have work because of the murderers. We're sick of it."    The north and the east of the landlocked country in West Africa endure frequent Islamist attacks, which have claimed some 600 lives in the past four years. There have also been some raids in the west.

In December 2018, an Italian man and his Canadian companion were kidnapped on the road from Bobo to the capital Ouagadougou. Last April, the Burkinabe government said it had information that the couple was still alive, but might have been taken to another country.   Bobo-Dioulassou itself has been relatively spared as the jihadist threat expands across poor nations of Africa's Sahel region.   Ministry of tourism statistics from 2017 show that of about half a million annual visitors to Burkina Faso, fewer than 150,000 came from abroad -- down 5.6 percent from 2015.   The number of nights stayed in the country by Westerners fell from 30,000 in 2012 to fewer than 15,000 in 2017. "This trend has probably sped up in 2018 and 2019," a local tour operator said.

- Crafts and wonders -
Renowned for its traditional masks, its batik print textiles and the balafon -- a West African instrument like a xylophone -- Bobo attracted thousands of Western tourists.   The Lonely Planet guide, which notes the security situation currently prohibits travel, says the city's "tree-lined streets exude a languid, semitropical atmosphere that makes it a favourite rest stop for travellers", adding that highlights include a "thriving live-music scene and excellent restaurants". 

The city itself has an array of charms, with its grand railway station, bustling market and striking Great Mosque -- an undulating white-plastered mud structure studded with wooden poles that dominates the historic centre.   Bobo-Dioulasso is a jumping-off point to visit regional highlights like the ruined fortress of Loropeni, a UNESCO World Heritage Site. It was also a base for exploring the Dogon country in Mali, Ivory Coast and Ghana.   "Everyone came through Bobo. We really were a tourist region. Now it's over," said Benjamin Ouedraogo, owner of the Watinoma hotel and president of the professional association of hotel and restaurant owners in High Basins.   He said hotels in the region only do a third of the business they did before the attacks   To avoid closing his hotel, Ouedraogo took on a second job in the building trade. "We asked for help, but state aid is a disaster," he said, explaining that the authorities rejected applications for tax rebates and preferential tariffs on water and electricity.

- 'We subsist' -
In Kibidwe, an old neighbourhood of the city near the mosque, children play in alleys and women wash clothes in the open air, but most of the shops that catered for tourists are now shut.   Sanon Bissiri, an artist, was quick to bring out his batik prints on spotting Western journalists.    "I don't hang them every day any more, that's pointless. Since July, I haven't even sold two. All this because of those jihadists. Now I have to do masonry whenever I'm wanted."   Bissiri used to sell his textiles to an Italian association that made regular visits.   "That's over. We just get by. It's my wife who meets our needs," he said. "I come in to work each day on foot, six kilometres (nearly four miles). I can't afford medicine for my son with his cough."   Bobo's nightlife is not what it was, though the locally-brewed beer is the same.    "There's still a little activity with Burkinabe visitors," said musician Gaoussou Ben Sanou. But "there's less money, fewer dates, fewer gigs. We can't sell records".   Governor Atiou said people were reluctant to go out.   "All that weighs on economic activity. Unfortunately, this is the aim of the terrorists."
Date: Wed 11 Sep 2019
Source: BBC Afrique [In French, trans. Mod.LXL, edited]

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

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

The remains of food have been secured, announced Professor Lougue, who calls on citizens to observe strict hygiene measures in the use of plant leaves for consumption. Pesticides are used for the needs of field work, especially in the countryside during this period of wintering.
Date: Mon, 24 Jun 2019 20:27:21 +0200

Ouagadougou, June 24, 2019 (AFP) - Hundreds of doctors and nurses demonstrated Monday in the Burkina Faso capital Ouagadougou to protest against declining health facilities and to demand better working conditions.   The main doctors' union also warned it would stage a general strike from June 30 to July 7 to demand "concrete responses" to their grievances.

Health professionals staged a series of strikes at the end of May, seriously disrupting work at health centres in the poor West African country.   "We are... asking health authorities not to underestimate the health crisis," said Alfred Ouedraogo, general secretary of the Union of Burkina Doctors.   "For several months, there have been recurring breakdowns in laboratories," he said. "In most health centres, there are no X-ray films."    The protesters marched to the health ministry and submitted their demands.

Health worker Idrissa Compaore said that ever since the introduction of free medical care for children under five and pregnant women, "basic goods were regularly lacking" at health facilities.   "The situation is the same in health centres," he said.   The doctors also want the implementation of an accord signed with the government in 2017 promising better working conditions which they say remains only on paper.   If their demands are not met, the health workers could launch an open-ended strike which would affect consultations and surgeries, Ouedraogo said.
Date: Thu, 29 Nov 2018 16:17:59 +0100

Ouagadougou, Nov 29, 2018 (AFP) - Several thousand people took the streets of Burkina Faso's capital Ouagadougou on Thursday as workers downed tools in a nationwide strike over higher fuel prices.   Petrol and diesel prices have shot up 12 percent over the past three weeks, sparking a wave of protest.   A grassroots group, the National Coalition Against Costly Living (CCVC), called the strike and protest, with a march from the chamber of commerce to the trade ministry in the heart of the capital of this West African country.   "No to the impoverishment of the citizens" read one of the slogans alongside others reading: "Bread and freedom for the people".   "Enough is enough," said civil servant Charles Coulibaly, 42.    "We can't get by on what we make, and now they're raising fuel prices, which will have the knock-on effect of making all products and services more expensive."

Another marcher, 36-year-old bookseller Prosper Zebango, expressed exasperation.   "Raising the price of petrol and diesel just when the price of a barrel was decreasing and justifying it with a so-called international increase?" he asked rhetorically.   "I think the government is showing incompetence."   Since reaching four-year highs in October, world oil prices have plunged around 30 percent as worries about falling demand in a slowing world economy have taken their toll.   In Burkina Faso, petrol and diesel prices have risen 12 percent since November 9, with a litre now costing 75 CFA francs (0.11 euros/$0.12), the equivalent of 47 US cents a gallon.   The protesters handed a list of demands to Trade Minister Harouna Kabore, who promised to relay them to the prime minister.

In addition to the revocation of the fuel price hike, they are also demanding the scrapping of a bill that would curtail the right to strike, according to CCVC vice president Chrisogone Zougmore.   "We are all fighting for improved living conditions for workers and people in general," Zougmore said.   The government cited rising fuel prices on international markets to justify the increase, as well as a need for increased revenue to fight jihadists operating in the restive north and east of the country.    The former French colony, among the world's poorest countries, has suffered jihadist attacks since 2015 that have claimed 229 lives, according to the last official toll published in late September.
More ...

World Travel News Headlines

Date: Thu, 23 Jan 2020 17:57:34 +0100 (MET)
By Eva XIAO

Beijing, Jan 23, 2020 (AFP) - The first fatality of China's new virus would come to represent a common set of traits for those who died to the disease: he was over the age of 60 and in poor health.   Since China reported the emergence of a new coronavirus at the end of December, the SARS-like virus has infected more than 500 and killed 17.   So far, the majority of the victims were elderly individuals with pre-existing health conditions, such as diabetes and liver cirrhosis.   All hailed from central Hubei province, where a local seafood market in the capital city of Wuhan is believed to be the epicentre of the epidemic.   But while older individuals have died from the Wuhan virus, some younger patients -- including a 10-year-old boy -- have since been released from the hospital.   Here's what we know so far about the deaths:

Most victims were over 60
According to details released by China's National Health Commission (NHC) on Thursday, the 17 victims of the virus were between 48 and 89 years old.   Only two were under the age of 60, while the average age of the victims was 73.   Most of them died this week, according to the NHC.   Among those who have been discharged from the hospital were younger patients, including a 35-year-old man from Shenzhen, a bustling tech hub in southern Guangdong province.   He was released from the hospital on Thursday, according to the local health commission, as well as the 10-year-old boy who had visited relatives in Wuhan before falling ill.

Many had pre-existing health conditions
Many of those who died from the virus also had pre-existing health issues before contracting the Wuhan disease, such as diabetes and hypertension.   One man, an 86-year-old who was hospitalised on January 9, had surgery for colon cancer four years prior, on top of suffering from high blood pressure and diabetes.   Another, an 80-year-old woman surnamed Hu, had Parkinson's Disease and more than 20 years of high blood pressure and diabetes in her medical history.

Some were hospitalised for weeks before dying
Several of the 17 victims were hospitalised for weeks before dying -- raising questions on the preparedness of hospitals that may have to treat patients for long periods of time.   The youngest victim of the Wuhan virus, a woman surnamed Yin, was hospitalised for more than a month before succumbing to the virus.   On December 10, the 48-year-old woman reported a fever, coughing, body soreness, and fatigue, and underwent anti-infection treatment for two weeks, according to the NHC.   Later in the end of the month, Yin suffered shortness of breath and chest tightness, and she passed away on January 20.

Not all of them had a fever
Currently, Wuhan authorities are screening passengers for fever at the airport, railway stations, and bus terminals.   At four airports in Thailand, authorities introduced mandatory thermal scans of passengers arriving from high-risk areas of China.   But not all those who died after being infected reported a fever before being hospitalised, according to the NHC.   A 66-year-old man surnamed Luo reported a "mainly dry cough" but no fever on December 22 before suffering from shortness of breath more than a week later.

By mid-January, Luo required a ventilator to help him breathe.   "A major concern is the range of severity of symptoms this virus is causing," said Dr Jeremy Farrar, Director of the Wellcome Trust.   "It is clear some people are being affected and are infectious while experiencing only very mild symptoms or possibly without experiencing symptoms at all," he said in an emailed statement.   "This may be masking the true numbers infected and the extent of person to person transmission," he added.
Date: Thu, 23 Jan 2020 16:05:30 +0100 (MET)

Singapore, Jan 23, 2020 (AFP) - Singapore Thursday confirmed its first case of the new SARS-like virus which has killed 17 people in China and spread to multiple countries including the United States.   The Ministry of Health (MOH) said the patient was a 66-year-old man from Wuhan who arrived in Singapore with his family on Monday.    He was immediately isolated after arriving at a hospital with a fever and cough, and test results later confirmed he was infected with the coronavirus.   One of his travelling companions, a 37-year-old man from Wuhan, has also been admitted to hospital as a suspect case.

Prior to admission, they had stayed at a hotel on the resort island of Sentosa, the ministry said.   It added that Singapore was expecting more cases and alarms "given the high volume of international travel".   Singapore's Changi Airport started screening flights from Wuhan at the beginning of the month, and on Wednesday extended the checks to all flights from China.   The travel hub receives over 430 flights from China every week.   The virus has caused alarm in China and abroad because of its genetic similarities to Severe Acute Respiratory Syndrome (SARS), which killed nearly 650 people across mainland China and Hong Kong in 2002-2003.

Singapore was among the hardest hit by SARS with 33 deaths.   Prime Minister Lee Hsien Loong, who is in Davos for the World Economic Forum, said there was "no need to panic".   Speaking to reporters travelling with him, Lee said Singapore has beefed up its hospital facilities and laid out response measures since the SARS epidemic.   "I think we are much better prepared now," he said in remarks carried by the Straits Times newspaper.
Date: Thu, 23 Jan 2020 14:43:33 +0100 (MET)

Barcelona, Jan 23, 2020 (AFP) - The death toll from a violent storm which has wrought havoc on huge swathes of Spain's eastern and southern coastline rose to nine on Thursday as rescuers pressed the hunt for at least five missing people.    The latest death was that of a man whose body was found in a flooded river near Jorba, some 70 kilometres (45 miles) northwest of Barcelona, the emergency services said.    Rescuers in Catalonia had been searching for a missing person in the same area but said it was too early to confirm if it was him.

Catalan rescuers had late on Wednesday found another body of a man who died after falling into the water in Palamos, a port town about 100 kilometres up the coast from Barcelona.    They are also searching for a man who went missing from a merchant ship in the same area, as well as a person in Cadaques near the French border.   Earlier on Thursday, regional officials confirmed the death of a 75-year-old woman whose house collapsed because of heavy rain in Alcoi, a town in the eastern Alicante region.

Storm Gloria hit the region on Sunday, bringing strong winds, torrential rains and heavy snow, battering Spain's southern and eastern flanks before moving north.   Gale-force winds and huge waves smashed into seafront towns, with dramatic images showing massive flooding that has damaged shops, houses and restaurants.   National weather agency Aemet had on Wednesday said the storm was starting to abate although it kept Catalonia and the Balearic Islands on alert.   As the storm eased, Prime Minister Pedro Sanchez was on Thursday visiting some of the worst-hit areas, overflying parts of Catalonia before heading to the Balearic Islands which on Tuesday were hit by record waves, the port authority said.

Rescuers on the islands are still searching for three people, including a 25-year-old Briton who went missing on a beach in northern Ibiza, and a 27-year-old Spaniard who disappeared in Mallorca while practising canyoning -- a mix of rappelling, climbing and watersliding through deep gorges.   Rescuers had found three other bodies on Wednesday, including that of a 67-year-old man who went missing in his car near the southeastern resort town of Benidom.    They also found two bodies in the southern Andalusia region, one of a 77-year-old man who died when a greenhouse collapsed on him in a hailstorm in Nijar as well as that of a homeless man who died of hypothermia.
Date: Wed 22 Jan 2020 1:04 PM EAT
Source: Uganda Red Cross Twitter [edited]

One confirmed case of Crimean-Congo haemorrhagic fever, 4 others suspected, in Kagadi [western Uganda]

A district Task Force has been formed to manage and coordinate the cases across the district @MinofHealthUG @robert_kwesiga @inakasiita1
========================
[Crimean-Congo haemorrhagic fever (CCHF) can cause serious disease in humans, with a case fatality rate of 10-40%. It can be responsible for severe outbreaks in humans, but it is not pathogenic for ruminants, their amplifying hosts. WHO states that the onset of symptoms in humans is sudden, with fever, myalgia, (muscle ache), dizziness, neck pain and stiffness, backache, headache, sore eyes and photophobia (sensitivity to light). There may be nausea, vomiting, diarrhoea, abdominal pain, and sore throat early on, followed by sharp mood swings and confusion. After 2-4 days, the agitation may be replaced by sleepiness, depression, and lassitude, and the abdominal pain may localize to the upper right quadrant, with detectable hepatomegaly (liver enlargement). Other clinical signs include tachycardia (fast heart rate), lymphadenopathy (enlarged lymph nodes), and a petechial rash (a rash caused by bleeding into the skin) on internal mucosal surfaces, such as in the mouth and throat, and on the skin.

Public education, especially among individuals in contact with livestock or their products, is needed to prevent cases of CCHF infection. A One Health approach is needed for effective surveillance, with effective communication between animal health and human health professionals.

The information in the tweet above indicates that there is one confirmed and at least 4 suspected cases of CCHF in Kagadi district, in the western region of Uganda.  Any updates on the epidemiology of these cases, occupational exposure, and public health response measures to control the transmission will be highly appreciated. - ProMED Mod.UBA]

[Maps of Uganda:
Date: Mon 20 Jan 2020
Source: Global News [edited]

A doctor working with Indigenous Services Canada (ISC) in Saskatchewan is urging caution to residents in and around Onion Lake First Nation following 2 people contracting a rare, deadly bacterial infection. Medical health officer Dr. Ibrahim Khan wrote a letter to the chief of the Onion Lake First Nation that said both patients were admitted to medical facilities shortly after New Years Day with diphtheria. He said one patient is under 18, while the other is an adult and was suffering from skin abrasions [? cutaneous diphtheria], which Khan said is rare for that disease.

In the letter, he said the disease is very uncommon in the province and can lead to "severe complications like breathing problems, heart failure, and paralysis, and without appropriate treatment can result in death." He applauded the medical team in Onion Lake, saying they contained the infection and made sure everyone in the community was aware of the risk and vaccinated.

"Everybody gets that vaccination, and they have that protection. That's why we don't see it. We don't see that many measles cases. We don't see that many prostatitis [pertussis?] cases, and we do not see any tetanus cases, because there is a good immunization for it. A good vaccination for it (and) people are aware of it," he told Global News. He said other local agencies, like pharmacies, made sure those on the front lines were supplied if they came across someone who wasn't vaccinated.

The letter to Chief Henry Louis said vaccination is the best method for preventing diphtheria and that the disease could virtually be eradicated if everyone who could be vaccinated received the shot. He said the target is for 97% of the population to receive the vaccination to prevent further spread in the community and noted the rates in Onion Lake are below that benchmark.  [Byline: Kyle Benning]
=====================
[Although the news report above says that one of the 2 patients with diphtheria was an adult "suffering from skin abrasions, which is rare for that disease," perhaps implying that this patient had cutaneous diphtheria, we are not told specifically the patients' clinical manifestations, i.e., whether they had respiratory diphtheria, cutaneous diphtheria, or both; if the strains of _Corynebacterium diphtheriae_ were toxin-producers; or if the patients were vaccinated against diphtheria.

Diphtheria became nationally notifiable in Canada in 1924, and that year 9057 cases were reported, the highest annual number of cases ever recorded in Canada  (<https://www.canada.ca/en/public-health/services/immunization/vaccine-preventable-diseases/diphtheria/health-professionals.html>).

The diphtheria vaccine was 1st introduced in 1926, and routine immunization in infancy and childhood has been widely practiced since 1930 in Canada. By the mid-1950s, routine immunization had resulted in a remarkable decline in the morbidity and mortality of the disease. Another steep decline in cases occurred in 1980, which has been attributed, in part, to a change in case definition to exclude carriers from reported cases in all provinces and territories. Since 1993, a total of 19 cases have been reported with a range of 0-4 cases annually  (<https://www.canada.ca/en/public-health/services/immunization/vaccine-preventable-diseases/diphtheria/health-professionals.html>).

In the USA, the case definition for reporting to the National Notifiable Diseases Surveillance System includes only respiratory diphtheria
(<https://wwwn.cdc.gov/nndss/conditions/diphtheria/case-definition/2010/>).

Similarly, the WHO case definition for reporting diphtheria only includes clinical respiratory diphtheria. Although no longer reportable, cutaneous diphtheria still occurs in the USA and has been most often associated with homelessness, poor sanitation, poverty, and crowded living conditions  (<https://www.cdc.gov/vaccines/pubs/pinkbook/dip.html>).

However, the Canadian case definition includes both respiratory diphtheria and infection at another site (e.g., wound, cutaneous)
(<https://www.canada.ca/en/public-health/services/immunization/vaccine-preventable-diseases/diphtheria/health-professionals/national-case-definition.html>).

Cutaneous diphtheria is contagious and can be a source of both respiratory and cutaneous infections in contacts. Acquisition of _Corynebacterium diphtheriae_, the cause of diphtheria, can occur even in vaccinated contacts, as vaccine-induced immunity is anti-toxin. - ProMED Mod.ML]

[HealthMap/ProMED-mail map:
Saskatchewan province, Canada: <http://healthmap.org/promed/p/262>]
Date: Wed, 22 Jan 2020 17:37:27 +0100 (MET)
By Helen ROXBURGH

Beijing, Jan 22, 2020 (AFP) - A new SARS-like virus has killed 17 people in China, infected hundreds and reached as far as the United States, with fears mounting about its spread as hundreds of millions travel for Lunar New Year celebrations, which start Friday.   Many countries have stepped up screening of passengers from Wuhan, the Chinese city identified as the epicentre, and the World Health Organization has called an emergency meeting.   Here's what we know so far about the virus:

- It's entirely new -
The pathogen appears to be a never-before-seen strain of coronavirus -- a large family of viruses that can cause diseases ranging from the common cold to Severe Acute Respiratory Syndrome (SARS), which killed 349 people in mainland China and another 299 in Hong Kong between 2002 and 2003.   Arnaud Fontanet, head of the department of epidemiology at the Institut Pasteur in Paris, told AFP the current virus strain was 80 percent genetically identical to SARS.   China has already shared the genome sequencing of this novel coronavirus with the international scientific community.   It has been named "2019-nCoV".

- It's being passed between humans -
The WHO said Monday it believed an animal source was the "primary source" of the outbreak, and Wuhan authorities identified a seafood market as the centre of the epidemic.   But China has since confirmed that there was evidence the virus is now passing from person to person, without any contact with the now-closed market.

The virus has infected more than 400 people across the country, with most cases in Wuhan, according to officials. Li Bin of China's National Health Commission on Wednesday said 1,394 people were still under medical observation.   Doctor Nathalie MacDermott of King's College London said it seems likely that the virus is spread through droplets in the air from sneezing or coughing.   Doctors at the University of Hong Kong published an initial paper on Tuesday modelling the spread of the virus which estimated that there have been some 1,343 cases in Wuhan -- similar to a projection of 1,700 last week by scientists at Imperial College, London.   Both are much higher than official figures.

- It is milder than SARS -
Compared with SARS, the symptoms appear to be less aggressive, and experts say the death toll is still relatively low.   "It's difficult to compare this disease with SARS," said Zhong Nanshan, a renowned scientist at China's National Health Commission at a press conference this week. "It's mild. The condition of the lung is not like SARS."   However, the milder nature of the virus can also cause alarm.

The outbreak comes as China prepares for the Lunar New Year Holiday, with hundreds of millions travelling across the country to see family.   Professor Antoine Flahault, director of the Institute of Global Health at the University of Geneva, told AFP that the fact that the virus seems milder in the majority of people is "paradoxically more worrying" as it allows people to travel further before their symptoms are detected.   "Wuhan is a major hub and with travel being a huge part of the fast approaching Chinese New Year, the concern level must remain high," said Jeremy Farrar, Director of the Wellcome Trust.

- International public health emergency? -
The WHO will hold a meeting on Wednesday to determine whether the outbreak constitutes a "public health emergency of international concern" and if so, what should be done to manage it.   Cases have so far been confirmed in Thailand, Japan, Taiwan, South Korea, Macau and the United States.

The WHO has only used the rare label a handful of times, including during the H1N1 -- or swine flu -- pandemic of 2009 and the Ebola epidemic that devastated parts of West Africa from 2014 to 2016.   The Chinese government announced Tuesday it was classifying the outbreak in the same category as the SARS outbreak, meaning compulsory isolation for those diagnosed with the disease and the potential to implement quarantine measures on travel.   But if the WHO decides to take this step, it would put the Wuhan virus in the same category as a handful of very serious epidemics.

- Global precautions -
As the number of confirmed deaths and infections has risen, so has concern worldwide about the disease spreading to other countries.   In Thailand, authorities have introduced mandatory thermal scans of passengers arriving at airports in Bangkok, Chiang Mai, Phuket and Krabi from high-risk areas in China.

In Hong Kong, where hundreds died during the SARS outbreak of 2002-2003, authorities have said they are on high alert, carrying out scans at the city's airport -- one of the world's busiest -- and at other international land and sea crossing points.

The United States also ordered the screening of passengers arriving on direct or connecting flights from Wuhan, including at airports in New York, San Francisco and Los Angeles.   Taiwan has issued travel advisories, and went to its second-highest alert level for those travelling to or from Wuhan. Vietnam has also ordered more border checks on its border with China.
Date: Wed, 22 Jan 2020 16:53:32 +0100 (MET)
By Beiyi SEOW

Beijing, Jan 22, 2020 (AFP) - The death toll from a new SARS-like virus that has infected hundreds in China rose to 17 on Wednesday, as authorities urged people to steer clear of the city at the centre of the outbreak.   The coronavirus has caused alarm because of its similarity to SARS (Severe Acute Respiratory Syndrome), which killed nearly 650 people across mainland China and Hong Kong in 2002-2003.   With hundreds of millions of people travelling across China this week for the Lunar New Year holiday, the National Health Commission announced measures to contain the disease -- including sterilisation and ventilation at airports and bus stations, as well as inside planes and trains.

In Wuhan, the epicentre of the epidemic, large public events were cancelled and international football matches were moved to a new location. Visitors were urged to stay away, while residents were advised to not to leave the central city, which is home to 11 million people.   "If it's not necessary we suggest that people don't come to Wuhan," Wuhan Mayor Zhou Xianwang told state broadcaster CCTV.    The illness is mainly transmitted via the respiratory tract and there "is the possibility of viral mutation and further spread of the disease", health commission vice minister Li Bin told a news conference in Beijing.   More than 500 cases have now been reported, with the majority in Wuhan, capital of Hubei province.

The virus has now infected at least 444 people in Hubei province alone, said provincial officials at a press conference, adding that the death toll had risen from nine to 17.   Major cities, including Beijing, Shanghai, and Chongqing have also reported cases, as well as provinces in northeastern, central, and southern China.   The World Health Organization started an emergency meeting Wednesday to decide whether or not to declare a rare global public health emergency over the disease, which has now been detected in the United States, Taiwan, Thailand, Japan, South Korea and Macau.

The Chinese government has classified the outbreak in the same category as the SARS epidemic, meaning compulsory isolation for those diagnosed with the illness and the potential to implement quarantine measures.   But they still have not been able to confirm the exact source of the virus.   "We will step up research efforts to identify the source and transmission of the disease," Li said, adding that "the cases are mostly linked to Wuhan".   Countries have intensified efforts to stop the spread of the pathogen -- known by its technical name 2019 Novel Coronavirus (2019-nCoV).   Passengers are facing screening measures at five US airports and a host of transport hubs across Asia. Britain and Italy on Wednesday also announced enhanced monitoring of passengers from Wuhan.

- Virus source -
A prominent expert from China's National Health Commission confirmed this week that the virus can be passed between people.   However, animals are suspected to be the primary source of the outbreak.   A Wuhan market is believed to be the epicentre of the outbreak.

A price list circulating online in China for a business there lists a menagerie of animals or animal-based products including live foxes, crocodiles, wolf puppies and rats. It also offered civets, the animal linked to SARS.   "We already know that the disease originated from a market which conducted illegal transaction of wild animals," said Gao Fu, director of the Chinese centre for disease control and prevention.   He said it was clear "this virus is adapting and mutating".   Hong Kong and British scientists have estimated that between 1,300 and 1,700 people in Wuhan may have been infected.

- Containment -
Health authorities are urging people to wash their hands regularly, avoid crowded places, get plenty of fresh air and wear a mask if they have a cough.   Anyone with a cough or fever was urged to go to hospital.   In Wuhan, city authorities made it mandatory to wear a mask in public places on Wednesday, according to state-run People's Daily.

In response to skyrocketing demand for masks -- which were starting to sell out at pharmacies and on some popular websites -- China's industry and information technology ministry said it would "spare no effort in increasing supply", state media reported.   "These days, I wear masks even in places that are not too crowded, although I wouldn't have done so in the past," said Wang Suping, 50, who works at a Beijing arts school.   At the capital's main international airport, the majority of people were wearing masks.

Hong Kong flag carrier Cathay Pacific said it had agreed to allow staff to wear surgical masks on mainland China flights, and that passengers from Wuhan would be offered masks and antiseptic wipes.   In Wuhan, police were conducting vehicle spot checks for live poultry or wild animals leaving and entering the city, state media said.   Officials also screened people on roads, the airport and the train station for fever.   The local government has cancelled major public activities and banned tour groups from heading out of the city.   Women's Olympics football qualifiers scheduled for February 3-9 in Wuhan have been moved to the eastern city of Nanjing.
Date: Wed, 22 Jan 2020 15:49:25 +0100 (MET)

Montreal, Jan 22, 2020 (AFP) - A Canadian guide died and five French tourists were missing after at least one snowmobile plunged through ice in northern Quebec, police said Tuesday.   The group were riding close to where a river exits the Saint-Jean lake, and were outside the approved area for snowmobiles, police spokesman Hugues Beaulieu told AFP.   Nine people, including the guide, were on the trip on Tuesday evening when the ice broke underneath them.   Police said they were alerted by two of the tourists who had rescued a third tourist from the freezing water.

The 42-year-old guide was pulled out by emergency response teams and taken to hospital, but he died overnight, Beaulieu said, adding "five French tourists are still missing."   The police and army were searching the area on Wednesday, assisted by divers.   "This sector was not part of a marked trail, they were off-piste," said the spokesman.
Date: Wed, 22 Jan 2020 04:55:57 +0100 (MET)

Hong Kong, Jan 22, 2020 (AFP) - Macau on Wednesday reported its first confirmed case of the new SARS-like coronavirus as authorities announced all staff in the city's bustling casinos had been ordered to wear face masks.   The former Portuguese colony is a huge draw for mainland tourists as the only place in China that allows gambling.

With the Lunar New Year approaching this weekend, a huge influx of mainland tourists is expected in the city.   Asian countries have ramped up measures to block the spread of the new virus, which emerged in the Chinese city of Wuhan and has so far killed at least nine people.

On Wednesday, Macau announced its first confirmed case -- a 52-year-old businesswoman from Wuhan who arrived in the city by high-speed rail on Sunday, via the neighbouring city of Zhuhai.    "A series of tests found that she was positive for the coronavirus and had symptoms of pneumonia," Lei Chin-lon, the head of Macau's health bureau, told reporters.    The woman had been staying at the New Orient Landmark Hotel with two friends who were being monitored since her admission to hospital on Tuesday.

Ao Ieong Iu, Macau's Secretary for Social Affairs and Culture, said staff in all casinos would be required to wear masks while anyone arriving at entry ports along the city's border with the mainland would need to fill out health declaration forms.    "We have not banned tourism groups from Wuhan but we are not encouraging them," Ao Ieong said.    "We will stay in close contact with tourism agencies and require them to notify us of all groups going to and coming from Wuhan," she added.
Date: Tue, 21 Jan 2020 22:23:22 +0100 (MET)
By Issam Ahmed with Helen Roxburgh

Washington/Beijing, Jan 21, 2020 (AFP) - The United States on Tuesday announced its first case of a new virus that has claimed six lives in China and sickened hundreds, joining countries around the world in ramping up measures to block its spread.   The man, a US resident in his 30s who lives near Seattle, is in good condition, according to federal and state officials, and approached authorities himself after reading about the SARS-like virus in news reports.   He is "currently hospitalized out of an abundance of precaution, and for short term monitoring, not because there was severe illness," said Chris Spitters, a Washington state health official.  "This is an evolving situation and again, we do expect additional patients in the United States and globally," added Nancy Messonier, a senior official at the Centers for Disease Control and Prevention (CDC), but stressed that the overall risk to Americans remained low.

The man entered the country on January 15 after traveling to Wuhan, two days before the US began deploying health officials at major airports to screen passengers arriving from that central Chinese city which is at the heart of the outbreak. The efforts are to be extended now to a total of five US airports.   It came as countries ramped up measures to block the spread of the virus -- known by its technical name 2019 Novel Coronavirus or 2019-nCoV -- as the number of cases surpassed 300, raising concerns in the middle of a major Chinese holiday travel rush.

Fears of a bigger outbreak rose after a prominent expert from China's National Health Commission confirmed late Monday that the virus can be passed between people.   That conclusion is shared by the CDC, which said "person-to-person spread is occurring, although it's unclear how easily the virus spreads between people," even as the World Health Organization (WHO) adopted a more cautious approach, saying it is still investigating.   The UN agency will hold an emergency meeting Wednesday to determine whether to declare a rare global public health emergency over the disease, which has also been detected in Thailand, Japan and South Korea and Taiwan.

- Holiday rush -
Authorities previously said there was no obvious evidence of person-to-person transmission and animals were suspected to be the source, as a seafood market where live animals were sold in Wuhan was identified as the center of the outbreak.   Hundreds of millions of people are criss-crossing China this week in packed buses, trains and planes to celebrate the Lunar New Year with relatives.

More than 80 new cases have been confirmed, bringing the total number of people hit by the virus in China to 315, with the vast majority in Hubei, the province where Wuhan lies, according to officials.   But cases have also been confirmed around the country, including Beijing and Shanghai.   The first case on the self-ruled island of Taiwan was also confirmed Tuesday, with a woman taken to hospital on arrival at the airport from Wuhan.   Wuhan mayor Zhou Xianwang told state broadcaster CCTV Tuesday that the death toll had risen from four to six.   The coronavirus has caused alarm because of its genetic similarities to Severe Acute Respiratory Syndrome (SARS), which killed nearly 650 people across mainland China and Hong Kong in 2002-2003.

- Fever checks -
At four airports in Thailand, authorities introduced mandatory thermal scans of passengers arriving from high-risk areas of China.   In Hong Kong, authorities said they were on "extreme high alert," with passengers from Wuhan required to fill out health declarations and face possible jail time if they do not declare symptoms.   Enhanced screening measures have also been set up at airports in Australia, Bangladesh, Nepal, Singapore and Russia, Malaysia and Vietnam.   A man showing symptoms of the disease who had travelled to Wuhan has been put in isolation in Australia as health officials await test results, authorities said Tuesday.   In China, the government announced it was classifying the outbreak in the same category as SARS, meaning compulsory isolation for those diagnosed ith the disease and the potential to implement quarantine measures on travel.

In Wuhan, authorities banned tour groups and police were conducting spot checks for animals in vehicles leaving and entering the city, state media said.   It added that city health authorities had scheduled 800 beds to be made available in three hospitals and 1,200 more would soon be ready, and passengers were being screened for fever at the airport, railway stations and bus terminals.   Doctors at the University of Hong Kong released a study on Tuesday estimating that there have been 1,343 cases of the new virus in Wuhan.   The WHO has only called a global public health emergency a handful of times, including during the H1N1 -- or swine flu -- pandemic of 2009 and the Ebola epidemic that devastated parts of West Africa from 2014 to 2016.