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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: 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.
Date: Tue, 13 Sep 2016 17:42:47 +0200

Copenhagen, Sept 13, 2016 (AFP) - Temperature records were broken in Greenland this year after parts of the territory's vast ice sheet began melting unusually early, the Danish Meteorological Institute (DMI) said Tuesday.   "These new results give us new and robust evidence of the tendency of warmer temperatures in the Arctic continuing," John Cappelen, a climatologist at the institute, said in a statement.

The average summer temperature was 8.2 degrees Celsius (46.8 degrees Fahrenheit) in Tasiilaq on Greenland's southeast coast, the highest since records began in 1895 and 2.3 degrees Celsius above the average between 1981 and 2010.   New highs were also recorded in the south and in the northeast this summer, after a balmy spring that broke records at six out of 14 weather stations in the territory.

In April, DMI said that the seasonal melting of Greenland's vast ice sheet had reached record levels, prompting it to check that its "models were still working properly."   Around 12 percent of the ice sheet was found to be melting almost one month earlier than the previous top three dates for when more than 10 percent of the ice had begun to melt, it said.   The Greenland ice sheet, a potentially massive contributor to rising sea levels, lost mass twice as fast between 2003 and 2010 as during the entire 20th century, researchers said in December.
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Philippines

Philippines US Consular Information Sheet
June 17, 2008
COUNTRY DESCRIPTION:
The Philippines is an emerging economy with a democratic system of government, located in Southeast Asia.
The archipelago consists of more than 7,000 islands
of which over 800 are inhabited.
The major island groupings are Luzon in the north, the Visayas in the center and Mindanao in the south.
Tourist facilities are available within population centers and the main tourist areas.
English is widely spoken in the Philippines, and most signs are in English.
Read the Department of State Background Notes on the Philippines for additional information.

ENTRY/EXIT REQUIREMENTS:
U.S. citizens may enter the Philippines without a visa upon presentation of their U.S. passport, valid for at least six months after the date of entry into the Philippines, and a return ticket to the United States or an onward ticket to another country.
Upon arrival immigration authorities will annotate your passport with an entry visa valid for 21 days.
If you plan to stay longer than 21 days you must apply for an extension at the Philippine Bureau of Immigration and Deportation's main office at Magallanes Drive; Intramuros, Manila, Philippines or at any of its provincial offices at http://www.immigration.gov.ph.

Persons who overstay their visas are subject to fines and detention by Philippine immigration authorities.
American citizens are urged to remain aware of their visa status while in the Philippines and to strictly follow immigration laws and regulations.
Travelers departing the country from international airports must pay a Passenger Service Charge in Philippine Pesos.
Visit the Embassy of the Philippines web site at http://www.philippineembassy-usa.org for the most current visa information.

Special requirements exist for the entry of unaccompanied minors.
In an effort to prevent international child abduction, the Philippine government requires that a waiver of exclusion be obtained from a Philippine Embassy or Consulate or from the Bureau of Immigration and Detention in Manila for a child under 15 years of age who plans to enter the Philippines unaccompanied by either a parent or legal guardian prior to the child's entry into the Philippines.

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:
U.S. citizens contemplating travel to the Philippines should carefully consider the risks to their safety and security while there, including those due to terrorism.
While travelers may encounter such threats anywhere in the Philippines, the southern island of Mindanao and the Sulu Archipelago are of particular concern.
Travelers should exercise extreme caution in both central and western Mindanao as well as in the Sulu Archipelago.

Kidnap for ransom gangs operate in the Philippines.
In October 2007, one such gang abducted a visiting U.S. citizen whose whereabouts are unknown at this time.
Several other foreigners were also kidnapped for ransom in 2007.
The New People’s Army (NPA), a terrorist organization, operates in many rural areas of the Philippines, including in the northern island of Luzon.
While it has not targeted foreigners in several years, the NPA could threaten U.S. citizens engaged in business or property management activities, and it often demands “revolutionary taxes.”

Terrorist groups, such as the Abu Sayyaf Group, the Jema’ah Islamiyah and groups that have broken away from the more mainstream Moro Islamic Liberation Front or Moro National Liberation Front, have carried out bombings resulting in deaths, injuries and property damage.
In November 2007, a bombing outside the House of Representatives in Metro Manila resulted in a number of deaths and injuries to bystanders.
On January 3, 2008, a bomb exploded at a Cotabato City disco pub, killing one and injuring eight.
The central and western areas of Mindanao have also experienced bombings targeting bus terminals and public buildings.
While those responsible do not appear to have targeted foreigners, travelers should remain vigilant and avoid congregating in public areas; U.S. Government employees must seek special permission for travel to Mindanao or the Sulu Archipelago.
When traveling in Mindanao, U.S. official travelers attempt to lower their profile, limit their length of stay and exercise extreme caution.
Some foreigners who reside in or visit western and central Mindanao hire their own private security personnel.

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, including 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 United States and Canada, 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:
As in many of the major metropolitan areas in the United States, crime is a significant concern in Metro Manila.
As a rule of thumb, Americans should exercise good judgment and remain aware of their surroundings.
Reports of confidence games, pick pocketing, internet scams and credit card fraud are common.
Be wary of unknown individuals who attempt to befriend you, especially just after you arrive in country.
A number of robberies and assaults involving the “date rape drug” (known locally as Ativan) have occurred; the drug is generally administered to unwitting male or female victims via food or drink.
It is best not to accept food, drink, or rides in private vehicles from strangers, even if they appear legitimate.
While Americans are not typically targeted for kidnapping, kidnappings and violent assaults do occur in the Metro Manila area.

Taxis are the recommended form of public transportation.
However, the following safeguards are important: do not enter a taxi if it has already accepted another passenger; and request that the meter be used.
If the driver is unwilling to comply with your requests, it is best to wait for another cab.
It is also a good idea to make a mental note of the license plate number should there be a problem.
When driving in the city, make certain that the doors are locked and the windows rolled up.
All other forms of public transportation, such as the light rail system, buses and “jeepneys” should be avoided for both safety and security reasons.

Visitors should also be vigilant when using credit cards.
One common form of credit card fraud involves the illicit use of an electronic device to retrieve and record information, including the PIN, from the card's magnetic strip.
The information is then used to make unauthorized purchases.
To limit your vulnerability to this scam, never let your card out of your sight.

A continuing problem is the commercial scam or sting that attempts to sell or to seek negotiation of fraudulent U.S. securities.
Visitors and residents should be wary when presented with supposed Federal Reserve Notes or U.S. securities for sale or negotiation.
For further information, consult the Federal Reserve System's web site at http://www.federalreserve.gov/.

In many countries around the world, counterfeit and pirated goods are widely available.
Transactions involving such products may be illegal under local law.
In addition, bringing them back to the United States may result in forfeitures and/or fines.
More information on this serious problem is available at http://www.cybercrime.gov/18usc2320.htm.

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 Philippines has a victim compensation program to provide financial compensation to victims of violent or personal crime and of unjust imprisonment.
Information may be obtained from the Philippine Department of Justice at 011-632-536-0447 or via the Internet at http://www.doj.gov.ph/.

The local equivalent to the “911” emergency line in the Philippines is: 117.

See our information on Victims of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION:
Adequate medical care is available in major cities in the Philippines, but even the best hospitals may not meet the standards of medical care, sanitation, and facilities provided by hospitals and doctors in the United States.
Medical care is limited in rural and more remote areas.

Serious medical problems requiring hospitalization and/or medical evacuation to the United States can cost several or even tens of thousands of dollars.
Most hospitals will require a down payment of estimated fees in cash at the time of admission.
In some cases, public and private hospitals have withheld lifesaving medicines and treatments for non-payment of bills.
Hospitals also frequently refuse to discharge patients or release important medical documents until the bill has been paid in full.
A list of doctors and medical facilities in the Philippines is available on the web page of the U.S. Embassy in Manila at http://manila.usembassy.gov/.

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

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

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

Travel within the Philippine archipelago is possible by boat, plane, bus or car.
Few tourists rent cars to drive, as the road system is crowded and drivers are undisciplined.
Driving off the national highways and paved roads is particularly dangerous, especially at night, and should be avoided.
To avoid overcrowded or unsafe transport, exercise caution in planning travel by older, inter-island ferryboats, or other public conveyances.

For specific information concerning Philippine driver's permits, vehicle inspection, road tax and mandatory insurance, please contact the Philippine Embassy in Washington, D.C. at tel. (202) 467-9300 or one of the Philippine consulates in the United State (Chicago, Honolulu, Los Angeles, New York, and San Francisco) or via the Internet at http://www.philippineembassy-usa.org/home.htm.
Please see also related information from the Philippine Department of Tourism at http://www.tourism.gov.ph and http://www.dotpcvc.gov.ph.

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

AVIATION SAFETY OVERSIGHT:
The U.S. Federal Aviation Administration (FAA) has assessed the Government of the Philippines’ Civil Aviation Authority as not being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for the oversight of the Philippines’ air carrier operations.
For more information, travelers may visit the FAA’s web site at http://www.faa.gov/safety/programs_initiatives/oversight/iasa
SPECIAL CIRCUMSTANCES: Marriage in the Philippines:
The Philippine Government requires foreigners who wish to marry in the Philippines to obtain from the U.S. Embassy a “Certificate of Legal Capacity to Contract Marriage” before filing an application for a marriage license.
Because there is no national register of marriages in the United States, the U.S. Embassy cannot provide such a certification.
As a result, the Philippine Government will accept an “Affidavit in Lieu of a Certificate of Legal Capacity to Contract Marriage” in its place.
Americans may execute this affidavit at the U.S. Embassy in Manila Monday-Friday, between 8:00 a.m. and 10:00 a.m., except for Philippine or American holidays.
The American must present his/her U.S. passport.
There is a fee of $30.00 or its peso equivalent for the affidavit.
Philippine authorities will not accept any substitute document issued in the United States.
Before traveling to the Philippines to be married, U.S. military personnel should contact their personnel office regarding Department of Defense joint service regulations.

Execution of the affidavit by a U.S. consular officer is a notarial act, and the consular officer is authorized by U.S. law to refuse to perform the service if the document will be used for a purpose patently unlawful, improper, or inimical to the best interests of the United States (see 22 C.F.R. section 92.9b).
Entering into a marriage contract for the principal purpose of facilitating immigration to the United States for an alien is an unlawful act, and the U.S. Code provides penalties for individuals who commit perjury in an affidavit taken by a consular officer.
Relationship fraud is a persistent problem in the Philippines, and it is not uncommon for Filipinos to enter into marriages with Americans solely for immigration purposes.
Relationships developed via correspondence, particularly those begun on the Internet, are particularly susceptible to manipulation.

The Marriage Application Process:
Once an American citizen has obtained from the U.S. Embassy an “Affidavit in Lieu of a Certificate of Legal Capacity to Contract Marriage,” he/she may file an application for a marriage license at the office of the Philippine Civil Registrar in the town or city where one of the parties is a resident.
The U.S. citizen applicant must present: (a) the affidavit; (b) divorce decree(s) or death certificate(s), if applicable (required to verify civil status and legal capacity to contract marriage); (c) his/her U.S. passport; and (d) documentation regarding parental consent or advice, if applicable.
(Persons aged 18 to 21 must have written parental consent to marry in the Philippines; those aged 22 to 24 must have received parental advice.
Philippine law prohibits marriage for persons under the age of 18.)
A judge, a minister, or other person authorized by the Philippine Government can perform the marriage.

Marriage to a U.S. citizen confers neither citizenship nor an automatic eligibility for entry to the United States.
A foreign spouse requires an immigrant visa to live in the United States.
Questions about filing a petition to bring a foreign spouse to the United States may be directed to the nearest U.S. Citizenship and Immigration Service office, to the U.S. Department of State’s Visa Office (telephone: (202) 663-1225) or, while in the Philippines, to the U.S. Embassy’s Immigrant Visa Unit at http://manila.usembassy.gov/.

Disaster Preparedness:
The Philippines is a volcano-, typhoon- and earthquake-prone country.
>From May to December, typhoons and flash floods often occur.
Flooding can cause road delays and cut off bridges.
Typhoons in the vicinity of the Philippines can interrupt air and sea links within the country.
Updated information on typhoons is available at http://www.pagasa.dost.gov.ph. Volcanic activity is frequent, and periodically the Philippine Government announces alerts for specific volcanoes.
Updated information on volcanoes in the Philippines is available at http://volcanoes.usgs.gov.
Earthquakes can also occur throughout the country.
General information about natural disaster preparedness is available via the Internet from the Philippines National Disaster Coordinating Council (NDCC) at http://ndcc.gov.ph/home/ and from the U.S. Federal Emergency Management Agency (FEMA) at http://www.fema.gov.

Customs: Philippine customs authorities enforce strict regulations concerning temporary importation into or export from the Philippines of items such as firearms and currency.
It is advisable to contact the Embassy of the Philippines in Washington, DC or one of the Philippine consulates in the United States (Chicago, Honolulu, Los Angeles, New York and San Francisco) for specific information regarding customs requirements.
Counterfeit and pirated goods are widely available in the Philippines; transactions involving such products are illegal and bringing them back to the United States may result in forfeitures and/or fines.

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 the Philippines’ laws, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in the Philippines 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 the Philippines 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 the Philippines.
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: 1201 Roxas Boulevard, Manila, Philippines, tel. (63) (2) 301-2000.
The American Citizen Services (ACS) section's fax number is (63) (2) 301-2017 and the ACS web page is at http://manila.usembassy.gov/.
*

*

*
This replaces the Country Specific Information for the Philippines dated January 17, 2008 to update sections on “Country Description,” “Safety and Security,” “Crime” and “Medical Facilities and Health Information.

Travel News Headlines WORLD NEWS

Date: Fri 6 Aug 2019 3:20 PM IST
Source: News 18 [edited]

A 14-year-old girl from Pangasinan province in the northern Philippines died of the mosquito-borne disease, Japanese encephalitis (JE). It is the 1st such fatality in the province. According to a PhilStar report, the girl was hospitalised for several days for suspected dengue at a Dagupan hospital, before succumbing to it.

Health officials in Pangasinan are working with officials in Tarlac, where the girl studied, to see if other students are infected as well.

Japanese encephalitis is a mosquito-borne viral disease and is the leading cause of viral encephalitis (inflammation of the brain) in Asia. Children are more prone to this vector-borne disease.

According to the Philippines Department of Health, one in in every 250 infected with the JE virus succumb due to severe illness. The onset is characterised by flu-like symptoms (sudden onset of high fever, chills, headache, and tiredness). Disease may rapidly progress to severe encephalitis (infection of the brain). At this stage, the patient may experience symptoms such as mental disturbances and progressive decline in consciousness to coma.

More than half of those who are diagnosed with JE show serious residual neurologic, psychosocial, intellectual, and/or physical disabilities such as paralysis, recurrent seizures, or inability to speak. The Japanese encephalitis virus is transmitted by _Culex_ mosquitoes that breed in water pools and flooded rice fields. People who live close to rice fields and pig farms are more prone to fall prey to this vector-borne disease.

The Philippines is endemic for Japanese encephalitis, with a number of cases tested positive in every region in the country. According to the data by the Department of Health (DoH) Epidemiology Bureau, Japanese encephalitis virus is the cause of encephalitis in 15 percent of all cases of acute encephalitis. DoH recorded 122 lab confirmed Japanese encephalitis cases in 2016, while 275 cases were reported in 2017. The year 2018 witnessed 340 confirmed cases of Japanese encephalitis cases, with Region III reporting the highest number of cases (110), followed by Regions I and II.
===================
[Pangasinan province is on the west side of Luzon Island. Cases of Japanese encephalitis (JE) occur sporadically in various parts of the Philippines, including Luzon Island. This is the 1st report of JE on Luzon this year (2019). The report above does not mention if the localities where the 14 year old student had been were in ecological situations where Japanese encephalitis virus might be transmitted, with abundant populations of _Culex_ vector mosquitoes. Ardeid water bird hosts such as herons and pigs serve as amplifying hosts. Presumably, the girl had not been vaccinated against Japanese encephalitis. - ProMED Mod.TY]

[Maps of Philippines: <https://goo.gl/vVg7ht> and
Date: Thu 5 Sep 2019
Source: SunStar [edited]

Amid flooding incidents due to recent heavy rains, the Department of Health (DOH)-Davao has recorded 44 suspected leptospirosis cases with 4 deaths in Davao Region from January to [2 Sep 2019].

DOH-Davao director Dr Annabelle Yumang said on [Tue 3 Sep 2019], that suspected leptospirosis cases is highest in Davao City with 14 patients and 3 who have died; Davao del Norte has 13 cases with no death recorded; Compostela Valley Province with 11 cases and 1 death; Davao del Sur and Davao Oriental recorded 1 case each.

Leptospirosis is an infection spread mainly through contact with water or soil contaminated with the urine of infected animals, particularly rats. Persons can get the disease by swimming or wading in fresh unchlorinated water contaminated with animal urine or by coming into contact with wet soil or plants contaminated with animal urine.

In the past weeks, Davao Region experienced a series of heavy downpour particularly in Davao City that has caused massive flooding. With this, Yumang advised the public and the flood victims to remain vigilant during the rainy season to prevent from acquiring this fatal disease.

"[It is important that after the flooding, the City Government visits the evacuation areas to administer antibiotic. Anyway, it is easy to administer the antibiotic since it is only a single-dose]," Yumang said.

DOH has given the flood victims doxycycline, the antibiotic drug used as standard prophylaxis for leptospirosis patients. She further assured that there is no shortage of the antibiotic and they are ready to respond should there is a need for these medicines to prevent the disease from being acquired which is caused by the flood.

The symptoms of the infection include fever, chills and severe headache, which usually appear four to 14 days after being exposed to contaminated floodwaters or mud. Aside from that, an infected individual may manifest red eyes, jaundice, tea-coloured urine and difficulty to urinate.

"[I advised the flood victims to go to the health centres if they were exposed to contaminated flood water]," Yumang said.  [Byline: Juliet C Revita]
=========================
[Leptospirosis is an infection transmitted to humans by exposure to soil or fresh water contaminated with the urine of wild and domestic animals (including dogs, cattle, and swine), especially rodents that are chronically infected with pathogenic _Leptospira_. The spirochete _Leptospira_ may survive in contaminated fresh water or moist soil for weeks to months. Outbreaks of leptospirosis frequently follow heavy rainfall, flooding with fresh water, and increasing rodent numbers.

ProMED-mail recently reported on a leptospirosis outbreak after flooding in the Calabarzon region of the Philippines (ProMED-mail post Leptospirosis - Philippines: flooding http://promedmail.org/post/20190826.6641939); Calabarzon situated south and east of Metro Manila on the island of Luzon (<https://en.wikipedia.org/wiki/Calabarzon>).

The leptospirosis outbreak reported in the news article above is occurring following flooding in the Davao Region, situated on the south-eastern portion of Mindanao, an island that comprises 5 provinces: Compostela Valley, Davao del Norte, Davao del Sur, Davao Oriental and Davao Occidental, the newly created province (<https://en.wikipedia.org/wiki/Davao_Region>). - ProMED Mod.ML]

[Maps of Philippines:
Date: Sun 1 Sep 2019 06:20 AM PHT
Source: Inquirer [edited]

The Department of Health (DOH) on [Sat 31 Aug 2019] appealed to parents to have their children vaccinated against polio, after a test on Manila's sewage showed the existence of the virus that causes the debilitating disease.

Health Secretary Francisco Duque III said a recent sampling of Manila's sewage tested positive for the vaccine-derived poliovirus (VDPV), which the World Health Organization (WHO) defined in its website as "an excreted vaccine-virus that can continue to circulate for an extended period of time."

No transmissions yet
--------------------
"The longer it is allowed to survive, the more genetic changes it undergoes. In very rare instances, the vaccine-virus can genetically change into a form that can paralyze -- this is what is known as a circulating vaccine-derived poliovirus (cVDPV)," WHO said in its website (<http://who.int/features/qa/64/en/>).

Duque said that while there are no recorded transmissions yet, parents should ensure that their children are protected since the virus is already in the environment. "We repeat our call to parents and caregivers: Let us prioritize the complete vaccination of our children so they remain safe from vaccine-preventable diseases, like polio," the health secretary said at a press conference. "We need to make sure that the polio vaccine coverage should be at 95 percent to ensure that this will not create problems to our children," Duque said.  There is no cure for the disease, he added. "Complete vaccination is the best way to prevent it," he said.

The Philippines since 2016 has been falling short of the ideal immunization coverage rate of 95 percent. Coverage was at 68 percent in 2016, increasing slightly to 71 percent the next year, but dropping again to 66 percent in 2018. A fatal and disabling disease, polio is transmitted through the faecal-oral route, especially where there's poor personal hygiene and environmental sanitation. It mostly affects children below 15.

Polio-free since 2000
Apart from the latest disclosure by Duque, the Philippines has been certified polio-free since 2000 by the DOH.  Given that VDPV was found in the city of Manila, Duque called on local governments to intensify the implementation of their zero open-defecation program as well as to strengthen their efforts to ensure good personal hygiene and sanitation.

The US Centers for Disease Control and Prevention described VDPV as a "strain of the weakened poliovirus that was initially included in oral polio vaccine (OPV) and that has changed over time and behaves more like the wild or naturally occurring virus."  "This means it can be spread more easily to people who are unvaccinated against polio and who come in contact with the stool or respiratory secretions, such as from a sneeze, of an infected person," the CDC said. Given that sewage usually end up in Manila Bay, Duque said it "remains unsafe for swimming."

As part of its efforts to ensure that no child is left unvaccinated, the DOH is currently conducting an immunization drive for polio aimed at covering 5.5 million children in the National Capital Region, Central Luzon, and Calabarzon.  "The vaccination is free and will be administered by giving a child 2 drops of OPV [oral poliovirus vaccines] by mouth. OPV has been used in the country since 1980," Duque said.  [Byline: Jovic Yee]
==========================
[The good news is that the Philippines are doing environmental monitoring for polioviruses. The not so good news is that with falling vaccination coverages over the past few years, there is now a vaccine derived poliovirus found in sewage sampling of the major metropolis of Manila with a population of approximately 24.7 million people in 2018, the 8th largest metropolitan area in the world. As of the present, there have not been confirmed cases of cVDPV identified among AFP (acute flaccid paralysis) cases in the Philippines....but will it remain that way???  

HealthMap/ProMED-mail map of the Philippines:
Date: Fri 30 Aug 2019
Source: The Philippine Star [abridged, edited]

Measles cases increased by 962% in Negros Occidental in 2019, according to the provincial health office. At least 828 cases and 5 deaths were reported from 1 Jan - 3 Aug [2019] compared to only 72 cases during the same period last year [2018].

Provincial health officer Ernell Tumimbang said 54% of the patients have no vaccination against measles.

Negros Occidental Gov. Eugenio Jose Lacson said the increase in the number of measles cases is not considered alarming. He said the provincial government is more focused in its campaign against dengue.

37 people have died of dengue in the province since January [2019].  [Byline: Gilbert Bayoran]
Date: Mon 26 Aug 2019, 12:00 pm
Source: Republic of the Philippines, Philippine News Agency [edited]
<https://www.pna.gov.ph/articles/1078716>

The Department of Health (DOH) in Calabarzon (Cavite, Laguna, Batangas, Rizal and Quezon) urged residents to take precautionary measures as the number of leptospirosis cases in the region has reached 75, with 12 recorded deaths. DOH Calabarzon regional director Eduardo C. Janairo also directed local health officials and local leaders to take the necessary precautions to prevent the spread of leptospirosis and the current dengue outbreak in the communities due to the rainy season. "Leptospirosis just like dengue is fatal but also preventable. All we need is to clean our surroundings, be sure that our garbage is well-attended and improve flood control measures in the community," Janairo said in his meeting with officials of the province of Cavite on [Fri 23 Aug 2019].

He also reminded parents of children to avoid playing outside their homes during rainy days to reduce risk of leptospirosis related to flooding. "If we have no business to go outside our homes, it is best to stay inside and be safe," he added. The DOH Regional Epidemiology and Surveillance Unit (RESU) showed a total of 75 leptospirosis cases recorded in the region from [1 Jan to17 Aug] this year [2019]. This, however, is 62% lower compared with last year's [2018] 199 recorded cases during the same period.

The infectious disease caused by leptospira bacteria from urine of rats has already claimed 12 lives in the region, with Rizal province having the highest number of cases at 34 with 7 deaths. Cavite has recorded 18 cases and 2 deaths; Laguna with 14 cases and 1 death; Batangas - 9 cases and 2 deaths, while Quezon has no reported cases. The cities and towns in the region with high incidence are Antipolo City with 15 recorded cases; Rodriguez - 9 cases and San Mateo - 6 cases in Rizal province while Binan City in Laguna and Dasmariñas City in Cavite reported 5 leptospirosis cases each. The ages of cases ranged from less than 1 year to 72 years old.

Majority of the cases were male and most of belonged to the 11-20 year-old age group. Janairo advised those who walk through or wade into flooded areas and streets to wear boots as the bacteria causing the disease may seep in through open wounds or scratches on feet and thighs. "Kailangan din nating uminom ng prophylaxis gaya ng docycyline bago tayo lumusong sa tubig upang makaiwas sa impeksyon na dala ngleptospirosis (it is necessary to take prophylaxis like doxycycline before wading through flood areas to prevent leptospirosis infection)," he said. According to the DOH, the leptospirosis disease is transmitted through skin abrasions while walking in moist soil, rice fields, and sugar cane plantations contaminated with the urine of an infected animal, like rats.

Other areas that may likely be contaminated with the disease are swimming pools, floodwaters, accidental immersion, occupational abrasion or direct contact with urine or even tissues of infected animals. Janairo also urged residents to go to the nearest health centre or hospital for any symptoms such as fever; body chills; headache and pains in the thigh, muscles and joints; redness in the eyes; skin turning pale and yellowish; and difficulty in urinating. [Byline: Saul Pa-a]
==============================
[Leptospirosis is an infection transmitted to humans by exposure to soil or fresh water contaminated with the urine of wild and domestic animals (including dogs, cattle, swine, and especially rodents) that are chronically infected with pathogenic _Leptospira_. The spirochete _Leptospira_ may survive in contaminated fresh water or moist soil for weeks to months. Outbreaks of leptospirosis frequently follow heavy rainfall, flooding with fresh water, and increasing rodent numbers.

Calabarzon, with a population of about 14.4 million residents in 2015, is a region situated south and east of Metro Manila that comprises 5 provinces: Cavite, Laguna, Batangas, Rizal, and Quezon, and a highly urbanized city, Lucena. It is also the country's 2nd most densely populated after Metro Manila (<https://en.wikipedia.org/wiki/Calabarzon>).

A map of Calabarzon can be found at
<https://www.google.com/maps/place/Calabarzon,+Philippines>.

A map showing the provinces of Calabarzon can be found at
<https://sites.google.com/site/region4ppadoj/regional-map>. - ProMED Mod.ML]

[HealthMap/ProMED map available at: Philippines:
<http://healthmap.org/promed/p/158>]
More ...

World Travel News Headlines

Date: Mon, 16 Sep 2019 08:19:07 +0200 (METDST)

Tokyo, Sept 16, 2019 (AFP) - Almost 80,000 homes are still without power a week after a powerful typhoon battered eastern Japan, authorities said Monday, with sustained heavy rain prompting evacuation orders and hampering recovery efforts.    Typhoon Faxai powered into the Tokyo region in the early hours of Monday last week, packing record winds that brought down power lines, disrupted Rugby World Cup preparations and prompted the government to order tens of thousands of people to leave their homes.

The storm killed two people, with at least three elderly later confirmed dead due to heatstroke as temperatures soared to above 35 degrees Celsius (95 degrees Fahrenheit) in areas affected by a post-typhoon blackout.   Some 78,700 households were still without power in Chiba, southeast of the capital, Tokyo Electric Co. (TEPCO) spokesman Naoya Kondo told AFP.   "A complete recovery is still unlikely until September 27 as we have difficulties in mountain areas," he added.   Some 16,700 households were also without water because several water purification plants had no power, a local official said.   With help from the military, officials were dispatching water tanker trucks to the affected areas.

The national weather agency Monday issued new warnings for heavy rain in Chiba, while local authorities issued non-compulsory evacuation orders to 46,300 people due to the risk of landslides.   "A delay in recovery work is expected due to heavy rain," said Kenta Hirano, a disaster management official in Futtsu in Chiba, where more than 1,000 houses were damaged by the typhoon.   Local media showed residents in Chiba hurriedly covering broken roofs with blue tarps.   "We are at a loss as we can't live there again," a 66-year-old man told public broadcaster NHK after the typhoon ripped off the roof of his house.
Date: Sun, 15 Sep 2019 15:38:29 +0200 (METDST)

Athens, Sept 15, 2019 (AFP) - More than 160 firefighters on Sunday battled to contain a large fire near Athens blazing for a second day amid gale force winds, officials said.   And in another emergency, authorities evacuated dozens of people from two villages and a hotel on the island of Zakynthos after a new fire broke out on Sunday.

The fire department said the blaze near Athens burned in the mountains above Loutraki, a coastal resort some 60 kilometres (35 miles) west of Athens.   "The fire is burning near the top of the mountain," Stefanos Kolokouris, the fire department's deputy chief of operations, told state TV ERT.   "We are trying to create a perimeter but the terrain is very difficult, with ravines," he said.   Four water bombers and six helicopters were participating in operations. Given a lack of roads in the area, two squads of firefighters had to be carried to the mountaintop by Super Puma helicopter, state agency ANA said.   Officials had already evacuated 50 people from a local monastery when the fire broke out on Saturday, but stressed that other inhabited areas were not in danger.

On Zakynthos, officials ordered the evacuation of the villages of Agalas and Keri in the south of the island. Some 120 tourists were also relocated to a safe area.   The Greek fire department on Sunday said it had been called to nearly 80 fires over the past 24 hours.   It has already faced more than 9,600 rural and urban fires this year.
Date: Sat, 14 Sep 2019 16:08:47 +0200 (METDST)

Singapore, Sept 14, 2019 (AFP) - Pollution from forest fires in Indonesia pushed Singapore's air quality to unhealthy levels for the first time in three years on Saturday, the government said, a week ahead of the Formula One night race in the city.   The toxic smoke caused by burning to clear land for plantations is an annual problem for Indonesia's neighbours, but has been worsened this year by particularly dry weather.   "There has been a deterioration in the haze conditions in Singapore this afternoon," the National Environment Agency (NEA) said in a statement.   "This was due to a confluence of winds over the nearby region that led to more smoke haze from Sumatra being blown toward Singapore," it said, referring to one of the Indonesian islands where fires are raging.

The NEA said the pollutant standards index (PSI) worsened to 112 in parts of the island Saturday night.   An index reading between 101-200 is considered unhealthy, with residents advised against doing prolonged strenuous exercises outdoors.   Singapore may continue to experience hazy conditions over the next few days, the agency warned.   The city-state of 5.6 million people was shrouded in a thin white haze, with a few residents seen wearing face masks, but there was no major disruption to daily activities.   The F1 race is scheduled from Friday to Sunday on a street circuit in the Marina Bay financial district.

Singapore GP, the Formula One organisers, said the possibility of haze is one of the potential issues covered in their contingency plan for this year's grand prix.   "The plan was formulated and refined with stake holders, government bodies and the Formula One community," Singapore GP said in an emailed statement.   "In the event that the haze causes visibility, public health or operational issues, Singapore GP would work closely with the relevant agencies before making any collective decisions regarding the event."

Neighbouring Malaysia has also been affected by the smoke, with air quality in parts of the country including the capital Kuala Lumpur reaching unhealthy levels over the past few days and triggering a diplomatic row with Jakarta.   In 2015, the index reached "hazardous" levels of more than 300 in Singapore, forcing the closure of schools. Indonesian forest fires were the worst in two decades that year, firing up smog that blanketed large parts of Southeast Asia for weeks.
Date: Sat, 14 Sep 2019 11:16:53 +0200 (METDST)

Bangkok, Sept 14, 2019 (AFP) - Floods in northeastern Thailand have submerged homes, roads and bridges, leaving more than 23,000 people in evacuation shelters as anger grows over the government's "slow" emergency response.   Torrential rain has lashed the country for the last two weeks, causing flash floods and mudslides in almost half its provinces, with families evacuated from their homes in boats or makeshift rafts.   Since August 29, 32 people have been killed in the deluge, said a statement from the disaster department on Saturday that also gave the number of people staying in emergency shelters.   Two weather events are behind the widespread floods, the department said -- Storm Podul and a tropical depression that formed over the South China Sea called Kajiki.

Local media reports from the worst-hit province of Ubon Ratchathani showed people wading through chest-deep water and rescuers in boats trying to steer buffalo to higher ground.   Flooding in the province, which borders Laos and Cambodia, has been exacerbated by rising water levels in the Moon and Chi rivers.   "It will take three weeks to drain the floodwater" from up to 90 percent of inundated households, said provincial governor Sarit Witoon.   "The water has slightly receded about four centimetres today and I think it will keep going down," he added.

But the situation is already "unlivable" for families in one-storey homes, said Pongsak Saiwan, local director of opposition party Future Forward.   Access to an entire district is currently cut off due to flood waters, which are about two metres (6.5 foot) deep in the main town, while three major bridges are "impassable", he said.   "The government has been very slow in responding to the situation since the floods started in the beginning of September," Pongsak told AFP.   Ubon Ratchathani's plight started trending on Twitter this week with the hashtag #SaveUbon.   Aerial shots of the flood-hit plains blanketed with muddy river water were widely shared, as well as photos of stray dogs being rescued by passing boats.

One Twitter user compared the flood response to how quickly the government had mobilised and saved 12 young boys and their football coach from a waterlogged cave last year -- an incident that catapulted Thailand to international attention.   "Only 13 lives stuck in the cave and it was still very high-profile, but this is hundreds of thousands of lives," tweeted Yosita8051. "It's not okay."   Thailand's junta leader-turned-premier Prayut Chan O-Cha tweeted on Saturday that he has told agencies to "expedite assistance" to those in the affected areas.
Date: Fri, 13 Sep 2019 16:44:33 +0200 (METDST)

Niamey, Sept 13, 2019 (AFP) - Niger launched a campaign on Friday to vaccinate more than four million children against measles, one of the biggest causes of child mortality in the country, the health ministry said.

The one-week nationwide vaccination programme aims to "eliminate measles by the end of 2020", Health Minister Illiassou Mainassara said, adding, it "will reach 4.254 million children" aged from 9 months up to the age of five.   "Despite all the efforts made in the fight against communicable diseases, we still note the persistence of localised measles epidemics (in Niger)," Mainassara said on his way to the capital Niamey to launch the campaign.    But some experts say the vaccination programme should have kicked in sooner    "The delay of this campaign which should have happened in 2018 has resulted in ...the emergence of epidemics in several health districts," said Niger's UNICEF representative, Felicite Tchibindat.

Since January this year, 9,741 suspected cases have been documented in Niger resulting in 53 deaths, she said.   "Measles is a serious and extremely contagious viral disease and remains one of the leading causes of early childhood death, while it can be prevented by vaccination," TchibiNdat said.    She believes the children of migrants, refugees and displaced people will especially benefit from the campaign.    Niger's vaccination programme is supported by the World Health Organization (WHO), UNICEF (United Nations Children's Fund) and the Gavi vaccine Alliance.
Date: Fri, 13 Sep 2019 16:08:16 +0200 (METDST)

Nairobi, Sept 13, 2019 (AFP) - Kenya on Friday became the third country to start routinely innoculating infants against malaria, using the world's first vaccine to combat a disease that kills 800 children globally every day.   The vaccine -- lab name RTS,S -- targets the deadliest and most common form of malaria parasite in Africa, where children under five account for two-thirds of all global deaths from the mosquito-born illness.

Kenya joins Malawi and Ghana, which commenced their own pilot programs for the vaccine supported by the World Health Organization (WHO) earlier this year.   The vaccine will be introduced in phases across malaria-endemic parts of western Kenya near Lake Victoria, starting with Homa Bay, the country's health ministry said.   "It's an exciting time for Kenya as we roll out this vaccine in parts of the country where the burden of malaria is the highest," Health Minister Sicily Kariuki said in a statement.   RTS,S will be added to the national immunisation schedule in these areas, given alongside other routine shots for children under two.

The health ministry said 120,000 Kenyan children were expected to be vaccinated under the pilot programme.   The country has distributed insecticide-treated mosquito nets, fumigated homes and improved diagnostics in its fight against malaria.   But the disease remains stubborn. The health ministry says malaria claimed more than 10,000 lives in 2016, and infected millions more.   As in the rest of the world, children in Kenya bear the brunt of the disease.    Up to 27 percent of Kenyan children under five have been infected with the disease, the health ministry said.   "This vaccine represents an additional tool that will boost Kenya's efforts in reducing malaria infections and deaths among children," Kariuki said.   WHO says a child dies roughly every two minutes from malaria somewhere in the world.

- 30 years in making -
Known under its commercial name as Mosquirix, the vaccine was developed over 30 years by British pharmaceutical giant GlaxoSmithKline in partnership with nonprofit PATH and African research institutes.   It is the only vaccine to date to show a protective effect against malaria in young children, WHO says.   It acts against Plasmodium falciparum, the deadliest malarial parasite and the most prevalent in Africa, where illness and death from the disease remain high despite some gains.   The shots, administered over four doses, have been shown in clinical trials to significantly reduce cases of malaria, and malaria-related complications, in young children.   The vaccine prevented about four in 10 cases of malaria and three in 10 cases of the most severe, life-threatening form of the disease, within the trial group, WHO says.

Evidence gained from the vaccine pilot schemes could guide decisions about whether RTS,S is rolled out more widely in future, WHO says.   "This is the most advanced malaria vaccine that we have today. It has been in the making for the last almost three decades," Dr Richard Mihigo, WHO's co-ordinator of immunisation and vaccine development programme, told AFP before the Kenyan launch.   "Children are the most vulnerable group to this severe disease that is malaria, so protecting children can make a big impact in preventing malaria."   The disease kills more than 400,000 people around the world every year. Of these about 290,000 are under five.    Most are in Africa, where more than 90 percent of the world's malaria cases -- and fatalities -- occur.
Date: Fri, 13 Sep 2019 11:40:02 +0200 (METDST)

London, Sept 13, 2019 (AFP) - British Airways has cancelled all its scheduled UK flights for September 27, when company pilots will again strike in a long-running row over pay.   It comes after the carrier cancelled all flights departing and arriving in the UK on Monday and Tuesday owing to BA's first strike by pilots in the company's 100-year history.

In a statement released late Thursday, BA called on the British Airline Pilots Association (BALPA) union "to call off their strike and return to negotiations".    The airline added: "We are very sorry that BALPA's actions will affect thousands more travel plans."   This week's strike sparked travel chaos for about 200,000 passengers, mostly using London's Gatwick and Heathrow airports.   BALPA estimates that the 48-hour strike cost the airline £80 million ($99 million, 89 million euros), but BA has yet to provide a figure.
Date: Tue, 10 Sep 2019 13:02:19 +0200 (METDST)

Khartoum, Sept 10, 2019 (AFP) - Sudan reported four confirmed cases of cholera in Blue Nile Tuesday and said three people had also died of acute diarrhoea in the war-torn state.   Health Minister Akram al-Toum has asked the World Health Organization to send supplies of cholera vaccine immediately, the ministry said.

Ministry and WHO officials have been sent to the affected area.   "There are 37 cases of acute diarrhoea in Blue Nile... There have been three deaths," the ministry said in a statement.   Dozens of people died from acute diarrhoea in Sudan in 2016 after thousands of cases were reported nationwide.   Blue Nile state, which has a large ethnic minority population, has been the focus of a rebellion by the Sudan People's Liberation Army-North since 2011.   The army declared a ceasefire after the  overthrow of veteran president Omar al-Bashir earlier this year.
Date: Sat 14 Sep 2019
Source: Vax Before Travel [edited]

A new report from Japan's National Institute of Infectious Disease (NIID) indicates the Rubella virus outbreak continues to spread. As of [4 Sep 2019], there have been 2156 Rubella cases reported by the NIID during 2019.

This is an increase of about 260 rubella cases in Japan since July 2019. On a local basis, the city of Tokyo has reported 37% of Japan's 2019 Rubella cases.

Since Rubella is very dangerous for a pregnant woman and her developing baby, the US Centers for Disease Control and Prevention (CDC) said on [7 Aug 2019], "pregnant women who are not protected against rubella through either vaccination or previous rubella infection, should not travel to Japan during this outbreak."

But, pregnant women should not get a Rubella vaccination with the measles-mumps-rubella (MMR) says the CDC. This is because the MMR vaccine is an attenuated "live virus" vaccine.

The CDC says "pregnant women who are not vaccinated should wait to get [the] MMR vaccine until after they have given birth. And, women of childbearing age should avoid getting pregnant for at least 4 weeks after receiving the MMR vaccine."

Additionally, the CDC says "if a pregnant woman contracts the rubella virus, her baby could have birth defects such as deafness, cataracts, heart defects, mental disabilities, and organ damage."

And, when a rubella infection occurs during early pregnancy, serious consequences, such as miscarriages, stillbirths, and severe birth defects in infants, which are known as Congenital Rubella Syndrome (CRS), [may result].

This new NIID report indicates there have been 3 CRS cases in Japan during 2019. As a comparison, during 2005-2015 in the USA, only 8 babies with CRS were reported.

Moreover, [fewer] than 10 people in the USA are reported as having rubella each year. Since 2012, all rubella cases had evidence that they were infected when they were living or traveling outside the USA.

To alert international travellers, the CDC issued a Level 2 Travel Alert regarding Japan's ongoing Rubella virus outbreak in August 2019. This "Practice Enhanced Precautions" Travel Alert says "travellers to Japan should make sure they are vaccinated against rubella with the MMR vaccine before visiting Japan." This CDC Travel Alert is important since approximately 4.5 million US citizens visit Japan annually.

Additionally, the Public Health Agency of Canada and the UK Foreign Travel Advice recommend "pregnant women who are not protected against rubella avoid traveling to Japan."

In the USA, there are 2 approved rubella vaccines: MMR II-Rubella and ProQuad. Both rubella vaccines are available at most pharmacies. Travelers to Japan can request a rubella vaccine counselling appointment with a local pharmacist.

Rubella vaccines, like any medicine, can produce side effects. [People] are encouraged to report vaccine side effects to a healthcare provider or the CDC.  [Byline: Dani Reiter]
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[See discussion of rubella in ProMED-mail Rubella - Japan (02)

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Date: Tue 10 Sept 2019
Source: Focus Taiwan [edited]

Taiwan's enterovirus cases continued to increase last week, bringing the total number to nearly 20 000 between [1 and 7 Sep 2019], the Centers for Disease Control (CDC) said Tuesday [10 Sep 2019].

A total of 19 254 patients sought outpatient or emergency treatment at hospitals for enterovirus infection around the country, up 4% from the figure recorded the previous week [25-31 Aug 2019] and the highest over the same period in nearly 5 years, according to CDC data.

CDC physician Lin Yung-ching said there were 2 severe cases recorded last week, one of which involved an 8-month-old girl and the other a 4-year-old boy, both in central Taiwan. The 2 children were reported in stable condition after treatment.

Some of the 2 patients' family members or classmates with whom they had had contact have also been confirmed as enterovirus cases, and the CDC judged that the infection might have been spread through contact, Lin said.

A total of 303 cases of enterovirus-71 (EV-71), the most severe enterovirus strain, have been reported so far this year [2019], the highest in the same period from 2016 to 2018.

Meanwhile, a total of 36 cases with severe complications have been recorded nationwide, including 27 EV-71 cases, according to CDC statistics.

EV-71 is a neurological disease that attacks the nervous system, and infants under the age of 5 are at highest risk of developing severe complications from this type of infection.

In extreme cases, EV-71 can cause polio-like permanent paralysis, according to the CDC. As Taiwan is still in the peak season for enterovirus infection, CDC Deputy Director-General Philip Lo urged the public to take precautions against the spread of the illness, especially among children.

Children infected with enterovirus should be kept away from school so as to prevent the spread of the disease, as enterovirus is highly contagious, Lo advised.  [Byline: Chen Wei-ting and Evelyn Kao]
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[The enteroviruses are spread from person to person by coughs, sneezes, or touching objects or surfaces that have the virus on them. Therefore, practicing good personal hygiene -- washing hands regularly and thoroughly with soap and water -- is the best way to prevent from getting and spreading the infectious disease.

However, most people infected with non-polio enteroviruses do not get sick, or present with mild illness, like the common cold. Infants, children, and teenagers are more likely than adults to get infected and become sick because they do not yet have immunity (protection) from previous exposures to the viruses. Adults can get infected too, but they are less likely to have symptoms, or their symptoms may be milder. Symptoms of mild illness may include fever; runny nose, sneezing, and cough; skin rash; mouth blisters; and body and muscle aches.

Some non-polio enterovirus infections can lead to:
- Viral conjunctivitis;
- Hand-foot-mouth disease;
- Viral meningitis (infection of the covering of the spinal cord and/or brain);
- Viral encephalitis (infection of the brain);
- Myocarditis (infection of the heart);
- Pericarditis (infection of the sac around the heart);
- Acute flaccid paralysis (a sudden onset of weakness in one or more arms or legs);
- Inflammatory muscle disease (slow, progressive muscle weakness).

Infants and people with weakened immune systems have a greater chance of having these complications. People who develop myocarditis may have heart failure and require long-term care. Some people who develop encephalitis or paralysis may not fully recover.

Enterovirus cases were reported from Taipei, Taiwan in 2017 (Human enterovirus - Taiwan: alert http://promedmail.org/post/20170418.4978387), and health alerts like the one mentioned in report above were issued to the general public to observe proper hygiene to reduce disease transmission. Also the case number for EV-71 associated severe disease has also increased, which is a cause for public health concern. - ProMED Mod.UBA]

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